Anaerobes in cardiac infections: A decade experience from the tertiary care center

PurposeAnaerobic infections are common yet life-threatening. They are being recovered from all sites of the body, including the cardiovascular system. This study was aimed to determine the retrospective analysis on the isolation of anaerobes in cardiovascular samples received for a decade-long duration. It helps in knowing the frequency of isolation of anaerobic causes of cardiovascular infection.MethodsAll cardiovascular samples from the department of Cardio-thoracic vascular surgery from January 2010 to December 2020 were studied.ResultsOf 601 samples received, predominant samples were vegetations and valvular tissues of 258, followed by 98 samples of pericardial tissues, 92 samples of embolus, 90 samples of blood and post-operative collections, and 63 excised aneurysms and vascular grafts. Of the total, 15 samples grew anaerobes where Clostridium species were the predominant isolates. Clostridioides difficile was isolated in 2 samples.ConclusionsAnaerobes in cardiovascular samples are uncommon yet form a significant cause of morbidity and mortality. Most infections are from the contiguous spread, penetrating trauma, and hematogenous causing endocarditis or valvular infections. These conditions and samples form the seat of infectious focus and clinical suspicion towards the anaerobic cause of these conditions, especially in conventional routine culture-negative samples. Timely diagnosis of anaerobic infections plays a vital role in the good prognostic outcome of patients undergoing cardiothoracic and vascular surgery.     

蒙药绿松石的质量标准研究＊

目的 建立蒙药绿松石的质量标准。方法 收集不同产地绿松石，共10批。观察绿松石样品和粉末的性状并进行理化鉴别；按2020年版《中国药典》（四部）通则方法测定绿松石样品中水分、浸出物含量；采用原子吸收光谱法测定绿松石样品铜元素含量。结果 绿松石为不规则、周围带有黑石的块状物，表面蓝绿色，体重，质硬脆，难砸碎，断面呈贝壳状，蜡样光泽，粉末呈灰绿色，无臭，味淡；理化鉴别结果显示，呈铜盐反应；10批次样品中水分含量为0.41%-3.94%（SD=1.37%），浸出物含量为0.21%-0.81%（SD=0.21%），铜元素含量为3.03%-4.63%（SD=0.63%）。结论 初步拟定绿松石中水分含量不得超多5.0%、浸出物含量不得低于0.10%，铜元素含量应为2.60%-4.84%，制定的标准可用于蒙药材绿松石的质量控制。     

家庭群居爆发型新型冠状病毒肺炎的临床与胸部HRCT表现

目的 探讨家庭群居爆发型新型冠状病毒肺炎（简称"新冠肺炎"）（novel coronavirus pneumonia，NCP）的临床与胸部HRCT表现特点。方法 收集2020年2月3所医院经核酸检测阳性确诊的新冠肺炎患者10例（4个家庭），其中男性6例（中位年龄60.5岁），女性4例（中位年龄59岁）。所有患者均接受胸部CT扫描并行薄层HRCT重建，由两名10年以上工作经验放射科医生共同阅片分析新冠肺炎HRCT病变发生部位、形态、分布、密度等特点，以及治疗前后HRCT征象变化。并收集临床和实验室指标进行分析和总结。结果 本组4个家庭中首例确诊病例均有武汉确诊病例或武汉疫区接触史，4例为输入型病例（占40%），平均潜伏期5 d。实验室检查中5例（50%）外周血白细胞总数降低，4例（40%）淋巴细胞明显降低；8例（80%）C-反应蛋白增高，10例（100%）乳酸脱氢酶增高。10例（100%）患者胸部CT均有阳性表现，其中7例（70%）表现为双肺散在分布磨玻璃密度影（ground glass opacity，GGO），病变界限大多清楚。8例（80%）累及多个肺叶，2例（20%）为单肺叶病变。绝大多数病灶位于胸膜下和肺外周处，以双肺下叶为著。5例患者（50%）病变内可见细支气管充气征，9例患者（90%）病变内可见增粗细小血管影。7例患者（70%）治疗后复查胸部CT，3例（30%）原肺内胸膜下病变出现不同程度实变及纤维化，2例（20%）实变影转变为GGO，1例（10%）原肺内GGO消失，又出现新发GGO，1例（10%）病变范围有增大。结论 新冠肺炎具有家庭群居爆发的特点，均可有输入性病例，潜伏期较短，其胸部HRCT表现具有一定特征性，且有助于治疗后患者病变动态观察；结合流行病学和实验室检查有助于对NCP做出临床诊断和提供疫情防控的可靠依据。     

蒙药朱日亨滴丸源头把控——基于Q-Exactive高分辨质谱结合指纹图谱技术的蒙药广枣药材质量评价研究

目的 运用Q-Exactive高分辨质谱结合指纹图谱评价不同批次广枣药材质量,为朱日亨滴丸源头把控提供参考。方法 采用Agilent ZORBAX ECLIPSE XDB-C18色谱柱,以0.1%甲酸水-甲醇梯度洗脱30min,柱温为30℃,流速为1.0ml.min^-1。采用电喷雾(ESI)质谱离子源,在正离子与负离子模式下采集数据,检测范围为m/z 100-1500。依据精确质量数以及二级碎片离子,结合标准物质及相关数据库信息,对蒙药广枣药材主要化学成分进行定性研究。同时测定10批广枣药材,应用“中药色谱指纹图谱相似度评价系统(2004A)”建立广枣指纹图谱,并对各共有峰进行化学成分归属,对鞣花酸进行定量,评价各批次药材的质量。结果 鉴定出广枣中的37种化合物,并以鞣花酸为参照物,建立广枣药材指纹图谱,10批次广枣药材相似均在0.90以上。不同批次广枣药材鞣花酸含量差异明显。结论 建立基于Q-Exactive高分辨质谱结合指纹图谱技术的蒙药广枣药材质量评价研究方法为广枣药材质量控制提供参考,也为主日亨滴丸源头保证提供科学依据。     

