Accuracy of urea breath test in Helicobacter pylori infection: Meta-analysis

AIM: To quantitatively summarize and appraise the available evidence of urea breath test(UBT) use to diagnose Helicobacter pylori(H. pylori) infection in patients with dyspepsia and provide pooled diagnostic accuracy measures.METHODS: We searched MEDLINE, EMBASE, Cochrane library and other databases for studies addressing the value of UBT in the diagnosis of H. pylori infection. We included cross-sectional studies that evaluated the diagnostic accuracy of UBT in adult patients with dyspeptic symptoms. Risk of bias was assessed using QUADAS(Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Diagnostic accuracy measures were pooled using the random-effects model. Subgroup analysis was conducted by UBT type(13C vs 14C) and by measurement technique(Infrared spectrometry vs Isotope Ratio Mass Spectrometry).RESULTS: Out of 1380 studies identified, only 23 met the eligibility criteria. Fourteen studies(61%) evaluated 13 C UBT and 9 studies(39%) evaluated 14 C UBT. There was significant variation in the type of reference standard tests used across studies.Pooled sensitivity was 0.96(95%CI: 0.95-0.97) andpooled specificity was 0.93(95%CI: 0.91-0.94). Likelihood ratio for a positive test was 12 and for a negative test was 0.05 with an area under thecurve of 0.985. Meta-analyses were associated with a significant statistical heterogeneity that remained unexplained after subgroup analysis. The included studies had a moderate risk of bias.CONCLUSION: UBT has high diagnostic accuracy for detecting H. pylori infection in patients with dyspepsia. The reliability of diagnostic meta-analytic estimates however is limited by significant heterogeneity.

Effect of subarachnoid nerve block anesthesia on glutamate transporte GLAST and GLT-1 expressions in rabbits

Objective: To observe the effect of subarachnoid nerve block anesthesia on glutamate transporter glutamate-aspartate transporter(GLAST) and GLT-1 expressions in rabbits, and to investigate the effect of peripheral nerve anesthesia on the morphology and function of the spinal cord. Methods: Twenty healthy New Zealand white rabbits were randomly divided into two groups: the experimental group and control group; with 10 rabbits in each group. For spinal nerve anesthesia, 5 g/L of bupivacaine was used in the experimental group, and sterile saline was used in the control group. After 30 min of cardiac perfusion, GLAST and GLT-1 protein expression in spinal neurons were detected by immunohistochemistry and immunofluorescence staining. Results: GLAST and GLT-1 protein-positive cells increased in neurons in the experimental group, compared with the control group(P<0.05). Conclusions: After subarachnoid nerve block anesthesia, rabbit glutamate transporter GLAST and GLT-1 expression is increased; and spinal cord nerve cell function is inhibited.

Multicentric occurrence of hepatocellular carcinoma with nonalcoholic steatohepatitis

AIM:To reveal the manner of hepatocellular carcinoma (HCC) development in patients with nonalcoholic steatohepatitis(NASH) focusing on multicentric occurrence (MO) of HCC.METHODS:We compared clinicopathological characteristics between patients with and without MO of HCC arising from NASH background.The clinical features were implicated with reference to the literature available.RESULTS:MO of HCC was identified with histological proof in 4 out of 12 patients with NASH-related HCC(2 males and 2 females).One patient had synchronous MO;an advanced HCC,two well-differentiated HCCs and a dysplastic nodule,followed by the development of metachronous MO of HCC.The other three patients had multiple advanced HCCs accompanied by a well-differentiated HCC or a dysplastic nodule.Of these three patients,one had synchronous MO,one had metachronous MO and the other had both synchronous and metachronous MO.There were no obvious differences between the patients with or without MO in terms of liver function tests,tumor markers and anatomical extent of HCC.On the other hand,all four patients with MO of HCC were older than 70 years old and had the comorbidities of obesity,type 2 diabetes mellitus(T2DM),hypertension and cirrhosis.Although these conditions were not limited to MO of HCC,all the conditions were met in only one of eight patients without MO of HCC.Thus,concurrence of these conditions may be a predisposing situation to synchronous MO of HCC.In particular,old age,T2DM and cirrhosis were suggested to be prerequisite for MO because these factors were depicted in common among two other cases with MO of HCC under NASH in the literature.CONCLUSION:The putative predisposing factors and necessary preconditions for synchronous MO of HCC in NASH were suggested in this study.Further investigations are required to clarify the accurate prevalence and predictors of MO to establish better strategies for treatment and prevention leading to the prognostic improvement in NASH.

