胆道闭锁预后相关因素研究进展

胆道闭锁(biliaryatresia,BA)是一种严重的先天性畸形.发病率各国不一,亚洲地区较高[1-2].病因至今未明,Kasai手术及其改良术式是有效的治疗手段,晚期BA及Kasai手术失败患儿应行肝移植.近年来,随着对BA研究的深入,尤其是肝移植水平的提高,其预后有了长足的进步,如我国台湾省5年生存率为74.8%,英国和法国4年生存率分别为89%和87.1%[1,3-4].现就BA患儿的预后相关因素综述如下.

异位妊娠危险因素的研究进展

异位妊娠是妇产科常见病,近几十年发病率有上升趋势.虽然异位妊娠早期诊断技术的提高和腹腔镜技术的应用使该病的死亡率显著降低,但目前该病仍是早期妊娠妇女死亡的首要原因[1].本文就异位妊娠的相关危险因素综述如下.

Application of Multi-factor Comprehensive Appraisal in Maize Breeding

The study was conducted to evaluate 12 traits of 15 hybrid maize culti- vars using multi-factor comprehensive appraisal. The results showed that Xianyu 335, ND8 and ND2 were better than other cultivars in these agronomic traits. Multi- factor comprehensive appraisal with simple computing, comprehensive and reason- able results is suitable to be used for evaluating the performance of hybrid maize cultivars in field.

Research of Biomass Accumulation and Saccharification Characteristics of Triarrhena lutarioriparia in Dongting Lake

[Objective] The aim was to analyze biomass accumulation, degradation and saccharification characteristics of Triarrhena lutarioriparia. [Method] With Triarrhena lutarioriparia as materials, samples were collected from April 2012 to November 2012 to explore monthly biomass changes and degradation and saccharification of Triarrhena lutarioriparia. [Result] Plant height was improving upon time; holocellulose and cellulose contents were increasing with dry weight of shoot system increasing and achieved the peak at 78.1% and 40% in September. It can be concluded that NaOH pre-treatment efficiency is better, when Triarrhena lutarionparia was treated with 2% NaOH at 100 ℃ for 20 min and reducing sugar yield achieved 178,42 mg/g. [Conclusion] Triarrhena lutarioriparia can be materials for ethyl alcohol production and the optimal harvest time is from middle September to middle October.

Effects of Vegetation Coverage and Management Practice on Soil Nitrogen Loss by Erosion in a Hilly Region of the Loess Plateau in China

Soil erosion and nutrient loss due to erosion are world-wide problems. Similar to soil loss by erosion, soil nitrogen (N) loss by erosion in small catchments is affected by vegetation coverage. The practice of comprehensive management for catchments mainly by adjusting cropland, grassland and woodland areas was widely adopted to reduce soil and water loss in catchments of the Chinese Loess Plateau. Three experiments under natural and artificial rainfall conditions on N loss by erosion for a model catchment and for an actual catchment in Zhifanggou of Ansai County in China was performed to determine the relationships between comprehensive management and N loss by runoff in small catchments. The results for vegetation coverage of 60%, 40%, 20% and 0 show that runoff loss of ammonium, nitrate, and total N were 87.08, 44.31, 25.16, 13.71 kg/km(2); 85.50, 74.06, 63.95, 56.23 kg/km(2); and 0.18, 1.18, 1.98, 7.51 t/ km(2), respectively. Due to reduction in the size of cropped area on steeply sloping land, soil N loss by erosion in the catchments was decreased by 15.8% as compared with that in 1992, i.e., from 8 758.5 kg in 1992 to 7 562.2 kg in 1998. Whereas, catchments act as a filter for ammonium and nitrate in rain, the catchment filtering effects on nitrate is remarkably higher than that on ammonium. The enrichment of < 20 mum aggregate in sediment results in the enrichment of organic matter and total N in flood sediment. Greater vegetation coverage can effectively decrease soil erosion and total N loss. However, soil mineral N loss increased as vegetation coverage increased.

