What some patients can eat during migraine attacks: therapeutic and conceptual implications

Although nausea and vomiting are diagnostic migraine symptoms, most patients can take tablets by mouth and a few say they can eat some food. This study was conducted to determine the proportion who could eat or drink, what was consumable and with what effect. One-hundred-and-nine migraineurs were asked what they could eat or drink at the beginning or height of their attacks; 59 could not take any food by mouth, but 50 could eat during the headache phase of their migraine attacks. Four ate normally, 5 took smaller amounts of their normal dietary intake, and 3 took lighter meals. Dry, carbohydrate foods were consumable by the remaining 38: a few had specific cravings, most stated the precise variety which, when eaten, reduced nausea, headache, other symptoms or length of attacks. Patients should therefore be encouraged to eat what they can tolerate, with their tablets taken as early as possible after the onset of attacks. Simultaneous nausea, tolerance or even craving for specific foods occur in other conditions, particularly high altitude headaches which share other features of migraine attacks. The observations in this paper support the notion that migraine is a central neuronal metabolic disturbance.     

Screening of Twenty-Four South African Combretum and Six Terminalia Species (Combretaceae) for Antioxidant Activities

The dried leaves of Combretum and Terminalia species (Combretaceae) were extracted with acetone, hexane, dichloromethane and methanol. Thin layer chromatography (TLC) plates were developed under saturated conditions and sprayed with 0.2% 2,2-diphenyl-1-picryl hydrazyl (DPPH) in methanol for antioxidant screening. Visualization of separated bands exhibiting antioxidant activities enabled the localization and the subsequent identification of the potential active compounds. The acetone and methanol extracts displayed the presence of antioxidant activity after spraying the chromatogram with DPPH. Hexane and dichloromethane extracts did not have any antioxidant activity. C. hereroense had the highest number of active compounds, followed by C. collinum ssp. taborense, which were 16 and 10, respectively. Acetone extracts of all tested Combretum species had 53 active bands and methanol had 55. All Terminalia species extracted with acetone and methanol had antioxidant activity. T. gazensis and T. mollis methanol extracts had 11 and 14 active compounds respectively in one of the solvent systems used. The qualitative DPPH assay on TLC was successfully used in this study to systematically assess the total antioxidant activity of the Combretum and Terminalia species extracts.     

Characterization of endometrial T lymphocyte subpopulations in spontaneous early pregnancy loss

T lymphocyte subpopulations were compared in normal first trimester human decidua and in decidua associated with spontaneous abortion. Cryostat sections were labelled using a panel of monoclonal antibodies specific for CD3, CD8, CD4 and for the alphabeta and gammadelta heterodimers of the T cell receptor using an avidin-biotin complex peroxidase method. All the endometrial T cell subsets which have been demonstrated in normal early pregnancy were detected in similar numbers and proportions in spontaneous abortion. The findings suggest that adverse pregnancy outcome is not influenced by altered proportions of T cell subpopulations; nevertheless, the possibility remains that these cells may have an altered antigenic phenotype in spontaneous abortion which could contribute to pregnancy success or failure.      

Germline mutations of the CDKN2 gene in UK melanoma families

Germline mutations in CDKN2 on chromosome 9p21, which codes for the cyclin D kinase inhibitor p16, and more rarely, mutations in the gene coding for CDK4, the protein to which p16 binds, underlie susceptibility in some melanoma families. We have sequenced all exons of CDKN2 and analysed the CDK4 gene for mutations in 27 UK families showing evidence of predisposition to melanoma. Five different germline mutations in CDKN2 were found in six families. Three of the mutations (Met53Ile, Arg24Pro and 23ins24) have been reported previously. We have identified two novel CDKN2 mutations (88delG and Ala118Thr) which are likely to be associated with the development of melanoma, because of their co-segregation with the disease and their likely functional effect on the CDKN2 protein. In binding assays the protein expressed from the previously described mutation, Met53Ile, did not bind to CDK4/CDK6, confirming its role as a causal mutation in the development of melanoma. Ala118Thr appeared to be functional in this assay. Arg24Pro appeared to bind to CDK6, but not to CDK4. No mutations were detected in exon 2 of CDK4, suggesting that causal mutations in this gene are uncommon. The penetrance of these mutant CDKN2 genes is not yet established, nor is the risk of non-melanoma cancer to gene carriers.      

Distribution of mutations in the PEX gene in families with X-linked hypophosphataemic rickets (HYP)

Mutations in the PEX gene at Xp22.1 (phosphate-regulating gene with homologies to endopeptidases, on the X-chromosome), are responsible for X-linked hypophosphataemic rickets (HYP). Homology of PEX to the M13 family of Zn2+ metallopeptidases which include neprilysin (NEP) as prototype, has raised important questions regarding PEX function at the molecular level. The aim of this study was to analyse 99 HYP families for PEX gene mutations, and to correlate predicted changes in the protein structure with Zn2+ metallopeptidase gene function. Primers flanking 22 characterised exons were used to amplify DNA by PCR, and SSCP was then used to screen for mutations. Deletions, insertions, nonsense mutations, stop codons and splice mutations occurred in 83% of families screened for in all 22 exons, and 51% of a separate set of families screened in 17 PEX gene exons. Missense mutations in four regions of the gene were informative regarding function, with one mutation in the Zn2+-binding site predicted to alter substrate enzyme interaction and catalysis. Computer analysis of the remaining mutations predicted changes in secondary structure, N-glycosylation, protein phosphorylation and catalytic site molecular structure. The wide range of mutations that align with regions required for protease activity in NEP suggests that PEX also functions as a protease, and may act by processing factor(s) involved in bone mineral metabolism.      

