Vitamin C and vitamin E supplement use and bladder cancer mortality in a large cohort of US men and women

Some epidemiologic studies suggest that use of vitamin C or vitamin E supplements, both potent antioxidants, may reduce the risk of bladder cancer. The authors examined the association between use of individual vitamin C and vitamin E supplements and bladder cancer mortality among 991,522 US adults in the Cancer Prevention Study II (CPS-II) cohort. CPS-II participants completed a self-administered questionnaire at enrollment in 1982 and were followed regarding mortality through 1998. During follow-up, 1,289 bladder cancer deaths occurred (962 in men and 327 in women). Rate ratios were adjusted for age, sex, cigarette smoking, education, and consumption of citrus fruits and vegetables. Regular vitamin C supplement use (>or=15 times per month) was not associated with bladder cancer mortality, regardless of duration (rate ratio (RR) = 0.91, 95% confidence interval (CI): 0.68, 1.20 for <10 years' use; RR = 1.25, 95% CI: 0.91, 1.72 for >or=10 years' use). Regular vitamin E supplement use for >or=10 years was associated with a reduced risk of bladder cancer mortality (RR = 0.60, 95% CI: 0.37, 0.96), but regular use of shorter duration was not (RR = 1.04, 95% CI: 0.77, 1.40). Results support the hypothesis that long-duration vitamin E supplement use may reduce the risk of bladder cancer mortality.     

维生素C与妊娠期糖尿病关系的Meta分析

目的 系统评价维生素C（VC）暴露与妊娠期糖尿病（GDM）的相关性。 方法 检索PubMed、Embase、Cochrane Library、SinoMed、中国知网数据库从建库至2021年7月VC摄入水平或血液VC浓度与GDM关联的文献,按纳入标准筛选文献、提取资料后进行meta分析。 结果 从检索的687篇文献中筛选得到21篇文献,其中17篇质量评分为5分及以上并纳入分析（n = 11 376）。结果显示,VC低暴露组的GDM发生率显著高于高暴露组（OR = 2.46, 95%CI: 1.42～4.25）,暴露浓度差距SMD = - 0.61（95%CI: - 1.13～- 0.08）。在亚组分析中,在以下分组时OR（95%CI）具有统计学意义:内暴露2.63（1.42～4.86）、外暴露2.52（1.07～5.94）、中国1.38（1.04～1.83）、欧美地区2.14（1.18～3.88）、印度4.73（1.24～18.10）、孕中期或晚期1.57（1.22～2.02）;以下分组SMD（95%CI）具有统计学意义:内暴露- 1.70（- 2.88～- 0.52）、欧美地区- 0.45（- 0.79～- 0.11）、印度- 1.84（- 3.64～- 0.04）、孕中期或晚期- 1.01（- 1.79～- 0.22）、ADA标准- 0.74（- 1.32～- 0.16）,即VC低暴露时GDM发生率更高。 结论 VC低暴露是GDM的危险因素。孕妇多摄入富含VC的食物,提高血液VC浓度,有助于预防GDM的发生,促进母婴健康。     

骨髓移植患儿移植前后饮食摄入的改变

目的分析骨髓移植患儿移植期间营养摄入及营养状况的改变,评估营养干预的重要性。方法以2012年1月至2012年11月在上海交通大学医学院附属上海儿童医学中心血液肿瘤科行骨髓移植的共计65名患儿为研究对象。以预处理前收集的患儿资料为基线值。预处理开始后至移植后30d每周2次、移植后30-100d每周1次收集患儿营养相关资料,并对患儿日常营养摄入进行膳食分析。在相应时间点收集患儿24h小便行定氮分析。结果患儿总能量和各项宏量营养素口服摄入基线值分别为：总能量（5844．9±2490．4）kJ/d,蛋白质（56．4±28．6）g/d,脂肪（49．7±38．9）g／d,碳水化合物（190．9±91．1）g/d。随着移植预处理开始,各项摄入均明显减少（P均=0．000）。移植后恢复期,患儿能量摄人自第6周开始与基线值差异无统计学意义,蛋白质自第13周开始与基线水平差异无统计学意义,碳水化合物和脂肪摄入分别自第4周和第6周起与基线水平差异无统计学意义。移植前患儿尿氮排出量为（3．9±2．4）g/d,进行预处理后尿氮量达到（16．7±11．0）g／d,显著高于基线尿氮量（P=0．000）。患儿移植后第1周的体重（P=0．000）、三头肌皮褶厚度（P=0．003）、中上臂围（P=0．000）、血清白蛋白（P=0．000）、前白蛋白（P=0．000）均显著低于基线值;移植后第9周的去脂百分比（P=0．010）、肌肉百分比（P=0．001）和蛋白质百分比（P=0．000）显著低于基线值,体脂百分比显著高于基线值（P=0．000）。结论骨髓移植患儿早期即有营养摄入量的改变,在移植恢复期逐渐恢复,其中蛋白质摄入恢复最慢,可能是影响患儿血清蛋白水平的重要因素。因此,骨髓移植患儿需要更为详细的营养指导,尽量以口服摄入满足营养需求,必要时可提供高蛋白营养配方。     

