血浆置换在儿童重症噬血细胞综合征中应用的疗效分析：前瞻性随机对照研究

目的探讨血浆置换在辅助救治儿童重症噬血细胞综合征（hemophagocytic syndrome，HPS）中的疗效和应用价值。方法采用前瞻性随机对照研究方法，选取2018年10月至2020年10月在湖南省儿童医院儿童重症监护室（pediatric intensive care unit，PICU）接受救治的重症HPS患儿40例为研究对象，将患儿随机分为置换组和常规组（n=20），常规组患儿进行病因和对症常规支持治疗，置换组在常规治疗的基础上加以血浆置换辅助治疗。对两组患儿的基本情况、治疗前后的临床症状体征、主要实验室检查指标、疗效和预后情况进行比较分析。结果两组患儿治疗前在性别、年龄、入院前病程、病因构成、小儿危重病例评分、器官或系统功能累及情况等指标上比较差异均无统计学意义（P>0.05），在实验室指标的比较上差异亦均无统计学意义（P>0.05）。两组患儿治疗7 d后，临床症状体征均有所缓解和改善。治疗后置换组C反应蛋白、降钙素原、血清铁蛋白、丙氨酸氨基转移酶、总胆红素水平均低于常规组（P<0.05）。置换组的PICU住院时间较常规组明显缩短，总有效率较常规组明显提高（P<0.05），但两组总的住院时间和3个月病死率比较差异无统计学意义（P>0.05）。结论血浆置换在辅助治疗儿童重症HPS上的疗效优于常规治疗，能改善患儿的临床症状体征和部分实验室指标，缩短PICU住院时间，可能成为治疗儿童重症HPS的一项有效辅助治疗方法。     

Daily Exposure to a Cranberry Polyphenol Oral Rinse Alters the Oral Microbiome but Not Taste Perception in PROP Taster Status Classified Individuals

Diet and salivary proteins influence the composition of the oral microbiome, and recent data suggest that TAS2R38 bitter taste genetics may also play a role. We investigated the effects of daily exposure to a cranberry polyphenol oral rinse on taste perception, salivary proteins, and oral microbiota. 6-n-Propylthiouracil (PROP) super-tasters (ST, n = 10) and non-tasters (NT, n = 10) rinsed with 30 mL of 0.75 g/L cranberry polyphenol extract (CPE) in spring water, twice daily for 11 days while consuming their habitual diets. The 16S rRNA gene sequencing showed that the NT oral microbiome composition was different than that of STs at baseline (p = 0.012) but not after the intervention (p = 0.525). Principal coordinates analysis using unweighted UniFrac distance showed that CPE modified microbiome composition in NTs (p = 0.023) but not in STs (p = 0.096). The intervention also altered specific salivary protein levels (α-amylase, MUC-5B, and selected S-type Cystatins) with no changes in sensory perception. Correlation networks between oral microbiota, salivary proteins, and sensory ratings showed that the ST microbiome had a more complex relationship with salivary proteins, particularly proline-rich proteins, than that in NTs. These findings show that CPE modulated the oral microbiome of NTs to be similar to that of STs, which could have implications for oral health.     

Synthesis and Characterization of LaNi0.5Ti0.5O3 and La2NiTiO6 Double Perovskite Nanoparticles

In the present work, LaNi_0.5Ti_0.5O₃ and La₂NiTiO₆ nanoparticles were synthesized by the modified Pechini method. LaNi_0.5Ti_0.5O₃ was calcined at 1073 K for 17 h or 100 h, while La₂NiTiO₆ was calcined at 1273 K for 135 h. The double perovskite calcined at 1073 K for 17 h presented orthorhombic symmetry with Pbnm space group, mean particle size was 31.9 ± 1 nm, random ordering of Ni²⁺ and Ti⁴⁺ cations, Néel temperature close to 15 K, and magnetic moment of 1.29 μB. By increasing the calcination time, this material showed the same symmetry and space group, a mean particle size of 50.7 ± 2 nm, short-range ordering of Ni²⁺ and Ti⁴⁺ cations, Néel temperature around 12 K, and magnetic moment of 0.96 μB. La₂NiTiO₆ presented a monoclinic crystal structure, with P2₁/n space group, mean particle size of 80.0 ± 5 nm, rock salt ordering of Ni²⁺ and Ti⁴⁺, Néel temperature of approximately 23 K, and magnetic moment of 2.75 μB.     

