本院出生和外院转运早产儿视网膜病发病情况的对比研究

目的探讨广东省妇幼保健院出生和外院转运早产儿视网膜病(ROP)的发病及诊治情况。方法回顾性分析2013年1月至2015年12月收入广东省妇幼保健院新生儿重症监护室并诊断为ROP的755例早产儿的临床资料。本院出生组239例,外院转运组516例。收集2组患儿的胎龄、体质量、性别、ROP病变程度及手术治疗等资料。结果外院转运组ROP早产儿出生体质量[(1290.64±392.87)g]低于本院出生组[(1586.21±512.74)g],差异有统计学意义(P<0.001);外院转运组ROP早产儿诊断胎龄[(35.53±2.81)周]高于本院出生组[(34.51±2.17)周],差异有统计学意义(P<0.001);外院转运组严重ROP[如病变Ⅰ区、急进性后部型早产儿视网膜病(AP-ROP)、合并Plus病变]所占比例高于本院出生组,差异均有统计学意义(均P<0.001);外院转运组ROP早产儿行激光光凝术、玻璃体注药术、二者联合术、补激光术治疗所占比例均高于本院出生组[60.1%(310/516例)比20.9%(50/239例);10.9%(56/516例)比2.5%(6/239例);8.1%(42/516例)比1.7%(4/239例);4.5%(23/516例)比1.3%(3/239例)],差异均有统计学意义(均P<0.001)。结论外院转运ROP早产儿出生体质量较低,ROP病变较重,手术干预率高。提高基层医院早产儿ROP筛查水平,及时诊断和高效转运可有效防止ROP进一步恶化,提高早产儿生活质量。     

Racial differences in characteristics and prognoses between Asian and white patients with nonsmall cell lung cancer receiving atezolizumab: An ancillary analysis of the POPLAR and OAK studies

This study aimed to compare the differences in characteristics and prognoses between Asian and white patients receiving immunotherapy for nonsmall cell lung cancer (NSCLC). We studied 390 patients who received atezolizumab as part of the POPLAR or OAK trial, and analyzed the differences in baseline characteristics, outcomes and genetic mutations in blood samples between Asian and white patients. Overall survival (OS) was longer in Asian compared to white patients (median OS: 18.7 vs. 11.1 months; p = 0.005). Race was identified as an independent prognostic factor for OS (Asian vs. white: hazard ratio 0.647, 95% confidence interval 0.447–0.936, p = 0.021), together with performance status, histology, baseline sum of the longest tumor diameters (BLSLD) and number of metastatic sites. The two groups also differed in terms of characteristics including smoking history, BLSLD, epidermal growth factor receptor (EGFR) mutation frequency, programmed death-ligand 1 expression and blood-based tumor-mutation burden. Blood mutations of STK11, EGFR, KEAP1, POLE, GRM3, ATM and STAG2 were associated with treatment response, and TP53, KEAP1, APC, RB1, CREBBP, EPHA5 and STAG2 mutations were associated with OS. The blood-based mutation profiles differentiated between Asian and white patients, especially in relation to EGFR (23.8 vs. 8.5%), TP53 (30.2 vs. 46.9%) and STK11 (1.6 vs. 12.3%) mutations (all p < 0.05). The different clinicopathological features and mutation profiles in Asian and white patients may explain the superior outcome following atezolizumab treatment in Asian patients with NSCLC. The results of this study have important implications for further studies on racial disparities in relation to immunotherapy.     

Hypocholesterolaemic mechanism of bitter melon aqueous extracts via inhibition of pancreatic cholesterol esterase and reduction of cholesterol micellar solubility

This study investigated the hypocholesterolaemic effects of bitter melon aqueous extracts (BMAE) in vitro, the inhibitory effects of BMAE on pancreatic cholesterol esterase (CEase) and incorporation of cholesterol into micelles were investigated. BMAE decreased the in vitro micellar solubility of cholesterol in a dose-dependent manner. The conformation of CEase was investigated by means of circular dichroism (CD) and fluorescence. The result revealed the decrease of α-helix contents, increase of β-sheet and exposure of aromatic amino acid residuals. The incorporation of cholesterol into micelles was inhibited by BMAE. A complex was observed by transmission electron microscopy (TEM), which indicated interaction between cholesterol and BMAE. The result revealed that BMAE can play a role in decreased intestinal cholesterol absorption via inhibition of CEase, and of micelle formation.     

