The Association of Maternal Body Composition and Dietary Intake with the Risk of Gestational Diabetes Mellitus during the Second Trimester in a Cohort of Chinese Pregnant Women

Objective To investigate the association of maternal body composition and dietary intake with the risk of gestational diabetes mellitus (GDM). Methods A total 154 GDM subjects and 981 controls were enrolled in a prospective cohort study in 11 hospitals from May 20, 2012 to December 31, 2013. Bioelectrical impedance analysis and dietary surveys were used to determine body composition and to evaluate the intake of nutrients in subjects at 21-24 weeks’ gestation (WG). Logistic regression analysis was applied to explore the relationships of maternal body composition and dietary intake with the risk of GDM morbidity. Results Age, pre-pregnant body weight (BW), and body mass index (BMI) were associated with increased risk of GDM. Fat mass (FM), fat mass percentage (FMP), extracellular water (ECW), BMI, BW, energy, protein, fat, and carbohydrates at 21-24 WG were associated with an increased risk of GDM. In contrast, fat free mass (FFM), muscular mass (MM), and intracellular water (ICW) were associated with a decreased risk of GDM. Conclusion Maternal body composition and dietary intake during the second trimester of pregnancy were associated with the risk of GDM morbidity.     

mTOR通路对癫痫的影响及中医药干预作用研究进展

癫痫是常见的神经系统疾病,其发病机制复杂,病理改变亦多样化,以海马神经元细胞凋亡、胶质细胞增生、苔藓纤维出芽等为主要病理表现。近年来,国内外对于抗癫痫治疗专注于分子水平及其信号通路的研究,其中哺乳动物雷帕霉素靶蛋白(mTOR)这一信号通路通过细胞生长增殖、蛋白质代谢、细胞凋亡自噬、突触可塑性等对抗癫痫发挥重要的作用。中医药在治疗癫痫上疗效明显,大量实验证明中医药干预,包括中药单体、中药复方等治疗,能够通过mTOR信号通路发挥抗癫痫作用,从而减少癫痫发作频率、保护神经元细胞、改善癫痫症状等。mTOR信号通路也成为中医药治疗癫痫的重要靶点。现综述mTOR通路对癫痫的影响及中医药干预作用的研究进展。     

The risk of intracranial infection in adults with hydrocephalus after ventriculoperitoneal shunt surgery: A retrospective study

Infection remains the most significant complication of ventriculoperitoneal shunt (VPS) surgery. The objective of this study was to investigate intracranial infections complicating VPS surgery in adults with hydrocephalus. Patients who underwent VPS surgery for hydrocephalus between 2000 and 2016 were included. Clinical data and follow‐up evaluations were examined and analysed retrospectively. A total of 502 patients with hydrocephalus who underwent VPS surgery were included. They were followed up for at least 2 years. Twelve patients with incomplete data were excluded. Four hundred and ninety patients were included in the final analysis. Twenty‐five cases of intracranial infection occurred, accounting for 5.1% of patients with VPS surgery. The mean age of the patients was 57.1 ± 10.1 years (range, 39–72 years). The incidence of intracranial infection in patients over 60 years of age was higher than that in patients under 60 years of age (P = .007). Age (P = .007), diabetes (P = .026), skin infection (P = .028), bed‐ridden (P = .007), and modified operation (P = .011) were highly correlated with the incidence of intracranial infection. The findings of this retrospective study show that age, diabetes, skin infection, bed‐ridden, and modified operation of hydrocephalus significantly and independently correlated with the incidence of infection. Prospective studies are needed to assess the relationship between the incidence of infection and risk factors in patients with hydrocephalus after VPS.     

