危重病患者血清瘦素表达及营养评价指标的作用

目的　探讨危重患者急性期禁食、全胃肠外营养 (TPN)治疗后血清瘦素的表达 ,以及营养评价指标对营养支持的作用。方法　用放射免疫法测定危重病患者血清瘦素 ,同时检测相关营养评价指标。结果　危重病患者急性期瘦素变化不明显 ,TPN治疗后迅速上升 ,第 3天达高峰 ,治疗后 5d仍高于正常。两组血浆纤维蛋白原、白蛋白、总胆固醇、甘油三脂、血淋巴细胞计数差异均无显著性意义 ,P >0 0 5。结论　危重病患者急性期禁食血清瘦素无显著性改变 ,但对TPN治疗反应迅速 ,血清瘦素有可能用来作为危重病患者急性期营养评价指标。血浆纤维蛋白原、白蛋白、总胆固醇、甘油三脂、淋巴细胞计数对危重病患者急性期营养状况无评价性作用。     

mGluR1 and mGluR5 antagonists in the amygdala inhibit different components of audible and ultrasonic vocalizations in a model of arthritic pain

Pain has a strong emotional component. The amygdala plays a key role in emotionality and is also involved in pain processing and pain modulation. Our previous studies showed an important role of group I metabotropic glutamate receptors (mGluRs) in pain-related synaptic plasticity and sensitization of neurons in the central nucleus of the amygdala (CeA). Here we address the roles of mGluR1 and mGluR5 subtypes in the CeA in the modulation of supraspinally organized behavioral responses in a model of arthritic pain. Audible and ultrasonic (25+/-4 kHz) vocalizations were measured in awake rats during and after innocuous and noxious stimulation (15 s) of the knee joint. Vocalizations were recorded in the same animals before arthritis, 6 h after arthritis induction and during administration of antagonists selective for mGluR1 (CPCCOEt) and mGluR5 (MPEP) into the CeA through stereotaxically implanted microdialysis probes. The duration of audible and ultrasonic vocalizations increased in the arthritic pain state. The duration of vocalizations during stimulation (VDS), which are organized at the brainstem level, was significantly reduced by CPCCOEt but not by MPEP. Vocalizations that continued after stimulation (VAS), which are organized in the limbic forebrain, particularly the amygdala, were inhibited by CPCCOEt and MPEP. These findings suggest differential roles of mGluR1 and mGluR5 in the CeA in pain-related vocalizations. Both mGluR1 and mGluR5 contribute to vocalizations generated in the amygdala whereas mGluR1, but not mGluR5, is involved in the amygdala-mediated modulation of vocalizations originating from activity in the brainstem.     

Intravenous iron sucrose in peritoneal dialysis patients with renal anemia.

OBJECTIVE: To explore the safety and efficacy of intravenous (IV) iron sucrose in maintenance peritoneal dialysis (PD). DESIGN: Randomized, controlled, parallel-group single-center trial. SETTING: Blood Purification Center of Chaoyang, Beijing Capital University of Medical Science, China. METHODS: 46 patients on PD were involved in this trial. 26 patients received IV iron sucrose (200 mg iron) once per week for 4 weeks then once every other week for a further 4 weeks. The other 20 patients received oral ferrous succinate, 200 mg three times per day, for 8 weeks. Hemoglobin, hematocrit, serum ferritin (SF) level, and transferrin saturation (TSAT) were assessed at baseline and then again after 2, 4, and 8 weeks of treatment. RESULTS: There were no differences between the IV and oral groups in terms of sex, age, duration of PD, mean dialysate dosage per day, erythropoietin dosage per week, or hematological parameters at baseline. After 4 and 8 weeks of treatment, mean Hb and Hct were significantly increased in the IV group and were also significantly higher than those in the oral group. Levels of SF and TSAT were also significantly increased in the IV group, and significantly higher than in the oral group. After 8 weeks, the response rate in the IV group was 94.8%, which was significantly higher than that in the oral group. The mean erythropoietin dose was significantly lower in the IV group than in the oral group. Hb, Hct, SF, and TSAT levels were maintained between 4 and 8 weeks in the IV group despite the decrease in dose frequency. There were no adverse events with IV iron. Eight patients in the oral group had adverse gastrointestinal effects. CONCLUSION: IV iron sucrose is safe in PD patients. It increases Hb levels and serum iron parameters more effectively than oral iron; it is well tolerated and can permit reductions in the required dose of erythropoietin.     

Role of fNIRS technology in observing the effect of needling Hegu (LI 4) on the functions of prefrontal cortex in healthy volunteers

Objective

To observe the effect of needling Hegu (LI 4) on functions of the prefrontal cortex using the functional near infrared spectroscopy (fNIRS).

Methods

A total of 12 healthy volunteers were randomly assigned to an acupuncture group (n=6) and a control group (n=6). The control group received no intervention. The acupuncture group received needling Hegu (LI 4) on the right side. The real-time concentration changes of oxygenated hemoglobin (HbO₂), deoxygenated hemoglobin (d-Hb) and total hemoglobin (t-Hb) in the prefrontal cortex were recorded using the fNIRS, allowing for effect analysis of needling Hegu (LI 4) on the functions of the prefrontal cortex.

Results

Compared with the control group, the HbO2 and t-Hb concentrations were increased in the acupuncture group and there were between-group statistical significances (both P<0.05). There was no between-group statistical significance in d-Hb concentration (P>0.05).

Conclusion

Needling Hegu (LI 4) can extensively activate the prefrontal cortex and therefore has significant effect on the functions of the brain’s prefrontal cortex.

     

Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy

Background

Although renal function recovery of living kidney donors has been reported in a number of studies, many patients show poor recovery, and the long-term prognosis of these patients has not been well studied. In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy.