Geographical patterns of human diet derived from stable-isotope analysis of fingernails

Carbon and nitrogen isotope ratios of human fingernails were measured in 490 individuals in the western US and 273 individuals in southeastern Brazil living in urban areas, and 53 individuals living in a moderately isolated area in the central Amazon region of Brazil and consuming mostly locally grown foods. In addition, we measured the carbon and nitrogen isotope ratios of common food items to assess the extent to which these isotopic signatures remain distinct for people eating both omnivorous and vegetarian diets and living in different parts of the world, and the extent to which dietary information can be interpreted from these analyses. Fingernail delta13C values (mean +/- standard deviation) were -15.4 +/- 1.0 and -18.8 +/- 0.8 per thousand and delta15N values were 10.4 +/- 0.7 and 9.4 +/- 0.6 per thousand for southeastern Brazil and western US populations, respectively. Despite opportunities for a "global supermarket" effect to swamp out carbon and nitrogen isotope ratios in these two urbanized regions of the world, differences in the fingernail isotope ratios between southeastern Brazil and western US populations persisted, and appeared to be more associated with regional agricultural and animal production practices. Omnivores and vegetarians from Brazil and the US were isotopically distinct, both within and between regions. In a comparison of fingernails of individuals from an urban city and isolated communities in the Amazonian region, the urban region was similar to southeastern Brazil, whereas individuals from isolated nonurban communities showed distinctive isotopic values consistent with their diets and with the isotopic values of local foods. Although there is a tendency for a "global supermarket" diet, carbon and nitrogen isotopes of human fingernails hold dietary information directly related to both food sources and dietary practices in a region.     

Na+ Recirculation and Isosmotic Transport

The Na(+) recirculation theory for solute-coupled fluid absorption is an expansion of the local osmosis concept introduced by Curran and analyzed by Diamond & Bossert. Based on studies on small intestine the theory assumes that the observed recirculation of Na(+) serves regulation of the osmolarity of the absorbate. Mathematical modeling reproducing bioelectric and hydrosmotic properties of small intestine and proximal tubule, respectively, predicts a significant range of observations such as isosmotic transport, hyposmotic transport, solvent drag, anomalous solvent drag, the residual hydraulic permeability in proximal tubule of AQP1 (-/-) mice, and the inverse relationship between hydraulic permeability and the concentration difference needed to reverse transepithelial water flow. The model reproduces the volume responses of cells and lateral intercellular space (lis) following replacement of luminal NaCl by sucrose as well as the linear dependence of volume absorption on luminal NaCl concentration. Analysis of solvent drag on Na(+) in tight junctions provides explanation for the surprisingly high metabolic efficiency of Na(+) reabsorption. The model predicts and explains low metabolic efficiency in diluted external baths. Hyperosmolarity of lis is governed by the hydraulic permeability of the apical plasma membrane and tight junction with 6-7 mOsm in small intestine and < or = 1 mOsm in proximal tubule. Truly isosmotic transport demands a Na(+) recirculation of 50-70% in small intestine but might be barely measurable in proximal tubule. The model fails to reproduce a certain type of observations: The reduced volume absorption at transepithelial osmotic equilibrium in AQP1 knockout mice, and the stimulated water absorption by gallbladder in diluted external solutions. Thus, it indicates cellular regulation of apical Na(+) uptake, which is not included in the mathematical treatment.     

Organelle distribution in neurons: Logistics behind polarized transport

Highly polarized neurons need to carefully regulate the distribution of organelles and other cargoes into their two morphologically and functionally distinct domains, the somatodendritic and axonal compartments, to maintain proper neuron homeostasis. An outstanding question in the field is how organelles reach their correct destination. Long-range transport along microtubules, driven by motors, ensures a fast and controlled availability of organelles in axons and dendrites, but it remains largely unclear what rules govern their transport into the correct compartment. Here, we review the emerging concepts of polarized cargo trafficking in neurons, highlighting the role of microtubule organization, microtubule-associated proteins, and motor proteins and discuss compartment-specific inclusion and exclusion mechanisms as well as the regulation of correct coupling of cargoes to motor proteins.     

股骨近端防旋髓内钉内固定治疗股骨粗隆间骨折的疗效及术后隐性失血的影响因素分析

目的:观察股骨粗隆间骨折患者经股骨近端防旋髓内钉(PFNA)内固定治疗后的效果,并分析术后隐性失血的影响因素。方法:回顾性选取2018年3月~2020年7月期间来我院就诊的220例股骨粗隆间骨折患者的资料,患者经PFNA内固定治疗,观察其治疗效果及并发症发生情况,记录所有患者术后隐性失血情况,单因素和多元线性回归分析术后隐性失血的影响因素。结果:220例患者均成功完成了手术,按照Harris髋关节功能评分标准,优良率为82.73%(182/220),隐性失血量为(787.07±58.92)mL,并发症发生率为4.09%(9/220)。单因素分析结果显示,股骨粗隆间骨折患者经PFNA内固定治疗后,术后隐性失血的发生与年龄、骨折Evans分型、高血压病、糖尿病、术前抗凝、受伤至手术时间有关(P<0.05),而与性别、体质量指数、手术时间、术后输血无关(P>0.05)。多元线性回归结果显示,年龄>75岁、骨折Evans分型为Ⅲ~Ⅳ型、存在高血压病、存在糖尿病、术前抗凝、受伤至手术时间>5 d是引起术后隐性失血的危险因素(P<0.05)。结论:PFNA内固定治疗股骨粗隆间骨折患者,疗效较好,术后并发症较少,同时患者均存在不同程度的隐性失血,隐性失血的量与糖尿病、年龄、高血压病、骨折Evans分型、术前抗凝、受伤至手术时间等因素密切相关。     

