Whole grain wheat sourdough bread does not affect plasminogen activator inhibitor-1 in adults with normal or impaired carbohydrate metabolism

Background and aimsEpidemiological studies suggest whole grain consumption is associated with a reduced risk of cardiovascular disease (CVD), possibly through alterations in glucose metabolism and subsequent effects on plasminogen activator inhibitor (PAI)-1, a novel biomarker for CVD. Our aim was to investigate the effect of 6 wk of whole grain wheat sourdough bread consumption versus refined white bread on PAI-1.Methods and ResultsNormoglycemic/normoinsulinemic (NGI; n = 14; age 53 ± 6 y; BMI 26.5 ± 2.9 kg/m²) and hyperglycemic/hyperinsulinemic (HGI; n = 14; age 57 ± 7 y; BMI 35.7 ± 5.7 kg/m²) adults incorporated whole grain wheat sourdough (162.5 g) or white (168.8 g) bread into their diet, for 6 wk in a randomized crossover study. Pre- and post-intervention, fasting blood samples were analyzed for PAI-1 (primary outcome), as well as glucose, insulin and glucagon (secondary outcomes) at fasting and postprandially after an oral glucose tolerance test (OGTT). Anthropometric measures, fasting glucose, insulin, glucagon and PAI-1 antigen and activity were not different between treatments in either NGI or HGI adults. Glucose incremental area under the curve (iAUC) was lower (19%, P = 0.02) after 6 wk consumption of whole grain wheat sourdough bread compared to white bread in the HGI group, with no differences in insulin or glucagon iAUC in either group.ConclusionOur data showed decreased glucose iAUC after an OGTT following 6 wk whole grain wheat bread consumption in adults with differing glycemic/insulinemic status, but no improvements in PAI-1 or fasting glycemic parameters.     

A longitudinal immunologic evaluation of hemophiliac patients

Over an average span of one year, we performed a prospective clinical and immunologic evaluation of 30 patients with hemophilia. No patient developed life-threatening opportunistic infection or malignancy; however, the immunologic abnormalities and lymphadenopathy initially present in nine patients (lymphadenopathy group) persisted. In addition, five patients, representing 24% of the initial group without lymphadenopathy, developed generalized lymphadenopathy (converter group). One episode of idiopathic thrombocytopenia (ITP) and one episode of staphylococcal sepsis occurred in this "converter" group; one episode of ITP also occurred in the lymphadenopathy group. Sixteen patients remained asymptomatic. At the time of the follow-up evaluation, those differences in mononuclear cell (MNC) percentages and numbers noted initially among the three hemophiliac groups were no longer present. Natural killer cell function alone or in the presence of biologic response modifiers was not different among hemophiliac and control groups. Before developing lymphadenopathy, the converter group of patients had significantly better lymphocyte mitogenic function than did the other two groups of patients with hemophilia. However, lymphocyte mitogenic responses of all groups of patients with hemophilia significantly deteriorated over the course of the study. The abnormal mitogenic responses noted in these patients was explained in part by higher levels of spontaneous suppressor cell activity in mononuclear cell preparations from patients with hemophilia. We conclude that long-term immunologic studies of this patient population requires both quantitative and qualitative evaluations. Our data show that patients with hemophilia have progressive dysfunction of cell- mediated immunity.     

Effects of Chronic Alcohol Abuse and HIV Infection on Brain Phosphorus Metabolites

We examined the effects of human immunodeficiency virus (HIV) infection and chronic alcohol consumption on cerebral phosphorus metabolites to determine if chronic alcohol abuse is a risk factor for the progression of neurological effects of HIV infection. We studied 15 HIV- alcoholics, 8 HIV- light/nondrinkers, 32 HIV+ alcoholics, and 41 HIV+ light/nondrinking men, with both HIV+ groups having similar CD4 lymphocyte counts. We used localized 31-phosphorus magnetic resonance spectroscopy after magnetic resonance imaging to examine two brain volumes in superior white matter and subcortical gray matter. Chronic alcohol consumption was associated with reduced white matter concentrations of phosphodiester (PDE) and phosphocreatine (PCr). Also in the white matter, acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) were associated with reduced concentrations of PDE and PCr, compared with both HIV- and clinically asymptomatic HIV+ subjects. Because no alcohol-by-HIV interactions were detected, the effects of HIV infection and alcohol abuse were cumulative. This is reflected in a successive decrease of white matter PDE and PCr concentrations in the order HIV- light/nondrinkers/HIV- alcoholics/HIV+ light/nondrinkers/HIV+ alcoholics. Subcortical gray matter PDE concentrations were lower in ARC/AIDS alcoholics than in HIV-light/nondrinking individuals. These findings suggest altered brain phospholipid metabolites and energy metabolites with alcohol abuse and HIV infection. They demonstrate that the adverse metabolic effects of HIV on the brain are augmented by chronic alcohol abuse.     

