Primary localized gastric amyloidosis: A scoping review of the literature from clinical presentations to prognosis

Localized gastric amyloidosis (LGA) is a rare disease characterized by abnormal extracellular deposition of amyloid protein restricted to the stomach and it is confirmed by positive results of Congo red staining. Over decades, only a few cases have been reported and studies or research focusing on it are few. Although LGA has a low incidence, patients may suffer a lot from it and require proper diagnosis and management. However, the pathology of LGA remains unknown and no overall review of LGA from its presentations to its prognosis has been published. Patients with LGA are often asymptomatic or manifest atypical symptoms, making it difficult to differentiate from other gastrointestinal diseases. Here, we report the case of a 70-year-old woman with LGA and provide an overview of case reports of LGA available to us. Based on that, we conclude current concepts of clinical manifestations, diagnosis, treatment, and prognosis of LGA, aiming at providing a detailed diagnostic procedure for clinicians and promoting the guidelines of LGA. In addition, a few advanced technologies applied in amyloidosis are also discussed in this review, aiming at providing clinicians with a reference of diagnostic process. With this review, we hope to raise awareness of LGA among the public and clinicians.     

H型高血压患者血压变异性与冠脉病变程度的关系

目的探讨H型高血压患者血压变异性与冠脉病变程度的关系。方法选择锦州市中心医院2017年1月-2018年12月收治的H型高血压患者349例,分为对照组(单纯H型高血压)186例和观察组(H型高血压+冠心病)163例。比较两组患者的日间收缩压(dSBP)、夜间收缩压(nSBP)及SCV;比较两组患者的日间舒张压(dSBP)、夜间舒张压(nSBP)及DCV,并对血压变异性与冠脉病变程度的关系进行探讨。结果两组dSBP.nSBP.SCV和dDBP.nDBP.DCV差异均有统计学意义(P<0.05).Gensini评分=2.231+3.414×SCV+2.917×SCV。结论H型高血压患者血压变异性与患者冠脉病变程度密切相关,SCV和DCV是其独立危险因素。     

Plantar Pressure Changes and Correlating Risk Factors in Chinese Patients with Type 2 Diabetes: Preliminary 2-year Results of a Prospective Study

Background:

Plantar pressure serves as a key factor for predicting ulceration in the feet of diabetes patients. We designed this study to analyze plantar pressure changes and correlating risk factors in Chinese patients with type 2 diabetes.

Methods:

We recruited 65 patients with type 2 diabetes. They were invited to participate in the second wave 2 years later. The patients completed identical examinations at the baseline point and 2 years later. We obtained maximum force, maximum pressure, impulse, pressure-time integral, and loading rate values from 10 foot regions. We collected data on six history-based variables, six anthropometric variables, and four metabolic variables of the patients.

Results:

Over the course of the study, significant plantar pressure increases in some forefoot portions were identified (P < 0.05), especially in the second to forth metatarsal heads. Decreases in heel impulse and pressure-time integral levels were also found (P < 0.05). Plantar pressure parameters increased with body mass index (BMI) levels. Hemoglobin A1c (HbA1c) changes were positively correlated with maximum force (β = 0.364, P = 0.001) and maximum pressure (β = 0.366, P = 0.002) changes in the first metatarsal head. Cholesterol changes were positively correlated with impulse changes in the lateral portion of the heel (β = 0.179, P = 0.072) and pressure-time integral changes in the second metatarsal head (β = 0.236, P = 0.020). Ankle-brachial index (ABI) changes were positively correlated with maximum force changes in the first metatarsal head (β = 0.137, P = 0.048). Neuropathy symptom score (NSS) and common peroneal nerve sensory nerve conduction velocity (SCV) changes were positively correlated with some plantar pressure changes. In addition, plantar pressure changes had a correlation with the appearance of infections, blisters (β = 0.244, P = 0.014), and calluses over the course of the study.

Conclusions:

We should pay attention to the BMI, HbA1c, cholesterol, ABI, SCV, and NSS changes in the process of preventing high plantar pressure and ulceration. Some associated precautions may be taken with the appearance of infections, blisters, and calluses.     

肿瘤发生发展过程中相关微环境的动态改变研究进展

在肿瘤干细胞(TSC)的自我更新及分化过程中,肿瘤微环境(TME)发挥着重要作用。在癌变过程中,微环境顺应肿瘤的发展而变化,促使肿瘤细胞获得更多的侵袭性。对肿瘤发展过程中微环境改变的深入研究,将有可能为肿瘤治疗带来新的思路和方法。     

Changes in Locus-of-Control Attitudes about Drug Misuse in a Self-Help Group in a Methadone Maintenance Clinic

Clients of a methadone-maintenance clinic in Brooklyn, New York participating in a clinically-guided self-help (CGSH) program plus standard treatment (methadone maintenance plus individual counseling) demonstrated statistically significant changes in locus-of-control beliefs, from external to internal causation, about personal responsibility for drug misuse. Members of two control groups—one participating in a didactic lecture program plus standard treatment and the other receiving only standard treatment—failed to demonstrate similar changes. This increase in internal locus of control in the CGSH group suggests the potential efficacy of CGSH as a relapse-prevention therapeutic technique.     

