Dietary approaches for weight loss with increased intakes of fruit, vegetables and dairy products

Aim:  To assess the effectiveness of specific advice for increasing fruit, vegetable and dairy intake in free-living men participating in a weight loss study.
Methods:  Subjects were randomised to one of two 12-week weight loss diets, either the WELL with daily targets of four serves of fruit, four serves of vegetables and three serves of dairy or a low fat diet (LF) with general advice to increase fruit and vegetable intake. Three-day food group diaries and a food frequency questionnaire assessed intake.
Results:  Fifty-four overweight/obese male adults completed the study (WELL, n = 27; LF, n = 27; body mass index (mean ± standard deviation), 30.4 ± 2.5 kg/m²; age, 47.7 ± 9.5 years). There was no difference in mean weight change between groups (WELL, −4.8 ± 3.3 kg; LF, −4.6 ± 3.1 kg). Subjects on the WELL diet had greater (mean difference ± standard error) fruit (0.7 ± 0.2 serves/day), vegetable (1.2 ± 0.2 serves/day) and dairy (1.1 ± 0.1 serves/day) intakes than the LF group (measured by the food group diaries) (all P  < 0.01). The WELL group reached the daily target for fruit from week 1 (4.7 ± 1.4 serves/day), vegetables by week 6 (4.1 ± 1.5 serves/day) and for dairy by week 8 (3.0 ± 0.8 serves/day).
Conclusions:  Providing specific dietary targets to men for weight loss appears to promote greater consumption of fruit, vegetable and dairy foods than providing general dietary advice. Meeting dietary targets appears to require different adjustment periods depending on the food type.     

公立二级医院亏损成因与对策

导致公立二级医院机制性经营亏损的根本原因，主要是医保总额控制、运行戍本增加、政府投入不足等政策性因素。解决公立二级医院机制性经营亏损问题的关键，是尽快建立健全体现公益性质，激励约束相容，确保投入绩效的财政补偿机制。     

微卫星DNA不稳定性及杂合性缺失和胃癌的血液或淋巴转移的关系

为了明确胃癌的血液或淋巴转移和微卫星ＤＮＡ不稳定性（Ｍｉｃｒｏｓａｔｅｌｉｔｅｉｎｓｔａｂｉｌｉｔｙ，ＭＳＩ）及杂合性缺失（Ｌｏｓｓｏｆｈｅｔｅｒｏｚｙｇｏｓｉｔｙ，ＬＯＨ）的关系，选择２９个多态微卫星ＤＮＡ标记（ＭＳ），采用ＰＣＲ－聚丙烯酰胺凝胶电泳及银染技术，分析了３８例胃癌的ＭＳＩ和ＬＯＨ频率。其中胃癌伴有血液或淋巴转移的２４例；不伴有血液或淋巴转移的１４例，结果表明：总的ＭＳＩ和ＬＯＨ频率分别为２０．８４％和２７．５９％，伴有血液或淋巴转移的胃癌，ＭＳＩ在Ｄ７Ｓ５２０、Ｄ８Ｓ２７９位点频率最高为５４．１７％；ＬＯＨ在Ｄ６Ｓ４３０位点频率最高为６２．５０％。无血液或淋巴转移的胃癌，ＭＳＩ和ＬＯＨ频率均为５７．１％。经χ２检验，ＬＯＨ和ＭＳＩ的发生频率在伴有或不伴有血液或淋巴转移胃癌中，两者无统计学差异。表明胃癌的血液或淋巴转移和ＭＳＩ及ＬＯＨ的发生频率无关，目前还难以以这两个指标作为辅助性的判断预后。     

Primary Gastric Carcinoma Cells Frequently Lose Heterozygosity at the APC and MCC Genetic Loci

Loss of heterozygosity (LOH) at APC and MCC gene loci (both mapped to 5q21) was investigated in 24 surgical specimens of primary gastric carcinomas using the polymerase chain reaction after tumor cell enrichment by cell sorting based on differences in DNA content. LOH at APC and/or MCC was detected in 87% (13/15) of the cases; at the APC in 86% (12/14) and at the MCC locus in 100% (7/7). LOH at the APC locus was always accompanied by LOH at the MCC locus. LOH at the APC and/or MCC was found in both differentiated and undifferentiated types in both early and advanced stages of gastric carcinoma. Thus, LOH at APC and/or MCC is considered to be one of the most prevalent genetic alterations in human gastric carcinoma and occurs at an early stage of the carcinogenesis.     

Malignant pancreatic tumour within the spectrum of tuberous sclerosis complex in childhood

A 12-year-old boy with tuberous sclerosis complex (TSC) presented with a large retroperitoneal tumour. Exploratory surgery revealed an infiltrative tumour originating from the pancreas, with local metastases to the lymph nodes. The histologal diagnosis was a malignant islet cell tumour. Retrospectively measured pancreatic hormone levels, however, were normal. A connection between the malignancy and TSC was demonstrated by loss of heterozygosity of the TSC2 gene in the tumour. The primary mutation Q478X in this patient was identified in exon 13 of the TSC2 gene on chromosome 16. Conclusion Pancreatic islet cell tumours have been mainly associated with multiple endocrine neoplasia syndrome type 1. In our case we demonstrate a direct relationship of this tumour to tuberous sclerosis complex, in the absence of further signs of multiple endocrine neoplasia syndrome type 1. Received: 17 February 1998 / Accepted in revised form: 8 July 1998     

Genetic Screening in Hereditary Multiple Endocrine Neoplasia Type 1: Absence of a Founder Effect among Japanese Families

Ten Japanese families with hereditary multiple endocrine neoplasia type 1 (MEN1) were examined. Five DNA polymorphic markers on the long arm of chromosome 11 were analyzed for genetic screening of MEN1 in members of affected families, and disease carriers were identified before clinical manifestations. Unlike MEN1 families in Newfoundland or in Tasmania, no consistent haplotypes were segregated with the disease in the Japanese families when defined by 5 nearby markers. The identification of asymptomatic disease carriers is of substantial clinical importance for early management, genetic counseling and to avoid unnecessary screening for non-disease carriers. However, genetic screening of family members by polymorphic markers could be useful only to each family, and no generally applicable markers were found for Japanese subjects with MEN1.     