Living The Discipline on a stem cell transplant unit: spiritual care outcomes among bone marrow transplant survivors

An oncology chaplain details, using The Discipline for Pastoral Care Giving, common themes in the spiritual journeys of stem cell/bone marrow transplantation survivors, and helpful chaplain interventions.     

Lipid peroxidation in relation to vitamin C and vitamin E levels

Oxidative stress plays an important contributory role in the pathogenesis of age-related chronic diseases. Increased lipid peroxidation process is caused by an enhanced free radical formation together with a higher supply of substrates and by an insufficient defense by antioxidants as well. Levels of malondialdehyde to content of lipid peroxidation substrates (polyunsaturated fatty acids), promoters (homocysteine--hydroxyl radical producer) and inhibitors (essential vitamins C and E) were estimated in a group (n=92) of subjective healthy adults randomly selected from general population. The relationship of malondialdehyde levels to values of peroxidisability index of fatty acids as well as to levels of homocysteine is significantly positive linear A significant inverse linear correlation between malondialdehyde levels and natural antioxidant levels (vitamin C, vitamin E) was recorded. Lipid peroxidation products (conjugated dienes of fatty acids--initial, malondialdehyde--secondary) are significantly increased in groups of subjects with deficient levels of vitamin C (below the limit from antioxidative point of view), vitamin E and both vitamins, if compared to group with normal vitamin levels (over limit in accordance with antioxidative criterion). The results document that the deficiency in two key antioxidants for lipid peroxidation inhibition means the insufficient defense against free radicals and the increased lipid peroxidation.     

补充抗氧化维生素对老年机体红细胞功能改善效果的研究

目的研究抗氧化维生素E(VE)、维生素C(VC)联合不同剂量β-胡萝卜素(β-C)补充,对老年机体红细胞溶血度、红细胞膜ATP酶和红细胞膜流动性的影响。方法经知情同意后选择300名60~75岁的老年人,随机分为5组,1~4组补充VC 300mg/d+VE 200mg/d的同时,再分别补充β-C 16.7、8.4、5.6和0.0mg/d,对照5组补充VE 5mg/d,连续补充16周。补充前、后分别抽取清晨空腹静脉血,用H2O2氧化诱导溶血法测红细胞溶血度,酶学比色法测红细胞膜ATP酶活性,荧光偏振法测红细胞膜流动性。结果干预后1~4组老年人红细胞溶血度(分别为38.8%、39.9%、37.6%和40.9%)显著低于其干预前(分别为54.5%、57.1%、56.4%和55.4%)(P<0.01)和干预后第5组(55.7%)(P<0.01);干预后第1组红细胞膜Na+-K+-ATP酶0.72μmol/(mg·h)、Ca2+-Mg2+-ATP酶0.85μmol/(mg·h)显著高于干预后第5组[分别为0.49μmol/(mg·h)和0.61μmol/(mg·h)](P<0.05);干预后第1~4组红细胞膜荧光偏振度ρ值、1至3组微粘度η值均明显高于其干预前(P<0.01),也高于干预后第5组(P<0.01或P<0.05)。结论抗氧化VE、VC联合不同剂量β-C补充可降低老年机体H2O2诱导的红细胞溶血度,提高红细胞膜ATP酶的活性,改善老年机体红细胞膜的流动性。     

补充维生素C和E对中老年人机体抗氧化功能的影响

目的了解补充抗氧化营养素对中老年人血清SOD与MDA水平的改善情况及其对机体抗氧化功能的影响。方法采用多级抽样方法,抽取年龄为40～70岁的中老年者97人为干预组,对其开展为期6个月的营养素补充干预;同时抽取同年龄段中老年者95人为对照组,不加以任何干预措施。6个月后对两组进行血清学检测分析。结果干预组男性和女性的SOD、MDA与LDL含量与对照组相比,差异均有显著性（P〈0.05）;干预组的中年组和老年前期组SOD含量高于对照组,MDA和LDL含量均低于对照组,且两组间SOD、MDA差异均有显著性（P〈0.05）;干预组老年组SOD含量高于对照组,MDA与LDL含量均低于对照组,差异均无显著性（P〉0.05）。结论抗氧化营养素干预应从中年开始,补充抗氧化营养素VE、VC可改善机体抗氧化功能。     

Bone mineral density,vitamin D,and nutritional status of children submitted to hematopoietic stem cell transplantation

ObjectiveThe aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y.MethodsWe conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods.ResultsWe observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average −9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (−5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS.ConclusionHSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.     

