急性脑血管病辨证分型与血浆胃动素关系研究

目的探讨急性脑血管病中医辨证分型与血浆胃动素的关系.方法将350例急性脑血管病患者辨证分为痰热腑实、风痰火亢、风痰瘀阻、风火上扰、痰湿蒙神、气虚血瘀、阴虚风动型7个证型,每个证型各5 0例,另设健康对照组50例,观察组与对照组均在入院后翌日、排便后翌日、病程第7天和第14天清晨空腹平卧采肘静脉血测定血浆胃动素.最后运用华西医科大学卫生统计学教研室提供的Pems软件包进行统计学处理.结果急性脑血管病患者血浆MTL水平显著高于正常人.其中以痰热腑实型、风痰瘀阻型、痰湿蒙神型、气虚血瘀型的空腹血浆胃动素水平较正常对照组显著升高,差异有非常显著性(P＜0.01).其中急性出血性脑血管病(ICH)的其余各证型差异亦有非常显著性(P＜0.01),急性缺血性脑血管病(CI)的风火上扰、阴虚风动型差异有显著性(P＜0.05).结论急性脑血管病中医辨证分型与血浆胃动素浓度有相关性.为临床辨病与辨证相结合,指导临床合理应用通腑药提供了一个客观指标.     

Combination effect of ribavirin and erythropoietin treatment on hemoglobin A1c in a diabetic patient with chronic hepatitis C

Any condition that shortens erythrocyte lifespan or decreases mean erythrocyte age may falsely lower hemoglobin A1c (A1C) test results. Ribavirin (RBV) used for chronic hepatitis C virus (HCV) infection can cause reversible hemolytic anemia; erythropoietin (EPO) used for treatment-related anemia can stimulate the production of red blood cells. We reported a 55-year-old woman with diabetes who received peginterferon alfa plus RBV for HCV infection. Four weeks following HCV therapy, her Hb level declined from 13.3 g/dL to 11.3 g/dL with elevated lactate dehydrogenase and reduced haptoglobin, which confirmed hemolysis. As her Hb fell to a nadir of 8.5 g/dL at the eighth week, darbepoetin alfa was administered to treat anemia consecutively for 10 weeks. Two months later, the patient's A1C declined from 7.5% to an extremely low value of 4.0%, accompanied by a fasting glucose level of 116 mg/dL. During the preceding 3 months, there was no self-reported hypoglycemia or documented low blood glucose. About 3 months after HCV therapy was terminated, the A1C returned to 6.1% without medication adjustment. The concurrent use of RBV and EPO treatments can synergistically cause falsely low A1C values and may lead to inappropriate relaxation of glycemic control. During HCV treatment with RBV, A1C should not be used alone to guide diabetes therapy.     

Response to pretransplant hypomethylating agents influences the outcome of allogeneic hematopoietic stem cell transplantation in adults with myelodysplastic syndromes

This study describes a retrospective analysis on the transplant outcome of 56 consecutive patients with myelodysplastic syndrome (MDS) according to their response to hypomethylating agents (HMA). While 2‐yr disease‐free survival (DFS) of patients who transformed to acute myeloid leukemia (n = 12) was 25%, that of the remaining patients with MDS according to response to HMA was 73.1%, 68.1%, 50.0%, and 20.8% in G‐COR (group of continuous response, n = 19), G‐NoC (group of no change, n = 15), G‐LOR (group of loss of response, n = 6), and G‐DP (group of disease progression, n = 4), respectively. When dichotomized as G‐COR/G‐NoC versus G‐LOR/G‐DP, significantly different 2‐yr DFS (71.0% vs. 33.3%; P = 0.004) and relapse (14.1% vs. 46.7%; P = 0.016) were demonstrated. On multivariate analysis, G‐LOR/G‐DP [hazard ratio (HR), 3.91; P = 0.008] and poor karyotype at transplantation (HR, 2.69; P = 0.017) were the significant predictors for poor DFS, as G‐LOR/G‐DP was for relapse (HR, 6.28; P = 0.011). DFS was significantly poor in patients with any of the two predictors in all MDS (81.5% vs. 34.9%; P = 0.001) or higher‐risk MDS (HrMDS) at the time of HMA (80.7% vs. 29.2%; P = 0.005). G‐COR showed a trend of better DFS compared with G‐NoC among HrMDS (74.6% vs. 36.5%; P = 0.090). These results implicate the significance of response to HMA on hematopoietic stem cell transplantation (HSCT) outcomes and support the need for future study to verify the suggested strategy of proceeding to transplantation before LOR or DP, especially for HrMDS.     

