Dysphagia management in a 3-year dental hygiene education programme in Japan

Abstract:  This paper reports the development and evaluation of a dysphagia management course taught to the third year dental hygiene students during 2004–2005 as one framework of the new curriculum. The course consisted of lectures by specialists in each field, basic practice and clinical practice at a facility for the elderly. Evaluation of the course showed that improvements were found in students' understanding in certain subjects when compared with that during 2003–2004. Scores on the post-test were statistically significantly higher than those on the pre-test, showing that basic knowledge of the students had been improved. Introductory and follow-up lectures by dental hygiene instructors and appropriate basic practice enhanced the learning process of the students. In the clinical practice, the concept of 'dental hygiene process of care' was incorporated. The dental hygiene process facilitated the students in planning and implementing dental hygiene care that meets the needs of the individual clients. This active learning experience enhanced the students' understanding of dysphagia management. Although further improvements are necessary, this dysphagia management course should help dental hygienists in playing a greater role in the field of oral care and dysphagia rehabilitation.     

掌跖角化牙周病综合征患者组织蛋白酶C基因的新突变

目的探讨掌跖角化牙周病综合征又称帕-勒综合征(PLS)患者组织蛋白酶 C 基因(CTSC)突变的特点,为该病发生的分子机制研究提供依据。方法对临床诊断为 PLS 的2例患者进行 CTSC 基因突变的分析。分别提取患者及其父母的基因组 DNA,应用聚合酶链反应和 DNA 直接测序进行基因突变的检测,进一步采用限制性内切酶酶切验证突变。结果 2例 PLS 患者均存在 CTSC基因的复合型杂合突变,患者Ⅰ的突变位点为 G139R 和S260P,患者Ⅱ的突变位点为 R250X 和C258W,健康对照组未发现基因突变,其中 S260P 和 C258W 突变是 CTSC 基因的新突变位点。结论CTSC 基因突变是导致2例 PLS 患者临床表型的致病原因,S260P 和 C258W 突变扩大了 CTSC 基因的突变谱,为我国 PLS 疾病的基因诊断提供了依据。     

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.     

Combined Effect of Smoking and Obesity on Coronary Heart Disease Mortality in Male Veterans: A 30-year Cohort Study

Objective Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans.This study aimed to explore the combined effect of smoking and obesity on coronary heart disease mortality in male veterans in China.Methods A cohort of 1,268 male veterans from 22 veteran centers in Xi’an(Shaanxi Province,China)were followed up once every 2 years from February 1,1987 to October 30,2016.The endpoint was death from any cause.The hazard ratio(HR)of each risk factor and the 95%confidence interval(CI)were calculated using a multivariate Cox proportional hazard model.Results The total follow-up was 24394.21 person-years;each subject was followed up for a mean duration of 19.24 years.By the end of the study,of the 1,268 veterans,889 had died,363 were alive,and 16 were lost to follow-up.Cox regression analysis results revealed that current smoking(HR:1.552,95%CI:1.074–2.243),obesity(HR:1.625,95%CI:1.024–2.581),and the combined effect of the two factors(HR:2.828,95%CI:1.520–5.262)were associated with coronary heart disease mortality.Conclusion Our results suggest that obese veterans who smoke might be an important target population for coronary heart disease mortality control.     

Proteomics Study on the Differentially Expressed Proteins in 16HBE Cells Exposed to Beryllium Sulfate

Beryllium (Be) is a non-radioactive element with carcinogenic properties, and presents serious occupational and environmental hazards from its resulting toxicants, which could significantly impact the health of the occupational population[1-3]. Beryllium and its compounds can cause diseases such as acute chemical pneumonia, lung cancer, and chronic beryllium disease, which predominantly occurs alongside either lung granuloma or pulmonary fibrosis[4,5]. Furthermore, the mechanism by which beryllium is toxic has not been fully elucidated; therefore, studies on its health hazards as well of its compounds are important. An in-depth study of the mechanism of beryllium toxicity is especially essential to prevent and control its associated health hazards. Tandem mass tag (TMT) technology is a reliable technology in quantitative proteomics, which can be implemented to perform relative quantification and identification analysis of proteins, peptides, nucleic acids, and other biological macromolecules.     

