C677T mutation in methylenetetrahydrofolate reductase gene and neural tube defects: Should Japanese women undergo gene screening before pregnancy?

We analyzed the role of maternal C677T mutation in methylenetetrahydrofolate reductase (MTHFR) gene on spina bifida development in newborns. A total of 115 mothers who had given birth to a spina bifida child (SB mothers) gave 10 mL of blood together with written informed consent. The genotype distribution of C677T mutation was assessed and compared with that of the 4517 control individuals. The prevalence of the homozygous genotype (TT) among SB mothers was not significantly different from that among the controls (odds ratio [OR] = 0.65; 95% confidence interval [CI] = 0.31–1.25; P = 0.182), suggesting that MTHFR 677TT genotype in Japan is not associated with spina bifida development in newborns. The T allele frequency was not increased in SB mothers (34.8%) as compared to that of the control individuals (38.2%). Further, the internationally reported association between the two groups was found to be similar in all 15 countries studied except the Netherlands, where the TT genotype was found to be a genetic risk factor for spina bifida. For the prevention of affected pregnancy every woman planning to conceive has to take folic acid supplements 400 μg a day and the government is asked to take action in implementing food fortification with folic acid in the near future. In conclusion, it is not necessary for Japanese women to undergo genetic screening C677T mutation of the MTHFR gene as a predictive marker for spina bifida prior to pregnancy, because the TT genotype is not a risk factor for having an affected infant.     

自噬及其抑制剂对脑损伤后脑细胞的作用

自噬是溶酶体清除并利用降解产物的过程,有助于保持蛋白代谢平衡及维持细胞环境的稳定,广泛参与多种病理生理过程.虽然近年在自噬的调控和分子机制等方面取得了一些进展,但是对细胞自噬与神经系统疾病的研究才刚刚开始.有研究发现,当癫(癎)发作时,将自噬抑制剂注入大鼠体内,可使抽搐的程度降低.故提出自噬可能与脑损伤及其信号转导有关,自噬通过某些信号通路加重脑损伤的假说.该文概述自噬及其抑制剂的新进展并进一步探讨对神经系统的作用.     

Anaglyph of Retinal Stem Cells And Developing Axons: Selective Volume Enhancement In Microscopy Images

Retinal stem cell culture has become a powerful research tool, but it requires reliable methods to obtain high‐quality images of living and fixed cells. This study describes a procedure for using phase contrast microscopy to obtain three‐dimensional (3‐D) images for the study of living cells by photographing a living cell in a culture dish from bottom to top, as well as a procedure to increase the quality of scanning electron micrographs and laser confocal images. The procedure may also be used to photograph clusters of neural stem cells, and retinal explants with vigorous axonal growth. In the case of scanning electron microscopy and laser confocal images, a Gaussian procedure is applied to the original images. The methodology allows for the creation of anaglyphs and video reconstructions, and provides high‐quality images for characterizing living cells or tissues, fixed cells or tissues, or organs observed with scanning electron and laser confocal microscopy. Its greatest advantage is that it is easy to obtain good results without expensive equipment. The procedure is fast, precise, simple, and offers a strategic tool for obtaining 3‐D reconstructions of cells and axons suitable for easily determining the orientation and polarity of a specimen. It also enables video reconstructions to be created, even of specimens parallel to the plastic base of a tissue culture dish, It is also helpful for studying the distribution and organization of living cells in a culture, as it provides the same powerful information as optical tomography, which most confocal microscopes cannot do on sterile living cells. Anat Rec, 297:770–780, 2014. © 2014 Wiley Periodicals, Inc.     

