• 【月经周期和食欲控制:对体重调节的影响。】 复制标题 收藏 收藏
    DOI:10.1093/humrep/12.6.1142 复制DOI
    作者列表:Dye L,Blundell JE
    BACKGROUND & AIMS: Hormonal fluctuations associated with the menstrual cycle influence appetite control and eating behaviour. Energy intake varies during the reproductive cycle in humans and animals, with a periovulatory nadir and a luteal phase peak. Patterns of macronutrient selection show less consistency but a number of studies report carbohydrate cravings in the premenstrual phase, particularly in women with premenstrual syndrome. The cyclical nature of food cravings are frequently, but not invariably, associated with depression. Fluctuations in appetite, cravings and energy intake during the menstrual cycle may occur in parallel with cyclical rhythms in serotonin, which can be accompanied by affective symptoms. The premenstrual phase can be considered as a time when women are especially vulnerable to overconsumption, food craving and depression; this is often associated with low serotonin activity.

    背景与目标: 与月经周期有关的荷尔蒙波动会影响食欲控制和饮食行为。在人类和动物的生殖周期中,能量的摄入量会有所不同,排卵期的最低点和黄体期相峰值。大量营养素选择的模式显示出较低的一致性,但是许多研究报告说在经前期对碳水化合物的渴望,特别是在经前期综合症的女性中。渴望食物的周期性通常与抑郁症有关,但并非总是如此。月经周期中食欲,食欲和能量摄入的波动可能与5-羟色胺的周期性节律同时发生,并伴有情感症状。经期可以被认为是妇女特别容易遭受过度消费,食物渴望和沮丧的时期。这通常与5-羟色胺活性低有关。

  • 【恒河猴从出生到成年的肺泡数量增加,但大小没有增加。】 复制标题 收藏 收藏
    DOI:10.1152/ajplung.00467.2006 复制DOI
    作者列表:Hyde DM,Blozis SA,Avdalovic MV,Putney LF,Dettorre R,Quesenberry NJ,Singh P,Tyler NK
    BACKGROUND & AIMS: :Postnatal developmental stages of lung parenchyma in rhesus monkeys is about one-third that of humans. Alveoli in humans are reported to be formed up to 8 yr of age. We used design-based stereological methods to estimate the number of alveoli (N(alv)) in male and female rhesus monkeys over the first 7 yr of life. Twenty-six rhesus monkeys (13 males ranging in age from 4 to 1,920 days and lung volumes from 41.7 to 602 cm(3), 13 females ranging in age from 22 to 2,675 days and lung volumes from 43.5 to 380 cm(3)) were necropsied and lungs fixed, isotropically oriented, fractionated, sampled, embedded, and sectioned for alveolar counting. Parenchymal, alveolar, alveolar duct core air, and interalveolar septal tissue volumes increased rapidly during the first 2 yr with slowed growth from 2 to 7 yr. The rate of change was greater in males than females. N(alv) also showed consistent growth throughout the study, with increases in N(alv) best predicted by increases in lung volume. However, mean alveolar volume showed little relationship with age, lung volume, or body weight but was larger in females and showed a greater size distribution than in males. Alveoli increase in number but not volume throughout postnatal development in rhesus monkeys.
    背景与目标: :恒河猴的肺实质的产后发育阶段约为人类的三分之一。据报道,人类肺泡的形成年龄高达8岁。我们使用基于设计的立体方法来估计生命的前7年中雄性和雌性恒河猴的肺泡(N(alv))数量。 26只猕猴(13只雄性,年龄从4到1,920天不等,肺活量从41.7到602 cm(3),13只雌性,年龄从22到2,675天不等,肺活量从43.5到380 cm(3))进行尸检并固定肺,各向同性,分馏,取样,包埋和切片,以进行肺泡计数。在最初的2年中,实质,肺泡,肺泡导管核心空气和肺泡间隔组织的体积迅速增加,而从2到7年的生长缓慢。男性的变化率大于女性。在整个研究过程中,N(alv)也显示出一致的增长,其中N(alv)的增加最好通过肺体积的增加来预测。但是,平均肺泡容量与年龄,肺活量或体重关系不大,但女性比男性更大,并且大小分布比男性更大。在猕猴的整个产后发育过程中,肺泡的数量增加,但体积没有增加。
  • 【体育活动在产生和维持体重减轻中的作用。】 复制标题 收藏 收藏
    DOI:10.1038/ncpendmet0554 复制DOI
    作者列表:Catenacci VA,Wyatt HR
    BACKGROUND & AIMS: :The majority of randomized, controlled trials (RCTs) show only modest weight loss with exercise intervention alone, and slight increases in weight loss when exercise intervention is added to dietary restriction. In most RCTs, the energy deficit produced by the prescribed exercise is far smaller than that usually produced by dietary restriction. In prospective studies that prescribed high levels of exercise, enrolled individuals achieved substantially greater weight loss-comparable to that obtained after similar energy deficits were produced by caloric restriction. High levels of exercise might, however, be difficult for overweight or obese adults to achieve and sustain. RCTs examining exercise and its effect on weight-loss maintenance demonstrated mixed results; however, weight maintenance interventions were usually of limited duration and long-term adherence to exercise was problematic. Epidemiologic, cross-sectional, and prospective correlation studies suggest an essential role for physical activity in weight-loss maintenance, and post hoc analysis of prospective trials shows a clear dose-response relationship between physical activity and weight maintenance. This article reviews the role of physical activity in producing and maintaining weight loss. We focus on prospective, RCTs lasting at least 4 months; however, other prospective trials, meta-analyses and large systematic reviews are included. Limitations in the current body of literature are discussed.
