Taking a Low Glycemic Index Multi-Nutrient Supplement as Breakfast Improves Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI) multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM). A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c). Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a −0.2% absolute reduction in HbA1c (95% CI (confidence interval), −0.38% to −0.07%, p = 0.004), while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005). The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032) due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007). These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM.     

A novel mutation of MSX1 inherited from maternal mosaicism causes a severely affected child with nonsyndromic oligodontia

Mutations of MSX1 have been associated with nonsyndromic hypodontia. To seek the causal gene mutation sites in a family with nonsyndromic oligodontia, whole-exome sequencing (WES) was performed to seek the causative locus of the family. The candidate mutation was further identified by Sanger sequencing afterward. Two mutations of MSX1 were found both in the proband and her mother. One novel heterozygous missense mutation (c.C667G, p.R223G) of MSX1 inherited from the asymptomatic mother with mosaic mutation was located in the highly conserved fragment of exon 2. The other was a synonymous mutation (c.C348T, p.G116G) in exon 1, which had been reported. The novel maternal heterozygous missense mutation (c.C667G, p.R223G) was likely to be the major reason for nonsyndromic oligodontia in the family. This is the first mosaic variant that has been recorded of the MSX1 gene. Our study expands the phenotype–genotype correlation associated with MSX1 variants. Our study also suggests that the determination of the mosaicism is essential for precise genetic counseling if a disease appears to arise de novo.     

突发公共卫生事件形势下医学文献资源保障与服务

以上海交通大学医学院图书馆为例,介绍文献资源服务模式与内容,阐述新型冠状病毒肺炎疫情期间数字资源保障服务举措并提出相关建议,包括多平台结合保障远程资源获取,鼓励并规范出版商资源开放与公益服务,创新发展在线教育健全服务推广。     

慢性咳嗽患者支气管激发试验的护理

目的探讨慢性咳嗽患者行组织胺吸入支气管激发试验的护理。方法选择符合慢性咳嗽标准的患者,测定基础肺功能及吸入不同剂量组织胺后的肺功能,对患者从预约到检查结束给予全程护理。结果136例患者均顺利完成检查,阳性者75例,占试验人数55%。结论组织胺吸入支气管激发试验是变态反应性哮喘的特异性检查方法之一。对反复发作的顽固性咳嗽患者进行激发试验有助于确认咳嗽变异性哮喘的诊断。保证结果的准确性及顺利完成试验,护理配合具有极其重要的作用。     

内消连翘丸治疗结节性甲状腺肿的临床观察

目的观察内消连翘丸治疗结节性甲状腺肿的疗效。方法采用随机单盲对照法，将80例结节性甲状腺肿患者分为2组，治疗组予以内消连翘丸，对照组予以优甲乐治疗，疗程均为2个月。两组治疗后进行前后的总疗效、甲状腺重量及肿物直径、T3、T4的比较。结果治疗组总有效率为83．8％，对照组总有效率为61．1％，两组比较有显著性差异（P〈0．05）。两组甲状腺的重量和结节最大直径治疗后均较治疗前降低（P〈0．05）；治疗后两组间甲状腺的重量无显著性差异（P〉0．05），而肿物最大直径有显著性差异（P〈0．05）。说明两种药物均可使甲状腺及其结节缩小，内消连翘丸肿物缩小作用大于优甲乐。结论内消连翘丸缩小甲状腺及其结节作用明显。     

综合治疗368例儿童弱视的疗效分析

目的探讨儿童弱视综合治疗的临床效果,为治疗儿童弱视提供参考依据。方法对368例694眼弱视儿童进行氦氖激光、光刷、红闪、光栅、精细作业结合配戴眼镜、遮盖法及家庭的传统穿珠子等增进视功能的弱视综合治疗。结果452眼基本痊愈,矫正视力提高至1.0以上,占65.13%,233眼进步,视力提高2行或以上,占33.57%,9眼无效1.3%,总有效率98.7%。结论综合治疗方法治疗儿童弱视有显著效果。     

Bone mesenchymal stem cell-conditioned medium decreases the generation of astrocytes during the process of neural stem cells differentiation

Objectives: The aim of this study was to investigate the effect of bone mesenchymal stem cell (BMSC) conditioned medium (CM) and Bone morphogenetic protein-4 (BMP-4) on the generation of astrocytes during the process of NSCs differentiation.

Design: Neural stem cells (NSCs) were grown under different culture conditions.

Setting: The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Outcome Measures: The study consisted of four groups: NSCs cultured under control conditions (group 1) or with the addition of BMSC-CM (group 2);(BMP-4) (group 3) or both (group 4).The expression of glial fibrillary acidic protein (GFAP) was detected by immunocytochemical staining and Western blotting.

Results: The expression of GFAP was higher in Group3 and lower in Group 2 compared to that in Group 1. The expression of GFAP in Group 4 was intermediate between that of Group 2 and Group 3.

Conclusions: These results suggest that BMSC-CM can decrease the generation of astrocytes and that the inhibition of the (BMP-4) /Smad1/5/8 signaling pathway may be the underlying mechanism. This phenomenon may be mediated by increasing the expression of Smad6.     

《管道护理》CAI课件在外科护理临床教学中的应用评估

目的提高《管道护理》的临床教学效果。方法制作《管道护理》的CAI课件,并将课件应用于实习学生和临床护士的教学中。将实习学生及外科护士共210人分层随机分为传统教学组、课件教学组,对两组人员分别进行传统的授课教学和CAI教学比较。结果两组人员的课后考试成绩经统计学处理(t检验),P值<0.01,具有显著性差异;对课件教学组人员进行CAI教学效果调查,结果显示:课件教学组人员认为课件整体结构合理为91.3%,知识层次分明为96.5%,界面美观为95.7%,文字表达清楚为96.5%,操作简单、人机交互性好为92.2%,能帮助理解教学中的难点、重点为96.5%,能帮助增强记忆为91.3%,能使课堂注意力更集中为90.4%,能增加学习兴趣为96.5%。结论应用《管道护理》CAI课件教学解决了临床缺乏病例等难题;《管道护理》CAI课件教学增强了学生的学习兴趣和记忆,提高了《管道护理》的教学质量;《管道护理》CAI课件教学有助于临床护士的培训。