Assessing the Association between Important Dietary Habits and Osteoporosis: A Genetic Correlation and Two-Sample Mendelian Randomization Study

Objective: Osteoporosis (OP) is the most common bone disease. The genetic and metabolic factors play important roles in OP development. However, the genetic basis of OP is still elusive. The study aimed to explore the relationships between OP and dietary habits. Methods: This study used large-scale genome-wide association study (GWAS) summary statistics from the UK Biobank to explore potential associations between OP and 143 dietary habits. The GWAS summary data of OP included 9434 self-reported OP cases and 444,941 controls, and the GWAS summary data of the dietary habits included 455,146 participants of European ancestry. Linkage disequilibrium score regression (LDSC) was used to detect the genetic correlations between OP and each of the 143 dietary habits, followed by Mendelian randomization (MR) analysis to further assess the causal relationship between OP and candidate dietary habits identified by LDSC. Results: The LDSC analysis identified seven candidate dietary habits that showed genetic associations with OP including cereal type such as biscuit cereal (coefficient = −0.1693, p value = 0.0183), servings of raw vegetables per day (coefficient = 0.0837, p value = 0.0379), and spirits measured per month (coefficient = 0.115, p value = 0.0353). MR analysis found that OP and PC17 (butter) (odds ratio [OR] = 0.974, 95% confidence interval [CI] = (0.973, 0.976), p value = 0.000970), PC35 (decaffeinated coffee) (OR = 0.985, 95% CI = (0.983, 0.987), p value = 0.00126), PC36 (overall processed meat intake) (OR = 1.035, 95% CI = (1.033, 1.037), p value = 0.000976), PC39 (spirits measured per month) (OR = 1.014, 95% CI = (1.011, 1.015), p value = 0.00153), and servings of raw vegetables per day (OR = 0.978, 95% CI = (0.977, 0.979), p value = 0.000563) were clearly causal. Conclusions: Our findings provide new clues for understanding the genetic mechanisms of OP, which focus on the possible role of dietary habits in OP pathogenesis.     

漂浮导管对重症急性胰腺炎继发脓毒血症患者临床治疗的价值研究

目的探讨分析漂浮导管技术对指导重症急性胰腺炎继发脓毒血症患者临床治疗的价值研究。方法选取2017年1月至2019年4月我院收治的重症急性胰腺炎继发脓毒血症患者60例,跟踪病情变化,其中病情好转患者40例（A组）,病情恶化患者20例（B组）。对比观察两组患者的治疗前后48 h的中心静脉压（CVP）、平均肺动脉压（MPAP）、肺毛细血管楔压（PCWP）、心率（HR）、心脏指数（CI）、外周血管阻力指数（SVRI）等指标的血流动力学变化,同时观察记录病情好转组治疗后1～6 d的血流动力学改变。结果相比于治疗前,A组患者治疗48 h后CVP、CI指标明显下降（P<0.05）,SVRI、HR、PCWP、MPAP指标明显升高（P<0.05）; B组患者治疗前后血流动力学指标差异均无统计学意义（P>0.05）。与对照值相比,A组患者治疗后1～3 d CI、CVP明显降低（P<0.05）,PCWP、SVRI明显升高（P<0.05）;治疗后4～6 d内SVRI明显降低（P<0.05）;治疗后6 d内MPAP和HR明显升高（P<0.05）。结论漂浮导管技术应用于重症急性胰腺炎继发脓毒血症患者,能够及时检测外周血管扩张和低血容量的问题,评估病情,在临床治疗的监测指导和预后评估有着重要价值     

1598例经颈内静脉带隧道中心静脉导管置入术分析

目的 探讨颈内静脉入路的带隧道中心静脉导管置管准确性和安全性的影响因素. 方法 回顾性分析2011年～2019年行颈内静脉带隧道中心静脉导管置入术的病例资料.收集人口学资料,手术相关资料,包括置管位置,是否用X线,置管失败原因,介入干预情况,干预失败原因等.研究主要终点是置管成功率和失败原因. 结果 1598例患者纳入...     

突触后密度蛋白-95在大鼠坐骨神经损伤后的表达

为了探讨突触后密度蛋白-95(PSD-95)在周围神经损伤过程中的表达变化,本实验建立大鼠坐骨神经夹伤模型,采用荧光定量PCR(real-timePCR)和Western blotting对PSD-95 mRNA及其蛋白水平进行定量检测,应用免疫荧光双标技术观察PSD-95与神经型一氧化氮合酶(nNOS)的共定位情况。结果显示,PSD-95 mRNA及其蛋白在正常坐骨神经中度表达,损伤后迅速下降;PSD-95 mRNA从损伤后2d开始表达上调;而其蛋白水平于损伤后1周明显升高。免疫荧光双标染色证实在坐骨神经损伤后1周PSD-95与nNOS共定位于Schwann细胞上,而与神经丝蛋白NF-200共定位不明显。本研究结果提示PSD-95通过nNOS参与了周围神经损伤修复过程。     