    背景与目标: :大多数随机,对照试验(RCT)仅通过运动干预仅显示适度的体重减轻,而将运动干预与饮食限制相结合时,体重减轻则略有增加。在大多数随机对照试验中,通过处方运动产生的能量缺乏症远小于通常通过饮食限制产生的能量缺乏症。在规定进行高水平运动的前瞻性研究中,与通过热量限制产生类似能量不足所导致的体重减轻相比,已入组个体的体重减轻显着更大。但是,对于超重或肥胖的成年人来说,高强度的运动可能难以实现和维持。研究运动及其对减肥维持的影响的随机对照试验结果不一。然而,维持体重的干预措施通常持续时间有限,长期坚持锻炼存在问题。流行病学,横断面和前瞻性相关研究表明,体育锻炼对维持体重减轻至关重要,而对前瞻性试验的事后分析表明,体育锻炼与维持体重之间存在明显的剂量反应关系。本文回顾了体育锻炼在产生和维持体重减轻中的作用。我们专注于持续至少4个月的预期RCT;但是,还包括其他前瞻性试验,荟萃分析和大型系统评价。讨论了当前文献的局限性。
  • 【神经性厌食症和情感障碍的大脑葡萄糖代谢:体重减轻或抑郁症状的影响。】 复制标题 收藏 收藏
    DOI:10.1016/s0925-4927(97)02971-5 复制DOI
    作者列表:Delvenne V,Goldman S,De Maertelaer V,Wikler D,Damhaut P,Lotstra F
    BACKGROUND & AIMS: :Relationships between eating and affective disorders remain complex and unclear. Brain glucose metabolism of anorectic patients has been demonstrated to be reduced both globally and regionally, with a particular relative hypometabolism in the parietal cortex. To explore the possible influence of weight loss or depressive symptomatology on brain metabolism, we studied age- and sex-matched low-weight anorectic and depressed patients, normal-weight depressed patients, and healthy volunteers. Absolute global and regional glucose activity levels were reduced in low-weight patients, with the lowest values being found for anorectic patients. In relative values, anorectic patients showed a significant parietal hypometabolism in comparison to control subjects while they had higher metabolism in the caudate nuclei when compared with the other groups. Absolute hypometabolism of glucose seems to be a consequence of low weight as it was found in both low-weight anorectic and low-weight depressive patients. In addition, absolute glucose values were significantly correlated with body mass index in all subjects. Future positron emission tomographic studies in psychiatric patients should control for alimentary parameters.
    背景与目标: 饮食和情感障碍之间的关系仍然复杂且不清楚。厌食症患者的脑葡萄糖代谢已被证实在全球和区域范围内均会降低,顶叶皮层中存在特定的相对代谢不足。为了探索减肥或抑郁症状对脑代谢的可能影响,我们研究了年龄和性别相匹配的低体重厌食症和抑郁症患者,正常体重的抑郁症患者以及健康志愿者。低体重患者的全球和区域绝对葡萄糖活性水平降低,而厌食患者的葡萄糖水平最低。在相对价值方面,与对照组相比,厌食患者的顶叶代谢明显降低,而尾核中的新陈代谢较其他组更高。葡萄糖的绝对低代谢似乎是低体重的结果,因为它在低体重厌食症患者和低体重抑郁症患者中均被发现。另外,在所有受试者中,绝对葡萄糖值与体重指数显着相关。未来精神病患者的正电子发射断层扫描研究应控制饮食参数。
  • 【极低体重婴儿的PBSC采集:单中心体验。】 复制标题 收藏 收藏
    DOI:10.1080/14653240701320270 复制DOI
    作者列表:Sevilla J,Plaza SF,González-Vicent M,Lassaletta A,Ramírez M,Madero L,Díaz MA
    BACKGROUND & AIMS: BACKGROUND:Peripheral blood progenitor cell (PBPC) collection has become the main source of hematopoietic cells for high-dose chemotherapy with stem cell rescue and, in some protocols, for allogeneic hematopoietic transplantation. This procedure is complicated in the smallest children because of difficulties related to their weight, and there is little published experience. We have conducted a prospective study to analyze the incidence of adverse events during PBPC collection in the smallest children (< or = 10 kg). METHODS:From January 2000 to November 2005, 257 leukapheresis were performed in our unit, and 13 of them (5%) in 12 children weighing up to 10 kg (median 9 kg, range 5.8-10.9 kg). RESULTS:Most cases had hypovolemic signs during the procedure (usually tachycardia); six cases had hypotension, five of them with pallor and diaphoresis, and, of those, two also had nausea. In all these cases infusion of saline or plasma volume expanders resolved the clinical findings. In two cases the nausea related to hypocalcemia was resolved after calcium gluconate infusion. Changes in platelet counts were also remarkable, with a median platelet loss of 52%. DISCUSSION:Leukapheresis with continuous-flow cell separators has frequent complications related to volume shift in the smallest children. These adverse events are mild and easily resolved with standard measures for hypovolemia, as plasma expander or normal saline infusions. However, we recommend that the procedure should only be performed by teams with extensive experience in the field.
