双歧三联活菌胶囊联合降脂化浊汤对非酒精性脂肪性肝炎患者肠黏膜屏障的保护作用

目的 探讨双歧三联活菌胶囊联合降脂化浊汤对非酒精性脂肪性肝炎患者肠黏膜屏障的保护作用。方法 选取门诊治疗的NASH患者90例,随机分为中西医组(n=45例)和西医组(n=45例)。西医组患者予以双歧三联活菌胶囊630mg/次,2次/d,温水口服;中西医组患者在西医组治疗基础上予以疏肝降脂汤,加水煎煮至200ml,分早晚两次口服,两组均连用12周。检测并比较两组患者治疗前后肝功能指标、血清内毒素、D-乳酸和二胺氧化酶(DAO)水平的变化。结果 治疗12周后,两组ALT、AST和γ-GT以及血清内毒素、D-乳酸和DAO水平较前均明显下降(P<0.05或P<0.01),且中西医组下降值较西医组更明显(P<0.05)。结论 双歧三联活菌胶囊联合疏肝降脂汤治疗NASH的疗效较显著,能降低血清内毒素、D-乳酸和DAO水平,减少或抑制内毒素血症产生,降低肠黏膜通透性,修复受损肠粘膜屏障,使得肝功能逐渐恢复正常。     

Overview of Surgical Scar Prevention and Management

Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.

Graphical Abstract

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Combining Antiplatelet and Antithrombotic Therapy (Triple Therapy): What Are the Risks and Benefits?

Most patients with mechanical heart valves and many patients with atrial fibrillation will require long-term anticoagulation therapy. For patients with mechanical prosthetic valves, only warfarin is indicated. However, for patients with nonvalvular atrial fibrillation who are at increased risk for embolic stroke, one of the newer antithrombotic medications, such as rivaroxaban, dabigatran, and apixaban, also can be used. Patients with indications for antithrombotic therapy often will have coexisting vascular disease, such as coronary artery disease, requiring concomitant antiplatelet therapy with aspirin alone or more commonly with a dual antiplatelet regimen, aspirin and clopidogrel, or prasugrel or ticagrelor. The risks and benefits of this approach are still not well defined, and current guidelines have included recommendations based primarily on expert opinion.     

The psychiatric phenotype in triple X syndrome: New hypotheses illustrated in two cases

Background: Triple X syndrome (47,XXX or trisomy X) is a relatively frequent cytogenetic condition with a large variety of physical and behavioural phenotypes.

Method: Two adult patients with a triple X karyotype are described.

Results: Their karyotype was unknown until some years ago. What these patients have in common is that they were diagnosed with a broader autism phenotype, they were sexually abused, they suffer from psychotic illness and they show challenging behaviour, suicidality and a decline in occupational capacity.

Discussion: These gene–environment interactions are discussed. Gene–environment interactions may explain the variety of behavioural and psychiatric phenotypes in triple X syndrome. Ongoing atypical development in adults is hypothesized.

Conclusions: Gene–environment interactions and ongoing atypical development in adults should be taken into account in research concerning the psychiatric phenotype of developmental disorders, especially those involving triple X syndrome.     

An exploratory study of health behaviors and the risks for triple H (hypertension,hyperlipidemia, and hyperglycemia) in young adults with disabilities between 20 and 39 years of age

Metabolic syndrome is highly prevalent and has important implications for the health care sector. However, information on the implications of metabolic syndrome for people with disabilities is limited. The purpose of this study was to explore the relationship between health behaviors and the risk for triple H (hypertension, hyperlipidemia, and hyperglycemia) in young adults with disabilities. The present study analyzed the annual health examination charts of 705 young adults with disabilities between ages 20 and 39 in Taiwan. Results found that the prevalence of hyperglycemia, hyperlipidemia, and hypertension in adults with disabilities was 5%, 15% and 17.7%, respectively. These prevalence figures were higher than those for the general population of the same age group in Taiwan. Multivariate logistic regression analyses revealed that almost none of the health behaviors were significantly correlated with the occurrence of triple H disorders among young adults with disabilities. Only one factor, BMI, independently predicted the occurrence of triple H disorders. We suggest that future studies should scrutinize the effects of health behaviors on triple-H disorders in people with disabilities to initiate personalize health promotion programs for this group.     

Space representation in children with dyslexia and children without dyslexia: Contribution of line bisection and circle centering tasks

Line bisection tasks (different space locations and different line lengths) and circle centering tasks (visuo-proprioceptive and proprioceptive explorations, with left or right starting positions) were used to investigate space representation in children with dyslexia and children without dyslexia. In line bisection, children with dyslexia showed a significant rightward bias for central and right-sided locations and a leftward bias for left-sided location. Furthermore, the spatial context processing was asymmetrically more efficient in the left space. In children without dyslexia, no significant bias was observed in central lines but the spatial context processing was symmetrical in both spaces. When the line length varied, no main effect was shown. These results strengthen the ‘inverse pseudoneglect’ hypothesis in dyslexia. In the lateral dimension of the circle centering tasks, children showed a response bias in the direction of the starting hand location for proprioceptive condition. For radial dimension, the children showed a forward bias in visuo-proprioceptive condition and more backward error in proprioceptive condition. Children with dyslexia showed a forward bias in clockwise exploration and more accurate performance in counterclockwise exploration for left starting position which may be in accordance with leftward asymmetrical spatial context processing in line bisection. These results underline the necessity to use the line bisection task with different locations as an appropriate experimental paradigm to study lateral representational bias in dyslexia. The contribution of the present results in the understanding of space representation in children with dyslexia and children without dyslexia is discussed in terms of attentional processes and neuroanatomical substrate.     