Challenges and Demands for College English Teachers Raised by Training All-round Qualified Persons

The latest issue of College English Curriculum Requirements has posed challenges and demands for teachers in terms of linguistic competence, academic knowledge, language skills, professional morality, emotional and attitudinal qualifications, etc., which requires teachers to embrace and handle with active and open-minded responses. Hence, teachers ought to strive to develop and improve their own overall qualifications in collaboration with the long-term development of the subject and of the national higher education, with the need of qualified persons demanded by social development and the students＇ learning. Teachers also ought to form a notion of scientific development by keeping pace with the time, so as to discern the trend of subject development, to form appropriate judgments concerning the social development and to properly regulate their own development.

Psychosocial determinants of irritable bowel syndrome

From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system,alteration of the gut microflora,an increased intestinal permeability and minimum intestinal inflammation.Psychological and social factors can interfere with the communication between the central and enteric nervous systems,and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome.There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders.In order to explain clustering of IBS in families,genetic factors and social learning mechanisms have been proposed.The psychological features,such as anxiety,depression as well as the comorbid psychiatric disorders,health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.

Comprehensive evaluation of water-inrush risk from coal floors

Lower groups of coal seams are presently being mined from water-inrush from coal floors in order to have safe production in the Yanzhou coal mining area. We need to evaluate the risk in the lower groups of coal seams in mines. Based on a systematic collection of hydrogeological data and some data from mined working faces in these lower groups, we evaluated the factors affecting water-inrush from coal floors of the area by a method of dimensionless analysis. We obtained the order of the factors affecting water-inrush from coal floors and recalculated data on depths of destroyed floors by multiple linear regression analysis and obtained new empirical formulas. We also analyzed the water-inrush coefficient of mined working faces of the lower groups of coal seams and improved the evaluation standard of the water-inrush coefficient method. Finally, we made a comprehensive evaluation of water-inrush risks from coal floors by using the water-inrush coefficient method and a fuzzy clustering method. The evaluation results provide a solid foundation for preventing and controlling the damage caused by water of an Ordovician limestone aquifer in the lower group of coal seams in the mines of Yanzhou. It provides also important guidelines for lower groups of coal seams in other coal mines.

Experimental study on the role of endotoxin in the development of hepatopulmonary syndrome

AIM: To evaluate the role of intestinal endotoxemia in the genesis of hepatopulmonary syndrome. METHODS: A rat model of cirrhosis was prepared with the method of compound factors. At the end of the eighth week, rats with cirrhosis were treated with 300 μg LPS/100 g body weight, and 1 g/rat of glycine about four h prior to LPS. After three h of LPS treatment, blood and tissues were collected for various measurements. Kupffer cells were isolated from male Wistar rats and cultured, and divided into five groups. Supernatant was harvested at 3 h after treatment with LPS for measurement of tumor necrosis factor-alpha (TNF-α). RESULTS: Our results showed that in rats with cirrhosis, slowed and deepened breath with occasional pause was. PaO2, PaCO2 and standard bicarbonate (SB) in arterial blood were decreased. Arterial O2 and actual bicarbonate (AB) were markedly decreased. There was a close correlation between decreased O2 and endotoxin. Metabolic acidosis accompanying respiratory alkalosis was the primary type of acid-base imbalance. The alveolar-arterial oxygen gradient was sharply widened. Massive accumulation of giant macrophages in the alveolar spaces and its wall and widened alveolar wall architecture were observed. The number of bacterial translocations in mesenteric lymph nodes increased. The ratio of TC99M-MAA brain-over-lung radioactivity rose. Endotoxin, and TNF-α, endothelin-1 (ET-1), nitric oxide (NO) in plasma and ET-1, carbon monoxide (CO) in lung homogenates increased. After administration of a given dosage of LPS in rats with cirrhosis, various pathological parameters worsened. Plasma level of endotoxin was related to TNF-α, ET-1, NO in plasma and ET-1, NO, CO in lung homogenates. TNF-α level was related to ET-1 and NO in plasma and lung homogenates and CO in lung homogenate as well. The level of TNF-α increased after infusion of LPS into culture supernatant of Kupffer cells in vitro. However, TNF-α significantly decreased after pretreatment with glycine, PD98059 and SB212850. Glycine could antagonize the effect of LPS in vivo and in vitro. CONCLUSION: Intestinal endotoxemia accompanying by cirrhosis may be an important mechanism in the development of hepatopulmonary syndrome in rats. Overproduction of TNF-α due to endotoxin stimulation of Kupffer cells via mitogen-activated protein kinase (MAPK) signal transduction pathway may be a major mechanism mediating the pathologic alterations of hepatopulmonary syndrome.

