Estimated Reductions in Added Sugar Intake among US Children and Youth in Response to Sugar Reduction Targets

BackgroundIn 2021, the National Salt and Sugar Reduction Initiative (NSSRI) released voluntary sugar reduction targets for packaged foods and drinks in the United States.ObjectiveThe objectives of this study were to describe trends in added sugar intake from NSSRI foods and beverages among children and youth and estimate possible reductions if industry were to meet the targets.DesignThis study consisted of cross-sectional and trend analyses of demographic and 24-hour dietary recall data from eight survey cycles (2003-2004 to 2017-2018) of the National Health and Nutrition Examination Survey.Participants/settingThe study sample included 23,248 children and youth (aged 2 to 19 years).Main outcome measuresThe main outcome measure was the percent of daily calories from added sugar for foods and beverages in NSSRI categories.Statistical analyses performedFoods and beverages reported by participants were mapped to one of the NSSRI’s categories or coded as a non-NSSRI item. Trends over time in added sugar intake were assessed using regression models. To assess possible reductions in added sugar intake if industry were to meet the targets, sales-weighted mean percent reductions for 2023 and 2026 targets were applied to NSSRI items in the 2017-2018 National Health and Nutrition Examination Suvey data. Results were examined overall and by demographic characteristics.ResultsFrom 2003-2004 to 2017-2018, added sugar intake from NSSRI foods and beverages declined, but consumption remained high. During 2017-2018, NSSRI categories accounted for 70% of US child and youth added sugar intake. If industry met the NSSRI targets, US children and youth would consume 7% (2023 targets) to 21% (2026 targets) less added sugar.ConclusionsAlthough added sugar intake from NSSRI foods and drinks has declined over the past decade, added sugar intake from all sources remains high and consumption of added sugar from certain NSSRI categories has remained steady over time. If met, the NSSRI targets are expected to result in meaningful reductions in added sugar intake for US children and youth.     

缩短禁食禁饮时间对妊娠期糖尿病剖宫产产妇分娩结局的影响

目的探讨缩短禁食禁饮时间对妊娠期糖尿病产妇剖宫产结局的影响。方法按时间段将100例妊娠期糖尿病剖宫产产妇分为两组各50例。对照组术前禁食8 h,禁饮6 h;观察组术前禁食6 h,禁饮2 h。结果观察组术前空腹血糖水平与对照组比较,差异有统计学意义(P 0. 01);观察组产妇术中出血量、肛门排气时间少于和短于对照组(P 0. 05,P 0. 01);观察组新生儿出生后血糖值高于对照组、低血糖发生率低于对照组(均P 0. 05);观察组术前口渴、饥饿、焦虑程度显著轻于对照组(P 0. 05,P 0. 01)。结论术前禁食6 h、禁饮2 h应用于妊娠期糖尿病剖宫产产妇可稳定其血糖水平,降低产妇术前低血糖及新生儿低血糖发生率,提高产妇舒适度,促进术后身体恢复。     

Toll-like receptor 2 expression on monocytes and microvascular complications in type 2 diabetic patients

Diabetes mellitus (DM) is a chronic debilitating illness, and atherosclerotic changes are inevitable and usually neglected during the follow-up of diabetic patients. Toll-like receptor 2 (TLR2) is under trial in many studies to hold responsibility for atherosclerosis process progression as they suggest a malfunction of these receptors expressed on monocytes in diabetic patients. This study aimed to assess the association between the TLR2 and type 2 diabetes mellitus (T2DM) in Egyptian diabetic patients and to investigate its relationship with some diabetic complications.MethodsThis study included a 60 diabetic patients group 1 (diabetic complicated), group 2 (diabetic non-complicated) and 30 age-matched normal healthy blood donors.ResultsToll-like receptors (TLRs) expression was significantly associated with T2DM. In this study, the mean fluorescent intensity (MFI) of TLR2 was 596.9 ± 84.78 in group 1, 326.23 ± 62.98 in group 2 while in group 3 it was 208.47 ± 156.73. There was a significant correlation between MFI of TLR2 and random blood sugar (RBS) and glycated haemoglobin (HbA1c) (p < 0.05).ConclusionTLR2 was overexpressed in diabetic patients with microvascular complications compared to diabetic non-complicated patients and normal healthy controls.     

