Rapid clearance of circulating Leishmania kinetoplast DNA after treatment of visceral leishmaniasis

With the aim of evaluating the utility of the detection of Leishmania kDNA in peripheral blood for the cure assessment of visceral leishmaniasis (VL), a PCR based method was performed in patients with confirmed VL at three follow-up periods after specific chemotherapy with pentavalent antimonial. In 16 out of 17 (94.1%) patients with pre-treatment detectable kDNA that were clinically cured, the PCR turned negative up to 37 days after the initiation of treatment, remaining negative over 90 days after treatment. The clearance of Leishmania kDNA from peripheral blood of patients with VL hints to occur during or shortly after treatment concurring or preceding clinical recovery.     

Seroepidemiological Survey of Human Visceral Leishmaniasis in Ilam Province,West of Iran In 2013

Background:

Visceral leishmaniasis (VL) as one of the most important human parasitic disease is endemic in some parts of Iran. Several cases of VL have been reported recently in the Ilam Province. The current study aimed to assess the present status of human VL in the region.

Methods:

A random cluster sampling method was used to collect 456 serums samples from the children up to 12 years of age and 10% of adults living in urban and rural areas of the province. All the collected serum samples were tested by direct agglutination test (DAT) to detect anti- Leishmania infantum antibodies.

Results:

Of the examined 456 serum samples with direct agglutination test (DAT), only 21 (0.43%) sera showed anti- Leishmania antibodies at titers 1:400 and higher. Distribution of anti- Leishmania antibodies titers were: 1:400(n=4), 1:800(n=11), 1:1600(n=3), 1:3200(n=1), and 1:6400(n=1). Individuals with titers ≥1:3200 showed clinical signs and symptoms such as fever and splenomegaly. The highest and lowest seropositivity were observed in the age groups of 5–9 and >15 years old, respectively. There were no significant difference between the rate of seropositivity in males and females.

Conclusion:

VL with a low prevalence circulates in some parts of Ilam province, particularly in the southern parts. Complementary studies should be needed to find animal reservoir hosts and vectors. Furthermore, health systems and physicians should pay particular attention to the disease.     

DXA-measured visceral fat mass and lean body mass reflect abnormal metabolic phenotypes among some obese and nonobese Chinese children and adolescents

Background and aim

The exact constellation of body composition characteristics among metabolically unhealthy obese (MUO) and nonobese (MUNO) children and adolescents remains unclear. The purpose of this study was to identify the major body composition determinants of metabolically unhealthy phenotypes among Chinese children and adolescents.

血清Vaspin及Omentin-1与不同类型肥胖儿童代谢改变的相关性研究

目的 了解肥胖儿童不同体脂分布状态下血清Vaspin及Omentin-1水平的差异,探讨其与儿童腹型肥胖及代谢的关系.方法 测量35例腹 型肥胖儿童、32例非腹型肥胖儿童及28例正常儿童的人体学指标及血脂、血糖、胰岛素水平,用酶联免疫吸附法（ELISA法）测定三组儿童血清Vaspin及 Omentin-1浓度.结果 腹型肥胖组及非腹型肥胖组血清Vaspin水平均明显高于正常组,Omentin-1水平均明显低于正常组（均P〈0.01）;腹型肥胖组血清 Vaspin水平均明显高于非腹型肥胖组,Omentin-1水平均明显低于非腹型肥胖组（均P〈0.01）.肥胖儿童血清Vaspin与BMI、WC、FPG、2hPBG、HOMA-IR呈正相关.Omentin-1与BMI、WC、FPG、2hPG、FINS、SBP、TC、HOMA-IR呈负相关,与HDL-C正相关.多元逐步回归分析显示WC、HOMA-IR 与Vaspin独立相关,BMI、HOMA-IR 与 Omentin-1 独立相关.结论 Vaspin及Omentin-1水平在儿童肥胖症中已发生改变,与腹型肥胖、糖脂代谢及胰岛素敏感性相关.     

