1H nuclear magnetic resonance-based metabolic profiling of cerebrospinal fluid to identify metabolic features and markers for tuberculosis meningitis

BackgroundTuberculosis meningitis (TBM) is the most severe form of tuberculosis, and currently lacks efficient diagnostic approaches. Metabolomics has the potential to differentiate patients with TBM from those with other forms of meningitis and meningitis-negative individuals. However, no systemic metabolomics research has compared the cerebrospinal fluid (CSF) of these patients.Methods¹H nuclear magnetic resonance (NMR) was used for CSF metabolic profiling. Principal component analysis and orthogonal signal correction-partial least squares-discriminant analysis (OPLS-DA) were used to screen for important variables. The Human Metabolome Database was used to identify metabolites, and MetaboAnalyst 4.0 was used for pathway analysis and over-representation analysis.ResultsOPLS-DA modeling could distinguish TBM from other forms of meningitis, and several significantly changed metabolites were identified. Additionally, 23, 6, and 21 metabolites were able to differentiate TBM from viral meningitis, bacterial meningitis, and meningitis-negative groups, respectively. Pathway analysis indicated that these metabolites were mainly involved in carbohydrate and amino acid metabolism, and over-representation analysis indicated that some of these pathways were over-represented.ConclusionsThe metabolites identified have the potential to serve as biomarkers for TBM diagnosis, and carbohydrate and amino acid metabolism are perturbed in the CSF of patents with TBM. Metabolomics is a valuable approach for screening TBM biomarkers. With further investigation, the metabolites identified in this study could aid in TBM diagnosis.     

Development of the NADPH-diaphorase-positive neurons in the sympathetic ganglia

Changes in the distribution of NADPH-diaphorase (NADPH-d) were studied in neurons of the superior cervical ganglion (SCG), stellate ganglion (SG) and celiac ganglia (CG) in newborn, 10-, 20-day-old, 1-month-old, 2-month-old and 6-month-old rats, mice and kittens. NADPH-d-positive neurons were revealed in all sympathetic ganglia in kittens but not in rodents from birth onwards. In kittens, the largest population of NADPH-d-positive cells was found in the SG, the smallest in the SCG (<1%) and we observed only a few cells in the CG. The proportion of NADPH-d-positive cells in the SG increased from 3.1±0.15% in newborn kittens to 9.3±0.63% in 20-day-old animals and decreased further from 8.1±0.75% in 30-day-old kittens to 3.4±0.54% in 2-month-old animals. The content of NADPH-d-positive cells in the CG and SCG did not change during development. There were no differences in cross-sectional area between neurons located in different ganglia of animals from the same age group under study. We conclude that the development of NADPH-d-positive neurons in different sympathetic ganglia has its own time dynamics and is completed by the end of the second month of life.     

黄芪多糖提取工艺、化学结构及药理作用的研究进展

黄芪多糖（Astragalus polysaccharides,APS）是黄芪的重要活性成分之一,随着黄芪在临床上的使用越来越广泛,学者对APS的提取工艺、化学结构及药理作用的研究也愈来愈深入。不同的提取工艺对APS的含量和纯度均会产生不同程度的影响,进而对其药理作用的发挥也会有所影响。APS具有调节免疫、抗肿瘤、降血糖、抗衰老和抗炎等药理作用。在全面查阅并梳理文献资料的基础上,对APS的提取工艺、化学结构及药理作用进行综述,并对APS的研究前景进行展望,以期对APS的进一步开发利用和研究提供有效的理论支持。     

电阻抗断层成像技术用于呼气末正压滴定的研究进展

适当的呼气末正压（PEEP）是保护性肺通气策略的重要组成部分,PEEP可以保持肺泡开放,减少肺萎陷伤。尽管个体化PEEP已被越来越多的临床医师认可,但最佳的PEEP滴定方法尚存争议。电阻抗断层成像（EIT）是一种无创、无辐射的成像技术,可在床边实时动态评估肺功能,将肺通气过程中的阻抗变化以动态图像呈现,能够反映PEEP调整前后肺内通气及气体分布变化,因此,EIT可用于滴定个体化PEEP。本文简要概括EIT的基本原理及监测指标,阐述临床应用EIT指导下的PEEP（PEEPEIT）滴定方法,旨在加强对EIT的优点和局限性的理解,为优化个体化PEEP的设置提供参考。     

三主体双轨道交互式护理对老年慢性阻塞性肺疾病患者应用及效果评价

目的 探究三主体双轨道交互式护理对老年慢性阻塞性肺疾病(COPD)患者的应用效果。 方法 选取2013年12月-2015年12月期间哈尔滨医科大学附属第一医院门诊确诊的老年COPD患者132例,按照单纯随机抽样的方式分为干预组和对照组;对照组患者采用常规化的护理方法,即患者在出院后,进行电话回访一次,提供给患者相应的自我管理知识和宣传教育,干预组患者采用三主体双轨道交互式护理干预模式,构建以老年COPD患者及医院专科护士为主体的医院延续护理干预轨道和以老年COPD患者及社区护士为主体的社区干预轨道,增强三主体双轨道的交互作用;三主体双轨道交互式护理在老年COPD患者应用及效果评价参考2组患者生活质量各维度评分、预后3个月后焦虑自评量表(SAS)/抑郁自评量表(SDS)评分以及干预效果、满意度等数据。 结果 干预后实验组患者和对照组患者的总体健康得分分别是61.6±4.6、53.6±3.7,实验组患者得分高于对照组,实验数据差异具有统计学意义(P<0.01);干预后实验组患者显效33例、有效28例、无效5例,对照组显效23例、有效17例、无效26例,实验组的干预效果优于对照组,实验数据差异具有统计学意义(P<0.01);干预后实验组患者和对照组患者的满意度分别为97.0%、72.7%,实验组患者满意度高于对照组,实验数据差异具有统计学意义(P<0.01)。 结论 三主体双轨道交互式护理干预模式激发患者的主观能动性,改善患者的心理状态,提高患者的生存质量,具有重要的推广价值。