Fusobacterium nucleatum Subspecies Identification by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

We explored the use of matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) for identification of Fusobacterium nucleatum subspecies. MALDI-TOF MS spectra of five F. nucleatum subspecies (animalis, fusiforme, nucleatum, polymorphum, and vincentii) were analyzed and divided into four distinct clusters, including subsp. animalis, nucleatum, polymorphum, and fusiforme/vincentii. MALDI-TOF MS with the modified SARAMIS database further correctly identified 28 of 34 F. nucleatum clinical isolates to the subspecies level.     

Mid‐ventricular obstruction is associated with non‐sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy

BackgroundMid‐ventricular obstruction (MVO) is a rare subtype of hypertrophic cardiomyopathy (HCM) but it is associated with ventricular arrhythmia. The relationship between MVO and non‐sustained ventricular tachycardia (NSVT) in HCM patients is unknown.HypothesisThe severity of MVO increases the incidence of NSVT in patients with hypertrophic obstructive cardiomyopathy (HOCM).MethodsFive hundred and seventy‐two consecutive patients diagnosed with HOCM in Fuwai Hospital between January 2015 and December 2017 were enrolled in this study. Holter electrocardiographic and clinical parameters were compared between HOCM patients with and without MVO.ResultsSeventy‐six (13.3%) of 572 patients were diagnosed with MVO. Compared to patients without MVO, those with MVO were much younger, and had a higher incidence of syncope, greater left ventricular (LV) posterior wall thickness, a higher percentage of LV late gadolinium enhancement, and higher prevalence of NSVT. Furthermore, the prevalence of NSVT increased with the severity of MVO (without, mild, moderate or severe: 11.1%, 18.2%, 25.6%, respectively, p for trend < .01). Similarly, the prevalence of NSVT differed among patients with isolated LV outflow tract (LVOTO), both MVO and LVOTO, and isolated MVO (11.1%, 21.3%, 26.6%, respectively, p for trend = .018). In addition to age, diabetes, left atrial diameter, and maximal wall thickness, multivariate analysis revealed the presence of MVO as an independent risk factor for NSVT (Odds ratio 2.69; 95% confidence interval 1.41 to 5.13, p = .003).ConclusionsThe presence and severity of MVO was associated with higher incidence of NSVT in HOCM patients.     

《药物分析》课程本科教学改革和思考

目的　分析《药物分析》课程在当今药学本科教育培养过程中的现状，探索《药物分析》课程在新时代药学教育背景下的教学改革与创新，构建符合药学培养要求、满足社会市场需要的复合型药学人才培养模式。方法　第一阶段，开展教学改革的建议和需求调查；第二阶段，开展《药物分析》课程改革探索与实践；第三阶段，教学效果评价。结果　需求调查显示《药物分析》课程的教学内容、课程设计、教学手段亟须进一步优化和拓展。结论　该课程通过调整教学内容、拓展教学手段、创新多元化实践教学、融入"课程思政"建设等，激发了学生的学习兴趣和创新精神，强化了学生理论素养和实践能力，培养了其国际化视野和崇高的职业道德。     

Diffusion MRI detects early brain microstructure abnormalities in 2‐month‐old 3×Tg‐AD mice

