特发性间质性肺炎患者18F-FDG PET/CT与肺功能及炎性指标的相关性

目的 观察特发性间质性肺炎（ⅡP）患者¹⁸F-FDG PET/CT显像与肺功能及实验室炎性指标的关系。方法 回顾性分析20例ⅡP患者（ⅡP组）和20例肺部正常患者（对照组）的PET/CT图像,测量全肺最大标准摄取值（SUV_max）和平均标准摄取值（SUV_mean）,并校正获得最大靶背景比（TBR_max）和平均靶背景比（TBR_mean）,比较ⅡP组与对照组间SUV和TBR的差异,评价ⅡP组TBR与肺功能及炎性指标的相关性。结果 ⅡP组SUV_max、SUV_mean、TBR_max和TBR_mean均显著高于对照组（P均<0.001）。ⅡP组TBR_mean与用力肺活量（FVC,r=-0.811,P=0.004）、肺一氧化碳弥散量（DLCO,r=-0.715,P=0.020）、第1秒用力呼气量（FEV1,r=-0.698,P=0.025）、残气量（RV,r=-0.844,P=0.002）、肺总量（TLC,r=-0.693,P=0.026）及RV/TLC（r=-0.711,P=0.021）呈负相关,与FEV1/FVC（r=0.888,P=0.001）呈正相关。TBR_max与FVC（r=-0.667,P=0.035）和RV（r=-0.643,P=0.045）呈负相关,与DLCO、FEV1、FEV1/FVC、TLC、RV/TLC无明显相关性（P均>0.05）。ⅡP组TBR_max和TBR_mean分别与红细胞沉降率、C反应蛋白均无明显相关性（P均>0.05）。结论 ⅡP患者¹⁸F-FDG放射性摄取增高,其程度与肺功能具有一定相关性。     

Affective and inflammatory responses among orchestra musicians in performance situation

A number of studies have shown that mental challenge under controlled experimental conditions is associated with elevations in inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). However, relatively little work has been done on the effects of ‘naturalistic’ stressors on acute changes in inflammatory markers. The present study examined whether perceived arousal, valence and dominance in musicians are associated with pro-inflammatory and oxidative responses to a concert situation. Blood and salivary samples obtained from 48 members of a symphony orchestra on the day of rehearsal (i.e. control situation) and on the following day of premiere concert (i.e. test situation) were used to determine changes in salivary cortisol, pro-inflammatory markers (plasma myeloperoxidase, serum CRP, plasma IL-6), oxidative stress markers (paraoxonase1 activity and malondialdehyde), and homocysteine, a risk factor for vascular disease. Results of regression analyses showed a significant trend to increased myeloperoxidase (MPO) response in individuals with low valence score. Both affective states, valence and arousal, were identified as significant predictors of cortisol response during concert. In addition, control levels of plasma malondialdehyde were positively correlated with differences in IL-6 levels between premiere and rehearsal (r = .38, p = .012), pointing to higher oxidative stress in individuals with pronounced IL-6 response. Our results indicate that stress of public performance leads to increased concentrations of plasma MPO (20%), IL-6 (27%) and salivary cortisol (44%) in musicians. The decreasing effect of pleasantness on the MPO response was highly pronounced in non-smokers (r = −.60, p < .001), suggesting a significant role of emotional valence in stress-induced secretion of MPO. Additional studies are needed to assess the generalizability of these findings to other ’naturalistic’ stress situations.     

Motor impairment,depression, dementia: Which forms the impression of disease severity in Parkinson's disease?

IntroductionClinical Global Impression of Severity (CGIS) is a common measure in clinical research on Parkinson's disease (PD). However, patient features that contribute to the impression of the physician remain unclear. In particular, the impact of cognitive impairment and depression is understudied.MethodsIn a nationwide study on 1449 outpatients with PD, examined by 315 office-based neurologists, PD severity was documented with the Unified Parkinson's Disease Rating Scale (UPDRS-I, II, and IV). All patients were screened with the Montgomery-Asberg Depression Rating Scale (MADRS) for depression. The diagnosis of dementia was based on Diagnostic and Statistical Manual of Mental Disorders IV Text Revision criteria. Each patient was rated on the CGIS.ResultsCGIS ratings were available for 1438 patients, of which 50.8% were rated as “borderline” to “moderately ill” and 49.2% as “markedly” to “extremely ill.” Worse ratings were associated with higher age (p < 0.001), longer PD duration (p < 0.001), and female sex (p < 0.001). The impact of patient and physician variables on CGIS rating was calculated with three regression models (A: single bivariate regression; B: multivariate regression; and C: multivariate, multilevel regression, including physician variables). In all models, higher UPDRS-II scores and longer disease duration of PD were the strongest predictors for a worse CGIS rating. In the multivariate models (B and C), neuropsychiatric symptoms were unrelated to the CGIS rating.ConclusionThe additional burden of dementia and depression was underestimated in the CGIS rating, suggesting that they are possibly relativized against the motor impairment.     

