Usefulness of the conicity index together with the conjoint use of adipocytokines and nutritional-inflammatory markers in hemodialysis patients

Abdominal fat has been recognized as the most hormonally active tissue secreting a variety of adipocytokines and, therefore, potentially contributing to inflammation. The conicity index (C_index) has been considered a valuable indicator of central obesity. This study aims to relate plasma concentrations of leptin, adiponectin, interleukin-6 (IL-6), and serum C-reactive protein (CRP) with C_index values in hemodialysis (HD) patients. Cross-sectional study in 45 HD patients (55.6 % men; DM 20 %; mean age, 68.1 year). C_index and nutritional-inflammatory markers were used for the abdominal fat depot assessment. Patients were classified as having a low or high median C_index (MC_index): low group (men, <1.39; women, <1.33) and high group (men, ≥1.39; women, ≥1.33). A combination of plasma leptin, IL-6, adiponectin, and CRP was used to design an inflammatory index (I_index) while a protein-energy wasting index (PEW_index) was calculated from the I_index plus the malnutrition-inflammation score (MIS). Waist circumference (WC) and C_index but not BMI were significantly higher in men than in women (p < 0.01). The MC_index was significantly associated with the adipocytokine profile (CRP, leptin, and adiponectin). Patients with a high MC_index had a higher I_index and PEW_index (p < 0.01). ROC curve analyses measured by area under the curve (AUC) were 0.69 and 0.68 (p < 0.05), for the C_index and MC_index, respectively, demonstrating the usefulness of the C_index as an abdominal fat mass biomarker able for wasting-inflamed HD patients. These findings in HD patients underscore the importance of incorporating the evaluation of one abdominal fat indicator, such as the C_index and an inflammatory biomarker such as the IL-6 and CRP, in substitution of the BMI, in current clinical practice.     

高龄患者腹腔镜结直肠癌根治术围手术期对机体应激及内脏蛋白的影响

目的:研究高龄病人(75岁以上)腹腔镜与开腹结直肠癌根治术围手术期白介素6(IL-6)、IL-10和C反应蛋白(CRP)及内脏蛋白的差异.方法:将41例行结直肠癌根治术的高龄患者按患者意愿分为腹腔镜组(n=20)和开腹组(n=21),两组患者的一般资料如年龄、性别、体重指数(BMI)等有可比性,检测两组患者术前、术后的应激指标:血清IL-6、IL-10和CRP及营养蛋白:前白蛋白(prealbumin,PRE)、转铁蛋白(transferrin,TRF)、视黄醇结合蛋(retinal-binding protein,RbP)的变化.结果:两组患者CRP在术后1、2、3d均较术前明显升高(P<0.01),术后2d达到峰值,腹腔镜组术后CRP明显低于开腹组(P<0.01);两组患者血清IL-6、IL-10术后也明显升高,腹腔镜组明显低于开腹组(P<0.01),但IL-10升高持续时间短.PRE、TRF、RbP术后两组均较术前有明显下降(P<0.01),术后1 d、2 d两组各指标无显著性差异(P>0.05),术后3 d腹腔镜组4种蛋白指标均明显高于开腹组(P<0.01).结论:对高龄病人两种不同手术方式应激水平及内脏蛋白指标的研究提示,腹腔镜结直肠癌根治术较开腹手术创伤小,应激水平低,有利于机体内脏蛋白的恢复,这对微创外科的实施是一个有力支持.     

Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases

This study examines the extent to which various ethnic-immigrant and US-born groups differ in their risks of all-cause and cause-specific mortality, morbidity, and health behaviors. Using data from the National Longitudinal Mortality Study, 1979-1989, we estimated, for major US racial and ethnic groups, mortality risks of immigrants relative to those of the US-born. The Cox regression model was used to adjust mortality differentials by age, sex, marital status, rural/urban residence, education, and family income. Logistic regression was fitted to the National Health Interview Survey data to determine whether health status and behaviors vary among ethnic-immigrant groups and by length of US residence. Compared with US-born whites of equivalent socioeconomic and demographic background, foreign-born blacks, Hispanics, and Asians/Pacific Islanders (APIs), US-born APIs, US-born Hispanics, and foreign-born whites had, respectively, 48%, 45%, 43%, 32%, 26%, and 16% lower mortality risks. While American Indians did not differ significantly from US-born whites, US-born blacks had an 8% higher mortality risk. Black and Hispanic immigrants experienced, respectively, 52% and 26% lower mortality risks than their US-born counterparts. Considerable differentials were also found in mortality for cancer, cardiovascular, respiratory, infectious disease, and injury, and in morbidity and health behaviors, with API and Hispanic immigrants generally experiencing the lowest risks. Consistent with the acculturation hypothesis, immigrants' risks of smoking, obesity, hypertension, and chronic condition, although substantially lower than those for the US-born, increased with increasing length of US residence. Given the substantial nativity differences in health status and mortality, future waves of immigrants of diverse ethnic and cultural backgrounds will likely have a sizeable impact on the overall health, disease, and mortality patterns in the United States.     

Inflammation and Renal Function after a Four-Year Follow-Up in Subjects with Unimpaired Glomerular Filtration Rate: Results from the Observational,Population-Based CARLA Cohort

Background

There is evidence that chronic inflammation is associated with the progression/development of chronic renal failure; however, relations in subjects with preserved renal function remain insufficiently understood.

Objective

To examine the association of inflammation with the development of renal failure in a cohort of the elderly general population.

Methods

After excluding subjects with reduced estimated glomerular filtration rate (eGFR<60 mL/min/1.73 m²) and missing data, the cohort incorporated 785 men and 659 women (aged 45–83 years). Follow-up was performed four years after baseline. Covariate adjusted linear and logistic regression models were used to assess the association of plasma/serum concentrations of soluble tumour necrosis factor receptor 1 (sTNF-R1), C-reactive protein (CRP), and interleukin 6 (IL-6) with change in eGFR/creatinine. The areas under the curve (AUCs) from receiver operating characteristics (ROCs) were estimated.

Results

In adjusted models sTNF-R1 was distinctively associated with a decline in eGFR in men (0.6 mL/min/1.73 m² per 100 pg/mL sTNF-R1; 95% CI: 0.4–0.8), but not in women. A similar association could not be found for CRP or IL-6. Estimates of sTNF-R1 in the cross-sectional analyses were similar between sexes, while CRP and IL-6 were not relevantly associated with eGFR/creatinine.

Conclusion

In the elderly male general population with preserved renal function sTNF-R1 predicts the development of renal failure.     

Population dynamics of the whitebacked planthopper,Sogatella furcifera (Hemiptera: Delphacidae) with special reference to the relationship between its population growth and the growth stage of rice plants

A population census was conducted to describe the effects of the growth stage of rice on the population dynamics ofS. furcifera, in particular, on immigration, seasonal abundance, population growth rate, and wing-form expression. The number of immigrants was highest on rice plants 17 to 30 days after transplanting (DAT), which suggested that immigrants prefer to settle or remain more on rice plants at the tillering stage (approximately 20–30 DAT). Population growth rate from immigration to the 1st generation decreased with an increase in rice plant age. In contrast, population growth rate from the 1st to 2nd generation was not influenced by rice plant age and was negatively density-dependent. The percentage of macropters (flyers) was positively related to the growth stage of rice when rice was in the vegetative or early part of the reproductive stage, and reached 100% at about 10 days before heading (booting stage). Threafter, most adult females molted into macropters regardless of population density. The roles of host plant age and crowding effect on the population dynamics ofS. furcifera are discussed.     

Effect of Zinc Supplementation on Inflammatory Markers and Adipokines in Young Obese Women