Effects of Cow’s Milk on Reproduction in ICR Male Mice

Objective To study the effects of Cow＇s milk on the reproduction in male mice. Methods Twenty-four male mice were divided randomly into two groups： milk group （M） and control group （C）. Each mouse was given 10 mL milk per day from 4 to 16 weeks in the group M. At the age of 17 weeks, all the mice were sacrificed. Results Serum testosterone was decreased in the group M （P=0.037）. No significant difference was found in weight of testes, seminal vesicle or adrenal gland of mice between the groups C and M. However, the weight of seminal vesicle decreased when expressed in g/100 g body weight in the group M. Epididymal sperm concentration, motility, morphology, and sperm head number were not affected by milk. Conclusion Cow＇s milk has adverse effects on the reproductive system in ICR male mice. Further studies are needed to clarify the specific effects of milk on reproductive health.

Fasting for Laboratory Tests Poses a High Risk of Hypoglycemia in Patients with Diabetes: A Pilot Prevalence Study in Clinical Practice

Objective: Fasting for lipid profiles is a deeply-rooted tradition that is being revisited. In patients with diabetes, such fasting poses a risk of hypoglycemia, as observed in recent studies and case reports. This iatrogenic, overlooked, form of hypoglycemia has been referred to as Fasting-Evoked En-route Hypoglycemia in Diabetes (FEEHD). The objective of the study is to determine the prevalence of FEEHD in clinical practice. Methods: A two-page survey was administered to adults with diabetes on anti-diabetic medication(s). Patients were asked if they recalled having experienced hypoglycemia while fasting for laboratory tests (FEEHD) during the preceding 12 months. Results: Of 168 patients enrolled, 166 completed the survey, with a mean age of 55.3 (SD: 15.4) years. Seventy-nine (47.6%) were females. Of these 166 patients, 119 (71 %) had type 2 diabetes. Forty-five patients (27.1%) reported having experienced one or more FEEHD events. Notably, only 31.1% of the patients who experienced a FEEHD event informed their provider of the event, and only 40% of FEEHD events reportedly resulted in any subsequent provider-made medication change(s) to prevent future events. Conclusions: This is the first study of FEEHD prevalence in clinical practice, the results of which serve to increase awareness amongst clinicians about the occurrence of FEEHD. We believe that FEEHD appears to be overlooked by clinicians. The prevalence of FEEHD in clinical practice is strikingly high (27.1%). More concerning is the significant underreporting of FEEHD events by patients to their clinicians (31%). We hope this study will trigger further investigation to confirm these preliminary findings and modify practice guidelines.

Effect of a program to control perioperative blood glucose on the incidence of nosocomial infections in patients with diabetes: A pilot study

Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. In the year 2008 we implemented perioperative insulin protocols aimed at blood glucose values from 80 to 180 mg/dL. Surgical patients with diabetes admitted on year 2009 (intervention group) were compared with a control group of patients with diabetes admitted for surgery on year 2007, matched 1:1 by traditional wound class. Results: We analyzed 96 patients. Implemented protocols were followed in 48% of patients intra-operatively and 75% of patients postoperatively. Patients in the intervention group had reductions in blood glucose at surgery 150 +/- 61 mg/dL vs. 172 +/- 53 mg/dL;p = 0.05), greater proportion of target glucose values throughout hospitalization (67% vs. 55%;p = 0.07), and reductions in the incidence of nosocomial infections after controlling for confounders (Odds Ratio: 0.20;95% Confidence intervals: 0.06 - 0.72;p = 0.014) when they were compared with the control group: The incidence of hypoglycemia was similar between two groups (0.12% vs. 0.10%, p = 0.867), respectively. Conclusion: Although our protocol needs improvements to increase implementation it was useful to control blood glucose safely and for reducing nosocomial infections.

