乳腺癌患者抑郁症状与肠道微生物相关性研究

目的 探究乳腺癌患者抑郁症状与肠道微生物的相关性。方法 选取辽宁省肿瘤医院2018年1月至2019年1月诊断及治疗的乳腺癌伴抑郁患者28例,作为抑郁组,同时选取无抑郁的乳腺癌患者28例作为对照组。对两组患者进行肠道微生物检测,使用Pearson模型探究患者肠道微生态特征与抑郁水平的相关性。结果 两组肠道菌群的组成存在一定差异,两组拟杆菌目、肠杆菌科、普氏菌属、克雷伯杆菌属、链球菌属、迟缓埃格特菌、乳杆菌属、拟杆菌属、帕拉拟杆菌、瘤胃球菌属的丰度具有差异（P＜0.05）,两组样本菌群多样性具有差异。Pearson相关性分析显示,乳杆菌属与抑郁自评量表（BDI）评分呈显著负相关（r=-0.792,P＜0.001）;拟杆菌目、克雷伯菌属与BDI评分呈显著正相关（r=0.458,0.477,P=0.003,0.002）。结论 乳腺癌患者抑郁症状与肠道菌群中的拟杆菌目、乳杆菌属、克雷伯菌属具有相关性。     

Early diagnosis of breast cancer: experience in a consultant breast clinic.

Of 2839 women referred to a consultant breast clinic for clinical, mammographic and thermographic examination, 480 underwent biopsy and 126 were found to have cancer. Ten percent of the tumours were occult and were classified as very early biologic disease; they were identified by routine mammography in women whose breasts were clinically normal. Biopsy of solid mass lesions non-suspicious on mammography identified 20% of the cancers; half these lesions, classified as early biologic disease, were discovered by doctors at routine annual clinical breast examination, though the earliest cancers were detected by women who were confident and competent in monthly self-examination of the breasts. Biopsy of solid mass lesions suspicious on mammography identified 70% of the cancers; these were classified as late biologic disease. Skin or nipple dimpling or retraction was evident in two thirds of the patients; their lesions seemed to be later biologically than the lesions of the patients without clinical signs, and 75% had discovered the lesions themselves accidentally.     

Menopausal symptoms emerging during hormonal therapy of breast cancer, and their treatment

Hormonal compounds play an important role in the treatment of breast cancer. Their side effects may lead to suspension of therapy and consequently to the failure of the expected effect. Common and the same way most prevalent side effects of hormonal compounds are the menopausal complaints which can alter quality of life significantly. The early recognition and treatment of menopausal complaints and symptoms help to reach therapeutic success. In general, of menopausal related complaints the role of hot flash, atrophic vaginitis and sexual dysfunction is emphasized. Within the topic, it is possible to mention some musculo-skeletal complaints according to their similar etiology, the failure of estrogen effect. In the treatment of hot flash non-pharmacologic and pharmacologic methods can be distinguished. Based on meta-analyses anti-depressants, some anti-convulsants and clonidine proved to be effective. Musculo-skeletal complaints explained by the lack of estrogen effect do not cause permanent impairment but may indicate greater efficacy of endocrine treatment. In the context of osteoporosis it is important to emphasize prevention. The main goal of endocrine therapies is to ameliorate remission rate or survival, but we should not forget to treat side effects which can influence quality of life.     

Early signs of language in cross-fostered chimpanzees

In cross-fostering the young of one species are reared by adults of another, as in the classical ethological studies of imprinting and song-learning. In our laboratory, infant chimpanzees were reared under human conditions that included two-way communication in American Sign Language (ASL) the gestural language of the deaf in North America. Here we describe the cross-fostering conditions of this laboratory and the contrast with operant conditioning. We also review the uses and the shapes of the signs in the vocabularies of five cross-fostered chimpanzees, tests demonstrating that the cross-fostered chimpanzees could use signs of ASL to communicate conceptual information to human observers whose only source of information was the signs of the chimpanzees, early development of inflections that resemble the early inflections of deaf human children, evidence based on errors and on inflections for duality of patterning, the continued use of sign language among the chimpanzees even when deprived of human input and the acquisition of signs by the infant Loulis from the cross-fostered chimpanzees.     

Evolutionary biology and the treatment of signs and symptoms of infectious disease

When viewed from an evolutionary perspective, manifestations of infectious diseases can be classified as (1) adaptations of the host to counteract harmful aspects of the disease, (2) adaptations of the pathogen to manipulate the host, or (3) “side effects” of the disease that do not serve adaptive functions for either the host or the pathogen. Although the functions of most manifestations are not known, support or rejection of these hypotheses should be readily derivable in many cases from analyses of existing data and relatively simple experiments. This approach should lead to improved medical treatment because preferred treatment depends on assessment of the validity of the three explanations. As an illustration, this perspective and its consequences for therapy are analyzed for fever, rhinorrhea and diarrhea.     

