Renal function in pediatric cystic fibrosis patients in the first decade of life

With increasing life expectancy and the need for lung transplantation in the cystic fibrosis (CF) population, there are increasing reports of chronic kidney disease (CKD). However, values for baseline or longitudinal glomerular filtration rate (GFR) as measured by exogenous clearance markers are lacking in this population. Retrospective cross-sectional study in 2 to 18-year-olds cared for at a single CF center who had a GFR measured by plasma disappearance of Technetium-99 m diethylenetriaminepentaacetic acid (mGFR). The primary outcome was evidence of renal dysfunction as defined by CKD stage II or below (mGFR < 90 ml/min/1.73 m², persistent abnormalities in urinary sediment, abnormal renal imaging). Of 63 patients evaluated, four had apparent renal dysfunction, one demonstrated decreased mGFR, and three others had persistent microscopic hematuria. The mean mGFR was substantially higher (140 ± 24 ml/min/1.73 m²) than expected or previously reported for healthy children. We did not demonstrate the presence of significant renal impairment after limited aminoglycoside exposure in the first decade following diagnosis with CF. However, we did document the presence of glomerular hyperfiltration in a significant proportion of our CF patients.     

针灸治疗脑卒中痉挛性偏瘫的临床研究进展

近年来,脑卒中后痉挛性偏瘫的治疗受到重视,针灸作为一种有效的方法报道较多,本文总结了近年来关于针灸治疗脑卒中后痉挛性偏瘫的现状和进展,从取穴、针法、针灸结合其他方法等方面进行综述,认为针灸能够缓解脑卒中后痉挛性瘫痪状态,而且疗效好、无不良反应,并提出优化选穴、规范临床试验设计、统一疗效标准、进行机制研究等建议。     

Heel overload associated with heel cord insufficiency

BACKGROUND: Heel cord lengthening is a common component of foot and ankle surgery. If the tendon is anatomically or functionally over lengthened patients may develop plantarflexion weakness and heel overload problems such as symptomatic plantar heel callosities and heel ulceration. METHODS: Nine patients who developed heel overload or heel ulcer after a heel cord lengthening or an irreparable rupture were identified. Initial foot injury, risk factors, treatment, and followup were reviewed. RESULTS: Five of the nine patients had diabetes and an insensate heel. The ulcer healed in two of five patients with a dorsiflexion stop brace, two with a tendon transfer, and one required a below knee amputation. There were four patients with heel overload with normal sensation and no diabetes. One improved with strengthening exercises, two with tendon transfer, and one required a below knee amputation. CONCLUSIONS: Heel cord insufficiency can lead to an overload callus or a heel ulcer. Patients with diabetes and an insensate heel are at highest risk, but this problem also can occur in patients with normal sensation. Obesity and ipsilateral first toe amputation also may be risk factors.     

Internal jugular vein compression to assess the correct placement of an epidural catheter in postpartum women

We investigated whether the increase in epidural pressure produced by jugular compression could be used as a test for correct placement of epidural catheters in 20 postpartum women who had good epidural analgesia during labour. We measured the epidural pressure by using the epidural catheter as a manometer, and measured the rise in the meniscus in response to jugular vein compression whilst the epidural catheter was still in the epidural space. The catheter was then withdrawn until the tip lay just outside the epidural space and the response to jugular vein compression reassessed. In all subjects, jugular vein compression produced a rise in the meniscus only whilst the catheter tip lay in the epidural space. Jugular compression is a useful test for confirming the correct placement of the epidural catheter.     

Mycotoxin Co-Occurrence in Michigan Harvested Maize Grain

Mycotoxins are secondary metabolites produced by fungi that, depending on the type and exposure levels, can be a threat to human and animal health. When multiple mycotoxins occur together, their risk effects on human and animal health can be additive or synergistic. Little information is known about the specific types of mycotoxins or their co-occurrence in the state of Michigan and the Great Lakes region of the United States. To understand the types, incidences, severities, and frequency of co-occurrence of mycotoxins in maize grain (Zea mays L.), samples were collected from across Michigan over two years and analyzed for 20 different mycotoxins. Every sample was contaminated with at least four and six mycotoxins in 2017 and 2018, respectively. Incidence and severity of each mycotoxin varied by year and across locations. Correlations were found between mycotoxins, particularly mycotoxins produced by Fusarium spp. Environmental differences at each location played a role in which mycotoxins were present and at what levels. Overall, data from this study demonstrated that mycotoxin co-occurrence occurs at high levels in Michigan, especially with mycotoxins produced by Fusarium spp., such as deoxynivalenol.     