非高密度脂蛋白胆固醇、载脂蛋白A-I及B100、标准脂质测量、脂质比值以及CRP作为女性心血管病危险因素的临床用途

背景：关于不同脂质测定、非高密度脂蛋白胆固醇（non-HDL-C）、脂质比值、载脂蛋白和C-反应蛋白（CRP）的临床应用，现行心血管危险检测指南仍有争议。 目的：直接比较总胆固醇（totalcholesterol，TC）、低密度脂蛋白胆固醇（LDL-C）、HDL-C、non-HDL-C、载脂蛋白A-I（apoA-I）及B100（apoB100）、高敏C-反应蛋白（高敏CRP）以及TC与HDL-C、LDL-C与HDL-C、apoB100与apoA-I、apoB100与HDL-C比值，在妇女作为将来心血管事件预测指标的临床用途。 设计、地点及参试者：于15 632例起始健康美国妇女进行的前瞻性队列研究。1992年11月至1995年7月人组时年龄≥45岁（4分位范围48～59岁）。所有参试者均经10年随访，观察将来心血管事件的发生情况。 主要观测指标：按照各项生化指标不同基线值而确定的首次主要心血管事件（n=4 764）的风险比（hazard ratios，HRs）及95％可信区间（confidence intervals，CIs）。 结果：在校正年龄、吸烟状况、血压、糖尿病及体重指数后，测量结果在最高5分位者将来发生心血管事件的风险比LDL-C为1．62（95％CI，1．17～2．25），apoA-I为1．75（95％CI，1．30～2．38），TC为2．08（95％CI，1．45～2．97），HDL-C为2．32（95％CI，1．64～3．33），apoB100为2．50（95％CI，1．68～3．72），non-HDL-C为2．51（95％CI，1．69～3．72），高敏CRP为2．98（95％CI，1．90～4．67）（P＜0．001，趋势贯穿所有5分位）。脂质比值风险比，apoBl00与apoA-I为3．01（95％CI，2．01～4．50），LDL-C与HDL-C为3．18（95％CI，2．12～4．75），apoB100与HDL-C为3．56（95％CI，2．31～5．47），TC与HDL-C为3．81（95％CI，2．47～5．86）（P＜0．001，趋势贯穿所有5分位）。高敏CRP与脂质参数的相关系数范围为-0．33到0．15，以CRP＜1、1～3和＞3 ms／L为临床分割点，可对每项脂质测量及脂质比值水平增加提供预后危险信息。 结论：non-HDL-C以及TC与HDL-C比值对将来心血管事件的预测效果与载脂蛋白相同或者更好。校正年龄、血压、吸烟、糖尿病和肥胖后，高敏CRP提供的预后信息超越各项脂质测量。

关于小剂量阿司匹林用于女性心血管疾病一级预防的随机试验

BACKGROUND: Randomized trials have shown that lowdose aspirin decreases the risk of a first myocardial infarction in men, with little effect on the risk of ischemic stroke. There are few similar data in women. METHODS: We randomly assigned 39,876 initially healthy women 45 years of age or older to receive 100 mg of aspirin on alternate days or placebo and then monitored them for 10 years for a first major cardiovascular event(i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes). RESULTS: During followup, 477 major cardiovascular events were confirmed in the aspirin group, as compared with 522 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent(relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0.13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group(relative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing to a 24 percent reduction in the risk of ischemic stroke(relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increase in the risk of hemorrhagic stroke(relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no significant effect on the risk of fatal or nonfatal myocardial infarction(relative risk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from cardiovascular causes(relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequent in the aspirin group than in the placebo group(relative risk, 1.40;95 percent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that aspirin significantly reduced the risk of major cardiovascular events, ischemic stroke, and myocardial infarction among women 65 years of age or older. CONCLUSIONS: In this large, primary-prevention trial among women, aspirin lowered the risk of stroke without affecting the risk of myocardial infarction or death from cardiovascular causes, leading to a nonsignificant finding with respect to the primary end point.