Obesity is a chronic inflammatory state characterized by altered adipokine production and increased levels of inflammatory cytokines. The study explored the effect of zinc supplementation on inflammatory markers and adipocyte hormones in young obese women. Twenty five non-obese women and forty obese women (body mass index ≥25 kg/m²) aged 19–28 years were recruited for this study. Twenty obese women of the study group took 30 mg/day of supplemental zinc as zinc gluconate for 8 weeks and 20 obese women of control group took placebo. Usual dietary zinc intake was estimated from 3-day diet records. Serum zinc and urinary zinc concentration were measured by Atomic Absorption Spectrophotometry. Inflammatory markers such as high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin (IL)-6 and adipocyte hormones such as lepin and adiponectin were measured by enzyme immunoassay. Inflammatory markers and leptin were significantly higher, but adiponectin was significantly lower in obese women than non-obese women. Zinc supplementation increased serum zinc by 15 % and urinary zinc by 56 % (P?<?0.05). The levels of hs-CRP (P?=?0.03) and IL-6 (P?=?0.006) significantly decreased with zinc supplementation, but not in placebo group. Serum leptin and plasma adiponectin concentration did not differ with either zinc supplementation or placebo. The levels of IL-6 and leptin were inversely associated with dietary zinc intake. These results suggest that zinc may have a favorable effect on obesity-related inflammation in young adults.     

A multifaceted analysis of immune-endocrine-metabolic alterations in patients with pulmonary tuberculosis

Our study investigated the circulating levels of factors involved in immune-inflammatory-endocrine-metabolic responses in patients with tuberculosis with the aim of uncovering a relation between certain immune and hormonal patterns, their clinical status and in vitro immune response. The concentration of leptin, adiponectin, IL-6, IL-1β, ghrelin, C-reactive protein (CRP), cortisol and dehydroepiandrosterone (DHEA), and the in vitro immune response (lymphoproliferation and IFN-γ production) was evaluated in 53 patients with active untreated tuberculosis, 27 household contacts and 25 healthy controls, without significant age- or sex-related differences. Patients had a lower body mass index (BMI), reduced levels of leptin and DHEA, and increased concentrations of CRP, IL-6, cortisol, IL-1β and nearly significant adiponectin values than household contacts and controls. Within tuberculosis patients the BMI and leptin levels were positively correlated and decreased with increasing disease severity, whereas higher concentrations of IL-6, CRP, IL-1β, cortisol, and ghrelin were seen in cases with moderate to severe tuberculosis. Household contacts had lower DHEA and higher IL-6 levels than controls. Group classification by means of discriminant analysis and the k-nearest neighbor method showed that tuberculosis patients were clearly different from the other groups, having higher levels of CRP and lower DHEA concentration and BMI. Furthermore, plasma leptin levels were positively associated with the basal in vitro IFN-γ production and the ConA-driven proliferation of cells from tuberculosis patients. Present alterations in the communication between the neuro-endocrine and immune systems in tuberculosis may contribute to disease worsening.     

Serum levels of leptin in multiple myeloma patients and its relation to angiogenic and inflammatory cytokines

BACKGROUND: Leptin, apart from the regulation of food intake, has been implicated in hematopoiesis, the immune response and angiogenesis. Leptin has been found to be decreased in various hematological malignancies. In the present study leptin was measured in multiple myeloma (MM) patients before and after treatment and correlated with other angiogenic molecules and markers of disease activity. METHODS: Serum leptin, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (b-FGF), interleukin-1 beta (IL-1beta), beta 2 microglobulin (beta2M) and C-reactive protein (CRP) were measured in 62 newly diagnosed MM patients, 22 of whom obtaining disease stabilization after treatment. The same parameters were measured in 20 healthy controls. Disease stage was defined according to the Durie-Salmon criteria. RESULTS: Leptin, VEGF, b-FGF, IL-1beta, and beta2M were significantly higher in newly diagnosed MM patients than in controls (p<0.05). VEGF, b-FGF, IL-1beta, beta2M, CRP but not leptin increased with advancing stage of disease (p<0.01). All parameters decreased significantly following treatment (p<0.001). Although IL-1beta correlated positively with VEGF, beta2M, b-FGF and CRP, leptin did not correlate with any of the measured parameters. CONCLUSION: Leptin serum levels do not reflect disease severity in MM. However, there seems to be a decrease in leptin following treatment, which may be associated with an alteration in the metabolic state or the chemokine milieu.     

