Beyond Food Promotion: A Systematic Review on the Influence of the Food Industry on Obesity-Related Dietary Behaviour among Children

An increased consumption of energy-dense, nutrient-poor food and beverages as a result of a changing obesogenic environment contributes substantially to the increasing prevalence of childhood overweight and obesity. This paper reviews the nature and extent of food industry influences which expose children to commercial influences and thus might affect unhealthy dietary behaviour and finally contributes to obesity. A systematic search of nine electronic databases (including PubMed, PsycINFO, EconLit) and reference lists of original studies and reviews using key search terms identified 1900 articles. Of these only thirty-six articles met the inclusion and quality criteria. A narrative synthesis of the reviewed studies revealed six key obesogenic environments by which the food industry possibly influences obesity-related dietary behaviours in young children. These were schools, retailers, mass media “television”, mass media “internet”, home and promotional campaigns. Identifying these obesogenic environments is critical for monitoring and controlling the food industry, the development of effective environmental-level interventions to prevent childhood overweight and obesity and to identify knowledge gaps to be addressed in future research to support informed decisions of policy makers.     

快速与标准三维时间飞跃法MRA在颅内动脉成像的对比研究

目的评价快速三维时间飞跃法(3D fast time of flight,3D Fast-TOF)磁共振血管成像(magnetic resonance angiography,MRA)在颅内动脉成像中的临床应用价值。材料与方法对34例临床怀疑脑血管病变的患者同时进行标准3D TOF MRA和3D Fast-TOF MRA序列进行脑部动脉成像,其中,2例不能同时顺利完成3D Fast-TOF MRA和标准3D TOF MRA扫描,1例由于运动伪影、图像质量较差,未纳入统计。共31例检查者(男15例,女16例)顺利完成扫描,采用MIP进行三维重建。分别测得原始横断位基底动脉中段和同层脑桥信号并计算图像的信噪比和对比噪声比,对颈内动脉的各级分支显示和图像质量进行评分,对二者的图像质量、血管分支、信噪比(signal to noise ratio,SNR)和对比噪声比(contrast to noise ratio,CNR)进行评分。结果3D Fast-TOF MRA组的颈内动脉分支显示评分为(3.21±0.86)分,标准3D TOF MRA组为(2.51±0.64)分,两组间具有统计学差异(P＜0.01),3D Fast-TOF MRA组显示血管分支优于标准序列。3D Fast-TOF MRA组图像质量为(4.84±0.58)分,标准3D TOF组图像质量为(4.87±0.56)分,3D Fast-TOF MRA组的SNR、CNR分别为161.17±11.72、124.13±11.28;标准3D TOF组的SNR、CNR分别为149.39±39.91、113.04±29.90;两组间图像质量、SNR、CNR无显著性差异(P＞0.05),3D Fast-TOF MRA序列扫描时间3.31 min,标准扫描序列扫描时间5.28 min。结论3D Fast-TOF MRA成像技术具有良好的图像质量、较高的空间分辨率,与标准3D TOF序列相比,扫描时间明显缩短,可以作为一种新的磁共振颅内动脉成像技术。     

Comparative structural analysis of human Nav1.1 and Nav1.5 reveals mutational hotspots for sodium channelopathies

Among the nine subtypes of human voltage-gated sodium (Na_v) channels, the brain and cardiac isoforms, Na_v1.1 and Na_v1.5, each carry more than 400 missense mutations respectively associated with epilepsy and cardiac disorders. High-resolution structures are required for structure–function relationship dissection of the disease variants. We report the cryo-EM structures of the full-length human Na_v1.1–β4 complex at 3.3 Å resolution here and the Na_v1.5-E1784K variant in the accompanying paper. Up to 341 and 261 disease-related missense mutations in Na_v1.1 and Na_v1.5, respectively, are resolved. Comparative structural analysis reveals several clusters of disease mutations that are common to both Na_v1.1 and Na_v1.5. Among these, the majority of mutations on the extracellular loops above the pore domain and the supporting segments for the selectivity filter may impair structural integrity, while those on the pore domain and the voltage-sensing domains mostly interfere with electromechanical coupling and fast inactivation. Our systematic structural delineation of these mutations provides important insight into their pathogenic mechanism, which will facilitate the development of precise therapeutic interventions against various sodium channelopathies.

