27High dose ondansetron is not effective for reducing motion sickness in highly susceptible subjects

Background: Delayed nausea occurs in many cancer patients during the three days following administration of a cytotoxic agent. Meals high in protein content decrease the nausea of motion sickness and pregnancy, possibly by enhancing normal gastric myoelectrical activity and/or by reducing gastric dysrhythmias. Ginger may also have anti‐nausea properties. The aim of this study was to explore the use of a nutritional intervention consisting of high protein meals and ginger for the management of delayed nausea experienced by chemotherapy‐naïve cancer patients. Method: Twenty‐eight cancer patients receiving emetogenic cytotoxic agents were assigned to one of three groups. During the three day study period following their first chemotherapy session, Control Group patients (n = 9) continued with their normal diet, Protein Group patients (n = 9) were provided with a protein drink (ProSure^®; 15 g protein) and 1 g of dried ginger root to consume twice daily, and High Protein Group patients (n = 10) were provided with a protein drink with additional protein powder (ProSure^® and ProMod^®; 31 g protein) and 1 g of dried ginger root to consume twice daily. All patients were asked to complete a symptom diary over the three days to assess the severity, frequency, and bothersomeness of the nausea they experienced, as well as their use of antiemetic medication. Gastric myoelectrical activity was assessed by electrogastrography as five patients ingested a protein meal with ginger on the first morning of the study. Results: Reports of nausea, of nausea being experienced often, and of nausea being bothersome were significantly less frequent in the High Protein Group than in the Control and Protein Groups (ps < 0.05); the Control and Protein Groups were not significantly different from each other. Furthermore, significantly fewer patients in the High Protein Group elected to use antiemetic medication than patients in the other two groups (p < 0.05). A significant increase in normal gastric myoelectrical activity, and a significant decrease in gastric tachyarrhythmia, the gastric dysrhythmia that frequently accompanies nausea, occurred with ingestion of the protein meals and ginger (ps < 0.05). Conclusions: High protein meals with ginger reduced the delayed nausea of chemotherapy, and reduced the use of antiemetic medications. Anti‐nausea effects of high protein meals with ginger were associated with enhancement of normal gastric myoelectrical activity and decreased gastric dysrhythmias. High protein meals with ginger represent a novel, nutritionally based treatment for the delayed nausea.     

Epigenetic alterations in inflammatory bowel disease: the complex interplay between genome-wide methylation alterations,germline variation,and gene expression

Background

Exploring DNA methylation in inflammatory bowel disease might provide an insight into the complex gene–environment interactions in disease pathogenesis. Our study aimed to characterise disease-associated methylation changes in newly diagnosed inflammatory bowel disease and explore its association with germline variation and gene expression.

失功能高密度脂蛋白与心血管疾病研究进展

高密度脂蛋白胆固醇被认为是心血管疾病的重要保护因素,它在血清中的水平与心血管疾病风险呈负相关。然而在心血管疾病中,高密度脂蛋白的蛋白质、脂质或microRNAs等发生变化,使其转变为失功能高密度脂蛋白,失功能高密度脂蛋白具有促进动脉粥样硬化、促氧化、促炎等特性。本文对失功能高密度脂蛋白的结构和功能改变进行概括。     

糖类抗原检测在非小细胞肺癌诊疗中的应用

目的 探讨糖类抗原检测用于非小细胞肺癌（NSCLC）诊疗的临床意义。方法 采用血清糖类抗原多肿瘤标志物蛋白芯片检测系统对已确诊的60例NSCLC患者的血清CA19-9、CA242、CA125和CA153水平进行检测,并与肺良性病变对照组和健康对照组进行比较。结果 肺癌组血清CA19-9、CA242、CA125和CA153的阳性检出率高于肺良性病变对照组和健康对照组,且3组血清CA19-9、CA125和CA153的差异尤为显著（P＜0.05）。肺腺癌患者血清CA19-9和CA125的阳性检出率高于肺鳞癌患者（P＜0.05）。NSCLC患者分期越晚,4种糖类抗原的阳性检出率越高,其中CA125和CA153在Ⅰ～Ⅱ期的阳性检出率分别为38.5%和30.8%,高于CA19-9和CA242的7.7%和7.7%（P＜0.05）。结论 糖类抗原检测在NSCLC诊疗方面具有较好的临床应用价值,可以作为诊断、分期及病程监测等方面常规检测方法的辅助手段。     

Longitudinal analyses of immune responses to Plasmodium falciparum derived peptides corresponding to novel blood stage antigens in coastal Kenya

