Association between Branched-Chain Amino Acid Intake and Physical Function among Chinese Community-Dwelling Elderly Residents

This study aimed to evaluate the potential associations of dietary BCAAs (isoleucine, leucine, and valine) with physical function in the elderly Chinese population. A validated semiquantitative food frequency questionnaire and anthropometric and physical function measurements were used to collect data. We modeled trends in physical function indicators for BCAA quartiles using multivariate linear regression models. Among 4336 (43.97% men) participants aged 72.73 ± 5.48 years, a higher dietary intake of BCAAs was positively associated with increased handgrip strength (all p trends < 0.001), shorter times for 4-m fast walking (all p trends < 0.001) and repeated chair rises (all p trends < 0.001). No linear association was found between subtypes of amino acids and any physical functions (all p trends > 0.05). Individuals in the highest quartiles of BCAA intake had a reduced risk of developing low muscle strength, and the multiadjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for women and men were 0.50 (0.38–0.65) and 0.67 (0.50–0.91), respectively. Similarly, higher BCAA consumption was associated with a lower risk of developing low physical performance (4-m walking speed: OR = 0.68 [0.50–0.93]; repeated chair rises: OR = 0.66 [0.54–0.81]). Higher dietary BCAA intake might be beneficial for physical function in the elderly population.     

Carcinogenesis resistance in the longest‐lived rodent,the naked mole‐rat

Certain mammalian species are resistant to cancer, and a better understanding of how this cancer resistance arises could provide valuable insights for basic cancer research. Recent technological innovations in molecular biology have allowed the study of cancer‐resistant mammals, despite the fact that they are not the classical model animals, which are easily studied using genetic approaches. Naked mole‐rats (NMRs; Heterocephalus glaber) are the longest‐lived rodent, with a maximum lifespan of more than 37 years, and almost never show spontaneous carcinogenesis. NMRs are currently attracting much attention from aging and cancer researchers, and published studies on NMR have continued to increase over the past decade. Cancer development occurs via multiple steps and involves many biological processes. Recent research on the NMR as a model for cancer resistance suggests that they possess various unique carcinogenesis‐resistance mechanisms, including efficient DNA repair pathways, cell‐autonomous resistance to transformation, and dampened inflammatory response. Here, we summarize the molecular mechanisms of carcinogenesis resistance in NMR, which have been uncovered over the past two decades, and discuss future perspectives.     

T-cell immunoglobulin mucin molecule-3, transformation growth factor β, and chemokine-12 and the prognostic status of diffuse large B-cell lymphoma

BACKGROUNDThe effects of T-cell immunoglobulin mucin molecule-3 (Tim-3), transforming growth factor β (TGF-β), and chemokine-12 (CXCL12) expression on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) have not been elucidated.AIMTo examine the correlation between Tim-3, TGF-β and CXCL12 expression and DLBCL prognosis.METHODSLymph node tissues of 97 patients with DLBCL and 93 normal-response hyperplastic lymph node tissues treated from January 2017 to May 2019 were selected as the DLBCL and control groups, respectively. The expression of Tim-3, TGF-β, and CXCL12 was detected immunohistochemically. Patients were followed up for 3 years, and progression-free survival was recorded. Cox multifactorial analysis was performed to analyze the risk factors for poor prognosis.RESULTSThe positive expression rates of Tim-3, TGF-β, and CXCL12 were higher in DLBCL tissues than in non-cancerous (control) tissues (P < 0.05). One-year post-surgery, the positive expression rates of Tim-3, TGF-β, and CXCL12 were higher in patients with effective treatment than in those with ineffective treatment (P < 0.05). The 3-year progression-free survival of 97 patients with DLBCL was 67.01% (65/97). Univariate analysis revealed that clinical stage, bone marrow infiltration, International Prognostic Index (IPI) score, Tim-3 positivity, TGF-β positivity, and CXCL12 positivity were associated with poor prognosis (P < 0.05). Multivariate Cox regression analysis demonstrated that clinical stage III–IV, bone marrow infiltration, mediate-to-high-risk IPI scores, Tim-3 positivity, TGF-β positivity, and CXCL12 positivity were independent risk factors affecting prognosis (P < 0.05).CONCLUSIONDLBCL tissues exhibit high positive expression of Tim-3, TGF-β, and CXCL12, and a high expression of all three indicates a poor prognosis.     