p27kip1和Skp2在损伤后大鼠坐骨神经中的表达变化

为了探讨损伤后周围神经p27kip1和S期激酶相关蛋白2(Skp2)的定位表达和变化,本实验将成年SD大鼠随机分为正常对照组、夹伤组和切断组,运用Western blot结合免疫组织化学及免疫荧光双标,在大鼠坐骨神经损伤时,对p27kip1和Skp2表达的影响进行了研究。结果表明:(1)坐骨神经夹伤后,p27kip1蛋白表达先逐渐下降,后又逐渐上升;坐骨神经切断后,远侧段p27kip1蛋白表达持续下降,而近侧段p27kip1蛋白表达在切断后6h明显下降,后又逐渐升高至正常水平,而Skp2表达变化与之相反;(2)免疫组织化学染色结果显示,坐骨神经切断后1w,远侧段从断端到末端,p27kip1阳性信号逐渐增加,而Skp2阳性信号逐渐减弱;(3)免疫荧光双标显示,正常和损伤坐骨神经的雪旺氏细胞中都有p27kip1和Skp2表达。以上结果提示:周围神经损伤后影响雪旺氏细胞中p27kip1和Skp2的表达变化,为进一步研究它们在周围神经损伤和修复中的作用机制奠定基础。     

脑卒中后遗症老年人易患肺炎及其影响预后的因素

目的分析影响脑卒中后遗症老年人易患肺炎及其影响预后的因素。方法分析117例脑卒中后遗症老年人因肺炎而反复住院的病史资料,对存活与病死不同转归的病人进行比较。结果53例死亡,占45．3％。单因素分析显示性别、卧床不起时间、吞咽反射障碍、血清白蛋白水平是影响脑卒中后遗症老年病人易患肺炎及其影响预后的因素。结论脑卒中后遗症老年人患肺炎及其影响预后有多方面因素,对吞咽反射障碍的病人置入鼻饲管可以改善预后。     

Risk factors of perioperative complications and management with enhanced recovery after primary surgery in women with epithelial ovarian carcinoma in a single center

The present study aimed to evaluate the postoperative complications and the impact of an enhanced recovery programme in patients who underwent primary surgery (including extensive upper abdominal surgery) for epithelial ovarian carcinoma (EOC). All patients with stage I–IV ovarian carcinoma who underwent primary surgery were identified, and postoperative complications were evaluated and graded according to the Clavien-Dindo classification. Of 161 patients, 46 (28.57%) underwent surgical staging, 27 (16.77%) standard cytoreduction, 12 (7.45%) en bloc debulking and 76 (47.20%) extraradical debulking. A total of 157 patients (97.52%) achieved optimal tumor reduction (<1 cm). The mean postoperative hospitalization time was 17.33±11.29 days after completion of the initial postoperative chemotherapy (IPC), and the IPC interval was 16.22±10.09 days. A total of 13 patients (8.07%) had grade 3 complications (9 with wound dehiscence, 3 with digestive tract leakage and 1 with a bladder fistula). A total of 2 patients (1.24%) had grade 4–5 complications [1 patient with severe pneumonia returned to the intensive care unit (ICU) for tracheotomy and respiration rehabilitation; the other patient died of septicemia on day 19]. The multivariate analysis of the preoperative factors revealed that a human epididymis protein 4 (HE4) level of ≥717 pM (P=0.015) and Federation International of Gynecology and Obstetrics (FIGO) stage IV (P=0.004; compared with stage IIIC) were associated with grade 3–5 complications. The bootstrap analysis revealed that a cancer antigen 125 (CA125) level of ≥1,012 U/ml (P=0.034), a HE4 level of ≥717 pM (P=0.007) and FIGO stage IV (P=0.002; compared with stage IIIC) were significantly associated with grade 3–5 complications. Meanwhile, the multivariate analysis of the postoperative factors did not reveal any risk factors associated with grade 3–5 complications; the bootstrap analysis revealed that only transfer to the ICU after surgery (P=0.026) was significantly associated with grade 3–5 complications. In conclusion, the study found that application of enhanced recovery after surgery protocols is feasible in patients with EOC, especially in those undergoing advanced extensive upper abdominal surgery, and CA125, HE4 and FIGO stage IV were related with the occurrence of adverse perioperative outcomes.     

MRI在帕金森病中的应用进展

帕金森病(PD)是常见的中老年期运动障碍,临床表现主要为静止性震颤、肌僵直、运动迟缓和姿势反射障碍等.长期以来,对PD的诊断主要依靠临床表现,缺少客观的实验室诊断依据,使得对早期或亚临床期PD的诊断比较困难.     

优化我国医药市场结构的对策建议

市场结构是指特定行业中企业的数量、规模、份额及相互关系以及由此决定的竞争形式。市场结构主要从企业是竞争或者是垄断的市场性质方面研究,微观经济学按照竞争程度的标准,从厂商数目、产品差别程度、进入和退出壁     

天冬药理作用研究进展

天冬系百合科天门冬属植物天冬的干燥块根。《中国药典》表述天冬"甘、苦、寒,归肺、肾经,具有养阴润燥、清肺生津功能,主治肺燥干咳、顿咳痰粘、咽干口渴、肠燥便秘。"天冬虽系常用药食同源的补阴中药,但直到20世纪90年代,人们才对其药理作用进行了较为深入的研究。