Differences in gut microbial metabolism are responsible for reduced hippurate synthesis in Crohn's disease

Background  

Certain urinary metabolites are the product of gut microbial or mammalian metabolism; others, such as hippurate, are mammalian-microbial 'co-metabolites'. It has previously been observed that Crohn's disease (CD) patients excrete significantly less hippurate than controls. There are two stages in the biosynthesis of this metabolite: 1) gut microbial metabolism of dietary aromatic compounds to benzoate, and 2) subsequent hepatorenal conjugation of benzoate with glycine, forming hippurate. Differences in such urinary co-metabolites may therefore reflect systemic consequences of altered gut microbial metabolism, though altered host metabolic pathways may also be involved.     

恶性黑色素瘤和非皮肤型恶性肿瘤的相关性

背景：黑色素瘤患者继发恶性肿瘤的发病率增减的报道不一：为了解恶性黑色素瘤与非皮肤型恶性肿瘤是否有关联，作者调查了印第安纳大学肿瘤中心的数据库。目的：作者搜寻黑色素瘤患者发生非皮肤型恶性肿瘤的证据。方法：分析1987年1月至2001年3月间病检确诊的恶性黑色素瘤患者。在这些患者中调查被诊断为黑色素瘤前后发生非皮肤型恶性肿瘤的数据。用实际继发恶性肿瘤人数和预期继发恶性肿瘤的比率作标准化发病率（SIR）的计算，从累积泊松分布估计SIR的95％CI。结果：14年间共955例黑色素瘤患者（其中男498例，女457例）记录在案。59例（6．2％）黑色素瘤患者（男39例，女20例）证实有69个非皮肤型恶性肿瘤。在男性，非霍奇金淋巴瘤（SIR=1．91，95％C10．88～3．62）和肾细胞癌（SIR=2．41，95％C10．97～4．97）有较高的危险度。但在女性患者中，未见非皮肤型恶性肿瘤的较高危险度。结论：本研究未显示黑色素瘤患者有发生前列腺癌、胃肠癌、白血病、子宫内膜癌或神经和神经内分泌系统肿瘤的较高危险度。女性患者无发生非皮肤型肿瘤的较高危险度。     

Randomised double-blind, placebo-controlled trial of coenzyme Q, therapy in class II and III systolic heart failure

BACKGROUND: Coenzyme Q10 (CoQ10) supplementation has been reported to improve symptoms of heart failure and quality of life, and to reduce hospitalisation. Most prior trials have been open-label and in some, only 50% of patients took angiotensin converting enzyme inhibitors (ACEI). AIM: To determine the effects of CoQ10 in patients with a New York Heart Association (NYHA) Class II or III heart failure due to ischaemic or dilated cardiomyopathy who have been treated with ACEI but not beta-blockers. Methods: Thirty-nine patients in NYHA Class II or III heart failure were randomised in ad ouble-blind, placebo-controlled study with 150 mg/day of oral CoQ10 or placebo.RESULTS: Thirty-five patients completed the trial. After 3 months of therapy, the NYHA class in the CoQ10 group (n = 17) showed a significant improvement of 0.5 class compared with the placebo (n = 18) (P = 0.01). Specific Activities Scale class showed a significant (P = 0.004) improvement in the CoQ10 group, but no change in the placebo group. The C-min walk-test distance showed a significant (P = 0.047) increase in the CoQ10 group with no change in the placebo group (between-group difference P = 0.29). For the Naughton exercise test times the difference in increase in exercise time approached significance in favour of the CoQ10 group (P = 0.056). There was a correlation between the increase in exercise time and the increase in serum CoQ10 level (P = 0.024). There was a threefold increase in the CoQ10 level in the treated group (0.7 +/- 0.4 to 2.1+/- 0.3 microg/mL), but no change in the placebo group. CONCLUSIONS: This pilot study accords with published data suggesting that CoQ10 therapy improves cardiac functional status in patients with moderately severe dilated cardiomyopathy receiving maximal non beta-blocker therapy. Future multicentre studies with larger numbers are indicated.     