小剂量阿司匹林在女性心血管疾病一级预防中所起作用的随机试验研究

BACKGROUND: Randomized trials have shown that lowdose aspirin decreases the ri sk of a first myocardial infarction in men, with little effect on the risk of is chemic stroke. There are few similar data in women. METHODS: We randomly assigne d 39,876 initially healthy women 45 years of age or older to receive 100 mg of a spirin on alternate days or placebo and then monitored them for 10 years for a f irst major cardiovascular event (i.e., nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes). RESULTS: During followup, 477 majo r cardiovascular events were confirmed in the aspirin group, as compared with 52 2 in the placebo group, for a nonsignificant reduction in risk with aspirin of 9 percent (relative risk, 0.91; 95 percent confidence interval, 0.80 to 1.03; P=0 .13). With regard to individual end points, there was a 17 percent reduction in the risk of stroke in the aspirin group, as compared with the placebo group (rel ative risk, 0.83; 95 percent confidence interval, 0.69 to 0.99; P=0.04), owing t o a 24 percent reduction in the risk of ischemic stroke (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.93; P=0.009) and a nonsignificant increa se in the risk of hemorrhagic stroke (relative risk, 1.24; 95 percent confidence interval, 0.82 to 1.87; P=0.31). As compared with placebo, aspirin had no signi ficant effect on the risk of fatal or nonfatal myocardial infarction (relative r isk, 1.02; 95 percent confidence interval, 0.84 to 1.25; P=0.83) or death from c ardiovascular causes (relative risk, 0.95; 95 percent confidence interval, 0.74 to 1.22; P=0.68). Gastrointestinal bleeding requiring transfusion was more frequ ent in the aspirin group than in the placebo group (relative risk, 1.40; 95 perc ent confidence interval, 1.07 to 1.83; P=0.02). Subgroup analyses showed that as pirin significantly reduced the risk of major cardiovascular events, ischemic st roke, and myocardial infarction among women 65 years of age or older. CONCLUSION S: In this large, primary-prevention trial among women, aspirin lowered the ris k of stroke without affecting the risk of myocardial infarction or death from ca rdiovascular causes, leading to a nonsignificant finding with respect to the pri mary end point.

偏头痛与女性发生心血管疾病的危险

背景：有先兆偏头痛与心血管疾病危险因素以及伴随偏头痛特殊生理学改变而产生的促血栓物质相关，可增加血管事件的危险。虽然有先兆偏头痛与缺血性卒中的危险增加相关，但是其与心血管疾病，特别是冠脉事件的相关性仍不清楚。 目的：评价有和无先兆的偏头痛与所有特定心血管疾病发生危险的相关性。 设计、地点及参试者：于27840位美国女性中进行前瞻性队列研究。参试者年龄≥45岁，均参加了女性健康研究（Women’s Health Study，WHS）。入选时（1992～1995年）无心血管疾病和心绞痛，有偏头痛和先兆症状自我报告资料以及血脂测量数据。随访至2004年3月31日。 主要观测指标：主要观测指标为重要心血管疾病复合终点事件（首次非致死性缺血性卒中、非致死性心肌梗死以及缺血性心血管疾病所致死亡），其他指标为首次缺血性卒中、心肌梗死、冠状动脉血运重建、心绞痛和缺血性心血管疾病所致死亡。 结果：基线时，5125名女性（18．4％）报告有偏头痛病史，其中3610名有活动性偏头痛（1年内发生偏头痛），1434名（39．7％）有先兆症状。在平均10年的随访期间，580例发生重要心血管事件。经多变量校正后，与无先兆偏头痛女性相比，报告有先兆活动性偏头痛的女性发生重要心血管疾病的风险比为2．15（95％CI，1．58～2．92；P〈0．001），缺血性卒中的风险比为1．91（95％CI，1．17～3．10；P=0．01），心肌梗死的风险比为2．08（95％CI，1．30～1．31；P：0．002），冠状动脉血运重建的风险比为1．74（95％CI，1．23～2．46；P=0．02）．心绞痛的风险比为1．71（95％CI，1．16～2．53；P=0．007），缺血性心血管疾病所致死亡的风险比为2．33（95％CI，1．21～4．51；P=0．01）。校正年龄后，每10000名女性每年有18例新发重要心血管事件可归因于有先兆偏头痛。报告无先兆活动性偏头痛的女性心血管病或心绞痛的危险并无增加。 结论：在本大规模前瞻性女性队列中，有先兆活动性偏头痛与女性发生重要心血管疾病、心肌梗死、缺血性卒中、缺血性心血管疾病所致死亡以及冠状动脉血运重建和心绞痛危险增加相关，无先兆活动性偏头痛与心血管疾病的危险增加无关。

