Adequate Vitamin D Intake Cannot Be Achieved within Carbon Emission Limits Unless Food Is Fortified: A Simulation Study

This study applied linear programming using a Dutch “model diet” to simulate the dietary shifts needed in order to optimize the intake of vitamin D and to minimize the carbon footprint, considering the popularity of the diet. Scenarios were modelled without and with additional fortified bread, milk, and oil as options in the diets. The baseline diet provided about one fifth of the adequate intake of vitamin D from natural food sources and voluntary vitamin D-fortified foods. Nevertheless, when optimizing this diet for vitamin D, these food sources together were insufficient to meet the adequate intake required, unless the carbon emission and calorie intake were increased almost 3-fold and 2-fold, respectively. When vitamin D-fortified bread, milk, and oil were added as options to the diet, along with increases in fish consumption, and decreases in sugar, snack, and cake consumption, adequate intakes for vitamin D and other nutrients could be met within the 2000 kcal limits, along with a relatively unchanged carbon footprint. Achieving vitamin D goals while reducing the carbon footprint by 10% was only possible when compromising on the popularity of the diet. Adding vitamin D to foods did not contribute to the total carbon emissions. The modelling study shows that it is impossible to obtain adequate vitamin D through realistic dietary shifts alone, unless more vitamin D-fortified foods are a necessary part of the diet.     

乳酸及降钙素原对一氧化碳中毒后迟发性脑病的预测价值

目的探讨检测血乳酸、降钙素原和联合检测对急性一氧化碳中毒后迟发性脑病(DEACMP)的预测价值。 方法随机抽取我院在急诊科收住院的ACMP患者70例,随访3个月,以其中发生DEACMP患者10例为DEACMP组,其余60例为非DEACMP组,随机抽取同期笔者医院40例健康体检者为对照组。对患者立即行动脉血Lac和血清PCT检测,并计算Lac和PCT诊断DEACMP的灵敏度、特异度。 结果DEACMP组血Lac和PCT检测值均明显高于非DEACMP和对照组,差异有统计学意义(采用秩和检验,P<0.05);检测异常率亦明显高于非DEACMP组及对照组,差异有统计学意义(采用χ²检验,P<0.05)。Lac和PCT升高预测DEACMP的敏感度均为90.0% ,特异度分别为50.0%和65.0% ,准确性分别为55.7%和68.6%。联合检测时若其中1个指标为阳性时即预测DEACMP发病,则联合检测的敏感度为100.0%,特异度为41.7%,阳性预测值为21.7%,阴性预测值为100.0%,准确性为71.4%。 结论DEACMP患者早期动脉血Lac和PCT均明显升高,PCT诊断价值优于Lac,联合检测较单项指标检测对DEACMP发病预测价值更理想。     

热应激蛋白70抗体滴度作为二硫化碳接触的生物标记物的研究

目的 :了解二硫化碳接触工人的血清热应激蛋白 70 (HSP 70 )抗体滴度及探讨其作为CS2 接触的分子生物标记物的可行性。方法 :选择某化纤厂 79名工人 ,5 4名为接触组 ,2 5名为对照组。用Westernblot ELISA法对工人血清HSP 70抗体水平进行了检测。采用Logistic回归分析技术 ,分析了HSP 70抗体与CS2 接触之间的关系。结果 :抗体各滴度接触组工人血清HSP 70抗体阳性率明显高于对照组 ,有非常显著意义 (P <0 .0 1)。采用Logistic回归分析控制了因素的混杂作用后 ,这种联系仍然存在。结论 :血清HSP 70抗体滴度可反映CS2 的接触状况。以血清HSP 70抗体滴度作为分子生物学标记物 ,对CS2 接触者进行健康监护有重要意义。     

A capnography and transcutaneous CO2 profile of bariatric patients during early postoperative period after opioid-sparing anesthesia

