小儿肺炎患者治疗前后单核细胞膜表面CD14和HLA—DR的表达

目的检测小儿肺炎患者治疗前后外周血单核细胞膜表面HLA—DR的表达,并探讨其临床诊断和治疗中的价值。方法用流式细胞术对4,3L肺炎患者治疗前后外周血单核细胞CD14、HLA—DR的检测。结果与治疗前相比,治疗后CD14^＋和CD14^＋HLA—DR^＋有显著性差异（P〈0．05）;与轻症组相比,重症组、中症组CD14^＋和CD14^＋／HLA—DR^＋都有显著性差异（P〈0．05）;重症组与中症组相比,CD14^＋无显著性差异（P〉0．05）,CD14^＋／HLA—DR^＋有显著性差异（P〈0．05）。与治疗前相比,治疗后CD3^＋CD4^＋与CD3^＋CD8^＋细胞数有显著性差异（P〈0．05）。结论小儿肺炎患者的免疫系统在早期就受到抑制,病情的严重程度与CD14^＋／HLA—DR^＋呈负相关,CD14^＋／HLA—DR^＋可以用来反映小儿肺炎的严重程度。     

The COVID-19 Pandemic Introduces Diagnostic and Treatment Planning Complexity for Individuals at Clinical High Risk for Psychosis

COVID-19 has led to a great deal of general suffering and an increased prevalence of psychiatric illness worldwide. Within the area of psychosis-risk syndromes, a highly heterogeneous clinical population, the picture is quite nuanced as the social restrictions resulting from the pandemic have reduced stress for some and increased it for others. Further, a number of pandemic-related societal and cultural changes have obfuscated the diagnostic and treatment landscape in this area as well. In this opinion article, we describe several prototypical cases, representative of presentations seen in our clinical high-risk (CHR) research programs. The cases highlight considerable clinical variability and, in addition, speak to the current complexities faced by diagnosticians and treatment providers. In addition to discussing these issues, this piece introduces potential solutions highlighting the promise of incorporating data-driven strategies to identify more homogenous CHR subtypes and employ precision medicine.     

重型肝炎和肝硬化并发肺炎95例临床分析

目的探讨重型肝炎和肝硬化并发肺炎的临床特点及其危险因素。方法对95例重型肝炎和肝硬化住院患者进行临床调查分析。结果重型肝炎和肝硬化患者合并肺炎的发生率为7.3%,病死率20%;临床表现不典型,诊断主要靠胸部X线检查和深部痰细菌培养;主要病原菌为金黄色葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌及白色念珠菌;疾病严重程度、肝性脑病（肝性脑病）、住院时间、广谱抗菌药物长期使用等是造成并发肺炎的主要危险因素。结论重型肝炎患者合并肺炎是由多种因素共同作用的结果,临床医务人员必须高度重视,采取综合措施加以防治。     

肺炎患者测定P-选择素和血小板参数的临床意义

目的：探讨P-选择素和血小板参数的检测在肺炎患者的病情评估及预后判断中的临床意义。方法：选取2008年1月～2010年12月在我院住院的急性肺炎患者126例,将其分为重症肺炎组（42例）和轻症肺炎组（84例）,同时,随机选取100例健康体检者作为对照组,比较三组患者的P-选择素和血小板参数检查结果。结果：急性肺炎患者的血小板（PLT）明显增高,与健康体检者比较,差异有高度统计学意义（P〈0.01）;重症肺炎组的P-选择素、PLT明显增高,血小板分布宽度（PDW）、平均血小板容积（MPV）及大血小板比例（P-LCR）明显降低,与轻症肺炎组和对照组比较,差异均有高度统计学意义（均P〈0.01）;轻症肺炎组的P-选择素、PDW、MPV及P-LCR与对照组比较,差异均无统计学意义（P〉0.05）。结论：血小板参数及功能状态异常是肺炎患者普遍存在的病理过程,检测肺炎患者的P-选择素、血小板参数可作为评估疾病进程及预后的一项参考指标。     