与安慰剂和晨起服用相比,每日睡前顿服地尔硫分级释放剂治疗慢性稳定型心绞痛的有效性和安全性

Background: The efficacy and safety of a once-daily graded-release diltiazem hydrochloride(GRD) formulation dosed at 10 pm in doses of 180, 360, and 420 mg were compared with placebo and with GRD 360 mg dosed once daily at 8 am in patients(n=311) with chronic stable angina pectoris. Methods: This was a 3-week multicenter, randomized, doubleblind, double-dummy, parallel-group, placebo-controlled trial. Standard Bruce protocol treadmill stress test was performed at baseline and end point between 6 and 8 pm(trough for evening doses) and between 7 and 11 am(trough for morning doses). Results: All GRD evening doses showed a significant(P≤.0201) increase in total duration of exercise at trough and a greater significant increase(P≤.0002) at peak, compared with placebo. The GRD 360-mg evening dose showed the greatest increase at trough. In contrast, GRD 360-mg morning dose showed an increase in total duration of exercise at trough that was not significantly different(P=.0555) from placebo am. GRD 360-mg evening dose showed a 4-fold placebo-adjusted improvement compared with GRD 360-mg morning dose between 7 and 11 am. Significant increases(P≤.0240) in time to onset of angina were obtained for all evening doses at trough and peak. All GRD doses were well tolerated, and incidence of adverse events for all GRD groups combined was less than that for placebo. Conclusions: Bedtime GRD significantly increases exercise tolerance in patients with angina pectoris over the 24-hour dosing interval. A greater 4-fold placebo-adjusted improvement occurred between 7 and 11 am compared with the same morning dose, coinciding with the period of increased cardiovascular risk. GRD was safe and well tolerated.

体力活动、锻炼与女性心脏性猝死

Context: Exercise is associated with a lower risk of cardiovascular events but may transiently increase the risk of ventricular arrhythmias. Its short-term and long-term associations with risk of sudden cardiac death among women are unclear. Objectives: To compare the risk of sudden cardiac death in women during mo derate to vigorous exertion with the risk of sudden cardiac death during lighter or no exertion; and to assess the long-term association between moderate to vi gorous exercise and sudden cardiac death. Design, Setting, and Participants: Pro spective, nested case-crossover study of 288 cases of sudden cardiac death with in the Nurses’Health Study(1980-2004); and a prospective cohort analysis of 69 693 participants without prior cardiovascular disease followed up from 1986-20 04. Main Outcome Measure: Risk of sudden cardiac death associated with moderate to vigorous exertion. Results: The absolute risk of sudden cardiac death associa ted with moderate to vigorous exertion was exceedingly low at 1 per 36.5 million hours of exertion. In case-crossover analyses, the risk of sudden cardiac death was transiently elevated during moderate to vigorous exertion(relative risk[RR ], 2.38; 95%confidence interval[CI], 1.23-4.60; P=.01) compared with the risk during lesser or no exertion. Habitual moderate to vigorous exertion modified th is transient risk(P=.005 for interaction) and the risk was no longer significant ly elevated among those who exercised 2 or more hours per week. In the cohort an alyses, an increasing amount of moderate to vigorous exercise was associated with a lower long-term risk of sudden cardiac death in ageadjusted and multivariable models that excluded biological intermediates(P=.006 for trend). This relatio nship was attenuated when biological intermediates were included(P=.06 for trend ); however, the reduction in risk remained significant among women who exercised 4 or more hours per week(adjusted RR, 0.41; 95%CI, 0.20-0.83; P=.01) compared with women who did not exercise. Conclusions: These prospective data suggest th at sudden cardiac death during exertion is an extremely rare event in women. Reg ular exercise may significantly minimize this small transient risk and may lower the overall long-term risk of sudden cardiac death.