辐照中脱矿骨基质粒径对胶原结构影响的实验研究

目的探讨不同粒径大小对γ辐照中脱钙骨基质(demineralized bone matrix,DBM)中胶原结构的影响以及辐照保护剂的有效性。方法取同一供体的冻干皮质骨,依据Urist改良法制备不同粒径的(0.5~1.0 mm、1.2~2.8 mm、3.3~4.7 mm及5.7~7.0 mm)DBM样品,按照不同剂量分为:0 kGy、15 kGy、25 kGy及25 kGy(辐照保护剂),真空密封后储存于-80℃冰箱待用。通过扫描电镜观察胶原表面形态,大体观察胶原表面结构损伤的程度;将样品按照0.2 g/ml生理盐水比例在50℃条件下72 h,利用浸提液颜色深度观察胶原被辐照损伤的程度;使用2,4-二硝基苯肼(吸光光度计法)测定样品中羰基含量;十二烷基硫酸钠聚丙烯酰胺钠凝胶电泳法(Sodium dodecyl sulfatepolyacrylamide gel electrophoresis,SDS-PAGE)测定样品中胶原分子量的变化;利用差示热量扫描法(differential scanning calorimetry,DSC)检测样品热变性温度以观察胶原热稳定性。结果样品浸提液颜色与γ辐照剂量相关度较高,未辐照样品浸提液颜色清亮,而在同粒径下随辐照剂量加大浸提液黄色逐渐加深,5.7~7.0 mm粒径组颜色相对较浅;25 kGy组相比于25 kGy+保护剂组浸提液颜色加深。扫描电镜观察到γ辐照导致胶原结构紊乱,纤维断裂,随着辐照剂量增大损伤区域增多,当粒径增大时,损伤区域有减少的趋势;相比于25 kGy组,25 kGy+保护剂组胶原结构性破坏减少。差示热量扫描法得出样品热交换曲线,随着粒径增大,热变性温度有增高的趋势,粒径间对比有统计学差异(F=189.4,P<0.001);同粒径间差异不明显。SDS-PAGE发现同粒径下γ辐照剂量愈大,胶原分子量愈小;同辐照条件下随粒径较小,高分子量胶原含量减少明显;225 kGy+保护剂组相比于25 kGy组,高分子量增多。羰基含量结果显示在同一粒径下,γ辐照使羰基含量增多,0.5~1.0 mm组(F=13.631,P=0.002),1.2~2.8 mm组(F=6.390,P=0.016),3.3~4.7 mm组(F=5.630,P=0.023),5.7~7.0 mm组(F=4.150,P=0.048)的差异均有统计学意义,不同粒径间随着粒径增大羰基含量逐渐减小但差异统计学意义(F=0.560,P=0.650)。结论γ辐照与胶原的氧化损伤具有明显的剂量反应关系,随着γ辐照剂量的增加,胶原损伤程度逐渐增加;DBM的粒径大小影响着胶原对γ辐照的敏感度,随着粒径的减小,DBM颗粒更易被γ辐照损伤;辐照保护剂在辐照过程中对胶原有一定程度的保护作用。     

Characterization of Mutants of the Vitamin-D-Binding Protein/Group Specific Component: GC Aborigine (1A1) from Australian Aborigines and South African Blacks, and 2A9 from South Germany

The structure and organization of the human vitamin-D-binding protein gene (DBP, group-specific component, GC) have recently been determined. Each ex-on may now be amplified by the PCR method using oligonucleotide primers deduced from the intron sequences near their 5' ends and 3' ends. In this study we examined the anodal GC variants 1A1 and 2A9. Genomic DNA of the variant 1A1 was obtained from Australian Aborigines and from South African Bantu-speaking Blacks. Amplification and sequencing of exon 11 of 1A1 revealed a point mutation in codon 429 at the second position. It is remarkable that this mutation was found in the Australian 1A1 variant and in the African 1A1 variant, and raises the question whether the mutation in these two ethnic groups has a common origin. Genomic DNA of the 2A variant called 2A9 was obtained from South Germany and a point mutation also concerning position 429 in exon 11 was found. The nucleotide exchange in this case, however, was at the first position of the codon. The widely distributed genetic polymorphism of DBP/GC is located in exon 11 and is characterized by substitution at amino acid positions 416 and 420. Variant 1A1 is due to a second site mutation of the allele GC*1F; variant 2A9 is due to a mutation in the GC*2 allele.     

Current treatment strategies of the German Hodgkin Study Group (GHSG)

Abstract:  Hodgkin's Lymphoma (HL) has developed to one of the best curable human cancers and overall about 80% of patients experience long-term disease free survival. Therefore, current treatment strategies aim at further improving treatment outcome, thereby trying to by minimize therapy-induced complications, such as infertility, cardiopulmonary toxicity, and secondary malignancies. Ongoing trials investigate a reduction of chemotherapy in terms of dose or cycles given, and the application of lower radiation doses and smaller radiation fields. For patients with a specific high-risk profile, new approaches with more intense drug combinations are currently being investigated. Moreover, the advent of effective salvage high-dose therapy for relapsed disease and a better understanding of prognostic factors have further improved the management of HL. Here, we summarize current strategies of the German Hodgkin Study Group (GHSG) in diagnostics and treatment of primary and relapsed HL, together with recent approaches for specific subgroups of HL patients.     

