外周血细胞计数及其比值预测百日咳患者疾病严重程度的分析

目的 ：评估外周血细胞计数[白细胞（white blood cell,WBC）、淋巴细胞绝对值、血小板（platelet,PLT）]及其相关比率,即中性粒细胞/淋巴细胞比率（neutrophil to lymphocyte ratio,NLR）、淋巴细胞与单核细胞比（lymphocyte to monocyte ratio,LMR）、血小板与淋巴细胞比率（platelet to lymphocyte ratio,PLR）、血小板计数与平均血小板体积（platelet count to mean platelet volume ratio,PLT/MPV）在预测百日咳患者合并呼吸道感染严重程度的价值。方法 ：回顾性分析1 129例百日咳患者资料,分组对比外周血WBC、PLT、NLR、PLR、LMR、PLT/MPV差异。结果：共1 129例患者纳入研究。重症肺炎组分别与3个非重症肺炎组（上呼吸道感染组、支气管炎组、肺炎组）WBC计数水平有统计学差异（P=0.000、0.041、0.000）,重症肺炎组WBC计数水平明显高于非重症肺炎的3组患者,WBC计数越高,越容易发生重症肺炎,提示外周血...     

数据驱动的三叉神经纤维束自动分割算法

目前三叉神经的纤维跟踪成像过程中普遍存在人工依赖性问题,主要包括人工绘制感兴趣区域(ROI)及手动筛选目标纤维束,导致结果的不确定性和数据误差。针对此类问题,提出一种数据驱动的三叉神经纤维自动分割算法。利用多组大脑样本的纤维数据,建立数据驱动的纤维聚类图谱,实现新样本纤维数据的自动分割,直接得到三叉神经纤维束。在实验中,选择25组青年健康人的数据作为样本数据。首先,利用FSL软件分割工具提取脑干作为ROI,进行确定性纤维跟踪。其次,通过对20组纤维数据进行多样本配准和谱聚类,创建数据驱动的纤维聚类图谱。根据三叉神经细小的特点,在建立纤维图谱过程中,通过对脑干纤维束进行二次分类来标注三叉神经纤维束。最后,选择5组青年健康人的新样本数据,将其脑干纤维数据应用纤维图谱自动分割得到三叉神经纤维束,并计算同一样本数据的自动分割结果与手动分割结果之间的加权Dice系数。结果显示,所提出的方法成功分割5组数据的三叉神经纤维束,而传统人工方法成功识别4组三叉神经纤维束,两者结果之间的加权Dice系数分别为0.865,0.939,0.824,0.942。该方法可以有效避免人为因素的影响,提高神经外科医生...     

Aerobic Exercise Prevents Chronic Inflammation and Insulin Resistance in Skeletal Muscle of High-Fat Diet Mice

Obesity is commonly accompanied by chronic tissue inflammation and leads to insulin resistance. Aerobic exercise is an essential treatment for insulin resistance and has anti-inflammatory effects. However, the molecular mechanisms of exercise on obesity-associated inflammation and insulin resistance remain largely unknown. Here, we evaluated the effects of aerobic exercise on inflammation and insulin resistance in skeletal muscles of high-fat diet (HFD) mice. Male C57BL/6J mice were fed a high-fat diet or a normal diet for 12 weeks, and then aerobic training was performed on a treadmill for 8 weeks. Body weight, fasting blood glucose, food intake levels, and glucose and insulin tolerance were evaluated. The levels of cytokines, skeletal muscle insulin resistance, and inflammation were also analyzed. Eight weeks of aerobic exercise attenuated HFD-induced weight gain and glucose intolerance, and improved insulin sensitivity. This was accompanied by enhanced insulin signaling. Exercise directly resulted in a significant reduction of lipid content, inflammation, and macrophage infiltration in skeletal muscles. Moreover, exercise alleviated HFD-mediated inflammation by suppressing the activation of the NF-κB pathway within skeletal muscles. These results revealed that aerobic exercise could lead to an anti-inflammatory phenotype with protection from skeletal muscle insulin resistance in HFD-induced mice.     

FilmArray脑炎/脑膜炎多重病原体核酸联检试剂盒在中枢神经系统感染病原学诊断中的价值

目的:探讨FilmArray脑炎/脑膜炎多重病原体核酸联检试剂盒(FilmArray ME Panel)在中国儿童中枢神经系统感染病原学诊断方面的应用价值。方法:收集2019年3月至11月上海交通大学医学院附属上海儿童医学中心收治的145例疑诊中枢神经系统感染患儿的经腰椎穿刺获得的脑脊液标本,对所有患儿的脑脊液标本行培...     

