压力波形联合回流液相双指征监测法定位硬膜外麻醉的临床应用

背景 硬膜外穿刺技术临床上广泛用于颈部、胸腹部、下肢手术的麻醉与疼痛治疗.现行传统硬膜外麻醉操作为一种盲探性穿刺置管技术,单独依靠操作者的感觉和经验及简单的试验方法评判麻醉成功与否,难以做到精确可控,而麻醉状态无客观指征监测,麻醉失败原因常无法得知.目的 为改进现行盲探方法,探求硬膜外麻醉的可视化指征的可行性.内容 自2006年以来,经不断深入研究,以“压力波形联合回流液相双指征法”用于辅助硬膜外麻醉,达到了可视化指征,辅助硬膜外麻醉定位与监测,效果理想.至今已在临床成功应用万例以上(内蒙古医学院附属医院完成硬膜外麻醉1万余例/年,约占麻醉总例数的50％).趋向 目前此项技术已常规应用于临床并加以推广,现予以介绍,以期建立新型硬膜外麻醉操作流程,从而使麻醉全程达到严谨、规范、安全、可靠,进一步提高硬膜外麻醉的安全有效性.     

A proteomic approach to investigate AuNPs effects in Balb/3T3 cells

Although gold nanoparticles (AuNPs) are currently used in several industrial products and biomedical applications, information about their biological effects is very limited. Thus, it is becoming crucial to assess their safety and adequately investigate the complexity of cell–nanoparticles interactions. In this work, the Balb/3T3 mouse fibroblast cell line was selected as an in vitro model to study the effects of AuNPs. Alteration of cellular processes and biochemical pathways caused by AuNPs exposure was investigated by analysing the differentially expressed proteome. Of interest was the difference observed in the protein pattern expression of cells exposed to AuNPs. It was found that 88 and 83 proteins were de-regulated after exposure to 5 and 15 nm AuNPs, respectively. Analysis of the proteome revealed that AuNPs triggers several pathways related to cellular growth and proliferation, cell morphology, cell cycle regulation, cellular function and maintenance, oxidative stress, and inflammatory response. Moreover, SPR analysis showed an increase of ECM proteins biosynthesis in cells exposed to AuNPs. We observed by TEM analysis that NPs are internalized and confined mainly in autophagosomes. Endoplasmic reticulum stressed and modification at mitochondrial level occurred. This study aims to improve existing knowledge necessary for a correct assessment of the balance between AuNPs potential adverse and beneficial effects and might have important implications for biomedical applications (e.g. nanomedicine).     

Micelle size effect on Fe-55 liquid scintillation efficiency

We used efficiency tracing techniques to study the micelle size effect on liquid scintillation counting of the electron capture nuclide, ⁵⁵Fe. We determined micelle hydrodynamic diameters for specific LS cocktails via dynamic light scattering, and sought trends in efficiencies as a function of micelle size. The presence of Fe³⁺ or Mn²⁺ ions in the cocktails did not significantly affect micelle sizes or fluorescence quenching. We did not detect any reductions in counting efficiencies due to the micelle size effect.     

Expanded Circulating Tumor Cells from a Patient with ALK-Positive Lung Cancer Present with EML4-ALK Rearrangement Along with Resistance Mutation and Enable Drug Sensitivity Testing: A Case Study

The emergence of liquid biopsy using circulating tumor cells (CTCs) as a resource to identify genomic alterations in cancer presents new opportunities for diagnosis, therapy, and surveillance. We identified EML4-ALK gene rearrangement in expanded CTCs from a patient with ALK-positive lung adenocarcinoma. At the time of radiographic progression, CTCs obtained from the patient revealed a drug resistance mutation (i.e., L1196M on the ALK gene). CTCs were expanded ex vivo and drug sensitivity testing was performed using two ALK inhibitors, crizotinib and ceritinib. The half maximal inhibitory concentration of ceritinib was 1664 nM compared with crizotinib (2268 nM), showing that ceritinib was a more potent ALK inhibitor. We show that it is feasible to detect serial genetic alterations in expanded CTCs and perform in vitro drug screening. These findings support the clinical utility of CTCs not only for diagnosis, but also a potential tool for drug sensitivity testing in distinct subsets of lung cancer and for personalized precision medicine.     

microRNA的液体芯片检测方法

microRNA表达谱的检测需要精确、高通量和多重检测方法 ,液体芯片可通过编码微球结合探针的序列差异,来检测相应的microRNA序列。本文介绍了两代液体芯片背景的FlexmiR产品,其通过锁核酸,逐步降温和单链酶解来提升对microRNA检测的特异性,为临床科研microRNA的研究提供新的检测工具。     

清肺止咳丸配合穴位贴敷治疗咳嗽变异性哮喘的研究

目的：探讨清肺止咳丸配合穴位贴敷对咳嗽变异性哮喘的治疗作用。方法：选取2013年1月-2014年9月的120例咳嗽变异性哮喘患者,随机分为两组,每组各60例,治疗组应用清肺止咳丸配合穴位贴敷治疗,对照组应用肺力咳胶囊治疗,两组均以10 d为一疗程,2个疗程后统计结果。结果：治疗组总疗效及主要症状评分、LCQ测评及各单项指标评分、小气道通气状况与对照组比较差异有统计学意义（P<0.05）,两组患者外周血嗜酸粒细胞计数均有改善。结论：清肺止咳丸配合穴位贴敷治疗咳嗽变异性哮喘有较好的临床疗效。     