Outcomes of coronary artery bypass grafting: a 3 year analysis using the Society of Thoracic Surgeons Database

BACKGROUND: Accurate risk factor analysis is a critical element in contemporary cardiac surgical practice. In the USA, the Society of Thoracic Surgeons Database allows institutions and individual surgeons to carry out detailed patient risk assessment and to review their cardiac surgical outcomes in a comparative fashion. METHODS: To evaluate outcomes of isolated coronary artery bypass grafting, data from all patients operated upon at the Alfred Hospital, Melbourne, Australia, over a 3 year period were entered into the Society of Thoracic Surgeons Database. RESULTS: Our results (mortality and morbidity) compared favourably with those contained within this large international database. CONCLUSION: It is hoped that a similar Australasian database can be established to facilitate a meaningful local risk assessment and a comparative analysis of outcomes of cardiac surgical procedures.     

体表高频超声技术评价家兔血管成形术后再狭窄模型与病理学结果的相关性

目的:分析体表高频超声检测家兔血管内球囊成形术后再狭窄程度与组织病理学分析的相关性。评估体表超声检测的可行性、可靠性及应用价值。方法:实验于2002-03/2003-12在北京中医药大学中医内科学重点学科实验室完成。①日本大耳白兔26只,随机分为正常组10只、假手术组6只、模型组10只。②模型组电刺激兔颈总动脉,电流1.2mA,刺激12～15min,术后第2天喂饲高脂饲料共8周,假手术组仅剥离颈总动脉,不做电刺激,喂高脂饲料,正常组不施加任何干预因素。③模型组和假手术组根据B超选择颈总动脉有斑块或血流明显改变者行球囊血管内成形术。分别于电刺激后8周、血管成形术后4周行超声检查动脉内径和动脉内膜厚度。④所有动物于血管成形术后4周处死取材,进行病理学半定量分析,并与超声测量结果进行相关分析。结果:进入结果分析数量24只,正常组中途死亡1只,原因为牙齿畸型影响进食。模型组1只因电刺激8周时超声评价颈动脉未形成斑块及血流无明显改变而剔出实验。①超声检测电刺激8周时正常组内膜厚为(0.028±0.004)cm,模型组管壁明显增厚(0.043±0.014)cm,差异有显著性(P<0.05),至血管成形术后膜厚增加更明显(0.064±0.002)cm,内径稍有扩大,但差异不显著。②超声检测模型组颈动脉内径与膜厚的测量结果与病理学测量结果呈正相关关系(OR=0.361,P<0.05;OR=0.526,P<0.01),病理狭窄率与超声是否检测到斑块呈正相关关系(OR=0.796,P<0.01)。结论:体表高频超声在评价家兔颈动脉狭窄诊断中有一定应用价值,与病理学半定量分析结果相关性良好。     

ENHANCED MYOCARDIAL METABOLISM IMPROVES RECOVERY AFTER CARDIAC SURGERY AND TRANSPLANTATION

Over the past 15 years many of the advances in the science of cardiac surgery have involved methods of protecting the heart against damage during operations. Hypothermic cardioplegia has become the preferred technique of protection. This involves supporting the circulation using the heart-lung machine, arresting the heart with a potassium-containing solution and maintaining a low myocardial temperature to minimize energy needs. This technique relies mainly on anaerobic metabolism to maintain cardiac viability.     

Environmental factors and refractive error in Chinese schoolchildren

We surveyed and assessed 2,323 schoolchildren aged seven to 17 years from four schools in China, two in the city of Tianjin and the other two in a neighbouring rural village, Ban Chau, to investigate the prevalence of refractive error and its relationship with environmental factors. Every child from each of the participating classes was recruited in this study to avoid self-selection. A questionnaire was issued which queried some aspects of the child's visual habits and home. Refraction was canied out using the Canon R-22 autorefractor. The degree and frequency of myopia in these children increased almost linearly from age seven to 17 years. There was little difference between the urban and rural groups. Of the factors explored, the number of hours spent on near work showed the best correlation with the degree of myopia, albeit only weakly.