Lower visceral and subcutaneous but higher intermuscular adipose tissue depots in patients with growth hormone and insulin-like growth factor I excess due to acromegaly

CONTEXT: GH and IGF-I are important regulators of metabolism and body composition. In acromegaly, a state of GH and IGF-I excess, the lipolytic and insulin antagonistic effects of GH may alter adipose tissue (AT) distribution. OBJECTIVES: Our objective was to test the hypothesis that in acromegaly whole-body AT mass is less and to examine for the first time the relationship between GH/IGF-I excess and intermuscular AT (IMAT), an AT depot associated with insulin resistance in other populations. DESIGN, SETTING, AND PATIENTS: We conducted a cross-sectional study in 24 adults with active acromegaly compared with predicted models developed in 315 healthy non-acromegaly subjects. OUTCOME MEASURES: Mass of AT in the visceral AT (VAT), sc AT (SAT), and IMAT compartments from whole-body magnetic resonance imaging and serum levels of GH, IGF-I, insulin, and glucose were measured. RESULTS: VAT and SAT were less in active acromegaly (P < 0.0001); these were 68.2 +/- 27% and 79.5 +/- 15% of predicted values, respectively. By contrast, IMAT was greater (P = 0.0052) by 185.6 +/- 84% of predicted. VAT/trunk AT ratios were inversely related to IGF-I levels (r = 0.544; P = 0.0054). Acromegaly subjects were insulin resistant. CONCLUSIONS: VAT and SAT, most markedly VAT, are less in acromegaly. The proportion of trunk AT that is VAT is less with greater disease activity. IMAT is greater in acromegaly, a novel finding, which suggests that increased AT in muscle could be associated with GH-induced insulin resistance. These findings have implications for understanding the role of GH in body composition and metabolic risk in acromegaly and other clinical settings of GH use.     

杨浦区水痘疫情特征分析及病例疫苗接种史调查

目的 掌握杨浦区水痘疫情特征,用发病资料评价疫苗流行病学免疫效果.方法 对2003-2005年发病资料进行描述分析,同时对所有病例进行疫苗接种史回顾性调查.结果 3年平均年发病率21.13/10万,暴发疫情中小学生占96.91%;发病时间和地区分布有集中趋势,年龄分布5～14岁组,占66.33%,94.75%病例无疫苗接种史.结论 水痘疫情呈上升趋势,0～4岁幼年组和年龄较大的在校学生均是水痘易感人群,疫情常在中小学校和幼托机构集体性单位频繁发生;病例疫苗接种率低.提高接种率是控制水痘发病的有效手段,当前应扩大疫苗接种年龄范围.     

Theophylline bioavailability: a comparison of the oral absorption of a theophylline elixir and two combination theophylline tablets to intravenous aminophylline.

The bioavailability of theophylline from single doses of an elixir (Elixophyllin) and two different tablet formulations, as compared to intravenous aminophylline, was studied with a crossover design in 12 normal volunteers. Both tablet formulations (Marax and Tedral) contain ephedrine. Marax contains hydroxyzine hydrochloride, and Tedral contains phenobarbital. The absorption of theophylline was most rapid from the elixir, whereas that from Marax was faster than that from Tedral. The peak concentrations of theophylline after administration of the 3 oral dosage forms were in the order, elixir greater than Marax greater than Tedral, however, the time to achieve peak concentration was highly variable and did not differ significantly among the 3 products. On the basis of area under the serum concentration-time curves, the absorption of theophylline from the elixir and from Marax was essentially complete. The area under the serum concentration curve after administration of Tedral was significantly less than that after intravenous aminophylline, elixir, and Marax; however, when the individual areas under the concentration curves were adjusted for intrasubject variation in elimination rate constant, the mean area under the concentration curve after Tedral no longer differed significantly from those of the intravenous and other two oral products. A large degree of intersubject variation in the oral absorption of theophylline was observe din this study. Therefore, in addition to the well-documented, large individual variation in the serum clearance of theophylline, intersubject differences in the absorption of the drug is another factor that complicates proper adjustment of the dose in oral theophylline therapy.     

二甲双胍治疗女性肥胖伴停经的疗效

本研究观察二甲双胍对肥胖女性伴停经的治疗效果。在21例二甲双胍治疗组患者中有12例月经恢复，体重均有不同程度的下降，代谢指标体重指数、腰围、体脂含量和舒张压改善；餐后血糖和胰岛素以及LH/FSH和睾酮改变明显，提示二甲双胍对某些肥胖伴停经女性有确切的治疗作用。     

Increased interleukin-10 in the the endocervical secretions of women with non-ulcerative sexually transmitted diseases: a mechanism for enhanced HIV-1 transmission?

