上海市骨科康复护理现状调查研究

目的 了解上海市骨科康复护理开展的状况及目前存在的主要问题,为上海市骨科康复的实施提供依据.方法 采用自行设计的骨科康复护理现状调查问卷,对上海市区和郊区共15所医院的300名骨科护士进行调查,收回287份,有效问卷282份.调查数据用SPSS 11.0软件进行统计分析.结果 骨科护士很少开展康复护理评估、指导病人做功能锻炼和训练日常生活活动能力以及心理护理.99.6%的护士认为康复训练对骨科病人的功能恢复很重要,92.9%的骨科护士认为自己应该指导病人做功能锻炼.骨科护士康复护理总论知识得分(30.26±13.87)分;骨科临床康复护理知识得分(58.76±10.41)分.结论 上海市骨科护士康复护理知识水平亟待提高,应增强对护理人员康复护理知识的普及,加强骨科康复护理工作的管理.     

An approach for evaluating the effects of dietary fiber polysaccharides on the human gut microbiome and plasma proteome

Increases in snack consumption associated with Westernized lifestyles provide an opportunity to introduce nutritious foods into poor diets. We describe two 10-wk-long open label, single group assignment human studies that measured the effects of two snack prototypes containing fiber preparations from two sustainable and scalable sources; the byproducts remaining after isolation of protein from the endosperm of peas and the vesicular pulp remaining after processing oranges for the manufacture of juices. The normal diets of study participants were supplemented with either a pea- or orange fiber-containing snack. We focused our analysis on quantifying the abundances of genes encoding carbohydrate-active enzymes (CAZymes) (glycoside hydrolases and polysaccharide lyases) in the fecal microbiome, mass spectrometric measurements of glycan structures (glycosidic linkages) in feces, plus aptamer-based assessment of levels of 1,300 plasma proteins reflecting a broad range of physiological functions. Computational methods for feature selection identified treatment-discriminatory changes in CAZyme genes that correlated with alterations in levels of fiber-associated glycosidic linkages; these changes in turn correlated with levels of plasma proteins representing diverse biological functions, including transforming growth factor type β/bone morphogenetic protein-mediated fibrosis, vascular endothelial growth factor-related angiogenesis, P38/MAPK-associated immune cell signaling, and obesity-associated hormonal regulators. The approach used represents a way to connect changes in consumer microbiomes produced by specific fiber types with host responses in the context of varying background diets.

Advances in our understanding of the role of the gut microbiome in regulating many aspects of human physiology hold the promise of evolving our view of human nutrition by establishing mechanistic connections between the foods we consume and how they affect health status. One manifestation of this effort is a series of studies, performed on well-phenotyped cohorts, that seek to relate features of gut microbial community composition (organisms, genes), dietary practices, and pre- and postprandial cardiometabolic responses to test meals (1–4). A key question raised by these initiatives relates to the nature of the “bioactive” components of foods. Specifically, what are the nutrients utilized by various gut community members or microbiome-encoded metabolic pathways? What products are produced by biotransformation of these nutrients? How are these products linked to specific host physiologic (or pathophysiologic) processes?Plant-derived dietary fibers represent a “poster child” for these efforts and illustrate the formidable challenges faced. The health benefits of dietary fibers are widely known, as is their inadequate representation in Western diets. However, natural fibers are structurally complex and highly diverse. They contain numerous, typically undefined polysaccharide structures and largely unspecified protein, lipid, and small molecule constituents. Their composition varies as a function of their origin (food staple and cultivar), the different methods employed to recover them from these sources, as well as the different techniques used to incorporate them into processed foods with acceptable organoleptic properties (5). Moreover, analyzing the host effects of metabolism of different fibers is confounded by the fact that there is substantial intra- and interpersonal variation in microbiome configuration (6, 7).Snacking is becoming an ever more dominant feature of daily life worldwide and thus provides an opportunity to introduce nutritious ingredients, such as fibers, into diets. However, obtaining structure-activity relationships for specific fiber types and their corresponding targets in the gut community is foundational for designing snack foods that evoke and/or reinforce microbiome responses that are beneficial to the host.Degradation of dietary polysaccharides is a function primarily performed by bacterial carbohydrate-active enzymes (CAZymes). The gut microbiome harbors tens of thousands of CAZyme genes belonging to at least 136 glycoside hydrolase (GH) and 29 polysaccharide lyase (PL) families [extrapolated and updated from El Kaoutari et al. (8)]. In contrast, the human genome only contains 98 GH and no PL genes (9), of which <20% contribute to the processing of dietary glycans.In the current study, we test the effects of dietary supplementation with two snack food prototypes, one containing pea fiber and the other orange fiber, in two pilot studies of overweight and obese individuals consuming their normal, unrestricted diets. Our strategy was to focus on fiber-associated changes in the abundances of microbial GH and PL genes to determine whether responses to the pea or orange fiber prototypes in the gut microbiome and host are decipherable against a background of varying dietary practices and starting microbiome configurations. Higher order singular value decomposition (10) was utilized as a feature selection tool to identify treatment-discriminating changes in GH and PL gene representation. Mass spectrometric assays of the levels of fecal glycan structures (glycosidic linkages) were subsequently performed and the results were correlated with changes in the abundances of treatment-discriminating GH and PL genes with known or predicted substrate specificities. Our analysis concluded by measuring changes in levels of 1,305 plasma proteins in each study participant as a function of fiber treatment and applying computational tools to identify links between these microbiome and plasma proteome changes in response to fiber consumption. Our results provide an approach, using pilot human studies, for selecting specific fiber preparations, plus informative microbiome and host biomarkers, that can be advanced to proof-of-concept clinical trials which assess their capacity for precise manipulation of microbiome and host features.     

