构建SD大鼠鱼藤酮中毒模型及其线粒体DNA突变的初步探索

目的构建SD大鼠鱼藤酮慢性中毒模型,同时对SD大鼠组织标本(脑组织和肝脏)进行线粒体DNA突变的初步探索,为后续实验提供线索。方法将75只雄性SD鼠随机分为三组,实验组:0.5 mg/(kg·d)鱼藤酮皮下注射4~8周,共45只;空白组:不予任何特殊处理4~8周,共15只;对照组:相同体积的二甲基亚砜(DMSO)皮下注射4~8周,共15只。其中实验组随机分为1、2、3小组,每小组15只;空白组和对照组也分别分为1、2、3小组,每小组5只。每组内相应的1、2、3小组分别在实验的第4、6、8周处死老鼠并留取相应的组织标本(中脑组织和肝脏),存储于-80℃冰箱中待用。在实验组的每个小组内分别随机选取3对组织标本,共9对;在空白组和对照组的每个小组内分别随机选取1对组织标本,共6对。随后进行组织DNA提取,采用2对引物进行长PCR并将PCR产物进行凝胶电泳分析,同时设计并利用线粒体DNA引物,用一代测序的方法进行线粒体全基因组测序。实验中观察各组大鼠的一般情况并进行行为学测试。结果1)实验组大鼠在实验中表现出较为明显的中毒症状。在体重增长速度上与对照组和空白组存在明显差异(P0.05)。在行为学上,实验组大鼠亦表现出了较为明显的行为学异常(P0.05)。2)大鼠脑以及肝脏组织的长PCR凝胶电泳结果未发现明显的异常条带;所有测序突变(缺失、插入、点突变)均为大鼠固有突变。结论 0.5 mg/(kg·d)鱼藤酮皮下注射4~8周可导致SD大鼠鱼藤酮慢性中毒。SD幼鼠的选择、鱼藤酮剂量及作用时间、一代测序等多种因素可能是导致本次实验未检测到有意义的线粒体DNA突变的原因。因此,后续实验应做相应改进。     

公共场所集中空调通风系统现场采样释义

近年来,公共场所内的集中空调越来越深受人们的欢迎。其通风系统现场样品采集样是监测工作的前提基础和关键控制点,为提高现场采样工作的效率,确保采集样品具有代表性,根据在现场采样的实际工作遇到的问题,从采样前期准备、现场采集、采样后贮藏等方面对公共场所集中空调通风系统现场采样进行探讨。     

Natural history and risk factors of long-term mortality in acute coronary syndrome patients with cardiogenic shock

PurposeCardiogenic shock (CS) is a severe complication of acute coronary syndromes (ACS). Intra-aortic balloon pump (IABP) is considered important mechanical therapy for acute CS. We aimed to analyze the natural history and possible prognostic factors in patients with CS complicating ACS.Patients/methodsAll 126 patients (mean age 65.8 ± 12.5 years), who were hospitalized in single center due to an episode of CS in the course of ACS, had IABP and were scheduled for coronary angiography. The assessed end-point was 5-year death from any cause.ResultsMedian left ventricle ejection fraction (LVEF) 28% (interquartile range (IQR) 23–35%), 39 patients (31%) were female, in 91 (72%) the initial diagnosis was ST-elevation myocardial infarction (STEMI). Mean time on the IABP was 3.8 ± 3 days. During index hospitalization there were 56 deaths (44%). Other 27 patients (out of 70 discharged – 38.5%) died during 5-year follow-up. In univariate logistic regression, the significant effect on long term mortality had age, female gender, reduced ejection fraction below 31% and hypotension on admission. The out of hospital survival was also determined by age, gender and hypotension, while LVEF lost its predictive value The multivariate survival analysis both in whole group and in patients discharged from hospital was independently affected by age and hypotension on the admission.ConclusionsThe mortality of patients with CS despite treatment with IABP remains very high, especially during the in-hospital period and early after discharge. Among assessed parameters age and hypotension on the admission are the most important predictors of adverse long term prognosis.     

Long QT Syndrome in Pregnancy: Are Vaginal Delivery and Use of Oxytocin Permitted? A Case Report

BackgroundPatients with congenital long QT syndrome (LQTS) are at increased risk of ventricular arrhythmia, particularly during labour and the puerperium.CaseA 28-year-old primigravida with known LQTS underwent induction of labour at 41 weeks’ gestation using a Foley catheter balloon and IV oxytocin. Vaginal delivery with passive second stage and outlet forceps was undertaken with early epidural analgesia to prevent tachycardia and psychological stress. The patient gave birth to a healthy female, and had an uncomplicated postpartum period under continuous electrocardiogram monitoring.ConclusionVaginal delivery with use of oxytocin for the induction of labour can be safely undertaken in patients with LQTS.     

