Risk factors and a simple scoring system for predicting bowel resection in infants with NEC

Background and aimsWe intended to investigate the predictors for bowel resection in infants with necrotizing enterocolitis (NEC). We further developed a scoring system for better predicting bowel resection.MethodsA total of 207 infants who underwent surgical management at Children's Hospital, Chongqing Medical University between April 2008 and December 2020 were identified for the following investigation. Bowel resection was reviewed among the infants who underwent the procedure. Potential parameters related to bowel resection were explored using a multiple logistic regression method, and then a scoring system was developed.ResultsAmong the 207 patients who underwent operative intervention that were reviewed, 109 infants underwent bowel resection. Multivariate logistic regression analysis showed that birth weight, hypotension, neutropenia, pneumoperitoneum, acidosis, and intestinal wall thickness were predictors related to the occurrence of bowel resection. A 6-point scoring system was further developed based on the obtained total coefficient, and the infants could be divided into low-, moderate- and high-risk groups according to cut values of 7 and 13.ConclusionThe results of this study demonstrated that severe NEC features and low birth weight were associated with bowel resection. The risk scoring system could accurately separate infants that were suspected to have bowel loss during surgery.     

An Adrenal Incidentaloma Diagnosed as Dopamine-Secreting Pheochromocytoma: A Case Report

BackgroundDopamine-secreting pheochromocytomas are exceedingly rare.Case presentationA 28-year-old woman, who was admitted due to 4 hours of acute-onset abdominal pain, detected an adrenal mass incidentally. She was almost asymptomatic without a known family history. Laboratory assessments showed significant increases in dopamine levels of serum and 24-h urinary. By using preoperative a-adrenergic receptor blockers, she developed orthostatic hypotension and palpitations. When she underwent laparoscopic left adrenalectomy, she experienced rapid cyclic fluctuations in systolic blood pressure from 90 mmHg to 200 mmHg. Postoperatively, she exhibited prolonged hypotension, requiring vasopressor therapy and fluid replacement. According to histopathological diagnosis, it was a pheochromocytoma. Dopamine levels in 24-h urine and serum decreased to normal after operation. Analysis of specific gene SDHB, SDHD, RET, VHL and NF1 detected no pathogenic mutations.ConclusionPatients with dopamine-secreting pheochromocytomas are mostly asymptomatic, leading to a significant delay in diagnosis. There is a large possibility for dopamine-secreting pheochromocytomas to show a malignant tendency than the adrenergic and noradrenergic phenotypes. The a-adrenergic receptor blocker is not indicated for preoperative medical treatment because it can cause hypotension and cardiovascular failure. Calcium channel blockers or metyrosine may be better alternatives. All patients with pheochromocytomas should receive targeted genetic testing based on specific clinical features. SDHB, SDHD, RET, VHL and NF1 mutations are suggested for genetic testing of adrenal dopamine-secreting pheochromocytomas.     

The influence of exercise training versus intensive insulin therapy on insulin resistance development in type 1 diabetes

The etiology of insulin resistance (IR) in Type 1 Diabetes (T1D) is unclear; however, intramyocellular lipids (IMCL) are likely contributors. While exercise lessens IR and IMCL content; T1D patients elevate glycemia to offset exercise-induced hypoglycemic risk. The preferred treatment for T1D patients is tight glucose management through intensive insulin therapy (IIT); however, IIT is accompanied with a sedentary lifestyle. The purpose of this study was to examine IR development and IMCL in combined exercise (DARE; aerobic/resistance) and IIT-treated T1D animals. 76 rats were divided into control sedentary (C), diabetic sedentary (CD), diabetes sedentary intensive insulin therapy (DIT) and DARE groups. Following streptozotocin (STZ), glycemia was maintained at either 9-15 mM (CD, DARE) or 5-9 mM (DIT) using insulin. DARE alternated between running and weighted climbing for 12 weeks. Results demonstrate that DARE exhibited reduced onset of IR compared with C, DIT and CD, indicated by increased glucose infusion rate (hyperinsulinemic-euglycemic-clamp). A shift in lipid metabolism was evident whereby diacylglycerol was elevated in DIT compared to DARE, while triacylglycerol was elevated in DARE. These findings indicate enhanced IMCL metabolism and the sequestration of fat as neutral triacylglycerol leads to reduced IR in DARE. In contrast, IIT and sedentary behavior leads to diacylglycerol accumulation and IR.     

