Short-Term Calorie Restriction Maintains Plasma Insulin Concentrations along with a Reduction in Hepatic Insulin-Degrading Enzyme Levels in db/db Mice

Maintaining blood insulin levels is important for patients with diabetes because insulin secretion capacity declines with the development of the disease. Calorie restriction (CR) is effective for the improvement of glucose tolerance, but it is not clear whether CR can maintain insulin levels in the late stage of diabetes. We examined the effect of CR on whole-body glucose tolerance and fasting blood insulin concentrations in the late stage of diabetes. Male db/db mice were subjected to either a standard laboratory diet ad libitum for 3 weeks (dbdb group) or 40% CR (dbdb+CR group). CR significantly decreased body mass and epididymal fat weight. Glucose tolerance and fasting glucose levels were significantly improved with 3-week CR. Fasting insulin concentrations were decreased in the dbdb group but were maintained in the dbdb+CR group. CR significantly reduced insulin-degrading enzyme (IDE) levels in the liver, and hepatic IDE levels were significantly positively and negatively correlated with plasma glucose concentrations (area under the curve) after glucose administration and after fasting insulin concentrations, respectively. Therefore, 3-week CR maintained blood insulin levels and improved glucose tolerance with decreased hepatic IDE levels in an animal model of late-stage diabetes.     

溶血对血清胰岛素测定的影响及应对措施

目的 探讨溶血对血清胰岛素测定的影响程度及相应的处理方法。方法采用免疫化学发光法检测两种不同程度的溶血标本以及溶血标本在加入酶抑制剂EDTA后分别在4℃、25℃温度下胰岛素浓度的变化情况。结果 轻度溶血标本（Hb5g／L）胰岛素浓度在25℃温度下3h内下降至原来的30％，在4℃温度下3h内下降到原来的84％。重度溶血标本（Hb20g／L）胰岛素浓度在25℃温度下3h内下降至原来的4％，在4℃温度下3h内下降到原来的35％；溶血标本（Hb5g／L）在加入酶抑制剂EDTA后，胰岛素浓度在25℃温度下3h内下降至原来的87％，在4℃温度下3h内基本不下降。结论溶血程度越高，胰岛素降解越快。低温及酶抑制荆EDTA可明显改善溶血对胰岛素测定结果的影响程度。因此，要测定胰岛素的血清需进行低温保存或加入酶抑制剂EDTA。     

Transcatheter Pulmonary Valve Replacement With the Melody Valve in Small Diameter Expandable Right Ventricular Outflow Tract Conduits

Objectives

This study sought to evaluate the safety, feasibility, and outcomes of transcatheter pulmonary valve replacement (TPVR) in conduits ≤16 mm in diameter.

Insights From the Early Experience of the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry

The current system for postmarket surveillance of medical devices in the United States is limited. To help change this paradigm for transcatheter valve therapies (TVTs), starting with transcatheter aortic valve replacement, the Society of Thoracic Surgeons and the American College of Cardiology partnered to form the TVT Registry program in close collaboration with the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services. The goal of the TVT Registry is to measure and improve quality of care and patient outcomes in clinical practice and to have a pivotal role in the scientific evidence and surveillance for medical devices. Challenges were faced in the early experience of the registry included developing multistakeholder partnerships, data collection requirements, and the use of the registry for pre- and post-market device evaluations. In addressing these challenges, the TVT Registry demonstrates that it is feasible for professional societies to assume a pivotal role in pre- and/or post-market studies, leveraging a clinical registry infrastructure. Sharing the TVT Registry experience may help other professional societies and stakeholders better anticipate and plan for these challenges.     

补阳还五汤对痴呆鼠胰岛素及相关蛋白表达影响的实验研究

目的观察补阳还五汤对老年性痴呆大鼠学习记忆能力的保护作用,并探讨其作用机制。方法Wistar雄性大鼠50只,随机分为5组,每组10只,即正常组、假手术组、模型组、补阳还五汤组和脑复康组,采用海马区注射Aβ1-40溶液制作AD大鼠模型。各组大鼠在造模后第7天开始给药治疗,正常组、假手术组与模型组大鼠给予等容积生理盐水,连续21d。脱察AD大鼠学习记忆能力,并用免疫组化法检测大脑海马区胰岛素（Ins）、胰岛素样生长因子-1（IGF-1）和胰岛素降解酶（IDE）蛋白表达的影响。结果补阳还五汤可显著降低Aβ1-40所致的AD模型大鼠IDE存腑I内海马中的阳性表达,提高Ins、IGF-1在海马中的阳性表达,起到防治老年性痴呆的作用。     

