Serological markers for monitoring disease progression in noncirrhotic primary biliary cirrhosis on ursodeoxycholic acid therapy

Background/Aim: Liver biopsy has so far been the only method to accurately follow the progression of primary biliary cirrhosis (PBC). The stage and the severity of lymphocytic piecemeal necrosis (LPN) have been shown to be an independent factor for the development of cirrhosis. In this 3‐year prospective study, we evaluated the diagnostic value of several liver function tests, surrogate markers of fibrogenesis, hyaluronic acid (HA), procollagen III N‐terminal peptide (S‐PIIINP), cholestanol and plant sterols in noncirrhotic PBC patients treated with ursodeoxycholic acid (UDCA) or with UDCA and budesonide to assess the stage, inflammation and fibrosis. Methods: Seventy‐seven stage I–III PBC patients were included into the study, with control biopsy at 36 months. Serum liver enzymes, bile acids (BA), HA, PIIINP, immunoglobulins, lipids and cholesterol precursors and plant sterols were measured at baseline and at 36 months. Results: Aspartate aminotransferase (AST), HA, BA and PIINP were significantly different between stages I to III and differentiated mild (F0F1) from moderate (F2F3) fibrosis. The combination of these variables (PBC score) exhibited best sensitivity and specificity, compared with AST/platelet ratio, Forns' score and fibrosis index. Using a cut‐off value of 66 for the PBC score, the sensitivity was 81.4% and specificity was 65.2% for classifying the stage of PBC, regarding the stage the and fibrosis in noncirrhotic PBC. Conclusions: Serum HA, BA, PIIINP and AST may serve as valuable simple tools to monitor the treatment response to UDCA in early stages of PBC. Combinations of these biomarkers into a single index further potentiate the diagnostic value of such measurements.     

Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study

OBJECTIVE: To examine the association between body size and depression in a longitudinal setting and to explore the connection between obesity and depression in young adults at the age of 31 years. DESIGN: This study forms part of the longitudinal Northern Finland 1966 Birth Cohort Study (N = 12,058). The follow-up studies were performed at 14 and 31 years. Data were collected by postal inquiry at 14 years and by postal inquiry and clinical examination at 31 years. SUBJECTS: A total of 8,451 subjects (4,029 men and 4,422 women) who gave a written informed consent and information on depression by three depression indicators at 31 years. MEASUREMENTS: Body size at 14 (body mass index (BMI) and 31 (BMI and waist-to-hip ratio (WHR)) years and depression at 31 years by three different ways: depressive symptoms by the HSCL-25-depression questionnaire (HSCL-25), the use of antidepressants and self-reported physician-diagnosed depression. RESULTS: Obesity at 14 years associated with depressive symptoms at 31 years; among male subjects using the cutoff point 2.01 in the HSCL-25 (adjusted odds ratio (OR) 1.97, 95% CI 1.06-3.68), among female subjects using the cutoff point 1.75 (adjusted OR 1.64, 95% CI 1.16-2.32). Female subjects who were obese both at baseline and follow-up had depressive symptoms relatively commonly (adjusted OR 1.40, 95% CI 1.06-1.85 at cutoff point 1.75); a similar association was not found among male subjects. The proportion of those who used antidepressants was 2.17-fold higher among female subjects who had gained weight compared to female subjects who had stayed normal-weighted (adjusted OR 2.17, 95% CI 1.28-3.68). In the cross-sectional analyses male subjects with abdominal obesity (WHR >or=85th percentile) had a 1.76-fold risk of depressive symptoms using the cutoff 2.01 in the HSCL-25 (adjusted OR 1.76, 95% CI 1.08-2.88). Abdominally obese male subjects had a 2.07-fold risk for physician-diagnosed depression (adjusted OR 2.07, 95% CI 1.23-3.47) and the proportion of those who used antidepressants was 2.63-fold higher among obese male subjects than among male subjects without abdominal obesity (adjusted OR 2.63, 95% CI 1.33-5.21). Abdominal obesity did not associate with depression in female subjects. CONCLUSION: Obesity in adolescence may be associated with later depression in young adulthood, abdominal obesity among male subjects may be closely related to concomitant depression, and being overweight/obese both in adolescence and adulthood may be a risk for depression among female subjects.     

