Radioactivity measurements of sewerage in 4 hospitals from Chongqing, China

Monitoring of any release of radioactive materials to the environment is necessary for the environmental protection. Measurement of medical radioactive elements in the hospital sewerage is very important too. However, few study of radioactivity in hospital sewerage has been carried out or reported.     

Improving trauma care in exsanguinating patients with CHOP (critical haemorrhage to operating-room patient) resuscitation protocol—A cumulative summation (CUSUM) analysis

IntroductionThe standard protocol for exsanguinating trauma patients involves initial evaluation and resuscitation in the emergency department which then sets the stage for subsequent definitive care and disposition. This involves major coordination and mobilisation of resources which may cause a delay in intervention especially when most of these cases present after office hours. Our centre has employed a second-tier activation system (CHOP protocol) that immediately mobilises all respective trauma specialists including interventional radiologists and allows rapid access to the operating room.ObjectiveWe hypothesised that exsanguinating patients managed by CHOP protocol have better overall outcome and survival.MethodsWe identified trauma patients that fulfilled CHOP criteria from 2016 to 2019 and divided them into two groups: preCHOP (standard protocol) and CHOP. Data was extracted from a prospectively maintained trauma registry. Demographics, injury pattern and in-hospital data were analysed. The key outcome studied was the impact of CHOP protocol on the mortality rate. Success and failure of the two groups were analysed using CUSUM methodology.ResultsThirty-seven patients were managed by CHOP protocol since its introduction in March 2018 compared to 36 patients who underwent standard protocol. Majority of the cases were blunt trauma (89% CHOP vs 92% preCHOP). The mean Injury Severity Score was 37 for CHOP group and 39 for preCHOP group. We observed a significant improvement in time to intervention in CHOP patients (78 min vs 113 min), both during and after office hours. CHOP patients had lower mortality compared to preCHOP group (11% vs 31%) and the effectiveness of the protocol was seen in achieving significantly lower mortality compared to the predicted model. CHOP protocol was able to produce a consistent trend of desired outcomes leading to the CUSUM curve exhibiting a sustained downward slope.ConclusionThe CHOP protocol, a relatively novel system in the local context, was able to achieve sustained improved outcomes compared to standard protocol. The CUSUM analysis concurred that implementation of CHOP protocol has helped to achieve consistent desired outcomes. It also suggested that the uptake and use of this protocol has integrated well into the existing workflow.     

内侧开放楔形胫骨高位截骨术治疗膝关节内侧单间室骨关节炎后的足底压力分析

目的 分析内侧单间室膝关节骨性关节炎(knee osteoarthritis, KOA)患者接受内侧开放楔形胫骨高位截骨术(medial opening wedge high tibial osteotomy, MOWHTO)治疗后的足底压力分布情况,为患者的手术治疗和康复提供生物力学参考。方法 选取31例行单侧MOWHTO治疗后的内侧单间室KOA患者作为实验组,同时以35例同年龄健康人群作为对照组,使用Pedomedic 40^?足底压力测试系统进行动态足底压力的测试。通过比较步行状态下实验组(术侧及未术侧)与对照组不同足底分区的峰值压强(p_max)、压力时间积分(force-time integral, FTI)和接触面积(contact area, CA),评估内侧单间室KOA患者MOWHTO术后的足底压力变化。结果 与未术侧和对照组相比,术侧第1跖骨区(MH1)CA和FTI偏高(P<0.05),第4跖骨区(MH4)CA偏小(P<0.001),第5跖骨区(MH5)p_max和FTI偏小(P<0.05)...     

烧伤小鼠IFIT1表达的初步观察

目的 观察烧伤小鼠干扰素诱导表达蛋白IFIT1的表达变化,初步探究其表达变化的原因.方法 实验小鼠致TBSA 15%Ⅱ度烧伤,1 d及7 d后处死,取肝、肺及脾组织.脂多糖掺入小鼠腹腔巨噬细胞株RAW264.7的培养基中,至终浓度0.1～1.0μg/ml,作用6 h.提取组织及细胞RNA,进行半定量逆转录-聚合酶链式反应,提取组织及细胞裂解上清,进行免疫印迹检测.结果 小鼠肝、肺、脾组织IFIT1的转录在烧伤后1 d升高,伤后7 d恢复至伤前水平;肝、肺、脾IFIT1的蛋白水平在伤后1 d一致升高,伤后7 d仍能检出升高.体外实验,细菌脂多糖显著激活RAW264.7细胞的IF-IT1转录及蛋白表达.结论 烧伤小鼠伤后早期IFIT1表达迅速升高,此变化与同期的内毒素血症引起的细胞应激有关.     

