饮食预防肝癌的作用研究进展

肝癌是世界上最常见的恶性肿瘤之一,具有高发病率、高死亡率的特点。因此,降低肝癌发病率的预防措施非常必要[1]。肝癌的主要危险因素包括：HBV/HCV感染、黄曲霉素暴露及肝硬化等,而吸烟、饮酒、肥胖和糖尿病等也可增加肝癌的发病风险。近几十年来,饮食习惯与癌症发病风险之间的关系越来越引起人们的重视。在肝癌研究中发现,一些常见饮食（如肉、蔬菜、水果、咖啡及茶等）在肝癌的发生、发展及预防中发挥着举足轻重的作用。     

The role of fermentable carbohydrates and beverages in the symptomatology of functional gastrointestinal disease

Objectives: The pathophysiology behind functional gastrointestinal disease (FGID) has not been defined, but an intestinal accumulation of fermentable short-chain carbohydrates (FODMAPs) is thought to be involved. A restricted coffee intake is recommended. The aim was to investigate if symptoms of FGID were associated with intake of certain foods (including FODMAPs), as well as beverages (including coffee and tea).

Method and materials: Data were used from participants, age range 45–75 years, who had answered the EpiHealth questionnaire about their background factors, health status and intake of food and beverages. After exclusion of organic bowel diseases, 16,840 participants remained. The impact of food and beverages on functional abdominal pain, functional bloating, functional constipation and functional diarrhea were examined by adjusted binary logistic regression.

Results: Wholemeal bread (Swedish cracker) (OR: 1.361; 95% CI: 1.001–1.851) and white bread (low fiber content) (OR: 1.527; 95% CI: 1.075–2.169) were associated with constipation, whereas soft wholemeal bread (high fiber content) was associated with diarrhea (OR: 1.601; 95% CI: 1.040–2.463). Cheese was associated with bloating (OR: 1.460; 95% CI: 1.004–2.123). A high tea intake was associated with abdominal pain (p for trend?=.003), bloating (p for trend?=?.039) and diarrhea (p for trend <.001), whereas coffee intake was associated with a decreased risk of abdominal pain (p for trend =?.002) and bloating (p for trend?=?.007). High soda intake associated with abdominal pain and bloating and juice with diarrhea.

Conclusion: There are weak associations between intake of grain and dairy products and FGID symptoms. Tea is associated with increased risks, whereas coffee is associated with lower risks, of FGID symptoms.     

Effect of type of alcoholic beverages on carbohydrate-deficient transferrin,sialic acid,and liver enzymes

BACKGROUND: There are only limited data obtained under well controlled conditions on the effects of moderate drinking on markers of alcohol use disorders. The aim of this study was to investigate the effects of moderate intake of different alcoholic beverages on these markers, including carbohydrate-deficient transferrin (CDT), sialic acid (SA), and the liver enzymes gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase. METHODS: Eleven apparently healthy, nonsmoking middle-aged men were included in a 12-week randomized, diet-controlled crossover trial according to a 4 x 4 Latin-square design. Changes in CDT, SA, gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase were analyzed after 3 weeks of daily intake of four glasses (40 g of alcohol) of red wine, beer, spirits (Dutch gin), or water (control). RESULTS: After 3 weeks' daily consumption of red wine, a significant decrease of serum CDT concentration was observed compared with water consumption. There was no effect of any alcoholic beverage on the other outcome measures. CONCLUSIONS: Daily consumption of 40 g of alcohol from different types of alcoholic beverages with dinner did not affect SA or liver enzymes. Further investigations to explore the mechanisms for the red wine-induced decreases of CDT, including changes in iron metabolism, are clearly needed.     

A short history on pacemakers

Artificial pacemakers have taken part or possibly driven many developments in cardiac science and medicine and are therefore a very important story to remember.     

Ultrasound imaging artifacts: How to recognize them and how to avoid them

Echocardiography has become a critical tool in clinical cardiology in evaluating cardiac physiology and diagnosing cardiac disease states. However, imaging artifacts are commonly encountered and often lead to misdiagnoses of life‐threatening diseases, such as aortic dissection and ventricular thrombus. It is, thus, critical for clinicians to understand these artifacts to avoid these misdiagnoses and protect patients from undue intervention. Artifacts can be broken down into two categories: those from violation of ultrasound system assumptions and those from interference by external equipment and devices. This review article discusses the most commonly encountered artifacts by category, explains their physical mechanisms, elaborates on their most common presentations, and instructs clinicians on how to avoid their misinterpretation.     

