三种置管用于治疗泪道阻塞效果比较

目的：比较采用泪道逆行置管、双套环顺行置管、泪道U形置管治疗泪道阻塞患者的治疗效果。

方法：前瞻性研究。选取2015-07/2018-06在我院诊治的108例108眼泪道阻塞患者,随机分为三组,A组行泪道逆行置管术36例36眼,B组行双套环顺行置管术36例36眼,C组行泪道U形置管术36例36眼,术后随访6mo,比较三组患者术中出血量、手术时间、住院时间、治疗疗效以及并发症和泪道阻塞复发情况。

结果：三组患者术中出血量、手术时间、住院时间比较差异有统计学意义(P<0.05)。A组的治疗总有效率为91.7%,B组为94.4%,C组为97.2%(P>0.05)。A组并发症发生率为11.1%,高于B组的5.6%,高于C组的2.8%(P=0.010); A组泪道阻塞复发率为9.1%,高于B组的5.9%,高于C组的5.9%(P=0.029)。

结论：泪道逆行置管、双套环顺行置管、泪道U形置管用于治疗泪道阻塞患者的疗效均较高,术后发生并发症和泪道阻塞复发较少,但泪道逆行置管术可减少术中出血量、手术时间,泪道U形置管术可减少患者住院时间。     

Perceptions of commercial snack food and beverages for infant and young child feeding: A mixed‐methods study among caregivers in Kathmandu Valley,Nepal

Ensuring nutritious complementary feeding is vital for child nutrition. Prior research in Kathmandu Valley found high consumption rates of commercially produced snack foods among young children, which are often energy‐dense/nutrient poor. This mixed‐methods study was conducted to elicit Nepali caregivers' perceptions of commercial snack foods and beverages and factors influencing their use for young child feeding. Seven facilitated focus group discussions (FGD) were conducted with Kathmandu Valley caregivers of children 12–23 months, and a survey of 745 primary caregivers of children 12–23 months of age was then conducted. During the FGD, caregivers reported commonly providing commercial food and beverage products to their children as snacks, and 98.6% of caregivers participating in the survey reported feeding their child such a food in the previous week. Because of processing and packaging, snack foods were not trusted by many FGD participants and considered as “junk foods” and not healthy for children. However, commercial snack foods were consistently ranked highly on convenience, both because of minimal preparation and ease of feeding; 48.5% of all surveyed caregivers reported providing a snack food because of convenience. Other family members' diets or provision of snack foods as treats also influenced children's consumption of these snack foods and beverages. This study indicates that caregivers of young children prefer snack options that are nutrient rich; however, this may conflict with preferences for foods that require minimal preparation and are appealing to young children. Such findings carry programmatic implications for interventions aiming to address children's diet quality in urban Nepal.     

Azobenzene‐Incorporated Single‐ and Double‐Stranded Polynorbornenes: Facile Synthesis and Diverse Photoresponsive Property

Double‐stranded polymeric ladderphane using azobenzene as linkers and the single‐stranded polynorbornene with azobenzene pendants are synthesized by the ring‐opening metathesis polymerization using Grubbs ruthenium‐based catalyst. Hydrolysis of these as‐prepared polynorbornenes gives the corresponding isotactic single‐stranded polynorbornene having similar polydispersity and degree of polymerization as those of the original polymers. The photosensitive property of double‐stranded ladderphane indicates significant interactions between adjacent chromophores. These single‐ and double‐stranded polynorbornenes incorporating azobenzene chromophores exhibit distinct photoresponsive performance in the dilute solutions. The rate of photoisomerization for double‐stranded ladderphane is found to be from 6 to 9 times slower than that obtained for single‐stranded polymer. This is ascribed to the differences in structure of polymers and the interaction between azobenzene chromophores in the polymers.     

Persistent double dorsal aorta: A systematic review of the literature

Our discovery of a case of persistent double dorsal aorta prompted us to systematically review the literature of all previously reported cases of this anomaly. For our case, we present a completely separated double dorsal aorta, with the right accessory aorta arising from the abdominal aorta and ascending through the aortic hiatus to supply posterior intercostal arteries (PIAs) to the 9th‐3rd spaces bilaterally. We examined and compiled data from the 10 previously reported cases, along with our observations from our cadaver, into a systematic review of all known cases of persistent double dorsal aorta. In addition to our case report and systematic review, we investigated the literature focusing on formation of the dorsal aorta in the embryo in order to postulate potential mechanisms for formation of this anomaly. Two variants of persistent double dorsal aorta have been reported in the literature. The first type is characterized by a double‐lumen descending aorta with a central dividing septum, and the second features complete separation of the two dorsal aortae. The completely separated variant shows further heterogeneity in the origins of the PIAs and the iliac arteries, and the majority of the reported cases also demonstrate additional anatomical anomalies. We outline the events in embryonic dorsal aorta formation as well as discuss several potential mechanisms that could underlie persistent double dorsal aorta formation. Clin. Anat. 30:517–524, 2017. © 2017 Wiley Periodicals, Inc.     

