经口咽前路寰枢椎复位钢板系统在陈旧性齿状突骨折治疗中的应用

背景：对颅颈交界区畸形及其他病变引起的寰枢椎脱位伴脊髓压迫症需减压内固定，可根据不同的情况选择不同的内固定方法，包括寰枢前路内固定、寰枢后路内固定或枕颈内固定。经口咽前路寰枢椎钢板内固定是新近发展起来的一种寰枢椎前路固定方法，用于先天性疾患、外伤或类风湿性关节炎等所致的难复性寰枢椎脱位。目的：探讨经口咽前路寰枢椎复位钢板系统在陈旧性齿状突骨折引起的寰枢椎脱位的临床应用。设计：单一样本观察。单位：解放军广州军区广州总医院骨科。对象：选择解放军广州军区广州总医院骨科2003—01／2005-11因陈旧性齿突骨折引起的寰枢椎脱位患者12例。男7例，女5例；年龄36～59岁，平均47岁；受伤时间4．5-36个月，平均19个月；Frank分级：C级6例，D级3例，E级3例。方法：对12例陈旧性齿状突骨折引起的寰枢椎脱位患者行经口咽前路松解减压，应用经口咽前路寰枢椎复位钢板系统复位和固定，两侧寰枢关节间植入自体髂骨融合。主要观察指标：①术后4周患者Frank分级。②术后内固定物是否有松动。结果：①术后4周Frank分级：原为C级的6例患者中4例改进为E级．2例改进为D级；原为D级的3例患者均改进为E级；原为E级的患者分级无改变。②除1例因跌倒引起螺钉松动再次脱位外，均固定牢固，融合理想，脊髓减压满意。结论：经口咽前路寰枢椎复位钢板系统一次完成寰枢椎脱位的复位和固定，避免了前路减压术后再行后路融合固定手术，避免在搬动、翻身过程中，因寰枢椎极度不稳可能对脊髓造成的致命的损伤。     

肌肉注射维生素D3对哮喘儿童血清25-羟基维生素D的影响

目的:探讨儿童哮喘在吸入沙美特罗替卡松同时一次性肌肉注射维生素D37.5 mg治疗前后血清25-羟基维生素D[25(OH)D]的变化。方法:选取2012年10月至2014年6月在成都市妇女儿童中心医院哮喘门诊就诊的哮喘急性发作初治患儿69例,采用随机数字表法分为对照组36例和观察组33例。两组均给予沙美特罗替卡松每次一吸(50μg/100μg),2次/天;观察组仅第1天加用维生素D330万IU肌肉注射一次。两组均在治疗前及治疗3个月后取静脉血清采用化学发光法测定25(OH)D水平。结果:观察组治疗后血清25(OH)D水平升高,虽未达到理想水平,但可纠正哮喘患儿存在的25(OH)D不足或缺乏,与治疗前比较差异有统计学意义(P<0.05);对照组治疗前后血清25(OH)D水平比较差异无统计学意义(P>0.05);治疗后观察组血清25(OH)D水平高于对照组(P<0.05)。结论:对哮喘患儿给予一次性维生素D330万IU肌肉注射可以纠正其存在的25(OH)D不足或缺乏,可能是改善哮喘患儿临床预后的积极补充治疗措施。     

Pharmacological targeting of GSK3β confers protection against podocytopathy and proteinuria by desensitizing mitochondrial permeability transition

Background and Purpose

Mitochondrial dysfunction, triggered by mitochondria permeability transition (MPT), has been centrally implicated in the pathogenesis of podocytopathy and involves a multitude of cell signalling mechanisms, among which, glycogen synthase kinase (GSK) 3β has emerged as the integration point and plays a crucial role. This study aimed to examine the role of GSK3β in podocyte MPT and mitochondrial dysfunction.

Experimental Approach

The regulatory effect of GSK3β on MPT was examined in differentiated podocytes in culture and in a murine model of adriamycin-induced podocytopathy using 4-benzyl-2-methyl-1,2,4-thiadiazolidine-3,5-dione (TDZD-8), a highly selective small-molecule inhibitor of GSK3β.

Key Results

TDZD-8 therapy prominently ameliorated the proteinuria and glomerular sclerosis in mice with adriamycin nephropathy; this was associated with a correction of GSK3β overactivity in the glomerulus and attenuation of podocyte injuries, including foot process effacement and podocyte death. Consistently, in adriamycin-injured podocytes, TDZD-8 treatment counteracted GSK3β overactivity, improved cell viability and prevented death, concomitant with diminished oxidative stress, improved mitochondrial dysfunction and desensitized MPT. Mechanistically, a discrete pool of GSK3β was found in podocyte mitochondria, which interacted with and phosphorylated clyclophilin F, a key structural component of the MPT pore. TDZD-8 treatment prevented the GSK3β-controlled phosphorylation and activation of cyclophilin F, desensitized MPT and alleviated the damage to mitochondria in podocytes induced by adriamycin in vivo and in vitro.

Conclusions and Implications

Our findings suggest that pharmacological targeting of GSK3β could represent a promising and feasible therapeutic strategy for protecting podocytes against mitochondrial dysfunction induced by oxidative injuries.     