Serum leptin levels in septic men correlate well with C-reactive protein (CRP) and TNF-alpha but not with BMI

Leptin, an adipocyte-derived signaling factor, is a member of the IL-6 cytokine family. However there is no direct evidence of leptin stimulation of the acute phase protein (APP) synthesis which is typical for all other IL-6-like factors. The purpose of this study was to characterize the dynamics of circulating leptin in relation to ten APPs. We used postoperative septic patients as a model of cytokine network hyperstimulation and intensive APP reaction. The prospective study was performed on 22 patients with proven postoperative intraabdominal sepsis after large abdominal surgery. Plasma levels of leptin, TNF-alpha, IL-1beta, soluble IL-2 receptor (sIL-2R), IL-6 (ELISA analysis) and ten APPs (nephelometric analysis) were estimated. We have demonstrated a statistically significant elevation of plasma leptin concentrations in the septic group compared with healthy subjects (p<0.001). The correlation of plasma leptin and BMI during postoperative sepsis was diminished. The regression coefficient was the highest for leptin and CRP (r=0.48, p<0.05), and for leptin and alpha-1-antitrypsin (r=0.46, p<0.05) in the septic group. There was significant correlation between TNF-alpha and leptin (r=0.47, p<0.05) and between IL-6 and leptin (r=0.45, p<0.05) in septic patients. No significant correlation was found between leptin and "negative" APP and between leptin and IL-1beta. Leptin has thus been shown as an acute phase reactant with a potential hematopoietic, immunomodulatory and hepatocyte stimulating activity during the infectious and non-infectious stress response. The significant correlation between leptin and CRP and leptin and alpha-1-antitrypsin indicates that leptin can participate in APP synthesis regulation during a systemic inflammatory response.     

福建省白背飞虱前期迁入虫源分析

近年来, 福建省白背飞虱Sogatella furcifera (Horváth)危害严重, 尤其2007年, 全省早稻白背飞虱特大发生, 迁入峰不但比常年偏早, 且虫量异常偏多。本文利用由美国国家大气与海洋局与澳大利亚国家气象局共同开发研制的大气质点轨迹分析平台模型HYSPLIT, 和气象图形分析显示软件GrADS对2007-2010年4-5月福建省白背飞虱早期主要迁入峰次进行了轨迹模拟, 并对2007年5月份的主要迁入过程进行了天气学背景分析。结果显示： (1) 福建省白背飞虱早期迁入虫源主要来自广东、海南省, 台湾省、 菲律宾仅在个别年份提供少量虫源, 非主要虫源地; (2) 低空急流与持续降水的配合是导致2007年白背飞虱集中降落的直接原因。2007年5月稻飞虱迁入同期, 福建850 hPa上空低空急流频繁, 5月份西太平洋副高比往年偏西、 偏强, 且北跳推迟, 使得华南地面准静止锋形成, 雨季延长; （3）2007年广东、 海南3月底至4月初的1代成虫迁入种群较多造成的田间2代白背飞虱虫源基数的增加是造成2007年福建白背飞虱迁入量增加的最根本原因。福建白背飞虱的主迁入虫量取决于两广早期田间虫源基数的多寡, 在副高偏强、 雨水较多年份, 提前对两广、 海南地区田间稻飞虱发生情况进行了解将有助于福建稻飞虱的预防与治理。     

Age at arrival and risk of obesity among US immigrants

Although immigrants are a rapidly growing subgroup, little is known about overweight/obesity among the foreign-born in the United States, especially regarding the effect of age at arrival. This study determined whether overweight/obesity prevalence is associated with age at arrival of immigrants to the United States. We analyzed data on 6,421 adult immigrants from the New Immigrant Survey (NIS), a study that is nationally representative of adult immigrants with newly acquired legal permanent residence (LPR). Multiple regression analyses tested the effects of duration of residence and age at arrival on overweight/obesity, defined by BMI of > or = 25 kg/m(2), and self-reported dietary change score. We found the relationship between duration of residence and overweight/obesity prevalence varied by age at arrival (P < 0.001). Immigrants < or = 20-years old at arrival who had resided in the United States > or = 15 years were 11 times (95% confidence interval: 5.33, 22.56) more likely to be overweight/obese than immigrants < 20-years old at arrival who had resided in the United States < or = 1 year. By comparison, there was no difference in overweight/obesity prevalence by duration among immigrants who arrived at >50 years of age. Higher self-reported dietary change is also associated with overweight/obesity. In conclusion, immigrants younger than 20 at arrival in the United States may be at higher risk of overweight/obesity with increasing duration of residence than those who arrive at later ages. Obesity prevention among young US immigrants should be a priority.     

