轻断食模式对超重者代谢作用的影响研究

背景　肥胖可增加多种慢性病的发生风险,饮食干预是防治肥胖的重要措施之一,其中轻断食模式可能是防治肥胖的一条新途径。但既往研究样本量较小,关于作用机制和量效关系的分析不足,尚不能提供充分的科学依据。目的　探讨轻断食模式对超重者代谢作用的影响。方法　2016年12月-2017年1月,选取在天津海滨医院接受体检的某企业员工86例进行轻断食模式干预,均为初次检出超重者（BMI≥24.0 kg/m2）。轻断食模式干预方法为：每周中不连续的2 d每日只摄入600 kcal能量,余5 d根据个人饮食习惯自由饮食,干预时间为60 d。分别于干预实施前1日和干预周期最后1日,检测受试者代谢相关指标。结果　80例超重者按要求完成了轻断食模式干预。干预后受试者舒张压、体质量、体脂百分比低于干预前（P<0.05）,收缩压、心率与干预前无差异（P>0.05）。干预后受试者低密度脂蛋白胆固醇高于干预前（P<0.05）,总胆固醇、三酰甘油、高密度脂蛋白胆固醇与干预前无差异（P>0.05）。干预后受试者果糖胺、糖化血红蛋白低于干预前（P<0.05）。糖耐量试验显示,干预后受试者空腹血糖与干预前无差异（P>0.05）,餐后1 h血糖、餐后2 h血糖低于干预前（P<0.05）。胰岛素释放试验显示,干预后受试者空腹胰岛素低于干预前（P<0.05）,餐后1 h胰岛素、餐后2 h胰岛素与干预前无差异（P>0.05）。结论　轻断食模式是超重者减重的有效方法,可以明显改善超重者的机体应激状态,提高胰岛素敏感性、降低餐后血糖,有助于减少超重相关并发症的发生。     

A comparative study of masticatory performance in complete denture patients before and after application of soft liner

BackgroundTo compare the masticatory performance in complete denture patients before and after application of soft liner and to assess the effect of aging of soft liner on masticatory performance at different intervals of time.MethodsA total of 30 complete denture wearers between age of 64 and 80 years, were selected from both the sex (20 men, 10 women). This study evaluated the effect of before and after application of chair-side soft liner on masticatory performance of complete denture wearers by using raw carrots and roasted peanut as the test food. This study further evaluated the cushioning effect of chair-side soft liner material at the interval period of 1week, 4 weeks, 8 weeks, 12 weeks and 16 weeks.ResultsThere were significant differences in masticatory performance without soft liner as compared to with soft liner at different intervals of time. The performance was found to be significantly higher for raw carrot as compared to roasted peanut (p < 0.001). For both the materials peak performance was recorded at 4th week.ConclusionThe use of soft liner helps in increasing the masticatory performance among complete denture wearers.     

Nitric oxide synthase in acute alteration of nitric oxide levels after subarachnoid hemorrhage

OBJECTIVE: Subarachnoid hemorrhage (SAH) is associated with acute decreases and subsequent recovery of cerebral nitric oxide (NO) levels, but the mechanisms of these alterations are not known. In this study, we measured NO synthase (NOS) protein and kinetics to determine its involvement in the alterations of cerebral NO levels after SAH. METHODS: The endovascular rat model of SAH was used. The number of NOS-1 (neuronal) and NOS-2 (inducible)-positive cells (0-96 h) was determined by counting immunoreactive cells in 8-microm cryostat sections. The tissue content of active NOS and its kinetic parameters were studied with an enzymatic l-citrulline assay. RESULTS: The number of NOS-1-positive cells increased between 1 and 3 hours after SAH, decreased to and below control values at 6 and 72 hours after SAH, and increased to control values 96 hours after SAH. The number of NOS-2-positive cells increased 1 hour after SAH, decreased to control values at 24 hours, and increased above control values 96 hours after SAH. The Michaelis-Menten kinetic parameters (V(max), K(m), slope) of NOS remained unchanged at 10 and 90 minutes after SAH. CONCLUSION: NOS-1 and -2 proteins undergo a triphasic alteration after SAH, whereas the amount of active NOS and its kinetic parameters remain unchanged during the first 90 minutes after SAH. Depletion of NOS is not involved in the acute alterations of cerebral NO levels after SAH.     