    背景与目标: 背景:外周血祖细胞(PBPC)收集已成为大剂量化疗,干细胞抢救以及同种异体造血移植中造血细胞的主要来源。对于最小的儿童,由于与体重有关的困难,此过程很复杂,并且几乎没有公开的经验。我们进行了一项前瞻性研究,以分析最小的儿童(<或= 10 kg)在PBPC采集过程中不良事件的发生率。
    方法:从2000年1月至2005年11月,我们单位进行了257例白细胞分离术,其中12例体重不超过10千克(中位数9千克,范围5.8-10.9千克)的儿童中有13例(5%)。
    结果:大多数病例在手术过程中出现低血容量征(通常是心动过速);有6例患有低血压,其中5例患有苍白和发汗,其中2例也有恶心。在所有这些情况下,输注生理盐水或血浆扩容器均可解决临床发现。在两种情况下,葡萄糖酸钙输注后可解决与低钙血症有关的恶心。血小板计数的变化也很显着,中位血小板损失为52%。
    讨论:采用连续流动细胞分离器进行白细胞分离术经常导致最小的儿童发生与体积变化有关的并发症。这些不良事件是轻度的,并且可以通过标准的血容量减少措施轻松解决,例如血浆扩容剂或生理盐水输注。但是,我们建议该程序仅应由在该领域具有丰富经验的团队执行。
  • 【出生时脑膜脊髓腔积液和高腰截瘫的婴儿的预后。道德工作组的评论。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:
    BACKGROUND & AIMS: :The findings presented in an accompanying paper by Menzies, Parkin, and Hey regarding the survival rates and quality of life of babies with severe spina bifida (Lancet 1985 Nov 2; 2(8462): 993-995) prompt the Working Group to reevaluate the ethical guidelines supporting selective treatment proposed in their 1975 report, "Ethics of Selective Treatment of Spina Bifida" (Lancet 1975 Jan 11; 1(7898): 85-88). Although Menzies, et al., report that survival rates are higher than previously expected and that in most cases the children's and parents' lives appear not to be excessively burdensome, the Working Group contends that there "continues to be ethical justification for selective treatment" of such newborns. Since medical, psychological, and social considerations now seem to be "more complex and less clearcut," the Group emphasizes that judgments regarding treatment should be made on a case-by-case basis.
    背景与目标: :孟席斯(Menzies),帕金(Parkin)和黑伊(Hey)随附的论文中有关严重脊柱裂的婴儿的存活率和生活质量的研究结果(《柳叶刀》 1985年11月2日; 2(8462):993-995)促使工作组重新评估支持选择性治疗的道德准则在其1975年的报告“脊柱裂的选择性治疗伦理”中提出(柳叶刀1975年1月11日; 1(7898):85-88)。尽管孟席斯等人报告说,存活率比以前预期的要高,而且在大多数情况下,儿童和父母的生活似乎并不过分负担,但工作组认为,“继续有道德地为选择治疗提供理由”这样的新生儿。由于现在医学,心理和社会方面的考虑似乎“更加复杂且不那么明确”,专家组强调有关治疗的判断应视具体情况而定。
  • 【改变生活方式和行为疗法可有效减轻肥胖的非糖尿病精神分裂症患者的体重,并增加其血清脑源性神经营养因子的水平。】 复制标题 收藏 收藏
    DOI:10.1016/j.psychres.2012.11.020 复制DOI
    作者列表:Kuo FC,Lee CH,Hsieh CH,Kuo P,Chen YC,Hung YJ
    BACKGROUND & AIMS: :The goal of the study was to elucidate the relationship between serum circulating brain-derived neurotrophic factor (BDNF) and body weight reduction via lifestyle modification and behavior therapy in obese non-diabetic patients with chronic schizophrenia. Thirty-three obese non-diabetic subjects with schizophrenia treated with stable antipsychotic medication in a day-care unit for at least 3 months were recruited. Thirty age-, body weight-matched subjects without psychiatric disorders were enrolled as controls. All participants underwent a 10-week weight reduction program, including lifestyle modification, psychosocial treatment, behavior therapy and exercise in the day-care unit. Blood biochemistry, serum BDNF, adipokine (adiponectin), inflammatory markers (C-reactive protein, tumor necrosis factor-alpha and interleukin-6) and oral glucose tolerance test were evaluated before and after the program. Serum BDNF concentrations were significantly lower among patients with schizophrenia compared to control subjects. Serum BDNF levels were significantly increased following the weight reduction program. Elevations in serum BDNF levels were positively correlated with body weight and body mass index reduction. Altogether, our results demonstrate that a non-pharmacological weight reduction program effectively reduces body weight with significant elevation of serum BDNF levels in obese non-diabetic patients with schizophrenia.
