超声新技术评估化学治疗乳腺癌致左心室功能损伤研究进展

化学治疗(简称化疗)是乳腺癌常规治疗手段之一,在有效抑制肿瘤的同时亦会导致心脏损伤。化疗所致心脏损伤的最直接表现是左心室收缩功能减低。目前临床评价左心室功能最常用方法为超声测量左心室射血分数(LVEF),而LVEF只有在心肌严重损伤情况下才会明显下降,此时多已错过最佳干预时机。随着超声技术的进步,一系列超声新技术已用于检测心功能,并能早期发现心肌损伤。本文对超声新技术评估乳腺癌化疗致左心室功能损伤研究进展进行综述。     

滤泡调节性T细胞在眼肌型重症肌无力中的研究进展

重症肌无力(MG)是由抗体介导、对T细胞依赖及不同补体参与共同发挥作用导致的自身免疫性疾病。眼肌型重症肌无力(OMG)是MG中的一种类型,其症状仅局限于眼外肌。新近研究表明,包括OMG在内的多种自身免疫性疾病的发生发展都与滤泡调节性T细胞(Tfr细胞)的表达失衡密切相关。因此,对Tfr细胞的探讨或许可作为眼OMG相关性研究的一个新切入点。本文总结了Tfr细胞在OMG免疫学发病机制中的研究进展。     

Association between daily egg intake and lipid profiles in adults from the Henan rural cohort study

Background and aimsThe association between daily egg intake and dyslipidemia remains a contentious issue. Therefore, our study was aimed to explore the relation of daily egg intake to lipid profile; and whether the association was mediated by body mass index (BMI).Methods and resultsA total of 39,021 participants (18–79 years) were enrolled from the Henan Rural Cohort Study. Data on egg consumptions and blood lipid indices were collected with standardized processes. Logistic regression and restricted cubic splines were used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI). Mediation analysis using bootstrap was performed to examine the contribution of BMI to daily egg intake and HDL-C. The participants were divided into 3 egg intake groups (＜26.79 g/d, 26.79–62.50 g/d, ＞62.5 g/d). According to our results, comparing with the low daily egg consumption group, medium and high egg intake tertiles were related with increased high-TC (OR_medium = 1.546, 95%CI (1.417,1.688); OR_high = 1.902,95%CI (1.703, 2.124)), high LDL-C (OR_medium = 1.224, 95%CI (1.121, 1.337); OR_high = 1.368,95%CI (1.220, 1.534)) and non-HDL-C(OR_medium = 1.486,95%CI(1.358,1.625); OR_high = 1.715,95%CI (1.499, 1.888)), as well as inversely associated with high-TG (OR_medium = 0.825, 95% CI(0.778, 0.875); OR_high = 0.778,95%CI(0.718,0.844)) and low HDL-C (OR_medium = 0.914, 95%CI (0.858, 0.973); OR_high = 0.756,95%CI(0.693,0.825)). Moreover, mediation analysis showed that both of BMI and WC partly mediated the relationship between daily egg intake and HDL-C.ConclusionsOur results suggested that the daily egg intake may have a role in effect on lipid profiles, and the effect of daily egg intake on HDL-C may be partly mediated by BMI and WC.     

Co-administration of a probiotic strain Lactobacillus plantarum LS/07 CCM7766 with prebiotic inulin alleviates the intestinal inflammation in rats exposed to N,N-dimethylhydrazine

The aim of this study was to determine the anti-inflammatory effects of preventive administration of a probiotic strain Lactobacillus plantarum LS/07 CCM7766 alone or in combination with prebiotic inulin or with flax-seed oil in the gut of rats, which developed chronic inflammation following administration of the pro-carcinogen N,N-dimethylhydrazine (DMH). After 28 weeks administration of probiotic/prebiotic-containing diet, rats were killed and their colons were examined by immunohistological criteria, whereas cytokines were determined in the jejunal mucosa. Application of DMH triggered the production of pro-inflammatory cytokines IL-2, IL-6, IL-17, and TNF-α, expression of pro-inflammatory mediators NF-κB, COX-2 and iNOS and caused depletion of goblet cells. Supplementing the diet with L. plantarum and its combination with the prebiotic abolished DMH-induced inflammatory process in the jejunal mucosa by inhibiting the production of pro-inflammatory cytokines and by stimulation of anti-inflammatory IL-10 cytokine synthesis, whereas concentration of TGF-β1 was not influenced significantly. Diet prevented a decrease in goblet cell numbers but numbers of mast cells were lowered only moderately. However, combined treatment of rats with L. plantarum and flax-seed oil had no significant effect on the parameters examined, except for decreased expression of NF-κB, in comparison with the negative control. Results indicate that the preventive administration of probiotic L. plantarum LS/07 CCM7766 alone or in combination with prebiotic inulin to rats with DMH-induced chronic inflammation can reduce inflammatory process in the jejunal and colon mucosa, probably indirectly, and involves down-regulation of synthesis of pro-inflammatory cytokines and suppression of NF-κB activity in mucosal cells.     

Application of a paraplegic gait orthosis in thoracolumbar spinal cord injury

Paraplegic gait orthosis has been shown to help paraplegic patients stand and walk, although this method cannot be individualized for patients with different spinal cord injuries and functional recovery of the lower extremities. There is, however, a great need to develop individualized paraplegic orthosis to improve overall quality of life for paraplegic patients. In the present study, 36 spinal cord(below T4) injury patients were equally and randomly divided into control and observation groups. The control group received systematic rehabilitation training, including maintenance of joint range of motion, residual muscle strength training, standing training, balance training, and functional electrical stimulation. The observation group received an individualized paraplegic locomotion brace and functional training according to the various spinal cord injury levels and muscle strength based on comprehensive systematic rehabilitation training. After 3 months of rehabilitation training, the observation group achieved therapeutic locomotion in 8 cases, family-based locomotion in 7 cases, and community-based locomotion in 3 cases. However, locomotion was not achieved in any of the control group patients. These findings suggest that individualized paraplegic braces significantly improve activity of daily living and locomotion in patients with thoracolumbar spinal cord injury.     

家族性高胆固醇血症遗传因素筛查的研究进展

家族性高胆固醇血症(FH)是常见的常染色体显性遗传代谢病,发病率约为杂合FH为1/(137～350),纯合FH为1/(16万～30万),早期诊断和治疗对于该人群至关重要,但全球超过190个国家的FH检出率甚至不足1%。现在临床上常用的FH诊断标准主要依赖胆固醇水平检查和患者的健康调查信息,在不进行基因检查的情况下确诊率十分有限,所以基因检测被认为是FH诊断的金标准,阳性结果可以直接确诊。国际上常用的FH基因筛查策略包括无差别普查(Uni S)、瀑布式筛查(Cas S)、反瀑布式筛查(RCS)、目标人群筛查(Tar S)以及电子病例库筛选(e HRI)。我国目前尚没有任何国家层面的FH流行病学调查,也没有官方的适应国情和人群的筛查方案和诊断或治疗指南出台,使得我国在这方面严重落后于国际水平。所以当务之急是尽快得出合适的基因检测方法和筛查方案来切实提高我国FH的检出率,再结合临床确保检出患者得到适合的治疗,最大程度的使众多FH患者获益。