Monoclonal Antibody Specific for TIRC7 Induces Donor-specific Anergy and Prevents Rejection of Cardiac Allografts in Mice

T cell immune response c-DNA (TIRC7) is up-regulated during the early stages of T-cell activation in response to alloantigens. In this study, we analyzed the effects of newly developed monoclonal antibodies (mAb) against TIRC7 in acute cardiac allograft rejection. Fully vascularized heterotopic allogeneic heart transplantation was performed in mice across a full-mismatch barrier (C57Bl/10 into CBA). Recipients received seven injections (day 0-7) of a novel anti-TIRC7 mAb or remained untreated. Graft survival, histology and ex vivo lymphocyte functions were tested. Targeting of TIRC7 with an anti-TIRC7 mAb diminishes lymphocyte infiltration into grafts resulting in delay of morphological graft damage and prolongation of allograft survival. The lymphocytes from anti-TIRC7 mAb-treated animals exhibit hypo-responsiveness without evidence of lymphocyte depletion against the donor allo-antigens. Proliferation and expression of interferon-gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) were down-regulated while interleukin-4 (IL-4) and IL-10 expression were spared. Moreover, anti-TIRC7 mAb enhanced up-regulation of CTLA-4 expression but suppressed up-regulation of CD25 on stimulated lymphocytes in vitro and in vivo. Ligation of TIRC7 has important effects on the regulation of co-stimulatory signaling pathways associated with suppressing of T-cell activation. Targeting of TIRC7 may therefore provide a novel therapeutic approach for modulating T cell immune responses during organ transplantation.     

A comparison of flow rates and warming capabilities of the Level 1 and Rapid Infusion System with various-size intravenous catheters

Cases involving massive blood transfusion may require the use of specialized blood warmers, such as the Level 1 (L-1) (Level 1 Technologies, Inc., Rockland, MA) or the Rapid Infusion System (RIS) (Haemonetics Corp., Braintree, MA). In this in vitro study, we compared the infusion and warming capabilities of the L-1 (model 1000) versus the RIS using pediatric- and adult-sized IV catheters. The time to infuse 2 L of lactated Ringer's solution and the end temperature after infusion through 20-, 18-, 16-, and 14-gauge catheters, and 4-, 5-, 6-, 7-, and 8.5-French catheters using both the L-1 and RIS were measured. The flow rates of both systems were similar for 18- and 20-gauge catheters; however, the flow rates with the RIS were progressively faster than the L-1 as catheter size increased to >18 gauge. The heating capabilities of the RIS were superior to the L-1 for all catheters >or=16 gauge. We conclude that the RIS was superior to the L-1 for both flow rates and warming capacity for all IV catheters >18 gauge, i.e., those used for cases with massive blood loss. The RIS provided no advantage (with regard to heating and flow) when used with typical pediatric-sized catheters. IMPLICATIONS: The rapid infusion system is superior to the Level 1 for warming and flow of crystalloid for IV catheters >18 gauge in vitro. The rapid infusion system provides no advantage with catheters typically used in small children (相似文献   

Changes in C-reactive protein predict insulin sensitivity in severely obese individuals after weight loss surgery