    背景与目标: :该研究的目的是阐明肥胖非糖尿病慢性精神分裂症患者的血清循环脑源性神经营养因子(BDNF)与通过生活方式改变和行为疗法减轻体重之间的关系。招募了33例在日托室中接受稳定抗精神病药物治疗,至少3个月的精神分裂症肥胖非糖尿病患者。纳入30名年龄,体重匹配且无精神疾病的受试者作为对照。所有参与者都接受了为期10周的减肥计划,包括在日间护理室进行的生活方式改变,心理社会治疗,行为疗法和锻炼。在该计划之前和之后,评估了血液生化,血清BDNF,脂肪因子(脂联素),炎性标志物(C反应蛋白,肿瘤坏死因子-α和白介素6)以及口服葡萄糖耐量测试。与对照组相比,精神分裂症患者的血清BDNF浓度显着降低。减重计划后,血清BDNF水平显着增加。血清BDNF水平升高与体重和体重指数降低呈正相关。总而言之,我们的结果表明,在肥胖的非糖尿病精神分裂症患者中,非药物减肥计划可以有效减轻体重,同时血清BDNF水平显着升高。
  • 【Karyomapping:单一中心从应用方法学到持续妊娠和活产率的经验。】 复制标题 收藏 收藏
    DOI:10.1016/j.rbmo.2017.06.004 复制DOI
    作者列表:Ben-Nagi J,Wells D,Doye K,Loutradi K,Exeter H,Drew E,Alfarawati S,Naja R,Serhal P
    BACKGROUND & AIMS: :This study aimed to determine whether karyomapping can be applied to couples requiring preimplantation genetic diagnosis (PGD) for single gene disorder (SGD) and/or chromosomal rearrangement. 75/82 (91.5%) and 6/82 (7.3%) couples were referred for autosomal SGD and X-linked disease, respectively. One couple (1.2%) was referred for SGD and chromosomal rearrangement. Of 608 embryos, 146 (24%, 95% CI 21-28) day-3 and 462 (76%, 95% CI 72-79) blastocyst biopsies were performed. A total of 81 embryo transfers were performed; 16/81 (20%) were following day-3 embryo biopsy, 65/81 (80%) were following blastocyst biopsy and cryopreserved embryo transfer. Of 81 embryo transfers with known pregnancy outcome, 51 (63%, 95% CI 52-73) were on-going pregnancies, 6/81 (7%, 95% CI 3-15) resulted in first trimester miscarriages and 24/81 (30%, 95% CI 21-40) were failed implantations. Of the 51 on-going pregnancies, 15 (29%, 95% CI 19-43) couples had a singleton live birth at the time of write up. There have been no reports of abnormal prenatal, genetic testing or diagnosis of phenotype at birth. Karyomapping is reliable, efficient and accurate for couples requiring PGD for SGD and/or chromosomal rearrangement. Additionally, it provides aneuploidy screening, minimising risks of miscarriage and implantation failure.
    背景与目标: :这项研究的目的是确定是否可以对需要单基因疾病(SGD)和/或染色体重排的需要植入前遗传学诊断(PGD)的夫妇进行核对。 75/82(91.5%)和6/82(7.3%)对夫妇因常染色体SGD和X连锁疾病而被转介。 SGD和染色体重排涉及一对夫妇(1.2%)。在608个胚胎中,第3天进行了146次(24%,95%CI 21-28)CI和462(76%,95%CI 72-79)胚泡活检。总共进行了81次胚胎移植。第3天胚胎活检后为16/81(20%),胚泡活检和冷冻保存的胚胎移植后为65/81(80%)。在有已知妊娠结局的81个胚胎移植中,有51个(63%,95%CI 52-73)正在进行妊娠,6/81(7%,95%CI 3-15)导致早孕流产和24/81 (30%,95%CI 21-40)植入失败。在进行的51次怀孕中,有15对(29%,95%CI 19-43)的夫妇在撰写本文时有单胎活产。没有关于出生前的异常产前,基因检测或表型诊断的报道。对于需要PGD进行SGD和/或染色体重排的夫妇,核定图是可靠,高效和准确的。此外,它还提供了非整倍性筛选,从而最大程度地减少了流产和植入失败的风险。
  • 【社区居民中老年人的脑白质信息完整性和认知能力:Lothian Birth Cohort,1936年。】 复制标题 收藏 收藏
    DOI:10.1037/a0033354 复制DOI
    作者列表:Booth T,Bastin ME,Penke L,Maniega SM,Murray C,Royle NA,Gow AJ,Corley J,Henderson RD,Hernández Mdel C,Starr JM,Wardlaw JM,Deary IJ
    BACKGROUND & AIMS: OBJECTIVE:The present study investigates associations between brain white matter tract integrity and cognitive abilities in community-dwelling older people (N = 655). We explored two potential confounds of white matter tract-cognition associations in later life: (a) whether the associations between tracts and specific cognitive abilities are accounted for by general cognitive ability (g); and (b) how the presence of atrophy and white matter lesions affect these associations. METHOD:Tract integrity was determined using quantitative diffusion magnetic resonance imaging tractography (tract-averaged fractional anisotropy [FA]). Using confirmatory factor analysis, we compared first-order and bifactor models to investigate whether specific tract-ability associations were accounted for by g. RESULTS:Significant associations were found between g and FA in bilateral anterior thalamic radiations (r range: .16-.18, p < .01), uncinate (r range: .19-.26, p < .001), arcuate fasciculi (r range: .11-.12, p < .05), and the splenium of corpus callosum (r = .14, p < .01). After controlling for g within the bifactor model, some significant specific cognitive domain associations remained. Results also suggest that the primary effects of controlling for whole brain integrity were on g associations, not specific abilities. CONCLUSION:Results suggest that g accounts for most of, but not all, the tract-cognition associations in the current data. When controlling for age-related overall brain structural changes, only minor attenuations of the tract-cognition associations were found, and these were primarily with g. In totality, the results highlight the importance of controlling for g when investigating associations between specific cognitive abilities and neuropsychology variables.