超声引导下经皮肾造瘘对肾结核孤立肾输尿管梗阻的疗效观察

目的 总结超声引导经皮穿刺肾造瘘对肾结核孤立肾肾盂积水治疗的效果.方法 选取2011年1月至2019年7月在解放军总医院第八医学中心收治的27例肾结核孤立肾肾积水患者,行超声引导下经皮造瘘置管留置,统计置管及换管成功率、并发症,采用t检验比较置管前后血清肌酐变化差异,调查长期带管对患者生活的影响.结果 27例患者共行置...     

HOXD8 hypermethylation as a fully sensitive and specific biomarker for biliary tract cancer detectable in tissue and bile samples

Background Biliary tract cancers (BTC) are rare but highly aggressive tumours with poor prognosis, usually detected at advanced stages. Herein, we aimed at identifying BTC-specific DNA methylation alterations.Methods Study design included statistical power and sample size estimation. A genome-wide methylation study of an explorative cohort (50 BTC and ten matched non-tumoral tissue samples) has been performed. BTC-specific altered CpG islands were validated in over 180 samples (174 BTCs and 13 non-tumoral controls). The final biomarkers, selected by a machine-learning approach, were validated in independent tissue (18 BTCs, 14 matched non-tumoral samples) and bile (24 BTCs, five non-tumoral samples) replication series, using droplet digital PCR.Results We identified and successfully validated BTC-specific DNA methylation alterations in over 200 BTC samples. The two-biomarker panel, selected by an in-house algorithm, showed an AUC > 0.97. The best-performing biomarker (chr2:176993479-176995557), associated with HOXD8, a pivotal gene in cancer-related pathways, achieved 100% sensitivity and specificity in a new series of tissue and bile samples.Conclusions We identified a novel fully efficient BTC biomarker, associated with HOXD8 gene, detectable both in tissue and bile by a standardised assay ready-to-use in clinical trials also including samples from non-invasive matrices.Subject terms: Diagnostic markers, Biliary tract cancer     

2019年“农村义务教育学生营养改善计划”覆盖地区学生餐剩饭状况及影响因素分析

目的:分析我国“农村义务教育学生营养改善计划”覆盖地区中小学学生餐剩饭情况及影响因素。方法:2019年在“农村义务教育学生营养改善计划”覆盖地区699个县中,分片选取1~3个国家试点县,共选取50个重点监测县。按照不同供餐模式,随机各抽取2所小学和2所初中作为重点监测学校。从小学三年级到初中三年级,每个年级抽取1~2个...     