双歧杆菌三联活菌散联合醒脾养儿颗粒治疗婴幼儿肺炎继发性腹泻的疗效观察

目的探讨双歧杆菌三联活菌散联合醒脾养儿颗粒治疗婴幼儿肺炎继发性腹泻的临床疗效。方法选取淮安市淮安医院2015年1月—2017年1月收治的婴幼儿肺炎继发性腹泻患儿108例,随机分成对照组(54例)与治疗组(54例)。对照组患儿口服醒脾养儿颗粒,0~1岁1 g/次,2次/d;1~2岁2 g/次,2次/d;2~3岁4 g/次,2次/d。治疗组在对照组基础上口服双歧杆菌三联活菌散,0~1岁0.5 g/次,3次/d;1~3岁1 g/次,3次/d。两组患儿均连续治疗7 d。评价两组患儿临床疗效,同时比较治疗前后两组患儿症状体征消失时间和大便次数。结果治疗后,对照组患儿总有效率为75.93%,显著低于治疗组的90.74%,两组比较差异具有统计学意义(P0.05)。治疗组循环不良、呕吐和腹泻消失时间比对照组显著缩短,两组比较差异具有统计学意义(P0.05)。在第3、5、7天治疗组大便次数显著少于对照组,两组比较差异具有统计学意义(P0.05)。结论双歧杆菌三联活菌散联合醒脾养儿颗粒治疗婴幼儿肺炎继发性腹泻可有效缓解临床症状体征、提高临床疗效,且安全性高,具有一定的临床推广应用价值。     

奈达铂联合吉西他滨治疗转移性三阴性乳腺癌的近期疗效和不良反应

目的探讨奈达铂联合吉西他滨治疗转移性三阴性乳腺癌(TNBC)的近期疗效和不良反应。方法选择2010-09—2014-12间入住的52例TNBC患者作为研究对象。其中首发组患者21例,术后复发组患者31例。化疗方案为:奈达铂80 mg/m2,d1;吉西他滨1 000 mg/m2,d1,8,静滴。每21 d为一个化疗周期。持续两个周期后对疗效进行评价。比较2组患者近期疗效及不良反应发生情况。结果 (1)首发组总缓解率显著高于术后复发组(P0.05)。首发组患者中位无进展生存时间(PFS)为(21.52±3.22)个月,术后复发组患者PFS为(16.73±1.82)个月,首发组患者PFS显著高于术后复发组(P0.05)。(2)本组患者治疗过程中,主要发生的不良反应包括:贫血、中性粒细胞减少、血小板减少、恶心呕吐、腹泻、便秘、脱发、皮疹等,且不良反应毒性分级以1~2级为主。结论奈达铂联合吉西他滨治疗转移性三阴性乳腺癌(TNBC)的近期疗效显著,不良反应主要以1~2级为主。     

理溃汤治疗消化性溃疡合并幽门螺旋杆菌感染临床研究

[目的]对中西药治疗消化性溃疡合并幽门螺旋杆菌感染的临床疗效进行对比,探讨中药治疗该疾病的可能机理。[方法]将70例消化性溃疡合并幽门螺旋杆菌感染的患者分成治疗组和西药对照组两组,每组各35例,观察比较两组的临床疗效、幽门螺旋杆菌根除率以及复发率。[结果]治疗组总有效率91.4%,对照组71.4%,两组组间比较差异具有统计学意义(P＜0.05)。两组患者1年后随访,治疗组复发率低于对照组,有显著性差异(P＜0.05)。[结论]中药治疗消化性溃疡合并幽门螺旋杆菌感染疗效确切,提高治愈率,减少复发率,无明显毒副作用。     

Chromosomal and Genetic Analysis of a Human Lung Adenocarcinoma Cell Line OM

Background:

Lung cancer has become the leading cause of death in many regions. Carcinogenesis is caused by the stepwise accumulation of genetic and chromosomal changes. The aim of this study was to investigate the chromosome and gene alterations in the human lung adenocarcinoma cell line OM.

Methods:

We used Giemsa banding and multiplex fluorescence in situ hybridization focusing on the human lung adenocarcinoma cell line OM to analyze its chromosome alterations. In addition, the gains and losses in the specific chromosome regions were identified by comparative genomic hybridization (CGH) and the amplifications of cancer-related genes were also detected by polymerase chain reaction (PCR).

Results:

We identified a large number of chromosomal numerical alterations on all chromosomes except chromosome X and 19. Chromosome 10 is the most frequently involved in translocations with six different interchromosomal translocations. CGH revealed the gains on chromosome regions of 3q25.3-28, 5p13, 12q22-23.24, and the losses on 3p25-26, 6p25, 6q26-27, 7q34-36, 8p22-23, 9p21-24, 10q25-26.3, 12p13.31-13.33 and 17p13.1-13.3. And PCR showed the amplification of genes: Membrane metalloendopeptidase (MME), sucrase-isomaltase (SI), butyrylcholinesterase (BCHE), and kininogen (KNG).

Conclusions:

The lung adenocarcinoma cell line OM exhibited multiple complex karyotypes, and chromosome 10 was frequently involved in chromosomal translocation, which may play key roles in tumorigenesis. We speculated that the oncogenes may be located at 3q25.3-28, 5p13, 12q22-23.24, while tumor suppressor genes may exist in 3p25-26, 6p25, 6q26-27, 7q34-36, 8p22-23, 9p21-24, 10q25-26.3, 12p13.31-13.33, and 17p13.1-13.3. Moreover, at least four genes (MME, SI, BCHE, and KNG) may be involved in the human lung adenocarcinoma cell line OM.