Non-invasive monitoring of core body temperature rhythms over 72 h in 10 bedridden elderly patients with disorders of consciousness in a Japanese hospital: A pilot study

The purpose of this study was to elucidate the body core temperature rhythms of bedridden elderly patients with disorders of consciousness (DOC) in a Japanese hospital using a simple, non-invasive, deep-body thermometer. We measured body core temperature on the surface of abdomen in 10 bedridden elderly patients with DOC continuously over 72 h. A non-heated core body temperature thermometer was used. The cycle of the body core temperature rhythm was initially derived by using the least squares method. Then, based on that rhythm, the mean, amplitude, and times of day of the highest and lowest body temperatures during the optimum cycle were determined using the cosinor method. We found a 24-h cycle in seven of the 10 patients. One patient had a 6-h, one a 12-h, and one a 63-h cycle. The mean value of the cosine curve in the respective optimum cycles was 36.48 ± 0.34 °C, and the amplitude was 0.22 ± 0.09 °C. Of the seven subjects with 24-h cycles, the highest body temperature occurred between 12:58 and 14:44 h in four. In addition to 24-h cycles of core temperature rhythm, short cycles of 12 and 6-h and a long cycle of 63-h were seen. In order to understand the temperature rhythms of bedridden elderly patients with DOC, it is necessary to monitor their core body temperatures, ideally using a simple, non-invasive device. In the future, it will be important to investigate the relationship of the core temperature rhythm to nursing care and living environment.     

骨髓间充质干细胞对高低转移潜能肝癌细胞影响的实验研究

目的观察人骨髓间充质干细胞(hMSC)对高低转移潜能肝癌细胞(MHCC97-H和MHCC97-L)侵袭能力和增殖能力的影响。方法 Transwell法检测hMSC对高低转移潜能肝癌细胞侵袭能力的影响,下室加入培养基和hMSC,上室加入高低转移潜能肝癌细胞悬液,共培养36 h,酶标仪吸光度(optical density,OD)值检测及细胞计数法观察侵袭能力的变化。CCK-8法检测hMSC对高低转移潜能肝癌细胞增殖能力的影响。PCR检测共培养前后转移相关因子骨桥蛋白(OPN)、唾液酸蛋白(BSP)、α-V基因、增殖相关基因TGFβ1和PDCD4的表达差异。结果 (1)侵袭能力检测结果:与对照组比较,镜下观察实验组高低转移潜能肝癌细胞迁移数量明显减少,OD值两组比较差异有统计学意义(P0.05)。MHCC97-H与hMSC共培养后OPN、BSP表达明显下降(P0.05),而α-V表达无明显变化(P0.05)。MHCC97-L与hMSC共培养后OPN、BSP、α-V表达均显著下降(P0.05)。(2)增殖能力检测结果:与对照组比较,实验组高低转移潜能肝癌细胞OD值明显增高(P0.05),实验组TGFβ1基因表达上调(P0.05),而PDCD4基因表达在两组间差异无统计学意义(P0.05),在MHCC97-L实验组PDCD4基因表达上调(P0.05)。结论 hMSC使高低转移潜能肝癌细胞的侵袭能力下调,增殖能力增强。     

Integrated self-monitoring of blood glucose system: handling step analysis

Self-monitoring of blood glucose (SMBG) implicates a number of handling steps with the meter and the lancing device. Numerous user errors can occur during SMBG, and each step adds to the complexity of use. This report compares the required steps to perform SMBG of one fully integrated (the second generation of the Accu-Chek® Mobile), three partly integrated (Accu-Chek Compact Plus, Ascensia® Breeze®2, and Accu-Chek Aviva), and six conventional (Bayer Contour®, Bayer Contour USB, BGStar™, FreeStyle Lite®, OneTouch® Ultra® 2, and OneTouch Verio™Pro) systems. The results show that the fully integrated system reduces the number of steps to perform SMBG. The mean decrease is approximately 70% compared with the other systems. We assume that a reduction of handling steps also reduces the risk of potential user errors and improves the user-friendliness of the system.     

