血压昼夜节律变化与脑卒中神经功能缺损程度的关系(附103例报告)

目的 :了解血压昼夜节律变化与脑卒中患者神经功能缺损程度的关系 ,探讨脑卒中的预测和治疗方法。方法 :对 10 3例高血压缺血性脑卒中患者的 2 4h动态血压检测与临床神经功能缺损程度评分进行回顾性分析。结果 :在神经功能缺损程度的轻、中度组 ,血压的杓形改变 (血压昼夜节律正常 )与非杓形改变 (血压昼夜节律消失 )无显著性差异 (P >0 0 5 ) ,重度组杓形与非杓形改变有显著性差异 (P <0 0 0 5 )。血压非杓形改变的高血压患者脑卒中的发生率明显高于血压杓形改变者。结论 :血压昼夜节律消失 ,易发生脑卒中 ,且脑卒中后神经功能缺损严重。     

Expression of mTOR signaling pathway markers in prostate cancer progression

BACKGROUND: The PI3K/AKT/mTOR pathway is central to prostate cancer progression. A preliminary investigation of immuno-histochemical expression of mammalian target of rapamycin (mTOR) pathway markers was undertaken to identify patterns of expression in prostate tissue. METHODS: Immunohistochemistry was performed on a custom-made prostate tissue array. Mean long scores and variability of long scores for each marker were recorded for normal lumenal cells, prostate intraepithelial neoplasia (PIN), and cancer. RESULTS: Expression of PTEN decreased and mTOR signaling pathway markers increased in PIN and in cancer as compared to normal cells in the majority of samples. Overexpression of 4E-BP1 and p-4E-BP1 was observed in PIN and cancer. However, in cancer, the overexpression of 4E-BP1 was significantly higher than with any other marker. DISCUSSION: Results suggest that 4E-BP1 overexpression is strongly associated with prostate cancer, especially when combined with PTEN and mTOR expression data. Hierarchical clustering analysis utilizing PTEN, mTOR, and 4E-BP1 separated normal from cancer cell populations in most cases.     

用神经网络法预测药物在体透过人皮肤的渗透性

目的：预测药物在体透过人皮肤的渗透性。方法：以正辛醇／水分配系数(logP)、分子体积(V)、氢键酸度(∑β2^H)和氢键碱度(∑β2^H)等理化参数作为输入层神经元，以药物在一定时间内在体透过人皮肤的透过比的对数值(R，透过量／未透过量)作为输出层神经元，建立起合适的BP(Back—propagation)神经网络。结果：17个药物在一定时间内在体透过人皮肤的透过比的神经网络计算值和实测值均相当符合。结论：用BP神经网络法可以较好地预测药物在体透过人皮肤的渗透性。     

an intelligent otologic drill

Objective To test a modified otologic drill under different drilling conditions for its ability toidentify drilling faults and stop drilling.MethodsBased on force analysis and previous works,an otologic drill was modified and equipped with three sensors.Under various conditions,the drill was used to simulate three drilling faults and normal drilling,and signals from the drill were analyzed to extract the characteristic signal.A multi-sensor information fusion system and a stop program were designed to recognize drilling faults and stop drilling.Results Signals from each sensor changed consistently in response to drilling condition changes,with high repeatability and regularity.The average identification rate was 72.625%,68.575%,70.5% and 81.3% respectively for the three simulated drilling faults and normal drilling.The stop program stopped drilling in 0.2-0.3 seconds when a drilling faults was detected.Conclusions This study shows that the forces acting on the drill bit change predictably in the three simulated drilling conditions;that using suitable BP neural networks,the drilling faults can be reliably identified,and that a stop program based upon characteristic signal recognition can stop drilling quickly upon detecting drilling faults.This lays a foundation for development of a system capable of predicting drilling faults and automatic drill control.Further studies are being undertaken for practical application of such a system.     

Expression of genes related to muscle plasticity after strength and power training regimens

The purpose of our study was to compare the effects of 8‐week progressive strength and power training regimens on strength gains and muscle plasticity [muscle fiber hypertrophy and phenotype shift, mammalian target of rapamycin (mTOR), regulatory‐associated protein of mTOR (RAPTOR), rapamycin‐insensitive companion of m‐TOR (RICTOR), calcineurin and calcipressin gene expression]. Twenty‐nine physically active subjects were divided into three groups: strength training (ST), power training (PT) and control (C). Squat 1 RM and muscle biopsies were obtained before and after the training period. Strength increased similarly for both ST and PT groups (P<0.001). Fiber types I, IIa and IIb presented hypertrophy main time effect (P<0.05). Only type IIb percentage decreased from pre‐ to post‐test (main time effect, P<0.05). mTOR and RICTOR mRNA expression increased similarly from pre‐ to post‐test (P<0.01). RAPTOR increased after training for both groups (P<0.0001), but to a greater extent in the ST (P<0.001) than in the PT group. 4EBP‐1 decreased after training when the ST and PT groups were pooled (P<0.05). Calcineurin levels did not change after training, while calcipressin increased similarly from pre‐ to post‐test (P<0.01). In conclusion, our data indicate that these training regimens produce similar performance improvements; however, there was a trend toward greater hypertrophy‐related gene expression and muscle fiber hypertrophy in the ST group.     

