Effects of green coffee bean extract on C-reactive protein levels: A systematic review and meta-analysis of randomized controlled trials

Background & objective: The effects of green coffee bean extract (GCBE) supplementation on inflammatory biomarkers have been widely spread. The purpose of this article was to assess the impact of GCBE supplementation on C-reactive protein (CRP) levels.MethodsThe literature search was performed in four databases (Scopus, PubMed, the Cochrane Library, and Google Scholar) to identify studies that examined the influence of GCBE supplementation on CRP levels up to August 2019. Mean and standard deviation (SD) of the outcomes were used to estimate the weight mean difference (WMD) between intervention and control groups for the follow-up period.ResultsFive (5) studies, with 6 arms, reported CRP as an outcome. Statistically, the use of GCBE supplements resulted in a significant change in CRP levels (WMD: −0.017 mg/dL, 95 % CI: −0.032, −0.003, p = 0.018), whose overall findings were obtained from random-effects model. In addition, a significantly greater reduction in CRP was noted for studies with doses of GCBE supplements ≥ 1000 mg/d (WMD: −0.015 mg/dL, 95 % CI: −0.020, −0.010, p < 0.000), length of intervention < 4 weeks (WMD: -0.015 mg/dL, 95 % CI: −0.020, −0.010, p < 0.001), and for non-healthy subjects (WMD: −0.019 mg/dL, 95 % CI: −0.027, −0.011, p < 0.001). Dyslipidemia, hypertension and non-alcoholic fatty liver disease were the ailments of the studies that encompassed non-healthy patients.ConclusionsThis meta-analysis shows that the use of GCBE supplements resulted in a statistical decrease in CRP levels, mainly for non-healthy subjects. However, due to the limited number of studies, further randomized clinical trials are crucial in this regard.     

Use of Second Window ICG in spinal cord biopsy of a mildly contrast-enhancing lesion: Technical note and review of the literature

IntroductionIndocyanine green (ICG) is commonly used to visualize cerebral vasculature, particularly in the management of cerebral aneurysms. There have also been attempts to use ICG for visualization of tumors. Injection of ICG followed by immediate fluorescence microscopy is limited by the short time window for imaging and administration and restricted depth of imaging. Second Window Indocyanine Green (SWIG) addresses these issues by allowing for longer contrast times and the imaging of deeper regions of brain tissue. Biopsy of spinal cord lesions is often difficult for a variety of reasons, including the delicate nature of the tissue and differentiating normal from lesional tissue visually, especially in lesions with heterogeneous enhancement.MethodsIn this case report, we describe the use of second window ICG to facilitate the visualization of a spinal cord lesion and subsequent biopsy of the lesion.ResultsThis patient is a 24-year-old female who had recurrence of a suprasellar germinoma. An MRI of the rest of the neuraxis was performed to assess for the presence of drop metastases. The spinal cord from C2-5 was expanded with areas of patchy enhancement; however, this lesion was asymptomatic. The patient's oncologist requested a biopsy of this lesion to help direct subsequent care of her recurrent germinoma. The day before surgery, the patient had an intravenous injection of ICG dye. She then underwent a C3-5 laminectomy for biopsy of her cervical intramedullary lesion. After opening of the dura, no visible abnormality of the spinal cord could be identified. A Stryker endoscope showed an area of ICG uptake in the cord at approximately the C3-4 level. A midline myelotomy was centered over the ICG demarcated area and several samples were taken for pathology. Final biopsy results determined the lesion to be spinal cord parenchyma with perivascular and intraparenchymal lymphocytes – not consistent with spinal cord tumor or germinoma.ConclusionSecond Window ICG is effective in visualizing otherwise visually unremarkable spinal cord lesions. This technology can facilitate biopsy of these lesions and possibly their surgical resection.     

The ‘space’ of friendship: young children's understandings and expressions of friendship in a reception class

The purpose of this study has been to explore young children's understandings and experiences of friendship as these manifested in children's behaviours, in a reception class setting. Drawing on an evolutionary, ecological framework, friendship is seen as not only the expression and further development of social understandings and cognitive advances; more than that, making and maintaining friends is seen as an evolutionary trait and a ‘drive’ to relate to similarly minded others. Through ‘niche picking’, children select the environments and opportunities that suit them in order to develop their dispositions and individual traits. The research employed a participatory design in order to capture the children's views and experiences. It took place in a reception class setting, where children's everyday experiences were observed and discussed with them. The study identified six themes of analysis and offered some suggestions about creating enabling educational environments that allow the ‘space’ for niche construction.     

急诊绿色通道在创伤性膈疝中的应用体会

目的阐述急诊绿色通道在创伤性膈疝中的应用体会。 方法回顾性分析2017年5月至2018年5月，江苏省人民医院收治的25例创伤性膈疝患者的临床资料，均采用急诊创伤绿色通道进行抢救。记录患者手术情况、治疗结果及术后并发症情况。 结果25例患者到达医院立即启动创伤通，所有创伤通道人员到位时间（5±5.5）min，到达医院至手术时间（60.7±6.2）min。23例入院后行急诊手术，另外2例均于入院后第2天手术。并发症发生率为8.70%，死亡率为8.00%，治疗成功率为92.0%。 结论急诊创伤绿色通道的设立可大大缩短受伤至手术时间，以最迅速的方式使创伤性膈疝患者得到及时救治，提倡更多的医院建立"急诊创伤绿色通道"，使更多的患者在最短的时间内接受有效的治疗。     

