The roles of prostaglandin E2 and D2 in lipopolysaccharide-mediated changes in sleep

When living organisms become sick as a result of a bacterial infection, a suite of brain-mediated responses occur, including fever, anorexia and sleepiness. Systemic administration of lipopolysaccharide (LPS), a common constituent of bacterial cell walls, increases body temperature and non-rapid eye movement (NREM) sleep in animals and induces the production of pro-inflammatory prostaglandins (PGs). PGE₂ is the principal mediator of fever, and both PGE₂ and PGD₂ regulate sleep–wake behavior. The extent to which PGE₂ and PGD₂ are involved in the effect of LPS on NREM sleep remains to be clarified. Therefore, we examined LPS-induced changes in body temperature and NREM sleep in mice with nervous system-specific knockouts (KO) for the PGE₂ receptors type EP₃ or EP₄, in mice with total body KO of microsomal PGE synthase-1 or the PGD₂ receptor type DP, and in mice treated with the cyclooxygenase (COX) inhibitor meloxicam. We observed that LPS-induced NREM sleep was slightly attenuated in mice lacking EP₄ receptors in the nervous system, but was not affected in any of the other KO mice or in mice pretreated with the COX inhibitor. These results suggest that the effect of LPS on NREM sleep is partially dependent on PGs and is likely mediated mainly by other pro-inflammatory substances. In addition, our data show that the main effect of LPS on body temperature is hypothermia in the absence of nervous system EP₃ receptors or in the presence of a COX inhibitor.     

Recent advances in the development of microparticles for pulmonary administration

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儿童呼吸道感染患者血清IP-10，MCP-1 平检测的临床意义

目的 研究皖南地区儿童呼吸道病原体感染的流行病学特点,探讨混合病原体感染患儿血清中干扰素诱生蛋白10(interferon-inducible protein-10,IP-10),单核细胞趋化蛋白-1( monogyte chemoattractant protein-1),MCP-1表达水平在急性呼吸道感染诊断中的应用价值。方法 收集2017年6月～2019年6月皖南医学院第一、二附属医院急性呼吸道感染患儿血标本,采用间接免疫荧光法检测呼吸道九项病原体IgM,分析不同年龄段呼吸道病原体感染的差异性。采用酶联免疫吸附试验检测混合感染患儿血清中IP-10,MCP-1的表达水平,分析炎症因子表达水平与疾病严重程度的相关性。结果 5 122例急性呼吸道感染患儿中,以肺炎支原体感染率最高,混合感染患儿共544例,以肺炎支原体联合呼吸道合胞病毒感染率最高。检测血清中的CRP,IP-10和MCP-1的表达水平相比较单独感染组,混合感染组升高更为明显,对比组之间的差异均具有统计学意义(F=1.045～4.889,均P<0.05)。相关性研究分析显示,混合感染组IP-10,MCP-1与CRP 表达水平呈正相关性(r = 0.612,P<0.001; r= 0.804,P<0.001)。结论 急性呼吸道感染患儿中,混合感染更易表现为咳嗽、鼻塞流涕及发热等症状,同时炎症反应增强,病情的严重程度增加,血清IP-10和MCP-1表达水平可作为急性呼吸道感染病情严重程度指标之一。     

Cockett综合征的影像学诊断和介入治疗

目的探讨Cockett综合征影像学诊断和介入治疗方法。方法对20例Cockett综合征患者进行临床分析,其中13例行介入治疗术。结果下肢深静脉造影术能明确诊断Cockett综合征,13例患者经介入治疗后其临床症状体征均有不同程度的改善,临床疗效明显。结论介入治疗Cockett综合征,是一种简单、安全和有效的方法。     

食管支架置入后再狭窄的介入治疗(附9例报告)

目的 探讨食管支架置入术后再狭窄的介入治疗方法。方法 回顾性分析了50例食管支架置入术治疗食管狭窄的病例，收集并总结了其中9例食管再狭窄的介入治疗。结果 9例介入治疗中，3例再次支架置入，1例校正支架位置，3例球囊扩张，2例清除支架腔内食物，均保持食管再通。结论 对食管术后吻合口狭窄的患者，接受支架置入术后再出现狭窄，仍可再次行食管球囊扩张治疗和食管支架再置入术，其效果良好。     

下肢静脉性溃疡的外科微创治疗

目的探讨下肢静脉性溃疡外科微创治疗的效果。方法对31例(33侧患肢)下肢静脉性溃疡通过静脉造影检查明确引起溃疡的原发病变,根据患肢血流动力学异常的种类和程度对10例(11侧患肢)行高位大隐静脉结扎联合静脉腔内激光治疗术;17例(18侧患肢)行高位大隐静脉结扎联合静脉腔内激光治疗、内镜深筋膜下交通静脉离断术;4例(4侧患肢)行高位大隐静脉结扎联合静脉腔内激光治疗、内镜深筋膜下交通静脉离断和股浅静脉瓣膜包窄术。溃疡一律行周缘环行缝扎。结果术后33侧患肢浅静脉曲张均消失,色素沉着、湿疹样病变均明显减轻;24侧小腿酸胀沉重感、疼痛、水肿12~16d消失;溃疡18~40d内愈合。随访1~36个月,平均14.8月,3侧(9.1%)肢体溃疡复发。结论纠正浅静脉、交通支静脉、深静脉功能不全和重视溃疡创面的处理是治疗下肢静脉性溃疡的有效疗法,静脉腔内激光治疗、内镜深筋膜下交通静脉离断术操作简便、微创、安全,联合股浅静脉瓣膜包窄术可以有效地减少下肢静脉性溃疡的复发。