针灸治疗单纯性肥胖症及机理研究探讨

单纯性肥胖症是当今社会常见病、多发病之一。近年来 ,针灸治疗单纯性肥胖症无论在临床方面还是在实验机理研究方面 ,均取得较大进展。但针灸减肥的机理研究大多局限在中枢神经核团神经递质含量的研究 ,没有新的突破 ,在临床方面有待于更多、更科学、更规范的临床研究报道。     

褪黑素与能量代谢

本文从季节性动物体重的改变这一自然现象与光照周期的改变之间的关系，讨论了褪黑素调节能量代谢的可能机制及其与人类肥胖的相关性。     

Serum alanine aminotransferase activity in obese children

To confirm the significance of the serum alanine aminotransferase (ALT) test for the diagnosis of fatty liver and to clarify the relationship between serum ALT activity and the duration of obesity, we analysed 310 obese young schoolchildren (195M, 115F), who were classified into three duration groups (1–3 y, 4–6 y, 7+ y), three age groups (6–7 y, 8–9 y, 10–11 y), and four obesity groups (weight excess; mild, 20–29%: moderate, 30–39%; severe. 40–49%; very severe. 50%). Seventy-seven patients with abnormal ALT test, >30 IU/1, and 27 patients with normal ALT test were examined by ultrasound study to identify the fatty-fibrotic pattern of the liver. Abnormal results of the serum ALT test were found in 24% of all patients. The fatty-fibrotic pattern was identified in 64/77 (83%) patients with abnormal ALT test and in 5/27 (18%) patients with normal ALT test. The serum ALT test has a sensitivity of 0.92 for detecting the fatty-fibrotic pattern proven by ultrasound study Frequencies of cases with abnormal serum ALT levels increased with the duration of obesity. In the shortest duration group, however, the frequencies of abnormal results in serum ALT test did not increase with advanced ages or the grades of obesity. In conclusion, the present study confirmed the usefulness of the serum ALT test for screening fatty liver, and showed that a longer duration of obesity is generally associated with the occurrence of fatty liver in a paediatric obese population. In young patients with mild obesity or a short duration of obesity, however, fatty liver or fatty fibrosis may develop. Early intervention should be made in the case of obese children.     

Risk Factors for Male Breast Cancer (United States)

Objectives: The etiology of male breast cancer is obscure, although an excess risk has been associated with Klinefelter syndrome, testicular disorders, benign breast disease including gynecomastia, use of exogenous estrogens, radiation, and a family history of male or female breast cancer. We conducted a case-control study to investigate risk factors further for breast cancer in men.Methods: Based on data from the 1986 National (United States) Mortality Followback Survey (NMFS) of almost 20,000 deceased adults (age 25 years or over), we compared information obtained from next-of-kin interviews of 178 men who died of breast cancer with that of 512 male controls who died of other causes. Information was obtained on selected demographic and other factors, including diet, exercise, occupation, height and weight, and use of tobacco and alcohol.Results: Increased risks were found for men who were described by their next-of-kin as very overweight (odds ratio [OR] = 2.3, 95 percent confidence interval [CI] = 1.1-5.0). The risks associated with the three upper quartiles of body mass index (BMI) (wt/ht²) were 1.3, 1.6, and 2.3, respectively, with a significant dose-response relationship (P < 0.01). An excess risk was also associated with limited exercise (OR = 1.3, CI = 0.8-2.0). Consumption of red meat was associated with an increased risk, and consumption of fruits and vegetables with a decreased risk, although the trends were not significant. No association was found for tobacco or alcohol use, but an excess risk was associated with higher levels of socioeconomic status (SES) (OR = 1.8, CI = 1.1-3.0).Conclusions: Our study suggests that obesity increases the risk of male breast cancer, possibly through hormonal mechanisms, while dietary factors, physical activity, and SES indicators also deserve further investigation. Cancer Causes andd Control 1998, 269-275     

Zur Bedeutung von sekretorischen und stukturassoziierten Proteasen von Aspergillus fumigatus für die Pathogenese der invasiven Aspergillose