Novel strategies for the treatment of inflammatory bowel disease: Selective inhibition of cytokines and adhesion molecules

The etiology of inflammatory bowel disease （IBD） has not yet been clarified and immunosuppressive agents which non-specifically reduce inflammation and immunity have been used in the conventional therapies for IBD. Evidence indicates that a dysregulation of mucosal immunity in the gut of IBD causes an overproduction of inflammatory cytokines and trafficking of effector leukocytes into the bowel, thus leading to an uncontrolled intestinal inflammation. Such recent advances in the understanding of the pathogenesis of IBD created a recent trend of novel biological therapies which specifically inhibit the molecules involved in the inflammatory cascade. Major targets for such treatment are inflammatory cytokines and their receptors, and adhesion molecules. A chimeric anti-TNF-α monoclonal antibody, infiiximab, has become a standard therapy for CD and it is also likely to be beneficial for UC. Several anti-TNF reagents have been developed but most of them seem to not be as efficacious as infliximab. A humanized anti-TNF monoclonal antibody, adalimumab may be useful for the treatment of patients who lost responsiveness or developed intolerance to infliximab. Antibodies against IL-12 p40 and IL-6 receptor could be alternative new anti-cytokine therapies for IBD. Antiinterferon-γ and anti-CD25 therapies were developed, but the benefit of these agents has not yet been established. The selective blocking of migration of leukocytes into intestine seems to be a nice approach. Antibodies against α4 integrin and α4β7 integrin showed benefit for IBD. Antisense oligonucleotide of intercellular adhesion molecule 1 （ICAM-1） may be efficacious for IBD. Clinical trials of such compounds have been either recently reported or are currently underway. In this article, we review the efficacy and safety of such novel biological therapies for IBD.

Evaluation of Intensive Urban Land Use Based on an Artificial Neural Network Model:A Case Study of Nanjing City,China

In this paper, the artificial neural network(ANN) model was used to evaluate the degree of intensive urban land use in Nanjing City, China. The construction and application of the ANN model took into account the comprehensive, spatial and complex nature of urban land use. Through a preliminary calculation of the degree of intensive land use of the sample area, representative sample area selection and using the back propagation neural network model to train, the intensive land use level of each evaluation unit is finally determined in the study area. Results show that the method can effectively correct the errors caused by the limitations of the model itself and the determination of the ideal value and weights when the multifactor comprehensive evaluation is used alone. The ANN model can make the evaluation results more objective and practical. The evaluation results show a tendency of decreasing land use intensity from the core urban area to the periphery and the industrial functional area has relatively low land use intensity compared with other functional areas. Based on the evaluation results, some suggestions are put forward, such as transforming the mode of urban spatial expansion, strengthening the integration and potential exploitation of the land in the urban built-up area, and strengthening the control of the construction intensity of protected areas.

Morphological,kinetic,membrane biochemical and genetic aspects of intestinal enteroplasticity

The process of intestinal adaptation("enteroplasticity") is complex and multifaceted.Although a number of trophic nutrients and non-nutritive factors have been identified in animal studies,successful,reproducible clinical trials in humans are awaited.Understanding mechanisms underlying this adaptive process may direct research toward strategies that maximize intestinal function and impart a true clinical benefit to patients with short bowel syndrome,or to persons in whom nutrient absorption needs to be maximized.In this review,we consider the morphological,kinetic and membrane biochemical aspects of enteroplasticity,focus on the importance of nutritional factors,provide an overview of the many hormones that may alter the adaptive process,and consider some of the possible molecular profiles.While most of the data is derived from rodent studies,wherever possible,the results of human studies of intestinal enteroplasticity are provided.

Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome

AIM： To investigate the effect and mechanism of electro-acupuncture lEA） at ST25 and ST37 on irritable bowel syndrome （IBS） of rats. METHODS： A total of 21 male Sprague-Dawley rats were randomly divided into normal group, model group and EA group. A rat model of IBS was established by constraining the limbs and distending the colorectum of rats. Rats in EA group received bilateral EA at ST25 and ST37 with a sparse and intense waveform at a frequency of 2/50 Hz for 15 min, once a day for 7 d as a course. Rats in normal and model groups were stimulated by distending colorectum （CR）. An abdominal withdrawal reflex （AWR） scoring system was used to evaluate improvements in visceral hypersensitivity. Toluidine blue-improved method, immunohistochemistry and radioimmunoassay were used to observe mucosal mast cells （MC）, changes of substance P （SP） and substance P receptor （SPR） in colon and change of corticotropin-releasing hormone （CRH） in hypothalamus. RESULTS： The threshold of visceral sense was significantly lower in model group than in normal group,and significantly higher in EA group than in model group. The number of mucosal MC was greater in model group than in normal group and significantly smaller in EA group than in model group. The CRH level in hypothalamus of rats was significantly higher in model group than in normal group, which was remarkably decreased after electro-acupuncture treatment. The SP and SPR expression in colon of rats in model group was decreased after electro-acupuncture treatment. CONCLUSION： EA at ST25 and ST37 can decrease the number of mucosal MC and down-regulate the expression of CRH in hypothalamus, and the expression of SP and SPR in colon of rats with IBS.

Physical literacy in the field of physical education——A challenge and a possibility

Publications of articles with physical literacy as a topic have increased dramatically since the beginning of 2000 s. The aim of this paper is to,through an explorative literature overview with an inductive approach, analyze frequent, and significant themes in published peer reviewed articles,with a focus on physical literacy. The database EBSCO has been used with the identifiers “physical literacy” and “physical literacy and evidence”.Furthermore ICSSPE Bulletin＇s special issue on physical literacy has been included in the overview. The findings have resulted in three key themes： assumptions of the concept physical literacy and its educative role, sports development and physical literacy, and assessment and physical literacy. Future studies are needed to examine if the advocated pedagogical strategies based on the concept physical literacy have led to a reorganized and revitalized school subject. There is also an existing critique towards making physical literacy an idealistic neutral concept or synonym with fundamental movement skills or sports talent identification. The role of higher education emerges as crucial for the next step of the development of the scientific framework as this involves how physical literacy will be socially configured, nurtured, and embodied in practice.Copyright ó 2015, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved.

Natural killer T cells and non-alcoholic fatty liver disease:Fat chews on the immune system

Natural killer T cells (NKT) are an important subset of T lymphocytes. They are unique in their ability to produce both T helper 1 and T helper 2 associated cytokines, thus being capable of steering the immune system into either inflammation or tolerance. Disruption of NKT cell numbers or function results in severe deficits in immune surveillance against pathogens and tumor cells. Growing experimental evidence suggests that hepatosteatosis may reduce resident hepatic as well as peripheral NKT cells. Those models of hepatosteatosis and the change in NKT cell numbers are associated with a disruption of cytokine homeostasis, resulting in a more pronounced release of proinflammatory cytokines which renders the steatotic liver highly susceptible to secondary insults. In this letter to the editor, we focus on recently published data in the World Journal of Gastroenterology by Xu and colleagues demonstrating reduced peripheral NKT cells in patients with non-alcoholic fatty liver disease, compare those findings with ours and others in different animal models of hepatosteatosis, and hypothesize about the potential underlying mechanism.

Second-trimester maternal β-human chorionic gonadotropin level associated with subsequent development of pregnancy-induced hypertension

Objective:To determine whether maternal β-human chorionic gonadotropin(β-hCG) level in second-trimester may be associated with subsequent development of pregnancy-induced hypertension(PIH).Methods:Seven hundred and sixty-two women in mid-trimester were to have maternal urine β-hCG standardized concentrations and maternal serum β-hCG measurements.Their case histories were recorded and reviewed from mid-trimester to delivery.The relation was observed between maternal urine,serum markers and subsequent development of PIH.Results:Among 762 women,504 cases were normal pregnancies,42 cases had PIH,94 cases had premature rupture of membrane (PROM),69 cases had preterm delivery (PD),53 other cases were excluded by various reasons.The levels of maternal urine,serum β-hCG in PIH were (61.75±9.78) IU/L and (304.56±54.17) ng/mg respectively,which were higher significantly than normal pregnancy group ([20.65±7.61] IU/L and [146.34±47.81] ng/mg,P<0.05).When maternal serum,urine β-hCG levels ≥2 MOM(multiple of mean),the incidences of developing PIH were increased significantly as compared with those of β-hCG <2 MOM women.The incidence of PIH increased from 5.1% in pregnancies with urine β-hCG ≥2 MOM to 11.7% in cases with urine β-hCG ≥4 MOM.Conclusion:The elevation of maternal mid-trimester urine,serum β-hCG levels is not only an early signal for dysfunction of placenta but also a dangerous signal for development of PIH.Second-trimester maternal urine β-hCG measurement proves to be superior to serum marker in clinical prediction.