We have recently described 95 predicted alpha-helical coiled-coil peptides derived from putative Plasmodium falciparum erythrocytic stage proteins. Seventy peptides recognized with the highest level of prevalence by sera from three endemic areas were selected for further studies. In this study, we sequentially examined antibody responses to these synthetic peptides in two cohorts of children at risk of clinical malaria in Kilifi district in coastal Kenya, in order to characterize the level of peptide recognition by age, and the role of anti-peptide antibodies in protection from clinical malaria. Antibody levels from 268 children in the first cohort (Chonyi) were assayed against 70 peptides. Thirty-nine peptides were selected for further study in a second cohort (Junju). The rationale for the second cohort was to confirm those peptides identified as protective in the first cohort. The Junju cohort comprised of children aged 1-6 years old (inclusive). Children were actively followed up to identify episodes of febrile malaria in both cohorts. Of the 70 peptides examined, 32 showed significantly (p<0.05) increased antibody recognition in older children and 40 showed significantly increased antibody recognition in parasitaemic children. Ten peptides were associated with a significantly reduced odds ratio (OR) for an episode of clinical malaria in the first cohort of children and two of these peptides (LR146 and AS202.11) were associated with a significantly reduced OR in both cohorts. LR146 is derived from hypothetical protein PFB0145c in PlasmoDB. Previous work has identified this protein as a target of antibodies effective in antibody dependent cellular inhibition (ADCI). The current study substantiates further the potential of protein PFB0145c and also identifies protein PF11_0424 as another likely target of protective antibodies against P. falciparum malaria.     

反复呼吸道感染婴幼儿与健康婴幼儿骨密度测定对比研究

【目的】对比健康婴幼儿和反复呼吸道感染患儿的骨密度状况,探讨反复呼吸道感染患儿的骨密度测定临床意义。【方法】临床诊断为反复呼吸道感染的婴幼儿91例为病例组,同一时期在儿童保健室进行常规体检的健康婴幼儿96例为对照组,使用超声骨强度检测仪,分别检测上述婴幼儿的骨密度。【结果】病例组骨密度不足明显高于对照组(P0.05)。【结论】反复呼吸道感染婴幼儿骨密度不足,对其应加强维生素D和钙剂的补充。     

Microalbuminuria in Type 1 Diabetes Is Associated With Enhanced Excretion of the Endocytic Multiligand Receptors Megalin and Cubilin

OBJECTIVE

Proteinuria is the hallmark of diabetic nephropathy; yet, glomerular histology does not fully explain mechanisms contributing to proteinuria. Our objective was to identify proteins in the urine of individuals with type 1 diabetes and microalbuminuria that might implicate a mechanistic pathway operative in proteinuria.

RESEARCH DESIGN AND METHODS

Using a GeLC/MS platform proteomics approach, we compared the urine proteome from 12 healthy nondiabetic individuals, 12 subjects with type 1 diabetes yet normal urinary albumin excretion rates, and 12 subjects with type 1 diabetes and microalbuminuria (type 1 diabetes + microalbuminuria).

RESULTS

The abundance of megalin and cubilin, two multiligand receptors expressed in kidney proximal tubule cells and involved with the reuptake of filtered albumin and megalin/cubilin ligands, was significantly increased in type 1 diabetes + microalbuminuria urine, compared with both nonalbuminuric groups.

CONCLUSIONS

Aberrant shedding of megalin and cubilin could contribute to albuminuria in diabetes and to deficiency states of important vitamins and hormones.Excess urinary albumin excretion (UAE) (30–299 mg/day), termed microalbuminuria, portends incipient diabetic nephropathy. Mechanisms contributing to proteinuria in diabetic nephropathy are incompletely understood but likely involve pathology within the glomerulus, including endothelial cell injury, glomerular basement membrane thickening, loss of slit diaphragm veracity, and podocytopenia (1). Additionally, in the proximal tubule (PT), decreased protein reabsorption likely occurs (1,2); data from diabetic animals suggest that altered PT handling and diminished albumin retrieval contribute to albuminuria (3,4). Because ∼70% of the urinary proteome originates from kidney or genitourinary tissues (5,6), we used the GeLC/MS platform proteomics approach to compare the urine proteome from 1) nondiabetic individuals, 2) subjects with type 1 diabetes yet normal UAE, and 3) subjects with type 1 diabetes and microalbuminuria (type 1 diabetes + microalbuminuria), so as to identify proteins that might implicate a mechanistic pathway operative in proteinuria.     

Guidelines for the safe practice of total intravenous anaesthesia (TIVA)

Guidelines are presented for safe practice in the use of intravenous drug infusions for general anaesthesia. When maintenance of general anaesthesia is by intravenous infusion, this is referred to as total intravenous anaesthesia. Although total intravenous anaesthesia has advantages for some patients, the commonest technique used for maintenance of anaesthesia in the UK and Ireland remains the administration of an inhaled volatile anaesthetic. However, the use of an inhalational technique is sometimes not possible, and in some situations, inhalational anaesthesia is contraindicated. Therefore, all anaesthetists should be able to deliver total intravenous anaesthesia competently and safely. For the purposes of simplicity, these guidelines will use the term total intravenous anaesthesia but also encompass techniques involving a combination of intravenous infusion and inhalational anaesthesia. This document is intended as a guideline for safe practice when total intravenous anaesthesia is being used, and not as a review of the pros and cons of total intravenous anaesthesia vs. inhalational anaesthesia in situations where both techniques are possible.