维生素A辅助治疗小儿肺炎的Meta分析

目的：系统评价维生素A辅助治疗小儿肺炎的疗效。方法：对应用维生素A辅助治疗小儿肺炎的随机对照试验或半随机对照试验进行Meta分析。结果：共纳入11个随机对照试验,Meta分析结果维生素A辅助治疗组总有效率明显高于对照组（OR=7．81,95％CI：1.41～43．23,P〈0．001）;能增加X线胸片阴转率（OR=7．34,95％CI：3．22～16．73,P〈0．001）;发热持续时间比较差异无统计学意义（WMD-0．29,95％CI：-0．58～0．00,P=O．05）;能缩短咳嗽持续时间（WMD=-0．97,95％CI：-1．87～0．06,P〈O．05）;能缩短肺部罗音消失时间（WMD=-0．61,95％CI：-0．88-O．34,P〈0．001）;能缩短患儿住院时间（WMD-0．87,95％CI：-1．61～0．13,P〈0．05）。结论：维生素A辅助治疗小儿肺炎具有较好的疗效。     

Effects of the selective 5-HT(7) receptor antagonist SB-269970 in animal models of psychosis and cognition

The 5-hydroxytryptamine₇ (5-HT₇) receptor is a G-protein coupled receptor for serotonin that has been implicated in the pathophysiology of psychiatric and neurological disorders including anxiety, depression and schizophrenia. A number of studies have attempted to evaluate the potential role of the 5-HT₇ receptor in schizophrenia by utilising genetic or pharmacological tools but to date these have provided conflicting results. Here we investigate the effect of a selective 5-HT₇ receptor antagonist, SB-269970, in in vivo psychosis and cognition models and relate efficacy to brain exposures of the compound. SB-269970 significantly attenuated amphetamine-induced rearing and circling in rats. A similar effect was observed in an N-methyl d-aspartic acid (NMDA) receptor antagonist driven psychosis model, where SB-269970 significantly reversed phencyclidine-induced hyperlocomotion, rearing and circling; although the effect was not as robust as with the 5-HT_2a receptor antagonist positive control, MDL100,907. SB-269970 also attenuated a temporal deficit in novel object recognition (NOR), indicative of an improvement in recognition memory. Pharmacokinetic analysis of plasma and brain samples taken after behavioural testing confirmed that efficacy was achieved at doses and pre-treatment times where receptor occupancy was substantial. These findings highlight the anti-psychotic and pro-cognitive potential of 5-HT₇ receptor antagonists and warrant further studies to explore their therapeutic potential in schizophrenia.     

Identifying emerging trends in recreational drug use; outcomes from the Psychonaut Web Mapping Project

Background

This paper presents the outcomes of the 2-year European Union funded Psychonaut Web Mapping Project which aimed at developing and implementing an integrated web mapping system to promptly identify and learn about novel psychoactive substances (NPS; “legal highs”) through the regular monitoring of the Internet.

Methods

More than 200 discussion forums, social media, online shops, websites and other Internet resources (e.g. YouTube, eBay, Google, Google Insight) have been extensively and regularly monitored in 7 European countries (UK, Finland, Norway, Belgium, Germany, Italy and Spain) for emerging trends of NPS throughout the period of the study.

Results

Key online resources have been identified as “leading edge” which have provided accurate and timely information on novel emerging compounds. In total more than 400 substances/products have been recorded. NPS have been noted online before reaching wider audiences.

Discussion

Although a high number of novel psychoactive substances have been identified in the 2-year duration of the project, not all have become trends that needed public health response. Conversely, new recreational drug phenomena such as “spice drugs,” mephedrone and naphyrone were all identified as emerging trends in forums and websites. In addition, it has been possible for the first time to collate detailed information on these and several more compounds even though no or limited scientific publications were available. It is therefore recommended that these monitoring activities are to be continued, that more countries, researchers and health professionals are involved, and that the findings are widely shared with all the relevant agencies, health professionals and future research projects.Implications, advantages and limitations of using the Internet as primary source for identifying emerging trends are also discussed.