A short history of anti-rheumatic therapy--V. analgesics

The pharmacological treatment of pain has very ancient origins, when plant-derived products were used, including mandrake extracts and opium, a dried latex obtained from Papaver somniferum. In the XVI and XVII centuries opium came into the preparation of two compounds widely used for pain relief: laudanum and Dover's powder. The analgesic properties of extracts of willow bark were then recognized and later, in the second half of the XIX century, experimental studies on chemically synthesized analgesics were planned, thus promoting the marketing of some derivatives of para-amino-phenol and pyrazole, the predecessors of paracetamol and metamizol. In the XX century, nonsteroidal anti-inflammatory drugs were synthesized, such as phenylbutazone, which was initially considered primarily a pain medication. The introduction on the market of centrally acting analgesics, such as tramadol, sometimes used in the treatment of rheumatic pain, is quite recent.     

A short history of portal hypertension and of its management

The aim of our study was to review the changing trends in the treatment of complications from portal hypertension. A short history of portal hypertension and of the treatment of its complications is reported, underlying the most important achievements and changes.     

Nutritively sweetened beverage consumption and body weight: a systematic review and meta‐analysis of randomized experiments

Nutritively sweetened beverages (NSBs) may play a role in the obesity epidemic. We abstracted data from randomized controlled trials (RCTs) and evidence‐based reviews through January 2009 concerning effects of consumption of NSBs on changes in body weight and adiposity. Studies included were those (i) conducted in humans; (ii) lasting at least 3 weeks; (iii) incorporating random assignment of subjects to conditions that differed only in the consumption of NSBs and (iv) including an adiposity indicator as an outcome. Twelve studies met the inclusion criteria. Meta‐analysis of six studies that added NSBs to persons' diets showed dose‐dependent increases in weight. Contrarily, meta‐analysis of studies that attempted to reduce NSB consumption consistently showed no effect on body mass index (BMI) when all subjects were considered. Meta‐analysis of studies providing access to results separately for subjects overweight at baseline showed a significant effect of a roughly 0.35 standard deviations lesser BMI change (i.e. more weight loss or less weight gain) relative to controls. The current evidence does not demonstrate conclusively that NSB consumption has uniquely contributed to obesity or that reducing NSB consumption will reduce BMI levels in general. We recommend an adequately powered RCT with overweight persons, for whom there is suggestive evidence of an effect.     

Complications of endoscopic retrograde cholangiopancreatography and how to minimize them

Endoscopic retrograde cholangiopancreatography in the recent past was one ofthe basic diagnostic and therapeutic methods of several biliary and pancreatic diseases. It was and is still associated with several complications that can lead to exit the patient and is therefore considered invasive methods. The most serious complications include acute pancreatitis and acute cholangitis. Bleeding and perforation may complicate papillosphincterotomy that precedes another performance (extraction of stones, drainage of biliary and pancreatic duct. The incidence of serious complications have led to efforts to reduce the number of ERCP. This allowed in particular the introduction of new diagnostic methods, especially MRCP and EUS, which led to the practical exclusion of diagnostic ERCP. At present, ERCP is considered to be purely therapeutic method. In addition, considerable experience has been published to reduce the incidence of complications in ERCP. Many of them can be applied to our clinic, which has experience of more than 10 000 ERCP performed.     

Caloric restriction, body fat and ageing in experimental models

Caloric restriction in animal models delays many age‐related pathological conditions. Ageing rats have characteristically increased body weight, fat mass and a specific body fat distribution. This report will focus on the potential cause–effect relationship between increased fat mass and accelerated ageing. In humans, increased fat mass (obesity), and in particular increases in abdominal obesity as a result of deposition of visceral fat, are associated with the metabolic syndrome of ageing. This syndrome is associated with hyperinsulinaemia, dyslipidaemia, type 2 diabetes mellitus, atherosclerosis, hypercoagulability and hypertension. Fat tissue, however, plays a major role by secreting multiple metabolically active factors, which are potentially responsible for the development of insulin resistance. This article will review various experimental models (in animals) used to prevent insulin resistance of ageing by decreasing fat mass, and in particular, decreasing visceral fat. We suggest that this decrease in fat mass and its beneficial repercussions observed in ageing animal models may apply also to human ageing and its related pathology.     