The nine subtypes of human voltage-gated sodium (Na_v) channels are responsible for the initiation and transmission of electrical impulses in different tissues: Na_v1.1 to Na_v1.3 and Na_v1.6 mainly function in the central nervous system, Na_v1.7 to Na_v1.9 are mostly distributed in the peripheral nervous system, Na_v1.4 is specialized in skeletal muscle, and Na_v1.5 is the primary cardiac isoform (1–4). Abnormalities of these channels, hinging on their tissue specificity, are associated with a broad spectrum of channelopathies. To date, more than 1,000 disease mutations have been identified in the primary sequence of Na_v channels, among which Na_v1.1 and Na_v1.5 each host more than 400 missense mutations (5–8).Na_v1.1 is encoded by SCN1A, which may have the largest number of epilepsy-related mutations. Up to 900 SCN1A mutations, more than half of which result in truncations (9), have been identified in epilepsy syndromes with different severities. Nonsense and hundreds of missense mutations of SCN1A are found in 70 to 80% of patients with Dravet syndrome, which is also known as the severe myoclonic epilepsy of infancy (10–13) (SI Appendix, Table S1). Several dozen missense mutations are associated with generalized epilepsy with febrile seizures plus and intractable childhood epilepsy with generalized tonic-clonic seizures (10) (SI Appendix, Table S2). Although most of the Na_v1.1 disease mutations lead to loss of function to different degrees, some represent gain of function. In most cases, the pathogenic mechanism remains elusive.A brief summary of Na_v1.5 pathophysiology is presented in the companion paper (14). Mechanistic understanding of the sodium channelopathies entails high-resolution structures of human Na_v channels. In the past 4 y, we have reported the cryoelectron microscopy (cryo-EM) structures, at resolutions ranging between 2.6 and 4.0 Å, of Na_v channels from insect (Na_vPaS), electric eel (EeNa_v1.4), and finally human, including Na_v1.2, Na_v1.4, Na_v1.5, and Na_v1.7, in the presence of multiple modulators, such as β1 and β2 subunits, peptide toxins, and small-molecule toxins tetrodotoxin and saxitoxin (15–21). Structures of a truncated rat Na_v1.5 were recently reported (22). All structurally resolved eukaryotic Na_v channels except for Na_vPaS exhibit similar conformations of potentially inactivated state.Notwithstanding these advances, high-resolution structures of human Na_v1.1 and Na_v1.5 wild-type and representative disease variants are necessary to provide accurate templates to directly map the disease mutations and to facilitate drug discovery. Furthermore, as these two channels harbor 80% of all identified mutations related to sodium channelopathies, a comparative analysis of their structures may reveal potential mutational hotspots, offering invaluable insight into the function and disease mechanism of Na_v channels.Here we present the cryo-EM structure of human Na_v1.1 associated with a modulating auxiliary subunit β4. In the accompanying paper, we report the structure of human Na_v1.5 that carries a common disease variant E1784K. Comparative structural analyses have revealed several clusters of disease mutations that are common to both Na_v1.1 and Na_v1.5.     

Study of Mechanical Properties and Durability of Alkali-Activated Coal Gangue-Slag Concrete

Herein, a new geopolymer is recognized as a potential alternative cementing material of ordinary Portland cement (OPC), which is used for reducing carbon emissions and efficiently recycling the waste. Therefore this paper mainly studied the alkali-activated coal gangue-slag concrete (ACSC) was prepared by using the coal gangue-slag and Na₂SiO₃ and NaOH complex activator. The ratio of coal gangue (calcined and uncalcined) coarse aggregate replacing the gravel was 0%, 30%, 50%, 70%, and 100%. The water and salt freeze-thaw resistance, compressive strength, chloride permeation, microstructure, performance mechanism, inner freeze-thaw damage distribution, and mechanics models of ACSC were investigated. Results show that ACSC displayed excellent early age compressive strength, and the compact degree and uniformity of structure were better compared with the ordinary Portland cement (OPC) when the coal gangue replacement rate was less than 50%. The ACSC demonstrated the best chloride penetration resistance under 30% uncalcined coal gangue content, which was less than 27.75% lower than that of using OPC. At the same number cycles, especially in the salt freezing, the calcined coal gangue had lowered advantages of improving resistance freeze-thaw damage resistance. Water and salt accumulative freeze-thaw damage mechanics models of ACSC were established by using the relative dynamic elasticity modulus. The exponential function model was superior to the power function model with better precision and relativity, and the models accurately reflected the freeze-thaw damage effect.     