参芪降糖颗粒联合二甲双胍对2型糖尿病患者降糖效果的分析

目的：探析2型糖尿病患者采取参芪降糖颗粒联合二甲双胍进行治疗的降糖效果。方法：选取2016年1月至2019年10月马鞍山市中心医院收治的2型糖尿病患者66例作为研究对象，按照随机数字表法分为对照组与观察组，每组33例，对照组通过二甲双胍进行治疗，观察组通过二甲双胍联合参芪降糖颗粒进行治疗，比较2组患者治疗总有效率、血糖参数、不良反应发生率等指标。结果：对照组、观察组的治疗总有效分别为75.76%、93.94%，与对照组比较，观察组的治疗总有效率明显较高（P<0.05）；观察组的空腹血糖、餐后2 h血糖等血糖参数在治疗后明显低于对照组患者（P<0.05）；对照组、观察组的治疗不良反应发生率分别为21.21%、3.03%，观察组治疗不良反应发生率明显低于对照组（P<0.05）。结论：2型糖尿病患者采取参芪降糖颗粒联合二甲双胍进行治疗能够获得较为理想的效果，可明显改善血糖指标，安全性较高，对改善患者的治疗预后有着促进的作用。     

尼莫地平与腰大池引流术联合应用对颅内动脉瘤夹闭术后患者脑氧饱 和度及并发症的影响

目的:探究尼莫地平与腰大池引流术（lumbar cisterna drainage，LD）联合应用对颅内动脉瘤夹闭术患者脑氧饱和度、血清基质金属蛋白酶-9（MMP-9）、可溶性细胞间黏附分子-1（sICAM-1）、可溶性血管细胞黏附分子-1（sVCAM-1）水平的影响。方法:将于我院行颅内动脉瘤夹闭术治疗的60例颅内动脉瘤（cerebral aneurysm，CA）患者随机分为观察组与对照组，各30例。两组均微量泵输注30 mg/d尼莫地平，对照组行腰椎穿刺，观察组行LD，比较两组大脑中动脉血流速度（VMCA）、脑脊液压力及脑脊液中红细胞计数（RBC），记录不同时间节点脑氧供需指标及脑氧饱和度（rSO2），比较MMP-9、sICAM-1、sVCAM-1水平、CVS及颅内感染发生率、美国国立卫生院神经功能缺损评分（NIHSS评分）。结果:术后1周至术后2周，两组VMCA水平呈先升高再降低趋势，而脑脊液压力及RBC水平持续降低，且观察组显著低于对照组（P<0.05）；T1至T4阶段，两组SjvO2、CjvO2、CaO2呈先升高后降低再升高趋势，且T2、T3时间点观察组显著高于对照组（P<0.05）；T1至T4阶段，两组Ca-jvO2、CERO2呈先降低后升高再降低趋势，且T2、T3时间点观察组显著低于对照组（P<0.05）；T2至T4阶段，两组rSO2呈先升高再降低趋势，且T2、T3时间点观察组显著高于对照组（P<0.05）；术后1周及术后2周，观察组MMP-9及sICAM-1、sVCAM-1水平及CVS发生率、NIHSS评分显著低于对照组（P<0.05），但颅内感染组间差异无统计学意义（P>0.05）。结论:CA患者颅内动脉瘤夹闭术后给予尼莫地平联合LD，于改善患者脑氧供需平衡及脑氧饱和度、降低CVS风险、减轻脑损伤及颅内炎症有重要价值。     

An update on polymer-lipid hybrid systems for improving oral drug delivery

Introduction: A promising approach that has recently emerged to overcome the complex biobarriers and interrelated challenges associated with oral drug absorption is to combine the benefits of polymeric and lipid-based nanocarriers within one hybrid system. This multifaceted formulation strategy has given rise to a plethora of polymer-lipid hybrid (PLH) systems with varying nanostructures and biological activities, all of which have demonstrated the ability to improve the biopharmaceutical performance of a wide range of challenging therapeutics.

Areas covered: The multitude of polymers that can be combined with lipids to exert a synergistic effect for oral drug delivery have been identified, reviewed and critically evaluated. Specific focus is attributed to preclinical studies performed within the past 5 years that have elucidated the role and mechanism of the polymer phase in altering the oral absorption of encapsulated therapeutics.

Expert opinion: The potential of PLH systems has been clearly identified; however, improved understanding of the structure–activity relationship between PLH systems and oral absorption is fundamental for translating this promising delivery approach into a clinically relevant formulation. Advancing research within this field to identify optimal polymer, lipid combinations and engineering conditions for specific therapeutics are therefore encouraged.     