BackgroundNoninvasive monitoring of partial pressure of carbon dioxide can be accomplished indirectly with capnography (P_ETCO₂) or with transcutaneous carbon dioxide monitoring (P_TCCO₂). The use of capnography has been shown to offer an advantage over pulse oximetry alone in the early detection of adverse respiratory events when supplemental oxygen is administered. Furthermore, capnography allows for the monitoring of various respiratory measures, including end-tidal carbon dioxide, respiratory rate, tidal volume, and changes in breathing patterns. Transcutaneous CO₂ also closely approximates arterial CO₂ values, but is not as easy to monitor for prolonged periods. The purpose of this study was to examine the usefulness of capnography and of transcutaneous carbon dioxide monitoring in patients recovering from obesity surgery at high risk of developing postoperative obstructive sleep apnea.MethodsIn a prospective observational study, 64 bariatric surgery patients at risk of developing obstructive sleep apnea were monitored in the postanesthesia care unit (PACU) with either capnography alone (31 patients) or capnography plus transcutaneous carbon dioxide monitoring (33 additional patients) every 3–5 minutes for the duration of their recovery. Primary endpoints included end-tidal and transcutaneous carbon dioxide, peripheral oxygen saturation, respiratory rate, pain scores, and incidence of adverse respiratory events.ResultsAlthough no adverse pulmonary events were observed, capnography detected several patients who experienced short periods of respiratory apnea while maintaining pulse oximetry readings within normal limits. Transcutaneous values were slow to change and averaged 4.5 ± 5.5 mm Hg (P < .05) higher than corresponding end-tidal measurements.ConclusionsThese results indicate the capabilities of both these noninvasive techniques for postoperative monitoring. Capnography acutely monitors changes in respiration, whereas transcutaneous monitoring more accurately reflects arterial CO₂ levels.     

纳米碳与吲哚菁绿导航腹腔镜胃癌根治术淋巴结清扫的对比性研究

目的对比纳米碳与吲哚菁绿(ICG)在腹腔镜胃癌根治术淋巴结清扫方面的优劣性。方法回顾性分析2016年1月至2019年12月接受腹腔镜胃癌根治术的167例患者资料,根据所使用的示踪剂种类,分为纳米碳组130例、ICG组37例,应用GraphPad Prism 8.0统计软件进行分析,围术期指标及淋巴结清扫数目等计量资料以(±s)表示,采用独立t检验;术后并发症、二次手术率等计数指标比较采用χ²检验,P<0.05为差异有统计学意义。结果两种示踪剂对不同病理分期胃癌的淋巴结清扫效果差异无统计学意义。在各种胃癌根治术式中,淋巴结分拣均有助于提高淋巴结总检出数。纳米碳组较ICG组更有助于提高根治性全胃切除术第5站淋巴结的清扫数目(P=0.02)、根治性近端胃切除术第1站淋巴结的清扫数目(P=0.03)以及根治性远端胃淋巴结的总清扫数目(P=0.03)。在提高淋巴结检出率方面,两种示踪剂差异无统计学意义。结论纳米碳与吲哚菁绿在不同病理分期中的总体淋巴结清扫效果差异无统计学意义。无论使用何种示踪剂,均提倡淋巴结分拣。纳米碳较吲哚菁绿更有助于提高根治性全胃第5站淋巴结的清扫数、根治性近端胃第1站淋巴结的清扫数以及根治性远端胃淋巴结的总清扫数目。     

Choleretic activity of 2-demethoxycarbonyl-2-ethoxycarbonyl-11-deoxymisoprostol on the model of CCl<Subscript>4</Subscript>-induced hepatitis

Therapeutic administration of 11-deoxymisoprostol had a hepatoprotective effect, which manifested in a decrease in the content of alanine transaminase and aspartate transaminase in blood plasma, and produced a choleretic effect in rats with CCl₄-induced toxic hepatitis. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 2, pp. 183–184, February, 2008     

Investigations into the effects of various hepatotoxic compounds on urinary and liver taurine levels in rats