The involvement of clathrin‐mediated endocytosis and two Sid‐1‐like transmembrane proteins in double‐stranded RNA uptake in the Colorado potato beetle midgut

RNA interference (RNAi) is a powerful tool in entomology and shows promise as a crop protection strategy, but variability in its efficiency across different insect species limits its applicability. For oral uptake of the double‐stranded RNA (dsRNA), the RNAi trigger, two different mechanisms are known: systemic RNA interference deficient‐1 (Sid‐1) transmembrane channel‐mediated uptake and clathrin‐mediated endocytosis. So far, a wide range of experiments has been conducted, confirming the involvement of one of the pathways in dsRNA uptake, but never both pathways in the same species. We investigated the role of both pathways in dsRNA uptake in the Colorado potato beetle, Leptinotarsa decemlineata, known to have an efficient RNAi response. Through RNAi‐of‐RNAi experiments, we demonstrated the contribution of two different sid‐1‐like (sil) genes, silA and silC, and clathrin heavy chain and the 16kDa subunit of the vacuolar H⁺ ATPase (vha16), elements of the endocytic pathway, to the RNAi response. Furthermore, the sid‐1‐like genes were examined through phylogenetic and hydrophobicity analysis. This article reports for the first time on the involvement of two pathways in dsRNA uptake in an insect species and stresses the importance of evaluating both pathways through a well‐devised reporter system in any future experiments on cellular dsRNA uptake.     

L-丙氨酰-L-谷氨酰胺双肽对水痘合并脓毒症患者影响分析与护理

目的观察L-丙氨酰-L-谷氨酰胺双肽对水痘合并脓毒症患者炎症反应、免疫功能及临床转归的影响。方法将患者随机分为观察组和对照组,每组各25例。对照组患者每天提供普通氨基酸1.5 g/kg,观察组每天提供普通氨基酸1.0 g/kg和L-丙氨酰-L-谷氨酰胺双肽0.5 g/kg,肠外营养的各种成分配制成3 L袋在容量输液泵控制下匀速静脉输注,连用7 d。观察比较两组治疗前后炎症反应、免疫功能及临床结局等指标。结果观察组在治疗后第8天炎症反应、血清蛋白及免疫指标改善均较对照组明显;观察组病死率及ICU住院天数较对照组均降低,差异均有统计学意义（均P〈0.05）。结论 L-丙氨酰-L-谷氨酰胺双肽可改善脓毒症患者免疫功能、减轻炎症反应、降低病死率、缩短ICU住院日。     

Role of viral RNA and lipid in the adverse events associated with the 2010 Southern Hemisphere trivalent influenza vaccine

In Australia, during the 2010 Southern Hemisphere (SH) influenza season, there was an unexpected increase in post-marketing adverse event reports of febrile seizures (FS) in children under 5 years of age shortly after vaccination with the CSL 2010 SH trivalent influenza vaccine (CSL 2010 SH TIV) compared to previous CSL TIVs and other licensed 2010 SH TIVs. In an accompanying study, we described the contribution to these adverse events of the 2010 SH influenza strains as expressed in the CSL 2010 SH TIV using in vitro cytokine/chemokine secretion from whole blood cells and induction of NF-κB activation in HEK293 reporter cells. The aim of the present study was to identify the root cause components that elicited the elevated cytokine/chemokine and NF-κB signature. Our studies demonstrated that the pyrogenic signal was associated with a heat-labile, viral-derived component(s) in the CSL 2010 SH TIV. Further, it was found that viral lipid-mediated delivery of short, fragmented viral RNA was the key trigger for the increased cytokine/chemokine secretion and NF-κB activation. It is likely that the FS reported in children <5 years were due to a combination of the new influenza strains included in the 2010 SH TIV and the CSL standard method of manufacture preserving strain-specific viral components of the new influenza strains (particularly B/Brisbane/60/2008 and to a lesser extent H1N1 A/California/07/2009). These combined to heighten immune activation of innate immune cells, which in a small proportion of children <5 years of age is associated with the occurrence of FS. The data also demonstrates that CSL TIVs formulated with increased levels of splitting agent (TDOC) for the B/Brisbane/60/2008 strain can attenuate the pro-inflammatory signals in vitro, identifying a potential path forward for generating a CSL TIV indicated for use in children <5 years.