The Currently Available Literature on Inpatient Foodservices: Systematic Review and Critical Appraisal

BackgroundAn adequate hospital foodservice is important to optimize protein and energy intake and to maintain or improve a patient’s nutritional status. Key elements that define an optimal foodservice have yet to be identified.ObjectivesTo systematically describe the effects of published foodservice interventions on nutrition and clinical outcomes and determine which elements should be considered essential. Secondly, to describe the outcome measures used in these studies and evaluate their relevance and validity to guide future research.MethodsPubMed, Embase, the Cochrane Library, and the Web of Science databases were searched. Studies that included assessment of nutrition and/or clinical outcomes of hospital foodservice up to December 2017 were eligible. The details of the subject population, the type of intervention, and the effects on reported outcomes were extracted from each study.ResultsIn total, 33 studies that met inclusion criteria were identified, but only nine (27%) were rated as having sufficient methodologic quality. These nine studies concluded that various elements of a foodservice can be considered essential, including using volunteers to provide mealtime assistance, encouraging patients to choose protein-rich foods, adding protein-enriched items to the menu, replacing existing items with protein-enriched items, giving patients the ability to order food by telephone from a printed menu (room service concept), or a combination of these interventions. The interstudy heterogeneity was high for both outcome measures and methods.ConclusionsVarious foodservice interventions have the potential to improve outcome measures. Recommendations are made to facilitate future research.     

色素上皮细胞衍生因子对脑胶质瘤细胞凋亡的影响

目的 本研究试图通过检测人脑胶质瘤U87细胞中色素上皮细胞衍生因子(PEDF)以及凋亡相关蛋白的表达,探讨其表达在胶质瘤的增殖和细胞凋亡调控中的作用.方法 将100μg/ml的PEDF加入U87细胞中(PEDF处理组),同时以未加PEDF蛋白的胶质瘤细胞作对照组(U87con),采用四甲基偶氮唑蓝法榆测PEDF对胶质瘤细胞U87增殖率的影响;流式细胞术检测胶质瘤细胞是否凋亡;Western-blot(免疫印迹)检测PEDF处理组凋亡相关蛋白p16的变化.结果 实验数据显示:与对照组相比,当PEDF浓度为100μg/ml时,对U87的抑制率为(54.29±0.62)%,PEDF处理组胶质瘤细胞的增殖明显减慢(t=2.63,P＜0.05);PEDF处理过的凋亡细胞产生明显增多,annexin V+和PI-的细胞为(21.84±0.36)%,提示胶质瘤细胞处于凋亡早期(t=2.86,P＜0.05);PEDF诱导的发生凋亡的胶质瘤细胞中,p16蛋白的表达量明显增加(0.82±0.09),与对照组相比(0.43±0.03),差异具有统计学意义.结论 PEDF与p16协同作用,可能在胶质瘤细胞凋亡的调控中起着重要的作用,从而抑制胶质瘤细胞增殖.     

非创伤性预处理对大鼠心脏复苏的影响及机制探讨

目的　以心脏为靶器官观察短暂下肢缺血预处理及药物预处理对心肺复苏术 (CPR)的影响。方法　以窒息法复制大鼠复苏模型 ,随机分为对照组 (C)、短暂下肢缺血预处理组 (IP)、复苏前后予去甲肾上腺 ,预处理组 (NEPCⅠ、NEPCⅡ )及复苏前后予腺苷处理组 (AdoⅠ、AdoⅡ ) ,观察复苏成功率、自主循环恢复时间 ,复苏成功后左心功能、用免疫组化法测定 ,C组及IP组蛋白激酶C (PKC)含量并定位。结果　复苏成功率IP组 (1 0 0 % )高于C组 (2 5 % )及Ado组 (1 6 6 7% ,0 % ) (P <0 0 5 ) ,但与NEPC组(6 6 6 7% ,5 0 % )比较差异无显著性 ;各药物干预组自主循环恢复时间 (NEPCⅠ 34 6 8± 2 6 7,NEPCⅡ31 5 9± 4 4 1 ;AdoI:2 5 2 6± 2 6 9,AdoⅡ :31 1 0± 6 72 )短于C组 (4 9 71± 6 1 0 ) (P <0 0 1 ) ,但与IP组(2 8 2 4± 8 70 )比较无显著性差异。复苏成功后各组间左心功能无差异 :IP组PKC含量 (灰度值 1 4 7 2 5±6 4 7)高于C组 (灰度值 1 6 4 1 6± 4 5 8)并出现向核及细胞膜的转位。结论　短暂下肢缺血预处理对CPR具正面影响 (对心肌的保护作用 ) ,其机制涉及PKC的激活 ;儿茶酚胺受体及腺苷受体可能部分介导了预处理的保护作用     

丝氨酸/苏氨酸蛋白激酶抑制剂治疗成人急性白血病的研究

目的应用基因表达谱芯片来检测丝氨酸/苏氨酸蛋白激酶Raf-1抑制剂对急性髓系白血病（AML）细胞基因表达的影响,试图进一步探讨丝氨酸/苏氨酸蛋白激酶Raf-1抑制剂抗白血病细胞增殖的机制。方法利用cDNA基因芯片研究10例成人AML,用两种不同的荧光素cy3和cy5通过逆转录反应将白血病细胞经丝氨酸/苏氨酸蛋白激酶Raf-1抑制剂作用前后的RNA分别标记成两种探针,并与基因表达谱芯片进行杂交,通过计算机扫描分析得出这些基因在经丝氨酸/苏氨酸蛋白激酶Raf-1抑制剂处理前后的表达差异。结果基因表达谱分析两次重复实验结果,最后筛选出包括与细胞凋亡、细胞周期等相关表达差异的基因共20条,其中12条表达上调,8条表达下调。结论结果提示丝氨酸/苏氨酸蛋白激酶Raf-1抑制剂抗成人急性粒细胞白血病的作用机制与抑制白血病细胞周期和诱导白血病细胞凋亡有很大关系。     

