Associations between physical activity and sedentary time on components of metabolic syndrome among adults with HIV

Recent data show that people living with HIV/AIDS (PLWHA) are at a greater risk of cardiovascular disease (CVD), which could possibly be explained by an increased prevalence of metabolic syndrome (MetSyn) due to the known toxicities associated with antiretroviral therapy (ART). The purpose of this study is to examine the relationships between physical activity (PA) and components of MetSyn in a sample of PLWHA taking ART. A total of 31 males and 32 females living with HIV and currently taking ART were enrolled in a home-based PA intervention aimed to reduce risk factors for CVD. Clinical assessments included measures of resting blood pressure (BP), waist circumference, height, weight, PA levels via accelerometer, and a fasted blood draw. Components of MetSyn were divided into three clusters (1 = 0–1; 2 = 2; 3 = 3 or more). A one-way analysis of variance was used to determine differences between clusters. Multiple linear regressions were used to identify significant associations between moderate intensity PA (MPA) and sedentary time among components of MetSyn. MPA was significantly lower across MetSyn clusters (p < 0.001), whereas sedentary time was significantly higher (p = 0.01). A multiple linear regression showed MPA to be a significant predictor of waist circumference after controlling for age, race, gender, and sedentary time. Routine PA can be beneficial in helping PLWHA reduce waist circumference ultimately leading to metabolic improvements. This in turn would help PLWHA self-manage known components of MetSyn, thus reducing their risk of CVD and mortality.     

雷公藤内酯醇结构修饰和构效关系研究进展

雷公藤中的雷公藤内酯醇具有抗肿瘤、免疫抑制等多种生物活性,但是副作用大等特点限制了临床的使用。为了获得高效低毒的雷公藤内酯醇衍生物,对其结构进行了改造。近5年来对雷公藤内酯醇的结构改造又有了新进展,包括对其14位羟基、不饱和五元内酯环、B环、13位异丙基和10位甲基的结构改造,得到一系列衍生物。其中对14位羟基进行前药设计,从而降低了雷公藤内酯醇的毒性,14位羟基改造为α-羟基衍生物后发现了与雷公藤内酯醇活性相当的衍生物。综述了近5年来对雷公藤内酯醇的结构改造及构效关系研究进展。     

4-苯基-1,3,5-三嗪-2-胺类衍生物的合成及其体外抗肿瘤活性研究

目的以IMC-038525为先导化合物,设计并合成4-苯基-1,3,5-三嗪-2-胺类化合物,考察其体外抗肿瘤活性。方法以2,4-二氯-1,3,5-三嗪为起始原料,经过氨化、Suzuki偶联和还原胺化合成一类4-苯基-1,3,5-三嗪-2-胺类化合物,采用噻唑蓝法(MTT)测定其对肿瘤细胞的抑制活性。结果设计并合成了13个新化合物,结构经1H-NMR和MS确证。活性测试结果显示该类化合物具有一定的抗肿瘤活性。结论合成了一类4-苯基-1,3,5-三嗪-2-胺类衍生物,具有一定抑瘤活性的化合物,为新型抗肿瘤化合物的设计与合成提供思路。     

基于CT图像的跨模态转换研究进展

医学图像在临床诊断和治疗上起着至关重要的作用。放射治疗过程中采用计算机体层成像（CT）进行靶区定位和勾画。为了从多个角度获取病变体信息,需利用医学图像多模态的优势。然而,获取多种模态的医学图像是比较耗费资源的,同时无法保证患者状态的一致性。医学图像跨模态转换,可以利用一种模态图像预测另一种模态图像。本文详细综述了基于CT图像的超声图像、磁共振（magnetic resonance,MR）图像、正电子发射计算机断层显像（positron emission tomography,PET）跨模态模型研究,分类阐述了各模型的特点和存在的挑战,指出尚待开展的研究领域。     

Mucoadhesive chitosan-coated nanostructured lipid carriers for oral delivery of amphotericin B

This study describes the properties of an amphotericin B-containing mucoadhesive nanostructured lipid carrier (NLC), with the intent to maximize uptake within the gastrointestinal tract. We have reported previously that lipid nanoparticles can significantly improve the oral bioavailability of amphotericin B (AmpB). On the other hand, the aggregation state of AmpB within the NLC has been ascribed to some of the side effects resulting from IV administration. In the undissolved state, AmpB (UAmpB) exhibited the safer monomeric conformation in contrast to AmpB in the dissolved state (DAmpB), which was aggregated. Chitosan-coated NLC (ChiAmpB NLC) presented a slightly slower AmpB release profile as compared to the uncoated formulation, achieving 26.1% release in 5?hours. Furthermore, the ChiAmpB NLC formulation appeared to prevent the expulsion of AmpB upon exposure to simulated gastrointestinal pH media, whereby up to 63.9% of AmpB was retained in the NLC compared to 56.1% in the uncoated formulation. The ChiAmpB NLC demonstrated mucoadhesive properties in pH 5.8 and 6.8. Thus, the ChiAmpB NLC formulation is well-primed for pharmacokinetic studies to investigate whether delayed gastrointestinal transit may be exploited to improve the systemic bioavailability of AmpB, whilst simultaneously addressing the side-effect concerns of AmpB.     

