不同高压氧吸氧时间对脑出血大鼠血肿周围B淋巴细胞瘤-2基因和BCL2-Associated X蛋白表达的影响

目的 观察不同高压氧（HBO）吸氧时间对脑出血（ICH）大鼠血肿周围B淋巴细胞瘤-2基因(Bcl-2)和BCL2-Associated X蛋白(Bax)表达的影响,以期探索HBO 治疗脑出血的治疗机制和最佳吸氧时间。 方法 选取Wistar大鼠130只,其中正常大鼠5只（正常组）,造模大鼠125只（胶原酶诱导法建立ICH模型）,按随机数字表法将造模大鼠随机分为对照组（无高压氧干预）25只和实验组（高压氧干预）100只,实验组根据吸氧时间的不同再按随机数字表法分为HBO 40 min组,HBO 60 min组,HBO 80 min组,HBO 100 min组,共4个亚组,每组25只大鼠。4个实验组亚组大鼠分别于ICH后6 h后行对应的HBO治疗,每日治疗1次,于治疗第1、3、5、7、14天后每个时间点各处死组内5只大鼠（对照组于相同时间点各处死组内5只大鼠,正常组于入组当天处死并取材）。采用免疫组化法检测各组大鼠各取材时间点血肿周边脑组织中Bax和Bcl-2蛋白的表达情况。 结果 HBO 40 min组、HBO 60 min组、HBO 80 min组、HBO 100 min组各时间点的Bax表达较对照组相同时间点均显著减少,差异均有统计学意义（P<0.05）。其中HBO 60 min组和HBO 80 min组的Bax表达分别与HBO40 min组和HBO 100 min组相同时间点比较,差异均有统计学意义（P<0.05）。造模成功3 d、5 d、7 d、14 d后,HBO 40 min组和HBO 60 min组的Bcl-2表达分别与HBO 80 min组和HBO 100 min组同时间点比较,差异均有统计学意义（P<0.05）。HBO 80 min组在造模成功7 d和14 d后的Bcl-2/Bax比值分别为1.5792和1.5733,与HBO 40 min组、HBO 60 min组以及HBO 100 min组比较,差异均有统计学意义（P<0.05）。 结论 HBO治疗ICH的机制可能与其可以下调出血灶周围Bax的表达水平以及提高Bcl-2的表达水平有关,而HBO治疗ICH的最佳吸氧时间是80 min。     

Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence Intubation

BackgroundTo our knowledge, no study has assessed the correlation of fraction of inspired oxygen (FiO₂) and end-tidal oxygen (EtO₂) values obtained from a gas analyzer during the preoxygenation period of rapid sequence intubation (RSI) to predict partial pressure of oxygen (PaO₂) among patients requiring intubation in the emergency department (ED).ObjectiveThe purpose of this study was to determine whether a simple equation using EtO₂ and FiO₂ at time of induction could reliably estimate minimal PaO₂ in ED patients undergoing RSI.MethodsWe conducted an observational pilot study performed in an adult ED utilizing a gas analyzer to obtain EtO₂ and FiO₂ values in ED patients undergoing RSI from data collectors blinded to our objective. The Pearson correlation coefficient was calculated between the equation's predicted PaO₂ and the PaO₂ drawn from an arterial blood gas shortly after intubation. A Bland-Altman plot analysis was performed to identify any additional bias.ResultsSeventy-five patients were enrolled. The equation's mean predicted minimal PaO₂ and mean PaO₂ from an arterial blood gas within 3 min after intubation was 178 mm Hg (95% confidence interval [CI] 145–211 mm Hg) and 209 mm Hg (95% CI 170–258 mm Hg), respectively. The Pearson correlation coefficient between the predicted minimal PaO₂ and post-intubation PaO₂ demonstrated a strong correlation (r² = 0.89). The Bland-Altman plot indicated no bias affecting the correlation between the predicted and actual PaO₂.ConclusionsAmong ED patients undergoing RSI, the use of a gas analyzer to measure EtO₂ and FiO₂ can provide a reliable measure of the minimal PaO₂ at the time of induction during the RSI phase of preoxygenation.     

