Anaplastic large cell lymphoma in a patient with MAGIC syndrome: a case and review of the literature

Clinical Rheumatology - Mouth and genital ulcer with inflamed cartilage syndrome (MAGIC syndrome) is a rare autoinflammatory disorder with unknown etiology. Except for the common clinical...     

Insomnia symptoms are associated with an increased risk of type 2 diabetes mellitus among adults aged 50 and older

Purpose

To evaluate the association of the different degrees of insomnia symptoms with subsequent incidence of type 2 diabetes mellitus (T2DM).

Methods

The data were extracted from Health and Retirement Study 2006–2014 waves. The association of insomnia symptoms with T2DM incidence was evaluated by the competing risk model with cumulative incidence function (death was considered a competing event) and Cox proportional hazard model with the Kaplan–Meier method. Population attributable fraction (PAF) was calculated. All analyses related to our study were conducted between November 2020 and January 2021.

Results

A total of 14,112 patients were included in this study, with an average follow-up of 6.4 years, and the incidence density was 17.9 per 1000 person-years. Insomnia symptoms were positively associated with T2DM incidence compared with those with no insomnia symptoms, regardless of competing risk model (≥?1 symptoms: sub-distribution hazard ratio (SHR) 1.13; 95% confidence interval (CI) 1.02–1.26; P-trend?=?0.012) and Cox proportional hazard model (≥?1 symptoms: hazard ratio (HR) 1.13; 95% CI 1.02–1.26; P-trend?=?0.013). The cumulative incidence function (Gray’s test, p?<?0.001) and Kaplan–Meier estimate (log-rank test, p?<?0.001) also presented this positive relationship. This positive association was more apparent in women and participants with ages from 50 to 65 years. The PAF was 4.1% with 95% CI (0.7–7.9%).

Conclusions

Insomnia symptoms may be an important risk factor for the development of T2DM, which is unbiased by the death competing risk. These findings suggest that management of sleep problems may be an important part of strategies to prevent T2DM.

     

Hepatitis B virus precore protein augments genetic immunizations of the truncated hepatitis C virus core in BALB/c mice

DNA immunization has been used to induce either humoral or cellular immune responses against many antigens, including hepatitis C virus (HCV). In addition, DNA immunizations can be enhanced or modulated at the nucleotide level. Genetic immunizations were examined in BALB/c mice through the use of plasmids and chimeric DNA constructs encoding HCV core proteins and hepatitis B virus (HBV) precore (preC) regions. Plasmids encoding the truncated HCV core induced potent humoral and cellular responses to HCV; pcDNA3.0A-C154 produced a stronger antibody response than pcDNA3.0A-C191 (P < 0.01) and pcDNA3.0A-C69 (P < 0.05). HBV preC enhanced the humoral and cellular immune responses of BALB/c mice to HCV; however, pcDNA3.0A-C69preC resulted in a weak cytotoxic T lymphocyte (CTL) response. In addition, the humoral and cellular immune responses to HCV of groups immunized with pcDNA3.0A-C154preC and pcDNA3.0A-C191preC plasmids were higher than those of groups immunized with pcDNA3.0A-C154 and pcDNA3.0A-C191. In vivo CTL responses verified that mice immunized with preC core fused DNAs showed significantly high specific lysis compared with mice immunized with HCV cores only (P < 0.01). In our study, pcDNA3.0A-C154preC led to the highest immune response among all DNA constructs. Conclusion: DNA that encodes truncated HCV core proteins may lead to increased immune responses in vivo, and these responses may be enhanced by HBV preC.     

新冠肺炎流行期急诊护士心理应激反应及相关因素

目的:了解新冠肺炎流行期急诊护士的心理应激反应现状并分析相关因素,为调控其心理应激反应提供参考依据。方法:使用修订版事件影响量表(IES-R)、一般健康问卷(GHQ-12)、简易应对方式问卷(SCSQ)调查广州地区7所新冠感染者定点救治医院的263名急诊护士的心理应激反应、心理健康水平及应对方式。结果:急诊护士IES-R总分为(28.1±14.8)分,心理应激反应检出率分别为轻度37.6%、中度39.3%、重度13.3%。多重线性回归分析显示,女性、本科及以上受教育程度的护士IES-R得分较高(β=0.11、0.12,均P<0.05),IES-R总分与GHQ-12得分、SCSQ消极应对得分与担心自己感染新冠肺炎程度呈正向关联(β=0.39、0.30、0.24,均P<0.05),与SCSQ积极应对得分呈负向关联(β=-0.15,P<0.05)。结论:新冠肺炎流行期,女性、受教育程度较高、心理健康水平较差、倾向消极应对方式及担心自己感染的护士心理应激反应更严重。     

2型糖尿病患者的氨基酸及酰基肉碱代谢水平分析

目的 检测并分析2型糖尿病患者血液中11种氨基酸和31种酰基肉碱的水平,评价小分子代谢物作为2型糖尿病的诊断价值.方法 收集门诊2型糖尿病患者302例,正常对照302例,利用液相串联质谱技术测定血液中的11种氨基酸和31种酰基肉碱的水平并进行比较分析.用ROC曲线判断诊断效能.结果 2型糖尿病患者与对照组的7种氨基酸和21种酰基肉碱水平差异有统计学意义,C2对2型糖尿病有辅助诊断价值,曲线下面积为0.771(95％CI=0.734～0.809),P<0.01,当临界值为12.50μmol/L时,灵敏度和特异性分别为60.3％和82.5％.结论 2型糖尿病患者存在氨基酸和酰基肉碱代谢紊乱,C2可以作为2型糖尿病的辅助诊断指标.     

外泌体:肝纤维化中药调控新靶标

肝纤维化是慢性肝病的早期阶段,肝纤维化的早期诊断和治疗是医学界研究的热点。随着对外泌体研究工作的不断深入,越来越多研究证实外泌体与肝纤维化的关系密切。外泌体作为细胞通讯间的重要物质,通过靶向传递活性物质到靶细胞体调节细胞功能。在肝脏中,肝实质和非实质细胞可以将外泌体靶向传递的活性物质释放到邻近的肝细胞或非实质细胞中以调节肝损伤后的肝脏重塑。作者团队以肝纤维化为研究目标,以外泌体为导向,以期为中医药调节外泌体靶向治疗肝纤维化提供了理论基础。     

抗生素降阶梯疗法治疗重症肺炎患者的临床效果分析

目的:分析探讨在重症肺炎患者治疗过程中应用抗生素降阶梯疗法的临床应用价值。方法:选择某院收治的110例重症肺炎患者作为研究对象,按照随机数字法分为对照组和观察组。对照组患者采用常规治疗措施,观察组患者实施抗生素降阶梯疗法,对比两组患者临床治疗效果以及肺功能等指标改善情况。结果:观察组患者治疗指标评分和对照组相比较具有显著差异,且肺功能等相关治疗指标改善情况和对照组相比较具有明显优势,P<0.05。结论:针对重症肺炎患者采用抗生素降阶梯疗法,具有显著的临床治疗效果,对改善患者肺功能相关指标具有重要意义,值得推广。