微波对体外培养的骨髓基质细胞脂质过氧化损伤

目的 :观察微波对体外培养的骨髓基质细胞的脂质过氧化损伤作用 .方法 :体外培养骨髓基质细胞 ,微波按强度分为 3组 (10 ,2 0和 30mW·cm-2 ) .辐照 1h ,共进行 2次试验 ,每次每组 4瓶细胞 .辐照后立即测定SOD活性 ,MDA含量 ,检测细胞存活率 .用方差分析进行统计分析 .结果 :微波辐照后 ,2 0mW·cm-2 组和 30mW·cm-2 组SOD活性下降(P <0 .0 1) ,MDA含量升高 (P <0 .0 1) ,细胞存活率明显下降 .结论 :在本实验条件下 ,微波可引起体外培养的骨髓基质细胞的脂质过氧化损伤     

电离辐射对T淋巴细胞IL-2分泌和细胞毒活性的影响

正常人外周血单个核细胞（ＰＢＭＣ）体外经１～６Ｇｙγ射线照射后，间接免疫荧光法分析受照Ｔ细胞Ｔ细胞抗原受体（ＴＣＲ）、ＣＤ＿３及ＣＤ＿（２３）阳性细胞百分率，Ｈ￣３－ＴｄＲ掺入及释放法测定白细胞介素－２（ＩＬ－２）分泌及Ｔ细胞细胞毒活性，免疫细胞化学法分析Ｔ细胞内ＴＣＲ及ＣＤ＿３表达．结果表明，Ｔ细胞ＴＣＲ、ＣＤ．及ＣＤ＿（２５）表达及ＩＬ－２分泌和细胞毒活性皆呈照射剂量依赖性降低．受照Ｔ细胞ＩＬ－２分泌及细胞毒活性抑制在一定程度上与细胞表面ＴＣＲ、ＣＤ＿３及ＣＤ＿（２５）表达减少、活性损伤有关，而细胞表面ＴＣＲ和ＣＤ＿３表达降低可能与大量ＴＣＲ及ＣＤ＿３在受照细胞胞浆内堆积有关．     

Evaluation of periodontitis in hospital outpatients with major depressive disorder. A focus on gingival and circulating cytokines

An imbalance in stimulated cytokine production is associated with the etiopathogenesis of numerous diseases such as major depressive disorder (MDD) and periodontal disease. Increased cytokine levels have been reported in the gingival crevicular fluid (GCF) of patients with MDD. Thirty-six outpatients with MDD participated in this study. Each outpatient was age-matched (±3 years) with a healthy control (n = 36). The patients were controlled for race and smoking habits. Unstimulated and stimulated interleukin 6 (IL-6), interleukin 1β (IL-1β), and interferon-γ (INF-γ) production in whole blood culture (WBC) and IL-6 and IL-1β levels in the GCF were evaluated. Circulating levels of IL-6 and IL-1β (unstimulated) as well as GCF IL-1β were modestly lower in MDD patients, compared to the levels in age-matched controls (Mann–Whitney, p = 0.002, 0.0075, ANCOVA, p = 0.025, respectively). In the unstimulated group, there was no correlation between the levels of circulating IL-6 and GCF IL-6 (r = 0.07, p = 0.67), and between the levels of circulating IL-1β and the IL-1β level in the CGF (r = −0.08, p = 0.63). In the LPS stimulation group, there was no correlation between the levels of circulating levels of IL-6 and GCF IL-6 (r = 0. 02, p = 0.91) or between the circulating IL-1β and GCF IL-1β (r = 0.13, p = 0.42). We observed modest immunosuppression in MDD patients (evaluated by no stimulation whole blood culture [WBC]), especially in patients with melancholic depression, chronic depression, and severe depression.     

爆炸冲击波对羊肝形态的影响

目的：观察三硝基甲苯（TNT）炸弹爆炸对肝组织的病理损伤特征，为爆炸伤的临床救治提供依据。方法：将25只健康山羊围绕爆心呈扇形布放于5～30m不同距离处，用电启动引爆TNT致伤动物。严密观察动物伤情，存活至4h的以颈动脉放血方式处死后，解剖观察肝脏组织，用40mg／L多聚甲醛固定制备石蜡标本、HE染色、光镜观察其组织病理改变。结果：距爆心5m处动物全部死亡（2／2），10m处死亡3只（3／5），15m处死亡2只（2／5），20m处死亡1只（1／5），25m和30m处各4只动物无一死亡（0／4）。肝组织的损伤主要是肝细胞空泡样变性、血窦淤血、出血明显；汇管区均有不同程度淤血、出血、炎性细胞浸润及胆管上皮细胞坏死脱落；非即刻死亡动物可出现中性粒细胞浸润。结论：致伤情况与动物分布距离密切相关，距爆心越近，死亡率越高。炸弹爆炸产生的冲击波可造成肝组织明显损伤。