小腿带腓肠神经远端筋膜蒂皮瓣移植的应用进展

目的:综合分析小腿、踝、足部复合伤后组织缺损与筋膜皮瓣移植的修复关系以及小腿带腓肠神经远端筋膜蒂皮瓣移植的解剖学基础与临床应用进展。资料来源:应用计算机检索Medline1990-01/2006-10有关小腿带腓肠神经远端筋膜蒂皮瓣移植的文章,检索词“sural nerve,fascia,flap,leg,lesser saphena”,并限定文章语言种类为English。同时计算机检索CNKI数据库1996-01/2006-10有关小腿带腓肠神经远端筋膜蒂皮瓣移植的文章,检索词“腓肠神经,皮瓣,筋膜,小隐静脉”,并对检索词进行分别组合,限定文章语言种类为中文。资料选择:对检索到的小腿带腓肠神经远端筋膜蒂皮瓣移植方面的相关信息进行整理,阅读2005,2006年度专业核心期刊的相关文章,在CNKI阅读查询到的引用2次以上的文献,选取针对性强的文章。资料提炼:有关小腿带腓肠神经远端筋膜蒂皮瓣移植的文献,有解剖学研究、病例报道、解剖与临床结合论著及综述等,相似的同一研究较多,国内研究、运用较国外丰富,其中有30篇纳入研究范畴。资料综合:小腿带腓肠神经远端蒂筋膜皮瓣具有以下优点:①蒂部具有穿支动脉,同时携带位于深筋膜层的皮神经及浅静脉,皮瓣移植难度较小,修复创面满意,不损失肢体的知名主干血管。②蒂部成形灵活,属于生理性皮瓣,成活可靠。③可重建感觉,以同样血供为基础的可形成复合瓣。小腿带腓肠神经远端筋膜蒂皮瓣是解决膝以下,足跖骨头以上皮肤组织缺损的简单、安全、效果良好的方法。结论:小腿带腓肠神经远端筋膜蒂皮瓣移植已成为创伤修复日渐青睐的手术方式,但在适应症、皮瓣血运基础、对小隐静脉处理、皮瓣质量(大小、外观、感觉)、术后护理等方面有待达成共识,使之成为修复创面的常用手段。     

人参皂甙Rb_1和Rg_1对小鼠中枢神经递质受体和脑内蛋白质合成的影响

应用放射配基结合法测定了人参皂甙Rb_1和Rg_1对α_1,α_2,β肾上腺素能受体、M胆碱能受体、5-羟色胺、多巴胺及GABA等七种受体的作用。结果均不能证明它们对这七种受体有亲和力。但给动物ip药物连续5天,Rb_1和Rg_1均能使中枢M胆碱受体密度显著增高。Rb_1及Rg_1还能显著增加脑内蛋白质的含量。上述实验结果对解释人参的中枢作用提供了重要证据。     

柯萨奇-腺病毒受体在肾癌组织中的表达及意义

目的:研究柯萨奇-腺病毒受体(CAR)在肾癌组织中的表达及意义.方法:应用免疫组化SP法检测12例癌旁正常肾组织和48例肾细胞癌组织中CAR的表达.结果:12例正常肾组织全部表达CAR,48例肾细胞癌组织中31例无CAR表达.不同分级CAR表达率分别为Ⅰ级54.5%(12/22)、Ⅱ级23.5%(4/17)、Ⅲ级11.1%(1/9);不同分期CAR表达率分别为Ⅰ期57.9%(11/19)、Ⅱ期30.8%(4/13)、Ⅲ期18.2%(2/11)、Ⅳ期0(0/5).结论:在多数肾细胞癌组织中CAR基因表达丧失;CAR表达变化与肾癌的分级、分期相关,可以作为肾癌分化、转移的重要生物学指标.     

The formation and function of the neutrophil phagosome

Neutrophils are the most abundant circulating leukocyte and are crucial to the initial innate immune response to infection. One of their key pathogen-eliminating mechanisms is phagocytosis, the process of particle engulfment into a vacuole-like structure called the phagosome. The antimicrobial activity of the phagocytic process results from a collaboration of multiple systems and mechanisms within this organelle, where a complex interplay of ion fluxes, pH, reactive oxygen species, and antimicrobial proteins creates a dynamic antimicrobial environment. This complexity, combined with the difficulties of studying neutrophils ex vivo, has led to gaps in our knowledge of how the neutrophil phagosome optimizes pathogen killing. In particular, controversy has arisen regarding the relative contribution and integration of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-derived antimicrobial agents and granule-delivered antimicrobial proteins. Clinical syndromes arising from dysfunction in these systems in humans allow useful insight into these mechanisms, but their redundancy and synergy add to the complexity. In this article, we review the current knowledge regarding the formation and function of the neutrophil phagosome, examine new insights into the phagosomal environment that have been permitted by technological advances in recent years, and discuss aspects of the phagocytic process that are still under debate.     

“It's a lot of things”: Household material hardship among Black and Hispanic parents of children with cancer

Household material hardship (HMH)—housing, food, transportation, or utility insecurity—is an adverse social determinant of health that is modifiable in the clinical setting. This mixed-methods, single-center study explored the experiences of HMH among Black and Hispanic pediatric oncology parents utilizing a single timepoint survey (N = 60) and semi-structured interviews (N = 20 purposively sampled subcohort). Forty-four (73%) parents reported HMH. Qualitatively, participants expressed stress, anxiety, and embarrassment due to unmet basic resource needs, and childcare emerged as an additional important domain of HMH. Participants recommend a standardized approach to HMH screening and resource allocation, offering insight into targets for future intervention.