Open medicine journal最新文献

英文中文

Chronic Inflammatory Demyelinating Polyneuropathy in Systemic Lupus Erythematosus: A Rare Entity 系统性红斑狼疮的慢性炎症性脱髓鞘性多神经病变:一种罕见的实体

Open medicine journal

Pub Date : 2018-09-29 DOI: 10.2174/1874220301805010056

R. Mohd, F. Nordin, Rizna Cader

Neurological manifestations in Systemic Lupus Erythematous (SLE) varies and commonly affects the Central Nervous System (CNS) rather than the peripheral nervous system. Neuropsychiatric or CNS manifestation can be as high as 24-54%, whereas the peripheral nervous system involvement is lower around 5-27%. Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP) is one of the three commonest peripheral nervous system involvements in SLE patients and results with severe debilitating effects. However, it is rarely reported.A retrospective review of all SLE patients that were diagnosed with CIDP between 2000 and 2015 was done under follow up at our center that were diagnosed with CIDP between 2000 and 2015. We reviewed their medical records and analyzed their clinical presentation, investigations, treatment instituted, response to therapy and any neurological sequealae.A total of 512 case notes were reviewed. Of these 4 patients presented with CIDP (3 females, 1 male) aged between 26 to 46 years old. Three presented with transverse myelitis and the other one with acute motor and sensory axonal neuropathy. All patients were treated with high dose corticosteroids, three patients received cyclophosphamide whilst the other patient was induced with mycophenolate mofetil. Complete recovery was seen in one patient, two had persistent but improving numbness and the other one had a residual weakness.Peripheral nervous system involvement in SLE can result in serious debilitating effects. Early diagnosis and treatment are crucial in limiting the neurological sequealae.

系统性红斑狼疮(SLE)的神经系统表现各不相同，通常影响中枢神经系统(CNS)而不是周围神经系统。神经精神或中枢神经系统的表现可高达24-54%，而周围神经系统的表现则低至5-27%左右。慢性炎症性脱髓鞘性多神经根病(CIDP)是SLE患者三种最常见的外周神经系统病变之一，并导致严重的衰弱效应。然而，鲜有报道。我们对2000年至2015年间诊断为CIDP的所有SLE患者进行回顾性研究，并对2000年至2015年间诊断为CIDP的患者进行随访。我们回顾了他们的医疗记录，分析了他们的临床表现、调查、治疗、治疗反应和任何神经系统后遗症。共审查了512份病例记录。这4例患者中有3例女性，1例男性，年龄在26至46岁之间。3例表现为横贯脊髓炎，1例表现为急性运动和感觉轴索神经病变。所有患者均接受大剂量皮质类固醇治疗，3例患者接受环磷酰胺治疗，另1例患者接受霉酚酸酯诱导。1例患者完全恢复，2例有持续但改善的麻木，另1例有残余无力。SLE累及周围神经系统可导致严重的衰弱效应。早期诊断和治疗是限制神经系统后遗症的关键。

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引用次数: 1

Standardization of Dhatryadi Ghrita: A Herbal Ghee Based Ayurvedic Medicinal Preparation Dhatryadi Ghrita的标准化：一种以Ghee为基础的阿育吠陀草药制剂

Open medicine journal

Pub Date : 2018-08-31 DOI: 10.2174/1874220301805010047

R. Pal, A. Mishra

In the current time, there is a need to thoroughly examine the process of systematic research methodology and to provide genuine findings to provide the reference for further investigations of traditional herbal medicines, which are beneficial for various disorders.To standardize Dhatryadi Ghrita on various parameters, in order to assure its safety and efficacy on various grounds.The Ghrita was analyzed for its organoleptic, physico-chemical features and screened for its phyto-constituents as well as its chromatographic analysis.The physicochemical standards would serve as a preliminary test for the standardization of the formulation, which helps to lay standards for further use as reference for the quality control/quality assurance laboratory of a Pharmaceutical house.The improvement of analytical methodologies can serve as a specific basis for research in herbal drug technology, thereby, facilitating the producers and researchers to set quality standards as well as parameters, so as to fulfill the requirements of regulatory bodies for the establishment of therapeutic efficacy, safety and purity of herbal drugs. The obtained values can be adopted to lay down new pharmacopoeial standards to be followed in its preparation with batch to batch consistency.