基础医学实验室仪器设备科学管理的思考

充分发挥基础医学实验室培育人才的重要作用,推动教学科研同步发展,必须不断强化基础医学实验室科学管理,健全仪器设备全生命周期各环节的管理制度,提升实验室仪器设备的使用价值并发挥其效益的最大化。文章结合汕头大学医学院在开展生物化学与分子生物学实验室建设中,强化对本科生人才培养的实践,系统阐述了加强基础医学实验室仪器设备科学管理多个层面上的思考。     

关节腔渗透压调控骨关节炎的研究进展

骨关节炎是一种慢性、进行性、不可逆性的关节退行性疾病,是一种中老年人的常见疾病,被认为是全球致残率较高的疾病之一。近年来,随着经济发展和人口老龄化,骨关节炎的患者数量在不断增加,这也让骨关节炎在临床上得到了极大的重视。而临床上治疗骨关节炎的一个关键性问题是关节软骨的丢失和难以自我修复。渗透压可以通过调节细胞体积和调控离子通道影响软骨细胞的生理代谢,从而影响关节软骨的损伤和修复。这一过程可能在骨关节炎发生发展中起到了重要作用。本文就离子通道、渗透压和骨关节炎三者间的相关性作一综述。     

Intraoperative lateral rectus electromyographic recordings optimized by deep intraorbital needle electrodes

ObjectiveWe demonstrate the advantages and safety of long, intraorbitally-placed needle electrodes, compared to standard-length subdermal electrodes, when recording lateral rectus electromyography (EMG) during intracranial surgeries.MethodsInsulated 25 mm and uninsulated 13 mm needle electrodes, aimed at the lateral rectus muscle, were placed in parallel during 10 intracranial surgeries, examining spontaneous and stimulation-induced EMG activities. Postoperative complications in these patients were reviewed, alongside additional patients who underwent long electrode placement in the lateral rectus.ResultsIn 40 stimulation-induced recordings from 10 patients, the 25 mm electrodes recorded 6- to 26-fold greater amplitude EMG waveforms than the 13 mm electrodes. The 13 mm electrodes detected greater unwanted volume conduction upon facial nerve stimulation, typically exceeding the amplitude of abducens nerve stimulation. Except for one case with lateral canthus ecchymosis, no clinical or radiographic complications occurred in 36 patients (41 lateral rectus muscles) following needle placement.ConclusionsIntramuscular recordings from long electrode in the lateral rectus offers more reliable EMG monitoring than 13 mm needles, with excellent discrimination between abducens and facial nerve stimulations, and without significant complications from needle placement.SignificanceLong intramuscular electrode within the orbit for lateral rectus EMG recording is practical and reliable for abducens nerve monitoring.     

浅谈可持续发展的临床科研数据平台建设

医学发展离不开大量临床经验的积累和总结,优秀的临床工作平台可以保障提供足量的病例,然而临床科研所需要的规范化数据还需要遵循科研的标准从海量的临床数据信息中筛选提取。单纯依靠个人的收集往往受其能力和时间限制不能尽善尽美,并且容易形成数据孤岛,不利于平台的持续发展和科研人才的培养效率。可持续发展的临床科研数据平台是医学科研创新和人才培养的基础,文章仅以四川大学华西口腔医院唇腭裂外科科研数据平台建设为例,从实例出发,详细介绍了如何建立临床科研数据平台以及如何保证其可持续性发展,旨在抛砖引玉,为更多可持续发展的临床科研平台建设提供参考。     

云南省中医药教育专业建设思路与实证研究*

中医药教育是我国国民教育的重要组成部分，应以新时代本科教育创新发展为契机，加快中医药专业特色发展，围绕产业需求，优化专业布局。本文以云南省中医药院校在一流本科教育建设过程中的探索实践为例，对中医药教育专业建设进行实证研究，构建专业评价机制，为各学科专业建设提供借鉴。     

Can we increase the speed and efficacy of antidepressant treatments? Part II. Glutamatergic and RNA interference strategies

In the second part we focus on two treatment strategies that may overcome the main limitations of current antidepressant drugs. First, we review the experimental and clinical evidence supporting the use of glutamatergic drugs as fast-acting antidepressants. Secondly, we review the involvement of microRNAs (miRNAs) in the pathophysiology of major depressive disorder (MDD) and the use of small RNAs (e.g.., small interfering RNAs or siRNAs) to knockdown genes in monoaminergic and non-monoaminergic neurons and induce antidepressant-like responses in experimental animals.The development of glutamatergic agents is a promising venue for antidepressant drug development, given the antidepressant properties of the non-competitive NMDA receptor antagonist ketamine. Its unique properties appear to result from the activation of AMPA receptors by a metabolite [(2 S,6 S;2 R,6 R)-hydroxynorketamine (HNK)] and mTOR signaling. These effects increase synaptogenesis in prefrontal cortical pyramidal neurons and enhance serotonergic neurotransmission via descending inputs to the raphe nuclei. This view is supported by the cancellation of ketamine's antidepressant-like effects by inhibition of serotonin synthesis.We also review existing evidence supporting the involvement of miRNAs in MDD and the preclinical use of RNA interference (RNAi) strategies to target genes involved in antidepressant response. Many miRNAs have been associated to MDD, some of which e.g., miR-135 targets genes involved in antidepressant actions. Likewise, SSRI-conjugated siRNA evokes faster and/or more effective antidepressant-like responses. Intranasal application of sertraline-conjugated siRNAs directed to 5-HT_1A receptors and SERT evoked much faster changes of pre- and postsynaptic antidepressant markers than those produced by fluoxetine.