Some unusual types of formation of the ansa cervicalis in humans and proposal of a new morphological classification

Ansa cervicalis (ansa hypoglossi) is a peripheral nerve structure—the primary choice for laryngeal reinnervation. Because the ansa formation is quite variable in humans, it is an object of a number of proposed classifications. Two interesting cases of formation of the ansa cervicalis were found during routine anatomical dissections. In the first case the unusual ansa had three basic roots—a superior one from the hypoglossal nerve, an aberrant middle root from the vagus nerve and an inferior root, coming from the cervical ventral branches. In the second case an ansa was described having roots from the vagus nerve and cervical ventral branches. Based on the reported variations and extensive review of the pertinent literature, a new morphological classification of the ansa cervicalis formation in human is proposed here. Clin. Anat. 26:961–965, 2013. © 2013 Wiley Periodicals, Inc.     

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。     

成人动脉血气分析标本采集技术的研究进展

本文在文献回顾的基础上对目前成人动脉血气分析采血部位、采血用具、穿刺方法等情况进行归纳分析,旨在为临床护士采集血气分析标本提供参考。     

Usefulness of the PARIS Score to Evaluate the Ischemic-hemorrhagic Net Benefit With Ticagrelor and Prasugrel After an Acute Coronary Syndrome

Introduction and objectives

The PARIS score allows combined stratification of ischemic and hemorrhagic risk in patients with ischemic heart disease treated with coronary stenting and dual antiplatelet therapy (DAPT). Its usefulness in patients with acute coronary syndrome (ACS) treated with ticagrelor or prasugrel is unknown. We investigated this issue in an international registry.

Selective degradation of cyclin B1 mRNA in rat oocytes by RNA interference (RNAi)

Cyclic adenosine monophosphate (cAMP) keeps oocytes in meiotic arrest, thereby preventing activation of the key regulators of meiosis, p34cdc2/cyclin B1, (known as maturation-promoting factor (MPF)) and Erk 1 and 2, members of the mitogen-activated protein kinase (MAPK) family. The activity of MAPK in oocytes is upregulated by Mos. We previously demonstrated that Mos translation in rat oocytes is negatively regulated by a PKA-mediated cAMP action, which inhibits c-mos mRNA polyadenylation and is associated with the suppression of p34 cdc2 kinase. The goal of the present study was to provide definitive evidence that Mos translation is subjected to MPF regulation. In order to inhibit MPF activity, we employed the double-stranded (ds) RNA interference (RNAi) of gene expression. We demonstrated that the introduction of cyclin B1 dsRNA into rat oocytes selectively depleted the corresponding mRNA, further ablating its protein product. These oocytes, which exhibit low MPF activity, failed to elongate the c-mos mRNA poly(A) tail, did not accumulate Mos and were unable to activate MAPK. We conclude that an active MPF in rat oocytes is necessary for c-mos mRNA polyadenylation and Mos translation.     

Modification of septic shock in mice by the antiglucocorticoid RU 38486.

The survival rate in murine septic peritonitis was inversely proportional to the size of the needle used for cecal puncture following ligation below the ileocecal valve. The smaller, 20-gauge needle permitted 20% survival. Only 20% of the animals survived 24 hr after cecal puncture with a 20-gauge needle compared to 90% survival after 5 days if mice had been rendered tolerant to lipopolysaccharide (LPS) prior to the induction of peritonitis. A single intravenous injection of 1 mg RU 38486, concurrent with puncture with a 21-gauge needle, lowered survival to only 15% from the control level of 71%. This same dose of the antiglucocorticoid decreased the survival rate to only 35% from 90% in the tolerant group. Tolerance to the lethal effects of endotoxins, possibly responsible for resistance to septic peritonitis, was also abolished by the antiglucocorticoid. Just 1 mg RU 38486 lowered the survival rate to 5% if it was given with 600 micrograms LPS, which permitted 95% survival in LPS-tolerant mice and 60% survival in normal controls. Whereas both 1 mg RU 38486 and 100 micrograms dexamethasone, given alone, sensitized mice to septic peritonitis (15% and 30% survival, respectively), their combined effects neutralized each other, leading to 80% survival vs. 71% in the control group. Thus receptor-mediated glucocorticoid-dependent mechanisms appear important in the pathogenesis of both endotoxin and septic shock, albeit to varying degrees and in a seemingly contradictory manner.     

A phase II study of continuous infusion recombinant human granulocyte- macrophage colony-stimulating factor as an adjunct to autologous bone marrow transplantation for patients with non-Hodgkin's lymphoma in first remission

Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) clearly hastens myeloid recovery in patients with relapsed hematologic malignancies undergoing autologous bone marrow transplantation (ABMT). In efforts to further improve neutrophil engraftment and shorten hospital stay in ABMT patients, rhGM-CSF was administered by a potentially more potent route (continuous infusion) to non-Hodgkin's lymphoma (NHL) patients with better BM reserve (first remission). Time to myeloid engraftment was compared with that of NHL patients treated in first remission at our institution on a similar ABMT protocol but without growth factor support (controls). Median neutrophil engraftment (absolute neutrophil count, 500 cells/microL) in first remission patients treated with rhGM-CSF was 14 days, compared with 22 days in controls (P = .0001). Hospital stays were also significantly reduced for rhGM-CSF patients (P = .0003). Platelet engraftment did not differ between the two groups. Persistent fever and generalized serositis were the primary toxicities. rhGM-CSF, delivered by this route, was efficacious but more toxic than 2-hour rhGM-CSF infusions previously reported by other investigators. Future alterations in both dose and schedule may retain comparable efficacy yet diminish toxicity.