早产儿早期神经运动干预研究进展

随着医疗救治水平的不断提高,早产儿的存活率明显增加,但早产常易伴发脑性瘫痪、运动和认知障碍等一系列神经发育问题,给家庭、社会带来沉重负担。生命早期大脑发育迅速,可塑性强,是进行早期运动干预的良好时机。本文就早产儿早期神经运动干预进行综述,旨在为临床医护人员对早产儿进行适宜有效的运动干预提供参考。     

Trends of self-reported non-adherence among type 2 diabetes medication users in the United States across three years using the self-reported Medication Adherence Reasons Scale

Background & aimsTo determine the trends of self-reported non-adherence rates among adults taking Type 2 medicines (T2D) medicines between 2017 and 2019 and to identify the patterns for the frequently reported reasons for non-adherence in the United States.Methods & resultsData from the National Health and Wellness Survey, a self-administered, internet-based cross-sectional survey of US adults from 2017 to 2019 was used. Non-adherence was measured using the self-reported Medication Adherence Reasons Scale (MAR-Scale). Frequencies were used to identify the reasons for non-adherence for insulin and non-insulin therapies for T2D.Data were obtained from 2983 respondents in 2017, 5416 in 2018, and 5268 in 2019. Based on the MAR-Scale, the self-reported medication non-adherence rate was 25% in 2017, 21% in 2018, and 27% in 2019. The most common reason for non-adherence across all the three years was simple forgetfulness, yet patients reported the lowest mean number of days missing medication for that reason. Though less frequently reported, non-adherence lasted longer when patient did not know how to take their medicines, cost was a reason, or had concerns about the long term effects of the medicines.ConclusionsWith no significant improvement in adherence with T2D medicines over time, regardless of better awareness and extensive diabetes education, focus should be on individualized non-adherence reasons-based interventions.     

Lactobacillus delbrueckii UFV-H2b20 increases IFN-γ production and CD39+CD73+ Treg cell numbers in lungs,and protects mice against experimental allergic asthma

Asthma is a disorder characterized by airflow obstruction, inflammation, declining airway function, bronchial hyperresponsiveness and tissue remodelling. Probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”. The use of probiotics is becoming increasingly studied and recent evidence has suggested that it may provide therapeutic benefits in asthma and other diseases. Lactobacillus delbrueckii UFV-H2b20 fulfils all the requirements to be classified as probiotic. Previous studies have already shown the ability of L. delbrueckii UFV-H2b20 to stimulate the immune system. Our objective was to evaluate the protective effects of L. delbrueckii UFV-H2b20 in experimental allergic asthma. We used a murine model of ovalbumin-induced allergic airway inflammation to mimic allergic asthma. Oral treatment with L. delbrueckii UFV-H2b20 improves respiratory parameters and inhibits the inflammatory response in the lungs by decreasing the numbers of inflammatory monocytes, eosinophils and alveolar macrophages, as well as IgE levels. Treatment increased the IFN-γ/IL-4 cytokine ratio. Levels of IL-10 in the lungs were also increased in treated animals. Our results also showed that the probiotic administration increases the number of CD39⁺CD73⁺ T regulatory lymphocytes in the lung, suggesting a role for purinergic signals in the regulation of inflammation promoted by the treatment. Understanding the mechanisms of modulation of the immune system by probiotics could allow the development of probiotic preparations that are safe and have a direct action. Our results suggest that oral administration of L. delbrueckii UFV-H2b20 could be helpful to treat chronic inflammatory airway diseases, such as asthma.     

Diagnosis of pituitary abscess and treatment via transsphenoidal surgery: experience from 15 cases

ObjectivePituitary abscess is an often misdiagnosed, rare clinical disorder. To improve diagnostic accuracy and the efficacy of surgical and antibiotic therapy for patients with pituitary abscess, herein, we retrospectively reviewed 15 patients who presented with pituitary abscesses from 2005 to 2022.DesignRetrospective study.PatientsFifteen patients underwent transsphenoidal surgery and received antibiotic treatment.MeasurementsComplete details regarding medical history, clinical manifestations, laboratory examinations, imaging studies, and treatment strategies were obtained for all patients.ResultsMost patients presented with hypopituitarism and headaches, while some presented with fever, visual disturbances, and diabetes insipidus (DI). Abscesses showed significant annular enhancement post gadolinium injection. In most patients, pituitary abscess can be cured via microscopic or endoscopic drainage of the abscess followed by antibiotic treatment. Complete cure of pituitary abscess was observed in nine patients, with six cases of prolonged hypopituitarism and only one case of recurrence. Long-term hormone replacement therapy was effective in the postoperative management of hypopituitarism.ConclusionsThe typical manifestations of pituitary abscess include hypopituitarism and headaches; the presence of an enhanced ring at the edge of the mass on contrast-enhanced magnetic resonance images (MRI) is highly suggestive of pituitary abscess. We recommend antibiotic treatment for 4–6 weeks postoperatively, based on the results of bacterial cultures or metagenomic next-generation sequencing (mNGS).     