中药配方精油——一种中药入药新形式的思考

饮片是中医临床用药的主体,随着中医用药现代化,中药配方颗粒逐步发展并初具规模。虽有中药注射剂、口服液等的加工形式,但只占中药市场的少部分,并以内服为主。而脂溶性成分口服时,溶出受限,吸收相对较少,且具有刺激胃肠道的副作用,造成患者耐受性低。虽有水提、醇提等加工制成的外用制剂,但多为粗制剂,且剂量随意,在一定程度上造成了脂溶性成分的浪费。而中药的脂溶性成分大多具有较好的生物活性,如五味子乙素、丹参酮、绿原酸甲酯等,但却没有合适的药用形式。若想"药"尽其用,就必须对中药的脂溶性成分进行系统研究,在提取、分离和收集工艺均相当成熟的基础上,研发以脂溶性成分为主的,药理药效确切的,又利于其吸收的药用形式。中药精油具有抗衰老、抗痴呆、抗氧化等多种活性,已广泛应用于临床、药妆、保健品等领域。但单方精油作用有限,配伍既可增强药效、降低毒性,也可扩大精油应用范围。因此,可将中药配方精油作为中药入药新形式,并以外用为主、内服为辅,以弥补中药外用多为粗制剂、剂量随意的不足和内服吸收少、刺激胃肠道的劣势,满足临床用药需求,更快、更准、更好、更强地发挥脂溶性成分的药效。     

玉液汤对2型糖尿病肥胖患者肠道菌群及脂质代谢的影响

目的：探讨玉液汤对2型糖尿病肥胖患者肠道菌群及脂质代谢影响。方法：选取2017年2月至2019年2月广州市中医医院收治的2型糖尿病肥胖患者106例作为研究对象，按照就诊顺序分为对照组和观察组，每组53例。2组均给予基础治疗+药物治疗，观察组再加用玉液汤治疗。观察2组治疗前、完成治疗后肠道菌群、脂质代谢、中医症状积分、血糖相关指标、体质量、腰围、体质量指数(BMI)变化并比较。结果：2组治疗前各指标比较差异无统计学意义（P>0.05），完成治疗后观察组患者的中医症状积分、FINS、HOMA-IR、HbAlc、BMI、腰围、体质量、TC、TG、LDL-C、肠杆菌、酵母菌、肠球菌、畏寒肢冷、腰膝酸软、脘腹2组患者治疗后HDL-C、双岐杆菌、乳杆菌、拟杆菌均较治疗后明显上升，且观察组高于对照组（P<0.05）。结论：玉液汤能改善2型糖尿病肥胖患者脂质代谢和临床症状，降低血糖，能调节肠道菌群紊乱，从而提高疗效。     

CTCL患者外周血淋巴细胞亚群、血清sIL-2R及炎性因子的水平变化特点及意义

目的:探讨皮肤T细胞淋巴瘤（CTCL）患者外周血淋巴细胞亚群及血清可溶性白细胞介素2受体（sIL-2R）、炎性因子的水平变化特点及意义。方法:选取2013年1月至2018年1月在我院治疗的CTCL患者35例（CTCL组），同时选取炎症性皮肤病患者35例作为对照组，检测两组血清sIL-2R、B淋巴细胞、T淋巴细胞和NK细胞水平以及白细胞介素-6（IL-6）、肿瘤坏死因子 （TNF-α）和C反应蛋白（CRP）。结果:CTCL组血清sIL-2R为（770.15±87.44）U/ml，明显高于对照组（P＜0.05），而B淋巴细胞为6.10（0.15～10.57）%，明显低于对照组（P＜0.05）；CTCL组和对照组T淋巴细胞和NK细胞比较差异无统计学意义（P＞0.05）；CTCL组血清IL-6、TNF-α和CRP分别为110.02(67.39,230.03)pg/ml、（31.29±7.28）pg/ml和（36.60±6.10）mg/L，明显高于对照组（P＜0.05）；皮损改善患者治疗后sIL-2R为（230.04±78.11）U/ml，明显低于皮损未改善患者（P＜0.05）。结论:CTCL患者血清sIL-2R、IL-6、TNF-α和CRP升高，而B淋巴细胞水平降低，其中sIL-2R与治疗效果有一定关系，值得进一步研究。