腹腔镜手术治疗粘连性肠梗阻的疗效及安全性研究

目的：探讨腹腔镜粘连松解术治疗粘连性肠梗阻（AIO）的疗效，减少再梗阻率。方法：将120 例AIO 患者随机分为两组，每 组60 例，开腹组实施开腹手术，腹腔镜组实施腹腔镜粘连松解术，观察两组术后恢复及并发症发生情况，对再梗阻危险因素进行 Logistic 回归分析。结果：腹腔镜组术中失血量（73.48± 9.32）mL，少于开腹组的（207.45± 33.21）mL（P<0.05）；腹腔镜组手术、术后 镇痛、下床活动、肠恢复蠕动、肛门恢复排气、拔除尿管及住院时间分别为（69.15± 10.13）min、（14.67± 7.23）h、（27.14± 7.04）h、 （3.11± 0.96）d、（3.24± 1.02）d、（3.37± 1.23）d、（7.95± 3.05）d，均短于开腹组的（83.84± 9.24）min、（27.38± 8.02）h、（36.23± 5.87） h、（4.05± 1.35）d、（4.35± 1.74）d、（5.02± 2.13）d、（10.35± 3.71）d（P<0.05)；腹腔镜组并发症发生率、再梗阻率分别为10.00%、 10.00%，均低于开腹组的33.33%、40.00%（P<0.05)；多因素Logistic 回归分析显示开腹手术、手术时间≥ 60 min 是再梗阻发生的独 立危险因素。结论：腹腔镜手术治疗AIO 疗效优于开腹手术，而且并发症与再梗阻率低。     

Association between light exposure at night and manic symptoms in bipolar disorder: cross-sectional analysis of the APPLE cohort

ABSTRACT

Previous studies have found that keeping the room dark at night was associated with a decrease in manic symptoms for patients with bipolar disorder (BD). However, the association between light at night of real-life conditions and manic symptoms is unclear. We investigated the association between bedroom light exposure at night and manic symptoms in BD patients. One-hundred and eighty-four outpatients with BD participated in this cross-sectional study. The average light intensity at night during sleep was evaluated using a portable photometer for seven consecutive nights. Manic symptoms were assessed using the Young Mania Rating Scale (YMRS), and scores ≥5 were treated as a “hypomanic state.” The median (interquartile range) YMRS score was 2.0 (0–5.0), and 52 (28.2%) participants were in a hypomanic state. The prevalence of a hypomanic state was significantly higher in the participants with an average light intensity at night exposure of ≥3 lux than in those with <3 lux (36.7% versus 21.9%; P = .02). In multivariable logistic regression analysis adjusted for BD type, depressive symptoms, sleep duration, and daytime physical activity, the odds ratio (OR) for a hypomanic state was significantly higher for the participants with an average light intensity at night exposure of ≥3 lux than for those with <3 lux (OR: 2.15, 95% confidence interval: 1.09–4.22, P = .02). This association remained significant at the cutoff value of YMRS score ≥6 (OR: 2.51, 95% confidence interval: 1.15–5.46; P = .02). The findings of this study indicate bedroom light exposure at night is significantly associated with manic symptoms in BD patients. Although the results of this cross-sectional investigation do not necessarily imply causality, they may serve to inform beneficial nonpharmacological intervention and personalized treatment of BD patients.     

Pulmonary Toxocariasis Mimicking Invasive Aspergillosis in a Patient with Ulcerative Colitis

A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.     

How to deal with oxygen radicals stemming from mitochondrial fatty acid oxidation

Oxygen radical formation in mitochondria is an incompletely understood attribute of eukaryotic cells. Recently, a kinetic model was proposed, in which the ratio between electrons entering the respiratory chain via FADH₂ or NADH determines radical formation. During glucose breakdown, the ratio is low; during fatty acid breakdown, the ratio is high (the ratio increasing—asymptotically—with fatty acid length to 0.5, when compared with 0.2 for glucose). Thus, fatty acid oxidation would generate higher levels of radical formation. As a result, breakdown of fatty acids, performed without generation of extra FADH₂ in mitochondria, could be beneficial for the cell, especially in the case of long and very long chained ones. This possibly has been a major factor in the evolution of peroxisomes. Increased radical formation, as proposed by the model, can also shed light on the lack of neuronal fatty acid oxidation and tells us about hurdles during early eukaryotic evolution. We specifically focus on extending and discussing the model in light of recent publications and findings.     

