Is dose modification or discontinuation of nilotinib necessary in nilotinib-induced hyperbilirubinemia?

Nilotinib is a specific breakpoint cluster region-Abelson leukemia virus-tyrosine kinase inhibitor that is used as an effective first- or second-line treatment in imatinib-resistant chronic myelogenous leukemia (CML) patients. Hepatotoxicity due to nilotinib is a commonly reported side effect; however, abnormal liver function test (LFT) results have been reported in asymptomatic cases. When alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels are more than five-fold the upper limit of the normal (ULN) or when the serum total bilirubin level is more than three-fold the ULN, dose modification or discontinuation of nilotinib is recommended, resulting in decreased levels of hematological indicators in certain patients with CML. Nilotinib-induced hyperbilirubinemia typically manifests as indirect bilirubinemia without elevated ALT or AST levels. Such abnormal liver functioning is thus not attributed to the presence of a true histologic lesion of the liver. The underlying mechanism may be related to the inhibition of uridine diphosphate glucuronosyltransferase activity. Therefore, nilotinib dose adjustment is not recommended for this type of hyperbilirubinemia, and in the absence of elevated liver enzyme levels or presence of abnormal LFT findings, physicians should consider maintaining nilotinib dose intensity without modifications.     

116例急性卒中患者院前流行病学特征

目的探讨镇江市急救中心救治的116例急性卒中患者的临床特征。 方法回顾性分析2019年1月1日至3月31日镇江市急救中心收治的116例脑卒中患者的病历资料，其中男性73例，女性43例；年龄23～96岁，平均(55.1±14.0)岁。分析内容包括患者基本特征、格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、送达医院时的生命体征等。 结果青年脑卒中(年龄<45岁)占全部患者的22.4%，65岁以下患者占78.4%。卒中患者以男性居多(62.9%)，城市居多(72.4%)。从卒中症状开始到到达医院的时间平均为27 h(范围为0.5～72 h)。40例患者(34.5%)在症状出现后4.5 h内(窗口期)到达有溶栓能力的医院。患者总体NIHSS为(15.71±7.52)分，出血性卒中患者[(17.54±7.54)分]高于缺血性卒中患者[(14±7.15)分](P<0.05)。所有脑卒中患者入院平均GCS评分为(12.12±3.35)分，缺血性卒中为(13.07±2.56)分，出血性卒中为[(11.11±3.80)分](P<0.05)。 结论镇江市急救中心院前救治的卒中患者以65岁以下患者为主，男性居多，尽管患者意识水平尚可，但普遍病情较重，而且仅约1/3患者能短时间到达医院。因此，社会、媒体和医疗机构应积极的宣传，使人们提高对危险因素和卒中的认识。急救中心也应进一步提升相应的救治能力。     

茶毛虫生态特性及人群皮炎暴发的观察

目的观察茶毛虫的生态特性,以及影响人群茶毛虫皮炎暴发的因素,为制定控制措施提供科学依据. 方法实验观察、实地调查茶场茶毛虫孵化、幼虫龄期、化蛹、羽化全世代特性,调查3起不同季节茶毛虫皮炎暴发的原因、影响因素及分布特点. 结果镇江地区茶毛虫1年发生3代.全世代发育速率受气象因素影响.3起茶毛虫皮炎暴发与茶场管理不善、没有适时灭虫,暖冬、第1代虫口基数较大有关.皮炎暴发的季节差异主要受气温影响.皮炎发生与职业、暴露机会、集居和工作环境有关,发病人数与虫口密度有关. 结论茶毛虫各期及全世代发育速率受气象因素影响.幼虫3龄期后虫口累积到一定数量,即造成人群皮炎暴发.     

一种无线闭环迷走神经刺激器及系统

为了治疗药物难治性癫痫,提出一种无线闭环迷走神经刺激器及系统,包括头戴式头皮脑电记录器、迷走神经刺激器、电磁耦合能量发射器和控制应用App,设计一种可以分离局部场电位和动作电位的生物信号前置放大器,一种刺激脉冲参数可调的迷走神经刺激器,一种电磁耦合能量发射器以及一个控制应用App。使用海岸线参数检测算法判定癫痫脑电信号的产生。测试结果表明,生物信号前置放大器对局部场电位和动作电位的放大增益分别为40和60 dB。迷走神经刺激器接收到来自控制应用App的刺激参数后,可以产生对应参数的双极性刺激脉冲。当发射器发射功率为30 dBm,发射线圈和接收线圈距离2 cm时,电磁耦合能量传输效率最大为15.4%。海岸线参数算法的正检率为88%。     

Ultrafine MoO2 nanoparticles encapsulated in a hierarchically porous carbon nanofiber film as a high-performance binder-free anode in lithium ion batteries