免疫效应细胞增殖与细胞毒性功能检测3种方法的比较

目的：对比研究用于检测免疫效应细胞增殖与细胞毒功能的方法。方法：分别采用CCK?8法、EdU标记法、CFSE标记法检测不同培养条件下NK92细胞增殖［组1：100 U/mL白细胞介素（interleukin,IL）?2;组2：100 U/mL IL?2+10 U/mL IL?15］。用乳酸脱氢酶（lactate dehydrogenase,LDH）释放法、活细胞染料双标流式法、荧光素酶法检测两组NK92对K562细胞的杀伤。结果：CCK?8法检测结果提示组2增殖能力强于组1,但差异无统计学意义（P＞0.05）,而EdU和CFSE标记法均提示两组间增殖能力有显著差异（P＜0.05）。活细胞染料双标流式法与荧光素酶法均能够检测出不同效靶比下两组NK92细胞毒功能的差异（P＜0.05）,LDH释放法在低效靶比下未检测出两组细胞毒性的差异（P＞0.05）。以双标流式法的检测值为标准参照,荧光素酶法和LDH释放法的检测值与其呈显著相关性（rS=0.979 4,P＜0.001;rS=0.973 2,P＜0.001）。结论：CCK?8法更侧重于检测代谢活性,EdU和CFSE标记法更适用于悬浮类免疫细胞的增殖检测。3种细胞毒功能检测具有一致性,活细胞染料双标流式法适合检测对悬浮类靶细胞的杀伤,荧光素酶法比LDH释放法更适用于检测对贴壁细胞的杀伤作用。     

Outcomes of emergency surgery for acute abdomen in dialysis patients: experience of a single community hospital

Purpose

Long-term dialysis often causes physiological and metabolic problems that may affect the outcomes of surgery. The aim of this study was to elucidate whether emergency surgery for acute abdomen yields similar outcomes in dialysis patients versus non-dialysis patients.

Methods

The subjects were 126 patients who underwent emergency surgery for acute abdomen between January, 2007 and November, 2011 in our hospital. They were divided into a dialysis group (HD group; n = 9) and a non-dialysis group (non-HD group; n = 117) and their postoperative morbidity and mortality were compared.

Results

Postoperative morbidity and mortality were significantly worse in the HD group. All 9 of these patients succumbed to postoperative complications versus only 5 of the 117 patients in the non-HD group.

Conclusion

The outcomes of emergency surgery for acute abdomen were significantly worse for dialysis patients than for non-dialysis patients. Prompt diagnosis, initiation of the most suitable surgical procedure, and meticulous postoperative cares are imperative to improving the surgical outcomes of dialysis patients.     

Efficacy of Metabolic Surgery on HbA1c Decrease in Type 2 Diabetes Mellitus Patients with BMI <35 kg/m2—a Review

High glycated hemoglobin A1c (HbA1c) is strongly correlated with developing type 2 diabetes mellitus (T2DM) complications; this study reviews the efficacy of various types of metabolic surgeries in reducing HbA1c levels in type 2 diabetics with BMI <35 kg/m². An electronic search of MEDLINE databases using terms ‘metabolic surgery’, type 2 diabetes mellitus, BMI <35 kg/m², and related keywords for studies published between 1987 and 2013. Data from 53 articles with 2,258 patients were selected for this review. The weighted mean change in HbA1c was ?2.8 % (95 % CI ?2.8 to ?2.7, p?<?0.01) and weighted mean BMI change was ?5.5 kg/m² (95 % CI ?5.6 to ?5.4, p?<?0.01). There was a strong correlation between weighted percentage mean change in HbA1c and BMI. Adjustable gastric banding and duodenal jejunal bypass were inferior to other surgeries in reducing BMI and HbA1c in BMI <35 kg/m². Metabolic surgery significantly decreases HbA1c in T2DM patients with BMI <35 kg/m² and that the magnitude of HbA1c change may be a useful surrogate of DM control.     

