Intrapartum fetal surveillance: a physiological approach

Continuous utero-placental circulation, and patent umbilical blood vessels ensure an uninterrupted transfer of oxygen and nutrients to the fetus as well as clearance of metabolic waste products. The onset of labour characterized by progressive and strong uterine contractions poses a threat to fetal oxygenation as a result of collapsing the spiral arterioles traversing the myometrium to supply the placental bed, and repetitive compression of the blood vessels within the umbilical cord. Human fetuses are equipped with compensatory mechanisms to cope with transient interruptions of blood supply during labour. The ability to compensate may be blunted in cases of poor fetal reserves, increased metabolic demand (macrosomia or maternal fever), and due to non-hypoxic pathways (e.g. chorioamniontis or fetal hypovolumia-hypotension syndrome). Intrapartum fetal surveillance involves prompt recognition of the features that signal the onset of fetal decompensation on the cardiotocograph (CTG) to ensure a timely intervention to avoid hypoxic-ischaemic encephalopathy (HIE) or perinatal deaths. This article summarises a ‘physiological approach’ to the interpretation of the CTG which, in places, conflicts with other current UK guidance.     

Preservation of Denonvilliers' fascia for nerve‐sparing laparoscopic total mesorectal excision: A neuro‐histological study

Urogenital complications due to pelvic autonomic nerve damage frequently occur following rectal surgery. We investigated whether total mesorectal excision (TME) with preservation of the Denonvilliers' fascia (DVF) can effectively prevent the removal of pelvic autonomic nerves through microscopy. Twenty consecutive male patients with mid‐low rectal cancer who received TME with preservation or resection of the Denonvilliers' fascia (P and R groups, respectively) were included. Serial transverse sections from surgical specimens were studied histologically. Nerve fibers at the surfaces of the mesorectum were counted. Clinical correlation between the amount of nerve fibers removed and post‐operative sexual function was analyzed. Nerve fibers closely localized to the DVF in the R group displaying rich erectile activity (positive anti‐nNOS immunostaining). At the anterior surface of the mesorectum, the mean numbers of nNOS‐positive nerve fibers per specimen in the P group were significantly lower than the R group (3.0 ± 1.8 vs. 5.0 ± 2.3, P < 0.05). Compared to the R group, patients in the P group had higher IIEF scores and better erectile function at 3 and 6 months post‐operatively. The DVF is a key risk zone for pelvic denervation during laparoscopic TME. Preservation of the DVF can prevent the removal of autonomic nerves and protect post‐operative erectile function. Clin. Anat. 32:439–445, 2019. © 2019 Wiley Periodicals, Inc.     

两种柽柳对盐胁迫的生理生化响应

柽柳属(Tamarix chinensis L.)植物,为多年生泌盐盐生植物,是一类重要灌木植物,具有许多独特的生物、生态学特征。本研究以刚毛柽柳(T.hispida Wild)和长穗柽柳(T.elongata Ledeb)为研究对象,采用盆栽实验,开展耐盐性实验:中性盐NaCl设置0、50、100、150和200 mmoL/L 5个浓度水平,通过测定盐胁迫下两种柽柳的光合速率、蒸腾速率、游离脯氨酸含量、干重等生理指标,结果显示:刚毛柽柳和长穗柽柳均表现出较强的耐盐能力,但刚毛柽柳受NaCl胁迫的影响较小,表明刚毛柽柳耐盐性强于长穗柽柳,可作为柽柳属植物耐盐生理和分子机制研究的备选材料。     

情景式营养教育对婴儿喂养状况的影响

目的探讨情景式营养教育，对婴儿监护人的营养知识水平和婴儿喂养状况的影响，以探索婴儿食物转换指导新模式。 方法选择2014年4月至12月，于江苏省淮安市妇幼保健院儿童保健门诊进行健康体检的272例1～2个月龄婴儿为研究对象。采用随机数字表法，将其分别纳入干预组(n＝140)和对照组(n＝132)。干预组婴儿于3～4个月龄时，由儿童营养专科医师和营养师，在营养厨房内，对婴儿监护人以10～15人小组形式，进行情景式营养教育；对照组则由门诊体检医师进行常规营养指导。2组婴儿12个月龄时，对其监护人采用本研究自行设计的《淮安市妇幼保健院婴儿喂养状况调查表》进行调查。采用χ²检验，对2组婴儿喂养状况，如母乳喂养率、食物转换合理率等，进行统计学比较。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求，并与受试儿监护人签署临床研究知情同意书。 结果①2组婴儿4个月龄时纯母乳喂养率、混合喂养率及人工喂养率比较，差异均无统计学意义(P>0.05)。干预组婴儿6、12个月龄时，继续母乳喂养率分别为88.6%、37.1%，均显著高于对照组的78.0%、23.5%，并且差异均有统计学意义(χ²＝5.468、P＝0.022，χ²＝5.977、P＝0.018)。②干预组婴儿监护人对食物转换指导模式的满意度、食物转换合理率，以及3类补充食品(谷类、果蔬类、动物性食物)均合理添加率，添加动物性食物合理率及监护人专用料理机使用率分别为90.0%、87.1%、77.1%、82.9%、50.0%，均显著高于对照组的77.3%、60.6%、54.5%、65.2%、25.8%，并且差异均有统计学意义(χ²＝8.116、P＝0.005，χ²＝25.033、P<0.001，χ²＝15.500、P<0.001，χ²＝11.114、P＝0.001，χ²＝16.908、P<0.001)。 结论情景式营养教育的婴儿食物转换指导新模式，可提高婴儿监护人的营养知识水平，改善婴儿喂养状况。     