Aging and Counseling:

Counselors are needed to help meet the mental health needs of older person; yet, to be effective they must understand fully the special needs of the older population. Counseling, an applied psychological science, is thus a field of study where gerontology curricula can be implemented optimally in a partnership manner. This article reviews the historical evolvement of gerocounselors and includes resources for special training of these professionals. Suggestions and resources for development of training programs and integration of gerontology and counseling curricula are provided.     

A single-gradient junction technique to replace multiple-junction shifts for craniospinal irradiation treatment

Craniospinal irradiation (CSI) requires abutting fields at the cervical spine. Junction shifts are conventionally used to prevent setup error–induced overdosage/underdosage from occurring at the same location. This study compared the dosimetric differences at the cranial-spinal junction between a single-gradient junction technique and conventional multiple-junction shifts and evaluated the effect of setup errors on the dose distributions between both techniques for a treatment course and single fraction. Conventionally, 2 lateral brain fields and a posterior spine field(s) are used for CSI with weekly 1-cm junction shifts. We retrospectively replanned 4 CSI patients using a single-gradient junction between the lateral brain fields and the posterior spine field. The fields were extended to allow a minimum 3-cm field overlap. The dose gradient at the junction was achieved using dose painting and intensity-modulated radiation therapy planning. The effect of positioning setup errors on the dose distributions for both techniques was simulated by applying shifts of ± 3 and 5 mm. The resulting cervical spine doses across the field junction for both techniques were calculated and compared. Dose profiles were obtained for both a single fraction and entire treatment course to include the effects of the conventional weekly junction shifts. Compared with the conventional technique, the gradient-dose technique resulted in higher dose uniformity and conformity to the target volumes, lower organ at risk (OAR) mean and maximum doses, and diminished hot spots from systematic positioning errors over the course of treatment. Single-fraction hot and cold spots were improved for the gradient-dose technique. The single-gradient junction technique provides improved conformity, dose uniformity, diminished hot spots, lower OAR mean and maximum dose, and one plan for the entire treatment course, which reduces the potential human error associated with conventional 4-shifted plans.     

LncRNA RP11-79H23.3在膀胱癌细胞中的作用及其发生、发展的研究

背景与目的：虽然许多长链非编码RNA(long non-coding RNA，lncRNA)的异常表达与膀胱癌的发生有密切关系，但对于lncRNA RP11-79H23.3暂未见报道。该研究旨在探讨lncRNA RP11-79H23.3在膀胱癌EJ细胞中的作用及其发生、发展的机制。方法：采用微阵列方法对4对膀胱癌患者的癌和癌旁组织进行组学分析，随后用实时荧光定量聚合酶链反应(real-time fluorescent quantitative polymerase chain reaction，RTFQ-PCR)检测膀胱癌组织、癌旁组织及正常人膀胱上皮细胞sv-HUC-1、膀胱癌EJ细胞中RP11-79H23.3的表达。通过转染pIRES2-RP11-79H23.3上调该基因后，采用细胞计数试剂盒(cell counting kit-8，CCK-8)和EdU的方法检测EJ细胞的增殖活性，通过Transwell小室和平板划痕实验分别检测EJ细胞的侵袭和迁移能力，应用流式细胞术、Hoechst33342及Tunel检测细胞凋亡，应用细胞免疫荧光检测PTEN在膀胱癌细胞中的定位，采用鬼笔环肽染色观察细胞骨架形成，应用蛋白［质］印迹法(Western blot)分析过表达RP11-79H23.3后EJ细胞中PI3K/AKT信号通路中相关蛋白的表达情况。结果：LncRNA RP11-79H23.3在膀胱癌组织和膀胱癌EJ细胞中表达下调(P ＜0.001，P＜0.01)，pIRES2-RP11-79H23.3转染EJ细胞结果显示，RP11-79H23.3的表达量较转染前显著增加(P＜0.01)。上调RP11-79H23.3的表达可诱导膀胱癌EJ细胞的凋亡，相反，转染pIRES2-EGFP可促进EJ细胞的增殖、侵袭和迁移能力，同时，Western blot结果显示，转染pIRES2-RP11-79H23.3后可上调PTEN在EJ细胞中的表达，下调p-PI3K、p-AKT及p-Gsk3β蛋白的表达(P＜0.05)。结论：LncRNA RP11-79H23.3在膀胱癌组织和膀胱癌EJ细胞中低表达(P＜0.001，P＜0.01)，并且过表达RP11-79H23.3会降低膀胱癌细胞增殖、侵袭和迁移能力，其作用机制可能与PI3K/AKT信号通路有关。提示lncRNA RP11-79H23.3在膀胱癌恶性肿瘤中发挥重要的作用，可能会成为治疗膀胱癌的药物作用靶点。