Body mass index,waist circumference and body fat are positively correlated with hair cortisol in children: A systematic review and meta‐analysis

The current body of research lacks a meta‐analysis of the relationship between hair cortisol concentration (HCC) and anthropometry in children. Therefore, this systematic review and meta‐analysis was conducted to examine this relationship and explore possible moderators between HCC and body mass index (BMI/BMI z‐score). Eleven databases were searched: CINAHL, Cochrane, Embase, PsycEXTRA, Psychology and Behavioral Sciences, PsycINFO, PubMed, Scopus, Social Sciences Full Text, Sociological Abstracts and Web of Sciences. Random‐effects models and exploratory moderator analyses with mixed‐effects models were performed using the Comprehensive Meta‐Analysis software. The meta‐analysis showed small positive correlations between HCC and BMI (r = 0.08, 95% confidence interval [CI]: 0.02, 0.14, n = 18, p = .009), BMI z‐score (r = 0.10, 95% CI: 0.03, 0.16, n = 12, p = .003), waist circumference (r = 0.10, 95% CI: 0.04, 0.17, n = 10, p = .001) and body fat including fat mass index (r = 0.06, 95% CI: 0.02, 0.11, n = 3, p = .005). The relationship between HCC and BMI/BMI z‐score was significantly moderated by children's sex. Results from this meta‐analysis provide initial objective support for a small positive relationship between HCC and anthropometric factors.     

数字化三维重建技术在隐神经营养血管皮瓣血供的可视化研究及临床应用

目的探讨数字化三维重建技术在隐神经营养血管皮瓣血供可视化研究的可行性及其临床应用效果。 方法新鲜捐献成人尸体1具,采用改良的明胶-氧化铅灌注方法进行灌注,灌注前和灌注后均用64排螺旋CT进行扫描,利用Mimics 10.01软件,获得血管、肌肉、骨骼以及皮肤的三维解剖结构图像,并对血管进一步分割,构建出单支血管及其分支,并对所构建的三维图像进行单独显示与组合显示,以设计切取隐神经营养血管皮瓣。在上述基础上,选择于2015年12月至2018年1月住院的小腿下段及足踝部皮肤软组织缺损需行隐神经营养血管皮瓣修复手术患者40例,随机分成A、B两组,每组20例,A组术前进行数字化重建,B组术前不予数字化重建。比较2组术后隐神经营养血管皮瓣存活率,手术所需时间,精确性以及皮瓣旋转点到内踝顶点距离。 结果灌注前数据可轻易重建出骨、肌肉、筋膜与皮肤,灌注后的数据可构建出血管,组合显示后可得到血管在某个局部的具体分布状况,为隐神经营养血管皮瓣的临床个性化设计与基础研究提供准确的血管解剖学基础。A组隐神经营养血管皮瓣经数字化重建后,可显示皮瓣主要血供,并能够清晰显示皮肤、肌肉与血管三维解剖关系;应用软件自带测量工具对血管、皮瓣进行测量,可以准确定位指导手术操作。术中探查血供与重建图像相符,体表定位准确。A组20例皮瓣均成活良好,伤口一期愈合,皮瓣质地良好,局部无瘢痕挛缩;B组20例皮瓣4例患者于术后出现皮瓣远端部分坏死,经二期清创换药和植皮术后愈合。术后随访3～12个月,A组皮瓣质地良好,外形满意,B组有6例皮瓣远端出现质硬瘢痕和轻度挛缩,行走时疼痛,后经手术松解植皮后好转。A组皮瓣成活率(100%)明显高于B组(70%),差异有统计学意义(P<0.05);A组手术所需时间[(114.05±10.36) min]明显短于B组[(123.20±11.91) min],差异有统计学意义(P<0.01);A组皮瓣切取精确性(0.17±0.03)明显高于B组(0.23±0.02),差异有统计学意义(P<0.01);A组皮瓣蒂部旋转点到内踝顶点距离[(4.14±0.38) cm]明显少于B组[(5.96±0.81) cm],差异有统计学意义(P<0.01)。 结论数字化三维重建技术为隐神经营养血管皮瓣临床手术的个性化设计提供了一个很好的辅助手段,临床应用修复小腿远端及足踝部软组织缺损效果满意,值得临床推广应用。     

Comparison of the modified Wiltse's approach with spinal minimally invasive system and traditional approach for the therapy of thoracolumbar fracture

Thoracolumbar fractures are usually treated by open posterior pedicle screw fixation. However, this procedure involves massive paraspinal muscle stripping, inflicting surgical trauma, and prolonged X-ray exposure. In this study, we observed 127 patients with single-segment injury thoracolumbar fractures. Thirty-six patients were treated by the modified Wiltse's paraspinal approach with minimally invasive channel system, while 91 patients were treated via traditional posterior approach. Operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, screw placement accuracy, visual analogue scale score, and Cobb's angle of two groups were compared. The X-ray exposure times were notably reduced (4.2±1.6) in the new approach group (P<0.05). The pedicle screw placement accuracy and Cobb's angle after surgery were similar in the two groups. We conclude that modified Wiltse's paraspinal approach with spinal minimally invasive channel system surgery can significantly reduce the X-ray exposure times and is an alternative therapy for the thoracolumbar fracture.     

