Involvement of ERK, p38 and NF-kappaB signal transduction in regulation of TLR2, TLR4 and TLR9 gene expression induced by lipopolysaccharide in mouse dendritic cells

Toll-like receptors (TLR) are sentinel receptors capable of recognizing pathogen-associated molecule patterns (PAMP) such as lipopolysaccharide (LPS) and CpG-containing oligonucleotides (CpG ODN). TLR2 and TLR4 are major receptors for Gram-positive and Gram-negative bacterial cell wall components, respectively. TLR9 is necessary for CpG signalling. LPS or CpG ODN can activate immature dendritic cells (DC) and induce DC maturation characterized by production of cytokines, up-regulation of co-stimulatory molecules, and increased ability to activate T cells. However, little is known regarding the regulation of TLR gene expression in mouse DC. In this study, we investigated the regulation of TLR2, TLR4 and TLR9 gene expression by LPS in murine immature DC. TLR2, TLR4 and TLR9 mRNA were up-regulated following LPS stimulation. The up-regulation of TLR9 expression coincided with significantly increased production of tumour necrosis factor-alpha induced by LPS plus CpG ODN. While inhibition of extracellular signal-related kinase and NF-kappaB activation suppressed the up-regulation of the expression of TLR2, TLR4 and TLR9 mRNA, inhibition of p38 kinase prevented the up-regulation of TLR2 and TLR4 mRNA expression but enhanced the up-regulation of TLR9 expression. These results demonstrated that TLR2, TLR4 and TLR9 gene expression was differently regulated by LPS in mouse immature DC. Up-regulation of TLR2, TLR4 and TLR9 expression by LPS might promote the overall responses of DC to bacteria and help to explain the synergy between LPS and other bacterial products in the induction of cytokine production.     

营养干预对社区几种慢性疾病的效果评价

选取８７名家住成都市有血糖、血压、血脂异常者为研究对象,经过配制食谱、营养教育咨询等干预措施,观察了以下指标的变化：１．空腹血糖和餐后２小时血糖;２．血清胆固醇和甘油三酯;３．血压和体重;４．症状评分。用配对ｔ检验、相关和逐步回归分析对资料进行处理。结果表明,采用营养干预措施１０周以后,以上各项指标均有显著降低。可以认为合理饮食是控制社区这几种慢性病简便有效的措施。     

多媒体教学现状的分析

多媒体教学是在传统教学基础上发展起来的,是传统教学的继承和必要补充。文章分析了目前多媒体教学的现状,并提出了建设性的意见和建议。     

Brevican knockdown reduces late-stage glioma tumor aggressiveness

Growing evidence supports the important role of the tumor microenvironment (TME) in cancer biology. A defining aspect of the glioma TME is the unique composition and structure of its extracellular matrix (ECM), which enables tumor cells to overcome the inhibitory barriers of the adult central nervous system (CNS). In this way, the TME plays a role in glioma invasion and the cellular heterogeneity that distinguishes these tumors. Brain Enriched Hyaluronan Binding (BEHAB)/brevican (B/b), is a CNS-specific ECM constituent and is upregulated in the glioma TME. Previous studies have shown B/b exerts a pro-invasive function, suggesting it may represent a target to reduce glioma pathogenesis. Herein, we also provide evidence that B/b expression is enriched in the glioma initiating cell (GIC) niche. We demonstrate that B/b plays roles in the pathological progression, aggressiveness, and lethality of tumors derived from human GICs and traditional glioma cell lines. Interestingly, we found that B/b is not required to maintain the defining phenotypic properties of GICs and thereby acts primarily in late stages of glioma progression. This study suggests that the increased expression of B/b in the TME is a valuable therapeutic target for glioma.     

The Angiopoietin-like protein 4: a promising biomarker to distinguish brucella spondylitis from tuberculous spondylitis

Clinical Rheumatology - The Angiopoietin-like protein 4 (ANGPTL-4) has been proved to be a protein associated with multiple inflammatory responses. Nevertheless, whether it contributes to...     

