益肾法对原发性高血压患者血管内皮细胞NO-NOS系统的影响

目的:探讨益肾中药对原发性高血压患者血管内皮细胞一氧化氮—氧化氮合成酶(NO-NOS)系统的影响。方法:观察30例原发性高血压患者采用益肾法治疗前后血清一氧化氮(NO)含量、一氧化氮合成酶(NOS)活力及NOS含量的变化。结果:益肾法治疗后,患者NO含量、NOS活力及NOS含量明显提高(P0.05)。结论:益肾法通过对NO-NOS系统的调控,从而降低高血压对血管内皮细胞(VEC)的损伤。     

Effect of carbohydrate counting using bolus calculators on glycemic control in type 1 diabetes patients during continuous subcutaneous insulin infusion

The present study examined the long‐term efficacy of insulin pump therapy for type 1 diabetes patients when carried out using carbohydrate counting with bolus calculators for 1 year. A total of 22 type 1 diabetes patients who had just started continuous subcutaneous insulin infusion were examined and divided into two groups: one that was educated about carbohydrate counting using bolus calculators (n = 14); and another that did not use bolus calculators (n = 8). After 1 year, the hemoglobin A1c levels of the patient group that used bolus calculators decreased persistently and significantly (P = 0.0297), whereas those of the other group did not. The bodyweight, total daily dose of insulin and bolus percentage of both groups did not change. Carbohydrate counting using bolus calculators is necessary to achieve optimal and persistent glycemic control in patients undergoing continuous subcutaneous insulin infusion.     

Dosimetric effects of bolus and lens shielding in treating ocular lymphomas with low-energy electrons

Radiation therapy is an effective treatment for primary orbital lymphomas. Lens shielding with electrons can reduce the risk of high-grade cataracts in patients undergoing treatment for superficial tumors. This work evaluates the dosimetric effects of a suspended eye shield, placement of bolus, and varying electron energies. Film (GafChromic EBT3) dosimetry and relative output factors were measured for 6, 8, and 10?MeV electron energies. A customized 5-cm diameter circle electron orbital cutout was constructed for a 6?×?6-cm applicator with a suspended lens shield (8-mm diameter Cerrobend cylinder, 2.2-cm length). Point doses were measured using a scanning electron diode in a solid water phantom at depths representative of the anterior and posterior lens. Depth dose profiles were compared for 0-mm, 3-mm, and 5-mm bolus thicknesses. At 5?mm (the approximate distance of the anterior lens from the surface of the cornea), the percent depth dose under the suspended lens shield was reduced to 15%, 15%, and 14% for electron energies 6, 8, and 10?MeV, respectively. Applying bolus reduced the benefit of lens shielding by increasing the estimated doses under the block to 27% for 3-mm and 44% for 5-mm bolus for a 6?MeV incident electron beam. This effect is minimized with 8?MeV electron beams where the corresponding values were 15.5% and 18% for 3-mm and 5-mm bolus. Introduction of a 7-mm hole in 5-mm bolus to stabilize eye motion during treatment altered lens doses by about 1%. Careful selection of electron energy and consideration of bolus effects are needed to account for electron scatter under a lens shield.     

Carbohydrate counting with an automated bolus calculator helps to improve glycaemic control in children with type 1 diabetes using multiple daily injection therapy: An 18-month observational study

Aims

This study aimed to investigate the effect of carbohydrate counting (carbC), with or without an automated bolus calculator (ABC), in children with type 1 diabetes treated with multiple daily insulin injections.

Methods

We evaluated 85 children, aged 9–16 years, with type 1 diabetes, divided into four groups: controls (n = 23), experienced carbC (n = 19), experienced carbC + ABC (n = 18) and non-experienced carbC + ABC (n = 25). Glycated haemoglobin (HbA1c), insulin use, and glycaemic variability – evaluated as high blood glucose index (HBGI) and low blood glucose index (LBGI) – were assessed at baseline and after 6 and 18 months.

Results

At baseline, age, disease duration, BMI, HbA1c, insulin use, and HBGI (but not LBGI; p = 0.020) were similar for all groups. After 6 months, HbA1c improved from baseline, although not significantly – patients using ABC (according to manufacturer's recommendations) HbA1c 7.14 ± 0.41% at 6 months vs. 7.35 ± 0.53% at baseline, (p = 0.136) or without carbC experience HbA1c 7.61 ± 0.62% vs. 7.95 ± 0.99% (p = 0.063). Patients using ABC had a better HBGI (p = 0.001) and a slightly worse LBGI (p = 0.010) than those not using ABC. ABC settings were then personalised. At 18 months, further improvements in HbA1c were seen in children using the ABC, especially in the non-experienced carbC group (−0.42% from baseline; p = 0.018).

Conclusions

CarbC helped to improve glycaemic control in children with type 1 diabetes using multiple daily injections. ABC use led to greater improvements in HbA1c, HBGI and LBGI compared with patients using only carbC, regardless of experience with carbC.     