Relationships between vitamin and mineral supplement use, dietary intake, and dietary adequacy among adolescents

OBJECTIVE: To examine patterns of supplement use among US adolescents and the relationship between supplement use and dietary intake and adequacy. DESIGN: Adolescents self-reported 2 days of food intake using the 24-hour recall method and supplement use during a personal interview conducted as part of the 1994 Continuing Survey of Food Intakes of Individuals (CSFII). SUBJECTS: A national sample of 423 adolescents included in the 1994 CSFII survey. STATISTICAL ANALYSIS: chi 2 analysis was used to determine which demographic factors were significantly related to patterns of supplement use. Weighted percentages of adolescents by category of supplement use for selected vitamins and minerals (calcium; iron; zinc; folic acid; and vitamins A, B-6, C, and E) are presented. Relationships between dietary intake of macronutrients and vitamins and minerals among adolescents and supplement use were determined using a least-squares model of general linear regression. RESULTS: Approximately one-third of adolescents reported using supplements, with 15.6% of youth using them on a daily basis. The majority of supplement users reported taking multivitamins (N = 95; 65.5%) whereas only one-third of supplement users reported taking individual vitamins or minerals. Supplement use was found to vary by gender, household size, and US region of residence. Adolescents who reported using supplements had higher mean dietary intakes of most micronutrients and lower intakes of total and saturated fat than those who did not use supplements. More than one-third of adolescents had dietary intakes of vitamins A and E, calcium, and zinc that were < 75% of the US Recommended Dietary Allowance. APPLICATIONS/CONCLUSIONS: The majority of US adolescents do not use vitamin or mineral supplements. Interestingly, adolescents who do use supplements, even on an infrequent basis, consume diets that are more nutrient-dense than those who do not use supplements. Dietary intakes of several micronutrients were inadequate among all adolescents in this study, regardless of supplement use status. There is a need to develop and implement programs aimed at improving the dietary intakes of US adolescents.     

Combined vitamin C and E supplementation retards early progression of arteriosclerosis in heart transplant patients

The development of arteriosclerosis is the limiting factor for the long-term survival and the major cause of mortality in patients with heart transplants. Various factors, including oxidative stress, contribute to the progression of the disease. In a recent clinical trial using the intravascular ultrasound technique, which detects the early stages of disease development, supplementation with vitamins C and E retarded the progression of coronary arteriosclerosis during the early stage following cardiac transplantation.     

造血干细胞移植后肠道急性移植物抗宿主病与肠道感染的关系

目的 探讨造血干细胞移植术后肠道急性移植物抗宿主病(aGVHD)的发生与肠道感染的关系,找出一般规律以指导临床护理.方法 回顾性调查医院造血干细胞移植术后并发肠道aGVHD患者44例,其中肠道未感染者24例,肠道感染者20例,对比分析其腹泻程度、持续时间、量及病原菌的分布,并提出针对性的护理措施.结果 肠道未感染者腹泻程度主要集中Ⅰ、Ⅱ度,分别占66.67％、25.00％,肠道感染者腹泻程度主要集中在Ⅲ、Ⅳ度,分别占45.00％、25.00％;腹泻持续时间及腹泻量两组比较差异有统计学意义(P＜0.05),而住院天数两组之间比较差异无统计学意义;肠道感染者粪便中检出的主要病原菌为白色假丝酵母菌和光滑假丝酵母菌,分别占24.00％、22.67％.结论 aGVHD发生后肠道感染的比例明显增加,特别是重度aGVHD易引起真菌感染,提示护理人员加强此类患者的护理,减少并发症的发生.     