阿维菌素中毒患者血清C反应蛋白的浓度变化及意义

目的探讨口服阿维菌素中毒患者血清C反应蛋白浓度变化与病情严重程度及预后的关系。方法将39例口服阿维菌素中毒患者分为轻度中毒组和中重度中毒组,42例健康体检者为对照组。轻、中重度中毒组患者分别于入院时及入院第3、5天检测血清C反应蛋白浓度,并进行组间比较。结果中毒组血清CRP水平明显高于对照组,差异有统计学意义（P〈0.05）;轻度中毒组血清CRP水平在入院时及入院第3、5天变化较小,各时点血清CRP水平比较无显著统计学意义（P〉0.05）;中重度中毒组血清CRP水平在入院时即显著升高,入院第3天达最高值,各时点血清CRP水平比较差异有统计学意义（P〈0.05）。结论血清C反应蛋白浓度可作为判断口服阿维菌素中毒患者病情严重程度及预后的敏感指标。     

Density-dependent immigration promotes population stability in a long-distance migratory bird

The spatial structure of populations determines the relative importance of reproduction, survival and movement on population dynamics. However, the mechanisms by which local individuals and immigrants interact and the subsequent effects of immigrants on productivity are poorly known. We developed an integrated population model (IPM) to study the extent and consequences of immigration on the dynamics of a neotropical migrant (American redstart, Setophaga ruticilla) over an 11-year period in Ontario, Canada. New immigrants represented the majority of the study population each year with higher immigration rates for males than females and for first-year breeders than breeders in their second year or older. Immigration was negatively density dependent, with immigrants replacing previously established breeders in a compensatory manner following their death or emigration. Because of the tradeoff between immigration and apparent survival, neither had a strong influence on population growth and reproductive output was most strongly correlated with a change in abundance between years. However, if immigration ceased, the study population would become locally extinct within 7 years and thus immigrants were essential for local population persistence. We found no evidence for reduced breeding success when immigrants represented a higher proportion of the study population. Our research highlights the importance of movement in the stability of open populations and the strong correlation between the fates of local breeders and the number of immigrants entering the population. We recommend the use of IPMs to address the spatial scale over which immigration occurs and how different scales influence its contribution to population dynamics.     

Family Member Deaths in Childhood Predict Systemic Inflammation in Late Life

Biological and epidemiological evidence has linked early-life psychosocial stress with late-life health, with inflammation as a potential mechanism. We report here the association between familial death in childhood and adulthood and increased levels of high-sensitivity C-reactive protein (CRP), a marker of systemic inflammation. The Cache County Memory Study is a prospective study of persons initially aged 65 and older in 1995. In 2002, there were 1,955 persons in the study with data on CRP (42.3 percent male, mean [SD] age = 81.2 [5.8] years), linked with objective data on family member deaths. Using logistic regression, high (> 10 mg/L) versus low (≤ 10 mg/L) CRP was regressed on cumulative parental, sibling, spouse, and offspring deaths during childhood and during early adulthood, adjusted for family size in each period (percentage family depletion; PFD). Findings revealed PFD during childhood to be significantly associated with CRP (OR = 1.02, 95% CI [1.01, 1.04]). Individuals with two or more family deaths were 79 percent more likely to have elevated CRP than those with zero family deaths (OR = 1.79, 95% CI [1.07, 2.99]). Early adulthood PFD was not related to CRP. This study demonstrates a link between significant psychosocial stress in early life and immune-inflammatory functioning in late life, and suggests a mechanism explaining the link between early-life adversity and late-life health.     