在当前的时代，有必要彻底检查系统研究方法的过程，并提供真正的发现，为进一步研究对各种疾病有益的传统草药提供参考。对Dhatryadi Ghrita的各种参数进行标准化，以确保其安全性和有效性。对Ghrita的感官、理化特征进行了分析，并对其植物成分进行了筛选和色谱分析。理化标准将作为制剂标准化的初步测试，有助于制定标准，作为制药厂质量控制/质量保证实验室的参考。分析方法的改进可以作为草药技术研究的具体基础，从而促进生产商和研究人员制定质量标准和参数，以满足监管机构对建立草药疗效、安全性和纯度的要求。所获得的值可用于制定新的药典标准，以在其制备过程中保持批次间的一致性。

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引用次数: 4

Association of Mannose-Binding Lectin Gene Polymorphisms with Liver Diseases: A Review 甘露糖结合凝集素基因多态性与肝病的关系

Open medicine journal

Pub Date : 2018-08-29 DOI: 10.2174/1874220301805010039

Robert S. Lo, A. Austin, J. Freeman

Mannose-Binding Lectin (MBL) is a member of the collectin family and is an important protein in the immune system. It is a pathogen pattern-recognition molecule that binds to specific carbohydrate motifs on the surface of many pathogens. MBL activates complement via lectin pathway. Single nucleotide polymorphisms in the MBL gene influence serum MBL concentration and function. MBL deficiencies increase the risk of infection and disease-specific complications, especially in those who are already immune compromised with pre-existing conditions. This review discusses the molecular genetics of human MBL and the association of MBL polymorphisms with liver diseases including liver fibrosis, viral hepatitis B, viral hepatitis C, and infection post-liver transplantation.

甘露糖结合凝集素（MBL）是凝集素家族的一员，是免疫系统中的一种重要蛋白质。它是一种病原体模式识别分子，与许多病原体表面的特定碳水化合物基序结合。MBL通过凝集素途径激活补体。MBL基因单核苷酸多态性影响血清MBL浓度和功能。MBL缺乏会增加感染和疾病特异性并发症的风险，尤其是那些已经因先前存在的疾病而免疫受损的人。本文综述了人MBL的分子遗传学以及MBL多态性与肝纤维化、乙型病毒性肝炎、丙型病毒性肝炎和肝移植后感染等肝脏疾病的关系。

引用次数: 0

The Importance of the Time that Elapses Before Spontaneous Circulation is Established Following an Out-of-Hospital Cardiac Arrest 院外心脏骤停后自发循环建立前时间的重要性

Open medicine journal

Pub Date : 2018-07-24 DOI: 10.2174/1874220301805010033

A. Sakurai, K. Kinoshita, A. Utagawa, J. Yamaguchi, M. Furukawa, A. Noda

In order to clarify indications for therapeutic hypothermia, we retrospectively examined patients resuscitated after Out-of-Hospital Cardiac Arrest (OHCA) who recorded an Auditory Brainstem Response (ABR) wave V according to the Utstein-style guidelines. Patients who recorded an ABR wave V immediately after resuscitation from OHCA were kept at 34 °C for 48 hours. The cohort was divided into two groups: A favorable neurological outcome group (F group: N=12) and an unfavorable neurological outcome group (U group: N=14). Favorable neurological outcome was defined as Pittsburgh Cerebral-Performance Scale (CPC) 1 or 2 and unfavorable as CPC 3-5. Data used to compare the groups included whether CA was witnessed, if a bystander initiated cardiopulmonary resuscitation, presence of cardiac etiology, initial cardiac rhythm and elapsed time from emergency call receipt until Return of Spontaneous Circulation (ROSC). Elapsed time from receipt of the emergency call until ROSC was significantly shorter in the F group than in the U group. ROC curve analysis indicated that the cut-off duration was 28 minutes for a favorable neurological outcome. For OHCA patients with an ABR wave V, elapsed time from receipt of emergency call until ROSC may be an important parameter within the Utstein-style guidelines to determine the usefulness of therapeutic hypothermia.

为了明确治疗性低温的适应症，我们回顾性检查了院外心脏骤停(OHCA)后复苏的患者，这些患者根据utstein式指南记录了听觉脑干反应(ABR) V波。OHCA复苏后立即记录ABR波V的患者在34℃下保存48小时。将该队列分为两组:神经预后良好组(F组:N=12)和神经预后不良组(U组:N=14)。匹兹堡脑功能量表(CPC) 1或2为神经学预后良好，CPC 3-5为神经学预后不良。用于比较两组的数据包括是否目击到CA，是否有旁观者启动心肺复苏，心脏病因的存在，初始心律以及从接到紧急呼叫到自然循环恢复(ROSC)的时间。F组从收到紧急呼叫到ROSC的时间明显短于U组。ROC曲线分析显示，神经系统预后良好的截止时间为28分钟。对于有ABR波V的OHCA患者，从收到紧急呼叫到ROSC的时间可能是utstein式指南中确定治疗性低温有效性的重要参数。