一种镇痛泵保护装置的制作与应用

目的 探讨一种电子镇痛泵保护装置的制作与应用效果。方法 选取2019年3月-2019年9月收治于复旦大学中山医院且术后携带电子镇痛泵的患者72例,随机分成对照组（n=36）和观察组（n=36）。观察组：使用自制的保护装置固定镇痛泵,对照组：使用裸机状态直接固定的传统方式固定镇痛泵。分别对两组在镇痛泵使用中固定的稳妥性、使用安全性及医患使用体验等方面进行比较。结果 两组在使用安全性方面比较：观察组优于对照组,表现为：在泵体意外坠床例数及不明原因的停泵例数中,观察组均较对照组明显下降,有统计学意义（P ＜0.05）。医护使用自制保护装置固定镇痛泵,两组满意度比较：观察组均优于对照组,有统计学意义（P ＜0.05）。结论 应用自制电子镇痛泵保护装置在固定泵体的稳固性、安全性及使用体验方面均较传统固定方法效果更佳。     

1例新型冠状病毒肺炎危重症患者人工气道的管理

目的总结新型冠状病毒肺炎(以下简称新冠肺炎)危重症患者人工气道的管理经验。方法2019年1月28日,某院收治了1例新冠肺炎危重症患者,予紧急有创机械通气治疗。结果经过积极治疗9 d,患者病情逐渐平稳,予试脱机试验。结论人工气道建立前的评估准备、个人防护要点,建立时的注意事项及建立后的气道管理工作的经验,可为以后收治烈性传染病提供参考。     

抗击新型冠状病毒肺炎护理人员自我防护培训方案建立与实践

目的建立新型冠状病毒肺炎护理人员自我防护培训方案,总结培训实践体会,为医疗机构在突发公共事件中有效组织培训提供借鉴。方法建立针对四个层面护理人员的自我防护培训方案,开展及时、高效、严格、针对性强的培训,包括理论知识培训和操作技能培训,采用在线授课、操作视频VCR教学、实时防护督导和培训的方式实施培训。结果通过培训,四个层面人员自我防护技术及理论考核通过率100%;进驻武汉一线、发热门诊、感染科隔离病房及全院护理人员至今未发生感染;拍摄制作的“医护人员自我防护技术”在全院得到推广使用。结论在抗击新型冠状病毒肺炎的疫情期间,加强护理人员自我防护能力的培训,可以提高护理人员的自我防护意识及自我防护技能,是确保医护人员“零感染”的重要保障。     

抗击新型冠状病毒肺炎中个人防护装备穿脱流程及要点解析

目的 描述负压条件下个人防护装备的穿脱流程并解析要点,确保医护人员在抗击新型冠状病毒肺炎的过程中个人安全。 方法 通过结合新型病毒特点、雷神山医院环境设施、临床实践,形成个人防护装备穿脱流程,包括一更、二更、一脱、二脱、三脱内的穿脱顺序。 结果 个人防护装备穿脱流程明确,医务人员容易掌握。结论 个人防护装备的穿脱流程及要点解析有助于医护人员快速有效掌握穿脱要领,降低医护人员交叉感染概率。     

单手保护会阴法对自由体位分娩产妇分娩结局的影响

目的:探讨单手保护会阴法对自由体位分娩产妇分娩结局的影响。方法:选取2016年5月1日~2017年5月31日给予常规助产方式分娩的产妇78例作为对照组,选取2017年6月1日~2018年6月30日给予自由体位单手保护会阴法分娩的产妇78例作为观察组。比较两组会阴裂伤程度、产后出血率、新生儿窒息率及临床满意度。结果:观察组干预后会阴裂伤程度轻于对照组(P<0.05),产后出血率、新生儿窒息率均低于对照组(P<0.05),临床满意度高于对照组(P<0.05)。结论:单手保护会阴法在自由体位分娩中可减轻产妇会阴裂伤程度,降低产后出血率和新生儿窒息率,提高临床满意度。     

新型冠状病毒肺炎疫情期间消毒供应中心隔离要求和工作人员防护建议

新型冠状病毒传染性强,医院消毒供应中心需处理新型冠状病毒感染患者的复用诊疗物品和医务人员的防护用具,同样具有高风险。医院消毒供应中心应根据区域工作性质做好隔离区域的划分,根据岗位性质落实各岗位工作人员防护用具的穿戴,严格执行消毒隔离和人员防护,确保工作正常开展。