雌激素治疗与冠状动脉钙化

背景:冠状动脉钙化斑块是动脉粥样硬化斑块负荷的标记物,可预测未来发生心血管事件的风险。作者在一项随机化临床试验中研究了雌激素治疗与冠状动脉钙化之间的关系。方法:在对已行子宫切除的女性接受结合型马雌激素(0.625mg/d)与安慰剂进行比较的女性健康倡议试验的一项辅助性亚组研究中。

女性总体心血管疾病危险评估改良算法的推导及验证：雷诺危险评分

背景：尽管人们对动脉粥样硬化血栓形成已有新的认识，但是，预测女性心血管事件的方法在很大程度上仍依赖于传统的危险因素。 目的：根据新旧危险因素对女性心血管疾病危险评估法进行改进并予验证。 设计、地点及参试者：于24558名健康的≥45岁的美国女性中对35个危险因素进行评估分析。随访中位时间为10．2年（截至2004年5月），观察心血管事件（复合终点包括心肌梗死、缺血性卒中、冠状动脉血运重建以及心血管死亡）的发生率。随机使用三分之二女性队列（推导队列，n=16400）的资料推导新的危险计算方法，然后将其结果与其余三分之一女性队列（验证队列，n=8158）的实际情况进行比较，借此对新计算方法的有效性进行验证。 主要观测指标：根据BIC（Bayes Information Criterion）最小化原则在推导队列中建立最适简易预测模型。在验证队列中比较10年心血管事件的预测发生率与实际发生率。对新的计算方法和根据成人胆固醇治疗计划Ⅲ（ATP-Ⅲ）危险评分协变量产生的模型亦进行比较。 结果：与ATP-Ⅲ危险评分协变量模型相比，在推导队列中，有1个最适模型（模型A）和1个临床简化模型（模型B，雷诺危险评分）具有较低的BIC评分。在验证队列中，应用模型A及模型B时，所有拟和、判别及校准指标均获改善。举例而言，根据ATP-Ⅲ危险评分标准，在非糖尿病女性参试者中，有603人10年心血管疾病危险为5％～10％，156人10年心血管疾病危险为10％～20％；而根据模型A，则可将其中的379人（50％）重新归类为更符合实际事件发生率的更高或更低的危险级别；根据年龄、收缩压、糖化血红蛋白A1c（如果患糖尿病）、吸烟、总胆固醇和高密度脂蛋白胆固醇、超敏C-反应蛋白以及60岁前心肌梗死家族史产生的简化模型B也能达到相似的效果。对于ATP-Ⅲ评分划归为极低危险组女性，采用两种新的计算方法并无明显不同。 结论：我们推出了两种可大大改善心血管事件危险预测准确性的临床计算方法。验证结果表明，这两种方法可将40％～50％的传统中危组女性重新划归为高危组或低危组。

包括C-反应蛋白的心血管风险预测模型对女性的预测效应

背景:当高敏C-反应蛋白(hsCRP)成为心血管风险的独立预测因素,总体风险预测模型便纳入使用。目的:探讨和比较包括与不包括hsCRP的心血管风险预测模型。设计:观察性队列研究。地点:美国女性卫生保健。参与者:参与女性健康研究并平均随访10年。

Withania somnifera extract reduces the invasiveness of MDA-MB-231 breast cancer and inhibits cytokines associated with metastasis

Aim:The aim was to examine the anti-proliferative effect of a Withania somnifera(WS)root extract in cell cultures and nude mouse xenografts of breast cancer cell line MDA-MB-231.Methods:WS root extract was used to treat tumor cells at concentrations up to 100μg and for nude mouse experiments,the mice received daily WS at 300 mg/kg by oral gavage for 8 weeks.Results:The WS extract reduced viability of MDA-MB-231 cells by 75%and 88%after exposure of the cells to 50 and 100μg/mL,respectively,compared to vehicle-treated controls.WS extract caused a dose-dependent increase in the percentage of cells in the sub-G1 phase compared to untreated controls by 6%and 10%after exposure to 25 and 50μg/mL WS extract,respectively.WS extract also inhibited proliferation of xenografted MDA-MB-231 cells.The WS extract caused reductions in xenograft size by 60%compared to the untreated control after 8 weeks of treatment.Six of ten mice in the control group showed tumor metastasis to the lung,whereas there was none in the mice treated with the WS extract.At the gene level,WS caused a 75%reduction in chemokine CCL2 expression(P<0.05)in the xenografted tumors of the treated mice.Conclusion:WS root extract inhibited proliferation of breast cancer cells in vitro and in vivo and signifi cantly reduced expression of the cytokine,CCL2.These results warrant further studies to assess the underlying molecular mechanism of the anti-tumor activity of the WS extract in breast cancer.

