社区动脉粥样硬化风险研究的进展和展望

社区动脉粥样硬化风险（ARIC）研究是1987年由美国心、肺和血液研究所资助的关注非洲裔美国人心血管健康的最大研究。旨在调查心脏病的危险因素以及心血管疾病与认知之间的联系。ARIC研究的许多发现加深了对动脉粥样硬化性心血管病病因的了解,在心血管病预防领域做出了重大贡献,证明了以人群为基础的研究对改善健康和预防疾病的重要性。主要概述ARIC研究的起源、目的、研究设计、对心血管医学的贡献以及未来的发展方向。     

持续性特发性耳鸣严重程度的相关因素分析

目的 探讨导致持续性特发性耳鸣严重程度的相关因素。 方法 分析870例持续性特发性主观性耳鸣患者的一般资料、病史、听力学结果、耳鸣匹配实验、耳鸣残疾量表、匹兹堡睡眠质量指数量表和焦虑自评量表,应用多因素Logistic回归分析研究与患者耳鸣严重程度相关的因素。 结果 (1)性别(P<0.001)、年龄(P=0.010)、耳鸣主调声频率(P=0.005)、听力损失(P=0.037)、焦虑程度(P<0.001)、睡眠状况(P<0.001)在THI分级上差异有统计学意义(P<0.05);(2)病程(P=0.053)、侧别(P=0.437)、主调声响度(P=0.120)在THI分级上差异均无统计学意义(P>0.05)。 结论 女性患者特发性耳鸣的程度较男性更为严重;低频较高频更扰人;焦虑程度和睡眠状况是影响耳鸣严重程度的因素,而病程、侧别、耳鸣主调声响度不是影响患者特发性耳鸣严重程度的因素。     

前列腺特异性膜抗原PET/CT特异性分子显像在非前列腺癌诊断中的应用

前列腺特异性膜抗原（PSMA）是由前列腺上皮细胞分泌的一种Ⅱ型谷氨酸缩肽酶，特异性高表达于前列腺癌及其转移灶的细胞中，在多数实体瘤部位毛细血管内皮细胞中有较高程度的表达。目前，已有超过二十种PSMA靶向的分子探针用于前列腺癌的诊断与治疗。本文综述了PSMA在除前列腺癌以外的多种实体瘤中的表达情况及PSMA-PET/CT特异性探针在非前列腺癌诊断中的临床应用实例，以期拓展以PSMA为靶点的新型PET探针在肿瘤分子诊断中的临床应用。     

《医用有机化学》课程中进行德育渗透

教学与德育有机融会贯通,是当前教育领域的共识。医学本科生秉承"以德载医"的精神,肩负"治病救人"的重任,因此德育教育在整个医学教学中占有重要的地位。《医用有机化学》教材中含有丰富的德育内容,高校教师传授专业知识的同时,在教学过程中巧妙的穿插辩证唯物主义、爱国主义和社会责任感的思政教育,可以帮助学生们树立正确的世界观和人生观。文章以医用有机化学课程为例,主要从教师的自身道德素养、德育在教学过程中的具体实践和德育实施过程中需要注意的问题三方面进行阐述,充分将新时代新理念融入大纲、教案和课堂中,化"知识"为"智慧",变"文化"为"品格",充分发挥医用有机化学课程的德育功能。     

硫酸镁对全麻下止血带相关高血压和术后疼痛的影响

目的探讨硫酸镁对全麻下止血带相关高血压和术后疼痛的影响。方法选择全麻下行单侧下肢手术且需要使用止血带的患者60例,男25例,女35例,年龄30～65岁,ASAⅠ或Ⅱ级,随机分为硫酸镁组(M组)和对照组(C组),每组30例。M组于诱导后5 min使用止血带前静脉泵注硫酸镁30 mg/kg,泵注时间为10 min,随后以15 mg·kg~(-1)·h~(-1)速度维持至松开止血带,C组同样方法泵注等容量生理盐水。记录入室后(T_0)、诱导后5 min(T_1)、止血带充气30 min(T_2)、充气1 h(T_3)、放气前(T_4)、放气后5 min(T_5)时HR、SBP、DBP、每搏量(SV)、心输出量(CO)、心脏指数(CI)。记录术中止血带相关高血压发生情况和降压药使用情况。记录术后3、6、24和48 h静息时VAS评分和Ramsay镇静评分。记录术后补救镇痛情况和寒战、恶心、呕吐、心动过缓、低血压、腱反射消失、呼吸抑制等不良反应发生情况。结果 T_2—T_5时M组HR明显慢于C组(P0.05);T_2—T_4时M组SBP和DBP明显低于C组(P0.05);T_2—T_5时M组SV明显高于C组(P0.05);M组术中止血带相关高血压发生率和降压药物使用率明显低于C组(P0.05)。术后3、6和24 h M组静息时VAS评分明显低于C组(P0.05)。结论全麻下静脉应用硫酸镁可以降低止血带相关高血压发生率和缓解术后疼痛。     

Relationship between Neurological Deterioration and Blood Pressure/Heart Rate Variability in Patients with Acute Cerebral Infarction

