胎盘前置剖宫产优质围术期护理对生产结局的影响

目的探究与分析胎盘前置剖宫产优质围术期护理措施的实施对胎儿生产结局的影响。方法选取本院自2016年5月—2019年5月收治的胎盘前置剖宫产患者68例,采取随机数字表法分为常规组与优化组,每组各34例,常规组给予基础的围术期护理措施,优化组在常规组的基础上建立并应用手术室信息平台优化护理人员技能,对比两组术中出血量、胎儿娩出时间、排气时间、住院时间、新生儿Apgar评分及护理满意度。结果优化组与常规组相比术中出血量少、胎儿娩出时间短、产妇排气时间短、住院时间短,组间差异具有统计学意义(P<0.05)。优化组与常规组相比新生儿1 min Apgar评分及5 min Apgar评分均较高,组间差异具有统计学意义(P<0.05)。优化组与常规组相比产妇对护理满意度较高,组间差异具有统计学意义(P<0.05)。结论在常规围术期护理的基础上建立并应用手术室信息平台优化护理人员技能应用于胎盘前置剖宫产中能够获得更好的围术期指标,缩短胎儿娩出的时间,新生儿Apgar评分较高,产妇对护理的满意度也较高。     

Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation

Background

Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery.

UHPLC-MS/MS测定人血浆中美托洛尔的含量

目的 建立测定人血浆中美托洛尔含量的UHPLC-MS/MS分析方法。方法 采用Agilent RRHD PLUS C₁₈色谱柱（2.1 mm×50 mm,1.8 μm）,0.2%甲酸水溶液-乙腈（68∶32）为流动相。质谱采用电喷雾离子源（ESI）,多反应监测（MRM）,检测离子为正离子,分别选择m/z 268/116、237/194作为美托洛尔和内标（卡马西平）的检测离子对。结果 血浆中美托洛尔在1.012~759.0 ng·mL^-1内线性关系良好（r=0.999 2）。高、中、低浓度美托洛尔的基质效应分别为105.9%,106.1%,106.9%;平均回收率分别为83.0%,99.3%,95.2%。批内精密度RSD≤3.22%,批间精密度RSD≤4.14%。结论 该方法简便、灵敏、快速、准确,适用于血浆中美托洛尔的含量测定。     

直缘乌头内生真菌Alternaria solani化学成分研究

摘 要 目的：对直缘乌头内生真菌Alternaria solani 的化学成分进行研究。方法: 采用各种柱色谱对直缘乌头内生真菌Alternaria solani的甲醇提取物进行分离纯化,经波谱数据 (¹ H-NMR,¹³ C-NMR,MS) 进行结构鉴定。结果:分离得到15个化合物,分别鉴定为：20 羟基麦角甾 4,6,8(14),22-四烯-3-酮（1）、(22E,24R)- 麦角甾-4,6,8(14),22-四烯-3-酮（2）、(22E,24R)-麦角甾-7,22-二烯-3-β-醇（3）、24-亚甲基-麦角甾-7-烯-3β-醇（4）、过氧麦角甾醇（5）、cyclo(D)-Pro-(D)-Leu（6）、cyclo-(L-Val-L-Pro)（7）、cyclo-(S-Pro-S-Ile)（8）、tentoxin（9）、porrotoxin（10）、7-dehydroxyl-zinniol（11）、zinniol（12）、8-zinniol methyl ether（13）、3-甲氧基-4-甲基-5-(3’,3′-二甲基烯丙氧基)-2-甲氧基甲基苯甲酸（14）、拟盘多毛孢H2-倍半萜内酯（15）。结论:从直缘乌头内生真菌Alternaria solani中分离得到15个化合物,其中化合物2~10,12~15是首次从该植物内生真菌中分离得到。     

Cationic liposome co-encapsulation of SMAC mimetic and zVAD using a novel lipid bilayer fusion loaded with MLKL-pDNA for tumour inhibition in vivo

The increase in multidrug resistance among colon cancer cells presents a challenge for the development of effective therapies. Small-molecule analogues of second mitochondria-derived activator of caspase (SMAC) mimetic in association with mixed lineage kinase domain-like protein (MLKL)-pDNA and z-VAD-fmk have shown ideal antitumor effects in colon cancer cells in vitro via induction of RIP3-dependent necroptosis. To achieve synergistic antitumor effects in vivo, liposomes loaded with SMAC mimetic, MLKL-pDNA and z-VAD-fmk have been developed using novel lipid fusion methods to co-localise the molecules of interest within the tumour cells. The co-encapsulation liposome (MLKL-zVAD-BV6-LP) had a high entrapment efficiency of approximately 95% for both zVAD and BV6 and was able to condense MLKL-pDNA very well. The vectors showed good biocompatibility, tumour targeting and small-molecule co-localisation. In a CT26 mouse model, the MLKL-zVAD-BV6-LP exhibited a tumour-suppression rate of over 60% in vivo, which was significantly higher than that of both the null-liposome and coadministration groups. Above all, the co-encapsulation system provided a novel approach to combination tumour therapy.     

Mutation spectrum of MMACHC in Chinese pediatric patients with cobalamin C disease: A case series and literature review

Cobalamin (cbl) C disease is a rare autosomal recessive inheritance disease, which is the most common cobalamin metabolic disorder. Its clinical phenotype involves multiple systems with varying degrees of severity, where in mild cases can be asymptomatic for many years, whereas severe cases may cause death during the neonatal period. The disease is caused by mutations in the MMACHC gene located on chromosome 1p34.1 that contains 5 exons; among which, exons 1–4 have an 849 bp coding sequence that encodes a protein containing 282 amino acids. Through clinical physical examination and laboratory tests, especially blood and urine screening, we found 28 cblC pediatric patients with clinical manifestations, such as mental retardation, motor development delay, epilepsy, metabolic acidosis, vomiting and diarrhea. By Sanger sequencing, we found homozygous or compound heterozygous mutations of MMACHC in 27 of the patients, and single heterozygous mutation of MMACHC in one of them. The c.609G > A, c.658-660delAAG, c.80A > G and c.482G > A mutations accounted for 43.64% (24/55), 10.91% (6/55), 9.09% (5/55) and 7.27% (4/55) of all the mutations, respectively. This spectrum finding is basically consistent with the previously reported data in Chinese patients. The most common c.609G > A mutation may likely lead to early-onset cblC disease. In previous literature involving a large sample of Caucasian cblC cases, the mutation spectrum of MMACHC gene is almost completely different from that of the Chinese population. The most common mutations in the Caucasian population were c.271dupA, c.394C > T and c.331C > T, which account for 48.05% (542/1128), 13.65% (154/1128) and 7.36% (83/1128) of all the mutant alleles, respectively. The c.271dupA mutation and c.331C > T mutation were mainly associated with early-onset cblC in children less than 1 year old, whilst the c.394C > T mutation was mainly associated with late-onset cblC patients characterised by isolated acute nervous system abnormalities. We also analysed the cause behind the different mutation spectrum of MMACHC gene between the Chinese and Caucasian populations.