Bone Metastases: From Mechanisms to Treatment

ObjectivesBone metastases are of high clinical relevance because they are a frequent complication of most types of common cancers, such as breast and prostate. The metastatic process is complex, requiring the completion of several different steps to allow successful dissemination and homing. In addition, preparation of the metastatic niche changes the constant cycle of bone matrix formation and degradation, leading to the clinical phenotypes of lytic and sclerotic lesions. We review our current knowledge on this topic and briefly explain the current treatment landscape of bone metastasis.Data SourcesThese include PubMed, international guidelines, and clinician experience.ConclusionBone metastases remain a clinical challenge that negatively impacts patients prognosis and quality of life. A comprehensive understanding of the complex molecular mechanisms that results in bone metastasis is the basis for successful treatment of affected patients. The disruption of bone matrix metabolism is already recognized as the prerequisite for metastasis formation, but many open questions remain that need to be addressed in future research to establish individually tailored treatment approaches.Implications for Nursing PracticePatient-centered therapy of bone metastases requires suitable pharmacological options, and importantly a holistic approach in care delivery across the multidisciplinary team. Nurses provide the cornerstone of the multidisciplinary team and provide the closest and the most frequent contact to the patient and their families to provide timely intervention. Nurses require a basic understanding of the complex physiology of metastasis to inform practice.     

产学研合作模式下长三角生物医药产业一体化协同创新发展研究——基于专利合作及基金项目合作

长三角一体化上升并发展为国家战略后，国内鲜有探讨长三角地区生物医药产业一体化协同发展的研究，长三角作为我国生物医药产业的重要地区，已初步形成产业集群的发展模式。本研究基于专利及基金项目合作的产学研模式，利用社会网络分析方法（SNA）对长三角地区生物医药产业中专利和国家自然科学基金重大项目合作进行分析研究。研究表明，长三角地区生物医药领域的产学研合作还处于发展阶段，一体化程度也有待提高；高校及科研院所更倾向于与企业合作开展发明专利，与高校合作开展基金项目研究。长三角地区三省一市间的生物医药产业发展也存在一定差距，建议长三角地区采取产学研深度融合模式，相关龙头科研机构建立开放式创新平台，医药类高校借助学科优势培养创新型人才，采取“揭榜挂帅”等方式进行关键核心技术攻关。     

洛克米兰醇对肝癌HepG2细胞的抗增殖作用及其机制研究

目的研究传统中药米仔兰Aglaiaodorata中洛克米兰醇对肝癌细胞HepG2增殖的影响及抗肿瘤作用机制。方法 MTT、细胞克隆形成、EdU染色和CFDA染色方法考察洛克米兰醇对HepG2细胞的抗增殖效果;流式细胞仪检测洛克米兰醇对HepG2细胞细胞周期和细胞凋亡的变化;Western blotting检测洛克米兰醇对细胞周期调控蛋白和丝裂原活化蛋白激酶(MAPK)信号通路相关蛋白表达的影响。结果洛克米兰醇可以时间和浓度依赖性抑制HepG2细胞增殖。同等浓度下洛克米兰醇抗HepG2细胞增殖的效果好于阿霉素,而对正常肝细胞(L02)的毒性弱于阿霉素。流式细胞技术检测发现洛克米兰醇给药48 h能够诱导HepG2细胞G_2/M期细胞周期阻滞,但不诱导细胞凋亡。Western blotting研究发现该化合物抑制调控G_2/M周期相关蛋白cdc25C、cdc2和cyclin B1的表达并且激活细胞外调节蛋白激酶(ERK)和c-Jun氨基末端激酶(JNK)。对其机制深入研究发现,ERK抑制剂(U0126)可以部分逆转洛克米兰醇对HepG2的抗增殖和G_2/M周期阻滞及其抑制蛋白cdc25C和cdc2表达的效果。结论洛克米兰醇在抑制肝癌细胞增殖的效果和对正常肝细胞的选择性方面优于阿霉素。洛克米兰醇能够通过过度活化ERK,从而引起HepG2细胞G_2/M周期阻滞而达到抗增殖效果。     

中外康复治疗学专业教育现状分析与启示

随着我国经济社会的发展和人口老龄化的趋势,康复技术人才的需求快速增长。与发达国家先进的康复教育水平相比,我国亟需借鉴成熟的康复治疗专业学科建设经验。通过介绍国内外康复治疗专业的学位模式、课程设置和执业资格,对比分析目前我国高校康复人才培养过程中存在的主要问题,为完善康复治疗学专业建设提供可行的建议。