Prospective analysis of gait characteristics in chronic inflammatory demyelinating polyradiculoneuropathy

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a disorder that may lead to functional impairment, including gait abnormalities. Our aim was to analyze gait characteristics in patients with CIDP compared to healthy controls (HC). Moreover, we sought to determine changes of gait parameters after six-month follow-up period. Twenty-four patients with CIDP and 24 HCs performed basic walking task, dual-motor task, dual-mental task, and combined task using the same GAITRite system. Lower limb MRC-SS and lower limb INCAT disability score were assessed. Fourteen patients were retested after six months. Majority of gait parameters showed significant differences in all experimental conditions when compared between CIDP and HCs. The most consistent findings in CIDP were shorter stride length (SL), prolonged cycle time (CT) and double support time (DS), as well as increased variation of SL and of swing time (ST) (p < 0.05). During follow-up, INCAT improved in nine (64.3%) of 14 patients and MRC-SS improved in eight (57.1%) patients. Six-month changes of CT and its variation during combined task significantly differentiated patients with improved vs. non-improved INCAT (p < 0.05). In conclusion, patients with CIDP had slower gait with prolonged DS and with shorter SL compared to HCs. Increased variation of SL and of ST in CIDP may suggest a potential risk for instability and falls. Shorter CT duration and less CT variation during time correlated well with improvement in disability.     

血清趋化因子检测在肺癌早期诊断中的应用价值

目的探讨血清趋化因子检测在肺癌早期诊断中的应用价值。方法采用回顾性总结研究方法,选择肺癌患者72例(肺癌组)、肺炎患者72例(肺炎组)与健康人72例(对照组),检测3组人群的白细胞计数,检测血清趋化因子MIP-3α、IL-8、Fractalkine水平,随访记录患者的预后,判断诊断价值。结果肺癌组与肺炎组的外周白细胞计数均显著低于对照组(P<0.05),但肺癌组与肺炎组对比差异无统计学意义(P>0.05)。肺癌组与肺炎组的血清MIP-3α、IL-8、Fractalkine水平都高于对照组(P<0.05),肺癌组高于肺炎组(P<0.05)。随访至2018年9月,肺癌组中患者死亡6例,存活66例,死亡率为8.3%。多因素logistic回归分析淋巴结转移、临床分期、组织学分化、MIP-3α、IL-8、Fractalkine为影响患者预后死亡的主要独立危险因素(P<0.05)。结论MIP-3α、IL-8、Fractalkine等趋化因子联合现有的肿瘤标志物,可用于诊断早期肺癌与预测预后。     

Dietary inflammatory index and incidence of and death from primary liver cancer: A prospective study of 103,902 American adults

Chronic inflammation plays an important role in primary liver cancer (PLC) etiology and can be influenced by dietary habits. No prospective study has investigated the association of dietary inflammatory index (DII) with PLC incidence and mortality. Therefore, we used prospective data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial to fill this gap. The DII was calculated from a validated 137-item food frequency questionnaire in a cohort of 103,902 individuals. Cox regression was used to estimate hazard ratios (HRs) for PLC incidence, and competing risk regression was used to estimate subdistribution HRs (SHRs) for PLC mortality. Restricted cubic spline regression was employed to identify the potential dose–response pattern. A total of 120 PLC cases and 102 PLC deaths were observed during follow-up. Higher DII scores from food and supplement were found to be associated with higher risks of developing PLC (HR_{Tertile 3 vs. 1} 2.05; 95% confidence interval [CI] 1.23–3.41) and death from this disease (SHR_{Tertile 3 vs. 1} 1.97; 95% CI 1.13–3.41). Similar results were obtained for DII score from food only. A nonlinear dose–response pattern was identified for the aforementioned associations (all p_nonlinearity < 0.05). Overall, a more pro-inflammatory diet, as suggested by higher DII scores, is associated with higher risks of PLC incidence and mortality. These findings indicate that encouraging intake of more anti-inflammatory dietary components and reducing intake of pro-inflammatory components represent an attractive strategy to reduce PLC incidence and mortality.     

食管腺癌患者血清中脂联素与炎症细胞因子水平的相关性探讨

目的:探讨食管腺癌（esophageal adenocarcinoma,EAC）患者血清中脂联素与炎症细胞因子水平及肿瘤组织病理特点之间的相关性,分析脂联素是否通过调节食管组织炎症而参与抑制肿瘤的进展。方法:收集25例健康人、23例Barrett食管（Barrett's esophagus,BE）患者和18例EAC患者。登记临床病例资料;采集空腹静脉血,采用ELISA法检测血清中脂联素和TNF-α、IL-8、IL-6水平并分析其相关性;进行HE染色观察食管组织局部炎症情况。结果:健康对照组、BE组、EAC组三组间相比较发现,随着食管病变的加重,食管局部炎症细胞浸润越明显,同时检测到血清中TNF-α、IL-8、IL-6水平逐渐升高,相反血清脂联素水平逐渐降低;相关性分析结果显示血清炎症细胞因子水平与脂联素水平间存在着负相关关系。结论:EAC发病过程中,食管局部炎症反应逐渐加重,血清炎症细胞因子水平逐渐升高,而脂联素水平逐渐降低,两者之间存在着明显的负相关关系。由此可知,低脂联素血症可能与EAC发生和进展过程中持续存在的慢性炎症有关。     

动脉粥样硬化与炎症及药物应用研究进展

越来越多的资料表明炎症在动脉粥样硬化中扮演重要角色,一些炎症标记物被用来评估动脉粥样硬化患者的临床疗效,在此基础上的大量研究发现降低动脉粥样硬化患者这类炎症标记物的水平能够降低其发生冠脉事件的危险度,这就为动脉粥样硬化的防治提供了新思路。     

Leukocytapheresis (LCAP) for Management of Fulminant Ulcerative Colitis with Toxic Megacolon

Leukocytapheresis (LCAP) is a method of therapeutic apheresis to remove patients peripheral leukocytes by extracorporeal circulation. Previous studies showed that LCAP for the treatment of ulcerative colitis (UC) was more effective and had fewer adverse effects compared to high-dose steroid therapy. However, there are no reports on the application of LCAP for UC patients with toxic megacolon (TM). This study reports the effectiveness and safety of LCAP in treating patients with severe or fulminant UC with TM. Six patients were enrolled in this study and LCAP sessions were performed three times per week for 2 weeks, followed by four further times in the next 4 weeks. After completion of therapy, four patients improved in TM and went into the remission stage of UC. The average Rachmilewitz clinical activity index of these four patients improved from 19.5 to 1. The remaining two patients had to undergo colectomy, however, the symptoms had been mitigated by LCAP and the operations were completed without any problems. These results suggest that LCAP is an additional effective and safe option for TM management in preventing colectomy or for bridging to a safer operation.     

慢性阻塞性肺疾病骨骼肌萎缩机制的研究进展

骨骼肌萎缩是COPD患者常见的全身症状,是导致COPD患者生活质量下降和病死率增加的主要危险因素。COPD骨骼肌萎缩的形成机制非常复杂,与全身炎症反应、氧化应激、缺乏锻炼等因素有关。碳酸酐酶Ⅲ可能也参与了COPD患者骨骼肌萎缩的发生。上述刺激因素会降低骨骼肌氧化代谢能力,使肌蛋白分解／合成过程失衡、影响骨骼肌纤维的凋亡过程及改变肌纤维类型和氧化表型,导致骨骼肌功能障碍。