疫情之下医学人文慕课建设的现状分析与思考

分析当前我国医学人文类慕课的建设现状,促进医学人文慕课优质课程资源共享,为课程设计规划提供信息参考。采用数理统计法、思维导图分析法对疫情期间17个在线课程平台上的42门医学人文慕课进行分析,结果显示：①医学人文慕课规模和数量有待扩增;②慕课建设存在地域不均衡性,华东地区建设最多;③慕课师资以团队授课为主,高级职称教师为团队主力,且部分教师团队为多学科背景;④课程内容中人文知识和能力相关教学内容丰富,但需适当增加医学人文精神认知相关内容。根据以上分析结果,建议医学人文慕课建设注重系统性和规范性,配备多学科专业背景师资团队,注意做好课程设计和规划,充分关注学习者的反馈与评价,以发现不足之处。     

疫情防控期间某医院开展临床医学课程在线教学的SWOT分析

利用SWOT理论分析疫情防控期间教学医院开展在线教学的内外部竞争环境和竞争条件。在综合性大学附属某医院开展临床医学课程在线教学,具有资源优势、组织优势和平台优势;但也存在临床医学专业的课程特殊性、临床教学医院的教师身份特殊性、疫情防控背景下在线教学的软硬件特殊性等劣势;为医院对标国家一流课程建设、发挥课程思政在教学阵地的主作用、营造主动型学习生态圈提供了发展基础;也对未来教学模式、教学管理模式、教学空间变革提出了挑战。基于此,提出推进医院医学教育信息化建设;全面提升教师信息素养;筑构适应于医院管理环境的教育信息化平台;搭建基于智慧教学空间的多元评价体系;基于多学科建设线上线下混合式课程体系等措施,以推进医院医学教育信息化建设和提升教学管理效率,促进“新医科”建设。     

Relationship between perfusion index and central temperature before and after induction of anesthesia in laparoscopic gastrointestinal surgery: A prospective cohort study

The perfusion index (PI) cutoff value before anesthesia induction and the ratio of PI variation after anesthesia induction remain unclear. This study aimed to clarify the relationship between PI and central temperature during anesthesia induction, and the potential of PI in individualized and effective control of redistribution hypothermia. This prospective observational single center study analyzed 100 gastrointestinal surgeries performed under general anesthesia from August 2021 to February 2022. The PI was measured as peripheral perfusion, and the relationship between central and peripheral temperature values was investigated. Receiver operating characteristic curve analysis was performed to identify baseline PI before anesthesia, which predicts a decrease in central temperature 30 minutes after anesthesia induction, and the rate of change in PI that predicts the decrease in central temperature 60 minutes after anesthesia induction. In cases with a central temperature decrease of ≥ 0.6°C after 30 minutes, the area under the curve was 0.744, Youden index was 0.456, and the cutoff value of baseline PI was 2.30. In cases with a central temperature decrease of ≥ 0.6°C after 60 minutes, the area under curve was 0.857, Youden index was 0.693, and the cutoff value of the PI ratio of variation after 30 minutes of anesthesia induction was 1.58. If the baseline PI is ≤ 2.30 and the PI 30 minutes after anesthesia induction is at least 1.58-fold the PI ratio of variation, there is a high probability of a central temperature decrease of at least 0.6°C within 30 minutes after 2 time points.     