罗格列酮对大鼠颈动脉球囊损伤后新生内膜及炎症因子的影响

目的观察罗格列酮对大鼠颈动脉损伤后新生内膜及炎症因子的影响。方法将SD大鼠随机分为3组(即对照组、手术组、治疗组)。手术组及治疗组均用球囊导管扩张法损伤左侧颈总动脉,治疗组给予罗格列酮灌胃治疗。术后4h,1d和7d,用放免法检测大鼠血浆中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平。2周后取损伤血管行苏木精-伊红染色、免疫组化染色及光镜观察,计算内膜面积(NIA)、内弹力板围绕面积(IELA)、管腔狭窄指数(SI)及核转录因子-κB(NF-κB)蛋白表达的光密度值。结果罗格列酮能抑制损伤动脉新生内膜的形成,抑制NF-κB的蛋白表达,降低血浆中TNF-α和IL-6水平。结论罗格列酮可以通过抑制损伤血管的炎症反应,减轻损伤血管的再狭窄。     

Ursolic acid induces apoptosis and autophagy in oral cancer cells

Oral squamous cell carcinoma (OSCC) is the fifth common cause of cancer mortality in Taiwan with high incidence and recurrence and needs new therapeutic strategies. In this study, ursolic acid (UA), a triterpenoid, was examined the antitumor potency in OSCC cells. Our results showed that UA inhibited the proliferation of OSCC cells in a dose‐ and time‐dependent manner in both Ca922 and SCC2095 oral cancer cells. UA induced caspase‐dependent apoptosis accompanied with the modulation of various biological biomarkers including downregulating Akt/mTOR/NF‐κB signaling, ERK, and p38. In addition, UA inhibited angiogenesis as evidenced by abrogation of migration/invasion and blocking MMP‐2 secretion in Ca922 cells. Interestingly, UA induced autophagy in OSCC cells, as manifested by LC3B‐II conversion and increased p62 expression and accumulation of autophagosomes. Inhibition by autophagy inhibitor enhanced UA‐mediated apoptosis in Ca922 cells. The experiment provides a rationale for using triterpenoid in the treatment of OSCC.     

Hepatitis C drugs: The end of the pegylated interferon era and the emergence of all-oral,interferon-free antiviral regimens: A concise review

Between 2001 and 2011, the standard of care for chronic hepatitis C virus (HCV) infection was a combination of pegylated interferon (PEGIFN) and ribavirin (RBV). In May 2011, boceprevir and telaprevir, two first-generation NS3/4A protease inhibitors, were approved in combination with PEG-IFN and RBV for 24 to 48 weeks in hepatitis C virus genotype 1 infections. In December 2013, simeprevir, a second-generation NS3/4A protease inhibitor, was approved for use with PEG-IFN and RBV for 12 weeks in genotype 1, while sofosbuvir, a NS5B nucleotide polymerase inhibitor, was approved for use with PEG-IFN and RBV for 12 weeks in genotypes 1 and 4, as well as with RBV alone for 12 weeks in genotype 2 and for 24 weeks in genotype 3. Sofosbuvir combined with simeprevir or an NS5A replication complex inhibitor (ledipasvir or daclatasvir) with or without RBV for 12 weeks in genotype 1 resulted in a sustained virological response >90%, irrespective of previous treatment history or presence of cirrhosis. Similarly impressive sustained virological response rates have been shown with ABT-450/r (ritonavir-boosted NS3/4A protease inhibitor)-based regimens in combination with other direct-acting antiviral agent(s) with or without RBV for 12 weeks in genotype 1. The optimal all-oral interferon-free antiviral regimen likely entails a combination of an NS5B nucleotide polymerase inhibitor with either a second-generation NS3/4A protease inhibitor or an NS5A replication complex inhibitor with or without RBV. Further research is needed to determine the role of resistance testing, clarify the optimal follow-up duration post-treatment, and evaluate the antiviral efficacy and safety in difficult-to-cure patient populations.