The role of size, sequence and haplotype in the stability of FRAXA and FRAXE alleles during transmission

Factors involved in the stability of trinucleotide repeats during transmission were studied in 139 families in which a full mutation, premutation or intermediate allele at either FRAXA or FRAXE was segregating. The transmission of alleles at FRAXA, FRAXE and four microsatellite loci were recorded for all individuals. Instability within the minimal and common ranges (0-40 repeats for FRAXA, 0-30 repeats for FRAXE) was extremely rare; only one example was observed, an increased in size at FRAXA from 29 to 39 repeats. Four FRAXA and three FRAXE alleles in the intermediate range (41-60) repeats for FRAXA, 31-60 for FRAXE) were unstably transmitted. Instability was more frequent for FRAXA intermediate alleles that had a tract of pure CGG greater than 37 although instability only occurred in two of 13 such transmissions: the changes observed were limited to only one or two repeats. Premutation FRAXA alleles over 100 repeats expanded to a full mutation during female transmission in 100% of cases, in agreement with other published series. There was no clear correlation between haplotype and probability of expansion of FRAXA premutations. Instability at FRAXA or FRAXE was more often observed in conjunction with a second instability at an independent locus suggesting genomic instability as a possible mechanism by which at least some FRAXA and FRAXE mutations arise.      

孤独症谱系障碍儿童睡眠障碍的评估和干预

睡眠障碍是孤独症谱系障碍(ASD)儿童最常见的共患障碍之一,不仅与ASD儿童核心症状存在显著相关,还会影响患儿的功能水平、生活质量以及干预康复效果,给父母造成巨大养育压力和经济负担。国际上已将睡眠障碍,特别是失眠纳入到ASD的综合诊治之中,但国内相关工作开展滞后,儿科专业人员对ASD儿童睡眠障碍的诊治能力有待提升。 因此,本研究将介绍ASD儿童睡眠障碍的评估和干预方法,为临床和研究工作提供依据。     

基于胸痛中心急救流程在急性心肌梗死患者救治中的应用

目的探讨基于胸痛中心急救流程在急性心肌梗死(AMI)患者救治中的应用效果。 方法选取镇江市急救中心2017年8月至2021年8月接诊的94例AMI患者为研究对象,其中男性50例,女性44例;年龄42~81岁,平均(60.37±4.31)岁。根据就诊顺序分为对照组和研究组,每组各47例,对照组患者接受常规急救流程,研究组患者接受基于胸痛中心基础上的急救流程,比较两组患者急救各环节时间、不良心血管事件发生率及患者满意度。 结果研究组患者急救各环节时间较对照组更短,两组比较差异有统计学意义(P<0.05);研究组患者不良心血管事件发生率显著低于对照组(6.38%比23.40%),两组比较差异有统计学意义(P<0.05);研究组患者满意度显著高于对照组(93.62%比78.72%),两组比较差异有统计学意义(P<0.05)。 结论基于胸痛中心急救流程可有效缩短急救过程中各环节时间,最大限度降低不良心血管事件发生风险,患者满意度高,对提高AMI患者救治效果、改善预后具有积极意义。     

自制IPS-Empress2铸瓷快速包埋材料物理机械性能表征

为降低IPS-Empress2铸瓷修复成本,研制了国产化包埋材料,以取代昂贵的进口专用包埋材料.对自制包埋材料的物理机械性能进行表征,与进口材料进行比较和统计分析,并用扫描电镜观察两种材料表面形貌的异同点.结果显示:自制包埋材料的凝固时间为9 min,烧结前密度为1.813 g/cm3,烧结后密度为1.402 g/cm3,开口孔隙率38.1%,凝固2 h后抗压强度和烧结后抗压强度分别为5.42 MPa和8.37 MPa,且耐火度在1000 ℃以上,高于铸造温度(920℃).与进口材料相比,自制包埋材料凝固时间更短,烧结前密度、凝固2h后抗压强度和烧结后抗压强度更高;开口孔隙率、烧结后密度和耐火度无统计学差异.扫描电镜观察显示两种材料结构相似,但自制材料的晶体尺寸略小于进口材料.可见自制包埋材料的主要物理机械性能指标接近或优于进口专用包埋材料,具有良好的临床应用前景.     

海绵中抗肿瘤抗病毒生物活性的生物碱研究进展

海绵中含有很多结构新颖且具有显著生物活性的生物碱。对近5年来具有抗肿瘤、抗病毒生物活性的生物碱加以概括。