抗生素制药菌渣的处理处置技术进展与分析

通过文献查阅和对国内数十家典型抗生素制药企业实地调研,本文分析了近6年(2007-2012年)国内抗生素制药菌渣产量、市场份额、地域分布等情况,对抗生素处理处置方法进行了分析总结,包括堆肥、厌氧消化、酵母膏用品、菌渣水煤浆、菌渣活性炭技术.分析结果发现,目前国内的菌渣处理处置和资源化技术中堆肥、厌氧消化最受多数企业认可.然而,各类抗生素制药菌渣处理处置技术都会不同程度的产生相关污染物,残留抗生素效价在进行资源化利用时还需谨慎处理.     

巴西诺卡菌感染1例

<正>诺卡菌在自然界分布广泛,多为腐生寄生菌[1]。诺卡菌病是由诺卡菌引起的一种急性或慢性化脓性或肉芽肿性病变[2],多由呼吸道吸入病原菌或经外伤感染引起,常见于免疫缺陷患者。与人类疾病密切相关的是星形诺卡菌和巴西诺卡菌[3]。笔者就本例巴西诺卡菌感染患者的临床资料,结合近年来诺卡菌报道相关文献进行分析,对诺卡菌的实验室鉴定、诊断及治疗总结如下。1病历资料1.1病史患者,男性,50岁,2013年1月19日入     

ACEI与长效CCB对高血压脑卒中二级预防的效果分析

目的：探讨ACEI与长效CCB对高血压合并脑卒中二级预防的效果。方法回顾性分析2009年6月~2014年6月社区健康档案中高血压合并脑卒中存活跃2个月的患者863例,以ACEI为降压基础治疗的408例,长效CCB为降压基础治疗的455例,主要观察脑卒中的复发、脑卒中死亡、心肌梗死发生及死亡、总死亡等,观察时间6~70个月,平均39个月。结果两组患者血压下降幅度比较差异无统计学意义（P>0.05）;两组危险因素干预情况比较差异无统计学意义（P>0.05）;ACEI组联合利尿剂的患者多于CCB组,差异有统计学意义（P<0.05）;两组≥2种联合用药率相比,差异无统计学意义（P>0.05）;ACEI组与CCB组所有脑卒中复发分别为111例（27.2%）、107例（23.5%）,差异有统计学意义（P<0.05）;两组其他心血管事件发生率比较,差异无统计学意义（P>0.05）。结论降压药对高血压合并脑卒中二级预防的效果与脑卒中一级预防相同,长效CCB优于ACEI。     

Disruption of the type 2 dopamine receptor gene causes a sodium-dependent increase in blood pressure in mice

BACKGROUND: Dopamine D(2) receptors (D(2)Rs) are expressed in the kidney. It has not been determined whether D(2)Rs are involved in the mechanism of sodium handling and blood pressure (BP) control. METHODS: The function of D(2)Rs was investigated in mice disrupted with D(2)R gene (D(2)KO mice). Six-week-old male D(2)KO mice and wild-type (WT) mice were fed high-salt (4% NaCl) or low-salt (0.01% NaCl) diets for 8 weeks. RESULTS: Before starting the metabolic diet, there were no significant differences in body weight, food consumption, and 24-h urine excretions of creatinine, sodium and potassium. The high-salt diet caused a significant elevation in systolic BP in D(2)KO mice but not in WT mice. Calculation of sodium and potassium balances revealed a significantly high level of sodium retention in D(2)KO mice placed on the high-salt diet. Twenty-four-hour urine norepinephrine excretions and heart rates, indicators of sympathetic activity, were not different in D(2)KO and WT mice on the high-salt diet. Administration of nemonapride, a specific D(2)-like receptor antagonist, to WT mice given 0.9% NaCl in drinking water caused suppression of urinary sodium excretion but had no effect in mice without salt loading. CONCLUSIONS: These results suggest that D(2) receptors promote sodium excretion during a period of high salt intake. A defect in this mechanism may result in sodium-dependent BP elevation.     

Incidence of Pleural Effusion in Patients with Pulmonary Embolism

Background:

No data on the incidence of pleural effusion (PE) in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism.

Methods:

This was a retrospective observational single-center study. All data of computed tomography pulmonary angiography (CTPA) performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed.

Results:

From January 2008 until December 2013, PE was identified in 423 of 3141 patients (13.5%) with clinically suspected pulmonary embolism who underwent CTPA. The incidence of PE in patients with pulmonary embolism (19.9%) was significantly higher than in those without embolism (9.4%) (P < 0.001). Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE.

Conclusions:

PEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.     

Inaccuracy of Self-reported Low Sodium Diet among Chinese:Findings from Baseline Survey for Shandong & Ministry of Health Action on Salt and Hypertension (SMASH) Project

This study was aimed to evaluate the agreement between the self-reported sodium intake level and 24-h urine sodium excretion level in Chinese.The 24-h urine collection was conducted among 2112 adults aged 18-69 years randomly selected in Shandong Province,China.The subjects were asked whether their sodium intake was low,moderate,or high.The weighted kappa statistics was calculated to assess the agreement between