Age-related changes in the meibomian gland

The purpose of this study was to characterize the age-related changes of the mouse meibomian gland. Eyelids from adult C57Bl/6 mice at 2, 6, 12 and 24 months of age were stained with specific antibodies against peroxisome proliferator activated receptor gamma (PPARγ) to identify differentiating meibocytes, Oil Red O (ORO) to identify lipid, Ki67 nuclear antigen to identify cycling cells, B-lymphocyte-induced maturation protein-1 (Blimp1) to identify potential stem cells and CD45 to identify immune cells. Meibomian glands from younger mice (2 and 6 months) showed cytoplasmic and perinuclear staining with anti-PPARγ antibodies with abundant ORO staining of small, intracellular lipid droplets. Meibomian glands from older mice (12 and 24 months) showed only nuclear PPARγ localization with less ORO staining and significantly reduced acinar tissue (p < 0.04). Acini of older mice also showed significantly reduced (p < 0.004) numbers of Ki67 stained nuclei. While Blimp1 appeared to diffusely stain the superficial ductal epithelium, isolated cells were occasionally stained within the meibomian gland duct and acini of older mice that also stained with CD45 antibodies, suggesting the presence of infiltrating plasmacytoid cells. These findings suggest that there is altered PPARγ receptor signaling in older mice that may underlie changes in cell cycle entry/proliferation, lipid synthesis and gland atrophy during aging. These results are consistent with the hypothesis that mouse meibomian glands undergo age-related changes similar to those identified in humans and may be used as a model for age-related meibomian gland dysfunction.     

circRNA作为ceRNA在结直肠癌中的研究进展

环状RNA(circRNA)是由前体mRNA反向剪接而产生的共价闭合RNA分子,在疾病中发挥着重要的调控作用。circRNA有潜力成为新型生物标志物,在肿瘤早期诊断、治疗和预后方面发挥重要作用。circRNA可以作为竞争性内源RNA(ceRNA),通过与miRNA相互作用,进而参与基因的转录后调控。本文重点概述了circRNA作为ceRNA调控结直肠癌发生发展的机制,以求能为结直肠癌的诊断与治疗拓展新视野。     

Flower Herbal Tea Used for Treatment of Menopathies

In long years of gynecological clinical practice, the author of this article often treats menopathies with flower herbal tea, which may show good therapeutic effects as reported in the following.     

Siddha fasting in obese acute decompensated heart failure may improve hospital outcomes through empowerment and natural ketosis

BackgroundMorbid obesity (BMI > 35 kg/m2 with comorbid conditions) is present in 25 – 35% of acute decompensated heart failure (AHF) patients. Prevalence of HF increases with duration of morbid obesity from 30% at 15 years to over 90% at 30 years. There is a need to develop pragmatic therapies that address the unique physical and mental challenges faced by obese AHF patients. Siddha is 5,000 year old Tamil Medicine using yoga and mind-body methods towards higher consciousness. Hunger gratitude Experience (HUGE) is intuitive Siddha fasting method which may improve in-hospital AHF outcomes independent of weight reduction.Case summaryWe present 5 cases of morbidly obese patients with cardiorenal syndrome (CRS) that began intermittent fasting either during their AHF hospitalization or in the outpatient setting for refractory symptoms despite hospitalization. Initiation of fasting correlated with reduction of respiratory distress and edema as well as improvements in psychological wellbeing and functional capacity.DiscussionSiddha fasting mediates hemodynamic and anti-inflammatory effects through natural ketosis and psychological benefits through empowerment in AHF. Potential role of fasting in reducing myocardial workload, coronary steal, angina, volume overload, and CRS needs further study in cardiac patients.     

Effects of meditation compared to music listening on biomarkers in breast cancer survivors with cognitive complaints: secondary outcomes of a pilot randomized control trial

ContextWe previously reported positive behavioral effects of both daily mantra meditation and classical music listening interventions in breast cancer survivors with cancer related cognitive complaints.ObjectiveThe objective of this pilot study was to compare the effects of the meditation intervention to a music listening intervention on biomarkers of inflammation and cellular aging (secondary outcomes) in breast cancer survivors.DesignRandomized control trial, baseline data collection (time 1), post intervention data collection (time 2)SettingCommunity-based, Central TexasParticipants25 breast cancer survivors (BCS) who were 3 months to 6 years post chemotherapy completion and reported cognitive changes.Intervention(s)Kirtan Kriya meditation (KK) or classical music listening (ML), 8 weeks, 12 min a dayMain OutcomeTelomerase activity [TA], c-reactive protein [CRP], soluble IL-2 receptor alpha [sIL-2Rα], soluble IL-4 receptor [sIL-4R], soluble IL-6 receptor [sIL-6R], soluble tumor necrosis factor receptor II [sTNF-RII], VEGF receptor 2 [sVEGF-R2], and VEGF receptor 3 [sVEGF-R3]ResultsRepeated measures analysis of variance models were analyzed from time 1 to time 2 by group for each biomarker. A pattern of greater telomerase activity across time in both groups (F (1,15) = 3.98, p = .06, ω² = 0.04); significant decreases in sIL-4R across time for both groups (F (1,22) = 6.28, p = .02, ω² = .003); group*time effect was nominally different but not statistically different for sIL-4R (F(1,22) = 3.82, p = .06, ω² = .001); and a pattern for a group*time effect with ML group showing higher levels of sVEGF-R3 at time 2 (F (1,20) = 2.59, p = .12, ω² = .009). No significant effects were found for CRP, sIL-2Rα, sIL-6R, sTNF-RII, or sVEGF-R2.     

