Cardiac arrest caused by accidental severe hypothermia and myocardial infarction during general anesthesia

Therapeutic hypothermia is often used for traumatic brain injury because of its neuroprotective effect and decreased secondary brain injury. However, this procedure lacks clinical evidence supporting its efficacy, and adverse outcomes have been reported during general anesthesia. A 61-year-old man with a history of percutaneous coronary intervention (PCI) was admitted with traumatic brain injury. Immediately after admission, he underwent mild therapeutic hypothermia with a target temperature of 33.0°C for neuroprotection. During general anesthesia for emergency surgery because he developed a mass effect, hypothermic cardiac arrest occurred following an additional decrease in the core body temperature. Moreover, myocardial infarction caused by restenosis of the previous PCI lesion also contributed to the cardiac arrest. Although the patient recovered spontaneous circulation after an hour-long cardiopulmonary resuscitation with rewarming, he eventually died of subsequent repetitive cardiac arrests. When anesthetizing patients undergoing therapeutic hypothermia, caution is required to prevent adverse outcomes that can be caused by unintentional severe hypothermia and exacerbation of underlying heart disease.     

完全腹腔镜下与开腹胰十二指肠切除术治疗壶腹周围肿瘤近期疗效比较

目的探讨完全腹腔镜下胰十二指肠切除术(TLPD)与开腹胰十二指肠切除术(OPD)治疗壶腹周围肿瘤的近期疗效。方法回顾性分析山西医科大学第一医院2016年6月至2019年3月收治的50例壶腹周围肿瘤患者的临床资料,根据手术方式不同分为TLPD组(22例)及OPD组(28例),比较两组患者围术期及术后各项指标情况。结果两组患者均顺利完成手术,TLPD组手术时间[(665±213)min]长于OPD组[(447±215)min],差异有统计学意义(t=-0.356,P=0.001);TLPD组术中出血量[100 ml(50~325 ml)]少于OPD组[300 ml(100~500 ml)],差异有统计学意义(Z=-2.230,P=0.026)。TLPD组与OPD组术中输血者比例、淋巴结清扫数量、切除肿瘤长径、术后禁饮食时间、术后拔管时间、术后住院时间及术后并发症发生率比较,差异均无统计学意义(均P>0.05)。结论TLPD与OPD治疗壶腹周围肿瘤临床近期疗效相近,TLPD手术时间较OPD长,但可有效控制术中出血量。     

Unbalanced lateral mandibular deviation associated with TMJ sound as a sign in TMJ disc dysfunction diagnosis

The aim was to study the characteristics of lateral mandibular horizontal deviations during opening–closing movements and their association with TMJ sounds of the clicking type. Subjects were 28 healthy volunteers and 38 patients diagnosed with MRI imaging as having TMJ disc dysfunction, 22 with disc displacement without (DD) and 16 as having disc displacement with reduction (DDR). TMJ sounds were recorded with miniature microphones placed in the ear canals, and jaw movements were documented with a kinesiograph. A sign, unbalanced lateral deviation (ubd) was defined as a rapid, short duration, change in jaw movement direction from, and back to, a smooth deviation path in the horizontal plane. The hypotheses were that degrees of maximal deviations, proportions of unbalanced deviation (ubd) and such deviation associated with TMJ sounds (ubdS), differ between healthy subjects and patients with DD or DDR. Comparisons between groups were made using one‐way anova and chi‐square analysis, as appropriate. No differences were found between groups regarding degree of lateral deviation per se. The proportions of ubd and ubdS were significantly higher in patients with DDR than in healthy subjects and than in patients with DD (P < 0·001), but no such differences were found between healthy subjects and patients with DD. For prediction of DDR, the sensitivity and specificity of the sign ubdS were found to be 68·8% and 89·3%, respectively. For the sign ubd, they were 100·0% and 64·3%. This indicates that the sign ubdS has diagnostic value in screening for DDR.     