克拉霉素联合鼻渊舒治疗慢性鼻-鼻窦炎疗效分析

目的 评价克拉霉素联合鼻渊舒口服液治疗慢性鼻-鼻窦炎(CRS)的疗效.方法 采用前瞻、随机、对照的临床试验方式将56例不伴鼻息肉CRS患者分为两组.对照组28例给予克拉霉素片0.25 g,次/d,连续口服3个月;治疗组28例在对照组基础上给予鼻渊舒口服液,前1个月10 ml,2次/d,后2个月10 ml,1次/d.两组的每位患者在治疗开始前均给予7～ 10日包括两种抗生素联用的综合强化治疗.采用鼻窦CT(Lund-Mackey)评分和视觉模拟量表(VAS)评分评定疗效.结果 56例患者中5例脱落,均按治疗无效病例处理.治疗组、对照组治疗后鼻窦CT得分分别为(3.28±2.11)分和(3.50±1.95)分,显著低于治疗前的(7.32±1.63)分和(7.07±1.74)分,治疗前后比较差异均有统计学意义(配对t检验,P＜ 0.01),均明显改善.两组鼻窦CT得分组间比较差异无统计学意义(t=0.394,P＞0.05).治疗组、对照组治疗后VAS总体影响得分分别为(2.39±2.13)分和(3.86±1.37)分,显著低于治疗前的(6.21±0.92)分和(6.14±0.85)分,治疗前后比较差异均有统计学意义(配对t检验,P＜ 0.01),均明显改善.两组的单项症状流涕、鼻塞、头面部痛的VAS得分治疗前、后比较差异也都有统计学意义(配对t检验,P＜0.01).组间比较:治疗后除流涕症状VAS得分两组差异无统计学意义外,总体影响及鼻塞、头面部痛VAS得分差异均有统计学意义,治疗组主观症状改善明显好于对照组.结论 3个月小剂量克拉霉素、鼻渊舒口服液联用和单用克拉霉素治疗不伴鼻息肉CRS都有效,但克拉霉素、鼻渊舒口服液联用疗效更好.治疗疗程开始前给予包括两种抗生素联用的短程综合强化措施对CRS抗炎治疗有益.     

高效液相色谱质谱联用法测定射干合剂中8种中药成分的含量

目的:建立一种高效液相色谱质谱联用法同时测定黄芩苷、野黄芩苷、汉黄芩素、咖啡酸、麻黄碱、射干苷、次野鸢尾黄素、黄芩素等8种中药成分的含量及其在我院自有制剂射干合剂中的应用。方法:色谱条件:色谱柱为ZORBAX SB-C18(2.1 mm×50 mm,1.8μm),流动相为0.1%甲酸水溶液-乙腈,梯度洗脱,流速为0.3 ml·min-1,柱温:35℃;质谱条件:采用电喷雾离子源(ESI),多反应离子监测(MRM),结合正负离子扫描切换,其中咖啡酸、野黄芩苷、射干苷采用负离子模式检测,黄芩苷、汉黄芩素、次野鸢尾黄素、黄芩素、麻黄碱采用正离子模式检测。结果:黄芩苷、野黄芩苷、汉黄芩素、咖啡酸、麻黄碱、射干苷、次野鸢尾黄素、黄芩素的定量限分别为1.44×10-4,4.20×10-3,2.95×10-4,7.80,4.90×10-3,4.6×10-2,3.18×10-4,4.85 ng·ml-1,检测限分别为4.32×10-5,1.3×10-3,8.84×10-5,0.77,2.90×10-4,3.33×10-4,9.5×10-5,1.46 ng·ml-1;在相应的线性范围内R2>0.992 3;日内和日间精密度(RSD)均小于5%,平均回收率均在80%~120%。结论:本方法在20 min内实现这8种化合物的分离和测定,简单、快速、灵敏、准确,可用于射干合剂多成分含量测定。     

康复新液保留灌肠治疗放射性肠炎的临床观察

目的：优选枇杷清肺颗粒的最佳醇提工艺。方法醇提工艺以盐酸小檗碱含量和浸膏得率为指标,采用正交试验优选枇杷清肺颗粒最佳醇提工艺。结果醇提最佳工艺条件为加10倍量70％乙醇,回流提取3次,每次2 h。结论优选出的提取工艺稳定,主要有效成分转移率高,为枇杷清肺颗粒的成型工艺研究奠定了基础。     

Determination of fluoroquinolones in chicken feces – A new liquid–liquid extraction method combined with LC–MS/MS

The application of antibiotics including fluoroquinolones to farming animals is widespread and may lead to the development of antibiotic resistance and other environmental effects. To calculate environmental loads and for a proper risk assessment it is necessary to determine the antibiotic concentration in feces. Therefore, a new liquid–liquid extraction method combined with HPLC–MS/MS for the detection of marbofloxacin, ciprofloxacin, enrofloxacin and difloxacin in chicken feces was developed. Recoveries ranged from 51.0% to 83.5%. LOQs were between 0.10 and 1.09 μg/kg. Feces of chickens treated with an enrofloxacin dosage of 10 mg/kg bodyweight revealed maximum enrofloxacin and ciprofloxacin concentrations of 61.3 and 18.8 mg/kg. Both antibiotics could be detected in feces up to two days after the last application in notable amounts (∼1 mg/kg). Thus, feces of recently medicated chickens should not be used as a fertilizer without any further processing.