Coexistent light chain deposition disease,light chain cast nephropathy,and vascular light chain amyloidosis in a patient with IgD lambda multiple myeloma

International Urology and Nephrology -     

Compensated active noise cancellation earphone for audiometric screening tests in noisy environments

Abstract

Objective: This study investigated hearing screening tests by using a custom-designed compensated hybrid active noise cancellation (ANC) earphone and compared it with TDH39 and Audiocups audiometric earphones under conditions of quiet, 45?dB HL masking narrowband, wideband speech-shaped, and white noise.

Design: The hearing screening tests were conducted to characterise the shifts of screening results under noisy conditions, and real-ear attenuations at thresholds were assessed to quantify real-ear noise reduction performance.

Study sample: Twenty-four normal-hearing adults, aged 20–25?years, participated in this study.

Results: The ANC earphone exhibited significantly lower/better mean screening results than those of the TDH39 earphone at 250 and 500?Hz and those of the Audiocups earphone at 250?Hz under conditions of narrowband, speech-shaped, and white noise. Compared with the TDH39 earphone at 250 and 500?Hz, applying a hybrid ANC earphone reduced the shifts in screening results by 14.2 and 12.3?dB, respectively, under the narrowband noise condition.

Conclusion: This study demonstrated that the compensated hybrid ANC earphone provided lower shifts of screening results than the TDH39 and Audiocups earphones and that it was capable of screening at 250 and 500?Hz from 20?dB HL under 45?dB HL masking narrowband and wideband noise.     

Melatonin overcomes apoptosis resistance in human hepatocellular carcinoma by targeting Survivin and XIAP

Apoptosis resistance in hepatocellular carcinoma (HCC) is one of the most significant factors for hepatocarcinogenesis and tumor progression, and leads to resistance to conventional chemotherapy. It is well known that inhibitor of apoptosis proteins (IAPs) play key roles in apoptosis resistance, it has become an important target for antitumor therapy. In this study, we examined if melatonin, the main secretory product of the pineal gland, targeted IAPs, leading to the inhibition of apoptosis resistance. To accomplish this, we first observed that four members of IAPs (cIAP‐1, cIAP‐2, Survivin, and XIAP) were overexpressed in human HCC tissue. Interestingly, melatonin significantly inhibited the growth of HepG2 and SMMC‐7721 cells and promoted apoptosis along with the downregulation of Survivin and XIAP, but had no effect on the expression of cIAP‐1 and cIAP‐2. These data suggest that the inhibition of Survivin and XIAP by melatonin may play an important part in reversing apoptosis resistance. Notably, cIAP‐1, Survivin and XIAP were significantly associated with the coexpression of COX‐2 in human HCC specimens. Melatonin also reduced the expression of COX‐2 and inhibited AKT activation in HepG2 and SMMC‐7721 cells. Inhibition of COX‐2 activity with the selective inhibitor, NS398, and inhibition of AKT activation using the PI3K inhibitor, LY294002, in tumor cells confirmed that melatonin‐induced apoptosis was COX‐2/PI3K/AKT‐dependent, suggesting that the COX‐2/PI3K/AKT pathway plays a role in melatonin inhibition of IAPs. Taken together, these results suggest that melatonin overcomes apoptosis resistance by the suppressing Survivin and XIAP via the COX‐2/PI3K/AKT pathway in HCC cells.