Primary Hyperparathyroidism: A Tale of Two Cities Revisited — New York and Shanghai

In the 1970s, with the advent of biochemical multichannel screening in the United States and other western countries, the clinical presentation of primary hyperparathyroidism (PHPT) changed from a symptomatic to an asymptomatic disorder. However, in Asian countries, like China, PHPT did not show this evolution, but rather continued to be a symptomatic disease with target organ involvement. In this paper, we revisit the clinical features of PHPT in New York and Shanghai, representative United States and Chinese cites, over the past decade. The questions we address are whether the disease evolved in China to a more asymptomatic one and, whether in the United States further changes are evident. The results indicate that while PHPT continues to present primarily as an asymptomatic disease in the United States, a new phenotype characterized by normal serum calcium and high parathyroid hormone levels, normocalcemic PHPT, has emerged. Data from Shanghai demonstrates a trend for PHPT to present more commonly as an asymptomatic disorder in China. However, most patients with PHPT in China still manifest classical symptoms, i.e. nephrolithiasis and fractures. A comparison of the two cohorts shows that Chinese patients with PHPT are younger, with higher serum calcium and PTH levels, and lower 25-hydroxyvitamin D levels than patients in New York. Normocalcemic PHPT has not yet been recognized in Shanghai. In summary, although the phenotypes of PHPT in both cities are evolving towards less evident disease, sharp clinical and biochemical differences are still apparent in PHPT as expressed in China and the United States.     

Edentulism trends among middle-aged and older adults in the United States: comparison of five racial/ethnic groups

Wu B, Liang J, Plassman BL, Remle C, Luo X. Edentulism trends among middle‐aged and older adults in the United States: comparison of five racial/ethnic groups. Community Dent Oral Epidemiol 2012; 40: 145–153. © 2011 John Wiley & Sons A/S Abstract – Objectives: This study examined edentulism trends among adults aged 50 and above in five ethnic groups in the United States: Asians, African Americans, Hispanics, Native Americans, and non‐Hispanic Caucasians. Methods: Data came from the National Health Interview Surveys between 1999 and 2008. Respondents included 616 Native Americans, 2,666 Asians, 15,295 African Americans, 13,068 Hispanics, and 86,755 Caucasians. Results: In 2008, Native Americans had the highest predicated rate of edentulism (23.98%), followed by African Americans (19.39%), Caucasians (16.90%), Asians (14.22%), and Hispanics (14.18%). Overall, there was a significant downward trend in edentulism rates between 1999 and 2008 (OR = 0.97, 95% CI: 0.96, 0.98). However, compared with Caucasians, Native Americans showed a significantly less decline of edentulism during this period (OR = 1.10, 95% CI: 1.02, 1.19). Conclusions: While there was a downward trend in edentulism between 1999 and 2008, significant variations existed across racial/ethnic groups. Innovative public health programs and services are essential to prevent oral health diseases and conditions for minority populations who lack access to adequate dental care. Additionally, given the increasing numbers of adults retaining their natural teeth, interventions designed to assist individuals in maintaining healthy teeth becomes more critical.     

小花清风藤化学成分的分离与鉴定(Ⅱ)

目的研究小花清风藤Sabia parviflora的化学成分。方法利用硅胶柱色谱、HP20树脂、以及半制备型液相色谱等,多种色谱技术进行分离,运用现代光谱技术鉴定化合物结构。结果从小花清风藤中分离得到15个化合物,分别鉴定为1,3,5-三甲氧基苯(1)、香草醛4-O-β-D-葡萄糖苷(2)、2,6-二甲氧基-4-羟基苄醇1-O-β-D-葡萄糖苷(3)、rel-5-(3S,8Sdihydroxy-1R,5S-dimethyl-7-oxa-6-oxobicyclo[3,2,1]-oct-8-yl)-3-methyl-2Z,4E-penta-dienoicacid(4)、原儿茶酸(5)、4-喹啉酮-2-羧酸(6)、3,4,5-三甲氧基苯甲酸(7)、邻苯二酚(8)、丁香酸-4-O-β-D-吡喃葡萄糖苷(9)、(-)-(7α,8S)-erythro-1-Csyringylglycerol 4-O-β-D-glucopyranoside(10)、3,4,5-三甲氧基苯甲酸(11)、1,2,4-苯三酚(12)、阿魏酸(13)、香草酸(14)、对羟基苯甲酸(15)。结论化合物1～11均为首次从该属植物中分离得到,12～15为首次从该植物中分离得到。     

