sRNA Antitoxins: More than One Way to Repress a Toxin

Bacterial toxin-antitoxin loci consist of two genes: one encodes a potentially toxic protein, and the second, an antitoxin to repress its function or expression. The antitoxin can either be an RNA or a protein. For type I and type III loci, the antitoxins are RNAs; however, they have very different modes of action. Type I antitoxins repress toxin protein expression through interacting with the toxin mRNA, thereby targeting the mRNA for degradation or preventing its translation or both; type III antitoxins directly bind to the toxin protein, sequestering it. Along with these two very different modes of action for the antitoxin, there are differences in the functions of the toxin proteins and the mobility of these loci between species. Within this review, we discuss the major differences as to how the RNAs repress toxin activity, the potential consequences for utilizing different regulatory strategies, as well as the confirmed and potential biological roles for these loci across bacterial species.     

来得时联合拜唐平治疗初发Ⅱ型糖尿病疗效观察

目的观察来得时联合拜唐平治疗初发Ⅱ型糖尿病的临床疗效，并作安全性评价。方法将符合初发Ⅱ型糖尿病纳入标准病例90例，按入院顺序随机分为治疗组45例与对照组45例，对照组予以诺和灵30R治疗，治疗组给予来得时联合拜唐平治疗，比较两组的疗效，以及两组治疗前后各项实验室指标的变化情况。结果治疗组总有效率明显优于对照组（P〈O．05），且治疗组在降低空服血糖、餐后2小时血糖及糖化血红蛋白水平方面均明显优于对照组（P〈0．05或P〈0．01）。治疗组低血糖发生率明显低于对照组，差异有统计学意义（P〈0．05）。结论来得时联合拜唐平治疗初发Ⅱ型糖尿病疗效确切，安全有效，低血糖发生率低，值得临床推广应用。     

Determining the risk of diabulimia and its relationship with diet quality and nutritional status of adolescents with type 1 diabetes

IntroductionDiabulimia is known as an eating disorder specific to individuals with diabetes.ObjectivesIn this study, it was aimed to determine the diabulimia risk and to evaluate the possible relationships between diabulimia risk and diet quality, anthropometric measurements, and biochemical parameters of adolescents with type 1 diabetes.Material and methodsIn total, 110 adolescents (male: 51.8%, female: 48.2%) with type 1 diabetes between 10–19 years were included in the study. Sociodemographic characteristics and information about diabetes of adolescents were collected using a questionnaire prepared by the researchers through face-to-face interview technique. Anthropometric measurements and 3-day food consumption records were obtained to evaluate their nutritional status, and their biochemical parameters were obtained from hospital files to evaluate their metabolic status. The diet quality was evaluated using the Healthy Eating Index-2015. Diabetes Eating Problem Survey was administered to individuals and it was accepted that diabetics with a total score of ≥ 20 were at risk of diabetes-related eating disorders.Results/ConclusionAmong the 110 adolescents included in this study, 31.8% were found to be at risk of diabulimia. There was a significant relationship between the groups with and without diabulimia risk in terms of diet quality scores (P < 0.05). All individuals with a risk of diabulimia as well as 86.8% of individuals without a risk of diabulimia had high HbA1c levels (P < 0.05). Diet quality, some anthropometric measurements and biochemical parameters of adolescents at risk of diabulimia should be improved. It is important to periodically evaluate the risk of diabulimia, the diet quality, and the nutritional status of adolescents with type 1 diabetes to reduce the occurrence of short and long-term complications.     

Pharmacy Student Performance on Constructed-Response Versus Selected-Response Calculations Questions

Objective. To introduce PharmD students to changes in calculations question types (constructed-response versus selected-response questions); measure and compare student performance on constructed-response and selected-response questions in a pharmaceutics course; and collect student feedback on the use of differing question types.Methods A pharmaceutics/pharmaceutical calculations examination was administered that included 15 pairs of questions; each pair consisted of a constructed-response question and a similar selected-response question. An online questionnaire was conducted to collect student feedback.Results. Of the 15 topics, the class scored higher on the constructed-response question for 4 topics and higher on the selected-response question for 10 topics. Eighty percent of the class preferred selected-response questions, although 47.8% felt constructed-response questions better prepared them for a career in healthcare.Conclusions. Students correctly answered more selected-response questions than constructed-response questions and felt more confident in doing so. Additional constructed-response teaching and testing methods should be incorporated into pharmacy education.     

