Use-dependent exacerbation of brain damage occurs during an early post-lesion vulnerable period

For a period of time after unilateral brain injury, surviving neural tissue surrounding the lesion may be vulnerable to extremely high behavioral demand. Previously, we found that lesions of the forelimb representation area of the sensorimotor cortex (FL-SMC) in rats increase in size substantially when the intact forelimb is immobilized with a plaster of paris cast during the first 15 days after surgery, which forces overuse of the impaired forelimb. The present study was designed to determine whether the adult brain is more vulnerable to forced overuse of the impaired forelimb during the first 7 days post-lesion than during the second 7 days post-lesion. Using behavioral tests of forelimb use and stereological analysis of remaining tissue volume 40 days after FL-SMC lesions, we found that forced overuse of the impaired forelimb during the first 7 days after the initial damage caused expansion of neural injury and greatly interfered with restoration of function. In contrast, forced overuse of the impaired forelimb during the second 7 days had no significant effect on lesion size but nevertheless interfered with restoration of function. Thus, surviving neural tissue in the damaged hemisphere and recovery of function appear to be vulnerable to prolonged forced overuse of the impaired forelimb throughout the first 15 days, but tissue loss was detectable only when the animal was forced to use the impaired forelimb during the first 7 days after injury.     

输血致香味沙雷氏菌生物Ⅰ型感染的确证与分析

发现３例输血感染香味沙雷氏菌败血症。３名病人均是免疫防御功能低下的易感患者，输血后即出现严重的败血症，于次日血培养出该菌，并从剩余血浆中分离出同种菌株。经过ＧＹＺ－１５ｅ肠杆菌科编码等４０项生化反应和４５种药物敏感性测定，性属反应一致，由同一批小量再分装的血源（袋）引发，污染源一致。ＳＯ在血库冰箱内能抵御吞噬、快速繁殖并产生多种蛋白质酶类和毒素，从而使受血的易感患者致病。若能早期使用敏感抗生素（氨基糖苷类和喹诺酮类药物）治疗，可望控制病情。     

20年来11种抗生素的敏感值回顾性分析

将７０年代和８０年代一批常用抗生素对胆道和尿道感染的大肠杆菌的抑菌敏感值用Ｒｉｄｉｔ法作回顾性统计分析，当以７０年代常用的１１种抗生素总体为Ｒ＝０．５时，８０年代已下降到Ｒ＝０．４０２（０．３９０～０．４１４），各种抗生素的敏感值均降低，预测９０年代更趋降低。呼吁慎用抗生素，手术中应严格掌握预防性用药的指征，以及用药的合理时机、时间和途径。     

413株细菌对氧氟沙星等3种喹诺酮类药物敏感试验

用氧氟沙星、环丙沙星、诺氟沙星对从我院各种标本分离出的４１３株细菌作敏感试验，试验菌株有金葡球菌、克雷伯氏菌、大肠杆菌、绿脓假单胞菌等常见病原菌。药敏试验结果表明：这３种药物对革兰氏阴性杆菌和部分革兰氏阳性球菌敏感率仍达７０％￣９９％，甚至更高，但比以往文献报道的敏感明显下降。本文提示要合理应用喹诺酮类药物，减少耐药菌株增加。     

氨氯地平对兔动脉粥样硬化及炎症因子妊娠相关血浆蛋白A作用的影响

目的 观察氨氯地平对动脉粥样硬化炎症因子妊娠相关血浆蛋白A的作用.方法 20只雄性新西兰大白兔应用球囊拉伤腹主动脉后高脂饲养12周,然后随机分为氨氯地平组和对照组,分别给予氨氯地平5 mg/d和溶媒对照治疗,治疗12周后处死动物;在实验开始,12周末和处死前耳缘静脉抽血检测高敏C反应蛋白和妊娠相关血浆蛋白A的水平,同时应用高频超声检测腹主动脉;处死动物后留取腹主动脉,分别进行常规病理检查,免疫组织化学染色检测妊娠相关血浆蛋白A的分布.结果 病理学和电镜结果 显示,与对照纽比较氨氯地平组斑块明显减小、脂质含量降低、平滑肌纤维较多而胶原少;超声检查也显示氨氯地平组内膜-中层厚度、收缩末期直径均明显减小(P<0.01),而校正的内中膜回声强度明显增加(P<0.01).氨氯地平还可以明显降低血清妊娠相关血浆蛋白A和高敏C反应蛋白的水平(P<0.01);免疫组织化学显示氨氯地平组斑块局部妊娠相关血浆蛋白A的表达减少;且血清妊娠相关血浆蛋白A的水平与高敏C反应蛋白和内膜-中层厚度相关(R2=0.424和R2=0.339).结论 妊娠相关血浆蛋白A与动脉粥样硬化的严重程度密切相关,氨氯地平可以抑制妊娠相关血浆蛋白A,从而延缓动脉粥样硬化的进展.     

