超声乳化术后眼前房炎性反应变化的初步临床报告

目的　观察白内障超声乳化术后眼前房蛋白浓度的变化。　 方法　采用FM 5 0 0型前房蛋白闪辉仪 (LaserFlareMeter ,LFM )对 32例 (42只眼 )白内障超声乳化术前及术后 1、3d ,1、2周的前房蛋白浓度进行测量。　 结果 　手术后第 1d前房蛋白浓度达最高为 6 2 .3光电符号数·毫秒 -1(pc·ms-1) >术后第 3d 2 7pc·ms-1(P <0 .0 5 )。术后 1周为 8.6 0pc·ms-1、2周为 8.6 3pc·ms-1,基本接近正常 ,2者间差异无显著性 (P >0 .0 5 )。　 结论　超声乳化所引起的眼前部血 房水屏障的功能性改变在术后 1周左右基本恢复。     

Independent effects of residual renal function and dialysis adequacy on dietary micronutrient intakes in patients receiving continuous ambulatory peritoneal dialysis

BACKGROUND: Dialysis patients are at risk of vitamin and mineral deficiencies, not only because of losses during chronic hemodialysis or peritoneal dialysis but also because of low intakes. OBJECTIVE: The objective was to determine the importance of urea clearance (calculated as K(t)/V) and residual renal function (RRF) in predicting micronutrient intakes in a large cohort of patients receiving continuous ambulatory peritoneal dialysis (CAPD). DESIGN: We conducted a survey of dietary intakes in 242 CAPD patients and divided them into 3 groups according to their weekly urea clearance and RRF: WD group (n = 84), a urea clearance >/= 1.7 and a glomerular filtration rate (GFR) >/= 1 mL x min(-1) x 1.73 m(-2); DD group (n = 71), a urea clearance >/= 1.7 and a GFR < 1 mL x min(-1) x 1.73 m(-2); and ID group (n = 87), a urea clearance < 1.7. RESULTS: Most of the patients had intakes of water-soluble vitamins and minerals that were lower than the recommended dietary allowance; most intakes were significantly higher in the WD group than in the DD and ID groups, except those of niacin and calcium. After age, sex, body weight, and the presence of diabetes were controlled for, total weekly urea clearance and the GFR (but not peritoneal dialysis urea clearance) were significantly associated with intakes of vitamins A and C, the B vitamins, and minerals (calcium, phosphate, iron, and zinc). Low intakes of vitamins and minerals with low RRF and urea clearance were the result of reduced overall food intakes, except for thiamine, vitamin B-6, and folic acid, which were deficient in the diet. CONCLUSIONS: Supplementation with most water-soluble vitamins and minerals, including iron and zinc, should be considered in CAPD patients, especially those with low RRF and low urea clearance. The optimal dose needs to be determined.     

糖尿病患者的主观幸福感调查及影响因素分析

目的研究糖尿病患者的主观幸福感及其影响因素。方法用纽芬兰纪念大学幸福度量表(MUNSH)、社会支持评定量表(SSRS)、生活事件评价问卷、Zung氏焦虑与抑郁自评量表(SAS和SDS)分别对35例门诊糖尿病患者和33例健康对照组的主观幸福感、生活事件评价、社会支持、情绪状态进行评价,并对患者的躯体状况(疾病严重程度、疾病持续时间、有无并发症等)进行评分。结果与正常对照组相比,糖尿病患者的主观幸福感明显降低(对照组为10±8,糖尿病患者为5±6),且患者的主观幸福感与生活事件评价、焦虑抑郁程度呈负相关(相关系数分别为0.25,0.23,0.13);与总社会支持呈正相关(相关系数为0.28)。结论糖尿病患者的主观幸福感与多种因素有关,其中生活事件评价是重要影响因素之一。     

Effectiveness of a lifestyle modification programme in weight maintenance in obese subjects after cessation of treatment with Orlistat

OBJECTIVE: To examine the efficacy of a lifestyle modification programme in weight maintenance for obese subjects after cessation of treatment with Orlistat. METHODS: Fifty-five subjects with and without diabetes mellitus were randomized to a lifestyle modification programme or to usual care at the end of 6 months' treatment with Orlistat. The intervention programme was nutritionist led, consisting of components of dietary management, physical activity, peer group support and discussion using techniques of self-monitoring, stimulus control and cognitive restructuring. Anthropometric indices, body composition, basal metabolic rate, blood pressure, fasting glucose, glycosylated haemoglobin, lipid profile, 24-hour urinary albumin excretion, dietary intake, physical activity level, and quality of life were assessed before and after the intervention period. Results Subjects in the intervention group maintained their weight loss and favourable anthropometric, metabolic, dietary intake, physical activity and quality of life profiles, while most parameters deteriorated in the usual care group, being more marked in subjects with diabetes. The magnitude of weight gain was comparable to that lost during Orlistat treatment. CONCLUSION: A specially designed nutritionist-led lifestyle modification programme for obese subjects is effective in weight maintenance after treatment with Orlistat, in the absence of which the benefits of drug treatment were lost. The magnitude of the effect of lifestyle modification is comparable to that observed with Orlistat.     

HMG-CoA Reductase Inhibitors (Statins) Activate Expression of PPARα/PPARγ and ABCA1 in Cultured Gallbladder Epithelial Cells

In gallbladder epithelial cells (GBEC), PPARα and PPARγ ligands modulate inflammation by suppression of TNFα production and prevent excessive accumulation of cholesterol by ABCA1 activation. Recently, HMG-CoA reductase inhibitors (statins) were shown to activate PPARα and PPARγ in various cells but no studies of their effects in GBEC have been conducted. The objective of this study was, therefore, to determine the effects of statins on PPAR and ABCA1 expression and the anti-inflammatory effect of statins in GBEC. Canine GBEC were cultured on Petri dishes. Expression of the proteins PPARα, PPARγ, and ABCA1 was measured by western blotting analysis after treatment with simvastatin, pravastatin, NO-pravastatin, PPARα ligand, or PPARγ ligand in the culture media. Expression of ABCA1 and LXRα mRNAs was estimated by RT-PCR. Expression of TNFα mRNA was measured by RT-PCR after 24 h pre-treatment with the statins, preceding 1 h of lipopolysaccharide (LPS) loading. Simvastatin, pravastatin, and NO-pravastatin increased expression of the proteins PPARα, PPARγ, and ABCA1, and expression of the mRNA of ABCA1 and LXRα in GBEC. Pre-treatment with simvastatin, pravastatin, and NO-pravastatin suppressed the production of TNFα mRNA induced by LPS. In conclusion, statins probably contribute to the preservation of GBEC function by activation of PPARα and PPARγ, which have anti-inflammatory effects by suppression of pro-inflammatory cytokines, and ABCA1 activation mediated by LXRα, which prevents the accumulation of cholesterol in GBEC.