脑型肝豆状核变性脑皮层及皮层下核团体积的磁共振研究

目的探索脑型肝豆状核变性患者脑灰质的损害。材料与方法采集30例初发且未经治疗的脑型肝豆状核变性患者脑3D T1WI图像,利用FSL软件,运用基于体素的形态学测量(voxel_based morphometry,VBM)对脑皮层及深部核团的体积进行分析。30名健康志愿者作为对照组,采用单因素方差分析对双侧脑叶灰质及深部核团统计分析。结果脑型肝豆状核变性患者与对照组相比,各脑区皮质萎缩率及两侧脑叶比较如下,小脑:左侧(16.48%)<右侧(16.54%),P>0.05;额叶:左侧(23.6%)>右侧(19.5%),P<0.001;颞叶:左侧(16.9%)<右侧(25.4%),P<0.001;顶叶:左侧(15.5%)<右侧(16.1%),P<0.05;枕叶:左侧(21.0%)<右侧(27.2%),P<0.001;岛叶:左侧(58.7%)>右侧(49.2%),P<0.001。脑干和深部核团(杏仁核除外)体积均显著萎缩,萎缩率依次为伏隔核>壳核>苍白球>丘脑>尾状核>脑干,但左、右两侧各核团萎缩率无显著性差异。结论脑型肝豆状核变性可引起脑皮层广泛而非对称性损害及深部核团对称性损害。     

非亲缘外周血造血干细胞移植治疗重型β-地中海贫血1例

患儿,女,4岁,体质量19kg。生后4个月开始进行性面色苍白伴巩膜黄染,血红蛋白65g/L,白细胞和血小板均正常,血红蛋白电泳血红蛋白A48.1%、血红蛋白A24.2%、抗碱血红蛋白47.7%,基因型为β地贫纯合子,诊断为重型β地中海贫血,以间断大量输血维持生命。于2005-12-09在厦门大学附属中山医院血液科接受非亲缘性外周血干细胞移植。预处理方案采用常规氟达拉滨、白消胺、环磷酰胺三药联合方案,以环孢菌素A、霉酚酸酯、抗胸腺淋巴细胞免疫球蛋白联合预防移植物抗宿主病,供受者人类白细胞抗原高分辨全相合,ABO血型次要不合(O-A),输入CD34 干细胞11.4×106/kg。植入成功,移植后12d中性粒细胞>0.5×109L-1,移植后37d血小板>50×109L-1,移植后35d患者血型检测转变为供者血型,患儿血红蛋白达到100g/L的时间是28d,移植后患儿未再输血,血红蛋白维持130g/L以上,整个移植过程顺利,未出现严重感染和移植物抗宿主反应,随访18个月,患儿生活正常,发育良好。     

护理迷你临床演练评估量表在急诊科护生护理技能教学中的应用

目的探讨护理迷你临床演练评估量表(nursing-mini-clinical evaluation exercise,Nursing-Mini-CEX)在急诊科护生护理技能教学中的应用效果。方法选取2018年9月至2019年8月在本院急诊科实习的护生72人,共12个实习批次,每批次6人,实习前应用SPSS 21.0软件将12个实习批次分别随机分配一个数字,将随机数进行排序,前6位对应的批次为对照组,后6位对应的批次为观察组。对照组采用传统护理带教方法;观察组在对照组基础上结合Nursing-MiniCEX进行操作技能的教学,两组护生急诊科实习时间均为4周。于实习第4周对两组护生操作进行考核和测评其人文关怀能力。结果观察组护生操作考核成绩(90.56±1.75)分高于对照组(85.39±3.51)分,差异有统计学意义(t=7.911,P<0.001)。观察组护生人文关怀能力总分(175.72±15.47)分高于对照组(168.08±13.83)分,差异有统计学意义(t=2.209,P=0.030)。结论将Nursing-Mini-CEX应用于急诊科护生护理技能教学中有助于提高护生的操作技能水平和人文关怀能力。     

比较超声妇科影像报告和数据系统分类与恶性风险指数4鉴别卵巢良恶性肿块的价值

目的 比较超声妇科影像报告和数据系统（GI-RADS）分类与恶性风险指数4（RMI 4）鉴别卵巢良恶性肿块的价值。方法 回顾性分析经病理证实的342例卵巢肿块患者的资料，以GI-RADS分类1~4a类为良性，4b~5类为恶性，RMI 4取450作为界值，判定良恶性肿块，并与病理结果对照，计算GI-RADS分类与RMI 4诊断卵巢良恶性肿瘤的效能。结果 GI-RADS分类与RMI 4鉴别诊断卵巢良恶性肿块的敏感度分别为70.71%（70/99）、53.54%（53/99），特异度分别为98.77%（240/243）、95.47%（232/243），阳性预测值分别为95.89%（70/73）、82.81%（53/64），准确率分别为90.64%（310/342）、83.33%（285/342），ROC曲线AUC分别为0.91、0.81，差异均有统计学意义（P均<0.05）。结论 超声GI-RADS分类鉴别卵巢良恶性肿块的价值优于RMI 4。     

Risk factors and outcomes of cerebrospinal fluid overdrainage in HIV-negative patients with cryptococcal meningitis after the ventriculoperitoneal shunting procedure

Purpose

Shunt procedures used to treat cryptococcal meningitis complicated with hydrocephalus and/or increased intracranial pressure (IICP) could result in cerebrospinal fluid (CSF) overdrainage, thereby presenting therapeutic challenges.