加速器机架旋转加速度约束条件对VMAT计划的影响研究

目的:研究直线加速器机架旋转加速度设置,对多病种容积旋转调强(VMAT)计划剂量学、机器效率和计划验证结果的影响,探讨机器模型中机架加速度约束条件的优化选择。方法:分别选取10例鼻咽癌、非小细胞肺癌、乙状结肠腺癌腹膜后淋巴结转移和乳腺浸润性导管癌病例,在Pinnacle v9.10计划系统中建立允许机架旋转加速度变化和...     

静脉用药调配中心环节质量特色管理与控制实践

目的加强静脉用药调配中心（pharmacy intravenous admixture service,PIVAS）的质量管理,保证静脉用药安全。方法系统总结医院PIVAS3年来在环节质量管理与控制方面的特色经验,探讨环节质量管理与控制对PIVAS安全管理的影响。结果PIVAS在预防性控制、各流程环节控制、事后控制与持续质量改进3个方面实施重点管控,大大提高了输液成品的质量。结论环节质量特色管理与控制,能有效促进患者的用药安全,可作为PIVAS首选的质量管理方法。     

The upregulated intestinal folate transporters direct the uptake of ligand-modified nanoparticles for enhanced oral insulin delivery

Transporters are traditionally considered to transport small molecules rather than large-sized nanoparticles due to their small pores. In this study, we demonstrate that the upregulated intestinal transporter (PCFT), which reaches a maximum of 12.3-fold expression in the intestinal epithelial cells of diabetic rats, mediates the uptake of the folic acid-grafted nanoparticles (FNP). Specifically, the upregulated PCFT could exert its function to mediate the endocytosis of FNP and efficiently stimulate the traverse of FNP across enterocytes by the lysosome-evading pathway, Golgi-targeting pathway and basolateral exocytosis, featuring a high oral insulin bioavailability of 14.4% in the diabetic rats. Conversely, in cells with relatively low PCFT expression, the positive surface charge contributes to the cellular uptake of FNP, and FNP are mainly degraded in the lysosomes. Overall, we emphasize that the upregulated intestinal transporters could direct the uptake of ligand-modified nanoparticles by mediating the endocytosis and intracellular trafficking of ligand-modified nanoparticles via the transporter-mediated pathway. This study may also theoretically provide insightful guidelines for the rational design of transporter-targeted nanoparticles to achieve efficient drug delivery in diverse diseases.     

Exosomes Derived from Glioma Cells under Hypoxia Promote Angiogenesis through Up-regulated Exosomal Connexin 43

Glioblastoma multiform (GBM) is a highly aggressive primary brain tumor. Exosomes derived from glioma cells under a hypoxic microenvironment play an important role in tumor biology including metastasis, angiogenesis and chemoresistance. However, the underlying mechanisms remain to be elucidated. In this study, we aimed to explore the role of connexin 43 on exosomal uptake and angiogenesis in glioma under hypoxia. U251 cells were exposed to 3% oxygen to achieve hypoxia, and the expression levels of HIF-1α and Cx43, involved in the colony formation and proliferation of cells were assessed. Exosomes were isolated by differential velocity centrifugation from U251 cells under normoxia and hypoxia (Nor-Exos and Hypo-Exos), respectively. Immunofluorescence staining, along with assays for CCK-8, tube formation and wound healing along with a transwell assay were conducted to profile exosomal uptake, proliferation, tube formation, migration and invasion of HUVECs, respectively. Our results revealed that Hypoxia significantly up-regulated the expression of HIF-1α in U251 cells as well as promoting proliferation and colony number. Hypoxia also increased the level of Cx43 in U251 cells and in the exosomes secreted. The uptake of Dio-stained Hypo-Exos by HUVECs was greater than that of Nor-Exos, and inhibition of Cx43 by ^37,43gap27 or lenti-Cx43-shRNA efficiently prevented the uptake of Hypo-Exos by recipient endothelial cells. In addition, the proliferation and total loops of HUVECs were remarkably increased at 24 h, 48 h, and 10 h after Hypo-Exos, respectively. Notably, ^37,43gap27, a specific Cx-mimetic peptide blocker of Cx37 and Cx43, efficiently alleviated Hypo-Exos-induced proliferation and tube formation by HUVECs. Finally, ^37,43gap27 also significantly attenuated Hypo-Exos-induced migration and invasion of HUVECs. These findings demonstrate that exosomal Cx43 contributes to glioma angiogenesis mediated by Hypo-Exos, and suggests that exosomal Cx43 might serve as a potential therapeutic target for glioblastoma.     

地龙类药材药理作用比较

地龙类药材热浸剂均具有明显的解热、降压、平喘和利尿作用,其中广地龙和沪地龙的解热作用强于土地龙,地龙类药材其它作用的大小无显著性差异。