Non-alcoholic fatty liver disease and the metabolic syndrome:An update

Sedentary lifestyle and poor dietary choices are leading to a weight gain epidemic in westernized countries, subsequently increasing the risk for developing the metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). NAFLD is estimated to affect approximate 30% of the general US population and is considered the hepatic manifestation of the metabolic syndrome. Recent findings linking the components of the metabolic syndrome with NAFLD and the progression to nonalcoholic steatohepatitis (NASH) will be reviewed; in particular, the role of visceral adipose tissue, insulin resistance, and adipocytokines in the exacerbation of these conditions. While no therapy has been proven effective for treating NAFLD/NASH, common recommendations will be discussed.

Relationship between resistin level in serum and acute coronary syndrome or stable angina pectoris

Objective： To investigate the relationship between serum resistin level and acute coronary syndrome （ACS） or stable angina pectoris （SAP）. Methods： Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups： acute myocardial infarction （AMI）, unstable angina pectoris （UAP） and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA （enzyme-linked immunosorbent assay）, and WBC （white blood cell count）, hsCRP （high sensitive C-reaction protein）, CKmax （maximum of creatinkinase）, CK-MBmax （maximum of isozyme of creatinkinase） and cTnImax （maximum of troponin） were measured by standard laboratory methods. Results： The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and I. 12 folds in SAP patients than in the healthy controls （P〈0.05）. The resistin levels were also significantly different between AMI [（8.16±0.79） ng/ml], UAP [（5.59±0.75） ng/ml] and SAP [（3.45±0.56） ng/ml] groups （P〈0.01）; WBC, hsCRP, CK CK-MBmax and cTnlmax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC （r=0.412, P=0.046）, hsCRP （r=0.427,p=0.037）, CK CK-MBmax and cTnImax （r=0.731, 0.678, 0.656; P〈0.01）. Conclusion： Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.

Use of agents stimulating erythropoiesis in digestive diseases

Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron def iciency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as f irst choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same eff icacy and safety.

Relationship of level of sex hormone and sex hormone receptor with development of metabolic syndrome in elderly men

Objective The sex hormone and the corresponding receptor may play some roles in the development of the metabolic syndrome （MS） in the elderly men. This study was designed to examine the relationship of level of the sex hormone and androgen receptor with MS in elderly men, thus to investigate the possible pathogenesis of MS. Methods This cross sectional study enrolled 587 elderly men, including 400 healthy controlls aged 62-92 years and 187 MS patients aged 60-87 years in Wan Shou Lu area of Beijing city. Dehydroepiandrosterone sulfate （DHAE-S）, total testosterone （TT）, sex hormone binding globulin （SHBG）, free testosterone （FT）, follicle-stimulating hormone （FSH）,Estradiol （E2）,luteinizing hormone（LH） and androgen receptor （AR） in blood were tested. Statistical analyses included the comparison analysis of variables and independent variables, correlation analysis using multi-factor linear regression, and multiple logistic regression analysis. Results DHAE-S, TT, SHBG, FT and AR fluorescence intensity in healthy control group were higher than those in MS group, however, FSH and E2 levels were lower in healthy group. Age was negatively correlated with diastolic blood pressure （DBP） and FT, but positively correlated with systolic blood pressure （SBP） and E2. AR fluorescence intensity was negatively correlated with SBP and LH. The logistic regression equation showed the negative correlation between DHEA-S, SHBG and the development of MS. Conclusions There are low levels of DHEA-S, TT, SHBG, FT and AR in the elderly patients with MS. On the contrary, FSH and E2 concentration are higher. It can be suggested that low levels of DHEA-S and SHBG may be the potential risk factors of MS in elderly men.