The Associations of Dietary Inflammatory Potential With Musculoskeletal Health in Chinese Community-Dwelling Older People: The Mr. OS and Ms. OS (Hong Kong) Cohort Study

Inflammation, an important contributory factor of muscle and bone aging, is potentially modulated by diet. This study examined the associations of dietary inflammatory index (DII) score with musculoskeletal parameters and related disease outcomes in 3995 community-dwelling Chinese men and women aged ≥65 years in Hong Kong. DII score at baseline was estimated from a food frequency questionnaire. Bone mineral density (BMD) and muscle mass estimated by dual-energy X-ray absorptiometry (DXA), hand grip strength, gait speed, and chair stand test were measured at baseline, year 4, and year 14. The associations of DII score with the longitudinal changes of musculoskeletal parameters, and incidence of osteoporosis, sarcopenia, and fractures were examined by using general linear model, multinomial logistic regression model, and Cox proportional hazards regression model, respectively. After multiple adjustments, each tertile increase in DII score in men was associated with 0.37 (95% confidence interval [CI], 0.10–0.64) kg loss in grip strength and 0.02 (95% CI, 0.01–0.03) m/s loss in gait speed over 4 years. In men, the highest tertile of DII was associated with a higher risk of incident fractures, with adjusted and competing death adjusted hazard ratio (HR) (95% CI) of 1.56 (1.14–2.14) and 1.40 (1.02–1.91), respectively. In women, DII score was not significantly associated with any muscle-related outcomes or incidence of fracture, but a significant association between higher DII score and risk of osteoporosis at year 14 was observed, with the highest tertile of DII score having adjusted odds ratio (OR) (95% CI) of 1.90 (1.03–3.52). In conclusion, pro-inflammatory diet consumption promoted loss of muscle strength and physical function, and increased risk of fractures in older Chinese men. Pro-inflammatory diets had no significant association with muscle related outcomes but increased the long-term risk of osteoporosis in older Chinese women. © 2022 American Society for Bone and Mineral Research (ASBMR).     

后Pilon骨折的诊治现状与进展

后Pilon骨折是一种新近报道的Pilon骨折的特殊模式,其特征是累及后外踝和后内踝.在过去由于后Pilon骨折没有得到充分的认识,常被误诊为后踝骨折,也导致这类患者功能恢复不良.因此是否能作出正确诊断至关重要,只有熟悉后Pilon骨折的各种影像学特征并了解合并损伤的机制,才能及时、准确地诊断后Pilon骨折,并改进这种具有挑战性骨折的术前计划和临床结果.本文着重介绍了后Pilon骨折的损伤机制,现有的分类方案,并讨论了目前使用的各种手术方法.     

Additional bedtime H2‐receptor antagonist for the control of nocturnal gastric acid breakthrough: A Cochrane systematic review

OBJECTIVES: To assess the effectiveness and safety of additional bedtime H₂‐receptor antagonists (H₂RAs) in suppressing nocturnal gastric acid breakthrough (NAB) via a systematic review. METHODS: Eligible trials were identified by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 2, 2004), MEDLINE (January 1966–June 2004), EMBASE (January 1980–June 2004) and CINAHL (January 1982–June 2004). Additional hand‐searching was conducted on the proceedings of correlated conferences, eight important Chinese journals and references of all included trials. All randomized controlled trials evaluating H₂RAs for the control of NAB were eligible for inclusion. The systematic review was conducted using methods recommended by The Cochrane Collaboration. RESULTS: Only two randomized crossover studies, comprising 32 participants, met the inclusion criteria. Because the design, dosage and duration of the treatments were different between the studies, it was not possible to conduct meta‐analysis. There were no consistent conclusions found between the two included studies in evaluating H₂RAs for the control of NAB. CONCLUSIONS: No implications for practice at this stage can be concluded. Appropriately designed large‐scale randomized controlled trials with long‐term follow up are needed to determine the effects of additional bedtime H₂RAs in suppressing NAB.     

卵巢子宫内膜异位囊肿粘连程度及相关因素分析

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.     

Ets-1、MMP-1及TIMP-1在膀胱移行细胞癌中的表达

目的研究Ets-1、基质金属蛋白酶1(MMP-1)及基质金属蛋白酶1抑制物(TIMP-1)在膀胱移行细胞癌(BTCC)中的表达及意义。方法用免疫组化方法检测40例BTCC组织和12例正常膀胱黏膜组织中Ets-1、MMP-1及TIMP-1的表达;分析Ets-1与BTCC临床病理特征间的关系;研究BTCC中MMP-1、TIMP-1表达与Ets-1表达的相关性。结果①Ets-1在BTCC中高度表达,阳性率为82.5%(P<0.01),且随BTCC临床分期和病理分级的升高而增加,肿瘤复发组高于无复发组,肿瘤转移组高于无转移组(P<0.05)。②MMP-1阳性表达率膀胱癌组(85.0%)明显高于对照组(58.3%)(p<0.05);TIMP-1阳性表达率对照组(83.3%)明显高于膀胱癌组(47.5%)(P<0.05)。③MMP-1与Ets-1表达呈正相关(Rs为0.824,P<0.01),而TIMP-1与Ets-1表达呈负相关(Rs为-0.821,P<0.01)。结论①Ets-1在BTCC中高度表达,并随BTCC分期分级升高而增加;Ets-1与BTCC转移及复发密切相关。②BTCC中Ets-1上调MMP-1表达,而下调TIMP-1表达,从而参与BTCC侵袭与转移。     

中国优秀马拉松运动员ACE基因I/D多态性频率分布特征

通过分析中国马拉松运动员ACE基因I/D多态频率分布特征,探讨其作为杰出耐力基因标记的可行性。选择我国马拉松健将、国际健将级运动员26名作为马拉松运动员组,汉族学生216名作为对照组。对两组受试者进行ACE基因I/D多态性测定。结果显示:我国马拉松运动员组的等位基因频率和基因型频率与对照组比较无显著差异,其中15名国际健将中无一DD型纯合子,提示我国优秀马拉松运动员的纯合子DD型频率低下是其ACE基因多态频率分布的主要特征。     

中央型肺癌术后螺旋CT检查价值探讨

目的探讨螺旋CT对于监测中央型肺癌术后局部复发及胸内淋巴结转移的价值。方法回顾性地对55例110人次中央型肺癌术后胸部增强螺旋CT资料进行分析。结果支气管残端或吻合口复发9例,12人次。胸内淋巴结26例33人次淋巴结短径≥1 cm,其中14例结合临床及CT诊断为淋巴结转移。结论对中央型肺癌术后复发的监测,螺旋CT是最好手段之一,但对肿大淋巴结性质的评价有一定局限性。     

眼眶内下壁爆裂性骨折整体修复29例

目的探讨眼眶内下壁骨折整体修复手术方法。设计回顾性病例系列。研究对象29例(29眼)眼眶内下壁骨折患者。方法对29例眼眶内下壁爆裂性骨折者采用整体羟基磷灰石复合人工骨(HA)修复。对比观察手术前后眼球突出度、复视程度,眼眶CT观察术后骨折修复情况。主要指标眼球突出度,复视程度。眼眶CT影像。结果29例眼眶内下壁骨折整体修复术中,加例眼球内陷全部矫正,9例欠矫1～2mm,4例术后复视未完全缓解。结论眼眶内下壁骨折整体修复是一种眼眶骨折修复的新方法,效果好,并发症少。(眼科,2006,15：348-350)