Integrated plasma cortisol concentration in children with asthma receiving long-term inhaled corticosteroids.

We assessed the effect of long-term therapy with inhaled beclomethasone dipropionate (BDP) on the pituitary-adrenal axis, by measuring the integrated concentration (IC) of plasma cortisol in eight children with asthma (age, 6-16 years) who regularly used inhaled BDP in doses ranging from 8 to 26.5 micrograms/kg (200-450 micrograms/day) for 6 months to 4 years. The control group included six children (age, 6-16 years) who had the IC of plasma cortisol measured as part of an endocrinological evaluation and were found to be healthy. Cortisol concentration was measured in blood samples collected continuously over a 24-hr period. Mean IC of plasma cortisol in the study group was significantly lower than in the healthy controls (mean +/- SD, 4.9 +/- 3.3 vs 9.1 +/- 1.9 micrograms/mL; P less than 0.02). Cortisol response to 0.25 mg ACTH (iv) was abnormal in one of the eight BDP-treated patients. No correlation was found between IC of plasma cortisol and the BDP dose, severity of asthma, height percentile, or the Tanner stage. We conclude that long-term therapy, even with relatively conventional doses of inhaled BDP may cause reduction in the normal physiological secretion of cortisol. The clinical relevance of low IC of plasma cortisol is not clear, but it may reflect partial suppression of the pituitary-adrenal axis.     

292例国人正常胎儿枕额径及双顶径的外测量分析

经对292例正常胎儿枕额径和双顶径的外测量,结果表明,枕额径和双顶径都随着胎龄的增长而增大,但其生长速度则随着胎龄的增长而逐渐减慢。经回归分析原理,分别得出预测方程。枕额径增长的速度和双顶径增长的速度没有明显差异(P>0.05)。     

Metabolic Surgery: Weight Loss,Diabetes, and Beyond

The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity. Moreover, observational data suggest that the reduction in cardiovascular risk factors translates to better patient outcomes. This review describes commonly used metabolic surgical procedures and their current indications and summarizes the evidence related to weight loss and glycemic outcomes. It further examines their potential effects on cardiovascular outcomes and mortality and discusses future perspectives.     

Compliance measurement in respiratory distress syndrome: the prediction of outcome

Dynamic compliance (Cdyn) measurements within the first three days of life predicted survival in 60 preterm infants suffering from respiratory distress syndrome. Cdyn was measured in 47 survivors at 2.3 +/- 1.4 days of life and in 13 nonsurvivors on 2.7 +/- 1.7 days. All nonsurvivors died from respiratory failure within the first two weeks of life. Mean Cdyn of the survivors was 0.83 +/- 0.33 ml/cm H2O and of the nonsurvivors 0.35 +/- 0.19 ml/cm H2O (p less than 0.001). Cdyn values below 0.45 ml/cm H2O predicted 11 of 13 deaths in infants, and Cdyn measurements above this value predicted 45 of 47 survivals, with a specificity of 81% and a sensitivity of 89%. Eleven of the survivors, who subsequently developed bronchopulmonary dysplasia (BPD), had a mean Cdyn of 0.56 +/- 0.23 ml/cm H2O. When these infants were matched with infants of comparable weight without evidence of BPD, the BPD group had a significantly lower Cdyn (p less than 0.05). Cdyn measurements during the first three days of life are useful in predicting outcome of respiratory failure secondary to respiratory distress syndrome.     

支气管肺发育不良患儿气管抽吸物单核细胞检测的临床意义研究

目的观察支气管肺发育不良(BPD)患儿气管抽吸物中单核细胞亚型的变化,借此探讨其与BPD的相关性。方法选取我院2018年1月至2019年6月需要机械通气治疗的呼吸窘迫综合征(RDS)早产儿62例,其中BPD组(氧依赖超过28天)24例,对照组38组。流式细胞仪检测患儿气管抽吸物中单核细胞亚型M1和M2所占的比例,ELISA法检测TNF-α、IL-1和IL-10表达。结果两组早产儿气管抽吸物中单核细胞比例差异无显著性(P>0.05),BPD组M1占7.65±1.28%,显著高于对照组的3.57±0.54%(P<0.01),BPD组M2占3.38±0.44%,显著低于对照组的7.35±1.32%(P<0.01)。BPD组早产儿气管抽吸物中TNF-α和IL-1表达显著高于对照组(P<0.01),BPD组IL-10表达显著高于对照组(P<0.01)。结论BPD患者单核细胞M1亚型比例显著升高,M2亚型比例显著减低。     

LncRNA GM15886在高氧诱导支气管肺发育不良新生小鼠肺组织的表达规律及生物信息学分析

[摘 要] 目的：探讨长链非编码RNA（long non-coding RNA,lncRNA）GM15886在高氧诱导新生小鼠支气管肺发育不良（bronchopulmonary dysplasia,BPD）肺组织中表达水平的变化,并运用生物信息学分析,预测其在BPD模型中的作用机制。方法：在已建立BPD模型小鼠肺组织lncRNA基因芯片中选取并验证GM15886,应用lncRNATargets、Multi Experiment Matrix和Ensemble数据库预测其靶基因;将64只新出生C57BL／6J小鼠随机分为高氧组和空气组,每组各32只;高氧组新生小鼠置于95％高氧环境下,空气组暴露于空气环境下,分别选取生后第0天、3、5、7天处死小鼠取肺组织,HE染色评价肺组织病理变化;采用qPCR检测GM15886、HIPK1 mRNA表达水平;免疫组化检测HIPK1表达情况。结果：lncRNATargets预测GM15886碱基序列能够和HIPK1第二个外显子碱基序列完全结合。qPCR示高氧组第3、5、7天GM15886表达量升高,分别为1.91±0.28、2.12±0.38、2.35±0.43,与第0天相比,差异均具有统计学意义（P均＜0.05）;HIPK1在第3、5、7天相对表达量分别为1.16±0.33、0.92±0.31、3.12±0.46,第7天表达量高于第0、3、5天（P均＜0.05）;HIPK1免疫组化表现与RNA表达的结果相对应。结论：随着高氧暴露时间的延长,肺组织GM15886表达量增加;生信分析和上述实验表明GM15886可能靶向HIPK1参与BPD的发病机制。