Transfection mediated by pH-sensitive sugar-based gemini surfactants; potential for in vivo gene therapy applications

In this study, the in vitro and in vivo transfection capacity of novel pH-sensitive sugar-based gemini surfactants was investigated. In an aqueous environment at physiological pH, these compounds form bilayer vesicles, but they undergo a lamellar-to-micellar phase transition in the endosomal pH range as a consequence of an increased protonation state. In the same way, lipoplexes made with these amphiphiles exhibit a lamellar morphology at physiological pH and a non-lamellar phase at acidic pH. In this study, we confirm that the gemini surfactants are able to form complexes with plasmid DNA at physiological pH and are able to transfect efficiently CHO cells in vitro. Out of the five compounds tested here, two of these amphiphiles, GS1 and GS2, led to 70% of transfected cells with a good cell survival. These two compounds were tested further for in vivo applications. Because of their lamellar organisation, these lipoplexes exhibited a good colloidal stability in salt and in serum at physiological pH compatible with a prolonged stability in vivo. Indeed, when injected intravenously to mice, these stable lipoplexes apparently did not substantially accumulate, as inferred from the observation that transfection of the lungs was not detectable, as examined by in vivo bioluminescence. This potential of avoiding ‘preliminary capture’ in the lungs may, thus, be further exploited in developing devices for specific targeting of gemini lipoplexes.     

热敏灸治疗顽固性呃逆案

热敏灸作为一种新型的灸疗方法,《医宗金鉴》中述“凡灸诸病,必火足气到,始能求愈”,故热敏灸讲究“敏消量足”,举一临床顽固性呃逆病案加以细说。     

热敏灸小镇建设助力江西热敏灸产业发展的对策研究

近年来,江西资溪、丰城等地的实践探索表明,热敏灸小镇建设对于助推江西热敏灸产业发展具有十分重要的作用。然而,当前江西热敏灸小镇建设在标准、人才、组织、产品、服务等方面还存在诸多问题。为此,有必要在借鉴省外成功经验的基础上,从找准定位、培养人才、规范管理、健全标准、强化保障等五个方面进一步加强热敏灸小镇建设,助力江西热敏灸产业发展。     

Avoidable hospitalisation for diabetes mellitus among immigrants and natives: Results from the Italian Network for Longitudinal Metropolitan Studies

Background and aimsItaly has experienced a relevant increase in migration inflow over the last 20 years. Although the Italian Health Service is widely accessible, immigrants can face many barriers that limit their use of health services. Diabetes mellitus (DM) has a different prevalence across ethnic groups, but studies focusing on DM care among immigrants in Europe are scarce. This study aimed to compare the rates of avoidable hospitalisation (AH) between native and immigrant adults in Italy.Methods and resultsA multi-centre open cohort study including all 18- to 64-year-old residents in Turin, Venice, Reggio-Emilia, Modena, Bologna and Rome between 01/01/2001 and 31/12/2013–14 was conducted. Italian citizens were compared with immigrants from high migratory pressure countries who were further divided by their area of origin. We calculated age-, sex- and calendar year-adjusted rate ratios (RRs) and 95% confidence intervals (95% CIs) of AH for DM by citizenship using negative binomial regression models. The RRs were summarized using a random effects meta-analysis. The results showed higher AH rates among immigrant males (RR: 1.63, 95% CI: 1.16–2.23), whereas no significant difference was found for females (RR: 1.14, 95% CI: 0.65–1.99). Immigrants from Asia and Africa showed a higher risk than Italians, whereas those from Central-Eastern Europe and Central-Southern America did not show any increased risk.ConclusionAdult male immigrants were at higher risk of experiencing AH for DM than Italians, with differences by area of origin, suggesting that they may experience lower access to and lower quality of primary care for DM. These services should be improved to reduce disparities.