生物标志物联合检测在脓毒症相关急性肝损伤患者中的应用价值

目的:探讨生物标志物联合检测对脓毒症相关急性肝损伤患者的早期诊断和预后评估的价值。方法:收集内蒙古科技大学包头医学院第一附属医院重症医学科(ICU)2019年11月-2022年1月收治的104例脓毒症患者临床资料,按照入ICU时是否发生急性肝损伤分为脓毒症相关急性肝损伤组(n=42)和非肝损伤组(n=62),将脓毒症相关急性肝损伤患者按28 d是否存活分为存活组(n=16)和死亡组(n=26),记录104例患者入ICU 6 h内血清正五聚蛋白3(PTX-3)、C-反应蛋白(CRP)、降钙素原(PCT)、总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、凝血酶原时间国际标准化比值(INR值)、凝血酶原时间(PT)、凝血酶原活动度(PTA)、血小板(PLT)、入ICU 24 h内急性生理与慢性健康状况评估量表II(APACHEII)评分最差值及序贯器官衰竭评估(SOFA)评分;同时记录脓毒症相关急性肝损伤患者28 d预后。PTX-3的相关性采用Spearman相关分析;绘制受试者工作特征曲线(ROC曲线),计算ROC曲线下面积(AUC),分析各指标单独检测以及联合检测对脓毒...     

极低体质量近存活期分娩儿一例的出生后早期管理

近存活期分娩（PVB）儿各组织系统发育极不成熟,易发生各种器官功能损害和并发症,预后常不佳。目前关于PVB儿出生后早期管理的报道不多,诸多尚待解决的问题仍是围产医学所面临的挑战。经有效的新生儿复苏和呼吸循环支持、积极的营养支持和喂养、防治感染、内分泌和代谢性疾病管理、积极处理早产儿相关并发症,以及发育支持护理、家庭参与式护理等一系列个体化管理和精细化护理,四川省医学科学院·四川省人民医院成功救治了1例胎龄23周,出生体质量（BW）为450 g的PVB儿。本文通过总结1例PVB儿的出生后早期管理,并结合文献复习进行归纳总结,以期为提高BW<500 g的PVB儿存活率并获得良好预后提供经验及借鉴。     

脂联素、直接胆红素及甘油三酯对2型糖尿病患者大血管病变的诊断价值

目的 探讨脂联素（APN）、直接胆红素（DB）、甘油三酯（TG）及三者联合对 2 型糖尿病（T2DM）患者大血管病变的诊断价值。方法 选取120例T2DM患者,根据是否合并大血管病变将其分为T2DM组（62 例）和 T2DM+大血管病变组（58 例）。比较两组的临床资料;采用非条件多因素逐步Logistic回归分析T2DM患者合并大血管病变的风险因素;绘制受试者工作特征（ROC）曲线评估APN、DB、TG及三者联合对T2DM患者合并大血管病变的诊断效能。结果 非条件多因素逐步Logistic回归分析结果显示,■是T2DM患者合并大血管病变的危险因素（P <0.05);■是T2DM患者合并大血管病变的保护因素（P <0.05）。ROC曲线分析结果显示,当APN ≤ 5.870 nmol/mL时,诊断T2DM患者合并大血管病变的曲线下面积（AUC）为0.718,敏感性为70.7%(95% CI:0.571,0.815）,特异性为61.3%(95% CI:0.480,0.713）;当DB ≤ 14.205 mol/L 时,AUC 为 0.772,敏感性为 74.1% (95% C...     

Five different tests of reaction time evaluated in HIV seropositive men

In an attempt to develop a short neuropsychological test battery five different tests of reaction time were assessed according to their ability to discriminate between HIV seropositive men and healthy controls. In all tests a patient group with clinical symptoms was slower than the control group. In the complex reaction time test, which has a large cognitive aspect, even a clinically "asymptomatic" group was slower than the control group. The movement test, a new test with a large motor component, identified most slow responders, defining approximately half of the patients with clinical symptoms and one third of the "asymptomatic" patients as such. A test battery consisting of three tests is suggested for serial assessment and screening.     