驻景丸加减治疗甲状腺功能减退性心脏病心肾阳虚型20例

目的评价驻景丸加减治疗甲状腺功能减退性心脏病心肾阳虚型的临床疗效。方法选取甲状腺功能减退性心脏病心肾阳虚型患者40例，随机分为治疗组和对照组。治疗组给予驻景丸加减联合左甲状腺素，对照组单纯给予左甲状腺素，观察临床疗效。结果治疗组总有效率为95．00％，对照组总有效率为80．00％，治疗组优于对照组（P〈0．01）。结论驻景丸加减联合左甲状腺素疗法优于单纯西药治疗。     

胰岛素泵与利拉鲁肽治疗老年超重2型糖尿病的疗效与安全性

目的:探讨胰岛素泵与利拉鲁肽治疗在老年超重2型糖尿病患者中的应用效果。方法:将68例老年超重2型糖尿病患者分为观察组(胰岛素泵)和对照组(利拉鲁肽)各34例,对比其治疗效果。结果:与对照组相比,观察组患者的治疗有效率(94.12%>73.53%)、SF-36评分((78.82±4.24)分>(69.14±5.16)分)相对更高(P<0.05),并发症发生率(8.82%<32.35%)、FBG((6.29±1.05)<(8.04±1.16)mmol/L)、2h PBG((8.74±1.38)<(10.39±1.57)mmol/L)、BMI((23.51±2.04)<(27.75±2.36)kg/m²)相对更低(P<0.05)。结论:老年超重2型糖尿病的临床治疗,胰岛素泵治疗在疗效和安全性方面具有显著优势。     

Personality and Self-Motivation during Biochemical Fatigue

Abstract

The present study was conducted to determine whether females exhibiting the Type A behavior pattern would exert greater effort and work to higher levels of physiological fatigue in a self-motivated ergometer test. Twenty female subjects, half of them Type A and the other half Type B, were administered an incremental ergometer test to determine their peak oxygen consumption value. On the first experimental session no experimenter encouragement was given to the subjects. Consequently the test measured physical motivation levels. During a second laboratory session, each subject was continuously encouraged by the experimenter to maintain exercising until she was truly incapable of further work. The highest rate of oxygen extraction during this latter session was considered the subject's maximum oxygen consumption (i.e., VO₂ max). Type A and B subjects were compared in the nonmotivated testing session (experimental session 1) to their “true” individual capacities (maximum oxygen consumption demonstrated in experimental session 2). ANOVAs indicated no significant differences in self-initiated competitive behavior during a physical stressor.     

特殊疾病医疗保险对糖尿病患者治疗费用的影响及相关因素分析

目的比较重庆市已纳入慢病管理系统2型糖尿病患者中，有、无特殊疾病医疗保险（简称特病医保）者之间的治疗费用情况及可能影响申请该特病医保的因素。方法采用结构化问卷，调查患者的基本信息及与糖尿病有关的药房、门诊、住院治疗费用情况。使用SAS 9.1软件进行数据统计分析，计数资料分析采用 χ ²检验，有统计学差异的变量再纳入多因素逐步logistic回归模型。连续性变量用中位数（四分位数间距）[ M（ Q）]来表示，采用Wilcoxon秩和检验。 结果门诊组有特病医保的患者年人均总费用[2160（3081）元]较无特病医保的患者高[1000（2100）元， P < 0.01]，年次均自费比例（54.04%）低于无特病医保患者的自费比例（93.78%， P < 0.01）。就申请特病医保而言，中等收入水平（ OR=1.94）、高收入水平（ OR=2.11）、参加城镇职工医疗保险（ OR=4.19）、病程超过5年（ OR=2.04）都是其可能的影响因素，具有这些特征的患者相对更容易申请到特病医保。 结论为缓解2型糖尿病患者经济负担，政府应大力宣传特病医保的相关政策，鼓励患者主动了解，积极申报。同时，医保部门与医疗机构应加强监管，简化办理流程，建议增加特殊疾病定点零售药店的数量和覆盖面，提高特病医保利用的可及性。同时，应更加关注低收入人群和病程相对较短的患者，增强他们抵御疾病经济风险的能力，提高特病医保的利用及公平性。     

Swallowing assessment in myotonic dystrophy type 1 using fiberoptic endoscopic evaluation of swallowing (FEES)

This study describes the swallowing function of patients with myotonic dystrophy type 1 (DM1) and the effect of bolus consistency on swallowing in this group. The aim of the study is twofold: (a) to identify which (and to what extent) swallowing variables change for DM1 patients relative to healthy control subjects and (b) to examine whether the degree of oropharyngeal dysphagia is associated with disease severity. Forty-five consecutive DM1 patients and ten healthy subjects underwent a swallowing assessment, at Maastricht University medical Center in the Netherlands. The assessment included a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol using different bolus consistencies. Clinical severity of the disease was assessed using the muscular impairment rating scale (MIRS). Significant differences were found between patients and controls for all FEES variables. The magnitude of these differences depended on the bolus consistency. The odds of a more pathological swallowing outcome increased significantly with higher MIRS levels. In conclusion, swallowing function is found to be significantly altered in DM1 patients. The results emphasize the importance of conducting a detailed swallowing assessment in all patients, even those with mild muscle weakness.