The 3×Tg‐AD mouse is one of the most studied animal models of Alzheimer's disease (AD), and develops both amyloid beta deposits and neurofibrillary tangles in a temporal and spatial pattern that is similar to human AD pathology. Additionally, abnormal myelination patterns with changes in oligodendrocyte and myelin marker expression are reported to be an early pathological feature in this model. Only few diffusion MRI (dMRI) studies have investigated white matter abnormalities in 3×Tg‐AD mice, with inconsistent results. Thus, the goal of this study was to investigate the sensitivity of dMRI to capture brain microstructural alterations in 2‐month‐old 3×Tg‐AD mice. In the fimbria, the fractional anisotropy (FA), kurtosis fractional anisotropy (KFA), and radial kurtosis (K_┴) were found to be significantly lower in 3×Tg‐AD mice than in controls, while the mean diffusivity (MD) and radial diffusivity (D_┴) were found to be elevated. In the fornix, K_┴ was lower for 3×Tg‐AD mice; in the dorsal hippocampus MD and D_┴ were elevated, as were FA, MD, and D_┴ in the ventral hippocampus. These results indicate, for the first time, dMRI changes associated with myelin abnormalities in young 3×Tg‐AD mice, before they develop AD pathology. Morphological quantification of myelin basic protein immunoreactivity in the fimbria was significantly lower in the 3×Tg‐AD mice compared with the age‐matched controls. Our results demonstrate that dMRI is able to detect widespread, significant early brain morphological abnormalities in 2‐month‐old 3×Tg‐AD mice.     

腹腔镜经腹腹膜前与局麻下开放式腹膜前疝修补术治疗股疝的对比研究

目的研究腹腔镜经腹腹膜前疝修补术（TAPP）与局麻下开放式腹膜前间隙疝修补术两种手术方式治疗股疝对比研究。 方法收集2015年1月至2016年6月，北京朝阳医院疝和腹壁外科收治40例股疝患者，对其的临床数据进行回顾性分析，根据手术方式不同分为腔镜组与开放组，腔镜组22例（55%），均采用TAPP手术治疗；开放组18例（45%），均采用开放腹膜前疝修补术治疗。比较不同手术方式的2组患者的住院时间、手术时间、术中出血量、术后疼痛、离床时间、术后住院时间，以及术后局部血肿、感染等并发症发生率。 结果腔镜组与开放组手术所用时间、术中出血量、住院时间、术后疼痛、术后住院时间比较，差异无统计学意义(P>0.05)；术后离床时间比较，差异有统计学意义（P<0.05），考虑与麻醉方式有关。2组均未出现血肿及感染等并发症，局部疼痛较轻，未发生慢性顽固性疼痛。术后随访6～18个月，2组均未出现复发病例。 结论技术成熟的术者对于股疝的手术，TAPP与局麻开放式腹膜前疝修补术无明显差异，两种不同的手术方法各有其优缺点，应根据术前评估及术者手术技术水平选择合适的手术方式。     

An unusual case of prenatal diagnosis of right coronary artery to right ventricle fistula with HD-flow render mode and spatiotemporal image correlation (STIC)

Coronary artery fistula is rare in prenatal diagnosis. We have reported a case diagnosis of coronary artery fistula by using high-definition flow (HD-flow) render mode and spatiotemporal image correlation (STIC), and then evaluated the postnatal outcomes in our hospital.     

Clinical characteristics and prognosis of postpartum acute kidney injury

ObjectiveTo investigate the clinical characteristics and prognoses of patients with postpartum acute kidney injury (PPAKI).MethodsWe retrospectively reviewed the clinical presentations, laboratory examinations, treatments, and outcomes of patients with PPAKI admitted to our hospital from January 2013 to December 2017. We then analyzed the clinical characteristics and prognoses of the mothers and their infants.ResultsOf 37 patients diagnosed with PPAKI, 26 (70.3%) received treatment in the intensive care unit, mainly for hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome (28/37, 75.7%), pre-eclampsia (26/37, 70.3%), and postpartum hemorrhage (22/37, 59.5%). Twenty patients required renal replacement treatment (RRT), but renal recovery times were similar in the RRT and non-RRT groups. Renal function recovered completely in 30 patients (81.1%) and partially in one patient (2.7%), and was not re-examined in two patients (5.4%). Three patients (8.1%) were lost to follow-up. Only one patient (2.7%) remained dialysis-dependent, and no maternal deaths occurred. The preterm birth, low birth weight, and infant survival rates were 70.7% (29/41), 68.3% (28/41), and 78.0% (32/41), respectively.ConclusionRRT does not reduce renal recovery time compared with non-RRT. Overall, the prognoses of both mothers and their fetuses are good following treatment for PPAKI.