119例婴幼儿铁缺乏症的调查和分析

本文对上海工厂托儿所119例6月～3岁婴幼儿进行铁缺乏症的调查,其中6月～<2岁组74例,2岁～3岁组45例,缺铁总患病率为39.05％,其中缺铁性贫血(IDA)11.43％,铁缺少期(ID)与红细胞生成缺铁期(IDE)共27.62％。ID+IDE占缺铁总患病率的70.07％,IDA占29.27％。小于2岁组总铁缺乏率为45.71％,2～3岁组为25.71％。与83年资料比较IDA下降75％,而ID、IDE患病率未见降低。建议儿保部门可从婴儿3个月后定期测检铁营养指标,以期早防早治,切实保证婴幼儿健康成长。     

高速数据存储在CT成像系统中的应用研究

计算机断层扫描系统（CT）是现代医学影像学中重要的临床诊断工具,它可以直接向医生提供患者组织和器官的生理及病理变化。现代CT的发展方向是更快的扫描时间和更好的图像质量,从而对数据存储系统提出了更高的要求。本文首先对比研究了目前数据存储系统的存在问题和解决速度瓶颈的可行性方案,提出了独立硬盘存储系统的设计思路。然后通过研究IDE硬盘的工作原理和模式,采用可编程控制器和VHDL实现高速数据存储系统设计。本文研究的高速数据存储系统,不通过计算机系统实现对数据的直接存储和读取,避免了对成像系统资源的占用。同时本高速数据存储系统具有可扩展性,可以满足未来系统发展对带宽的不断需要。通过实验验证,本文设计的高速数据存储系统实现了大容量数据的高速传输和存储,速度稳定达到160MB/s,通过扩展还可以进一步提高性能,完全满足了螺旋CT系统对数据存储功能和速度方面的要求。上述成果在实际CT系统中的成功试用,表明了本文研发结果的有效性与实用性。     

Ginsenoside compound K attenuates cognitive deficits in vascular dementia rats by reducing the Aβ deposition

Ginsenoside compound K (CK) is the main metabolite of protopanaxadiol-type ginsenosides and has been demonstrated to exert neuroprotective and cognition-enhancing effects. The effects of CK on cognitive function in vascular dementia (VD) has not been elucidated. Therefore, the present study aims to elucidate the effects of CK on memory function as well as its potential mechanism in VD rats. Sprague–Dawley rats were subjected to Chronic Cerebral Hypoperfusion (CCH) by permanent bilateral common carotid artery occlusion (2VO). CCH induced neuronal damage and aggravated the aggregation of Amyloid-β_1-42 peptides (Aβ_1-42), which plays a critical role in the neurotoxicity and cognitive impairment. CK treatment attenuated CCH-induced Aβ_1-42 deposition and ameliorated cognition impairment. Furthermore, CK enhanced the activity of the pSer9-Glycogen synthase kinase 3β (pSer9-GSK3β) and the insulin degrading enzyme (IDE), which mainly involved the production and clearance of Aβ_1-42. Moreover, CK treatment enhanced the activity of protein kinase B (PKB/Akt), a key kinase in phosphatidylinositol 3 kinase (PI3K)/Akt pathway that can regulate the activity of GSK-3β and IDE. In short, our findings provide the first evidence that CK might attenuate cognitive deficits and Aβ_1-42 deposition in the hippocampus via enhancing the expression of pSer9-GSK-3β and IDE.     

One-Year Follow-Up of the Melody Transcatheter Pulmonary Valve Multicenter Post-Approval Study

ObjectivesThis study sought to confirm that the short-term hemodynamic effectiveness of the Melody transcatheter pulmonary valve (TPV) (Medtronic, Inc., Minneapolis, Minnesota) achieved by real-world providers is equivalent to the historical results established in the initial 5-center Investigational Device Exemption trial.BackgroundTPV replacement has been used to treat right ventricular outflow tract (RVOT) conduit dysfunction for >10 years. The Melody TPV received U.S. Food and Drug Administration approval in 2010 as a Humanitarian Use Device.MethodsPatients with dysfunctional RVOT conduits were entered in this prospective, nonrandomized study at 10 centers. The primary endpoint was acceptable hemodynamic function at 6 months post-implantation, defined as a composite of RVOT echocardiographic mean gradient ≤30 mm Hg, pulmonary regurgitation less than moderate as measured by echocardiography, and freedom from conduit reintervention and reoperation.ResultsCardiac catheterization was performed in 120 patients for potential implantation of the Melody TPV; of these, 100 patients were implanted, with a 98.0% procedural success rate. There were no procedure-related deaths. Acceptable hemodynamic function at 6 months was achieved in 96.7% of patients with evaluable data (87.9% of the entire implanted cohort), with results maintained through 1 year. No patient had moderate or severe pulmonary regurgitation after implantation. No patient required catheter reintervention in the first year after implantation, and 2 patients required reoperation for conduit replacement. The rate of freedom from TPV dysfunction was 96.9% at 1 year.ConclusionsThis first prospective, real-world experience with the Melody TPV in the United States demonstrates continued high procedural success, excellent short-term TPV function, and low reintervention and reoperation rates at 1 year. (Melody Transcatheter Pulmonary Valve Post-Approval Study; NCT01186692)