Relationship between restorations and the level of the periodontal attachment

Two hundred and forty stained extracted teeth with a restoration on one proximal surface and with no restoration on the opposite surface were investigated for the position and quality of the restoration and the position of the periodontal attachment. Only 27% of restorations were of good quality, 60% had overhangs and 13% deficiencies. The mean difference in loss of periodontal attachment (LOA) between the two surfaces for all teeth was 0.36 mm when the distance from the cemento-enamel junction to the periodontal membrane on the unrestored surfaces was subtracted from that on the restored surfaces. If allowance is made for those restorations located apical to the cemento-enamel junction, the LOA difference was 0.18 mm.     

Voluntary alcohol intake in two rat lines selectively bred for learned helpless and non-helpless behavior

Rationale A high comorbidity between depression and alcoholism has been reported in several studies, but the mechanisms underlying this relationship remain unknown.Objectives We tested whether learned helplessness in rats as a model for depression is associated with enhanced alcohol intake and relapse behavior.Methods Congenital learned helplessness (cLH) and congenital non-learned helplessness (cNLH) rats were selectively bred for differences in an escape paradigm. Sucrose preference was tested at the first hour of the dark phase. In order to study an association with alcohol drinking behavior, rats underwent a free-choice procedure with access to water, and 5% and 20% alcohol solutions for 6 weeks. After acquisition of alcohol drinking behavior, the alcohol deprivation effect (ADE) was assessed. Sensitivity to the sedative-hypnotic effect of alcohol was measured by loss of the righting reflex.Results cLH rats showed significantly lower preference for sucrose solutions during the second half hour of the dark phase than cNLH rats. Alcohol intake of male cLH rats was not significantly different from that of male cNLH rats. In contrast, cLH female rats consumed higher amounts of alcohol than female cNLH rats. The ADE was more pronounced in female animals, although the magnitude of the ADE was similar in both cNLH and cLH female rats. The time to regain the righting reflex was significantly higher in both male and female cLH rats than in cNLH rats.Conclusions In summary, these data suggest that an inborn depressive-like behavior in female rats is associated with enhanced alcohol intake.     

Endogenous gamma-aminobutyric acid (GABA)(A) receptor active neurosteroids and the sedative/hypnotic action of gamma-hydroxybutyric acid (GHB): a study in GHB-S (sensitive) and GHB-R (resistant) rat lines

In the rat brain, gamma-hydroxybutyric-acid (GHB) increases the concentrations of 3alpha-hydroxy,5alpha-pregnan-20-one (allopregnanolone, 3alpha,5alpha-THP) and 3alpha,21-dihydroxy,5alpha-pregnan-20-one (allotetrahydrodeoxycorticosterone/3alpha,5alphaTHDOC), two neurosteroids acting as positive allosteric modulators of gamma-aminobutyric acid (GABA)(A) receptors. This study was aimed at assessing whether neurosteroids play a role in GHB-induced loss of righting reflex (LORR). Basal and GHB-stimulated brain concentrations of endogenous 3alpha,5alpha-THP and 3alpha,5alpha-THDOC were analyzed in two rat lines, GHB-sensitive (GHB-S) and GHB-resistant (GHB-R), selectively bred for opposite sensitivity to GHB-induced sedation/hypnosis. Basal neurosteroid concentrations were similar in brain cortex of the two rat lines. However, in male GHB-S rats, administration of GHB (1000 mg/kg, i.p., 30 min) increased brain cortical concentrations of 3alpha,5alpha-THP and 3alpha,5alpha-THDOC 7- and 2.5-fold, respectively, whilst male GHB-R animals displayed only a 4- and 2-fold increase, respectively. In GHB-S rats this increase lasted up to 90 min and declined 180 min following GHB administration, a time course that matches LORR onset and duration. In contrast, in GHB-R rats, which failed to show GHB-induced LORR, brain cortical 3alpha,5alpha-THP and 3alpha,5alpha-THDOC had returned to control values within 90 min. At onset of LORR, a similar increase in brain cortical levels of 3alpha,5alpha-THP and 3alpha,5alpha-THDOC (2-3-fold) was observed in GHB-S female rats and in the few female GHB-R rats that lost the righting reflex after GHB administration, but not in female GHB-R rats failing to show LORR. Sub-hypnotic doses (7.5 and 12.5 mg/kg, i.p.) of pregnanolone, administered 10 min before GHB, dose-dependently facilitated the expression of GHB-induced LORR in GHB-R male rats. These results suggest that the GHB-induced increases of brain 3alpha,5alpha-THP and 3alpha,5alpha-THDOC concentrations are implicated in the eliciting of the sedative/hypnotic action of GHB.