Mixotrophic basis of Atlantic oligotrophic ecosystems

Oligotrophic subtropical gyres are the largest oceanic ecosystems, covering >40% of the Earth's surface. Unicellular cyanobacteria and the smallest algae (plastidic protists) dominate CO(2) fixation in these ecosystems, competing for dissolved inorganic nutrients. Here we present direct evidence from the surface mixed layer of the subtropical gyres and adjacent equatorial and temperate regions of the Atlantic Ocean, collected on three Atlantic Meridional Transect cruises on consecutive years, that bacterioplankton are fed on by plastidic and aplastidic protists at comparable rates. Rates of bacterivory were similar in the light and dark. Furthermore, because of their higher abundance, it is the plastidic protists, rather than the aplastidic forms, that control bacterivory in these waters. These findings change our basic understanding of food web function in the open ocean, because plastidic protists should now be considered as the main bacterivores as well as the main CO(2) fixers in the oligotrophic gyres.     

Influence of Bolus Consistency on Lingual Behaviors in Sequential Swallowing

Thickened liquids are a commonly recommended intervention for dysphagia. Previous research has documented differences in temporal aspects of bolus transit for paste versus liquid consistencies; however, the influence of liquid viscosity on tongue movements during swallowing remains unstudied. We report an analysis of the influence of bolus consistency on lingual kinematics during swallowing. Electromagnetic midsagittal articulography was used to trace tongue body and dorsum movement during sequential swallows of three bolus consistencies: thin, nectar-thick, and honey-thick liquids. Rheological profiling was conducted to characterize viscosity and density differences among six liquids (two of each consistency). Eight healthy volunteers participated; four were in a younger age cohort (under age 30) and four were over the age of 50. The primary difference observed across the liquids of interest was a previously unreported phenomenon of sip-mass modulation; both flavor and density appeared to influence sip-sizing behaviors. Additionally, significantly greater variability in lingual movement patterns was observed in the older subject group. Systematic variations in lingual kinematics related to bolus consistency were restricted to the variability of downward tongue dorsum movement. Otherwise, the present analysis failed to find empirical evidence of significant modulations in tongue behaviors across the thin to honey-thick consistency range.     

Bolus position at swallow onset in normal adults: Preliminary observations

A “delayed swallowing reflex/response” (i.e., when the swallow reflex is not triggered when the bolus passes the back of the tongue at the anterior faucial arch) Logemann [8] has been widely accepted as an abnormality. Careful review of the literature supports the premise that a “delayed swallowing reflex/response” may in fact be a variation of normal. This paper describes swallowing in normal adults. We report the videofluoroscopic measurements of bolus position at the onset of swallow. A radiopaque marker was affixed to the anterior faucial arch and the distance between the head of the bolus and the anterior faucial arch was measured at the onset of swallow. A statistically significant proportion of swallows (22 of 30) occurred after the head of the bolus passed the anterior faucial arch. This finding suggests that there may be diverse sites for elicitation of the swallowing response/reflex rather than a single site (i.e., the anterior faucial arch). The relevance of this finding to treatment using thermal stimulation is discussed, as is the versatility of the normal pharynx.     

A new application for electropalatography: Swallowing

Electropalatography (EPG) has been applied to linguistic research and speech pathology. This study evaluated whether EPG could provide useful information on swallow-related tongue action. Specifically, the investigation focused on the quantification of tongue-palate contact patterns for swallowing and on the effects of bolus volume and consistency. Five normal subjects were tested during swallows of 5 and 30 ml of water, 5 and 30 ml of gelatin, and saliva. By segmenting the EPG time-motion sequences into four stages (prepropulsion, propulsion, full contact, withdrawal) and compartmentalizing the palate into six bins (front, central, back, lateral, medial, midline), temporal and spatial characteristics of deglutitive tongue-palate contact were revealed. Significant differences (p<0.01) were found in contact timing across bolus sizes and consistencies for the propulsion and full contact stages. Water was propelled faster than gelatin, and 30-ml gelatin faster than 5-ml gelatin. Dry swallows had a longer full contact stage than water. Contact patterns, though not statistically analyzed at this time, appeared to vary little as a function of bolus properties. Our findings suggest potential value in using EPG to investigate the timing and patterning of abnormal tongue movements associated with disordered swallowing.     

肾气丸不同剂量配比对庆大霉素肾损伤大鼠肾功能及电解质影响的研究

目的观察肾气丸不同剂量配比对肾功能损伤大鼠的影响,探索肾气丸治疗肾功能损伤的药物合理配比剂量。方法用正交试验设计方法,选择正交表为L8（27）,将肾气丸方中8种药物分为4个因素,并根据不同剂量组成8个配方。给大鼠腹腔注射庆大霉素制造肾损伤模型,观察肾气丸不同剂量配比对肾功能损伤大鼠的影响。结果肾气丸各因素水平间对尿素氮的影响均无差异（P〉0.05）;在降低肾功能损伤大鼠24h尿蛋白含量方面,干地黄4两、山萸肉4两的配伍比例优于干地黄8两、山萸肉4两的配比;在降低肾功能损伤大鼠血清肌酐（Cr）的含量方面,泽泻3两、牡丹皮2两较优于泽泻3两、牡丹皮3两的剂量配比。在降低大鼠血清钾离子浓度方面,肾气丸方中干地黄8两的用量比例优于干地黄4两的用量比例;在升高肾功能损伤大鼠血清钙离子方面,干地黄4两、山萸肉4两的配比剂量优于干地黄8两、山萸肉4两的配比;肉桂1两、附子1两的配比优于肉桂2两、附子2两的配比。结论肉桂、附子用量以原方比例为佳,干地黄、牡丹皮的用量比例较原方所用比例减少为宜;提示临床肾功能损伤时,用药以小剂量为佳,否则将加重肾脏负担,不利于疾病的治疗。