Analysis and Study on 47 Cases of Adverse Reactions of Chinese Medicine Injection

Background

Along with efficacy, Chinese medicine is increasingly being known to people, Chinese medicine and its preparations are increasingly widespread in clinical use. People generally believe that Chinese medicine has few side effects and is safe, especially Chinese medicine injections. Due to the direct injection in blood, rapid onset and good efficacy, they are welcomed by people. However, with increased use, adverse reactions are increasing, even causing serious consequences. The objective is to learn about the characteristics and laws of the adverse effects of Chinese medicine injections, provide references for the clinical safe drug use, and reduce the incidence of adverse reactions.

Materials and Methods

The method was established to analyze the data of 47 cases of adverse reactions caused by Chinese medicine injections in our hospital from the year, 2009 to 2010.

Results

The organs / systems involved in the 47 cases of adverse reactions are primarily skin and its accessories and secondly systemic damage, involving a total of eight varieties of drugs.

Conclusion

The adverse reactions of Chinese medicine injections are mostly in Chinese patent drugs, which should be paid attention to, to find out the problems and laws, use the drugs rationally, and reduce the incidence of the adverse reactions.     

Epidemiology of Group B streptococcus isolated from pregnant women in Beijing,China

Group B Streptococcus (GBS) was the main causative organism of invasive infections in newborns due to vertical transmission from the colonized mothers. The study was undertaken to determine colonization rate, serotype distribution, genotypic characterization, antibiotic susceptibility profiles and molecular characteristics of erythromycin-resistant strains of GBS in pregnant women in Beijing, China. Vaginal–rectal swabs were collected from a total of 2850 pregnant women at 35–37 weeks of gestation, in which 7.1% were GBS positive. Serotypes III, Ia and V predominated. All isolates were penicillin susceptible, whereas the resistance rates for erythromycin and clindamycin were strikingly high.     

Study and evaluation of mechanisms of dual targeting drug delivery system with tumor microenvironment assays compared with normal assays

A dual targeting delivery system was developed to completely conquer the two barriers that glioma treatment faces: the blood–brain barrier (BBB) and the brain–glioma barrier. Recently, a system comprising AS1411 aptamer (for glioma targeting) and TGN peptide (for BBB targeting) modified nanoparticles (AsTNPs) was developed, which can effectively target brain glioma and improve the survival of glioma-bearing mice. However, the in vitro models currently used are far too different from the in vivo tumor microenvironment that the glioma targeting delivery system actually faces. In this study, the pharmacology mechanisms of AsTNPs were explored in several models that imitated the tumor microenvironment. AsTNPs can be selectively taken up by endothelial and glioma cells, effectively penetrating the BBB and brain–glioma barriers to reach glioma cells and display their anti-glioma effect. The cell monolayers, tumor spheroids and coculture systems were more suitable in vitro models for the pharmacology evaluation of targeted drug delivery systems.     