Similar effects of general and spinal anaesthesia on perioperative stress response in patients undergoing haemorrhoidectomy

Surgery induces release of neuroendocrine hormones (cortisol), cytokines (interleukin-6: IL-6, tumour necrosis factor-alpha: TNF-alpha), acute phase proteins (C-reactive protein: CRP, leptin). We studied the effects of general and spinal anaesthesia on stress response to haemorrhoidectomy. Patients were assigned to general and spinal anaesthesia groups (n = 7). Blood samples were drawn before induction and 24 hours after surgery. Perioperative levels of IL-6, TNF-alpha, CRP, cortisol, and leptin were comparable among the groups. Twenty four hours after surgery, TNF-alpha and cortisol did not change; IL-6 and CRP increased significantly in all patients. Significant increase in leptin levels was found in patients undergoing spinal anaesthesia. Except for the increase in leptin levels, there was no significant difference related to the effects of general and spinal anaesthesia.     

CRP is related to higher leptin levels in minority peripubertal females regardless of adiposity levels

Overweight is related to higher levels of C-reactive protein (CRP) and leptin, which have been independently associated with increased risk for diabetes, cardiovascular disease, and the metabolic syndrome. Elevated CRP may trigger leptin resistance by inhibiting the binding of leptin to its receptors. We cross-sectionally examined the relationship between CRP, leptin, BMI z-score, percent body fat (%BF) assessed by air plethysmography (BodPod), and insulin sensitivity (SI) and acute insulin response (AIRg) measured by intravenous glucose tolerance test in 51 Latina and African-American females (77% Latina), mean age 9.2 (±0.9) years, at either Tanner Pubertal Stage (TPS) 1 (n = 25) or TPS 2 (n = 26). Females at TPS 2 had higher BMI z-scores, %BF (23% ± 10.1 vs. 30% ± 10.0, P = 0.02), AIRg (976.7 ± 735.2 vs. 1555.3 ± 1,223 μIU/ml, P = 0.05), fasting insulin (11.0 ± 10.8 vs. 17.2 ± 13.6 μlU/ml, P = 0.00) and leptin levels (11.0 ± 7.1 vs. 19.6 ± 10.9 ng/ml, P < 0.001) than those at TPS 1. There were no ethnic differences in any of the measured variables. CRP was positively correlated with BMI z-score (P = 0.001), %BF (P = 0.006), fasting insulin and AIRg (P = 0.02), and fasting leptin (P = 0.00), and negatively correlated with SI (P = 0.05). A linear regression model showed that CRP independently explained 10% (P = 0.00) of the variance in leptin after adjusting %BF, TPS, ethnicity, habitual physical activity and SI. Hence, low-grade inflammation may contribute to prolonged leptin exposure and leptin resistance, even in healthy children.     

C-reactive protein modifies the association of plasma leptin with coronary calcium in asymptomatic overweight individuals

Evidence suggests putative interactions of leptin and C‐reactive protein (CRP) in the pathogenesis of adiposity‐related atherosclerotic cardiovascular disease (CVD). Therefore, we investigated whether CRP levels modify the relationship of leptin levels with coronary artery calcium (CAC). We examined 1,460 asymptomatic individuals from two community‐based cross‐sectional studies coordinated at a single, university‐based research center. We focused on subjects who were overweight or obese (BMI ≥25) given greater biologic plausibility in this setting. In multivariable CAC models, we analyzed the interaction of log‐transformed plasma leptin levels with higher CRP levels as defined by three cut‐points: two clinically based (2 mg/l, 3 mg/l) and one dataset specific (sex‐specific upper quartile). The association of plasma leptin with CAC was modified by higher CRP regardless of cut‐point (interaction term P values all <0.01 in fully adjusted models). Leptin levels were associated with CAC in those with high, but not low CRP levels (e.g., tobit ratio for a 1 unit increase in ln(leptin) (95% CI): 2.18 (1.29–3.66) if CRP level ≥3 mg/l; N = 461 vs. 0.94 (0.67–1.31) if CRP levels <3 mg/l; N = 999) in fully adjusted models. No interaction with CRP was present in control analyses with adiponectin, BMI and waist circumference. In conclusion, in asymptomatic overweight and obese adults, increased leptin levels were independently associated with increased CAC in the presence of high, but not low CRP levels, supporting a leptin‐CRP interface in atherosclerosis risk.     