The incidence of hyperglycemia in hematopoietic stem cell transplant recipients receiving total parenteral nutrition: a pilot study

OBJECTIVE: To determine whether total parenteral nutrition (TPN)-induced hyperglycemia is associated with adverse clinical outcomes. DESIGN: A retrospective cohort investigation comparing the medical records of hematopoietic stem cell transplant patients was conducted to determine clinical differences between those who received TPN and those who did not receive TPN during transplant. SUBJECTS/SETTING: Forty-eight adult patients (> or =18 years) undergoing initial autologous or allogeneic hematopoietic stem cell transplant at two urban university-affiliated hospitals were eligible for inclusion. MAIN OUTCOME MEASURES: Hyperglycemia (glucose > or =6.1 mmol/L or 110 mg/dL), presence of infection, infection duration, and in-hospital mortality. Statistical analyses performed chi 2, Student t, and Wilcoxon rank-sum tests were used to detect differences among the study participants. RESULTS: Patients had similar baseline demographic and clinical characteristics, with 63% receiving TPN during transplant. When standardized for time, TPN recipients at both institutions experienced significantly more hyperglycemia ( P <.05) after TPN initiation. TPN patients also experienced 69% of all infections and 100% of repeat positive cultures. Additionally, significantly greater differences for TPN recipients were found for length of stay and daily charges than those who did not receive TPN. No differences were found for in-hospital mortality. CONCLUSIONS: TPN is strongly associated with hyperglycemia, which may be linked to increased infections of longer duration in a profoundly immunocompromised group of patients who frequently receive TPN. The implications of these findings are limited by the small number of subjects; a larger investigation is warranted.     

Effect of a blueberry nutritional supplement on macronutrients, food group intake, and plasma vitamin E and vitamin C in US athletes

Antioxidants from a blueberry beverage may impact plasma vitamins. We examined vitamins/food selection in 12 college athletes during 30 days compared with placebo. Blood was collected before and after exercise at the beginning of the study (day 1) and then after a 30-day period of taking a daily supplemental beverage (day 30). The six trials involved blood that was drawn pre-beverage ingestion/pre-exercise (trials 1 and 4), post-beverage ingestion/pre-exercise (trials 2 and 5), and post-beverage ingestion/1 h post-exercise (trials 3 and 6), on day 1 (trials 1, 2, and 3) and day 30 (trials 4, 5, and 6). Analysis of variance revealed non-significant differences for macronutrient or gamma-tocopherol and vitamin C intakes by food frequency questionnaire or plasma vitamins by liquid chromatography. There was a trend (P = 0.083) in the group x time interaction for alpha-tocopherol intake by repeated-measures analysis of variance. Blueberry alpha-tocopherol (23.91 +/- 9.31 mg) was significantly (P < 0.05) higher than placebo alpha-tocopherol intake (7.59 +/- 0.95 mg) on day 1, but not on day 30 (blueberry, alpha-tocopherol = 9.04 +/- 2.35 mg, placebo, alpha-tocopherol = 11.46 +/- 3.65 mg) by pairwise comparisons. Blueberry supplementation did not affect plasma vitamin concentrations or gamma-tocopherol and vitamin C intakes, and may reduce alpha-tocopherol intake in those starting with a higher alpha-tocopherol intake, yet not altering athletes' eating habits.     

Effect of a blueberry nutritional supplement on macronutrients,food group intake,and plasma vitamin E and vitamin C in US athletes

Antioxidants from a blueberry beverage may impact plasma vitamins. We examined vitamins/food selection in 12 college athletes during 30 days compared with placebo. Blood was collected before and after exercise at the beginning of the study (day 1) and then after a 30-day period of taking a daily supplemental beverage (day 30). The six trials involved blood that was drawn pre-beverage ingestion/pre-exercise (trials 1 and 4), post-beverage ingestion/pre-exercise (trials 2 and 5), and post-beverage ingestion/1 h post-exercise (trials 3 and 6), on day 1 (trials 1, 2, and 3) and day 30 (trials 4, 5, and 6). Analysis of variance revealed non-significant differences for macronutrient or γ-tocopherol and vitamin C intakes by food frequency questionnaire or plasma vitamins by liquid chromatography. There was a trend (P=0.083) in the group×time interaction for α-tocopherol intake by repeated-measures analysis of variance. Blueberry α-tocopherol (23.91±9.31 mg) was significantly (P<0.05) higher than placebo α-tocopherol intake (7.59±0.95 mg) on day 1, but not on day 30 (blueberry, α-tocopherol=9.04±2.35 mg, placebo, α-tocopherol=11.46±3.65 mg) by pairwise comparisons. Blueberry supplementation did not affect plasma vitamin concentrations or γ-tocopherol and vitamin C intakes, and may reduce α-tocopherol intake in those starting with a higher α-tocopherol intake, yet not altering athletes' eating habits.     