ObjectivesNeurological deterioration (ND) during hospitalization is an independent predictor of poor prognosis after stroke. Risk factors affecting early ND within 48 h post stroke have been intensively investigated, while few data are available on those for late ND after transfer to a wheelchair. Therefore, it was investigated whether hemodynamic factors may affect the late ND during hospitalization.Materials and methodsA retrospective study was conducted on 135 patients with atherothrombotic or cardiogenic cerebral infarction who were admitted to our hospital between April 1st, 2014 and July 31st, 2017. During hospitalization, average, maximum, and minimum values were determined for systolic blood pressure (sBP), diastolic BP (dBP), and heart rate (HR), respectively.135 patients were classified into two groups; ND (+) group, in which modified Barthel index score at the time of transfer to a wheelchair showed five points or more decrease between wheelchair transfer and discharge, and ND (?) group, which did not. Vital indices were compared between the two groups and subjected to ROC-curve analysis.ResultsThe ND (+) group included 32 patients, and the ND (?) 103. Significant differences were found between the groups in four items; sBPmin (p = 0.029), dBPmin (p = 0.019), HRave (p = 0.028), and HRmax (p < 0.01). The ND (+) group showed lower sBPmin and dBPmin, and higher HRave and HRmax than the ND (?) group.ConclusionsLate ND after transfer to a wheelchair is related to the vital indices during hospitalization and should be cautiously managed to prevent late ND     

Fast and effective removal of contamination from scalp electrical recordings

ObjectiveTo present a new, automated and fast artefact-removal approach which significantly reduces the effect of contamination in scalp electrical recordings.MethodWe used spectral and temporal characteristics of different sources recorded during a typical scalp electrical recording in order to improve a fast and effective artefact removal approach. Our experiments show that correlation coefficient and spectral gradient of brain components differ from artefactual components. We trained two binary support vector machine classifiers such that one separates brain components from muscle components, and the other separates brain components from mains power and environmental components. We compared the performance of the proposed approach with seven currently used alternatives on three datasets, measuring mains power artefact reduction, muscle artefact reduction and retention of brain neurophysiological responses.ResultsThe proposed approach significantly reduces the main power and muscle contamination from scalp electrical recording without affecting brain neurophysiological responses. None of the competitors outperformed the new approach.ConclusionsThe proposed approach is the best choice for artefact reduction of scalp electrical recordings. Further improvements are possible with improved component analysis algorithms.SignificanceThis paper provides a definitive answer to an important question: Which artefact removal algorithm should be used on scalp electrical recordings?     

Alpha-lipoic acid protects mice against concanavalin A-induced hepatitis by modulating cytokine secretion and reducing reactive oxygen species generation

BackgroundAlpha-lipoic acid (α-LA), which exits in almost all types of prokaryotic and eukaryotic cells, is a key regulator of energy metabolism in mitochondria. This study was designed to explore the protective effect of α-LA against concanavalin A (Con A)-induced hepatitis in mice and explore the potential mechanism.MethodsAcute autoimmune hepatitis was induced by intravenous (IV) injection of Con A (15 mg/kg) in C57BL/6 mice. α-LA (100 mg/kg) was administered four days before Con A injection. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and histopathological change of the liver tissue were measured. Serum cytokine TNF-α, IL-6, IFN-γ and IL-10 were detected by ELISA. The mRNA levels of these inflammatory cytokines in the liver were detected by RT-PCR. Malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and reduced/oxidized glutathione (GSH/GSSG) in liver were determined using commercial kits. Phosphorylated NF-κB p65, IκBα and phosphorylated MAPK were measured by Western blot.ResultsCon A injection induced severe immune responses and extensive hepatocellular apoptosis within 12 h. Pretreatment of α-LA markedly reduced the serum ALT and AST activity and the increase of plasma TNF-α, IL-6, IFN-γ and IL-10. In addition, α-LA pretreatment decreased the tissue MPO activity and lipid peroxidation, but increased SOD and GSH levels. α-LA inhibited the phosphorylation of NF-κB p65, IκBα and JNK.ConclusionPretreatment of α-LA markedly attenuated Con A-induced hepatitis by modulating cytokine secretion and reducing reactive oxygen species generation.     

Photodecomposition,photomutagenicity and photocytotoxicity of retinyl palmitate under He–Ne laser photoirradiation and its effects on photodynamic therapy of cancer cells in vitro

ObjectiveOur aim was to study photodecomposition, photomutagenicity and cytotoxicity of retinyl palmitate (RP), a principal storage form of vitamin A in humans and animals, under He–Ne laser photoirradiation. Moreover, the effect of different concentrations and timing protocol of antioxidants on photodynamic therapy (PDT) is contradictory, so the effect of RP (as antioxidant) on the PDT cytotoxicity was studied.MethodsPhotomutagenicity was tested by Ames test. Photodecomposition was studied by UV–vis spectroscopy. Cytotoxicity was measured with MTT-assay. Moreover, the effect of PDT, using hematoporphyrin derivatives (HpD) as photosensitizer under He–Ne laser irradiation (10 J/cm²), was studied on HeLa cells either with or without RP (1–100 μM) which incubated with the cells for short or long incubation period (1 h or 24 h) prior to PDT.ResultsNo photodecomposition of RP alone was obseved whereas there is a little photodecomposition of RP only in presence of HpD under irradiation with He–Ne laser. Moreover, no photomutagenicity was observed in Salmonella typhimurium strains under laser irradiation in presence or absence of HpD. RP alone (1–100 μM) significantly decrease the viability of HeLa cells. Laser irradiation of HeLa cells pre-incubated with RP alone for 24 h showed further significant decrease in viability of the cells. While RP incubations for 1 h before PDT had slight effect on the cells, 24 h incubation before PDT enhanced the cytotoxicity of PDT on HeLa cells.ConclusionsRP can be used 24 h before PDT to enhance its effects. RP is not mutagenic under irradiation with He–Ne laser.