2016年辽宁省肿瘤登记地区恶性肿瘤流行情况分析

目的 分析2016年辽宁省肿瘤登记地区恶性肿瘤流行状况。方法 收集2016年辽宁省肿瘤登记地区(35个县区)上报的恶性肿瘤发病与死亡资料,计算发病与死亡粗率、标化率、累积率(0~74岁)和年龄别率等,标化率使用Segi's世界标准人口年龄构成和2000年中国人口年龄构成为标准进行计算。结果 2016年辽宁省肿瘤登记地区恶性肿瘤发病率为383.54/10万,世标率为200.06/10万,中标率为204.44/10万,城市地区发病中标率(201.40/10万)高于农村地区(186.43/10万);40-岁及以上各年龄组发病率快速升高,在80-岁组达到峰值;35-岁以上各年龄组城市男性和女性恶性肿瘤发病率分别高于农村男性和女性;肺癌、结直肠癌、乳腺癌是辽宁省发病最高的恶性肿瘤。2016年恶性肿瘤死亡率为249.79/10万,世标率为123.00/10万,中标率为124.32/10万,城市地区死亡中标率(121.93/10万)低于农村地区(131.03/10万)。恶性肿瘤年龄别死亡率峰值在80-岁组。20~79岁男性各年龄组死亡率均为农村高于城市,55~79岁女性各年龄组死亡率均为农村高于城市。肺癌、肝癌、结直肠癌是辽宁省死亡率最高的肿瘤。结论 辽宁省恶性肿瘤发病和死亡均高于全国水平,总发病率和死亡率均为男性高于女性,城市发病率高于农村,农村死亡率高于城市,城乡居民恶性肿瘤负担差异明显。     

微课介入医学生物化学传统课堂教育教学模式的探索

目的探索微课介入传统医学生物化学课堂教学对教学效果的影响。方法选取护理本科2个大班学生作为研究对象,其中一个大班作为传统教学对照班,另一个班作为微课介入传统课堂教学试验班,试验结束后,通过随堂检测、问卷调查、期末考试及线上检测,获得测评结果。结果微课结合传统课堂教学能够增加学生学习生物化学的兴趣,加强了学生对生物化学难重点知识的掌握能力,学生们可不受时间和空间限制观看视频,对这种教学很满意,最终在期末考试中发挥出色,成绩提高,优秀率提高。     

Stafne’s bone defect with bicortical perforation: a need for modified classification system

Oral Radiology - Stafne’s bone defect (SBD) or salivary gland-related bone defects are asymptomatic bone cavities in the mandible caused by impingement by the salivary glandular tissue. The...     

Pharmacological treatment options for severe hypertriglyceridemia and familial chylomicronemia syndrome

Introduction: A spectrum of disorders, ranging from rare severe cases of homozygous null lipoprotein lipase deficiency (LPLD)–familial chylomicronemia syndrome (FCS) to heterozygous missense LPLD or polygenic causes, result in hypertriglyceridemia and pancreatitis. The effects of mutations are exacerbated by environmental factors such as diet, pregnancy, and insulin resistance.

Areas covered: In this review, authors discuss chronic treatment of FCS by ultra-low fat diets allied with the use of fibrates, omega-3 fatty acids, niacin, statins, and insulin-sensitizing therapies depending on the extent of residual lipoprotein lipase (LPL) activity; novel therapies in development target triglyceride (TG)-rich lipoprotein particle clearance. Previously, a gene therapy approach to LPL-alipogene tiparvovec showed that direct targeting of LPL function reduced pancreatitis events. An antisense oligonucleotide to apolipoprotein-C3, volanesorsen has been shown to decrease TGs by 70–80% and possibly to reduce rates of pancreatitis admissions. Studies are underway to validate its long-term efficacy and safety. Other approaches investigating the role of LPL modulating proteins such as angiopoietin-like petide-3 (ANGPTL3) are under consideration.

Expert opinion: Current therapeutic options are not sufficient for management of many cases of FCS. The availability of antisense anti-apoC3 therapies and, in the future, ANGPTL3 therapies may remedy this.     

Successes and failures of uterine leiomyoma drug discovery

Introduction: To-date, the only cure for symptomatic uterine fibroids (UFs) is surgical intervention. However, surgery may eliminate the hope of future pregnancies; moreover, the intrinsic risks of surgery make it a less favorable to women with UFs. Because of this, conservative medical therapies have become an attractive and prior option for those women. Leuprolide acetate (LA), a gonadotropin-releasing hormone (GnRH) agonist, is the only pharmacological agent currently approved for the short-term and pre-operative management of symptomatic UFs in the USA.

Areas covered: This systematic review covers the successes and failures of prominent drugs that have been researched for UFs in the past and agents that have shown promise in recent clinical trials. The most recent clinical trials and advances in drug therapy are presented in a comprehensive overview outlining the direction UF drug discovery is heading.

Expert opinion: Experts in the field are already on the forefront leading the responsibility to uncover potential drugs as long term fertility friendly viable options for non-invasive treatment/prevention of UFs. Indeed, a shift in the UF management is expected in the future.