The production of inflammatory mediators by abdominal adipose tissue may link obesity and insulin resistance. We determined the influence of systemic levels of interleukin-6 and C-reactive protein on insulin sensitivity after weight loss via Roux-en-Y gastric bypass surgery. Severely obese individuals (n 5 15) were evaluated at baseline and at 6 months after surgery. Insulin sensitivity was determined by frequently sampled intravenous glucose tolerance testing at the same time points. Visceral and subcutaneous adipose tissue volumes were quantified by computed tomography. Interleukin-6 and C-reactive protein were measured by enzyme-linked immunoassay in plasma and in adipose tissue biopsies. Correlation analysis was used to determine associations between insulin sensitivity and other outcome variables. Significance was set at P < 0.05. Plasma interleukin-6 concentrations were significantly correlated to the IL-6 content of subcutaneous adipose tissue (r = 0.71). At 6 months postsurgery, subcutaneous and visceral adipose tissue volumes were significantly reduced (34.7% and 44.1%, respectively) and insulin sensitivity had improved by 160.9%. Significant longitudinal correlations were found between insulin sensitivity and plasma C-reactive protein (r = 20.61), but not plasma interleukin-6 at 6 months. These findings offer insights that link obesity and insulin resistance via the activity of inflammatory mediators. Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18, 2005 (oral presentation). Supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases 1R03 DK067167-01A1 (N.G.), the Emory University Research Committee Grant (N.G.), and the National Institutes of Health/National Center for Research Resources General Clinical Research Center Grant M01 RR00039 (N.G., E.L.).     

Stemming Resistance to HER-2 Targeted Therapy

Although the development of trastuzumab and lapatinib has improved the outlook for women with HER-2 positive breast cancer, resistance to HER-2 targeted therapy is a growing clinical dilemma. Recent evidence indicates that the HER-2 pathway may play an important role in the maintenance of cancer stem cells (CSCs). The success of HER-2 targeted therapies may, in part, be explained by their direct activity against HER-2 positive CSCs. Our understanding of the mechanisms involved in resistance to trastuzumab, including loss or blockade of the trastuzumab binding site, activation of alternative signaling pathways, and induction of epithelial–mesenchymal transition (EMT), suggests that CSCs may be at the root of resistance of HER-2 targeted therapy. A variety of novel HER-2 targeted approaches have demonstrated promising preliminary clinical activity. Future clinical trials should involve the integration of technologies to assess the impact of novel HER-2 targeted therapies on HER-2 positive CSCs.     

Percutaneous revascularization in acute myocardial infarction due to left main stem occlusion

Following the encouraging results of trials testing the effect of primary percutaneous coronary intervention (PCI) more cases of left main arterial stenosis (LMS) as culprit lesions in acute myocardial infarction (AMI) are being handled. Not many cases of primary PCI on LMS have been published. We present 12 cases of primary PCI on LMS. Eighty-three percent of the patients presented with cardiogenic shock and only 42% were discharged alive. Due to the high rate of cardiogenic shock at presentation, PCI seems to be the treatment of choice, over coronary artery bypass grafting (CABG), although one might consider using PCI as a bridge over to CABG.     

幽门螺杆菌感染对功能性消化不良患者的自主神经功能和降钙素基因相关肽的影响

目的探讨幽门螺杆菌(H.pylori)感染对功能性消化不良(FD)患者自主神经功能和降钙素基因相关肽的影响。方法以符合罗马Ⅳ诊断标准的31例FD患者为研究对象,根据是否感染H.pylori将FD患者分为H.pylori+组和H.pylori-组,分别对两组患者进行消化不良症状指数(SID)、尼平消化不良指数(NDI)和医院焦虑抑郁量表的测评,并检测患者的心率变异性(HRV)及降钙素基因相关肽(CGRP)的表达。结果两组患者在SID(Z=-0.858,P=0.858)、NDI(Z=-1.464,P=0.143)和医院抑郁评分(Z=0.699,P=0.485)方面差异无统计学意义,但H.pylori+组患者的医院焦虑评分明显高于H.pylori-组(Z=-2.470,P=0.014)。H.pylori+组的CGRP水平为(0.999±0.274)ng/ml,明显高于H.pylori-组的(0.812±0.172)ng/ml(t=2.238,P=0.033)。两组患者的HRV在极低频率(t=-1.210,P=0.236)、低频功率(LF)(t=0.419,P=0.678)、高频功率(HF)(...