大学生病态使用因特网症与述情障碍关系研究

采用青少年病理性互联网使用量表(APIUS)和多伦多述情障碍量表(TAS-20)研究工具,对随机抽取的大学生进行病态使用因特网症(PIU)大学生述情障碍的主要特征及PIU与述情障碍之间关系的研究,提出以情绪训练为导向的团体辅导方案.研究发现:PIU群体述情障碍得分显著高于非PIU群体;PIU群体中男生的外向性思维得分平均高于女生得分;PIU与述情障碍存在显著正相关.

不容忽视的社会与健康问题!网络时代流行病态症

当今．互联网给百姓的生活带来了更多的方便与实惠．给商家带来了无限的商机?然而，由于互联网的虚拟性．让青年男女饱受其苦．罹患了种种网络病态症。这是一个不容忽视的社会与健康问题！

脓毒症诱导大鼠延髓内脏带胆碱能神经元凋亡及其对系统性炎症和行为学的影响

目的:探索脓毒症诱导的系统性炎症对延髓内脏带(MVZ)胆碱能神经元活性与凋亡、大鼠行为学的影响及胆碱能抗炎通路(CAP)干预的效应。方法:纳入无特定病原体(SPF)级Sprague Dawley(SD)大鼠64只,随机分为3组:对照组,不做任何处理。假手术组(8只),大鼠剖腹但不进行盲肠结扎穿刺法(CLP)并予哌拉西林预防感染(50 mg/kg,腹腔注射,每日3次,连续3 d)。脓毒症组(48只),制备CLP脓毒症模型并予哌拉西林预防感染(使用方法同假手术组),制备成功后随机再分为模型组、GTS-21组及甲基牛扁亭(MLA)组,各16只。模型组予生理盐水(1 mL/100 g,腹腔注射,每日3次,连续3 d);GTS-21组以α7烟碱型乙酰胆碱受体(α7nAchRs)特异性激动剂GTS-21(4 mg/kg,腹腔注射,每日1次,连续3 d)进行干预;MLA组以α7nAchRs特异性拮抗剂MLA(4.8 mg/kg腹腔注射,每日1次,连续3 d)进行干预。采用脓毒症严重程度评分(MSS)系统对大鼠每天行为进行分类评分、3 d后处死大鼠采用灌注取脑方式摘取延髓标本,采用免疫荧光双标测定延髓标本的Caspase-3/胆碱乙酰转移酶(CHAT)表达。结果:脓毒症模型组、GTS-21组及MLA组MSS评分高于对照组,且MLA组MSS评分高于GTS-21组(P<0.05),分类评分中,脓毒症3组外观、意识水平、行为表现、对刺激反应、睁眼反应、呼吸频率、呼吸质量评分均高于对照组和假手术组,3组间分类评分比较差异无统计学意义;MLA组CHAT表达较对照组降低(P<0.05),GTS-21具有升高CHAT表达的趋势(P>0.05);脓毒症各组Caspase-3表达升高(P<0.05)。结论:脓毒症诱导的系统性炎症的紊乱可能通过MVZ诱导脓毒症的病态行为,干预CAP可调控脓毒症炎症风暴和病态行为。

腹腔镜胃空肠转流术治疗减重及糖尿病进展

2型糖尿病(Type 2 diabetes mellitus,T2DM)是一种胰岛素功能缺陷所致的、主要以慢性高血糖为特征的代谢综合征。T2DM的关键发病环节为胰岛素抵抗和胰岛素分泌异常。随着病程迁延,胰岛β细胞逐渐发生主要由氧化应激等介导的细胞凋亡,最终不可逆地发生胰岛功能衰竭,即由起初的非胰岛素依赖型转化为终末期胰岛素依赖型。目前,T2DM临床治疗策略主要是以改变生活方式为基础的口服降糖药物为主,必要时改用或加用胰岛素治疗,以期预防和延缓糖尿病的微血管并发症,提高患者的生活质量。患者需要终身服药,治疗效果在很大程度上依赖患者的治疗依从性,存在明显的个体差异性。