内脏脂肪指数在甲状腺功能正常人群血尿酸/血肌酐比值与代谢综合征发生风险间的中介效应研究

背景 我国代谢综合征（MS）患病率逐年升高,血尿酸（SUA）水平与MS的发生密切相关,由于SUA受肾功能影响,采用标化SUA〔SUA/血肌酐比值（SUA/Scr）〕可更好地预测MS。内脏脂肪指数（VAI）是衡量内脏脂肪蓄积程度的重要指标,可更直接地预测MS的发生风险。但目前在甲状腺功能正常人群中,关于VAI是否介导SUA/ Scr与MS关联的研究较少。 目的 探讨VAI在甲状腺功能正常人群中SUA/Scr与MS发生风险间的中介效应。 方法 选取2020年1月至2021年6月于河北省人民医院体检中心进行年度体检的10 042例体检人群。收集研究对象的基本信息,并进行体格检查和生化检测,计算SUA/Scr和VAI。采用中华医学会糖尿病学分会制定的标准诊断MS。将研究对象分别按照SUA/Scr水平四分位数和VAI四分位数,各分为4组：Q1~Q4组和V1~V4组。采用Pearson相关分析探究SUA/Scr与VAI的相关性;多因素Logistic回归分析探讨SUA/Scr和VAI对MS发生的影响;采用bootstrap方法分析VAI是否介导SUA/Scr与MS之间的关联。 结果 10 042例研究对象中,MS患者1 833例（18.25%）,非MS患者8 209例（81.75%）。Pearson相关分析结果显示,SUA/Scr与VAI呈正相关（P<0.05）。多因素Logistic回归分析结果显示,与Q1组相比,Q2组〔OR=1.310,95%CI（1.039,1.651）〕、Q3组〔OR=1.372,95%CI（1.089,1.729）〕、Q4组〔OR=1.744,95%CI（1.381,2.203）〕人群发生MS的风险增加（P<0.05）;与V1组相比,V3组〔OR=6.721,95%CI（4.600,9.819）〕、V4组〔OR=33.327,95%CI（21.509,51.640）〕人群MS的发病风险增加（P<0.01）。中介效应分析表明,SUA/Scr对MS发病率具有直接影响〔β=0.154,95%CI（0.104,0.205）〕,并且VAI部分介导了SUA/Scr对MS发病率的影响〔β=0.183,95%CI（0.156,0.213）〕,中介效应占总效应的54.25%。 结论 甲状腺功能正常人群SUA/Scr和VAI是MS发生风险的预测指标,VAI部分介导了SUA/Scr对MS发病率的影响。     

Aging is only significant factor causing CPR-induced injuries and serious injuries

BackgroundCardiopulmonary resuscitation (CPR) sometime cause severe injuries and can affect quality of life, lead to long-term disabilities or death of the patient. The aim of this study is to identify the risk factors causing CPR-induced injuries and those of serious injuries.MethodsThis was a retrospective forensic autopsy study in a single institution. Among 885 forensic autopsies undertaken between 2011 and 2018, those in which the victim had undergone CPR immediately after cardiac arrest were recorded. ‘Serious injuries’ were defined as an Abbreviated Injury Scale (AIS) score ≥ 3. CPR-induced injuries were evaluated by three experienced forensic pathologists. With the background and history of the patient, the circumstances of cardiac arrest and risks of causing CPR-induced injuries were determined by multivariate analyses.ResultsSeventy-five victims comprised the study cohort. CPR-induced injuries were found in 52 victims (69.3%). Rib fracture was the most common (60.0%), followed by sternal fracture (37.3%), heart injury (21.3%) and liver injury (8.0%). Multivariate analysis revealed higher age to be an independent factor causing CPR-induced injuries (odds ratio [OR], 1.07, P < 0.001). Thirty-six victims had 39 serious injuries in the chest or abdomen: fracture of ≥ 3 ribs (35 cases), aortic dissection (two), lung contusion (one) and rupture of the heart (one). Multivariate analysis revealed higher age to be an independent factor causing CPR-induced serious injuries (OR, 1.09; P < 0.001).ConclusionAging was the significant factor causing CPR-induced injuries and serious injuries.     

P2X受体介导慢性疼痛的研究进展

慢性疼痛是临床常见的病症之一,给患者和社会都带来较大的负担,其发病机制较为复杂,因此,慢性疼痛的治疗一直是临床上的难题之一。三磷酸腺苷(ATP)是一种重要的疼痛信号物质,ATP可作用于P2X受体产生效应。近年来研究发现,P2X受体在神经病理性疼痛、炎性痛、癌痛及内脏痛等慢性疼痛的痛觉形成、传导和调节中起着重要作用,有望成为慢性疼痛治疗的新靶点。本文就P2X介导慢性疼痛的研究进展进行了综述。