Fungal immigration dynamics and community development on apple leaves

Fungal immigration dynamics and community development were followed over time on sets of surface-disinfested apple leaves in the field. Immigration was defined as the arrival of viable propagules on the leaf surface. In three separate experiments (May, June, July), total numbers of fungal immigrants, numbers of filamentous fungal immigrants, and numbers of yeast immigrants per leaf were estimated for successive 12-hour immigration periods. Communities developing over 2–14 immigration periods (1–7 days) were compared with the corresponding estimates of cumulative immigration. There were significant differences among both experiments and immigration periods within each experiment in mean numbers of immigrants per leaf. Leaf area was often significantly correlated with numbers of immigrants. Developing communities supported progressively fewer individuals than the corresponding sums of immigrants, suggesting that losses due to emigration and/or death play a critical role in shaping these communities.     

腹腔镜胆囊切除术与小切口胆囊切除术治疗胆结石的临床效果及对应激反应的影响

目的:探讨腹腔镜胆囊切除术与小切口胆囊切除术治疗胆结石的临床效果及对应激反应的影响。方法:选取2016年1月至2016年12月于我院行胆囊切除术治疗的胆结石患者80例作为研究对象,根据治疗方案不同将研究对象分为腹腔镜组和小切口组,腹腔镜组采用腹腔镜胆囊切除术,小切口组采用小切口胆囊切除术,比较两组患者手术时间、术中出血量、肛门排气时间、住院时间以及术后并发症的发生情况,检测并比较两组患者术前、术后1d、3d的白细胞(WBC)计数、中性粒细胞(NE)百分数、空腹血糖(Glu)、血清皮质醇(Cor)含量、C-反应蛋白(CRP)含量。结果:腹腔镜组的手术时间、术中出血量、肛门排气时间、住院时间均明显短于小切口组(P0.05),并发症发生率显著低于小切口组(P0.05)。术前,两组的WBC、NE、Glu、Cor、CRP水平比较差异均无统计学意义(P0.05);腹腔镜组术后1 d的WBC、NE、Glu、Cor、CRP水平均显著高于术前(P0.05),术后3 d的Glu、Cor、CRP恢复至术前水平(P0.05),WBC、NE也有所降低但仍高于术前(P0.05);小切口组术后1 d的WBC、NE、Glu、Cor、CRP水平均显著高于术前(P0.05),且高于同期腹腔镜组(P0.05),术后3 d的WBC、NE、Glu、Cor、CRP水平有所降低但仍高于术前(P0.05),且高于同期腹腔镜组(P0.05)。结论:腹腔镜胆囊切除术引起的应激反应更轻,并有利于胆结石患者术后快速恢复,并减少并发症的发生。     

A Systematic Review on the Development of Asthma and Allergic Diseases in Relation to International Immigration: The Leading Role of the Environment Confirmed

Background

The prevalence of asthma and allergic diseases is rising worldwide. Evidence on potential causal pathways of asthma and allergies is growing, but findings have been contradictory, particularly on the interplay between allergic diseases and understudied social determinants of health like migration status. This review aimed at providing evidence for the association between migration status and asthma and allergies, and to explore the mechanisms between migration status and the development of asthma and allergies.

Methods and Findings

Systematic review on asthma and allergies and immigration status in accordance with the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The pooled odds ratio (OR) of the prevalence of asthma in immigrants compared to the host population was 0.60 (95% CI 0.45–0.84), and the pooled OR for allergies was 1.01 (95% CI 0.62–1.69). The pooled OR for the prevalence of asthma in first generation versus second generation immigrants was 0.37 (95% CI 0.25–0.58). Comparisons between populations in their countries of origin and those that emigrated vary depending on their level of development; more developed countries show higher rates of asthma and allergies.

Conclusions

Our findings suggest a strong influence of the environment on the development of asthma and allergic diseases throughout the life course. The prevalence of asthma is generally higher in second generation than first generation immigrants. With length of residence in the host country the prevalence of asthma and allergic diseases increases steadily. These findings are consistent across study populations, host countries, and children as well as adults. Differences have been found to be significant when tested in a linear model, as well as when comparing between early and later age of migration, and between shorter and longer time of residence.