Membrane Binding and Homodimerization of Atg16 Via Two Distinct Protein Regions is Essential for Autophagy in Yeast

Macroautophagy is a bulk degradation mechanism in eukaryotic cells. Efficiency of an essential step of this process in yeast, Atg8 lipidation, relies on the presence of Atg16, a subunit of the Atg12–Atg5-Atg16 complex acting as the E3-like enzyme in the ubiquitination-like reaction. A current view on the functional structure of Atg16 in the yeast S. cerevisiae comes from the two crystal structures that reveal the Atg5-interacting α-helix linked via a flexible linker to another α-helix of Atg16, which then assembles into a homodimer. This view does not explain the results of previous in vitro studies revealing Atg16-dependent deformations of membranes and liposome-binding of the Atg12–Atg5 conjugate upon addition of Atg16. Here we show that Atg16 acts as both a homodimerizing and peripheral membrane-binding polypeptide. These two characteristics are imposed by the two distinct regions that are disordered in the nascent protein. Atg16 binds to membranes in vivo via the amphipathic α-helix (amino acid residues 113–131) that has a coiled-coil-like propensity and a strong hydrophobic face for insertion into the membrane. The other protein region (residues 64–99) possesses a coiled-coil propensity, but not amphipathicity, and is dispensable for membrane anchoring of Atg16. This region acts as a Leu-zipper essential for formation of the Atg16 homodimer. Mutagenic disruption in either of these two distinct domains renders Atg16 proteins that, in contrast to wild type, completely fail to rescue the autophagy-defective phenotype of atg16Δ cells. Together, the results of this study yield a model for the molecular mechanism of Atg16 function in macroautophagy.     

Autism-related dietary preferences mediate autism-gut microbiome associations

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Decreased Hardness of Dietary Fiber-Rich Foods by the Enzyme-Infusion Method

A novel technique is reported for softening plant tissues while retaining their shape by impregnating them with macerating enzymes under reduced pressure after defrosting the frozen plants. Samples were removed immediately from the enzyme solution after the freeze-infusion treatment, and the hardness was measured. Six enzymes and three enzymes were respectively chosen from 18 commercial enzymes for softening burdock roots and bamboo shoots. The tissue degradation due to impregnation of the tissues with the enzymes and the reaction time were investigated. Burdock roots and bamboo shoots were progressively softened during the reaction: the hardness reached 1.0×10⁴ N/m² or less. The water-soluble dietary fiber contents increased as a result of the freeze-infusion treatment. This softening technique, which retained the food shape, could enhance the production of food products for elderly persons and those under nursing care. Foods produced by this method can replace current minced and liquid dietary components.     

Frequency of Buddleja davidii Franch. (Buddlejaceae) in Germany along ecological gradients

In Central Europe as in most other temperate regions of the world, Buddleja davidii has become a very successful invader. A thorough observation, documentation and analysis of the spread of invasive species is the precondition for the understanding of invasion processes. Therefore, I documented the occurrence of the species along a west–east transect as well as an altitudinal transect, and I tried to reconstruct the spread of the species in the course of the last decades along railroad areas, which have proved to be the most favorized habitats for colonization of Buddleja. Additionally, a literature review is given on its general spread and distribution in Germany. Based on the investigation of 52 stations, the results show that the species, in Germany, has its optimum in the Rhein-Ruhr- and the Rhein-Main-area, that its abundance significantly decreases from west to east and with increasing altitude. A literature review combined with own investigations shows, that it was very successful in Germany on ruins of World War II but decreased and sometimes totally disappeared in cities of East Germany and of the altitudinal higher regions of Germany, i.e. also in many towns of South Germany. In West Germany, the recent spread started about three decades ago and is still in process. As cold winters seem to be the limiting factor for the spread of Buddleja, even an accelerated spread of this species and perhaps a loss of its ruderal character can be expected, considering the progress of climate change.