Cardiac Denervation for Arrhythmia Treatment with Transesophageal Ultrasonic Strategy in Canine Models

Stellate ganglion (SG) modification has been investigated for arrhythmia treatment. In this study, transesophageal SG imaging and intervention were explored using a homemade 30F integrated focused ultrasonic catheter in healthy mongrel canines in vivo. Anatomic details of SGs were ultrasonically imaged and evaluated. SG had a heterogeneous echoic structure and characteristic profiles sketched by hyper-echoic outlines in an ultrasonogram. Left SGs in the experimental group were successfully ablated through the esophagus under ultrasonic guidance provided by the catheter itself. Two weeks after the ablation, the QT and QTc of the experimental group decreased compared with those of the sham group and at baseline (both p values < 0.001). Histologic examination revealed that left SGs were destroyed. No major complications were observed. This approach may be further explored as a method for ganglia remodeling evaluation and as a strategy of ganglia modification for arrhythmia and for other diseases.     

健康支持性环境对四川农村人群的不同血压水平的影响分析

目的 探讨健康支持性环境中的不同特征变量对四川省农村人群的不同血压水平的影响。方法 采用多阶段整群抽样的方法，随机抽取四川省7个县（区）8400名的18岁以上常住居民为调查对象。问卷调查一般人口学特征、身体活动行为特征和环境等信息。采用标准方法测量身高、体重、腰围和血压。采用无序多分类logistic回归分析。结果 本调查人群中共检出正常高值血压者4270例，检出率为50.83%，标化率为37.02%，平均年龄（56.22±14.89）岁；高血压患者1498例，检出率为17.83%，标化率为7.92%，平均年龄（65.26±11.28）岁。无序多分类logistic回归结果显示，住宿环境好、获得运动方面的健康信息和参与中等强度活动150Symbol~A@300min/周是正常高值血压和高血压人群的共同保护因素；住宿便利（OR=0.789, 95%CI:0.649~0.958, P=0.017）、医疗服务可及性便利（OR=0.686, 95%CI:0.509~0.924, P=0.013）、对健身步道和健身广场满意为高血压人群的保护因素。结论 多途径合理构建健康支持性环境，对农村正常高值血压者和高血压患者具有保护作用，对遏制农村高血压的流行现状起到一定作用。     

补阳还五汤加伸筋草治疗脑梗死后痉挛型偏瘫疗效研究

目的:探讨补阳还五汤重用伸筋草治疗脑梗死后痉挛型偏瘫的作用。方法:收集脑梗死后痉挛型偏瘫患者共88例,分为两组,对照组44例,西医治疗加康复训练和补阳还五汤治疗; 研究组44例,西医治疗加康复训练及补阳还五汤重用伸筋草治疗。比较治疗前后患者患侧上下肢肌张力、临床疗效、NIHSS、日常生活能力Barthel指数以及上下肢运动功能和不良反应发生率。结果:治疗后,两组患者患侧上下肢肌张力≤1级者占比均升高,且研究组中≤1级者占比均高于对照组,组间比较有统计学意义(P<0.05)。两组临床疗效等级分布和总有效率比较,差异有统计学意义(P<0.05)。治疗后两组患者NIHSS评分均降低,且研究组NIHSS评分低于对照组,治疗后两组患者Barthel指数和患侧上下肢FMA评分均升高,且研究组均高于对照组,组间比较有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:补阳还五汤重用伸筋草能够显著降低患者患侧上下肢肌张力,改善临床疗效和神经功能缺损,提高患者日常生活能力和患侧运动功能,且安全性良好。     

Elevated serum levels of Interleukin‐37 are associated with inflammatory cytokines and disease activity in rheumatoid arthritis

Interleukin‐37 (IL‐37) is closely associated with several inflammatory diseases. However, the role of IL‐37 in the pathogenesis of rheumatoid arthritis (RA) remains unclear. The aim of this study was to assess the associations between serum levels of IL‐37 and disease activity, inflammatory cytokines, and bone loss in patients with RA. Serum cytokines levels were examined by Enzyme‐linked immunosorbent assay (ELISA). Radiographic bone erosion was assessed using the van der Heijde‐modified Sharp score and bone mineral density (BMD) was measured using DXA. Serum IL‐37 levels in RA patients were significantly higher than those in HCs (p < 0.001), and were significantly positively correlated with clinical parameters of disease activity and serum levels of IL‐17 and IL‐23. In addition, serum IL‐37 levels were significantly higher in patients with stage IV of radiographic bone erosion than those with stage III and stage I–II, and they were significantly higher in those with osteopenia and osteoporosis than in those with normal BMD. Our results suggest that serum IL‐37 levels were increased in patients with RA and were positively associated with disease activity, IL‐17/IL‐23 and bone loss in RA, suggesting that IL‐37 may play a critical role in the pathogenesis of RA.     