Prediction of human pharmacokinetics of typical compounds by a physiologically based method using chimeric mice with humanized liver

1. In this study, total body clearance (CL_t), volume of distribution at steady state (V_ss) and plasma concentration–time profiles in humans of model compounds were predicted using chimeric mice with humanized livers.

2. On the basis of assumption that unbound intrinsic clearance (CL_Uint) per liver weight in chimeric mice was equal to those in humans, CL_t were predicted by substituting human liver blood flow and liver weights in well-stirred model. V_ss were predicted by Rodgers equation using scaling factors of tissue-plasma concentration ratios (SF_Kp) in chimeric mice estimated from a difference between the observed and predicted V_ss. These physiological approaches showed high prediction accuracy for CL_t and V_ss values in humans.

3. We compared the predictability of CL_t and V_ss determined by the physiologically based predictive approach using chimeric mice with those from predictive methods reported by Pharmaceutical Research Manufacturers of America. The physiological approach using chimeric mice indicated the best prediction accuracy in each predictive method.

4. Simulation of human plasma concentration–time profiles were generally successful with physiologically based pharmacokinetic (PBPK) model incorporating CL_Uint and SF_Kp obtained from chimeric mice.

5. Combined application of chimeric mice and PBPK modeling is effective for prediction of human PK in various compounds.

     

A systematic review of physiological reactivity to stimuli in autism

Objective: The prevalence of abnormal behavioural responses to a variety of stimuli among individuals with autism has led researchers to examine whether physiological reactivity (PR) is typical in this population. This article reviewed studies assessing PR to sensory, social and emotional, and stressor stimuli in individuals with autism. Methods: Systematic searches of electronic databases identified 57 studies that met our inclusion criteria. Studies were analysed to determine: (a) participant characteristics; (b) physiological measures used; (c) PR to sensory, social and emotional or stressor stimuli; (d) the relation between PR and behavioural or psychological variables and (e) baseline physiological activity. A novel measure of methodological quality suitable for use with non-randomized, non-interventional, psychophysiological studies was also developed and applied. Results: Individuals with autism were found to respond differently than typically developing controls in 78.6%, 66.7% and 71.4% of sensory, social and emotional, and stressor stimulus classes, respectively. However, this extant literature is characterized by variable and inconsistent findings, which do not appear to be accounted for by varying methodological quality, making it difficult to determine what specific factors differentiate individuals with autism who present with atypical PR from those who do not. Conclusions: Despite this uncertainty, individual differences in PR are clearly present in autism, suggesting additional research is needed to determine the variables relating to PR among those with ASD and to examine the possible existence of physiological subtype responders in the population.     

基于电生理信号的生物医学工程专业课程体系建设

生理电信号作为生物医学工程中的重要信号,其中蕴含了丰富的人体信息。该研究以生理电信号为主线,通过对其信号的学习、获取、分析、处理将生物医学工程的专业课串联起来,使学生将专业知识和实际仪器设计分析结合起来,能较为全面的掌握信号与系统方面的知识,加强学生的实际分析和解决医学问题的能力。     

The role of glutamate receptors in attention‐deficit/hyperactivity disorder: From physiology to disease

Attention‐deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children and adolescents, which is characterized by behavioral problems such as attention deficit, hyperactivity, and impulsivity. As the receptors of the major excitatory neurotransmitter in the mammalian central nervous system (CNS), glutamate receptors (GluRs) are strongly linked to normal brain functioning and pathological processes. Extensive investigations have been made about the structure, function, and regulation of GluR family, describing evidences that support the disruption of these mechanisms in mental disorders, including ADHD. In this review, we briefly described the family and function of GluRs in the CNS, and discussed what is recently known about the role of GluRs in ADHD, that including GluR genes, animal models, and the treatment, which would help us further elucidate the etiology of ADHD.