Dipeptidyl peptidase‐4 inhibitor‐associated bullous pemphigoid in a patient with acquired reactive perforating collagenosis

Bullous pemphigoid (BP) is a common autoimmune blistering disorder with unknown etiology. Recently, increasing numbers of BP cases which developed under the medication with dipeptidyl peptidase‐4 inhibitors (DPP4i), widely used antihyperglycemic drugs, have been reported in published works. Here, we report a case of DPP4i (teneligliptin)‐associated BP that developed in a 70‐year‐old Japanese man. Interestingly, the patient had acquired reactive perforating collagenosis (ARPC), which is also known to be associated with the onset of BP. In the present case, clinical, histopathological and immunological findings suggested that DPP4i rather than ARPC was associated with the onset of BP.     

Angiotensin-Converting Enzyme Inhibitors in Hypertension: To Use or Not to Use?

Most guidelines for the management of patients with cardiovascular disease recommend angiotensin-converting enzyme (ACE) inhibitors as first-choice therapy, whereas angiotensin receptor blockers (ARBs) are merely considered an alternative for ACE inhibitor–intolerant patients. The aim of this review was to compare outcomes and adverse events between ACE inhibitors and ARBs in patients. In patients with hypertension and hypertension with compelling indications, we found no difference in efficacy between ARBs and ACE inhibitors with regard to the surrogate endpoint of blood pressure and outcomes of all-cause mortality, cardiovascular mortality, myocardial infarction, heart failure, stroke, and end-stage renal disease. However, ACE inhibitors remain associated with cough and a very low risk of angioedema and fatalities. Overall withdrawal rates because of adverse events are lower with ARBs than with ACE inhibitors. Given the equal outcome efficacy but fewer adverse events with ARBs, risk-to-benefit analysis in aggregate indicates that at present there is little, if any, reason to use ACE inhibitors for the treatment of hypertension or its compelling indications.     

Dietary intervention with emphasis on folate intake reduces serum lipids but not plasma homocysteine levels in hyperlipidemic patients

Hyperlipidemia and hyperhomocysteinemia are regarded as major risk factors for cardiovascular disease. Medical nutrition therapy (MNT), which involves a combination of nutritional diagnosis, therapy, and counseling for at-risk patients, has been proposed as a protocol to control these risk factors. The purpose of this study was to investigate the effect of an intensive MNT, specifically tailored to Korean hyperlipidemic patients, on levels of serum lipids and plasma homocysteine. Forty hyperlipidemic patients with blood levels of total cholesterol ≥200 mg/dL or triacylglycerol ≥150 mg/dL were recruited from the Kyung Hee University Medical Center (Seoul, Korea). They were randomly divided into control (no treatment) or experimental (MNT treatment) groups. A registered dietitian performed MNT, emphasizing dietary folate intake based on the guidelines for Korean hyperlipidemic patients; this was performed 5 times during the 12 weeks of the experiment. After the MNT period, we observed that body mass index (P < .001) and fat percentage (P < .05) was significantly decreased in the experimental group but not in the control group. Daily energy consumption, as well as carbohydrate, fat, and cholesterol intakes, all decreased significantly (P < .05) in the MNT group, whereas folate intake increased (P < .05). Blood levels of triacylglycerol (−30.8%), total cholesterol (−20.9%), low-density lipoprotein cholesterol (−14.5%), and ratio of low-density lipoprotein/high-density lipoprotein (−17.1%) were significantly lower in the experimental group after MNT (P < .001) compared with the control group. Plasma homocysteine levels were unchanged (P = .98); however, the levels of folate (P < .01), vitamin B₆ (P < .01), and vitamin B₁₂ (P < .05) increased significantly in the experimental group. These results indicate that MNT, with an emphasis on folate intake, can be effective at reducing blood levels of lipids and improving the blood levels of folate, vitamin B₆, and vitamin B₁₂ in Korean hyperlipidemic patients.