    背景与目标: 目的:本研究调查了居住在社区的老年人(N = 655)中脑白质束完整性与认知能力之间的关系。我们探讨了晚年白质物质与认知的关联的两个潜在的混淆:(a)物质与特定认知能力之间的关联是否由一般认知能力(g)解释; (b)萎缩和白质病变的存在如何影响这些关联。
    方法:使用定量扩散磁共振成像体层摄影术(区域平均分数各向异性[FA])确定道的完整性。使用验证性因素分析,我们比较了一阶和双因素模型,以调查特定的道能力关联是否由g解释。
    结果:在双侧丘脑前部辐射中,g和FA之间存在显着相关性(r范围:.16-.18,p <.01),单核(r范围:.19-.26,p <.001),弓状筋膜(r范围:.11-.12,p <.05)和call体脾(r = .14,p <.01)。在双因素模型中控制g之后,仍然存在一些重要的特定认知域关联。结果还表明,控制全脑完整性的主要作用是对g的联想,而不是特定的能力。
    结论:结果表明,g占了当前数据中大部分但并非全部的道认知关联。当控制与年龄相关的整体大脑结构变化时,仅发现了道认知关联的轻微衰减,而这些衰减主要与g有关。总体而言,这些结果凸显了在调查特定认知能力与神经心理学变量之间的关联时,控制g的重要性。
  • 【有氧运动与腹腔镜可调式胃绑带术后体重减轻有关。】 复制标题 收藏 收藏
    DOI:10.1007/s11695-012-0826-6 复制DOI
    作者列表:Shada AL,Hallowell PT,Schirmer BD,Smith PW
    BACKGROUND & AIMS: BACKGROUND:Laparoscopic adjustable gastric banding (LAGB) is a common surgical treatment for obesity. Evidence for and against the association of aerobic exercise (AE) and weight loss after LAGB exists. We hypothesize that aerobic exercise is associated with improved weight loss and resolution of comorbidities after LAGB. METHODS:A review of a prospectively collected database identified patients who underwent LAGB over a 3-year period at a single institution. Body mass index (BMI), comorbidities, frequency, and duration of exercise were collected preoperatively and at 6, 12, 24, and 36 months postoperatively. Excess weight loss (EWL) was calculated. Groups were analyzed using Fisher's exact test and ANOVA. RESULTS:Of the 145 LAGB patients, 120 had adequate data for analysis. AE had no association with weight loss at 6 months. At 12, 24, and 36 months following LAGB, patients who reported 150 min or more per week of exercise had an EWL of 35.5, 47.3, and 54.1 %, respectively, while those reporting 0-59 min per week of AE had an EWL of 25.3, 32.1, and 33.0 % (p = 0.03, 0.03, and 0.02, respectively). BMI and age was not statistically different among groups. Diabetes and obstructive sleep apnea were significantly improved in patients exercising at least 60 min per week as compared to those exercising 0-59 min. CONCLUSIONS:AE is significantly associated with weight loss and comorbidity resolution after LAGB. We propose that patients who perform more AE will have higher levels of EWL.
    背景与目标: 背景:腹腔镜可调胃绑带术(LAGB)是肥胖的一种常见手术治疗方法。有证据支持和反对有氧运动(AE)与LAGB术后体重减轻之间的关系。我们假设有氧运动与LAGB术后体重减轻和合并症的缓解相关。
    方法:对前瞻性收集的数据库进行的审查确定了在单一机构接受了3年以上LAGB治疗的患者。术前以及术后6、12、24和36个月收集体重指数(BMI),合并症,运动频率和运动时间。计算了多余的体重减轻(EWL)。使用费舍尔精确检验和方差分析对各组进行分析。
    结果:在145名LAGB患者中,有120名具有足够的数据用于分析。 AE在6个月时与体重减轻无关。 LAGB后12、24和36个月,报告每周运动150分钟或以上的患者的EWL分别为35.5%,47.3和54.1%,而报告每周运动0-59分钟的患者的EWL分别为分别为25.3%,32.1%和33.0%(p分别为0.03、0.03和0.02)。各组之间的BMI和年龄在统计学上没有差异。与每周运动0-59分钟的患者相比,每周至少运动60分钟的患者的糖尿病和阻塞性睡眠呼吸暂停明显改善。
    结论:AE与LAGB后的体重减轻和合并症的缓解密切相关。我们建议执行更多AE的患者应具有更高的EWL水平。
  • 【回顾透析间体重增加和死亡率与血清白蛋白相互作用的关系:日本透析结果和实践模式研究。】 复制标题 收藏 收藏
    DOI:10.1053/j.jrn.2017.05.003 复制DOI
    作者列表:Kurita N,Hayashino Y,Yamazaki S,Akizawa T,Akiba T,Saito A,Fukuhara S
    BACKGROUND & AIMS: BACKGROUND:The dialysis practice guideline in Japan sets a limit on the allowed interdialytic weight gain (IDWG) <6%. However, the effects of relative gain of fluid volume to body weight may differ in presence of morbid conditions. Here, we examined whether or not the associations between IDWG and mortality differ by serum albumin (sAlb), a nutritional and illness marker. DESIGN:The study type used was prospective cohort study. SUBJECTS:Patients who participated in the Japan Dialysis Outcomes and Practice Pattern Study (phase 1-4 [1999-2011]) and received thrice-weekly hemodialysis. METHODS:IDWG was the exposure of interest and was collected every 4 months, divided into 7 categories as follows: <2%, 2% to 3%, 3% to 4% (reference), 4% to 5%, 5% to 6%, 6% to 7%, and >7%. sAlb was treated as both an effect modifier and confounder and dichotomized into ≥3.8 g/dL and <3.8 g/dL segments, according to the protein-energy wasting criteria proposed by the International Society of Renal Nutrition and Metabolism. MAIN OUTCOME MEASURE:The outcome in this study was all-cause mortality. RESULTS:A total of 8,661 patients were analyzed. Time-varying Cox regression analyses revealed that, when sAlb was ≥3.8 g/dL, an IDWG >7% was associated with greater risk of mortality (adjusted hazard ratio [AHR] 2.74; 95% confidence interval [CI], 1.49-5.05). When sAlb was <3.8 g/dL, however, IDWGs <2% (AHR 1.89; 95% CI, 1.50-2.39) and 4% to 5% (AHR 0.75; 95% CI, 0.58-0.96) were associated with mortality (P for interaction = .001). Cubic spline analyses showed that the mortality increased when IDWG exceeded 6% for patients with sAlb ≥3.8 g/dL; in contrast, for patients with sAlb <3.8 g/dL, the mortality increased when IDWG was <3% and decreased when IDWG was between 4% and 6%. LIMITATION:The main limitation was possible residual confounding. CONCLUSIONS:The direction and magnitude of the associations between IDWG and mortality were modified by sAlb. Dialysis experts should take these results into account when revising the clinical practice guidelines.
    背景与目标: 背景:日本的透析实践指南对允许的透析间增重(IDWG)<6%设置了限制。但是,在存在病态的情况下,体液量相对于体重的相对增加的影响可能会有所不同。在这里,我们检查了IDWG和死亡率之间的关联是否因营养和疾病标志物血清白蛋白(sAlb)而异。
    设计:使用的研究类型为前瞻性队列研究。
    参加日本透析结果和实践模式研究(1-4期[1999-2011])并每周接受三次血液透析的患者。
    方法:IDWG是感兴趣的暴露量,每4个月收集一次,分为7类,分别为:<2%,2%至3%,3%至4%(参考),4%至5%,5%至6%,6%至7%和> 7%。根据国际肾脏营养与代谢学会提出的蛋白质能量浪费标准,将sAlb视为效应修饰剂和混杂因素,并分为3.8 g / dL和<3.8 g / dL的区段。
    主要观察指标:本研究结果为全因死亡率。
    结果:共分析了8661例患者。随时间变化的Cox回归分析显示,当sAlb≥3.8 g / dL时,IDWG> 7%与更大的死亡风险相关(调整后的危险比[AHR] 2.74; 95%置信区间[CI],1.49-5.05 )。但是,当sAlb <3.8 g / dL时,IDWGs <2%(AHR 1.89; 95%CI,1.50-2.39)和4%至5%(AHR 0.75; 95%CI,0.58-0.96)与死亡率相关(互动的P = .001)。三次样条分析表明,当sAlb≥3.8g / dL的患者IDWG超过6%时,死亡率增加;相反,对于sAlb <3.8 g / dL的患者,当IDWG <3%时死亡率增加,而当IDWG在4%至6%之间时死亡率降低。
    局限性:主要局限性是可能的残余混杂。
    结论:sAlb改变了IDWG与死亡率之间的关联的方向和大小。修订临床实践指南时,透析专家应考虑这些结果。
  • 【姿势调整中的性别和躯体类型差异:对高跟鞋的反应和模拟的体重增加。】 复制标题 收藏 收藏
    DOI:10.1016/0268-0033(88)90060-5 复制DOI
    作者列表:Opila KA
    BACKGROUND & AIMS: :Postural alignment was analysed in 77 subjects grouped for gender and somatotype under four conditions: barefoot, in low-heeled shoes, in low-heeled shoes with a simulated abdominal weight gain, and in high-heeled shoes. Significant gender differences were found in the distances between the line of gravity of the whole body and the thoracic spine (P<0.001) and greater trochanter (P<0.001) during barefoot stance. The centre of gravity of the body was measured to pass anterior to the greater trochanter in males and posterior in females. In response to the external stresses of a simulated weight gain and high-heeled shoes, subjects consistently had significant anterior displacements of the head and posterior displacements of the upper trunk, with only 2 out of 16 groups having changes at the greater trochanter. The combination of these compensations must cause a flattened lumbar lordosis, opposite to the increased lumbar lordosis observed clinically in habitual wearers of high-heeled shoes and overweight individuals.