转化生长因子β3/聚乳酸-羟基乙酸微球对干细胞的调控

文题释义：转化生长因子β3：是转化生长因子β超家族成员,在胚胎软骨形成的多个时期都是必不可少的软骨组织形成的关键调节因子,可以促进间充质干细胞迁移并诱导其向软骨组织分化与成熟,促进软骨缺损的愈合。 聚乳酸-羟基乙酸微球：属于食品药品监督管理局(Food and Drug Administration,FDA)批准的可生物降解聚合物,具有可控的降解性和良好的生物相容性,被广泛应用于医药领域。由于其生物可降解性,聚乳酸-羟基乙酸微球微球被广泛应用于小分子药物、蛋白质和其他大分子药物的可控持续释放。 背景：转化生长因子β3/聚乳酸-羟基乙酸缓释微球系统可使药物在作用部位维持有效药物浓度,提高生长因子的利用率。 目的：优化转化生长因子β3/聚乳酸-羟基乙酸缓释微球制备工艺,探究其对脂肪间充质干细胞增殖和迁移的影响。 方法：采用乳化-溶剂挥发法制备转化生长因子β3/聚乳酸-羟基乙酸缓释微球,并对微球的形态、粒径大小、药物空间分布、包封率、载药量和缓释性能进行表征。将转化生长因子β3/聚乳酸-羟基乙酸缓释微球溶解于PBS中,于相应的时间点检测上清液中转化生长因子β3浓度,对应时间点扫描电镜观察微球形态。将脂肪间充质干细胞分6组培养,分别加入培养基(阴性对照)、含转化生长因子β3的培养基、含空白聚乳酸-羟基乙酸微球的培养基、含10,100,1 000 g/L转化生长因子β3/聚乳酸-羟基乙酸微球的培养基,于对应的时间点CCK-8法检测增殖。将脂肪间充质干细胞分别与培养基(阴性对照)、含转化生长因子β3的培养基、含聚乳酸-羟基乙酸微球的培养基、含10,100,1 000 g/L转化生长因子β3/聚乳酸-羟基乙酸微球的培养基以非接触方式共培养24 h,检测细胞迁移数量。结果与结论：①转化生长因子β3/聚乳酸-羟基乙酸微球呈球形,表面光滑,无粘连,粒径均匀分布,微球直径2-50 μm,微球内的蛋白药物分布均匀,具有较高的包封率与载药量;②缓释微球具有良好的降解性能,体外可于6个月后完全降解;同时具有良好的缓释性能,体外可缓慢释放转化生长因子β3长达45 d;③空白微球及含转化生长因子β3的缓释微球对脂肪间充质干细胞增殖无影响;④空白微球对脂肪间充质干细胞的迁移无影响,转化生长因子β3及含转化生长因子β3的缓释微球可促进脂肪间充质干细胞的迁移,不同质量浓度缓释微球间的促进效果无差异;⑤结果表明,转化生长因子β3/聚乳酸-羟基乙酸缓释微球可在不影响脂肪间充质干细胞增殖的情况下促进其迁移。 ORCID: 0000-0002-2267-4589(杨振) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

A propensity-matched study of hypertension and increased stroke-related hospitalization in chronic heart failure

Hypertension is a risk factor for heart failure and stroke. However, the effect of hypertension on stroke in patients with heart failure has not been well studied. In the Digitalis Investigation Group trial, 3,674 (47%) of the 7,788 patients had a history of hypertension. Probability or propensity scores for a history of hypertension were calculated for each patient through use of a multivariable logistic regression model and were then used to match 2,386 pairs of patients with and without a history of hypertension. Kaplan-Meier and matched Cox regression analyses were used to estimate associations of a history of hypertension hospitalization for stroke during 37 months of median follow-up. After matching, patients without and with a history of hypertension had a mean systolic blood pressure of 127 mm Hg. Hospitalization for stroke occurred in 90 patients (rate, 129/10,000 person-years of follow-up) without a history of hypertension and 121 patients (rate, 178/10,000 person-years of follow-up) with a history of hypertension (hazard ratio when hypertension was compared with no hypertension=1.52; 95% confidence interval=1.11 to 2.08; p=0.010). This association was also observed among patients with baseline systolic blood pressure <140 mm Hg (hazard ratio=1.35; 95% confidence interval=1.01 to 1.81; p=0.044). In conclusion, a history of hypertension was associated with increased risk of hospitalization for stroke among patients with heart failure who were balanced in all measured baseline covariates, including blood pressure.