Composition of Maternal Circulating Short-Chain Fatty Acids in Gestational Diabetes Mellitus and Their Associations with Placental Metabolism

Short-chain fatty acids (SCFAs), which are produced by gut microbiota from dietary fiber, have become candidates for gestational diabetes mellitus (GDM) treatment. However, the associations of circulating SCFAs with maternal–neonatal clinical parameters in GDM and further influences on placental immune–metabolic responses are unclear. Acetate, propionate, and butyrate were decreased in GDM during the second and third trimesters, especially in those with abnormal glucose tolerance at three “oral glucose tolerance test” time points. Butyrate was closely associated with acetate and propionate in correlation and dynamic trajectory analysis. Moreover, butyrate was negatively correlated with white blood cell counts, neutrophil counts, prepregnancy BMI, gestational weight gain per week before GDM diagnosis, and ponderal index but positively correlated with total cholesterol and low-density lipoprotein levels in all pregnancies. On the premise of reduced SCFA contents in GDM, the placental G-protein-coupled receptors 41 and 43 (GPR41/43) were decreased, and histone deacetylases (HDACs) were increased, accompanied by enhanced inflammatory responses. The metabolic status was disturbed, as evidenced by activated glycolysis in GDM. Maternal circulating acetate, propionate, and butyrate levels were associated with demographic factors in normal and GDM women. They influenced placental function and fetal development at birth through GPRs or HDACs, providing more evidence of their therapeutic capacity for GDM pregnancies.     

基于“生物-心理-社会”模式的甲状腺癌术后患者一例报道及全科诊疗思路

以患者为中心的医疗之家,通过健康团队的形式将各领域的专业人员集中在一起,整合生物、心理、社会的各方面来评估治疗患者,这是非常优化的全科医学模式,同时也对全科医生提出了巨大挑战。本文报道1例31岁女性患者,以“月经不规律13年,甲状腺癌术后6个月,想了解如何全面治疗”为主诉于2018-12-07就诊于北京交通大学社区卫生服务中心医疗之家,本例患者甲状腺癌术后,同时患有多囊卵巢综合征、2型糖尿病,性格上追求完美,自我要求高,有生育需求。从这个真实的患者身上,能看到全科医生的重要性。患者不仅需要生物层面对症治疗,还需要心理疏导,同时协调家庭、单位的资源。这是全科医生与专科医生的最大区别,全科医生以系统观看待患者,层层剖析复杂的病情,基于生物-心理-社会医学模式提出治疗方案。     

正常东方田鼠血清及脾细胞体外杀血吸虫童虫作用的初步观察

目的研究野生和繁殖东方田鼠血清和/或脾细胞在体外对日本血吸虫童虫的杀伤作用.方法东方田鼠血清和/或脾细胞与童虫在体外共培养,16～18h后在倒置显微镜下观察,计算童虫死亡率.结果东方田鼠血清或脾细胞对童虫的校正死亡率分别为67.36%土4.00%(野生鼠)和64.39%±5.86%(繁殖鼠)、66.02%±1.40%(野生鼠)和66.38%±2.18%(繁殖鼠);东方田鼠血清加脾细胞的童虫校正死亡率为76.68%±6.27%(野生鼠)和79.03%±8.00%(繁殖鼠),均显著高于单纯血清或脾细胞的校正死亡率;野生鼠和繁殖鼠对童虫的杀伤作用无显著性差异.结论东方田鼠血清和脾细胞均具有体外杀童虫作用,并表现出一定的协同杀伤作用,且野生鼠与繁殖鼠之间无显著性差异.     

孕妇及新生儿血清硒,铜,锌的含量关系

测定56例非孕妇和66例不同孕期妇女及30例新生儿(脐血)血清中硒、铜、锌三种微量元素。结果表明,孕妇血清硒锌随孕期进展明显低于非孕妇,而孕晚期血清铜显著升高;新生儿血清硒、锌显著高于母血水平,铜低于母血。     

一次鼠伤寒沙门氏菌胃肠炎医院内爆发的流行病学研究

1982年10月21日~11月20日,某医院妇产科婴儿室及儿科病房发生一起鼠伤寒沙门氏菌胃肠炎医院感染的爆发,216名住院儿童中,30名发病,罹患率达13.9%。发病年龄最小为2天,最大为9岁,2岁以下儿童罹患率最高;男女儿童罹患率无差别。流行主要通过医护人员的手交叉感染引起;流行期间从哺乳母亲的乳头、工作人员及家长的手、医疗用具及病房的褐家鼠中检出了鼠寒伤沙门氏菌。     