Treatment non‐negotiables: why we need them and how to make them work

In this paper, we define mandatory treatment components as ‘treatment non‐negotiables’ and suggest that the manner in which non‐negotiables are set and implemented has a significant impact on therapeutic alliance and outcome in the eating disorders. Common non‐negotiable difficulties are reviewed and a philosophy is provided that can be applied to all stages of treatment: non‐negotiables need to have a sound rationale, be consistently implemented, not take the client by surprise, and maximize client autonomy. We do not believe that a given non‐negotiable is ‘right’ or ‘wrong’, but rather that treatment non‐negotiables are optimally developed in response to the client population, treatment setting, clinician values and beliefs about change, and client and clinician input and experience. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.     

Modulation of adipose tissue lipolysis and body weight by high-density lipoproteins in mice

Background:

Obesity is associated with reduced levels of circulating high-density lipoproteins (HDLs) and its major protein, apolipoprotein (apo) A-I. As a result of the role of HDL and apoA-I in cellular lipid transport, low HDL and apoA-I may contribute directly to establishing or maintaining the obese condition.

Methods:

To test this, male C57BL/6 wild-type (WT), apoA-I deficient (apoA-I^−/−) and apoA-I transgenic (apoA-I^tg/tg) mice were fed obesogenic diets (ODs) and monitored for several clinical parameters. We also performed cell culture studies.

Results:

ApoA-I^−/− mice gained significantly more body weight and body fat than WT mice over 20 weeks despite their reduced food intake. During a caloric restriction regime imposed on OD-fed mice, apoA-I deficiency significantly inhibited the loss of body fat as compared with WT mice. Reduced body fat loss with caloric restriction in apoA-I^−/− mice was associated with blunted stimulated adipose tissue lipolysis as verified by decreased levels of phosphorylated hormone-sensitive lipase (p-HSL) and lipolytic enzyme mRNA. In contrast to apoA-I^−/− mice, apoA-I^tg/tg mice gained relatively less weight than WT mice, consistent with other reports. ApoA-I^tg/tg mice showed increased adipose tissue lipolysis, verified by increased levels of p-HSL and lipolytic enzyme mRNA. In cell culture studies, HDL and apoA-I specifically increased catecholamine-induced lipolysis possibly through modulating the adipocyte plasma membrane cholesterol content.

Conclusions:

Thus, apoA-I and HDL contribute to modulating body fat content by controlling the extent of lipolysis. ApoA-I and HDL are key components of lipid metabolism in adipose tissue and constitute new therapeutic targets in obesity.     

A (very) short history of diets for gout

Gout has been a relatively well-defined condition for centuries,throughout which diet has featured in its treatment. In thiscontext, it is rather difficult to distinguish diet from medication.Medical opinion, admixed with clinical observation and anecdotes,has reflected contemporary health beliefs up to and includingmodern times (Fig. 1). For example, the Hippocratic     

A short history of anti-rheumatic therapy. IV. Corticosteroids

In 1948 a corticosteroid compound was administered for the first time to a patient affected by rheumatoid arthritis by Philip Showalter Hench, a rheumatologist at the Mayo Clinic in Rochester, Minnesota (USA). He was investigating since 1929 the role of adrenal gland-derived substances in rheumatoid arthritis. For the discovery of cortisone and its applications in anti-rheumatic therapy, Hench, along with Edward Calvin Kendall and Tadeusz Reichstein, won the 1950 Nobel Prize for Medicine. In this review we summarize the main stages that led to the identification of the so-called compound E, which was used by Hench. We also consider the subsequent development of steroid therapy in rheumatic diseases, through the introduction of new molecules with less mineralocorticoid effects, such as prednisone, and more recently, deflazacort.     

A short history of anti-rheumatic therapy - VII. Biological agents

The introduction of biological agents has been a major turning-point in the treatment of rheumatic diseases, particularly in rheumatoid arthritis. This review describes the principle milestones that have led, through the knowledge of the structure and functions of nucleic acids, to the development of production techniques of the three major families of biological agents: proteins, monoclonal antibodies and fusion proteins. A brief history has also been traced of the cytokines most involved in the pathogenesis of inflammatory rheumatic diseases (IL-1 and TNF) and the steps which have led to the use of the main biological drugs in rheumatology: anakinra, infliximab, adalimumab, etanercept and rituximab.