Positive Nitrogen Balance in Hypercatabolic States: Results Obtained with Parenteral Feeding after Major Surgical Procedures

Conclusive evidence that positive nitrogen balance can regularly be achieved during hypercatabolic states has not yet been established. Nitrogen balance has been measured in 15 patients over the first ten days following major surgical procedures whilst they were receiving parenteral alimentation with constant high caloric intake. A linear correlation was found between daily nitrogen intake and balance. The slope of the regression lines (0.430 to 0.837) and the nitrogen needs (9 to 18 g/m2 /day) vary from one patient to another. All patients were in positive nitrogen balance when intake was high, regardless of the post-operative day considered. Positive or equilibrated cumulative nitrogen balance could be obtained when mean nitrogen intake was kept over 13 g/m2 /day. This positive nitrogen balance can be obtained during hypercatabolic states. From this study and from data found in the literature it can be concluded that parenteral hype ralimentation is beneficial in the immediate post operative period after major surgical procedures.     

Meningococcemia and purpura fulminans in adults: acute deficiencies of proteins C and S and early treatment with antithrombin III concentrates

It has been recently suggested that an acquired deficiency of proteins C and S could contribute to the pathogenesis of meningococcemic purpura fulminans (PF) in children. Our study was designed to measure the levels of antithrombin III (AT III), protein C, and protein S during adult PF and to determine the effects of an early infusion of high doses of AT III concentrates on clinical and biological alterations of PF. We studied five consecutive adult patients with meningococcemia (type B) and PF. The levels of AT III, protein C (antigen and activity), and protein S (total and free) were measured at admission and 24 h and 1 month later. The treatment included in each case: amoxycillin, dobutamine and high doses of AT III concentrates. All patients survived and were discharged without any sequelae. At admission, biological data were consistent with severely depressed protein C and protein S levels and moderately decreased AT III levels, without any discrepancy between protein C antigen and activity. After 24 h, AT III and protein S levels were within normal ranges, whereas protein C levels were still depressed. These data are consistent with the theory of a particular imbalance in the anticoagulant systems during meningococcemic PF, contrasting with the usual findings observed during septic disseminated intravascular coagulation. The possibility must be considered that high doses of one anticoagulant (AT III concentrates) could compensate for the acute decrease in the other (protein C system).     

蛋白质二硫键异构酶在幽门螺杆菌感染者胃黏膜中的表达及意义

目的：了解蛋白质二硫键异构酶(protein disulfide isomerase,PDI)在幽门螺杆菌(H pylon)感染人胃黏膜组织中的表达情况．方法：分别应用半定量RT-PCR方法及Westem blot方法检测感染(n=32)与未感染(n=28)H pylori的人胃黏膜组织中PDI mRNA及蛋白的表达情况．结果：未感染组PDI mRNA及蛋白表达量分别为0．5704±0．0794,0．5198±0．0379,感染组PDI mRNA及蛋白表达量分别为1．0642±0．1533,0．8252±0．0321：两组相比差异显著(P＜0．01)．结论：正常情况下胃黏膜组织有PDI mRNA的表达及蛋白的合成,H pylori感染可使胃黏膜增加PDI mRNA的表达及蛋白的合成．     

Thrombosis in congenital deficiencies of AT III, protein C or protein S: a study of 44 children

Abstract. Congenital deficiency in coagulation inhibitors is a cause of hereditary thrombotic disease. The severity of symptoms is variable and depends on the type of deficit. In this paper, 44 children suffering from deep venous thrombosis, with a mean age of 5 years, were studied. A search for Lupus anticoagulant (LA) and coagulation inhibitor deficiency showed: 3/44 cases (6.8%) had protein S deficiency, 2/44 cases (4.5%) had protein C deficiency, 1/44 cases (2.3%) had deficiencies in both protein C and S; no cases of AT III deficiency and LA was positive in 2/44 cases (4.5%). Only 1 case of APC resistance out of 13 studied was found. Four family studies were performed and confirmed the congenital origin of the disorder.     

Involvement of Protein Kinase C in Ethanol-Induced Inhibition of NMDA Receptor Function in Cerebellar Granule Cells

Ethanol inhibits N -methyl- d -aspartate (NMDA)-stimulated increases in intracellular Ca²⁺ in cerebellar granule cells apparently by reducing the potency of glycine to act as a co-agonist at the NMDA receptor. The inhibitory effect of ethanol on the NMDA response in these cells can be reversed not only by a high concentration of glycine, but also by the protein kinase inhibitors, staurosporine and calphostin C. We previously showed that activation of protein kinase C in cerebellar granule cells also resulted in inhibition of the NMDA response, and in decreased potency of glycine at the NMDA receptor. Furthermore, the inhibitory effects of ethanol and protein kinase C activation are not additive. These results suggest a role for protein kinase C in ethanol inhibition of NMDA responses in cerebellar granule cells. In contrast, although ethanol can inhibit the response to kainate in these cells in a "competitive" manner, this response is not affected by activation of protein kinase C.