The effect of various hepatotoxicants on urinary taurine and urinary creatine has been studied in the rat. Several hepatotoxic agents, carbon tetrachloride, thioacetamide, galactosamine and allyl alcohol which all caused hepatic necrosis (sometimes accompanied by steatosis), resulted in a rise in urinary taurine and in some cases creatine, when administered to rats. Ethionine and hydrazine also raised urinary taurine but caused only steatosis and did not raise urinary creatine. Therefore urinary taurine and possibly creatine may be useful markers of liver injury and dysfunction. Liver taurine levels were also affected by some of the hepatotoxicants but in those cases where there was a rise in urinary taurine this could not be accounted for by the loss in liver taurine. It is suggested that the increase in urinary taurine is partly due to changes in protein synthesis and hence in sulphur amino acid metabolism caused by hepatotoxic agents. However, bromobenzene did not increase urinary taurine and-naphthylisothiocyanate and lithocholate caused reduced levels. It is suggested that this lack of increase in urinary taurine may be due to depletion of glutathione or interference with the biliary system.     

离子交换树脂法与活性炭吸附法提取左旋多巴结果比较

以水和盐酸为溶剂从猫豆中提取左旋多巴,并对提取液分别用离子交换树脂法和活性炭吸附法富集左旋多巴,再分别用氨水和醇洗脱,经浓缩、精制得左旋多巴。实验结果表明,前法提取周期较长,平均提取率为2．50％,后法提取周期较短,平均提取率为2．66％,提示后法优于前法。     

脑电图结合CT预测一氧化碳中毒迟发性脑病

探讨预测一氧化碳中毒迟发性脑病的检查方法,以及高压氧治疗时间与脑病的关系。方法用脑电地形图和头颅ＣＴ分析２９３例一氧化碳中毒不同程度、不同高压氧治疗时间与一氧化碳中毒迟发性脑病发生的关系。结果中重度中毒脑电地形图与轻度中毒异常率比较差异显。     

Monitoring during paediatric cardiac anaesthesia

Monitoring of paediatric anaesthesia has become increasingly more complex in recent years and this is particulary true of cardiac anaesthesia. The purpose of this review is to give a comprehensive update of published material related to both routine and specialized cardiac monitoring. Routine monitoring can be particularly affected by the alterations of cardiac rhythm, blood flow, cardiac output and oxygenation which result from the congenital heart abnormalities themselves, the type of surgery undertaken and the effects of cardiopulmonary bypass. The use of specialized monitoring is becoming more widespread, particularly in the areas of cerebral function, mixed venous oxygenation, cardiac output measurement and coagulation. In the last five years, with the development of smaller probes, a great deal has been published on transoesophageal echocardiography. The use of the current monitors of cerebral function still remains controversial despite the need for a monitor of adequate brain perfusion, reflecting the need for a great deal of further research in this area. This review will concentrate on particular areas which have seen the most profound changes and on monitoring that may form the standards of tomorrow. Finally, amongst all the technology, it should not be forgotten that the most important clinical monitor is the bedside clinical monitoring of the physicians themselves. Depuis quelques années, le monitorage de l’anesthésie pédiatrique devient déplus en plus complexe et tout particulièrement en anesthésie cardiaque. L’objectif de ce travail consiste à passer en revue la littérature actuelle qui traite du monitorage usuel et spécialisé. Le monitorage usuel peut être influencé par les modifications de la fréquence cardiaque, du courant sanguin, du débit cardiaque et de l’oxygénation provoqués par les anomalies cardiaques congénitales, du type de chirurgie et des retentissements de la circulation extracorporelle. L’utilisation du monitorage spécialisé est de plus en plus répandu et concerne particulièrement la circulation cérébrale, l’oxygénation du sang veineux mêlé, la mesure du débit cardiaque et la coagulation. Au cours des cinq dernières années, le développement de sondes plus petites a généré de nombreuses publications sur l’échocardiographie transoesophagienne. L’utilisation des moniteurs actuels de la fonction cérébrale demeure sujet à controverse bien qu ’un moniteur de perfusion cérébrale adéquat demeure toujours aussi essentiel, confirmant ainsi le besoin de recherches supplémentaires sur ce sujet. Ce survol se portera spécialement sur les champs d’activités qui ont connu les changements les plus profonds et sur le monitorage qui établira les standards du futur. Finalement, au milieu de cette technologie, il ne faut jamais oublier que le moniteur clinique le plus important se trouve au chevet du malade en la personne du médecin.