冠心病病人A型行为研究进展

从A型行为对冠心病的影响、冠心病病人A型行为的评估、心理干预3方面对冠心病病人A型行为的研究进展进行综述。     

雌二醇对大鼠骨髓基质细胞过氧化物酶增殖活化受体γ2基因表达的影响

背景:雌二醇能否改变骨髓基质细胞分化过程中过氧化物酶增殖活化受体γ2-mRNA的表达进而影响其向成骨细胞分化有待研究。目的:观察骨髓基质细胞在向成骨细胞分化的介质中,17β-雌二醇对其过氧化物酶增殖活化受体γ2mRNA及蛋白表达的影响。设计:对比观察实验。单位:成都军区总医院中心实验室,德阳市人民医院检验科,成都百奥生物技术有限公司。材料:选用1只雌性SD大鼠,3月龄,清洁级,体质量(200±20)g,由成都中医药大学实验动物研究中心提供(动物许可证号码11)。DMEM培养液购自Hyclone,1,25一双羟维生素D3、地塞米松和雌二醇购自Sigma公司,引物用Jellyfish软件设计,由大连宝生物技术有限公司合成。RT-PCR试剂盒和RNA提取试剂盒均由大连宝生物提供。兔抗山羊多抗(北京中山生物技术有限公司),山羊抗鼠PPARγ2抗体和Western Blotting增强化学发光试剂均购自Santa Cruz公司。方法:实验于2001-04/2002-07在成都军区总医院中心实验室和成都百奥生物技术有限公司完成。①无菌条件下分离大鼠骨髓基质细胞,1,25一双羟维生素D3和地塞米松诱导大鼠骨髓基质细胞向成骨细胞分化,观察细胞生长情况。②用0,0.1,10和1000nmol/L不同浓度雌二醇对细胞分化过程进行干预3d。培养细胞用Tris-Triton X-100缓冲液加超声粉碎裂解细胞,在Beckman CX-7生化分析仪上测定碱性磷酸酶的活性,观察不同浓度雌二醇条件下细胞产生碱性磷酸酶的情况。③100g/L中性甲醛固定培养于24孔板的骨髓基质细胞,Weigert苏木素染液染色10min,自来水冲洗,5g/L盐酸乙醇分化,Van Gieson染色,体积分数为0.95乙醇分化脱水,二甲苯透明,显微镜下观察并照相,观察细胞胶原合成情况。④应用半定量RT-PCR及Northern blot、Western blot技术,观察不同浓度雌二醇对骨髓基质细胞分化过程中PPAR-γ2mRNA及蛋白表达的影响。主要观察指标:①骨髓基质细胞生长情况、细胞胶原合成情况。②不同浓度雌二醇条件下细胞产生碱性磷酸酶的情况。③不同浓度雌二醇对骨髓基质细胞分化过程中PPAR-γ2mRNA及蛋白表达的影响。结果:①骨髓基质细胞接种后4h开始贴壁,24～72h可见贴壁细胞明显增大且分裂增殖,细胞呈三角形,多角形或梭形。3d后首次换液,贴壁细胞体积增大,呈集落生长,10d左右融合成遍。多次传代的骨髓基质细胞呈有序的成纤维细胞样分布。②随着雌二醇浓度的增加,胞浆染色越淡,由鲜红、淡红到黄色。胞浆呈红色说明有胶原合成,红色越深,表明胶原越多。③不同浓度雌二醇条件下细胞均能产生碱性磷酸酶,其活性随雌二醇浓度增加而降低,雌二醇浓度从0nmol/L增加到1000nmol/L时,碱性磷酸酶从(710.1±41.7)nkat/g降至(60.0±11.7)nkat/g(t=29.0,P<0.01)。④雌二醇浓度为0.1,10和1000nmol/L时,PPAR-γ2mRNA的表达量均明显高于雌二醇0mol/L组(t=6.1,7.2,11.5,P<0.01),Northern blot结果显示雌二醇浓度为0.1,10和1000nmol/L时PPAR-γ2mRNA表达量分别为(4.0±0.4)%,(1.7±0.2)%,(2.8±0.2)%,明显高于雌二醇0mol/L组[(1.5±0.1)%,t=5.4,105.0,14.2,P<0.01]。⑤Western Blot检测结果显示雌二醇能明显增加骨髓基质细胞PPAR-γ2蛋白的表达。雌二醇浓度为0.1,10和1000nmol/L时,PPAR-γ2蛋白的表达量分别为(2.2±0.2)%,(2.6±0.2)%,(4.1±0.2)%,明显高于雌二醇0mol/L组[(1.2±0.10)%,t=6.6,8.5,13.2,P<0.01]。结论:雌二醇能明显抑制体外培养的骨髓基质细胞碱性磷酸酶的表达,同时促进骨髓基质细胞内过氧化物酶增殖活化受体γ2mRNA和蛋白的表达。