Complex interaction of sensory and motor signs and symptoms in chronic CRPS

Spontaneous pain, hyperalgesia as well as sensory abnormalities, autonomic, trophic, and motor disturbances are key features of Complex Regional Pain Syndrome (CRPS). This study was conceived to comprehensively characterize the interaction of these symptoms in 118 patients with chronic upper limb CRPS (duration of disease: 43±23 months). Disease-related stress, depression, and the degree of accompanying motor disability were likewise assessed. Stress and depression were measured by Posttraumatic Stress Symptoms Score and Center for Epidemiological Studies Depression Test. Motor disability of the affected hand was determined by Sequential Occupational Dexterity Assessment and Michigan Hand Questionnaire. Sensory changes were assessed by Quantitative Sensory Testing according to the standards of the German Research Network on Neuropathic Pain. Almost two-thirds of all patients exhibited spontaneous pain at rest. Hand force as well as hand motor function were found to be substantially impaired. Results of Quantitative Sensory Testing revealed a distinct pattern of generalized bilateral sensory loss and hyperalgesia, most prominently to blunt pressure. Patients reported substantial motor complaints confirmed by the objective motor disability testings. Interestingly, patients displayed clinically relevant levels of stress and depression. We conclude that chronic CRPS is characterized by a combination of ongoing pain, pain-related disability, stress and depression, potentially triggered by peripheral nerve/tissue damage and ensuing sensory loss. In order to consolidate the different dimensions of disturbances in chronic CRPS, we developed a model based on interaction analysis suggesting a complex hierarchical interaction of peripheral (injury/sensory loss) and central factors (pain/disability/stress/depression) predicting motor dysfunction and hyperalgesia.     

Early warning signs of an acute myocardial infarction and their influence on symptoms during the acute phase,with comparisons by gender

Background: Identifying early warning signs of an acute myocardial infarction (AMI) may aid in the early diagnosis of coronary artery disease.Objectives: This study was conducted to assess early warning signs (prodromal symptoms) of AMI, with comparisons made by gender. Another aim was to determine whether these early warning signs had any influence on the patients' acute symptoms of AMI.Methods: This was a multicenter, cross-sectional study of Norwegian patients (aged ≤75 years) hospitalized with their first AMI. A self-administered questionnaire was used to gather information on prodromal symptoms, defined as pain in the chest, pain in the shoulder or back, radiating pain or numbness in the arms, dyspnea, and fatigue. Symptoms were reported for the year before AMI and during the acute stage. Logistic regression analyses were used to examine the association between prodromal symptoms and acute symptoms and the effect of medical history (hypertension, diabetes, and hypercholesterolemia).Results: The self-administered questionnaire had a 72% response rate; the study included 149 women and 384 men diagnosed with first-time AMI. Symptoms occurring during the year before AMI included pain in the chest in 45% (240/533), shoulder or back pain in 51% (270/533), arm pain in 38% (205/533), dyspnea in 33% (176/533), and fatigue in 62% (330/533). There were no statistically significant gender differences. The risk of experiencing chest symptoms in the acute phase was >5 times higher in women who had experienced prodromal symptoms in the chest (adjusted odds ratio [OR] = 5.11; 95% CI, 1.38-18.88) and nearly 3 times higher in men (OR = 2.80; 95% CI, 1.17–6.70). The risk of experiencing shoulder or back pain was almost 5 times higher in men with prodromal shoulder or back pain (OR = 4.96; 95% CI, 3.01–8.19), but no statistically significant association was found in women. The risk of experiencing radiating arm pain or numbness in the acute phase was more than doubled in women with prodromal arm pain (OR = 2.68; 95% CI, 1.19–6.20) and more than tripled in men with prodromal arm pain (OR = 3.11; 95% CI, 1.90–5.07). The risk of experiencing dyspnea in the acute phase was more than doubled in women with prodromal dyspnea (OR = 2.67; 95% CI, 1.25–5.71) and >5 times higher in men with prodromal dyspnea (OR = 5.73; 95% CI, 3.42–9.62). Finally, the risk of fatigue was almost tripled in women (OR = 2.97; 95% CI, 1.28–6.85) and more than doubled in men (OR = 2.51; 95% CI, 1.54–4.11). Hypertensive women, but not men, were less likely to experience chest symptoms in the acute phase (OR = 0.29; 95% CI, 0.10–0.82).Conclusions: Almost half of the study patients (45%) experienced prodromal chest symptoms the year before their first AMI. These prodromal symptoms predicted the symptoms that occurred during the acute stage of AMI, with some differences between the sexes.     

Physical fatty acid deficiency signs in children with ADHD symptoms

Fatty acid deficiency symptoms (FADS) of dry hair and skin, frequent thirst and urination have been observed to be higher in children with attention deficit hyperactivity disorder (ADHD). Two studies investigated FADS in 7-12-year-old children; Study 1 in a general population (N=347) and Study 2 in children with ADHD symptoms (N=104). Correlations between FADS and ADHD-related symptoms were found at baseline in Study 1 but not Study 2. FADS did not improve after supplementation with omega-3 and omega-6 polyunsaturated fatty acids (PUFA) versus placebo after 15 weeks in Study 2, and were not related to improvements in ADHD symptoms in the PUFA groups. However, FADS did improve in all groups, possibly attributable to the linoleic acid present in both the PUFA and placebo (palm oil) supplements. FADS are not a reliable selection criterion for children with ADHD who might benefit from omega-3 PUFA supplementation.