腰大肌及侧腹肌相关CT参数评价肝硬化肌少症

目的 观察腰大肌及侧腹肌相关CT参数评价肝硬化肌少症的价值。方法 采集210例临床诊断肝硬化患者腹部CT,获得L3水平骨骼肌总横截面积,计算相应骨骼肌指数（SMI）。根据SMI结果将患者分为肌少症组（n=105）与非肌少症组（n=105）,测量相同层面右侧腰大肌轴径及横径、右侧腹肌厚度,计算腰大肌轴径指数（APMI）、腰大肌横径指数（TPDI）及侧腹肌厚度指数（LWMI）;比较组间差异。以SMI结果为标准,绘制TPDI、APMI及LWMI鉴别肝硬化肌少症的受试者工作特征（ROC）曲线,计算曲线下面积（AUC）,并分析TPDI、APMI及LWMI与SMI的相关性及肌少症的影响因素。结果 组间体质量指数、胆固醇、NRS2002评分、APMI、TPDI和LWMI差异均有统计学意义（P均<0.05）。TPDI（r=0.71）、APMI（r=0.59）和LWMI（r=0.61）均与SMI呈正相关（P均<0.01）。APMI、TPDI及LWMI鉴别肝硬化肌少症的AUC分别为0.61、0.71及0.72（P均<0.05）。男性、三酰甘油为肌少症的危险因素,TPDI、LWMI为肌少症的保护因素（P均<0.05）。结论 腰大肌及侧腹肌相关CT参数可用于评估肝硬化肌少症,并有望成为临床评估肌少症的新方法。     

减重代谢术后患者饮食体验的系统评价

目的 系统评价肥胖症患者减重代谢术后的饮食体验的研究,全面了解其存在的饮食问题与管理需求,为更好地开展临床医疗工作提供依据。 方法 计算机检索Cochrane Library、乔安娜布里格斯研究所循证卫生保健中心数据库、PubMed、Embase、Web of Science、CINAHL、PsycINFO、中国知网、万方数据库、中国生物医学文献数据库。搜集有关肥胖症患者减重代谢术后饮食体验的质性研究,检索年限为建库至2021年1月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法进行结果整合。 结果 共纳入18项研究,提炼39个结果,归纳为7个类别,综合为4个整合结果。①减重代谢术后患者进食状态的变化:饮食方式的变化、饮食管理阶段的变化;②减重代谢术后积极的进食策略;③减重代谢术后消极的进食体验和不良饮食行为:消极的进食体验、不良饮食行为及原因;④减重代谢术后患者寻求多方面的饮食管理支持:医护人员的饮食管理支持、家人和朋友的饮食管理支持、社会组织的饮食管理支持。 结论 医护人员应重视患者在减重代谢术后已出现的或可能会出现的饮食问题,根据相关原因,有针对性的提供支持与帮助以应对术后饮食挑战,指导患者建立正确的饮食行为,实现并维持最佳的减重效果,提高生活质量。     

上海市社区医务人员循证慢性病防控证据获取能力自我认知实证研究

背景　目前慢性病防控形势依然严峻,提升社区医务人员慢性病防控能力迫在眉睫。循证慢性病防控作为一种提升医务人员慢性病防控能力的手段在西方国家已取得了一定成效,但在我国却鲜有研究。目的　探讨社区医务人员慢性病防控证据的获取途径、能力及影响因素,为提升社区医务人员循证慢性病防控能力提供理论依据。方法　于2019年4-7月,采用分层抽样的方法,以上海市75家社区卫生服务机构的975例医务人员为研究对象,对其进行问卷调查。问卷内容包括个人基本信息、循证基本认知情况、慢性病防控证据获取途径、慢性病防控证据获取能力。慢性病防控证据获取途径和慢性病防控证据获取能力由被调查者依据Likert 7级评分自评。采用多元线性逐步回归分析社区医务人员循证慢性病防控证据获取能力的影响因素。结果　892例（91.5%）社区医务人员的问卷被有效回收。临床指南为被调查医务人员获取慢性病防控证据的最常用途径,自评得分为（4.583±1.177）分。被调查对象自评获得的循证慢性病防控证据精准有效平均得分为（4.312±0.979）分,能获取针对慢性病危险因素的证据平均得分为（4.244±1.028）分,能应用针对慢性病危险因素的证据平均得分为（4.280±0.995）分。多元线性逐步回归分析结果显示,单位是否为大学附属是社区医务人员获得的循证慢性病防控证据精准有效、能获取针对慢性病危险因素的证据、能应用针对慢性病危险因素的证据的影响因素（P<0.05）。结论　所在社区卫生服务机构是否为大学附属是社区医务人员循证慢性病防控证据获取能力的主要影响因素,社区应重视慢性病防控证据获取途径的提供,并加强对医务人员慢性病防控证据获取及利用能力的培养。