Rejuvenation of chondrogenic potential in a young stem cell microenvironment

Autologous cells suffer from limited cell number and senescence during ex vivo expansion for cartilage repair. Here we found that expansion on extracellular matrix (ECM) deposited by fetal synovium-derived stem cells (SDSCs) (FE) was superior to ECM deposited by adult SDSCs (AE) in promoting cell proliferation and chondrogenic potential. Unique proteins in FE might be responsible for the rejuvenation effect of FE while advantageous proteins in AE might contribute to differentiation more than to proliferation. Compared to AE, the lower elasticity of FE yielded expanded adult SDSCs with lower elasticity which could be responsible for the enhancement of chondrogenic and adipogenic differentiation. MAPK and noncanonical Wnt signals were actively involved in ECM-mediated adult SDSC rejuvenation.     

医科研究生对学风、学习期望、学习态度的自我评价调查

目的调查医科研究生对本校学习风气的评价,并具体调查了研究生对自己学习(科研)期望和态度的看法,为相关管理部门加强教育引导提供依据。方法应用自制问卷,比较某医科大学研究生总体、不同性别、不同年级、不同录取类别、不同培养层次、不同学位类型、不同专业对学风、学习期望、学习态度的看法。结果医科研究生总体对于本校学习风气的评价主要为"较好"(48.3%),其次是"一般"(25.7%)和"很好"(22.3%);不同专业、不同年级、不同录取类别(χ2=49.188,24.517,29.248;P<0.05)之间不同。研究生总体对自己学习(科研)的期望主要是优秀(43.7%)和良好(42.2%);不同年级、不同培养层次、不同录取类别之间有差异(χ2=37.788,35.836,61.120;P<0.05)。研究生总体对自己学习(科研)态度的评价主要为比较严谨(60.5%)和很严谨(19.7%);不同年级、不同培养层次、不同录取类别之间有差异(χ2=17.350,15.423,40.327;P<0.05)。结论医科研究生整体学风较好,尤其是公共卫生与预防医学专业和计划研究生;整体学习期望较高,学习态度较好。     

Mutations within the rplD Gene of Linezolid-Nonsusceptible Streptococcus pneumoniae Strains Isolated in the United States

Three invasive Streptococcus pneumoniae strains nonsusceptible to linezolid were isolated in the United States between 2001 and 2012 from the CDC''s Active Bacterial Core surveillance. Linezolid binds ribosomal proteins where structural changes within its target site may confer resistance. Our study identified mutations and deletions near the linezolid binding pocket of two of these strains within the rplD gene, which encodes ribosomal protein L4. Mutations in the 23S rRNA alleles or the rplV gene were not detected.     

发生在绝经妇女的无症状巨大卵巢甲状腺肿瘤一例报道(英文)

Struma ovarii, a rare varity of ovarian neoplasm, belongs to the group of monodermic teratomas mainly composed of thyroid tissue. The preoperative diagnosis is always difficult to identify without histopathological examination. Surgery is the only treatment because malignant alteration is possible and thyroid hyperactivity or hyperthyroidism may occur. Our patient, a post-menopausal women, had unilateral, large, multiloculated ovary mass of 20cm×15cm×10cm size without any thyroid hyper activity. The radical excision of the tumor with right ovary was preformed. Histopathological examination confirmed struma ovarii. The post-operative period was uneventful and her thyroid function remained normal.     

本草纲目药物警戒数据库设计与应用研究

目的:为深入分析研究本草纲目中的药物警戒思想提供新方法。方法:基于本草纲目金陵本文献著作设计了药物警戒数据库,阐述了数据库建立的要求和存储模型的选取,以及数据库的概念和逻辑设计。结果:在此数据库的基础上可建立知识发现系统,应用数据挖掘算法,对本草纲目中的药物警戒思想进行分析。结论:本草纲目药物警戒思想数据库的建立可以为深入研究药物警戒思想提供方便、准确的手段,此方法也可应用于其他文献著作研究。