Safety and efficacy of early vaccination with live attenuated measles vaccine for hematopoietic stem cell transplant recipients and solid organ transplant recipients

Background and objectiveVaccination with the live attenuated measles vaccine is currently recommended two years after hematopoietic stem cell transplantation (HSCT) and generally contraindicated after solid organ transplantation (SOT) due to safety concerns.However, in the last few years new data on the administration of the measles vaccine to HSCT recipients less two years post-transplantation and to SOT recipients have become available.This new data may change current guidelines and practices. The objective of this review is to provide an overview of the current data on the safety and efficacy of early measles vaccination for HSCT- and SOT recipients.MethodPubMed and EMBASE were searched from the earliest date available through October 2019 to identify all research that reported on the safety and efficacy of measles vaccination after SOT or less than two years after HSCT.ResultsA total of ten studies was included in this review. In the six studies that evaluated the efficacy of measles vaccination after SOT, seroconversion rates ranged from 41 to 100% after one dose and 73 to 100% after two doses. In the four studies that evaluated the efficacy of measles vaccination less than two years after HSCT, seroconversion rates ranged from 33 to 100% after one dose and 100% after two doses. In all studies, the administration of the measles vaccine after transplantation was considered to be safe. There were no cases of infection with the attenuated vaccine strain, and there were no adverse events related to the vaccination.ConclusionData on the administration of the measles vaccine after SOT and less than two years after HSCT is scarce. However, the current data available suggest that it is efficacious and well tolerable. Therefore, early measles vaccination could be considered in selected groups of SOT- and HSCT recipients during increased measles transmission or an outbreak setting.     

乙型肝炎病毒感染患儿造血干细胞移植前后肝功能变化

目的探讨乙型肝炎病毒(HBV)感染患儿造血干细胞移植前后肝功能变化,为临床治疗提供参考依据。方法回顾性分析医院2006年8月-2011年8月58例行造血干细胞移植的HBV感染患儿临床资料,HBsAg阳性者15例为HBsAg阳性组,HBsAb阳性者43例为HBsAb阳性组;随机抽取同期行造血干细胞移植的无HBV感染患儿30例为对照组,分析移植前后肝功能变化,数据采用SPSS13.0进行分析。结果在移植后1周时各组患儿均出现ALT、AST、TBIL、IBIL升高,TP降低;在移植后6个月时,ALT及AST异常率HBsAg阳性组为73.33%、60.00%,HBsAb阳性组为39.53%、30.23%,对照组为30.00%、13.33%;HBsAg阳性组与HBsAb阳性组及对照组比较,差异均有统计学意义(P<0.05);移植后6个月时HBsAg阳性组存活的11例患儿均转为HBsAg携带者,HBsAb阳性组存活的34例患儿中26例乙型肝炎指标全部转阴。结论 HBsAg阳性患儿在行造血干细胞移植时肝功能受损,较HBsAb阳性患儿及未合并有HBV感染患儿更为严重,需要加强保肝治疗。     

前列腺素E2与肿瘤的关系

流行病学,动物实验和临床研究表明,肿瘤的发生发展与患者癌组织分泌的前列腺素E2有着密切关系。研究表明前列腺素E2在肿瘤组织中高表达,并且前列腺素E2的含量与肿瘤的大小、肿瘤的分期、肿瘤有无转移、肿瘤的预后以及肿瘤的复发等方面都有相关性。因此使用前列腺素E2的抑制剂及其含量的检测,将在肿瘤的预防,治疗等方面起着重要的作用。     

造血干细胞移植患者中心静脉置管感染因素的分析与预防对策

目的 分析造血干细胞移植行中心静脉置管患者感染的相关因素,找出与导管菌血症(CRB)相关的护理因素,并探讨预防感染的有效方法.方法 选择造血干细胞移植行中心静脉置管患者408例,对导管使用带管时间、维护方法、局部并发症、使用中细菌培养进行分析.结果 CRB的发生与性别无明显的相关性,但与年龄、置管位置、置管时间、移植前后有明显的相关性;静脉导管与感染相关并发症为导管破损、穿刺点局部渗血或渗液、静脉炎、导管堵塞及导管周围皮肤潮湿,其发生率分别为4.17％、7.35％、5.39％、6.86％及6.86％.结论 如年龄偏大、置管时间＞2周,对移植后患者需密切观察其感染指征,做好导管维护,预防CRB的发生.