从《周易》坤卦浅论脾脏功能

从"脾"之造字,可得人体之"脾"与自然界之"土"关系密切。将中医脾脏的功能(承载、化生、运达、收纳)与《周易》坤土之卦的功能(厚德载物、万物滋生、行地无疆、辟户阖户)相比较,两者皆可一一对应,以此作为佐证,可以看出中医确实是植根于中国传统文化。同时中医确为"天人合一"之医学,其大而无外,天地万物皆在其中,小而无内,一人之身无有其外,皆可取类比象。中医之整体观,包罗万象,宇宙自然皆在其中,并非割裂人体而谈某脏器功能。脾脏"厚德载物""万物滋生""行地无疆""辟户阖户"这四大功能突出"脾脏"与"土地"的对应关系,此四种功能在人体内"如环无端,不分主次",不可割裂。将中医所讲人体脏器的功能,与自然界中所对应事物的功能取类比象,将抽象的脏腑功能具体化,方便理解记忆的同时,更能使中医的核心理论得到体现。     

Changes in United Kingdom oral and maxillofacial surgical specialty trainees since 1995 – numbers,gender, first degrees,and nations of origin

Training in UK surgery has changed dramatically since 1995, from a relative lack of structure to time-limited and highly documented programmes. Training in oral and maxillofacial surgery (OMFS) has shared these changes and included some significant changes of its own. Minutes from the OMFS Specialty Advisory Committee (SAC) were reviewed over the last 25 years to record the number and location of newly approved posts. The General Medicine Council’s (GMC) OMFS specialist list in 2019 was combined with the records of OMFS specialists’ dental qualifications held by the General Dental Council (GDC) and augmented from a database of OMFS trainees and consultants in the UK. Data on demographics, location, and nature of the first medical or dental degree were noted for analysis.A total of 691 OMFS specialists and trainees were identified from GMC, OMFS SAC and consultant databases. Of these, 12 consultants held only dental qualification/registration. First degree data could not be obtained for 12 specialists (all male). A further 20 OMFS specialists, whose training was outside the UK, were also excluded from further analysis.In 1995 there were 95 national training posts, by 2013 there were 150. Over the last quarter of a century, there has been an increase in medicine first trainees, an increase in female trainees and specialists, and a relative decrease in OMFS trainees from the Indian subcontinent. The varied origins of the OMFS workforce has contributed to greater diversity and inclusion within the specialty. In the UK, OMFS appears to have produced the correct number of specialists whilst maintaining a high standard of training. The next change in OMFS training programmes is to deliver The Postgraduate Medical Education and Training Board’s (PMETB) recommendations. As we move to achieve this it is imperative that as new doors open, we do not close others.     

热性惊厥患儿血清离子及微量元素变化与精神运动发育的关系研究

目的研究热性惊厥患儿血清离子及微量元素变化与精神运动发育的相关性。方法 128例热性惊厥患儿,根据惊厥发作次数分为观察组和对照组,各64例。观察组为一次热程度再次和多次热性惊厥发作患儿,对照组为仅发作1次热性惊厥患儿。比较两组患儿两组患儿血清钙离子、铁离子、钠离子、镁离子水平及智力测评评分、行为能力评分。结果观察组钙离子水平(2.02±0.88)μmol/L、铁离子水平(9.76±1.81)μmol/L均高于对照组的(1.55±0.56)、(7.56±1.13)μmol/L,钠离子水平(133.43±10.21)μmol/L低于对照组的(140.23±10.23)μmol/L,差异有统计学意义(P<0.05);两组镁离子水平比较差异无统计学意义(P>0.05)。两组语言智商评分、操作智商评分及总智商评分比较差异无统计学意义(P>0.05)。观察组独立因子评分(54.32±3.56)分、认知因子评分(52.65±5.78)分、社会自制因子评分(60.34±5.93)分及总评分(102.45±10.56)分均低于对照组的(56.23±3.58)、(63.23±5.47)、(68.34±5.82)、(122.56±10.68)分,差异有统计学意义(P<0.05)。结论热性惊厥患儿精神运动发育与其血清离子及微量元素变化有关,病情发作时其血清离子及微量元素出现异常,一次热程度再次和多次热性惊厥发作患儿其精神运动发育迟滞较为明显。     

Sexual function,satisfaction with life and menopausal symptoms in middle-aged women

Purpose

To assess sexual function, satisfaction with life (SWL), and menopause-related symptoms among mid-aged Spanish women.

Materials and methods

Cross-sectional study of 260 women, aged 40–59, attending the public gynecology consultations completed the 14-item Changes in Sexual Functioning Questionnaire (CSFQ-14), the SWL Scale (SWLS), the Menopause Rating Scale (MRS), and a socio-demographic questionnaire.

Results

Median [inter quartile range] age was 47 [8.0] years, 87.7% had a stable partner, 27.0% were postmenopausal, and 53.9% had increased body mass index (BMI). The prevalence of sexual dysfunction was 46.5% (CSFQ-14 score ≤ 41). Postmenopausal status was associated with lower CSFQ-14 scores (worse sexual function) and severe menopausal symptoms whereas there were not significant differences in SWLS scores. CSFQ-14 scores correlated with SWLS (p < 0.04), and inversely correlated with menopausal symptoms (p < 0.02). Multiple linear regression analysis model predicted 26.6% of the total CSFQ-14 score variance, and higher scores (better sexual function) were correlated with better SWL, and inversely correlated to female age and worse menopausal symptoms. A second model predicted 38.4% of the SWLS score variance. The SWLS score correlated with the total CSFQ-14 score and BMI, and inversely correlated with economical problems, female tobacco use, lack of healthiness, menopausal symptoms, not having a partner, and partner's lack of healthiness.

Conclusions

Lower sexual function was related to low SWL, age and menopausal symptoms while low SWLS score was related with economical problems, smoking, menopausal symptoms, and partner factors.