OBJECTIVE: Although non-ulcerative sexually transmitted diseases (STD) and bacterial vaginosis are implicated as cofactors in heterosexual HIV-1 transmission, the mechanisms have not been defined. Recent in vitro data suggest that interleukin (IL)-10 may increase susceptibility of macrophages to HIV-1 infection. Therefore, we performed this study to assess whether non-ulcerative STD are associated with detection of IL-10 in the female genital tract. METHODS: Women with clinical pelvic inflammatory disease with or without cervicovaginal discharge were recruited from an STD clinic in Nairobi, Kenya. Endocervical and endometrial specimens were obtained for Neisseria gonorrhoeae and Chlamydia trachomatis DNA detection, Trichonomas vaginalis culture, and CD4 and CD8 T-cell enumeration. Bacterial vaginosis was diagnosed by Gram stain. IL-10 was detected in endocervical specimens using enzyme-linked immunosorbent assay. Blood was obtained for HIV-1 serology. RESULTS: One hundred and seventy-two women were studied. N. gonorrhoeae, C. trachomatis, bacterial vaginosis, and T. vaginalis were detected in 38 (21%), 17 (9%), 71 (43%), and 22 (12%) women, respectively. Cervical IL-10 was detected more often in women with N. gonorrhoeae [adjusted odds ratio (AOR), 3.4; 95% confidence interval (CI), 1.4-8.4], C. trachomatis (AOR, 4.4; 95% CI, 1.2-15.6), and bacterial vaginosis (AOR, 3.1; 95% CI, 1.4-6.9) than in women without these infections. CONCLUSIONS: The association of non-ulcerative STD and bacterial vaginosis with increased frequency of IL-10 detection in endocervical secretions suggests a potential mechanism through which these infections may alter susceptibility to HIV-1 infection in women.     

Clinical features,diagnosis and treatment of intussusception secondary to inverted Meckel's diverticulum in children北大核心CSCD

Objective To explore the clinical characteristics, diagnosis, treatment and prognosis of inverted Meckel's diverticulum in children, and to summarize the clinical experience. Methods Ten children who received surgical treatment in Beijing Children's Hospital, Capital Medical University from October 2018 to October 2021 were retrospectively analyzed. The children were diagnosed with Meeker's diverticulum. Their data were complete and their follow-up information was available. The clinical features, diagnosis, treatment and prognosis were summarized. There were 6 males and 4 females, whose age of onset ranged from 5 months to 12 years and 5 months. The clinical manifestations were abdominal pain in 8 cases, crying in 2 cases and bloody stool in 3 cases. B - ultrasound showed suspected diseases secondary to inverted Meckel's diverticulum, including small intestinal intussusception in 6 cases and back junction type intussusception in 4 cases. One case of small intestinal intussusception was misdiagnosed after laparoscopic exploration in other hospitals and suffered from recurrent intussusception. All patients underwent segmental bowel resection. Results Of the 10 children, 8 cases received laparoscopic exploration and 2 cases underwent open surgery for secondary intestinal necrosis. Postoperative pathology revealed Meckel's diverticulum. Ectopic tissue was accessible in 8 cases, including ectopic gastric tissue in 7 cases, and ectopic pancreas in 1 case. During the postoperative follow - up period (1 month - 3 years), the patients were generally in good condition with no complications such as intestinal obstruction. Conclusions Intussusception secondary to inverted Meckel's diverticulum is rare and difficult to diagnose before operation. The diagnosis should be confirmed by surgical exploration and postoperative pathology. However, careful surgical exploration is required since inverted Meckel's diverticulum is prone to be misdiagnosed during exploration. © 2022 ＣｈｉｎＪＡｐｐｌＣｌｉｎＰｅｄｉａｔ. All rights reserved.     

机器人辅助腹腔镜治疗肾盂输尿管连接部梗阻的临床应用及研究进展

肾盂输尿管连接部梗阻是尿路梗阻中最常见的先天性畸形, 常常导致小儿肾积水。近年来, 达芬奇机器人手术系统的运用逐步成为热点, 具有操作灵活、手术精准度高等优势, 保证了手术的安全性、准确性以及疗效, 从而在小儿泌尿外科中的应用日渐广泛。本文就运用机器人辅助腹腔镜治疗小儿肾盂输尿管连接部梗阻的临床应用及研究进展进行综述。     

黄芪、莪术配伍对胃癌细胞COX-2表达的调节作用

目的:观察黄芪、莪术配伍对MKN-45细胞COX-2、PPlAR-Y、NF-KB的影响.方法:以黄芪、莪术配伍作用于MKN-45细胞,并设塞莱希布组、罗格列酮组、黄芪组、莪术组和空白组相对照.用MTT法观察各组药物对胃癌细胞的抑制率,用RT-PCR以及Western blot方法检测给药后人胃癌细胞COX-2、PPARy、NF-KB基因及COX-2蛋白表达的变化.结果:各组对COX-2和NF-KB的mRNA表达均有抑制作用,除莪术外对PPARy mRNA均有促表达作用,其中以塞莱希布组和配伍组对COX-2 mRNA表达的抑制作用最为明显,且配伍组作用明显强于黄芪组和莪术组,以罗格列酮组和配伍组对NF-KB mRNA的表达抑制作用和对PPARy表达的促表达作用都是最明显.结论:黄芪、莪术配伍能起到增效作用,对细胞的抑制效应明显,对COX-2的抑制作用大于黄芪、莪术的单独效应,与塞莱希布相近,其对COX-2的抑制作用可能是通过PPARy/NFKB信号途径发挥作用的.