Investigation of the Optimal Parameters of Median Nerve Stimulation Using a Variety of Stimulation Methods and Its Effects on Heart Rate Variability: A Systematic Review

ObjectivesThere is a wealth of literature supporting the use of median nerve stimulation (MNS) for modulating autonomic nervous system (ANS) dysfunction such as in hypoxia, recovery after heart valve replacement, ischemia, and cardiac contractibility. Heart rate variability (HRV) is considered a gold standard for measuring autonomic modulation and dynamic nonlinear ANS processes through the use of an electrocardiogram (ECG). Although the use of MNS on HRV in animals and humans has been documented, optimal stimulation parameters are yet to be outlined.Materials and MethodsThis review aims to synthesize findings of neurostimulation using MNS on animals and humans while observing HRV using an ECG. Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with search parameters of “Median nerve stimulation,” “Neiguan,” “PC-6,” “HRV,” “Heart rate variability,” and “Heart-rate variability” observing on animals and human subjects, we found a total of 17 eligible articles.ResultsIn this review, changing two parameters, that is, stimulation frequency and side of stimulation, appears to be the most influential in effecting frequency-domain ECG analysis of HRV. However, it is evident from this review that to perform an effective comparison of the effects of MNS on HRV, more detailed reports of the studies are required.ConclusionsFinding the optimal stimulation parameters for MNS is crucial for improving HRV. This will in turn contribute to normalizing ANS function impaired in numerous clinical conditions, such as epilepsy or diabetes.     

球囊仿生助产术在产科的临床价值

目的观察分析球囊仿生助产术在产科中的临床价值。方法选取本院(在2018年1月—2019年2月)收治的260例产妇,按照不同助产处理方法分为实验组(130例,实施球囊仿生助产术)和对照组(130例,实施常规助产术)。采用统计学分析两组产妇的顺产率、总产程时间(第一产程时间、第二产程时间)、平均产后出血量、并发症(会阴血肿、尿潴留)发生率以及新生儿窒息率。结果实验组产妇顺产率高于对照组(P<0.05),实验组新生儿窒息率低于对照组(P<0.05),实验组产妇的总产程时间短于对照组(P<0.05),实验组产妇平均产后出血量少于对照组(P<0.05),实验组产妇并发症(会阴血肿、尿潴留)发生率低于对照组(P<0.05)。结论球囊仿生助产术在产科中的临床价值显著。     

PBL教学法在临床心肺复苏术教学中的应用分析

目的 分析重症医学科PBL教学法在临床心肺复苏术教学中的应用效果.方法 本次实验的开展基础数据选择2016年9月—2018年7月进入医院重症医学科实习学生64例,按照学生自身意愿以及学校安排将参与实验学生分为均数相同的两个小组(对照组、观察组),每组实验人数均为32例,其中对照组(n=32)采用传统教学方法 ,观察组(n=32)则应用PBL教学法教学,对比两组学生在学期结束后整体的学习质量情况和教学满意率.结果 观察组学生经过测试后理论知识和专业技能得分均对比对照组更高,教学效果更加理想,观察组学生对于教学的满意率评价更高,P<0.05.结论 重症医学科临床心肺复苏术教学中应用PBL教学法,将理论与实践进行结合,对教学方法 进行改进,全面提升学生的思维理解能力,培养良好的动手能力,促进理论教学与实践的结合,为学生以后的职业生涯提供更加理想的条件.     

Design,synthesis and pharmacological evaluation of 4-(3-chloro-4-(3-cyclopropylthioureido)-2-fluorophenoxy)-7-methoxyquinoline-6-carboxamide (WXFL-152): a novel triple angiokinase inhibitor for cancer therapy

Angiokinases, such as vascular endothelial-, fibroblast- and platelet-derived growth factor receptors (VEGFRs, FGFRs and PDGFRs) play crucial roles in tumor angiogenesis. Anti-angiogenesis therapy using multi-angiokinase inhibitor has achieved great success in recent years. In this study, we presented the design, synthesis, target identification, molecular mechanism, pharmacodynamics (PD) and pharmacokinetics (PK) research of a novel triple-angiokinase inhibitor WXFL-152. WXFL-152, identified from a series of 4-oxyquinoline derivatives based on a structure–activity relationship study, inhibited the proliferation of vascular endothelial cells (ECs) and pericytes by blocking the angiokinase signals VEGF/VEGFR2, FGF/FGFRs and PDGF/PDGFRβ simultaneously in vitro. Significant anticancer effects of WXFL-152 were confirmed in multiple preclinical tumor xenograft models, including a patient-derived tumor xenograft (PDX) model. Pharmacokinetic studies of WXFL-152 demonstrated high favourable bioavailability with single-dose and continuous multi-dose by oral administration in rats and beagles. In conclusion, WXFL-152, which is currently in phase Ib clinical trials, is a novel and effective triple-angiokinase inhibitor with clear PD and PK in tumor therapy.     

