早期肠内营养支持对胃癌术后患者肠黏膜屏障功能保护的研究进展

胃癌患者在手术应激状况下，内脏血流减少，肠黏膜处于低灌注状态，易发生肠黏膜损伤。此外，手术刺激可导致肠黏膜充血、水肿、糜烂，加重肠黏膜损伤。近年来，肠内营养被作为保护肠黏膜屏障功能的有效手段。早期肠内营养在肠黏膜屏障功能保护中的作用机制已被证实，然而不同研究结果有一定差异。本研究综述了国内外有关胃癌术后患者行早期肠内营养支持的相关研究，整理、分析既往研究的结论和争议，为早期肠内营养支持的推广应用提供参考。     

Risk factors and prognosis of invasive fungal infections in allogeneic stem cell transplantation recipients: a single‐institution experience

P. Zhang, E.‐L. Jiang, D.‐L. Yang, Z.‐S. Yan, Y. Huang, J.‐L. Wei, M. Wang, Q.‐L. Ma, Q.‐G. Liu, D.‐H. Zou, Y. He, L.‐G. Qiu, S.‐Z. Feng, M.‐Z. Han. Risk factors and prognosis of invasive fungal infections in allogeneic stem cell transplantation recipients: a single‐institution experience. Transpl Infect Dis 2010: 12: 316–321. All rights reserved Objective. Invasive fungal infections (IFI) are frequent complications of allogeneic hematopoietic stem cell transplantation (SCT) and major causes of a poor prognosis. Analysis of risk factors and prognosis of IFI are important for the control of IFI. Patients and methods. We retrospectively reviewed the medical records of all allogeneic SCT recipients from January 2000 to December 2007. For the homogeneity of analysis, only 286 patients with no history of IFI were included. Results. Fifty‐five cases of IFI were identified, corresponding to cumulative incidence of 19.8%. Different overall survival rates were recorded in patients with or without IFI (20.3% vs. 55.3%, P=0.004). Multivariate analysis identified 2 risk factors of IFI: use of high‐dose steroid and cytomegalovirus infections, and risk stratification can classify the patients into 3 subgroups with different incidences of IFI (9.2%, 25.4%, and 34.1%, P=0.0007). Further analysis confirmed use of steroid as a risk factor of inferior prognosis in IFI cases (0 vs. 57.1%, P<0.0001), which was due to higher rates of IFI‐related mortality (64.7% vs. 23.9%, P=0.018). Conclusion. Post‐transplant IFI was an unfavorable prognostic factor of the SCT recipients, and risk stratification can identify patients with high risk of IFI. Use of steroid played an important role in the pathogenesis as well as prognosis of IFI.     

Full length sequence of a novel HLA-B*132202 allele

Full length sequences of this novel HLA-B*132202 allele are identical to those of HLA-B*132201 allele, except for a synonymous amino acid substitution from ACG to ACC at codon 138 in exon 3.     

Conceptual issues specifically related to health-related quality of life in critically ill patients

During recent years increasing attention has been given to the quality of survival in critical care. Health-related quality of life (HRQOL) is an important issue both for patients and their families. Furthermore, admission to the intensive care unit can have adverse psychological effects in critically ill patients. Recent studies conducted in critically ill patients have measured HRQOL. However, usually absent from such reports are evaluations of conceptual issues, addressing factors such as why HRQOL should be measured in critically ill patients, how to define and standardize domains of HRQOL, whether proxies can provide useful information about HRQOL in critically ill patients, whether response shift occurs in critically ill patients, and whether post-traumatic stress disorder (PTSD) occurs in critically ill patients. Some studies reported moderate agreement between patients and their proxies, although lower levels of agreement may be reported for psychosocial or physical functioning. Response shift (adaptation and change in perception) appears to be an important phenomenon and likely to be present, but it is seldom measured when estimating HRQOL in critically ill patients. Furthermore, vigilance for symptoms of PTSD and early interventions to prevent PTSD are needed.     

Dietary intervention with vitamin D,calcium, and whey protein reduced fat mass and increased lean mass in rats

The aim of the current study was to determine the effects and the mechanisms of inclusion of dietary whey protein, high calcium, and high vitamin D intake with either a high-sucrose or high-fat base diets on body composition of rodents. Male Wistar rats were assigned to either no whey protein, suboptimal calcium (0.25%), and vitamin D (400 IU/kg) diet (LD), or a diet containing whey protein, high calcium (1.5%), and vitamin D (10 000 IU/kg) diet (HD), and either high-fat (40% of energy) or high-sucrose (60%) base diets for 13 weeks. Liver tissue homogenates were used to determine [¹⁴C]glucose and [¹⁴C]palmitate oxidation. mRNA expression of enzymes related to energy metabolism in liver, adipose, and muscle, as well as regulators of muscle mass and insulin receptor was assessed. The results demonstrated that there was reduced accumulation of body fat mass (P = .01) and greater lean mass (P = .03) for the HD- compared to LD-fed group regardless of the background diet. There were no consistent differences between the LD and HD groups across background diets in substrate oxidation and mRNA expression for enzymes measured that regulate energy metabolism, myostatin, or muscle vascular endothelial growth factor. However, there was an increase in insulin receptor mRNA expression in muscle in the HD compared to the LD groups. In conclusion, elevated whey protein, calcium, and vitamin D intake resulted in reduced accumulation of body fat mass and increased lean mass, with a commensurate increase in insulin receptor expression, regardless of the level of calories from fat or sucrose.     

原发性高血压患者高脂肪餐后体重指数与代谢综合征相关指标分析

目的 探讨原发性高血压患者高脂肪餐后各时间点血清TG水平及其增长值与餐后TG曲线下面积(TG-AUC)的关系,分析体重指数(BMI)与代谢综合征(MS)相关指标的关系.方法 26例高血压病患者禁食12 h后进行高脂肪餐负荷试验,采集空腹和餐后2、4、5、7 h静脉血检测血脂,并测定空腹和餐后2 h血清胰岛素(Ins)、C肽及空腹血尿酸(UA).结果 餐后2、4、5、7 h TG水平明显升高,TC、HDL-C无明显变化;餐后2、4、5、7 hTG增加值与TGAUC均呈正相关,其中4、5 hTG增加值(△TG4h、△TG5h)与TG-AUC的相关系数最大;高血压患者BMI与UA、空腹TG、餐后2h TG、Ins、餐后2h Ins、C肽、餐后2h C肽及稳态模型胰岛素抵抗指数(HOMA-IR)均呈显著正相关.结论 原发性高血压患者△TG4h、△TG5h均可作为TG-AUC的替代指标;BMI与尿酸代谢异常、TG代谢异常、高胰岛素血症、胰岛素抵抗状态这些MS组分密切相关.     

HPLC法测定羚牛角二十五味丸中栀子苷含量

建立高效液相色谱法测定羚牛角二十五味丸中栀子苷含量的方法.采用Hypersol C18色谱柱,流动相为乙腈-水(12:88),检测波长为238nm,流速1.0mL·min-1,柱温为30℃.栀子苷在0.1067～0.6403цg范围内线性关系良好,r=0.9996;平均回收率为99.69%,RSD为0.18%(n=9).本方法简便、准确、重现性好,适用于该药品成分的含量测定.