Behavioural effects of selective μ-, κ-, and δ-opioid agonists in neonatal rats

The behavioural effects of selective -, - and -opioid agonists in 5-, 10- and 20-day-old rats were investigated by observational analysis. The predominant response to -agonists was behavioural depression. High doses (10 mg/kg IP) of morphine and DAGO (d-Ala², NMe-Phe⁴, Glyol⁵-enkephalin) produced overt sedation in all the age groups and also induced catalepsy which was particularly apparent in the 5- and 10-day-old animals. These compounds did not produce any signs of behavioural activation in the neonatal rats. In contrast, rat pups treated with the -agonists U50,488H and PD 117,302 (1,10 mg/kg IP) exhibited marked hyperactivity with increases in wall-climbing and locomotion. Sedative effects of the highest dose of the -agonists began to emerge, however, as the animals grew older, resulting in significant decreases in behaviours such as gnawing and grooming at 20 days of age. The -agonist (+)-tifluadom (0.1–10 mg/kg), but not its corresponding (-)-isomer, produced an increase in activity in 5-day-old rats, thus extending the observations made with U50,488H and PD 117,302 and establishing the stereoselective nature of the response. The involvement of -receptors in opioid-induced hyperactivity was further substantiated by using a variety of opioid antagonists. In this context, the increase in activity induced by U50,488H (10 mg/kg) in 5-day-old neonates was attenuated by naltrexone (1 mg/kg IP) but not by larger doses (10 mg/kg) of either M8008 (which has low affinity for -receptors) or the selective -receptor antagonist ICI 174,864. Finally, DPDPE (d-Pen², d-Pen⁵-enkephalin) which acts selectively at -opioid receptors, did not exert any behavioural effects in either the 5-, 10- or 20-day-old rat pups at doses of up to 10 mg/kg. These results demonstrate behavioural effects of - and -but not -agonists in neonatal rats. There is a clear differentiation between - and -receptor effects and both - and -mediated behaviours show dissimilarities from the adult profile.     

New spectral detection and elimination test algorithms of ECG and EOG artefacts in neonatal EEG recordings

New methods for the detection of ECG and EOG artefacts in the EEG are introduced, which can also be used for the evaluation of the quality of the elimination procedure. These algorithms are based on the estimation of the power or coherence spectrum by means of FFT. The advantage of this method is that the EEG spectrum is monitored by the test algorithm. The spectrum will be plotted if no influence of the ECG and EOG can be found. On the other hand, if artefacts are detected the correction of the EEG time series will be carried out and the spectrum of the corrected EEG time series will be plotted after repeated monitoring by the test algorithm.     

Chronic ethanol exposure differentially regulates NOS1 mRNA levels depending on rat brain area

In vitro experiments were performed on brainstem – spinal cord preparations from mouse neonates to compare the noradrenergic regulations of the respiratory network in the control C3H/HeJ strain and the transgenic Tg8 strain which has been created from the C3H/HeJ strain by deletion of the gene encoding monoamine oxidase A (MAOA), the main enzyme for serotonin degradation. In both control and MAOA-deficient strains, we show: (i) that the pontine A5 area exerts a potent inhibitory modulation on the respiratory rhythm generator; (ii) that noradrenaline application induces a tonic phrenic activity; and (iii) that noradrenaline increases the respiratory rhythm. The latter effect is however delayed and weak in the Tg8 strain. Therefore, MAOA-deficiency has only slightly altered the noradrenergic regulations of the respiratory network.     

应用荧光斑点法和比值法检测G6PD

目的建立适合于G6PD缺乏的新生儿筛查及确诊方法。方法应用荧光斑点法(FST)对新生儿筛查滤纸干血片进行检测，对可疑阳性者召回，抽静脉血以D6PD／6PGD比值法进行确诊，同时结合新生儿父母亲的G6PD结果，根据遗传关系综合分析。结果FST筛查25000例新生儿，G6PD缺乏阳性率为4．56％，确诊检出率为4．09％。与比值法的符合率为90．4％，G6PD重度缺乏者的符合率为100％，G6PD中间缺乏者的符合率为78．5％，室间质量控制结果与反馈结果符合率为100％。结论FST汀具有高的敏感性、特异性和准确性，方法简便、快捷、费用低廉，可对滤纸干血片标本进行大规模的筛查检测，同时利用比值法进行确诊，可减少假阳性及假阴性，有利于早期诊断和防治G6PD缺乏所致的新生儿黄疸和急性溶血。     

Clinical application of rapid assay of interleukin-6 in influenza-associated encephalopathy

The characteristics of influenza-associated encephalopathy is the high mortality and nimble progress with coma which appears in general cases within 48 hours. Most of patients show no abnormalities in the standard blood checks on admission or in early stage. In this study we investigated if a rapid assay of interleukin (IL)-6 is useful in influenza-associated encephalopathy in early stages. The levels of IL-6 in patients with influenza-associated encephalopathy did not show any significant difference compared with those in patients with febrile convulsion and rotavirus-associated convulsion. However the levels of IL-6 in severe cases were significantly higher than those of mild cases with influenza-associated encephalopathy. Consequently the rapid assay of serum IL-6 is useful to evaluate and decide the therapies.     

Transcytosis and catabolism of antibody

This review describes the evolution of our knowledge of the transmission of immunoglobulin G (IgG) from mother to infant and the factors which regulate the persistence of IgG in the circulation. These apparently unrelated processes involve the same Fc receptor, FcRn (n=neonatal). FcRn appears to carry out these diverse roles by binding to IgG and then either transporting the bound IgG across cells (transcytosis) or recycling its cargo back to the cell surface (control of catabolism). IgG that is taken up by cells in the absence of binding to FcRn undergoes degradation. Thus, FcRn is the “protective” receptor that servesto maintain IgG homeostasis and deliver IgGs across cellular barriers.