Zusammenfassung. Ein Charakteristikum der invasiven Aspergillose ist, daß Aspergillus fumigatus in der Lage ist, proteinreiche Gewebsschichten des Wirtes zu penetrieren. Verantwortlich hierfür könnten sekretorische Proteasen des Pilzes sein, die fibrilläre Proteine wie Kollagen oder Elastin aufweichen und so der Hyphe das Eindringen ermöglichen. Allerdings sprechen Infektionsversuche mit Gendeletions-Mutanten von allen bekannten sekretorischen Aspergillus-Proteasen gegen eine entscheidende Beteiligung dieser Enzyme an der Pathogenese der invasiven Aspergillose. Ebenso deuten mikroskopische Untersuchungen an Gefäßwand-pene-trierenden Aspergillen nicht auf eine stärkere Auflösung des Bindegewebes, so daß auch eine rein mechanische Verdrängung der Struktur-Proteine durch das Wachstum der Hyphe möglich wäre. Weiter vorstellbar ist auch eine streng lokalisierte Proteolyse an dén Wachstumszonen der Hyphen durch Zellwand-assoziierte Proteasen. Kandidaten für einen solchen Mechanismus sind Aspartat- und Serinproteasen, deren Aktivitäten in der Zellwandfraktion von A. fumigatus gefunden wurden. Summary. In the course of invasive aspergillosis, Aspergillus fumigatus is capable of penetrating any tissue of the host. Secretory proteinases of the fungus might facilitate the hyphae to grow through fibrillar proteins like elastin and collagen. However, using systemic infection models, no significantly reduced virulence could be shown with fungal mutants deficient for all known secretory proteinases. Thus, secretory proteinases might be of minor relevance for the pathogenesis of invasive aspergillosis. In addition, microscopic examination of aspergilli penetrating vessel walls did not reveal obvious lysis of wall proteins, thus emphasizing a mechanical disruption of fibrillar proteins by the growing hyphae. However, a strictly localized proteolysis at the tips of growing hyphae caused by wall associated proteinases might be involved. Candidates for such a mechanism art the activities of aspartic and serine proteinases which we have discovered in the cell wall fraction of A. fumigatus.     

Is obesity a risk factor for psychopathology among adolescents?

BACKGROUND: Although several studies have documented the existence of psychopathology in obese adolescents, disagreement remains regarding the extent and nature of this psychopathology. The aim of the present study was to explore the type and frequency of psychopathology in a clinical as well as a non-clinical sample of obese adolescents, and in a normal weight control group. METHODS: The study sample consisted of a clinical study group of 30 obese adolescents, a non-clinical obese group of 30 obese adolescents, and a control group of 30 normal weight adolescents. Psychological assessment was performed using a non-structured psychiatric interview, the Child Behavior Checklist (CBCL), Children Depression Inventory (CDI), Rosenberg Self-esteem scale (SES) and the Eating Attitude Test (EAT). RESULTS: More than half of the clinical obese adolescents (16/30) had a DSM-IV diagnosis, often involving major depressive disorder (n = 10). The mean scores of anxiety-depression, social problems, social withdrawal and total problem in the CBCL scale of the clinical obese group were significantly higher than the non-clinical obese group and the normal weight control group. The mean total scores of the SES and the CDI of the clinical obese group were higher than the normal weight control group. The mean total score of EAT of the clinical obese group was significantly higher than the normal weight control group, and the mean score of EAT of the non-clinical obese group was significantly higher than the normal weight control group. CONCLUSIONS: The results support previously published reports which show a higher ratio of psychopathology (depression, behavioral problems, low-esteem) among clinical obese adolescents than among non-clinical obese adolescents. Findings provided evidence for a psychosocial at-risk population in a subgroup of obese adolescents.     

Leptin and Its Emerging Role in Children and Adolescents

Leptin is an adipocyte-secreted hormone which plays a key role in energy homeostasis. Recent “proof of concept” studies involving leptin administration to humans support its critical role in regulating energy homeostasis, neuroendocrine and immune function as well as insulin resistance in states of energy/ caloric deprivation. Moreover, interventional studies in leptin deficient children and observational studies in normal girls and boys support a role for leptin as a permissive factor for the initiation of puberty in children. The potential clinical usefulness of leptin in several disease states in children and adolescents, including hypothalamic amenorrhea, eating disorders and syndromes of insulin resistance is still under investigation.     

儿童特发性再生障碍性贫血的诊断与治疗

再生障碍性贫血(再障)以全血细胞减少和骨髓增生降低为显著特点。绝大多数病例为特发性,部分为继发性,与辐射、化学物和药物暴露、病毒感染有关。特发性再障发病机制不清,但免疫机制介导的造血干细胞损伤发挥着极为重要的作用。诊断主要依靠典型的临床表现和骨髓形态学检查,注意与其他可导致全血细胞减少的疾病鉴别,尤其是低增生性骨髓增生异常综合征。应综合患者年龄、临床严重程度、有无造血干细胞来源及其种类等因素,制定个体化治疗方案,合理选择联合免疫抑制治疗和造血干细胞移植的类型和时机。重视对症支持治疗措施。     

儿童呼吸道病毒感染与免疫应答

急性呼吸道感染(ARTI)是儿科最为常见的疾病,其中病毒所致的ARTI占半数以上。呼吸道病毒与机体免疫系统之间的相互作用是发病的关键环节。文章介绍了我国常见的呼吸道病毒病原的流行病学、病毒免疫逃逸与进化、机体保护性/病理性抗病毒免疫应答的研究进展,以提高儿科医师对呼吸道病毒感染的认识。