    背景与目标: :在以下四个条件下对性别和躯体类型分组的77个受试者的姿势进行了分析:赤脚,穿着低跟鞋,模拟腹部增重的低跟鞋和高跟鞋。在赤脚姿态下,全身重力线与胸椎的距离(P <0.001)和大转子(P <0.001)之间存在明显的性别差异。人体的重心经测量在雄性大转子之前通过,在雌性中通过后面。为了响应模拟体重增加和高跟鞋的外部压力,受试者始终具有明显的头部前移和上部躯干后移,在16个组中只有2个在大转子处发生了变化。这些补偿措施的结合必须导致腰椎前凸变平,这与习惯于穿着高跟鞋和超重个体的临床上观察到的腰椎前凸增高相反。
  • 【出生体重很低的婴儿出现贫血的原因。放血损失不是第一被告。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Testa M,Birocchi F,Carta P,Fanos V
    BACKGROUND & AIMS: AIM:The specific aim of the study was to determine the correlation between the severity of pathology, the amount of blood removed for diagnostic purposes in the 1st week of life and the incidence of early anaemia in very low birth weight (VLBW) infants. METHODS:We recorded the level of haemoglobin (Hb) and haematocrit (Ht) in each of the 50 infants entered in the study at their admission in our neonatal intensive care unit (NICU) and at the age of 8 days. We quantified for each infant the blood drawn for clinical purpose during the 1(st)week of life, using microanalytic techniques for all types of analysis performed. Using the neonatal therapeutic intensive score system (NTISS) we divided all patients into 2 groups: group A= mild light pathology; group B= severe pathology. RESULTS:There was statistically significant difference between the percent decrease of Hb and Ht with reference to the birth weight in the 2 groups. Logistic regression analysis indicated a strong correlation (P = 0.009) between higher degree of illness severity and higher percent decrease of Hb and Ht. The difference due to the amount of phlebotomy losses was not significant. CONCLUSIONS:To our knowledge, this study is the first that strongly suggest that phlebotomy losses is not the main cause of anaemia in VLBW preterm infants in the 1st week of life, when a policy of strictly attention to the amount of blood removed is performed.
    背景与目标: 目的:该研究的具体目的是确定病理严重程度,生命的第一周用于诊断目的的采血量与极低出生体重(VLBW)婴儿的早期贫血发生率之间的相关性。
    方法:我们记录了入院新生儿重症监护病房(NICU)以及8天大的50例婴儿中每人的血红蛋白(Hb)和血细胞比容(Ht)的水平。我们使用微分析技术对每位婴儿在生命的第一(st)周内抽取的用于临床目的的血液进行了定量分析,以进行所有类型的分析。使用新生儿治疗密集评分系统(NTISS),我们将所有患者分为两组: B组=严重病理。
    结果:相对于出生体重,两组的Hb和Ht降低百分比存在统计学差异。 Logistic回归分析表明,较高的疾病严重程度与较高的Hb和Ht降低百分比之间有很强的相关性(P = 0.009)。由于放血损失量的差异不明显。
    结论:据我们所知,该研究是第一个强烈建议放血切开不是出生第一周内VLBW早产儿贫血的主要原因,这是一项严格注意采血量的政策。
  • 【人黑素瘤异种移植在注射甲氨蝶呤的裸鼠中的退化,该甲氨蝶呤与人高分子量-黑素瘤相关抗原的单克隆抗体225.28相连。】 复制标题 收藏 收藏
    DOI:10.1007/BF01741341 复制DOI
    作者列表:Ghose T,Ferrone S,Blair AH,Kralovec Y,Temponi M,Singh M,Mammen M
    BACKGROUND & AIMS: :Intravenous injections into nude mice of 5 mg/kg methotrexate (MTX) linked to the antibody to human high molecular weight-melanoma associated antigen (HMW-MAA), monoclonal antibody (mAb) 225.28, an IgG2a, on days 1, 4, 7, 10 and 14, starting 24 h after subcutaneous inoculation of 2 x 10(6) cultured human M21 melanoma cells inhibited mean tumor volume by 90% on day 14 and by 65% on day 50 after the beginning of the treatment. Injections of equimolar amounts of free MTX and MTX linked to normal mouse IgG or to an isotype-matched myeloma protein did not inhibit tumor growth significantly. MTX linked to mAb 225.28 did not inhibit the xenograft of a subline of human melanoma cell line M21 without detectable expression of HMW-MAA. In a clonogenic assay, the MTX-225.28 conjugate was three times more potent in inhibiting the growth of M21 melanoma cells than free MTX, but did not inhibit the growth of kidney carcinoma cells Caki-1, which do not express high-Mr MAA. In contrast, MTX linked to the mAb DAL K29, reacting with kidney carcinoma cells Caki-1, inhibited their growth but did not affect that of melanoma cells. M21 melanoma cells isolated from the residual tumor of a mouse treated with the MTX-225.28 conjugate did not differ in their reactivity with mAb 225.28 and in their sensitivity to MTX when compared with M21 cells from an untreated mouse.