创伤后重型急性弥漫性脑肿胀临床治疗策略

目的 探讨重型创伤后急性弥漫性脑肿胀（PADBS）患者保守治疗与手术治疗的疗效。方法 分析 2016年1月—2019年12月该院神经外科收治的44例重型PADBS患者，根据治疗方式分为手术组和保守治疗组，统计入院时格拉斯哥昏迷量表（GCS）评分、头颅CT检查情况、伤后6个月格拉斯哥预后量表（GOS）评分等资料。结果 两组患者入院时年龄、性别及GCS评分比较，差异无统计学意义（P>0.05）。两组患者伤后6个月时GOS评分比较，差异无统计学意义（P>0.05），但两组住院时间比较，差异有统计学意义（P<0.05），手术组长于保守治疗组。结论 重型PADBS在无瞳孔变化及GCS评分下降的情况下，可密切观察病情下选择保守治疗。     

低分子肝素钙预防腰椎退行性疾病术后深静脉血栓形成的有效性和安全性

目的探讨低分子肝素钙预防腰椎退行性疾病术后深静脉血栓形成(DVT)的有效性和安全性。方法回顾性分析广安市广安区人民医院68例腰椎退行性疾病患者的临床资料,术后均采用抗凝预防血栓形成,按照术后预防DVT所采用方式的不同分为对照组和低分子肝素钙组。分析比较2组患者术后引流量、切口愈合情况、DVT发生率、皮下瘀斑情况、血小板数值、凝血功能、D-二聚体。结果术后2组患者引流量、切口愈合情况、皮下瘀斑情况、凝血功能相关指标比较,差异无统计学意义(P>0.05)。术前和术后1、10 d 2组患者血小板数量的变化差异无统计学意义(P>0.05)。DVT发生率2组患者比较差异有统计学意义(P<0.05)。术前及术后1 d 2组患者D-二聚体比较,差异无统计学意义(P>0.05);术后10 d,对照组患者D-二聚体显著增加,2组比较差异有统计学意义(P<0.05)。结论腰椎退行性疾病术后使用低分子肝素钙进行抗凝,可以显著降低DVT的发生率,具有良好的安全性。     

Hair shaft miRNA‐221 levels as a new tumor marker of malignant melanoma

miRNA‐221 (miR‐221) is known to be abnormally expressed in many human cancers. The serum levels of miR‐221 have been reported as a tumor marker for malignant melanoma (MM). We hypothesized that the hair shaft miR‐221 levels may be increased in patients with MM. We therefore assessed the possibility that hair shaft miR‐221 levels could be a marker for MM. The hair shaft miR‐221 levels were significantly higher in patients with MM than controls. The rates of increased hair shaft miR‐221 levels above the cut‐off value were comparable to those of serum 5‐S‐CD, which is a tumor marker commonly used for MM. Measurements of the hair shaft miR‐221 levels could have potential clinical value in the detection of MM. This is the first report investigating the hair shaft levels of an miRNA in patients with MM. Our investigations offer new insight into the relationship between miR‐221 and MM, and may provide a new, non‐invasive way to screen for melanoma.     

尿干化学法和离心沉渣镜检法检测穿刺羊水母体细胞污染的应用

目的　探讨一种快速简便鉴别羊水母血污染的方案。方法　选取30 例2019 年6~10 月羊水穿刺样本, 检测 羊水及母血DNA，将母血DNA 污染量换算对应体积全血量建立羊水母血DNA 污染梯度模型，运用尿干化学法及离 心沉渣镜检法检测母血污染情况。结果　羊水母血DNA 污染率为5%，10%，20% 和30%，尿干化学法检出率分别为 16.67%，60%，100% 和100%；离心沉渣镜检法检出率分别为60%，100%，100% 和100%。结论　尿干化学法及离心 沉渣镜检法联合检测可更简便快捷地进行羊水母血污染鉴定，检出率与母血DNA 污染率呈正比关系。