输血相关气动物流时间分析

目的统计分析使用气动物流在不同日期,不同时间段,不同病房楼之间运输物品的耗时情况,探讨适当的血液制剂运输方案。方法本院输血科在2018年6月4-15日两周内的周一-五8∶00-17∶00,使用德国欧泰气动物流传输系统在4栋病房楼的病区与输血科之间运输物品,共73次。每次运输记录发出和收到的时间,并在发出和收到后,立即电话联系输血科,确保时间准确无耽搁。以传输时间为基础,将收集到的数据根据不同日期,不同病房楼和每日不同时间段进行分组分析。结果总体时间占比最高为11-20 min,达到35.21%(25/71),其次为0-10 min,26.76%(19/71),其余皆超出20 min。以0-10 min为基础讨论,每周三占比最高,为31.58%(6/19);5#占比最高,为80%;14∶00-15∶00占比最高,为47.37%。结论气动物流系统运输时间不稳定,不符合相关规定,在本院不适用于血液制剂的运输。     

帝视内镜与Macintosh喉镜在小儿气管插管中应用效果的比较

目的 探讨帝视内镜在小儿扁桃体切除术中气管插管的应用效果,并与Macintosh喉镜作比较。方法 选择该院择期行扁桃体切除术的患儿60例,年龄6～9岁,美国麻醉医师协会（ASA）分级Ⅰ至Ⅱ级,Mallampati气道分级Ⅰ至Ⅱ级,扁桃体肿大Ⅰ至Ⅱ度,随机分为帝视内镜组（DE组）和Macintosh喉镜组（MA组）。全麻诱导后,分别使用帝视内镜和Macintosh喉镜行气管插管。记录两组的声门暴露时间、气管插管总时间、声门暴露分级、气管插管次数、插管并发症发生例数、各麻醉诱导时相的心率（HR）、平均动脉压（MAP）和患儿与麻醉医师口对鼻距离（MN间距）。结果 DE组声门暴露时间、气管插管总时间短于MA组（P = 0.000）;DE组声门暴露分级优于MA组（P < 0.01）;DE组均一次插管成功,MA组有3例需二次插管;DE组插管并发症发生率低于MA组（P < 0.05）;DE组MN间距明显大于MA组（P = 0.000）;两组患儿麻醉诱导前（T₀,记为基础值）、麻醉诱导后插管前即刻（T₁）和气管插管后3 min（T₄）的HR和MAP比较,差异均无统计学意义（P > 0.05）;DE组患儿气管插管后即刻（T₂）和气管插管后1 min（T₃）的HR和MAP均低于MA组（P < 0.01）。结论 相比Macintosh喉镜,在小儿扁桃体切除术气管插管时使用帝视内镜,能明显改善声门显露效果、缩短气管插管操作时间、减少插管并发症和减轻血流动力学波动,并增大MN间距。     

维迪欧视频喉镜在神经监护气管插管定位的应用研究

目的:评估维迪欧视频喉镜在甲状腺肿瘤手术全麻神经监护气管插管定位中的有效性和安全性。方法: 120例择期行甲状腺肿瘤手术且需要神经监测的患者随机分为三组:A组：维迪欧视频喉镜组,B组：GlideScope喉镜组和C组：Macintosh喉镜组。分别记录各组插管前后血流动力学变化、声门暴露时间、神经监护气管插管时间、一次插管成功数、一次导管定位成功数,插管并发症等。结果:行神经监护气管插管时, A组心率及平均动脉压较B组有显著升高（P＜0.05）,声门显露时间A组（9.5±3.2s）显著短于C 组(12.8±3.6s),与B组(9.1±3.5s)无差异,插管时间A组（49.5±17.8s）及C组（51.8±13.1s）均显著长于B组（38.8±10.9s）。A组和B组插管1次成功例数高于C组,且一次导管定位成功例数显著高于C组。结论:神经监护气管插管时,维迪欧视频喉镜优于Macintosh喉镜,但血流动力学变化比GlideScope喉镜明显,时间比GlideScope喉镜稍长,但一次插管成功率无差异。因此,维迪欧视频喉镜在甲状腺肿瘤患者神经监护气管插管中是安全有效的。     