“信息疾病”与图书馆的对策

信息技术在带来社会进步的同时也对人们产生了各种负效应,存在着各种隐患,信息污染综合症、信息技术恐惧综合症、病态使用互联网症等信息疾病就是典型的表现。本文对这三种疾病的概念、发展、症状、成因分别进行了探讨和分析,并指出图书馆作为社会的文化信息中心,在信息时代应扩充自身的职能,在信息的组织和导航、信息教育、人文关怀等方面做出努力,为预防和医治信息疾病贡献自己的力量。

Genetic predisposition to inflammation:a new risk factor of Alzheimer's disease

Inflammation has been shown to play an important role in the progression of Alzheimer＇s disease （AD）. Recent epidemical study indicates that the incidence of AD in some populations is substantially influenced by the gene polymorphisms of the inflammation mediators. Meanwhile, an ensured risk factor, the ApoE ε4 allele is also reported to directly promote inflammation. Accordingly, it appears that an individual genetic background has partly determined his predisposition for AD by the extent of the inflammation response to the chronic stimulus by β-amyloid peptide （Aβ） deposits and other antigen stressor in the elderly. Hence we present a hypothesis that the inflammation genotypes may contribute to AD susceptibility. This may provide a new orientation both for future identification of individuals at risk and for personalized medication.

IBD5 polymorphisms in inflammatory bowel disease: Association with response to infliximab

AIM: Inflammatory bowel diseases (IBD) are multifactorial pathologies of unknown etiology. One susceptibility locus, IBD5, has been mapped to chromosome 5q31. We analyzed our Spanish cohorts of Crohn's disease (CD) and ulcerative colitis (DC) patients to determine whether this locus is associated with IBD, and to ascertain the main clinical phenotype influenced by this risk factor. The kind of interaction, either genetic heterogeneity or epistasis, between this IBD5 susceptibility region and the NOD2/CARD15 gene mutations was studied as well. Finally, we assessed whether this locus can predict response to infliximab therapy. METHODS: A case control study was performed with 274 CD and 211 UC patients recruited from a single center and 511 healthy ethnically matched controls. Two polymorphisms were genotyped in the IBD5 locus and three in the CARD15/NOD2 gene. RESULTS: Our results evidence association only with CD especially with the fistulizing phenotype and in the absence of NOD2/CARD15 variants (mutant allele frequency in patients vs controls: OR = 2.03, 95% CI = 1.35-3.06, P<0.01). The frequency of the IBD5 homozygous mutant genotype significantly increased in CD patients lacking response to infliximab (RR = 3.88, 95% CI = 1.18-12.0, P<0.05). UC patients overall do not show association with 5q31 polymorphisms, although a similar trend to the one observed in CD is found within the worse prognosis group. CONCLUSION: The IBD5 variants may enhance an individual carrier's risk for CD, mainly in the absence of the NOD2/CARD15 mutations and in fistulizing patients. The data presented suggest the potential role of the 5q31 polymorphisms as markers of response to infliximab.

HOUSE DUST MITE ALLERGEN (Derp1 AND Blot5) LEVELS IN ASTHMATICS' HOME IN HONGKONG

To measure Derp1 and Blot5 allergen levels in asthmatics’ homes in Hongkong. Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients’ house: bed and floor. Derp1 and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique. Results The levels of Derp1 allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g) and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P = 0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derp1 and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P < 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 = 0 μg/g of dust as compared with Derp1 in bed and on the floor (4.3% and 14.5% respectively, P < 0.05). Conclusions Derp1 and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus(Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hong-kong.

Abnormal cortical functional connections in Alzheimer’s disease: analysis of inter-and intra-hemispheric EEG coherence

To investigate inter- and intra-hemispheric electroencephalography (EEG) coherence at rest and during photic stimulation of patients with Alzheimer's disease (AD). Thirty-five patients (12 males, 23 females; 52～64 y) and 33 sex- and age-matched controls (12 males, 21 females; 56～65 y) were recruited in the present study. EEG signals from C3-C4, P3-P4, T5-T6and O1-O2 electrode pairs resulted from the inter-hemispheric action, and EEG signals from C3-P3, C4-P4, P3-O1, P4-O2, C3-O1,C4-O2, T5-O 1 and T6-O2 electrode pairs resulted from the intra-hemispheric action. The influence of inter- and intra-hemispheric coherence on EEG activity with eyes closed was examined, using fast Fourier transformation from the 16 sampled channels. The frequencies of photic stimulation were fixed at 5, 10 and 15 Hz, respectively. The general decrease of AD patients in inter- and intra-hemispheric EEG coherence was more significant than that of the normal controls at the resting EEG, with most striking decrease observed in the alpha-1 (8.0-9.0 Hz) and alpha-2 (9.5-12.5 Hz) bands. During photic stimulation, inter- and intra-hemispheric EEG coherences of the AD patients having lower values in the alpha (9.5-10.5 Hz) band than those of the control group. It suggests that under stimulated and non-stimulated conditions, AD patients had impaired inter- and intra-hemispheric functional connections, indicating failure of brain activation in alpha-related frequency.