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引用次数: 0

Adiponectin and Inflammation in Health and Disease: An Update 脂联素和炎症在健康和疾病:最新进展

Open medicine journal

Pub Date : 2018-05-31 DOI: 10.2174/1874220301805010020

A. Geagea, S. Mallat, C. Matar, R. Zerbe, Estelle Filfili, Maria Francis, Hanine Haidar, A. Jurjus

Adiponectin, a protein secreted by adipocytes, gained a special medical attention in the past two decades mostly due to its relation to obesity, a major health problem worldwide. Moreover, adiponectin has shown to have a preventive effect on insulin resistance, diabetes and cardiovascular diseases. Lately, obesity has been classified as a chronic inflammatory state, whereby dysregulated adipocytes and high infiltration of macrophages shift toward the production of pro-inflammatory cytokines like TNF-α and IL-6 among others. This status contributes to a decrease in adiponectin levels, thus leading to the emergence of obesity related complications. This review will focus on the hormone adiponectin and its mechanisms of action in relation to insulin resistance, diabetes, cardiovascular effect and atherosclerosis. It will also cover the various therapeutic approaches aiming to increase the levels of this important cytokine, and to highlight the promising role of AdipoRon, an adiponectin receptor agonist, and of diet.

脂联素是脂肪细胞分泌的一种蛋白质，在过去二十年中引起了医学界的特别关注，主要是因为它与肥胖有关，肥胖是世界范围内的一个主要健康问题。此外，脂联素已被证明对胰岛素抵抗、糖尿病和心血管疾病具有预防作用。最近，肥胖被归类为一种慢性炎症状态，其中失调的脂肪细胞和巨噬细胞的高浸润转向产生促炎细胞因子，如TNF-α和IL-6等。这种状态导致脂联素水平下降，从而导致肥胖相关并发症的出现。本文将重点介绍脂联素及其与胰岛素抵抗、糖尿病、心血管影响和动脉粥样硬化的作用机制。它还将涵盖旨在提高这种重要细胞因子水平的各种治疗方法，并强调脂联素受体激动剂AdipoRon和饮食的良好作用。

引用次数: 16

Frailty Characteristics in Chronic HIV Patients are Markers of White Matter Atrophy Independently of Age and Depressive Symptoms: A Pilot Study 慢性HIV患者的虚弱特征是独立于年龄和抑郁症状的白质萎缩的标志:一项初步研究

Open medicine journal

Pub Date : 2016-08-29 DOI: 10.2174/1874220301603010138

K. Kallianpur, Marissa E Sakoda, L. M. Gangcuangco, L. Ndhlovu, Tracie M Umaki, D. Chow, Suwarat Wongjittraporn, C. Shikuma

Background Chronic HIV disease is associated with neurocognitive impairment and age-related conditions such as frailty. Objective To determine whether regional brain volumetric changes correlate with frailty parameters in older (≥ 40 years) HIV+ patients on stable combination antiretroviral therapy. Method Thirty-five HIV-infected participants in the Hawaii Aging with HIV Cohort - Cardiovascular Disease study underwent T1-weighted brain magnetic resonance imaging, frailty assessment and neuropsychological testing. Five physical frailty traits were assessed: low physical activity; exhaustion; unintentional weight loss; weak hand grip strength; slow walking speed. Linear regression quantified cross-sectional relationships of 12 brain regions to walking times and hand grip strength. Results Participants were 50.6 ± 6.8 years old and 77% had undetectable plasma viral load. One subject was frail (possessing ≥ 3 frailty traits); 23% were pre-frail (1–2 frailty traits) and had worse composite learning and memory z-scores than did non-frail individuals (p=0.06). Pre-frail or frail subjects had reduced hand grip strength relative to the non-frail group (p=0.001). Longer walking times (slower gait) related independently to lower volumes of cerebellar white matter (p<0.001, β=−0.6) and subcortical gray matter (p<0.05, β=−0.30). Reduced thalamus volume was linked to weaker grip strength (p < 0.05, β=0.4). Caudate volume was negatively associated with grip strength (p<0.01, β=−0.5). Conclusion Volumetric changes in cerebellar white matter and subcortical gray matter, brain regions involved in motor control and cognition, may be connected to frailty development in well-controlled HIV. Gait speed is particularly sensitive to white matter alterations and should be investigated as a predictor of frailty and brain atrophy in chronically infected patients.

