Microsporidia and Acanthamoeba: the role of emerging corneal pathogens

Parasitic organisms are increasingly recognized as human corneal pathogens. A notable increase in both well-defined Acanthamoeba keratitis and a more dramatic increase in reported cases of Microsporidia keratitis have suggested significant outbreaks of parasitic keratitis around the world. Historical and contemporary baselines as well as a familiar associated clinical presentation reinforce the significant outbreak of Acanthamoeba keratitis in the United States. The remarkable rise in cases of Microsporidia keratitis, however, lacks these established baselines and, further, describes a disease that is inconsistent with previous definitions of disease. While a well-defined, abrupt increase strongly suggests temporally related risk factors, most likely environmental, involved in the Acanthamoeba outbreak, the rise in Microsporidia keratitis suggests that increased awareness and improved diagnostic acumen are a significant factor in case ascertainment. Regardless, recent evidence indicates that both parasitic diseases are likely underreported in various forms of infectious keratitis, which may have unrecognized but significant implications in the pathogenesis of both primary protozoal and polymicrobial keratitis. Further understanding of the incidence and interaction of these organisms with current therapeutic regimens and more commonly recognized pathogens should significantly improve diagnosis and alter clinical outcomes.     

Development of 3D IVOCT Imaging and Co-Registration of IVOCT and Angiography in the Catheterization Laboratory

Intravascular optical coherence tomography (IVOCT) has become the imaging modality of choice for the evaluation of coronary artery disease and percutaneous coronary intervention (PCI). Both for clinical practice and research, there is a growing interest in 3-dimensional (3D) visualization, as this gives a more comprehensive and intuitively easier to understand representation, compared with 2-dimensional, cross-sectional images. Integrating 3D-IVOCT with classic X-ray angiographic images offers additional advantages and the prospect of integrating IVOCT in fluoroscopic guidance during PCI. Different vendors of IVOCT technology already provide integrated 3D rendering software in their consoles, making 3D images available at the ‘push-of-a-button’. In this review, we will discuss (1) the basic principles and elaboration of 3D-IVOCT in recent years, (2) the feasibility and potential advantages of co-registration with X-ray angiography, (3) the currently available solutions for 3D imaging and their potential clinical applications, and (4) the ongoing development of applications for advanced 3D visualization.     

Using a nutritional screening tool to evaluate the nutritional status of patients with colorectal cancer

We assessed which nutrition evaluation method [subjective global assessment (SGA); malnutrition universal screening tool (MUST); nutritional risk index (NRI)] provided the most efficacious combination of high validity, low cost, and ease of use to examine and improve the status of malnutrition for colorectal cancer (CRC) patients. The SGA, MUST, and NRI scales were used to analyze the preoperative status of malnutrition for 45 CRC patients in a medical center in Taiwan. Differences in the reliability of the 3 methods were compared using the kappa (κ) coefficient of agreement. Lengths of hospital stays were compared using the Mann-Whitney U test to examine the effect of malnutrition in CRC patients. The SGA κ coefficient was higher with the MUST than with the NRI. Preoperative and postoperative weight losses were significantly different on the NRI, and the longer the length of the hospital stay, the greater was the weight loss. Although the SGA had a higher validity and lower cost than the NRI, we recommend using the MUST method for a routine nutrition evaluation because it is easier to use and is less expensive than the SGA and the NRI.     