Active and passive smoking and the risk of breast cancer in women aged 36-45 years: a population based case-control study in the UK

Active smoking has little or no effect on breast cancer risk but some investigators have suggested that passive smoking and its interaction with active smoking may be associated with an increased risk. In a population based case-control study of breast cancer in women aged 36-45 years at diagnosis, information on active smoking, passive smoking in the home, and other factors, was collected at interview from 639 cases and 640 controls. Women were categorised jointly by their active and passive smoking exposure. Among never smoking controls, women who also reported no passive smoking exposure were significantly more likely to be nulliparous and to be recent users of oral contraceptives. Among those never exposed to passive smoking, there was no significant association between active smoking and breast cancer, relative risk (RR) of 1.12 (95% confidence interval (CI) 0.72-1.73) for past smokers and RR of 1.19 (95% CI 0.72-1.95) for current smokers, nor was there an association with age started, duration or intensity of active smoking. Compared with women who were never active nor passive smokers, there was no significant association between passive smoking in the home and breast cancer risk in never smokers, RR of 0.89 (95% CI 0.64-1.25), in past smokers, RR of 1.09 (95% CI 0.75-1.56), or in current smokers, RR of 0.93 (95% CI 0.67-1.30). There was no trend with increasing duration of passive smoking and there was no heterogeneity among any of the subgroups examined. In this study, there was no evidence of an association between either active smoking or passive smoking in the home and risk of breast cancer.     

miR-95与胃癌细胞洛铂 敏感性的关系及 作用机制研究

目的：探讨miR-95与胃癌细胞洛铂敏感性的关系及作用机制。方法：收集30例手术切除的胃癌组织及癌旁组织标本,实时定量PCR（qPCR）法检测组织中miR-95的表达情况,CCK-8法检测洛铂对胃癌组织细胞的体外抑制率。采用miR-95抑制物（anti-miR-95）和miR-95模拟物（miR-95 mimics）分别转染人胃癌细胞株SGC7901,检测转染前后细胞对洛铂敏感性的变化;采用qPCR及Western blot法检测细胞耐药相关基因MDR1、GST-π、LRP、Survivin、xIAP、Bad mRNA和蛋白的表达。结果：qPCR检测结果显示,30例胃癌组织miR-95的相对表达水平（0.106±0.023）显著高于癌旁组织（0.046±0.025）（P < 0.05）。以miR-95表达均值为界将胃癌组织分为miR-95高表达组17例,低表达组13例。洛铂对miR-95表达水平高的胃癌细胞的抑制率低于miR-95低水平者（P < 0.05）。anti-miR-95转染后,SGC7901细胞对洛铂的敏感性明显增高（P < 0.01）,耐药相关基因MDR1、Survivin、xIAP mRNA和蛋白表达水平明显降低（P < 0.05）,而Bad mRNA和蛋白表达水平明显增高（P < 0.05）。miR-95 mimics转染后,洛铂对SGC7901细胞的抑制率明显增加（P < 0.01）,耐药相关基因MDR1、Survivin、xIAP mRNA和蛋白表达水平明显升高（P < 0.05）,而Bad mRNA和蛋白表达水平明显降低（P < 0.05）。结论：miR-95通过调节一些耐药基因的表达影响胃癌组织和细胞对洛铂的敏感性。     

Lutein/zeaxanthin isomers regulate neurotrophic factors and synaptic plasticity in trained rats

Background/aim This study was conducted to elucidate the effects of lutein/zeaxanthin isomers (L/Zi) on lipid metabolism, oxidative stress, NF-κB/Nrf2 pathways, and synaptic plasticity proteins in trained rats.Materials and methods Wistar rats were distributed into four groups: 1) control, 2) L/Zi: rats received L/Zi at the dose of 100 mg/kg by oral gavage, 3) exercise, 4) exercise+L/Zi: rats exercised and received L/Zi (100 mg/kg) by oral gavage. The duration of the study was eight weeks. Results Exercise combined with L/Zi reduced lipid peroxidation and improved antioxidant enzyme activities of muscle and cerebral cortex in rats (p < 0.001). In the Exercise + L/Zi group, muscle and cerebral cortex Nrf2 and HO-1 levels increased, while NF-κB levels decreased (p <0.001). Also, L/Zi improved BDNF, synapsin I, SYP, and GAP-43 levels of the cerebral cortex of trained rats (p < 0.001). The highest levels of BDNF, synapsin SYP, and GAP-43 in the cerebral cortex were determined in the Exercise+L/Zi group.Conclusion These results suggested that exercise combined with L/Zi supplementation might be effective to reduce neurodegeneration via improving neurotrophic factors and synaptic proteins, and oxidative capacity in the cerebral cortex.     

The formation and function of the neutrophil phagosome

Neutrophils are the most abundant circulating leukocyte and are crucial to the initial innate immune response to infection. One of their key pathogen-eliminating mechanisms is phagocytosis, the process of particle engulfment into a vacuole-like structure called the phagosome. The antimicrobial activity of the phagocytic process results from a collaboration of multiple systems and mechanisms within this organelle, where a complex interplay of ion fluxes, pH, reactive oxygen species, and antimicrobial proteins creates a dynamic antimicrobial environment. This complexity, combined with the difficulties of studying neutrophils ex vivo, has led to gaps in our knowledge of how the neutrophil phagosome optimizes pathogen killing. In particular, controversy has arisen regarding the relative contribution and integration of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-derived antimicrobial agents and granule-delivered antimicrobial proteins. Clinical syndromes arising from dysfunction in these systems in humans allow useful insight into these mechanisms, but their redundancy and synergy add to the complexity. In this article, we review the current knowledge regarding the formation and function of the neutrophil phagosome, examine new insights into the phagosomal environment that have been permitted by technological advances in recent years, and discuss aspects of the phagocytic process that are still under debate.