慢性艾滋病毒病与神经认知障碍和年龄相关疾病(如虚弱)有关。目的探讨接受稳定联合抗逆转录病毒治疗的老年(≥40岁)HIV阳性患者的脑容量变化是否与衰弱参数相关。方法在夏威夷老年伴HIV队列-心血管疾病研究中，35例HIV感染者接受了t1加权脑磁共振成像、虚弱评估和神经心理测试。评估了五种身体虚弱的特征:低体力活动;疲惫;意外减肥;手握力弱;缓慢的行走速度。线性回归量化了12个脑区与步行时间和握力的横截面关系。结果50.6±6.8岁，77%的患者血浆病毒载量检测不出。1名受试者体弱(具有≥3项脆弱特征);23%的人身体虚弱(1-2个脆弱特征)，其综合学习和记忆z分数低于非虚弱个体(p=0.06)。体弱或体弱受试者的握力相对于非体弱组有所降低(p=0.001)。较长的步行时间(较慢的步态)与小脑白质(p<0.001， β= - 0.6)和皮层下灰质(p<0.05， β= - 0.30)的体积降低独立相关。丘脑体积减小与握力减弱相关(p < 0.05， β=0.4)。尾状核体积与握力呈负相关(p<0.01， β= - 0.5)。结论控制良好的HIV感染者小脑白质和皮层下灰质体积变化与运动控制和认知有关。步态速度对白质改变特别敏感，应作为慢性感染患者虚弱和脑萎缩的预测指标进行研究。

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引用次数: 14

Group, One-on-One, or Internet? Preferences for Mindfulness Meditation Delivery Format and their Predictors. 小组、一对一还是互联网？对正念冥想授课形式的偏好及其预测因素。

Open medicine journal

Pub Date : 2014-01-01 Epub Date: 2014-11-28 DOI: 10.2174/1874220301401010066

Helané Wahbeh, Matthew N Svalina, Barry S Oken

Objectives: Group mindfulness meditation interventions have improved symptoms in many health conditions. However, many people are unwilling to receive group treatment, so alternative delivery methods such as individual and internet may be a useful option. The study objective was to examine mindfulness meditation intervention delivery format preferences and their relationship to potential predictors.

Design: An online survey was conducted of adult English speakers. Data was collected on interest and preference for internet, individual, or group formats of a mindfulness meditation intervention. Age, gender, personality, and posttraumatic stress disorder score and status and depression status were also collected.

Results and conclusions: 500 eligible participants completed the survey (mean age 39±15; range 18-70; 68% female). Participants were more interested in the Internet (n=356) and individual formats (n=384) than the group format (n=245). Fifty-five participants (11%) said they would refuse a group format. Internet was the first choice format for most participants (Internet 212 (43%), Individual 187 (38%), Group 97 (20%) and group was the last choice for most participants (Internet 140 (29%), Individual 70 (14%), Group 279 (57%)). Age, extraversion and emotional stability were significant in predicting first choice format. These results support the need for more research and implementation of alternative mindfulness meditation intervention delivery formats. Future research will incorporate additional predictors and include a broader range of participants.

目的：团体正念冥想干预可以改善许多健康问题的症状。然而，很多人不愿意接受集体治疗，因此个人和互联网等替代方法可能是一种有用的选择。本研究旨在考察正念冥想干预的实施形式偏好及其与潜在预测因素之间的关系：设计：对讲英语的成年人进行在线调查。收集的数据涉及对正念冥想干预的互联网、个人或小组形式的兴趣和偏好。此外，还收集了年龄、性别、性格、创伤后应激障碍得分和状态以及抑郁状态等方面的数据：500 名符合条件的参与者完成了调查（平均年龄为 39±15；年龄范围为 18-70；68% 为女性）。与小组形式（245 人）相比，参与者对互联网（356 人）和个人形式（384 人）更感兴趣。55名参与者（11%）表示他们会拒绝小组形式。互联网是大多数参与者的首选形式（互联网 212 人（43%）、个人 187 人（38%）、小组 97 人（20%）），而小组是大多数参与者的最后选择（互联网 140 人（29%）、个人 70 人（14%）、小组 279 人（57%））。年龄、外向性和情绪稳定性在预测首选形式方面具有重要意义。这些结果支持了对其他正念冥想干预形式进行更多研究和实施的必要性。未来的研究将纳入更多的预测因素，并包括更广泛的参与者。

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