Antiproliferative and apoptosis-inducing effects of maslinic and oleanolic acids, two pentacyclic triterpenes from olives, on HT-29 colon cancer cells

We have previously reported the anticarcinogenic effects of an olive fruit extract composed of pentacyclic triterpenes, the main components of which are maslinic acid (73.25%) and oleanolic acid (25.75%). Here we examined the effects of the individual components on proliferation, necrosis and apoptosis rates by fluorescence-based techniques in human HT-29 colon cancer cells. Oleanolic acid showed moderate antiproliferative activity, with an ec50 of 160.6 (se 10.6) micromol/l, and moderate cytotoxicity at high concentrations ( > or = 250 micromol/l). On the other hand, maslinic acid inhibited cell growth with an ec50 of 101.2 (se 7.8) micromol/l, without necrotic effects. Oleanolic acid, which lacks a hydroxyl group at the carbon 2 position, failed to activate caspase-3 as a prime apoptosis protease. In contrast, maslinic acid increased caspase-3-like activity at 10, 25 and 50 micromol/l by 3-, 3.5- and 5-fold over control cells, respectively. The detection of ROS in the mitochondria, which serve as pro-apoptotic signal, evidenced the different bioactivity of the two triterpenes. Confocal microscopy analysis revealed that maslinic acid generated superoxide anions while oleanolic acid-treated cells did not differ from the control. Completion of apoptosis by maslinic acid was confirmed microscopically by the increase in plasma membrane permeability, and detection of DNA fragmentation. In conclusion, the anticancer activity observed for olive fruit extracts seems to originate from maslinic acid but not from oleanolic acid. Maslinic acid therefore is a promising new compound for the chemoprevention of colon cancers.     

宫腔镜下子宫黏膜下肌瘤切除不同治疗模式的对比研究

目的探讨宫腔镜下子宫黏膜下肌瘤切除不同治疗模式的治疗效果。方法回顾性分析2014年3月至2015年12月因子宫黏膜下肌瘤在海南省农垦三亚医院就诊的患者160例,其中日间手术组80例,住院手术组80例。对患者手术时间、术后不良反应、住院时间、医疗花费、患者满意度及术后1年复发情况进行对比分析。结果两组治疗方式均能使患者月经紊乱情况得以改善,日间手术组比住院手术组住院时间短、医疗花费少、患者满意度高,差异有统计学意义(P0.05)。两组手术时间、术后不良反应、术后1年复发率及术后恢复率比较,差异无统计学意义(P0.05)。结论日间手术在医疗花费与住院时间上优于住院手术,在临床上可优先考虑。     

老年菌血症患者血小板及凝血功能的变化与意义

目的探讨重症监护室（ICU）老年菌血症患者血小板（PLT）及凝血功能的变化与临床意义。方法选择经实验室检测确认的 24例ICU老年菌血症患者为研究对象,比较其发生菌血症前后PLT及凝血功能的变化,以及不同病原体（革兰阳性球菌、革兰阴性杆菌和真菌）感染组、存活组与死亡组PLT及凝血功能的变化。结果发生菌血症后,老年患者PLT计数为（144.50±84.10）×109/L,部分活化的凝血酶原时间（APTT）为（47.04±14.60）s,凝血酶原时间（PT）为（18.63±8.92）s,纤维蛋白原（FIB）为（4.20±0.98）g/L,与基础值［分别为（233．18±78.20）×109/L、（33.98±7.36）s、（12.83±2.17）s、（3.16±0.79）g/L］比较,差异均有统计学意义（P＜0.05）;凝血酶时间（TT）无统计学差异（P＞0.05）。不同病原体感染组间PLT及相关凝血功能指标比较,差异无统计学意义（P＞0.05）。死亡组的PLT计数［（89.60±36.42）×109/L］低于存活组［（213.13±76.06）×109/L］,APTT值［（54.55±13.21）s］高于存活组［（35.93±7.03）s］（P＜0.05）,FIB及PT无统计学差异（P＞0.05）。结论PLT及部分凝血功能指标可作为辅助诊断老年菌血症的参考之一,并可在一定程度上判断预后。     

贻贝多糖胶囊毒理学安全性研究

目的:对贻贝多糖胶囊的食用安全性进行毒理学评价。方法:采用急性毒性实验、遗传毒性实验(Ames试验、小鼠骨髓微核试验、小鼠精子畸形试验)和30 d喂养试验进行评价。结果:小鼠经口MTD均大于15.0 g/kg,Ames试验、小鼠骨髓微核试验、小鼠精子畸形试验三项遗传毒性试验结果均为阴性。30 d喂养试验未见大鼠的生长发育、血液学、生化、脏器比及组织病理学有异常变化。结论:贻贝多糖胶囊急性毒性分级属无毒级,无遗传毒性,最大无损害作用剂量大于1.6 g/kg,相当于人体推荐摄入量的120倍。在本实验剂量范围内,贻贝多糖胶囊属安全性保健食品。