补体成分3与骨质疏松症关系的研究进展

骨质疏松症是老年人常见病,目前相关研究证实骨质疏松症与免疫系统之间存在联系,骨保护素(osteoprotegrin,OPG)/核因子κB受体活化因子配体(receptor activator of nuclear factor-κB ligand,RANKL)/核因子κB受体活化因子(receptor activator of nuclear factor-κB,RANK)信号通路是连接二者的关键通路。补体系统是重要的免疫系统,补体成分3在补体系统中占据重要地位。研究表明,补体成分3与骨质疏松症之间存在密切关系。开展补体成分3及其他免疫系统成分与骨质疏松症关系的研究,有助于为骨质疏松症的诊治提供新的方向。本文简要概述了补体系统,分析了OPG/RANKL/RANK信号通路在骨质疏松症发生发展中的作用机制,就补体成分3及其他免疫系统成分与骨质疏松症的关系的研究进展进行了综述。     

Primary Inflammatory Myofibroblastic Tumors of the Breast with Metastasis: Radiographic and Histopathologic Predictive Factors

Primary inflammatory myofibroblastic tumors (IMTs) of the breast are uncommon and metastasis of IMTs is extremely rare. To date, the natural course of this disease is not fully understood. Although patients with IMTs should undergo regular follow-up after complete surgical resection of the tumor, the appropriate interval and method of follow-up are unclear. We report the case of a patient with an IMT of the breast that metastasized 2 years after complete surgical resection. This unusual case emphasizes the importance of preoperative examinations to determine whether the IMT has atypical features that should guide the interval and method of follow-up.     

Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction

PurposeThis study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique.MethodsWe retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient''s subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon.ResultsFunctional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test).ConclusionsThe success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.     

A Case of Nonalcoholic Steatohepatitis and Small Intestinal Bacterial Overgrowth with Peripheral Edema Caused by Intestinal Bypass Surgery and Relieved by Repair

Intestinal bypass surgery, particularly jejuno-ileal bypass surgery, performed for the purpose of weight reduction may cause an unexpected exacerbation of nonalcoholic steatohepatitis (NASH). Here, we report a case of NASH caused by small intestinal bacterial overgrowth, which developed after jejuno-colic bypass surgery and resolved dramatically after surgical correction.     

Pharmaceutical perspectives for the delivery of TNF-α in cancer therapy

TNF-?? is an endogenous signaling protein which controls physiological activities and participates in immune response. It is known to interact with TNF receptors (TNFR), of which have two kinds leading to totally different effects. Binding of TNF-?? to TNFR1 can induce either cell proliferation or cell death, i.e., necroptosis, depending on the kinds of protein to which it binds during the signaling cascade. On the contrary, binding of TNF-?? to TNFR2 induces only cell death process. TNF-?? can also cause antiviral effect by inducing interferon, and can inhibit tumor growth. Moreover, TNF-?? helps action of immune cells and it leads to increasement of tumor cell lysis. TNF-?? also makes tumor vessels more permeable and induces coagulation and thrombosis in the tumor vessels, which ultimately contribute to antitumor effect. However, TNF-?? also has several toxic effects, which include the change in redox status of antioxidant factors, induction of excess inflammation response, and action as pro-inflammatory cytokine of itself. These toxicities need to be considered when developing TNF-?? as an anticancer agent. In this review, pharmaceutical approaches to optimize and utilize its antitumor activity of TNF-?? as well as to decrease its adverse effect are discussed.     

Role of metabolism by intestinal microbiota in pharmacokinetics of oral baicalin

Baicalin (baicalein-7-glucuronide) is a flavonoid purified from Scutellaria baicalensis Georgi that has traditionally been used for treatment of hypertension, cardiovascular diseases, and viral hepatitis. In this study, the effects of intestinal microbiota on the pharmacokinetics of baicalin were investigated in normal and antibiotic-pretreated rats following p.o. administration of 100 mg/kg baicalin by using liquid chromatography/ion trap mass spectrometry. When rats were pretreated orally with cefadroxil, oxytetracycline and erythromycin for 3 days to control the number of intestinal bacteria, the pharmacokinetic parameters of oral baicalin were significantly affected by antibiotics: C_max, T_1/2(β), K_el and AUC values were significantly changed compared to those in normal rats. These results indicate that intestinal microbiota might play a key role in the oral pharmacokinetics of baicalin.     

Estimation of 24-Hour Urinary Sodium Excretion Using Spot Urine Samples

The present study evaluated the reliability of equations using spot urine (SU) samples in the estimation of 24-hour urine sodium excretion (24-HUNa). Equations estimating 24-HUNa from SU samples were derived from first-morning SU of 101 participants (52.4 ± 11.1 years, range 24–70 years). Equations developed by us and other investigators were validated with SU samples from a separate group of participants (n = 224, 51.0 ± 10.9 years, range 24–70 years). Linear, quadratic, and cubic equations were derived from first-morning SU samples because these samples had a sodium/creatinine ratio having the highest correlation coefficient for 24-HUNa/creatinine ratio (r = 0.728, p < 0.001). In the validation group, the estimated 24-HUNa showed significant correlations with measured 24-HUNa values. The estimated 24-HUNa by the linear, quadratic, and cubic equations developed from our study were not significantly different from measured 24-HUNa, while estimated 24-HUNa by previously developed equations were significantly different from measured 24-HUNa values. The limits of agreement between measured and estimated 24-HUNa by six equations exceeded 100 mmol/24-hour in the Bland-Altman analysis. All equations showed a tendency of under- or over-estimation of 24-HUNa, depending on the level of measured 24-HUNa. Estimation of 24-HUNa from single SU by equations as tested in the present study was found to be inadequate for the estimation of an individual’s 24-HUNa.