Flexible free-standing hierarchically porous carbon nanofibers embedded with ultrafine (∼3.5 nm) MoO₂ nanoparticles (denoted as MoO₂@HPCNFs) have been synthesized by electrospinning and subsequent heat treatment. When evaluated as a binder-free anode in Li-ion batteries, the as-obtained MoO₂@HPCNFs film exhibits excellent capacity retention with high reversible capacity (≥1055 mA h g⁻¹ at 100 mA g⁻¹) and good rate capability (425 mA h g⁻¹ at 2000 mA g⁻¹), which is much superior to most of the previously reported MoO₂-based materials. The synergistic effect of uniformly dispersed ultrasmall MoO₂ nanoparticles and a three-dimensionally hierarchical porous conductive network constructed by HPCNFs effectively improve the utilization rate of active materials, enhance the transport of both electrons and Li⁺ ions, facilitate the electrolyte penetration, and promote the Li⁺ storage kinetics and stability, thus leading to a greatly enhanced electrochemical performance.

A novel binder-free LIB anode made of ultrafine MoO₂ nanoparticles encapsulated in hierarchically porous carbon nanofibers exhibits high Li-storage performance.     

江苏省镇江市肺结核患者电子药盒管理模式评估

目的 分析电子药盒在镇江市肺结核患者管理的应用情况,为全市推广使用提供借鉴。方法 以2017年10月1日—12月30日确诊并符合条件患者为研究对象,分析不同特征患者强化期末和疗程结束时服药依从性变化、停止使用电子药盒原因;对医务人员使用电子药盒的满意度和接受度进行问卷调查。结果 使用电子药盒管理的患者中,初治患者2月末及疗程结束时规则服药率均显著高于复治患者(P <0.05);每日服药时间相同或接近患者治疗2月末规则服药率显著高于每日服药时间不同患者(P <0.05);强化期规则服药的患者全疗程规则服药率显著高于强化期规则服药较差患者(P <0.05);≥60岁患者全疗程停止使用电子药盒比例显著高于其他年龄段(P =0.04);93.8%的医务人员认为电子药盒对提醒患者服药/复诊有帮助。结论 电子药盒具有一定推广价值,但在使用中需关注患者每日服药时间及强化期规则服药情况,同时加强对复治患者及低年龄组随访管理。     

Brief report on a systematic review of youth violence prevention through media campaigns: Does the limited yield of strong evidence imply methodological challenges or absence of effect?

BackgroundWe present a brief report on a systematic review which identified, assessed and synthesized the existing evidence of the effectiveness of media campaigns in reducing youth violence.MethodsSearch strategies made use of terms for youth, violence and a range of terms relating to the intervention. An array of academic databases and websites were searched.ResultsAlthough media campaigns to reduce violence are widespread, only six studies met the inclusion criteria. There is little strong evidence to support a direct link between media campaigns and a reduction in youth violence. Several studies measure proxies for violence such as empathy or opinions related to violence, but the link between these measures and violence perpetration is unclear. Nonetheless, some evidence suggests that a targeted and context-specific campaign, especially when combined with other measures, can reduce violence. However, such campaigns are less cost-effective to replicate over large populations than generalised campaigns.ConclusionsIt is unclear whether the paucity of evidence represents a null effect or methodological challenges with evaluating media campaigns. Future studies need to be carefully planned to accommodate for methodological difficulties as well as to identify the specific elements of campaigns that work, especially in lower and middle income countries.     

基于HHT变换的SEMG信号中MUAP的数目估计

对表面肌电（SEMG）信号中单位动作电位（MUAP）的数目进行估计可为神经肌肉控制的理论研究和神经肌肉疾病的诊断开辟新途径,本文给出了一种基于Hilbert-Huang变换（HHT）的表面肌电信号中运动MUAP数目估计方法.通过对SEMG信号经验模态分解后的第一内禀模态函数分量进行瞬时频率分析,利用其瞬时频率极值点的计数即可估计出运动MUAP数目.仿真信号与真实信号的实验结果均表明,基于HHT的SEMG信号中MUAP的估计方法是有效的.     

定量测定硫酸软骨素的双抗体夹心ELISA的建立

目的建立定量测定硫酸软骨素(CS)的双抗体夹心酶联免疫吸附试验(ELISA),并对其应用价值进行初步评价。方法以CS为抗原分别免疫Balb/c小鼠和日本大耳白兔,制备2种动物的多克隆抗体。用鼠抗体包被微孔板,兔抗体为第2抗体,辣根过氧化物酶(HRP)标记的羊抗兔抗体为标记抗体,建立双抗体夹心ELISA,并对线性范围、精密度、回收率和方法学比较进行了评价。结果本研究建立的ELISA线性范围为2～500 mg/L,批内和批间精密度分别为4.48%和5.97%,回收率在99.52%～101.77%之间,与间苯三酚分光光度法测定结果具有良好的相关性(r=0.999 0,P<0.05)。结论建立的定量测定CS的双抗体夹心ELISA具有敏感性高、重现性好等优点,适合检测应用。