养肝活血汤对酒精性肝病大鼠的影响

目的:探讨养肝活血汤对酒精性肝病大鼠的影响.方法:将SD大鼠按照随机数字表法分为空白对照组、模型对照组、养肝活血汤组(12.8 g ? kg-1)、硫普罗宁钠组(60 mg ? kg-1).检测各组大鼠血清中天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、谷丙氨酸氨基转移酶(ala...     

The Extracellular Mass to Body Cell Mass Ratio as a Predictor of Mortality Risk in Hemodialysis Patients

The extracellular mass/body cell mass ratio (ECM/BCM ratio) is a novel indicator of nutritional and hydration status in hemodialysis (HD) patients. This study aimed to explore the ECM/BCM ratio as a predictor of mortality risk with nutritional-inflammatory markers in HD patients. A prospective observational study was conducted in 90 HD patients (male: 52.2%; DM: 25.60%). Clinical and biochemical parameters [serum albumin, serum C-reactive protein (s-CRP), interleukine-6 (IL-6)] were analysed and bioelectrical impedance analysis (BIA) was performed. Protein-energy wasting syndrome (PEW) was diagnosed using malnutrition-inflammation score (MIS). Based on BIA-derived measurements, the ECM/BCM ratio with a cut-off point of 1.20 was used as a PEW-fluid overload indicator. Comorbidity by Charlson index and hospital admissions were measured. Out of 90 HD patients followed up for 36 months, 20 patients (22.22%) died. PEW was observed in 24 survivors (34.28%) and all non-survivors. The ECM/BCM ratio was directly correlated with MIS, s-CRP, Charlson index and hospital admissions but was negatively correlated with phase angle and s-albumin (all, p < 0.001). Values of the ECM/BCM ratio ≥ 1.20 were associated with higher probability of all-cause mortality (p = 0.002). The ECM/BCM ratio ≥ 1.20, IL-6 ≥ 3.1 pg/mL, s-CRP and s-albumin ≥ 3.8 g/dL and Charlson index were significantly associated with all-cause mortality risk in multivariate adjusted analysis. This study demonstrates that the ECM/BCM ratio ≥ 1.20 as a nutritional marker and/or fluid overload indicator had a significant prognostic value of death risk in HD patients.     

内关穴双向调节作用考略

[目的]归纳内关穴对多病症的双向调节作用。[方法]采集古代文献,整理出内关穴定位、主治症及相关配穴处方的原文,按病症进行分析归纳。[结果]通过本次文献研究,证明了内关穴对心肺、脾胃、大肠小肠、女子胞宫等脏腑的病症有双向调节作用。[结论]内关穴有多项双向调节作用。     

Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis

Interleukin‐6 is a pleiotropic cytokine that plays a pathogenic role in type 1 diabetes. Therefore, anti‐interleukin‐6 receptor antibody, tocilizumab, used for the treatment of rheumatoid arthritis, is considered a candidate for immune intervention in type 1 diabetes. Here, we report the case of a 73‐year‐old woman (HLA‐DR9‐DQ3 homozygote) with well‐controlled rheumatoid arthritis who developed type 1 diabetes while receiving tocilizumab treatment. At 57 years‐of‐age, the patient was diagnosed with rheumatoid arthritis, for which she underwent tocilizumab therapy that enabled complete suppression of her joint inflammation. A total of 17 months after starting tocilizumab therapy, she noticed polydipsia, polyuria, general fatigue and weight reduction (−2 kg/month), and was diagnosed with type 1 diabetes with diabetic ketoacidosis based on an arterial pH of 7.26, serum ketone body of 7,437 μmol/L, blood glucose level of 925 mg/dL, glycated hemoglobin of 13.2% and the presence of anti‐islet autoantibodies. This case report shows valuable insight regarding the effect of anti‐interleukin‐6 receptor antibody therapy on type 1 diabetes prevention.