扩散加权成像与传统磁共振成像联合诊断乳腺疾病

目的探讨扩散加权成像(DWI)与常规MRI征象联合诊断乳腺疾病的模式及诊断效能。资料与方法采用前瞻性研究,99例乳腺疾病患者共109个病变术前行3.0T乳腺MRI及DWI检查,经术后病理或长期随访确诊。乳腺良恶性病变的表观扩散系数(ADC)值进行同一观察者、不同观察者共3次测量,采用受试者操作特征曲线、串联并联诊断试验、机器学习探讨多参数联合对乳腺良恶性疾病的诊断效能。结果 ADC值的观察者内组内相关系数为0.950(95%CI 0.928~0.965);观察者间组内相关系数为0.937(95%CI 0.909~0.956);良性病变与恶性病变的ADC值分别为(1.447±0.377)×10-3 mm2/s、(1.054±0.255)×10-3 mm2/s,差异有统计学意义(P<0.05)。以ADC值1.125×10-3 mm2/s为阈值鉴别良恶性病变的敏感度和特异度分别为82.4%、74.1%,联合其他传统MRI征象可使敏感度、特异度高于单一ADC值诊断。结论 ADC值具有良好的可重复性和稳定性,ADC值与传统MRI征象联合应用可以更好地鉴别乳腺病灶的良恶性。     

cN0期甲状腺乳头状癌预防性中央区淋巴结清扫的争议与进展

甲状腺癌是近年来全世界发病率较高的恶性肿瘤之一,乳头状癌是其最常见的病理类型,治疗方式以手术为主,中央区淋巴结为其前哨淋巴结,故转移首先发生于此。对于存在中央区淋巴结转移的甲状腺乳头状癌患者,行中央区淋巴结清扫已被国内外学者所认可,但对于cN_0期肿瘤,是否行预防性中央区淋巴结清扫目前尚存争议。笔者就中央区淋巴结的解剖概念、cN_0期甲状腺乳头状癌转移规律、高危因素、对预防性淋巴结清扫的不同观点、并发症的预防及术式的选择等方面进行综述,旨在提高此类疾病的认识,为其治疗方式的完善提供参考。     

Application of KDQOL-SFTM 1.3 version in evaluating quality of life of maintenance hemodialysis patients in multiple centers

Objective To understand the quality of life (QOL) and its influencing factors in maintenance hemodialysis patients (hemodialysis maintenance, MHD), and to provide theoretical basis for improving QOL of patients. Methods A cross-sectional study was conducted in the blood purification centre in 8 hospitals of Hefei, and patients clinical data were collected. KDQOL-SF self-administered questionnaire was applied to assess the health related quality of life (HRQL) of patients and to analyze the factors influencing the QOL. Results The QOL of MHD patients in Hefei City was better compared with previous similar research results. Generally speaking, gender (male), education degree and household income were positive correlated with QOL scores (P＜0.05), and the scores of primary disease of patients with diabetic nephropathy or drugs were lower (P＜0.05) in physiological component summary (PCS), mental component summary (MCS), SF-36 and KDTA. Charlson comorbidity index (CCI) was negatively correlated with the MCS scores, PCS scores and SF scores (P＜0.05), and patients' occupational and medical insurance had impacts on MCS and KDTA score (P＜0.05). Conclusions The QOL of MHD patients are affected by many factors, and the CCI and cultural level are possible independent influencing factors. In addition, gender, household income per capita, primary disease, occupation, medical insurance also have certain influence.     

清金化痰汤对慢性阻塞性肺疾病急性加重期模型大鼠肺组织 Foxp3和 RORγt 表达的影响

目的探讨清金化痰汤对慢性阻塞性肺疾病急性加重期(AECOPD)模型大鼠肺组织叉头翼状螺旋转录因子P3(Foxp3)、维甲酸相关孤核受体γt(RORγt)表达的影响。方法 40只SPF Wistar雄性大鼠随机分为正常组、模型组、清金化痰汤组、克拉霉素组。除正常组外,其余组采取气道滴注脂多糖(LPS)联合烟熏的方法建立AECOPD气道黏液高分泌模型,并同时连续30 d分别给予生理盐水、清金化痰汤(8.4 g/kg)、克拉霉素(50 mg/kg)灌胃。实验第31天,提取大鼠肺组织,制作病理切片,并采用免疫组化法检测肺组织中黏蛋白5AC(Muc5AC)、中性粒细胞弹性蛋白酶(NE)的表达,观察Foxp3和RORγt的表达,免疫印迹法检测肺组织中Foxp3和RORγt的蛋白表达。结果与正常组比较,模型组Foxp3表达量无明显差异(P0.05),RORγt、Muc5AC、NE表达显著升高,Foxp3/RORγt显著下降(P0.01);清金化痰汤组与模型组比较,Foxp3表达量无明显差异(P0.05),RORγt、Muc5AC、NE表达显著降低,Foxp3/RORγt显著升高(P0.01或P0.05)。清金化痰汤组与克拉霉素组比较,Muc5AC显著降低(P0.05)。结论清金化痰汤可显著下调模型大鼠肺组织中RORγt蛋白表达,上调Foxp3/RORγt,这可能是清金化痰汤调节AECOPD黏液高分泌的机制之一。     