Modern approaches to the treatment of breast cancer

Breast cancer is the most common cause of cancer death in women in this country. Until recently, the traditional treatment has been radical surgery with or without radiation therapy for patients with primary breast cancer, and palliative endocrine therapy followed by chemotherapy for patients with advanced disease. These treatments have met with limited effectiveness in terms of eradicating the disease. Studies in the past decade have given cause for optimism for breast cancer patients. Adjuvant systemic therapy after local treatment appears promising for certain subsets of patients with primary breast cancer. The development of estrogen receptor assays has markedly changed our approach to the disease and improved patient care. Estrogen receptor is an important prognostic factor and is useful in planning appropriate therapy for patients with primary breast cancer as well as those with advanced disease. Further research is urgently needed to improve the dismal survival of certain women with this common malignancy.     

CCK对孤束核中胃扩张相关神经元电活动的影响

目的：研究胆囊收缩素对孤束核中胃扩张相关神经元电活动的影响。方法：记录乌拉坦麻醉大鼠孤束核内胃扩张相关神经元的电活动,观察胃扩张以及静脉注射CCK对神经元电活动的影响。结果：外周静脉注射CCK对孤束核内胃扩张相关神经元自发电活动的影响是多样的,既具有兴奋效应（9／14）,也具有抑制效应（5／14）。但对于胃扩张诱发的孤束核神经元放电,不管是胃扩张兴奋性神经元还是胃扩张抑制性神经元,CCK均表现为抑制效应。结论：外周CCK可以影响孤束核内胃扩张相关神经元的活动。     

尖锐湿疣皮损中的微卫星DNA不稳定性

目的：探讨微卫星不稳定性在尖锐湿疣及其癌变中的作用及意义。方法：采用聚合酶链-单链构象多态性分析(PCR-SSCP)检测28例尖锐湿疣皮损中的微卫星DNA改变。结果：28例尖锐湿疣皮损中8例存在微卫星不稳定性。而且其主要出现在尖锐湿疣癌变中，未发现杂合性丢失。结论：尖锐湿疣及其癌变与微卫星不稳定性有关，临床上通过对尖锐湿疣患者微卫星不稳定性的检测，有可能对尖锐湿疣癌变作出可能性预测及早期诊断，为发现癌变高危人群提供新的依据。     

脑血管病急性期MMP-9、IL-6和IL-10水平变化的研究

目的：探讨基质金属蛋白酶‐9（MMP‐9）、白细胞介素‐6（IL‐6）和白细胞介素‐10（IL‐10）与脑动脉粥样硬化斑块不稳定性以及脑梗死的关系。方法选择急性脑血管病患者56例,其中反复短暂性脑缺血发作（TIA）16例,急性脑梗死40例。对照组为21例健康体检者。所有缺血性脑血管病患者均经头CT血管造影（CTA）检查或颈部血管超声证实存在不稳定斑块,且发病机制考虑与不稳定斑块破裂有关。采用ELISA方法检测各组血清MMP‐9、IL‐6和IL‐10水平并进行比较。结果急性脑梗死组患者血清中MMP‐9、IL‐10水平分别为（137.10±69.38）ng/mL和（39.16±32.82）pg/mL,TIA组患者血清中MMP‐9、IL‐10水平分别为（119.79±65.54）ng/mL和（33.00±21.36）pg/mL,均明显高于对照组〔分别为（65.42±36.81）ng/mL和（19.83±12.16）pg/mL〕;脑梗死组患者血清MMP‐9及IL‐10水平均高于TIA组（均P＜0.05）。各组间IL‐6水平差异无统计学意义（均P＞0.05）。结论MMP‐9和IL‐10水平升高可能与动脉粥样硬化不稳定斑块破裂以及脑梗死灶形成有关。     

胃底折叠术治疗胃食管反流病对高血压的影响

[目的]观察胃底折叠术治疗胃食管反流病对高血压的影响。[方法]回顾性分析2011-06—2012-08期间20例行腹腔镜胃底折叠术的胃食管反流病合并高血压患者的临床资料,依照反流病诊断问卷在手术前和手术后进行反流症状评分。[结果]20例均成功实施腹腔镜手术并于术后第12个月随访。反流总积分(Sc)由术前20.0±9.5降至术后0.5±0.9(P0.05),术后收缩压下降了(11.0±12.0)mm Hg(1mmHg=0.133kPa),舒张压下降了(9.0±11.5)mm Hg(均P0.05)。术后随访12个月11例血压恢复正常,停药时间均在9个月以上;2例减少2种降压药,1例减少1种降压药;6例无效,仍用术前降压药物。[结论]胃食管反流病与部分高血压密切相关,腹腔镜胃底折叠术治疗胃食管反流病合并高血压安全、有效。