New method for long-term monitoring of intragastric pH

AIM: Consecutive monitoring of intragastric pH using the Bravo? capsule. METHODS: We put threads through a Bravo? capsule and then affixed it to the gastric wall by endoscopic hemoclipping in seven subjects. Study data were uploaded to a computer via Datalink every 48 h. In this way,repeated monitoring of intragastric pH was undertaken. RESULTS: All subjects were able to monitor gastric pH over a 1-wk period,and five for > 2 wk. No complications were encountered during the monitoring. After pH monitoring,we safely retrieved the capsule endoscopically. CONCLUSION: Clipping a Bravo? capsule onto the gastric wall enabled long-term intragastric pH monitoring. This is a methodological report of pH monitoring over a period of > 2 wk.

Short-term clinical outcomes of laparoscopic vs open rectal excision for rectal cancer: A systematic review and metaanalysis

AIM To review evidence on the short-term clinical outcomes of laparoscopic(LRR) vs open rectal resection(ORR) for rectal cancer.METHODS A systematic literature search was performed using Cochrane Central Register, MEDLINE, EMBASE, Scopus, Open Grey and Clinical Trials.gov register for randomized clinical trials(RCTs) comparing LRR vs ORR for rectal cancer and reporting short-term clinical outcomes. Articles published in English from January 1, 1995 to June, 30 2016 that met the selection criteria were retrieved and reviewed. The Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) statements checklist for reporting a systematic review was followed. Random-effect models were used to estimate mean differences and risk ratios. The robustness and heterogeneity of the results were explored by performing sensitivity analyses. The pooledeffect was considered significant when P < 0.05.RESULTS Overall, 14 RCTs were included. No differences were found in postoperative mortality(P = 0.19) and morbidity(P = 0.75) rates. The mean operative time was 36.67 min longer(95%CI: 27.22-46.11, P < 0.00001), the mean estimated blood loss was 88.80 ml lower(95%CI:-117.25 to-60.34, P < 0.00001), and the mean incision length was 11.17 cm smaller(95%CI:-13.88 to-8.47, P < 0.00001) for LRR than ORR. These results were confirmed by sensitivity analyses that focused on the four major RCTs. The mean length of hospital stay was 1.71 d shorter(95%CI:-2.84 to-0.58, P < 0.003) for LRR than ORR. Similarly, bowel recovery(i.e., day of the first bowel movement) was 0.68 d shorter(95%CI:-1.00 to-0.36, P < 0.00001) for LRR. The sensitivity analysis did not confirm a significant difference between LRR and ORR for these latter two parameters. The overall quality of the evidence was rated as high. CONCLUSION LRR is associated with lesser blood loss, smaller incision length, and longer operative times compared to ORR. No differences are observed for postoperative morbidity and mortality.

Classification of anemia for gastroenterologists

Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classifi cation (microcytic, macrocytic and normocytic) and pathogenic classi-fication (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other comple-mentary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time.