沙棘油治疗造血功能障碍动物实验及临床研究

在６００余只ＢＡＬＢ／Ｃ小鼠中建立了造血功能障碍疾病模型，观察了经６０ＣＯ射线一次全身照射后外周血象、骨髓象和肝、脾、骨髓的病理学变化及死亡曲线；探讨了沙棘油治疗动物中造血功能障碍的机理。与此同时，还先后进行了沙棘油治疗３１例各类造血功能障碍疾病病人的临床观察。动物实验结果及临床观察均提示，沙棘油可作为治疗造血功能障碍疾病的有效药物之一。     

医疗失效模式与效应分析在临床用血安全管理中的应用

目的 确保住院患者用血安全.方法 运用医疗失效模式与效应分析对临床用血的关键环节进行分析,找出不安全环节及原因,采取将LIS医嘱检验信息捆绑、设立临床护理送血站、加强护士输血相关知识培训等对策.结果 应用后输血适应证符合率保持在95%以上,临床成分输血率达100%,输血病历合格率由43%提高至89%.结论 运用医疗失效模式与效应分析理论前瞻性地对住院患者用血系统进行全过程分析,结合实际情况制定改进计划并落实,可保证临床用血安全.     

Regulation of hematopoietic stem cell trafficking and mobilization by the endocannabinoid system

The cannabinoid receptors CB(1) and CB(2) are seven-transmembrane Gαi protein-coupled receptors and are expressed in certain mature hematopoietic cells. We recently showed that these receptors are expressed in murine and human hematopoietic stem cells (HSCs) and that CB(2) agonists induced chemotaxis, enhanced colony formation of marrow cells, as well as caused in vivo mobilization of murine HSCs with short- and long-term repopulating abilities. Based on these observations, we have further explored the role of CB(2) and its agonist AM1241 on hematopoietic recovery following sublethal irradiation in mice. Cannabinoid receptor 2 knockout mice (Cnr2(-/-) deficient mice) exhibited impaired recovery following sublethal irradiation as compared with irradiated wild-type (WT) mice, as determined by low colony-forming units and low peripheral blood counts. WT mice treated with CB(2) agonist AM1241 following sublethal irradiation demonstrated accelerated marrow recovery and increased total marrow cells (approximately twofold) and total lineage- c-kit(+) cells (approximately sevenfold) as well as enhanced HSC survival as compared with vehicle control-treated mice. When the CB(2) agonist AM1241 was administered to WT mice 12 days before their sublethal irradiation, analysis of hematopoiesis in these mice showed decreased apoptosis of HSCs, enhanced survival of HSCs, as well as increase in total marrow cells and c-kit+ cells in the marrow. Thus, CB(2) agonist AM1241 promoted recovery after sublethal irradiation by inhibiting apoptosis of HSCs and promoting survival, as well as enhancing the number of HSCs entering the cell cycle.     

Microglial cells initiate vigorous yet non-protective immune responses during HSV-1 brain infection

Central nervous system (CNS) infection with herpes simplex virus (HSV)-1 triggers neuroinflammatory responses leading to peripheral immune cell infiltration into the brain. Previous in vitro studies from our laboratory, using primary human brain cells, implicated microglia as the cellular source of infection-induced chemokines, such as CXC ligand 10 (CXCL10) and CC ligand 2 (CCL2). Here, we evaluated the role of microglial cells in HSV-induced neuroimmune responses using an in vivo murine model of herpes encephalitis. Data obtained during this study demonstrated robust levels of CXCL10, CCL2 and CXCL9 detectable in the brains of infected BALB/c mice between 5 and 8 days post-infection (p.i.). Microglial cells were identified as a source of this HSV-induced chemokine production. Additional experiments established that induction of these immune mediators preceded the presence of CD3, CD4, CD8, and CD45 mRNA in the brain, and immunohistochemical analysis confirmed the presence of infiltrating CD3(+) cells. Further analysis suggested that microglia-derived chemokines drive peripheral immune cell chemotaxis, as antibodies to CXCL10 and CCL2 blocked the migration of murine splenocytes toward HSV-infected microglia by approximately 59.3+/-4.1% and 17.5+/-1.4%, respectively. Taken together, these results demonstrate that a vigorous microglia-driven cascade of pro-inflammatory immune responses is not sufficient to protect susceptible mice from HSV-1 brain infection.