不同人群H7N9禽流感知识掌握情况调查与分析

目的了解桐乡市不同人群对H7N9禽流感的基本认知和态度,为制定适宜的健康教育策略提供科学依据。方法自行设计不同人群(高危人群、脆弱人群、城乡社区居民)H7N9知识掌握情况调查问卷,其中高危人群和脆弱人群调查采用拦截式调查,城乡社区居民用分层多阶段整群随机抽样,共随机选取1 000人进行自填式问卷调查。结果收回有效问卷985份,不同人群对疾病咨询电话知晓程度较高,不同人群对"常开窗通风""文明咳嗽""避免接触鸡、鸭、鸽等家禽"预防措施知晓率较高;电视是各类人群获得H7N9禽流感信息的主要来源,脆弱人群从周围人谈论中获取知识成为其获得信息的第二途径,高危人群和城乡社区居民将网络视为人们获得相关信息的第二途径。结论高危人群疾病相关知识及预防措施总体知晓程度高于其他两类人群。     

ST elevation acute myocardial infarction accelerates non-culprit coronary lesion atherosclerosis

The previously study found, using a mouse model, that acute myocardial infarction accelerated atherosclerosis. This study assessed whether ST elevation myocardial infarction (STEMI) accelerates the progression of non-culprit coronary lesion (NCCL) in patients who underwent percutaneous coronary interventions (PCI). Four hundred and forty-nine patients who underwent successful PCI with stents and follow-up coronary angiography in a single center were enrolled. The NCCL progression was assessed using three-dimensional quantitative coronary angiography and was defined as ≥10 % diameter reduction of a preexisting stenosis ≥50, ≥30 % diameter reduction of a stenosis <50 %, development of a new stenosis ≥30 % in a previously normal segment, or progression to total occlusion. The patients were classified into two groups according to whether the progression existed or not. The median age of patients was 58.4 years. The mean angiographic follow-up period was 12.3 months, 134 (29.8 %) patients had NCCL progression. Multivariate Cox regression analysis (step-wise) showed that STEMI was the only independent determinant of NCCL progression. Compared to the other coronary artery disease group, the crude hazard ratio (HR) of NCCL progression for the STEMI group was 3.20 (95 % CI 2.27–4.50; p < 0.001), and the association remained significantly after adjustment for age, sex, BMI, SBP, DBP, serum lipids, fasting blood glucose, peak monocyte count, smoking, drinking, hypertension, diabetes mellitus and lesion characteristics of NCCL (adjusted HR 3.56, 95 % CI 2.41–5.27; p < 0.001). The ST elevation acute myocardial infarction accelerates non-culprit coronary lesion atherosclerosis.     

肝癌组织内类阿片肽LVV-血衍吗啡素-6的作用

目的:分析肝癌组织与正常肝组织中血衍吗啡素类肽含量的差异并探究其意义.方法:肝癌患者12例,利用弱酸洗涤法从肝癌细胞和肝细胞表面提取肽段,然后用高压液相(HPLC)和质谱分析这些肽段并进行差异比较,筛选肿瘤特异性肽段.用这些肽段(0,10-7,10-8,10-9,10-10,10-11,10-12mol/L)处理人肝癌细胞株HLE,采用MTT法、流式细胞仪法观察其对肝癌细胞的生长、细胞凋亡的影响.结果:从7例患者的肝癌细胞表面成功检测出一条天然的类阿片肽——Leu-Val-Val(LVV)-血衍吗啡素-6(Mr1160.76).不同浓度LVV-血衍吗啡素-6均对HLE细胞有抑制作用,并且当浓度为10-7和10-8mol/L时有显著意义(24h:10-7vs10-8:P=0.044,10-8vs10-9:P=0.047;48h:10-7vs10-8:P=0.031,10-8vs10-9:P=0.040).同时,LVV-血衍吗啡素-6可诱导HLE细胞发生凋亡(浓度为0,10-7,10-8,10-9mol/L时的凋亡率分别为0.38%±0.09%,20.23%±1.25%,12.64%±2.15%,1.65%±0.34%),而阿片受体阻断剂naloxone能够逆转这种抑制效应(以上对应浓度时凋亡率分别为0.41%±0.11%,1.23%±0.45%,0.98%±0.55%,1.34%±0.43%).两组在LVV-血衍吗啡素-6浓度为10-7和10-8mol/L时有显著差异(P<0.05).结论:LVV-血衍吗啡素-6为肝癌细胞的病理产物,可激活阿片受体对肝癌细胞产生抑制作用.