咬合抬高对后牙重度磨耗患者咀嚼肌表面肌电值的影响

目的：探讨后牙重度磨耗患者咬合抬高后对咀嚼肌表面肌电反应的影响。方法：随机选取2012年1月至2014年1月在我北京航空总医院口腔诊疗中心就诊的,伴有双侧后牙重度磨耗的患者40名为受试对象,其中男性23名,女性17名,年龄40-50岁,治疗前及咬合抬高不同距离后分别进行咬肌及颞肌的肌电检查,并对结果采用多样本均数比较的单因素方差分析进行统计学处理。结果：切牙区颌间距离增加1mm时,双侧咬肌,双侧颞肌肌电值差异无统计学意义。切牙区颌间距离增加2mm时,左侧咬肌,右侧咬肌,左侧颞肌肌电值差异无统计学意义,右侧颞肌肌电值有所增加（17.08±3.27 VS 24.66±3.18,P〈0.05）。切牙区颌间距离增加3mm时,除右侧咬肌肌电值差异无统计学意义外（22.35±3.14 VS 27.74±4.26,P〉0.05）,左侧咬肌,左侧颞肌,右侧颞肌肌电值差异均有统计学意义。切牙区颌间距离增加4mm时,双侧咬肌,颞肌肌电值差异均有统计学意义。结论：切牙区颌间距离增加2mm时对咬肌和颞肌肌电值影响不大,切牙区颌间距离增加3mm会对咬肌和颞肌肌电值产生较大影响。     

Parkinson's disease patient preference and experience with various methods of DBS lead placement

IntroductionPhysiology-guided deep brain stimulation (DBS) surgery requires patients to be awake during a portion of the procedure, which may be poorly tolerated. Interventional MRI-guided (iMRI) DBS surgery was developed to use real-time image guidance, obviating the need for patients to be awake during lead placement.MethodsAll English-speaking adults with PD who underwent iMRI DBS between 2010 and 2014 at our Center were invited to participate. Subjects completed a structured interview that explored perioperative preferences and experiences. We compared these responses to patients who underwent the physiology-guided method, matched for age and gender.ResultsEighty-nine people with PD completed the study. Of those, 40 underwent iMRI, 44 underwent physiology-guided implantation, and five underwent both methods. There were no significant differences in baseline characteristics between groups. The primary reason for choosing iMRI DBS was a preference to be asleep during implantation due to: 1) a history of claustrophobia; 2) concerns about the potential for discomfort during the awake physiology-guided procedure in those with an underlying pain syndrome or severe off-medication symptoms; or 3) non-specific fear about being awake during neurosurgery.ConclusionParticipants were satisfied with both DBS surgery methods. However, identification of the factors associated with a preference for iMRI DBS may allow for optimization of patient experience and satisfaction when choices of surgical methods for DBS implantation are available.     

Evaluation of perioperative prophylaxis with fosfomycin tromethamine in ureteroscopic stone removal: an investigator-driven prospective,multicenter, randomized,controlled study

Purpose

To compare efficacy, safety, and cost-effectiveness of fosfomycin tromethamine with other standard-of-care antibiotics in patients undergoing ureteroscopic lithotripsy.

Methods

This study was a prospective, multicenter, randomized, controlled trial. Eligible patients scheduled for ureteroscopic lithotripsy were randomly assigned to receive either fosfomycin (fosfomycin group, N = 101 patients) or standard-of-care antibiotic therapy as prophylaxis (control group, N = 115 patients). The incidence of infectious complications and adverse events was analyzed between the two groups, as well as the cost–benefit analysis.

Results

The incidence of infections following lithotripsy was 3.0% in the fosfomycin group and 6.1% in the control group (p > 0.05). Only asymptomatic bacteriuria was reported in fosfomycin group. In the control group was reported asymptomatic bacteriuria (3.5%), fever (0.9%), bacteremia (0.9%), and genitourinary infection (0.9%). The rate of adverse events was very low, with no adverse event reported in the fosfomycin group and only one in the control group (forearm phlebitis). The average cost per patient of antibiotic therapy with fosfomycin was 151.45 ± 8.62 yuan (22.7 ± 1.3 USD), significantly lower compared to the average cost per patient of antibiotics used in the control group 305.10 ± 245.95 yuan (45.7 ± 36.9 USD; p < 0.001).

Conclusions

Two oral doses of 3 g fosfomycin tromethamine showed good efficacy and safety and low cost in perioperative prophylaxis of infections following ureteroscopic stone removal.

     

糖皮质激素在病毒性脑炎中的应用

通过文献检索探讨糖皮质激素应用于病毒性脑炎的合理性.糖皮质激素能减轻脑水肿,抑制过度炎症反应,因此在病毒性脑炎的治疗中能起到积极的作用;但其免疫抑制的作用利于病毒的复制,也可能影响疾病的治愈.因此建议轻中度病毒性脑炎慎用糖皮质激素,对于重症病毒性脑炎应用糖皮质激素应及时、合理.