Mildly elevated serum bilirubin is associated with a lower risk of hearing loss in Chinese adults

To the Editor:Hearing loss is the most common sensory deficit in humans,affecting daily communication and the overall quality of life.Oxidative stress plays a critical role in the development and progression of age-related hearing loss.Studies show that endogenous antioxidant deficiency or insufficient dietary antioxidant nutrient intake increased hearing loss risk,while antioxidant supplementation could prevent age-related hearing loss development.

云南省某矿区工人性行为和艾滋病病毒/性传播感染状况的调查

目的了解云南省某地矿工艾滋病病毒/性传播感染(HIV/STIs)相关知识、态度、行为及其感染状况和影响因素。方法2005年1月在云南省个旧市进行了由13名社区顾问委员会成员和12名矿工班组长参加的2个专题小组讨论;在个旧市2个矿区,用整群抽样方法招募矿工233名进行匿名问卷调查,并采血样进行HIV/STIs检测。结果矿工艾滋病相关知识贫乏,三种传播途径的正确回答率为54.4%(92/169),日常生活是否传播艾滋病的正确回答率为7.7%(13/169)。自我报告嫖娼的比例为9.0%。HIV和淋病感染率均为0.4%,衣原体感染率为8.2%。衣原体感染与文化程度(P=0.0347)和婚姻状况(P=0.032)有统计学联系。结论矿工HIV/STIs预防意识差,安全套使用率低,是今后控制HIV的重点人群。

12个既往有偿献血村艾滋病病毒传播潜在危险性综合评价

目的了解12个既往有偿献血村艾滋病病毒(HIV)传播潜在危险性。方法选择12个村的HIV感染率、丙型肝炎病毒感染率、献血(浆)员比例、艾滋病知识、性乱行为发生情况和既往病例报告数等7个指标,运用秩和比法(RSR)对各村HIV传播潜在危险性进行综合评价。结果根据专家评价,HIV感染率权重系数最高(0.28),艾滋病知识回答正确率权重系数最低(0.09);RSR综合评价结果为:01和02号村发生HIV传播的潜在危险性较大,03、05、09、10和12号村属于中等,04、06、07、08和11号村发生HIV传播的潜在危险性较低。结论12个既往有偿献血村HIV传播潜在危险性不同,应根据分类指导的原则采取不同的艾滋病防治措施。

ω3和ω6脂肪酸在体脂增加及肥胖发展中的作用

流行病学研究中观察到总的脂肪摄入量和体质量增加之间存在矛盾关系。膳食中的脂肪组成成分可能部分解释了这一矛盾关系。在过去的几十年中,西方日常膳食中ω6与ω3多不饱和脂肪酸(PUFA)比值显著上升。人群中总能量摄入和总脂肪摄入不变的情况下,ω6和ω3PUFA组成的变化可能对于肥胖的流行起到重要作用。实验研究表明,ω3和ω6脂肪酸通过脂肪生成、脂类平衡、脑—肠—脂肪轴和全身性炎症等机制在调控体脂增加中起着不同的作用。但是,观察性人群研究和人体临床试验提供的证据仍然有限。对ω3和ω6PUFA亚型的最佳摄入量和膳食中ω6与ω3脂肪酸最佳比值仍缺乏共识。本文对美国膳食中PUFA的组成在近几十年的变化,ω3和ω6脂肪酸对体脂作用的实验研究及膳食中PUFA与肥胖关系的流行病学研究进行了综述。未来的研究还需要进一步评估膳食脂肪酸及其生物标记物与体内脂肪增加和肥胖发展的客观与纵向测量指标之间的关联性,阐明在肥胖的初期预防阶段均衡膳食中ω3和ω6脂肪酸组成的潜在作用。