芥子气经腹腔和气管致大鼠急性肺损伤细胞凋亡的变化

目的  经腹腔和气管建立大鼠芥子气（SM）急性肺损伤动物模型,比较两种大鼠急性肺损伤模型细胞凋亡的差异。方法  选取Sprague Dawley大鼠136只,随机分为5组,正常对照组8只,其他4个组为腹腔SM组、腹腔丙二醇对照组、气管SM组、气管丙二醇对照组,每组32只。腹腔SM组腹腔内注入稀释的SM 0.1 ml（0.96 LD50=8 mg/kg）,气管SM组气管内注入稀释的SM 0.1 ml（0.98 LD50=2 mg/kg）,正常对照组未做任何处理。采用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记测定法（TUNEL）染色和免疫组织化学法及电镜观察,判断细胞凋亡情况。结果  ①腹腔SM组各时间段肺泡间隔TUNEL染色阳性细胞表达率较气管SM组增多（P <0.05）。②腹腔SM组各时间段肺泡间隔凋亡蛋白Bax阳性表达率较气管SM组升高（P <0.05）;腹腔SM组各时间段肺泡间隔凋亡蛋白Bcl-2阳性表达率较气管SM组降低（P <0.05）。③腹腔SM组各时间段肺泡间隔凋亡蛋白酶Caspase-3、Caspase-9阳性表达率较气管SM组增多（P <0.05）。④电镜显示,染毒72 h,腹腔SM组和气管SM组Ⅰ型和Ⅱ型肺泡上皮凋亡细胞形态特征为上皮细胞膜附着的微绒毛断裂缺失,排列紊乱;线粒体嵴模糊,粗面内质网表面附着的核糖体脱离,并游离于细胞质中。结论  SM经腹腔和气管染毒致大鼠急性肺损伤,通过内源性通道引发细胞凋亡调节异常,SM经腹腔染毒大鼠各项细胞凋亡指标比经气管明显升高,推测可能与SM腹膜腔的快速吸收有关。

     

Construction of a Caco-2/EAhy926 cell tandem compound model and its application in mechanism study of nanoparticle transcytosis

Based on the physiological structure of the intestine, a Caco-2/EAhy926 tandem compound model was constructed in order to simulate the intestinal-vascular barrier. This model was applied in the study of transcytosis of nanoparticles, and it was compared with the traditional intestinal cell model in the whole study. Briefly, Fe₃O₄ nanoparticles with a size about 30 nm were used as model nanoparticles, which remained steady during transcytosis. The nanoparticles hardly had cytotoxicity to Caco-2 cells and EAhy926 cells within the incubation concentrations. The cell tandem model was established by connecting upper Caco-2 monolayer and lower EAhy926 monolayer. Based on the FD4 permeability or TEER, all cell models remained integrity within certain period of culture time. The expression of Claudin-4 or VE Cadherin demonstrated the presence of tight junctions. The intact morphology of microfilament F-actin indicated the favorable intracellular connection. It was found that the two-layer cell tandem model created a bigger barrier for the transcytosis of FD4 than Caco-2 and EAhy926 monolayer models, and the translocation of Fe₃O₄ nanoparticles showed a similar pattern. Interestingly, we found that the main barrier of tandem model for nanoparticles was caused by the upper Caco-2 cell monolayer, while the lower layer of EAhy926 monolayer remained high permeability. Generally, the cell tandem compound model established here enabled us to evaluate the impact of both intestinal epithelial and endothelial layer on transcytosis, and it might provide a novel approach to study bio-nano interaction in the intestine.     

核桃健脑片对东莨菪碱诱导记忆障碍小鼠的作用及其机制考察

摘 要 目的：考察核桃健脑片对东莨菪碱诱导记忆障碍小鼠的作用及机制。方法: 小鼠随机分为正常组,模型组,磷脂酰丝氨酸组（40 mg·kg-1）,核桃酶解提取物（66.7 mg·kg-1）组,核桃健脑片低（333 mg·kg-1）、中（667 mg·kg-1）、高（1 333 mg·kg-1）剂量组,连续给药30 d后注射东莨菪碱进行跳台测试,观察潜伏期和错误次数。各组小鼠连续给药第26~30天注射东莨菪碱进行水迷宫测试,观察定位航行测试的逃避潜伏期和空间探索测试穿越原平台次数、到达原平台的时间和在原平台象限游泳的时间;然后取脑组织测定乙酰胆碱酯酶（AChE）、乙酰胆碱转移酶（ChAT）、Na+/K+ ATP酶（Na+/K+ ATPase）的活性,试剂盒测定乙酰胆碱（ACh）、谷氨酸（Glu）、γ 氨基丁酸（GABA）的含量。结果: 核桃健脑片中、高剂量可减少跳台测试中小鼠错误次数（P<0.05）;缩短水迷宫定位航行测试的逃避潜伏期和空间探索测试的到达原平台时间（P<0.05）,增加在原平台象限游泳的时间（P<0.05）和穿越原平台次数。核桃健脑片中、高剂量可降低脑组织的AChE活性和GABA含量（P<0.05）,增加脑组织的ChAT和Na+/K+ ATPase的活性,增加ACh、Glu的含量（P<0.05）。结论: 核桃健脑片中、高剂量可改善东莨菪碱诱导记忆障碍小鼠的学习记忆,其作用机制与调节ACh的代谢,调节Glu与GABA的比例,增加Na+/K+ ATPase的活性有关。