弹性髓内钉与接骨板内固定治疗儿童股骨干骨折的临床疗效对比研究

摘要 目的：对比弹性髓内钉与接骨板内固定治疗儿童股骨干骨折的临床疗效。方法：本研究为回顾性研究,选取我院于2018年3月~2019年8月期间收治的儿童股骨干骨折患者98例,根据固定方式的不同将患儿分为A组（n=50,接骨板内固定治疗）和B组（n=48,弹性髓内钉治疗）,观察两组优良率、术前/术后相关指标及并发症发生情况。结果：B组的优良率高于A组（P<0.05）。B组手术时间、切口长度短于A组,术中出血量少于A组（P<0.05）。B组骨折愈合时间、住院时间、手术至内固定拆除时间、取出内固定手术时间短于A组（P<0.05）。两组患儿并发症发生率对比,差异无统计学意义（P>0.05）。结论：相对于接骨板内固定治疗,弹性髓内钉治疗儿童股骨干骨折,疗效更好,可有效改善术中、术后指标,且不增加并发症的发生率。     

血清NSE、LP-PLA2联合CAR对老年股骨粗隆间骨折患者PFNA内固定术后谵妄的预测价值

摘要 目的：探讨血清神经元特异性烯醇化酶（NSE）、脂蛋白相关磷脂酶A2（LP-PLA2）联合C-反应蛋白与白蛋白比值（CAR）对老年股骨粗隆间骨折患者闭合复位防旋髓内钉（PFNA）内固定术后谵妄的预测价值。方法：选择2020年4月至2023年2月北京中医药大学第三附属医院收治的209例老年股骨粗隆间骨折患者。所有患者均行PFNA内固定术治疗，术前检测血清NSE、LP-PLA2、CAR，术后根据是否发生谵妄分为谵妄组和非谵妄组。多因素Logistic回归分析术后谵妄的因素。受试者工作特征（ROC）曲线分析NSE、LP-PLA2、CAR预测术后谵妄的价值。结果：术后43例发生谵妄，发生率为20.57%。谵妄组血清NSE、LP-PLA2、CAR高于非谵妄组（P＜0.05）。多因素Logistic回归分析显示年龄偏大、手术时间过长、高NSE、高LP-PLA2、高CAR是老年股骨粗隆间骨折患者术后谵妄的危险因素（P＜0.05）。NSE、LP-PLA2、CAR预测老年股骨粗隆间骨折患者术后谵妄的曲线下面积（AUC）为0.784、0.808、0.820，联合预测的AUC 为0.907，高于单独预测。结论：老年股骨粗隆间骨折PENA术后谵妄患者血清NSE、LP-PLA2、CAR增高，高水平NSE、LP-PLA2、CAR是术后谵妄的主要危险因素。联合NSE、LP-PLA2、CAR对术后谵妄风险有较高预测价值。     

人工髋关节置换和内固定治疗复杂股骨转子间骨折的疗效及对预后的影响

目的:对比人工髋关节置换和内固定治疗复杂股骨转子间骨折的疗效及对预后的影响。方法:选择2008年1月~2012年5月我院骨科收治的复杂股骨转子间骨折患者85例,按知情同意原则分成人工髋关节置换组(A组,46例)及内固定组(B组,39例)2组,记录患者的一般临床资料及治疗情况,比较两组患者疗效指标及预后指标。结果:A组患者卧床时间低于B组患者,差别有统计学意义(P0.05);术后1、3、6个月的Harris评分情况A组均优于B组患者,差异有统计学意义(P0.05)。结论:人工髋关节置换治疗复杂股骨转子间骨折能有效缩短患者卧床时间,迅速恢复关节功能,远期疗效效果好。     

21例胫骨近端骨肉瘤保肢治疗临床分析

目的：探讨胫骨上端骨肉瘤保肢手术中使用人工关节重建的疗效和并发症。方法：回顾性分析2000年6月-2010年6月对21例胫骨上段骨肉瘤患者行根治性切除人工关节重建手术的临床资料,其中男性13例,女性8例,年龄21—62岁,平均34．1岁。依据Enneking分期：ⅡA期12例、ⅡB期9例。均采用广泛性边缘切除手术治疗。所有患者均接受术前、术后化疗。结果：1例患者发生术后胫前肌群坏死。所有患者均随访6—72个月,平均45．1个月。ⅡA期12例患者中,1例因肺转移死亡（占8．3％）,局部复发1例,行股骨下段截肢,10例无病生存;ⅡB期9例,4例死亡,5例存活;Enneking分期明显影响预后。结论：胫骨上段人工关节重建对胫骨上段骨肉瘤的保肢治疗具有良好的疗效。     

聚多曲霉引起甲真菌病1例

报告1例聚多曲霉所致的甲真菌病。患者为48岁男性,仓库管理员,因足甲出现红斑1 a余就诊。取甲屑作真菌检查及真菌培养。在含氯霉素的沙堡弱培养基中25℃长出白至青绿色的绒毛状菌落,转种察氏培养基经形态及rDNA序列分析,菌种鉴定为聚多曲霉。14 d后从甲红斑处再取标本培养仍为聚多曲霉。经抗真菌药物治疗后痊愈。