134例老年急性髓系白血病的临床特点及预后分析

  目的  分析老年急性髓系白血病（acute myeloid leukemia,AML）（非早幼粒细胞白血病）的临床特点,治疗方式以及疗效和预后特点。  方法  收集2015年1月至2023年2月北京大学国际医院收治的134例老年AML患者资料,回顾性分析患者初诊时的白细胞计数、骨髓原始细胞计数、细胞遗传学及分子学特点、ELN危险分层,根据不同治疗方案将患者分为高强度化疗组和低剂量治疗组,观察在治疗过程中强化疗是否能给患者带来生存获益以及影响老年患者生存的因素。  结果  高强度化疗患者36例,22例完全缓解（complete response,CR）（61.1%）,低剂量治疗90例中46例获得CR（51.1%）,其中19例阿扎胞苷（AZA）联合维奈克拉（VEN）治疗换着中14例获得CR（73.7%）;高强度化疗与低剂量治疗的总生存期（overall survival,OS）分别为15个月和14.5个月（P=0.226）。欧洲白血病网（ELN）危险分层低、中、高危组患者OS分别为18、14、9个月（P=0.009）,低危组高强度化疗和低剂量治疗的OS分别为22个月和15个月（P=0.745）,中危组分别为9个月和15个月（P=0.783）,高危组分别为9个月和8个月（P=0.739）。强化疗（36例）与阿扎胞苷+维奈克拉治疗（19例）相比OS分别为15个月和17个月（P=0.689）。TP53基因突变者6例,预后明显差于无突变者,中位生存期分别为2个月和14个月（P=0.004）。低、中、高危患者的1年生存率为79%、53%和44%,3年生存率分别为41%、20%和3%。多因素分析显示外周血高白细胞计数（P=0.034）、ELN危险分层（P=0.002）、合并症（P=0.017）与OS相关,而治疗强度、年龄、性别、骨髓原始细胞计数与OS 无明显相关性。  结论  高强度化疗在老年AML中没有显示明显的生存获益,但这一结果在低危患者中有待于进一步观察。TP53突变者预后较差。多因素分析预测老年AML的生存期时,基线的分子学特征、白细胞计数、合并症比治疗强度更重要。     

肺血栓栓塞症大鼠血浆尿激酶型纤溶酶原激活物及其受体的动态变化及其意义

目的观察大鼠肺血栓栓塞症(PTE)后不同时间血浆尿激酶型纤溶酶原激活物(uPA)和尿激酶型纤溶酶原激活物受体(uPAR)的动态变化,并探讨两者与血栓自溶率的相关性。方法经颈外静脉注入加热125I-标记纤维蛋白原自体血栓,复制大鼠PTE模型,随机分组如下:1)正常对照组;2)PTE组:又分为PTE 4 h组(PTE 4 h)、PTE 24 h组(PTE 24 h)、PTE 3 d组(PTE 3d)、PTE 5 d组(PTE 5 d),即分别在造模成功后观察4 h2、4 h3、d、5 d后处死小鼠,留取血浆标本测定uPA、uPAR的水平;留取左肺观察肺组织病理改变;留取心脏、肺脏、全血以计算血栓自溶率。结果血浆uPA、uPAR水平在PTE后4 h略有上升(P>0.05),PTE后24 h明显增加(P<0.05),3 d时最高(P<0.01),5 d时开始下降,但仍明显高于正常对照组(uPAP<0.05,uPARP<0.01);PTE后4 h组、24 h组、3 d组血浆uPA质量浓度与血栓自溶率正相关(4 hr=0.758,P<0.05;24 hr=0.764,P<0.05;3 dr=0.778,P<0.05),血浆uPAR质量浓度与血栓自溶率正相关(4 hr=0.701,P<0.05;24 hr=0.764,P<0.05;3 dr=0.777,P<0.05)。肺组织病理改变:PTE后4 h有少量继发血栓形成,血栓及血管壁内可见白细胞浸润;PTE后3 d、5 d见注入的血凝块明显溶解,代之以新形成的血栓。结论PTE后血浆uPA、uPAR水平增加,促进内源性纤维蛋白溶解。     

反相高效液相色谱法测定二妙散中生物碱的含量

采用反相高效液相色谱法,以盐酸小檗碱、盐酸巴马汀、盐酸药根碱、黄柏碱、ＨＢ－１为定量指标,测定二妙散中上述各成分的含量。色谱柱Ｎｕｃｌｅｏｓｉｌ－ＯＤＳ;流动相为甲醇－磷酸盐缓冲液－十二烷基硫酸钠（６０∶４０∶０．１）;流速１．０ｍｌ／ｍｉｎ;检测波长２６４ｎｍ。盐酸小檗碱、盐酸巴马汀和ＨＢ－１的加样回收率分别为９９．１２％,９８．３５％,９９．８２％,ＲＳＤ分别为３．４２％,３．１５％,３．７４％。测得二妙散中各生物碱含量分别为：小檗碱０．９１４％,巴马汀０．６０９％,药根碱０．０２４７％,黄柏碱０．０８３９％,ＨＢ－１０．３１３％。