Risk factors and gene polymorphisms of inflammatory bowel disease in population of Zhejiang,China

AIM:To identify the risk factors and three single nucleotide polymorphisms(SNPs) of NOD2/CARD15 gene in inflammatory bowel disease(IBD) of the population in Zhejiang,China.METHODS:A case-control study was conducted using recall questionnaire to collect data on demographic,socioeconomic,lifestyle characteristics and dietary behaviors from 136 determined IBD patients and 136 paired healthy controls.COX regression method was used to screen the statistically significant risk factors for IBD.The polymorphisms of NOD2/CARD15 gene Arg702Trp,Gly908Arg and Leu1007fsinsC were genotyped and further compared between 60 patients with IBD and 60 healthy controls by polymerase chain reaction and restriction fragment length polymorphism.RESULTS:IBD occurred primarily in young and middle-aged people.The mean age for IBD patients was 42.6 years.The ratio of males to females was 1.23:1.COX regression indicated a higher statistical significance in milk,fried food and stress compared with the other postulated risk factors for IBD.None of the patients with IBD and healthy controls had heterozygous or homozygous SNPs variants.CONCLUSION:Milk,fried food and stress are associated with increased risk of IBD.The common variants in NOD2/CARD15 gene are not associated with IBD in China's Zhejiang population.

Pathogenesis of congenital pyrimidine 5′ -nucleotidase | deficiency: A study on relationship among erythrocyte morphology, enzyme protein content and activity

Objective: To further explore the mechanism of congenital pyrimidine 5'-nucleotidase I deficiency. Methods; The samples were collected from the family members of a patient with P5'N- I deficiency. The enzyme activities were measured by UMP method and the enzyme proteins were quantified by ELISA while the morphology of peripheral blood cells was observed. Results: The enzyme contents reduced as their enzyme activities decreased in the family especially in four members. There was a significant positive correlation(r =0. 955) between the activity and the content of P 5'N- I . The count of the stippling cell was varied in the family. Conclusion.- One of the reasons for congenital P5' N- I deficiency might be the deficiency in the enzyme content. The morphology of peripheral blood erythrocyte may be an assistant diagnotic index. The P5'N- I activities and contents were measured simultaneously may be a effective method in clinic diagnosis.

From genetics and epigenetics to the future of precision treatment for obesity

Obesity has become a major global health problem,epitomized by excess accumulation of body fat resulting from an imbalance between energy intake and expenditure.The treatments for obesity range from modified nutrition and additional physical activity,to drugs or surgery.But the curative effect of each method seems to vary between individuals.With progress in the genetics and epigenetics of obesity,personalization of the clinical management of obesity may be at our doorstep.This review presents an overview of our current understanding of the genetics and epigenetics of obesity and how these findings influence responses to treatments.As bariatric surgery is the most effective long-term treatment for morbid obesity,we pay special attention to the association between genetic factors and clinical outcomes of bariatric surgery.Finally,we discuss the prospects for precision obesity treatment.

CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

Objective：The aim of this study was to evaluate the concentrations of C-reactive protein （CRP）, tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, and the degree of homeostasis model assessment-insulin resistance （HOMA-IR） in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy. Methods：The study included 33 patients （25 females and 8 males; mean age 46 years） with body mass index （BMI） values of〉40 kg/m2. Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before （baseline data） and three weeks after the treatment. The control group consisted of 20 healthy volunteers （15 females and 5 males） with a mean age of 39 years and BMI values of≤24.9 kg/m2. Results：In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a de-creased level of high density lipoprotein （HDL）-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4%reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concen-tration of CRP, but no change in TNF-αor IL-6. HOMA-IR was significantly reduced. Conclusions：The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients.

Clinical study on Jin's three-needle therapy for post-stroke cognitive impairment

Objective:To observe the clinical efficacy of Jin's three-needle therapy on post-stroke cognitive impairment(PSCI)and the effect on neuroelectrophysiology(event-related potentials).Methods:A total of 60 PSCI patients were selected and divided into a treatment group and a control group according to the method of random number table,with 30 cases in each group.The patients in the control group received routine treatment while the patients in the treatment group received additional Jin's three-needle therapy.The treatment for both groups lasted four weeks.Mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores as well as amplitude and latency of potential 300(P300)were adopted to compare the between-group results before and after treatment.Results:Before treatment,there were no significant differences(all P>0.05)in MMSE and MoCA scores,P300 latency and P300 amplitude between the two groups.After 4 weeks of treatment,the MMSE and MoCA scores and P300 amplitudes were improved in both groups,and the P300 latencies became shorter.The results showed significant intra-group and between-group differences(all P<0.05).Conclusion:Based on the routine treatment,Jin's three-needle therapy is effective for PSCI.The mechanism is probably through its regulation on the patients'neuroelectrophysiology.