Role of fine‐needle aspiration cytology and fluid cytology in extra‐pulmonary tuberculosis

Extra‐pulmonary tuberculosis is the presence of disease in an organ without obvious involvement of the lungs (World Health Organization, Tuberculosis Fact sheet, 2006). The present article focuses on the incidence of extra‐pulmonary tuberculosis as an emerging and clinically significant disease to be reckoned with in the present era. It also highlights fine‐needle aspiration cytology (FNAC) as an inexpensive, less invasive procedure for early diagnosis of such tuberculosis and timely initiation of specific therapy. All cases of proved tuberculosis presenting to the M.V.J. Medical College and Research Hospital were recorded over a period of two years (2008–2010); and categorized as pulmonary and extra‐pulmonary cases. A total of 96 cases of tuberculosis were observed; extra‐pulmonary tuberculosis was seen in 64 cases. Of these 56 cases were from lymphnodes and 8 from extra‐nodal sites which included tuberculous dactylitis (two cases), tuberculous mastitis (two cases), tuberculous synovial effusion (one case), pericardial effusion (one case), epididymo‐orchitis (one case), and cold abscess (one case). The cytology patterns observed included granulomatous inflammation and necrosis with or without acid fast bacilli. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc.     

复杂先天性心脏病矫治术后的快速康复研究

目的探索复杂先天性心脏病快速康复（fast track,FT）的可行性和安全性,探讨其相关影响因素。方法回顾性分析2008年1月至2010年6月阜外心血管病医院小儿外科中心复杂先天性心脏病矫治术后患者865例的临床资料。病种包括：法洛四联症,肺动脉闭锁、右心室双出口,大动脉转位,肺静脉畸形引流,心内膜垫缺损,主动脉缩窄合并室间隔缺损等。分析先天性心脏病手术风险分级评估（risk adjustment forcongenital heart surgery 1,RACHS-1）,病种类型、年龄、体质量等因素对FT的影响。结果总体FT比率为42.65%。按年龄分组（0～6个月、6～12个月以及〉12个月）3组FT比率分别为19.70%、40.20%、62.61%,3组间比较差异有统计学意义（P〈0.05）。FT组机械通气时间、重症监护病房住院时间比非FT组明显降低,差异有统计学意义[（6.51±4.06）h vs.（58.07±74.81）h,P〈0.05;（2.05±1.06）d vs.（7.64±8.75）d,P〈0.05]。Logistic回归分析提示年龄、体质量、高RACHS-1分级是复杂先天性心脏病FT治疗影响因素。结论部分复杂先天性心脏病矫治术后可行FT治疗,高RACHS-1风险分级、疾病类型、年龄〈6个月是复杂先天性心脏病矫治术后FT的影响因素。     

快速康复外科在胆道结石患者ERCP术后饮食管理中的应用

目的探讨快速康复外科理念用于胆管结石患者ERCP术后饮食管理的效果。方法选择60例拟行ERCP取石的胆管结石患者,随机分为观察组与对照组各30例,两组患者术后当天均常规禁食。观察组患者术后次日如腹痛的症状及体征均不明显,且血淀粉酶正常或基本正常,则开始进食。对照组患者术后次日如腹痛的症状及体征均不明显,且血淀粉酶完全正常,则开始进食,否则延长观察期,继续禁食,直至结果正常后再逐步过渡到流质饮食及普食。比较两组患者术后口渴、饥饿感、输液量、住院时间的差异。结果观察组患者术后口渴、饥饿感发生率低于对照组;术后输液量、住院时间少于对照组。差异均有统计学意义(P<0.05)。均未发生出血、穿孔、胰腺炎的并发症。结论在胆管结石患者ERCP术后应用快速康复外科理念是安全、有效的,缩短了术后禁食时间,加快了病人康复速度,缩短了住院时间。