    背景与目标: :在第1天,第4天,静脉注射5 mg / kg甲氨蝶呤(MTX)与人高分子量黑素瘤相关抗原(HMW-MAA)抗体,单克隆抗体(mAb)225.28和IgG2a抗体相连。在皮下接种2 x 10(6)培养的人M21黑色素瘤细胞后24小时开始,如图7、10和14所示,治疗开始后第14天的平均肿瘤体积抑制了90%,第50天的平均肿瘤抑制了65%。注射等摩尔量的游离MTX和与正常小鼠IgG或同型匹配的骨髓瘤蛋白连接的MTX不会显着抑制肿瘤的生长。没有检测到HMW-MAA表达,与mAb 225.28连接的MTX不会抑制人黑素瘤细胞系M21亚系的异种移植。在克隆形成测定中,MTX-225.28缀合物在抑制M21黑色素瘤细胞生长方面比游离MTX强三倍,但不抑制不表达高Mr MAA的肾癌细胞Caki-1的生长。相反,与单克隆抗体DAL K29连接的MTX与肾癌细胞Caki-1反应,抑制了它们的生长,但不影响黑色素瘤细胞的生长。与未经处理的小鼠的M21细胞相比,从用MTX-225.28缀合物处理的小鼠的残留肿瘤中分离出的M21黑色素瘤细胞与mAb 225.28的反应性和对MTX的敏感性没有差异。
  • 【孕早期使用选择性5-羟色胺再摄取抑制剂和出生缺陷的风险。】 复制标题 收藏 收藏
    DOI:10.1056/NEJMoa067407 复制DOI
    作者列表:Louik C,Lin AE,Werler MM,Hernández-Díaz S,Mitchell AA
    BACKGROUND & AIMS: BACKGROUND:The risk of birth defects after antenatal exposure to selective serotonin-reuptake inhibitors (SSRIs) remains controversial. METHODS:We assessed associations between first-trimester maternal use of SSRIs and the risk of birth defects among 9849 infants with and 5860 infants without birth defects participating in the Slone Epidemiology Center Birth Defects Study. RESULTS:In analyses of defects previously associated with SSRI use (involving 42 comparisons), overall use of SSRIs was not associated with significantly increased risks of craniosynostosis (115 subjects, 2 exposed to SSRIs; odds ratio, 0.8; 95% confidence interval [CI], 0.2 to 3.5), omphalocele (127 subjects, 3 exposed; odds ratio, 1.4; 95% CI, 0.4 to 4.5), or heart defects overall (3724 subjects, 100 exposed; odds ratio, 1.2; 95% CI, 0.9 to 1.6). Analyses of the associations between individual SSRIs and specific defects showed significant associations between the use of sertraline and omphalocele (odds ratio, 5.7; 95% CI, 1.6 to 20.7; 3 exposed subjects) and septal defects (odds ratio, 2.0; 95% CI, 1.2 to 4.0; 13 exposed subjects) and between the use of paroxetine and right ventricular outflow tract obstruction defects (odds ratio, 3.3; 95% CI, 1.3 to 8.8; 6 exposed subjects). The risks were not appreciably or significantly increased for other defects or other SSRIs or non-SSRI antidepressants. Exploratory analyses involving 66 comparisons showed possible associations of paroxetine and sertraline with other specific defects. CONCLUSIONS:Our findings do not show that there are significantly increased risks of craniosynostosis, omphalocele, or heart defects associated with SSRI use overall. They suggest that individual SSRIs may confer increased risks for some specific defects, but it should be recognized that the specific defects implicated are rare and the absolute risks are small.
    背景与目标: 背景:产前暴露于选择性5-羟色胺再摄取抑制剂(SSRIs)后出生缺陷的风险仍然存在争议。
    方法:我们评估了参加妊娠流行病学中心出生缺陷研究的9849例婴儿和5860例无出生缺陷的婴儿中,孕妇在孕早期使用SSRI与出生缺陷风险之间的相关性。
    结果:在先前与SSRI使用相关的缺陷分析中(涉及42个比较),SSRI的整体使用与颅突狭窄的风险显着增加无关(115名受试者,有2名暴露于SSRI中;比值比为0.8; 95%置信区间[CI] ],0.2到3.5),全卵裂(127名受试者,暴露3;比值比,1.4; 95%CI,0.4到4.5)或整体心脏缺陷(3724名受试者,暴露100,比值比,1.2,95%CI,0.9)至1.6)。对单个SSRI与特定缺陷之间的关联进行的分析显示,使用舍曲林和卵母囊肿(赔率,5.7; 95%CI,1.6至20.7; 3个暴露的受试者)与间隔缺损(赔率,2.0; 95%CI)之间存在显着关联。 ; 1.2至4.0; 13位暴露的受试者)以及在帕罗西汀和右室流出道阻塞缺陷之间的使用(赔率,3.3; 95%CI,1.3至8.8; 6位暴露的受试者)。其他缺陷或其他SSRI或非SSRI抗抑郁药的风险未显着或显着增加。涉及66个比较的探索性分析表明,帕罗西汀和舍曲林可能与其他特定缺陷有关。
    结论:我们的研究结果并未表明与SSRI的使用相关的颅前突增生,卵泡扩张或心脏缺陷的风险显着增加。他们认为,单个SSRI可能会增加某些特定缺陷的风险,但是应该认识到,所涉及的特定缺陷很少,绝对风险也很小。

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