特发性扩张型心肌病患者左心室逆重构的发生率、预测因素和预后分析

目的探讨特发性扩张型心肌病患者左心室逆重构(LVRR)的发生率、预测因素及预后。方法回顾性分析2014年1月至2017年5月于焦作市第二人民医院住院的51例特发性扩张型心肌病患者的一般临床资料和超声心动图数据,以复查时左心室射血分数(LVEF)绝对值增加10%以上的患者为LVRR组,LVEF绝对值增加低于10%的为NLVRR组。计算LVRR的发生率,采用logistic回归分析LVRR的预测因素,比较两组心力衰竭恶化再住院率,并采用Kaplan-Meier生存曲线法分析两组死亡率。结果特发性扩张型心肌病患者LVRR的发生率为51.0%(26/51)。LVRR的预测因素为心力衰竭病史<1年(OR=0.065,95%CI:0.007~0.562,P=0.013)和首次LVEF≥35%(OR=23.457,95%CI:2.687~204.770,P=0.004)。LVRR组的住院次数为2.8±2.9,NLVRR组为3.4±2.3,两组比较差异有统计学意义(P=0.003)。Kaplan-Meier生存曲线法分析显示,LVRR组患者的预后优于NLVRR组(95%CI:96.442~120.323和95%CI:69.909~98.364,P=0.017)。结论特发性扩张型心肌病患者的LVRR发生率为51.0%,心力衰竭病史小于1年和首次LVEF≥35%为其预测因素,此类患者预后改善。     

Does proteostasis get lost in translation? Implications for protein aggregation across the lifespan

Protein aggregation is a phenomenon of major relevance in neurodegenerative and neuromuscular disorders, cataracts, diabetes and many other diseases. Research has unveiled that proteins also aggregate in multiple tissues during healthy aging yet, the biological and biomedical relevance of this apparently asymptomatic phenomenon remains to be understood. It is known that proteome homeostasis (proteostasis) is maintained by a balanced protein synthesis rate, high protein synthesis accuracy, efficient protein folding and continual tagging of damaged proteins for degradation, suggesting that protein aggregation during healthy aging may be associated with alterations in both protein synthesis and the proteostasis network (PN) pathways. In particular, dysregulation of protein synthesis and alterations in translation fidelity are hypothesized to lead to the production of misfolded proteins which could explain the occurrence of age-related protein aggregation. Nevertheless, some data on this topic is controversial and the biological mechanisms that lead to widespread protein aggregation remain to be elucidated. We review the recent literature about the age-related decline of proteostasis, highlighting the need to build an integrated view of protein synthesis rate, fidelity and quality control pathways in order to better understand the proteome alterations that occur during aging and in age-related diseases.     

Pharmacological and pathological modulation of cerebral physiology

Homeostatic mechanisms exist to enable the supply of oxygen and glucose for cerebral metabolism and neuronal function. In health, cerebral autoregulation, neurogenic and metabolic processes ensure that the supply of these nutrients is adequate to meet metabolic requirements, thus preventing neuronal cell damage. The goals of neuroanaesthesia are to provide optimal operating conditions and provide adequate cerebral blood flow, often in the context of a vulnerable brain which is exposed to the physiological stress of surgical trauma. This article outlines how delivery of anaesthesia and disease processes affecting the brain modulate the mechanisms that regulate cerebral blood flow and metabolism.     

Large-Bore Aspiration Thrombectomy versus Catheter-Directed Thrombolysis for Acute Pulmonary Embolism: A Propensity Score–Matched Comparison

PurposeTo compare effectiveness and safety of large-bore aspiration thrombectomy (LBAT) with catheter-directed thrombolysis (CDT) for treatment of acute massive and submassive pulmonary embolism (PE).Materials and MethodsThis retrospective review included patients with acute PE treated with LBAT or CDT using tissue plasminogen activator (tPA) between December 2009 and May 2020. A propensity score based on Pulmonary Embolism Severity Index class and PE severity (massive vs submassive) was calculated, and 26 LBAT cases (age 60.2 y ± 17.1, 14/26 women) were matched with 26 CDT cases (age 59.7 y ± 14.2, 14/26 women).ResultsThe CDT group had 22.1 mg ± 8.1 tPA infused over 21.2 h ± 6.6. Both groups demonstrated similar initial and final systolic pulmonary artery pressure (PAP) (LBAT: 54.5 mm Hg ± 12.9 vs CDT: 54.5 mm Hg ± 16.3, P = .8, and LBAT: 42.5 mm Hg ± 14.1 vs CDT: 42.6 mm Hg ± 12.1, P = .8, respectively) and similar reductions in heart rate (LBAT: −5.4 beats/min ± 19.2 vs CDT: −9.6 beats/min ± 15.8, P = .4). CDT demonstrated a higher reduction in Miller score (−10.1 ± 3.9 vs −7.5 ± 3.8, P = .02). LBAT resulted in 1 minor hemorrhagic complication and 2 procedure-related mortalities, and CDT resulted in 1 minor and 1 major hemorrhagic complication.ConclusionsLBAT and CDT resulted in similar reductions of PAP and heart rate when used to treat acute PE. CDT reduced thrombus burden to a greater degree. Although hemorrhagic complications rates were not significantly different, the LBAT group demonstrated a higher rate of procedure-related mortality. Larger studies are needed to compare the safety of these techniques.     

中药结肠透析对慢性重型肝炎患者肝功能及预后的影响

目的探讨中药结肠透析对慢性重型肝炎患者肝功能及预后的影响。方法选择2015年4月-2018年6月收治的慢性重型肝炎患者共80例,随机分为观察组(40例)和对照组(40例)。对照组给予综合治疗,观察组给予中药结肠透析治疗,对比2组肝功能及并发症发生情况,并记录2组生存率。结果观察组患者谷丙转氨酶(ATL)、总胆红素(TBil)水平均低于对照组患者,而胆碱酯酶(CHE)、血浆白蛋白(ALB)水平均高于对照组,差异有统计学意义(P<0.05);观察组患者并发症发生率低于对照组患者,差异有统计学意义(P<0.05);观察组患者生存率高于对照组患者,差异有统计学意义(P<0.05)。结论中药结肠透析治疗慢性重型肝炎患者疗效显著,可有效改善患者肝功能,并明显降低其并发症发生率,提高患者生存率,值得在临床应用。