Inflammatory status modulates plasma lipid and inflammatory marker responses to kiwifruit consumption in hypercholesterolaemic men

Background and aimsKiwifruit has the potential to improve markers of metabolic dysfunction, but the response may be influenced by inflammatory state. We aimed to investigate whether inflammatory state would modulate the effect of consuming two green kiwifruit daily on plasma lipids and markers of inflammation.Methods and resultsEighty-five hypercholesterolaemic men completed a 4-week healthy diet run-in, before randomisation to a controlled cross-over study of two 4-week interventions of two green kiwifruit/day plus healthy diet (intervention) or healthy diet alone (control). Anthropometric measures and fasting blood samples (plasma lipids, serum apolipoproteins A1 and B, high-sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6, tumour necrosis factor-alpha (TNF-α) and IL-10) were taken at baseline, 4 and 8 weeks. Subjects were divided into low and medium inflammatory groups, using pre-intervention hs-CRP concentrations (hs-CRP <1 and 1–3 mg/L, respectively).In the medium inflammatory group the kiwifruit intervention resulted in significant improvements in plasma high-density lipoprotein cholesterol (HDL-C) (mean difference 0.08 [95% CI: 0.03, 0.12] mmol/L [P < 0.001]), total cholesterol (TC)/HDL-C ratio (−0.29 [−0.45, −0.14] mmol/L [P = 0.001]), plasma hs-CRP (−22.1 [−33.6, −4.97]% [P = 0.01]) and IL-6 (−43.7 [−63.0, −14.1]% [P = 0.01]) compared to control treatment. No effects were seen in the low inflammatory group. There were significant between inflammation group differences for TC/HDL-C (P = 0.02), triglyceride (TG)/HDL-C (P = 0.05), and plasma IL-6 (P = 0.04).ConclusionsInflammatory state modulated responses to the kiwifruit intervention by improving inflammatory markers and lipid profiles in subjects with modestly elevated CRP, suggesting this group may particularly benefit from the regular consumption of green kiwifruit.Registered 16th March 2010, Australian New Zealand Clinical Trials Registry (no. ACTRN12610000213044), www.ANZCTR.org.au.     

脑出血穿刺引流术后再出血脑疝15例救治体会

目的 探讨脑出血穿刺引流术后再出血脑疝患者的治疗方法及预后。方法 回顾分析2014年9月—2021年12月脑出血穿刺引流术后再出血脑疝15例患者的临床资料。结果 11例患者通过早期血肿抽吸及尿激酶溶解引流清除血肿,6个月后日常生活能力（ADL）分级,Ⅱ级4例,Ⅲ级6例,Ⅳ级1例,4例患者转为开颅血肿清除术及去骨瓣减压术,6个月后ADL分级,Ⅲ级2例,Ⅳ级1例,Ⅴ级1例。结论 早期血肿抽吸可以作为脑出血穿刺引流术后再出血脑疝患者的首选手段,病情不缓解再行开颅手术治疗。 [国际神经病学神经外科学杂志, 2023, 50(3): 12-15]     

Low thymic output in the 22q11.2 deletion syndrome measured by CCR9+CD45RA+ T cell counts and T cell receptor rearrangement excision circles

Thymic hypoplasia is a frequent feature of the 22q11.2 deletion syndrome, but we know little about patients' age‐related thymic output and long‐term consequences for their immune system. We measured the expression of T cell receptor rearrangement excision circles (TREC) and used flow cytometry for direct subtyping of recent thymic emigrant (RTE)‐related T cells in 43 patients (aged 1–54 years; median 9 years) from all over Norway and in age‐matched healthy controls. Thymic volumes were estimated by ultrasound in patients. TREC levels correlated well with RTE‐related T cells defined by co‐expression of CD3, CD45RA and CCR9 (r = 0·84) as well as with the CD4⁺ and CD8⁺ T cell subtypes. RTE‐related T cell counts also paralleled age‐related TREC reductions. CD45RA⁺ T cells correlated well with absolute counts of CD4⁺ (r = 0·87) and CD8⁺ (r = 0·75) RTE‐related T cells. Apart from CD45RA^‐ T cells, all T cell subsets were lower in patients than in controls. Thymic volumes correlated better with RTE‐related cells (r = 0·46) than with TREC levels (r = 0·38). RTE‐related T cells and TREC levels also correlated well (r = 0·88) in patients without an identifiable thymus. Production of RTEs is impaired in patients with a 22q11.2 deletion, and CCR9 appears to be a good marker for RTE‐related T cells.     