Triplex PCR‐based detection of enterotoxigenic Bacillus cereus ATCC 14579 in nonfat dry milk

Although many strains of Bacillaceae are considered nonpathogenic, Bacillus cereus is recognized worldwide as a bacterial pathogen in a variety of foods. The ability of B. cereus to cause gastroenteritis following ingestion of contaminated food is due to the production of enterotoxins. The ubiquity of this genus makes it a persistent problem for quality assurance in food processing environments. The primary objective of this study was to develop and apply a multiplex real‐time PCR‐based assay for rapid and sensitive detection of enterotoxigenic B. cereus. Template DNA was separately extracted from tryptic soy broth (TSB)‐grown and 2.5% Nonfat Dry Milk (NFDM)‐grown B. cereus using a commercial system. Three enterotoxin gene fragments (hblC, nheA, and hblA) were simultaneously amplified in real‐time followed by melting curve analysis to confirm amplicon identity. Resolution of melting curves (characteristic T_m) was achieved for each amplicon (hblC = 74.5 °C; nheA = 78 °C; and hblA = 85.5 °C in TSB and 84 °C in NFDM) with an assay sensitivities of 10¹ CFU/ml for both TSB and NFDM‐grown B. cereus compared to 10⁴ CFU/ml in either matrix using gel electrophoresis. The results demonstrate the potential sensitivity of real‐time bacterial detection methods in a heterogenous food matrix using real‐time PCR. (© 2011 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Attention and memory in aged rats: Impact of lifelong environmental enrichment

Aged rodents exhibit memory and attention dysfunctions. Environmental enrichment (EE) attenuates memory impairments. Whether it may reduce attention deficits is not known. At the age of 1 month, Long-Evans female rats were placed in standard or EE conditions and tested after 3 (young), 12 (middle-aged) or 24 (aged) months of differential housing. Spatial reference memory was assessed in a water-maze task. Attention performance was evaluated in the five-choice serial reaction time (5-CSRT) task. EE improved spatial memory at all ages, but did not ameliorate 5-CSRT performance in young and middle-aged rats; it prevented, however, the degradation of attention performances detected in aged rats. The number of ChAT (+30 to +64%)- and p75^NTR-positive (+35 to +44%) neurons was higher in the basal forebrain of aged enriched vs. standard rats, suggesting their EE-mediated protection. The weaker deficit of attention found in aged EE rats might be linked to a better survival in the very long term of neurons in the basalo-cortical system.     

利用脉搏波传播时间计算动脉血压的研究

本研究的目的是研究动脉血压和脉搏波传播时间的关系,探讨通过脉搏波传播时间计算动脉血压的可靠性。采用麻省理工学院MIMIC数据库,通过心电和光电容积脉搏波计算得到脉搏波传播时间,通过有创动脉血压获得平均动脉压,使用线性回归方法分段求得脉搏波传播时间和平均动脉压之间的线性方程,应用该方程结合脉搏波传播时间计算动脉血压,并与实际血压比较评价算法的效果。结果表明,脉搏波传播时间和动脉血压存在负相关关系,在一定时间范围内,可通过脉搏波传播时间计算平均动脉压,均方根误差小于5 mmHg。对临床采集数据的分析同样说明,通过脉搏波传播时间计算动脉血压是可行的。     

弓形虫速殖子入侵对宿主细胞窖蛋白-1的表达变化

胞膜窖Caveolae,又称细胞膜穴样凹陷,是细胞表面特异性的内陷微区,Caveolin-1是其的标记蛋白.Caveolae结构和caveolin蛋白在多种细胞生理功能方面如细胞信号转导、胆固醇转运、内吞和肿瘤抑制等发挥着重要作用.在动脉硬化、肌营养不良和Alzheimer'S综合征等多种疾病中均发现存在caveola...