瞬时受体电位香草酸亚型1对血压的调控和靶器官的保护作用

高血压是心血管疾病的重要危险因素之一,但目前导致高血压的具体机制尚未完全阐明。近年来越来越多的研究发现感觉神经对血压具有调控作用,而该作用需依赖表达于感觉神经的瞬时受体电位香草酸亚型1。现主要研究瞬时受体电位香草酸亚型1对血压的调控及其对靶器官的保护作用。     

Clinical features and management of haemophilic pseudotumours: a single US centre experience over a 30‐year period

Given the rarity of haemophilic pseudotumours, consensus on management is lacking. We describe the clinical features and management of haemophilic pseudotumours by retrospectively reviewing the medical records of haemophilia patients with a diagnosis of pseudotumour seen at our Hemophilia Center from 1981 to 2011. We recorded the following data: type and severity of haemophilia, documented aetiological antecedent, localization of the pseudotumour, presenting symptoms, management and outcome. We identified 12 pseudotumours in 11 patients over a 30‐year period. Six patients had known inhibitors or a history of inhibitor. An aetiological antecedent leading to the development of pseudotumour was reported in nine cases. Localization of the pseudotumour was confined to soft tissue (n = 3) and bone (n = 8). Six of the 12 pseudotumours (50%) were not diagnosed at the time of initial presentation, with a delay ranging from 6 weeks to 6 years. In eight cases, surgical intervention (surgical drainage, n = 2; excision, n = 4; limb amputation, n = 2) was the initial treatment choice, with complete resolution in six cases. Conservative management with close monitoring occurred in three cases, with one case subsequently requiring surgical resection. We conclude that haemophilic pseudotumours still occur sporadically, and the diagnosis is frequently delayed. Surgical intervention is generally a safe and effective treatment, although conservative management may be appropriate in selected cases.     

角膜共焦显微镜对于肌萎缩侧索硬化症小纤维神经病变的临床研究

目的通过角膜共焦显微镜(CCM)评价肌萎缩侧索硬化症患者小纤维病变情况及其诊断价值。方法肌萎缩侧索硬化症患者57例, 为2015年6月至2016年2月北京大学第三医院神经内科门诊和住院患者, 男性37例、女性20例, 年龄24～80(52±11)岁。健康对照组30名, 男性21名、女性9名, 年龄23～76(55±13)岁。采用CCM量化分析角膜神经纤维的角膜神经纤维长度(NFL), 神经分支密度(NBD), 神经纤维密度(NFD), 神经纤维弯曲度(NFT), 并同时进行接触性热痛诱发电位(CHEP), 皮肤交感反射(SSR)等检查。计量资料用xˉ±s或M(Q₁, Q₃)表示;计量资料符合正态分布者组间比较用t检验, 偏态分布计量资料可用秩和检验等非参数检验, 计数资料分析用χ2检验。多因素计量资料相关分析用简单相关分析。所有统计分析采用SPSS 12.0软件处理。结果肌萎缩侧索硬化症组角膜NFL、NFD均显著低于健康对照组[(12.2±4.4)mm/mm2比(15.1±4.5)mm/mm2, P=0.028;(50.8±24.0)个/mm...     

Efficacy and Safety of Ramucirumab in Patients with Unresectable Hepatocellular Carcinoma with Progression after Treatment with Lenvatinib

Objective A survival benefit was demonstrated for ramucirumab (RAM) in patients with unresectable hepatocellular carcinoma (uHCC) and α-fetoprotein (AFP) concentrations ≥400 ng/mL who had previously received sorafenib (SOR). However, it is unclear whether RAM has a similar efficacy in patients with uHCC that progresses after lenvatinib (LEN) treatment. This study aimed to evaluate the early anti-tumor response to RAM as a second-line treatment for advanced uHCC after LEN treatment. Methods We retrospectively assessed the efficacy and safety of RAM at 6 weeks after initiation. The therapeutic effects were evaluated according to the Response Evaluation Criteria in Solid Tumors version 1.1. Patients We evaluated 7 patients with uHCC who received RAM as a second- or third-line treatment after LEN failure. Results The disease control rate (DCR) was 28.6% (2 of 7 patients). After the initiation of RAM, a rapid disease progression resulted in 1 patient death after 19 days. The median progression-free survival (PFS) was 41 days. There were no grade 3 or 4 treatment-related adverse events. At 6 weeks, there was no deterioration in the modified albumin-bilirubin (mALBI) grade. In patients with an imaging response of stable disease (SD), the rate of AFP production decreased from the baseline. Conclusion RAM may have a therapeutic potential for the suppression of uHCC progression in patients previously treated with LEN, as well as for maintaining the liver function during treatment. Evaluating the AFP trends may therefore be useful for predicting RAM effectiveness.