高血压脑出血术后再出血的原因分析

目的：探讨高血压脑出血术后再出血的原因及对策。方法回顾性分析2003年8月～2012年8月在苏州大学附属第一医院行高血压脑出血手术治疗的712例患者的临床资料,采用X2检验对各原因进行单因素分析。结果术后2周内46例患者发生再出血,再出血率为6．46％,其中87％的患者术后再次出血发生在术后48 h内。凝血功能异常、高血压病程大于10年、血肿位于小脑、超早期手术及术后血压剧烈波动是术后再出血危险因素。结论积极纠正凝血异常患者凝血指标,掌握合适手术时机,术中严密止血,术后加强监护,维持血压平稳是控制术后再出血关键。     

内镜下套扎联合卡维地洛治疗食管静脉曲张再出血的临床效果

目的 观察内镜下套扎联合卡维地洛治疗食管静脉曲张再出血的临床效果。方法 选取2017年8月至2020年8月我院收治的90例食管静脉曲张再出血患者,根据治疗方式将其分为对照组（45例,内镜下套扎）和观察组（45例,内镜下套扎+卡维地洛）。比较两组的食管静脉曲张程度、血流动力学指标、血管内皮损伤指标及预后情况。结果 术前,两组的食管静脉曲张程度比较,差异无统计学意义（P>0.05）;术后半年,两组的食管静脉曲张程度均减轻,且观察组优于对照组,差异具有统计学意义（P<0.05）。术前,两组的血小板计数、脾脏厚度、门静脉内径、血流量比较,差异无统计学意义（P>0.05）;术后半年,两组的血小板计数、血流量均增大,脾脏厚度、门静脉内径均减小,且观察组优于对照组（P<0.05）。术前,两组的NO、ET-1、UⅡ水平比较,差异无统计学意义（P>0.05）;术后半年,两组NO、ET-1水平均降低,UⅡ水平均升高,且观察组优于对照组（P<0.05）。观察组的术后半年再出血率低于对照组,差异具有统计学意义（P<0.05）。术前,两组的Child-Pugh评分比较,...     

应届毕业医学生心理韧性现状及影响因素分析

目的:调查新冠肺炎疫情下应届毕业医学生的心理韧性现状,并分析其影响因素。方法:采用Conner-Davidson心理韧性量表,对湖北医药学院480名应届毕业医学生采用问卷方式进行调查,分析其影响因素。结果:应届毕业医学生的心理韧性总分为(53.54±11.56)分,处于中等水平。多元线回归分析显示:性别、生源地、家庭结构、职业生涯规划、人生目标是应届毕业生心理韧性的影响因素。结论:应届毕业医学生的心理韧性水平有待提升,学校应高度关注应届毕业医学生的心理韧性状况,针对性地进行干预和指导,避免负性情绪带来的不良影响。     

Modified ‘sandwich’ injection with or without ligation for variceal bleeding in patients with both esophageal and gastric varices: a retrospective cohort study

Abstract

Objectives

Esophagogastric variceal bleeding (EGVB) is a serious disease with high mortality. Endoscopic therapy has long been shown to be effective but the optimum technique is still unclear. We aimed to investigate the efficacy, safety and predictive factors of 1-year rebleeding of modified ‘sandwich’ injection combined with esophageal variceal ligation (EVL) for treating EGVB.