头孢曲松联合匹多莫德对血清固定梅毒病人的效果

目的观察研究头孢曲松联合匹多莫德对血清固定的梅毒病人的治疗效果。方法 59例血清固定的梅毒病人随机分为实验组31例和对照组28例,实验组给予头孢曲松2.0 g静脉滴注,每日1次,连用15 d,同时口服匹多莫德口服液800 mg,每日1次,连用15 d。对照组单用头孢曲松2.0 g静脉滴注,每日1次,连用15 d。治疗后3、6个月复查快速血浆反应素环状卡片试验滴度并判断疗效。结果治疗后3个月两组疗效比较差异无显著性(P>0.05)。治疗后6个月,两组疗效比较差异有显著性(u=2.02,P<0.05)。结论头孢曲松联合匹多莫德治疗血清固定的梅毒病人具有良好的效果。     

Repression of miR-142–3p alleviates psoriasis-like inflammation by repressing proliferation and promoting apoptosis of keratinocytes via targeting Sema3A

Psoriasis is a multifactorial, recurring, and chronic inflammatory skin disease characterized by hyperproliferation of keratinocytes. Evidence is rapidly accumulating for the role of microRNAs in psoriasis. The object of the study was to explore the functions and precise mechanism of miR-142–3p in human keratinocyte HaCaT cells in the presence of M5. Here, the results showed that miR-142–3p expression was heightened in HaCaT cells induced by M5. In addition, inhibition of miR-142–3p dramatically restricted cell proliferation and enhanced apoptosis in HaCaT cells exposed to M5, as exemplified by a decrease in the antiapoptotic Bcl-2 protein, concomitant with an increase in the proapoptotic proteins Bax. Moreover, depleting miR-142–3p effectively ameliorated M5-induced inflammation response, as reflected by the attenuation of multiple inflammatory factors. Importantly, Sema3A was identified as an authentic target of miR-142–3p, and indeed regulated by miR-142–3p. Mechanistically, silencing of Sema3A effectively abolished the anti-proliferative, apoptosis-promoting, and anti-inflammatory effects of miR-142–3p inhibition in keratinocytes. Taken together, these data elucidated that repression of miR-142–3p protect HaCaT cells against M5-induced hyper-proliferation and inflammatory injury by suppressing its target Sema3A, implying that the miR-142–3p/Sema3A axis may be a new target for preventing keratinocyte injury process. These findings provide a new and better understanding of the mediating role of miR-142–3p in psoriasis.     

MicroRNAs在银屑病发病机制中的研究进展

近年来在MicroRNAs（miRNAs）与银屑病的相关研究中发现，其在银屑病的发病机制中扮演了重要角色，包括调控T细胞、细胞因子、固有免疫及调节角质形成细胞增殖分化、皮肤屏障等方面。miRNAs在血清和组织中均可以稳定存在，未来可能成为银屑病诊断、评价疾病严重程度、监测治疗后反应及预后的新的标志物。本文对miRNAs在银屑病发病机制中的研究进展进行了综述。     

固定伴侣是男同性爱者/男男性行为者的女性与公共卫生

本文介绍了固定伴侣是男同性爱者/男男性行为者(男同/MSM)的异性爱女性伴侣普遍面临的挑战。西方国家当代的一般女性很少与男同/MSM结合成固定伴侣,但这一情况在很多中低收入国家常见。在中国,大量男同/MSM与一般女性结合成固定伴侣,他们同时存在男男性行为。中国的许多研究提示,MSM的固定女性伴同样生活在易感染艾滋病及性病的高危环境中,而一般女性的固定伴侣是男同时,会普遍面对特殊的心理困境。由于社会传统文化等原因,该女性群体的生存环境相当脆弱,并希望获得医界帮助。医界需要从女性学和社会性别平等的高度认识相关问题,积极参与解决相关问题的社会进程。     

Livin和Smac在鲍恩病及皮肤鳞状细胞癌中的表达

目的：确定Livin和Smac在鲍恩病（BD）及皮肤鳞状细胞癌（SCC）中的表达和意义.方法：应用免疫组化SP法检测35例BD和32例SCC中Livin和Smac的表达,分析二者表达的相关性.结果：Livin表达：BD组高于BD癌旁组织（P〈0.001）;BD癌旁组织高于正常对照组（P〈0.05）.SCC组高于SCC癌旁组织（P〈0.001）;SCC癌旁组织高于正常对照组（P〈0.05）.SCC组高于BD组（P〈0.05）.Smac表达：BD组低于BD癌旁组织（P〈0.01）;BD癌旁组织低于正常对照组（P〈0.05）;SCC组低于SCC癌旁组织（P〈0.001）;SCC癌旁组织低于正常对照组（P〈0.05）;SCC组低于BD组（P〈0.05）.Livin和Smac在BD中表达无相关性（P〉0.05）,在SCC中表达呈负相关（P〈0.05）.结论：Livin的过表达和Smac的低表达可能在BD和SCC的发生、发展中起一定作用.