银杏达莫注射液对血脂指标影响的研究

目的探讨银杏达莫注射液对血脂指标的影响。发现治疗心脑血管病合并高血脂的新型药物。方法建立以银杏达莫注射液为基础的治疗方案,通过监测治疗前后的血脂指标,评价其必要性,可行性及实用性。结果银杏达莫注射液治疗后胆固醇显著降低,高密度脂蛋白显著升高,而甘油三脂无明显变化。结论银杏达莫注射液是治疗冠心病,脑血管病并发高脂血症及高粘血症的有效而理想的药物。     

Comprehensive Analysis of Seasonal and Geographical Variation in UVB Radiation Relevant for Vitamin D Production in Europe

Dermal synthesis, following sun exposure, is the main source of vitamin D. This study characterizes ambient UVB radiation relevant for vitamin D production in Europe. A biological weighing function was applied to data from the Tropospheric Emissions Monitoring Internet Service (TEMIS) for 46 capital cities over an 18-year period (2004–2021) to isolate wavelengths relevant for vitamin D production (D-UVB). Cumulative and weighted D-UVB (CW-D-UVB) were calculated to approximate seasonal vitamin D accumulation and diminution. Monthly 25(OH)D concentration measurements were extracted from published reports. All data were analyzed by location and time. Despite a moderate latitudinal range (35–64° N), we observed large—up to five-fold—regional differences: the highest mean diurnal D-UVB dose of 5.57 kJ/m² (SD = 3.55 kJ/m²) was observed in Nicosia (Cyprus) and the lowest in Reykjavik (Iceland, 1.16 ± 1.29 kJ/m²). Seasonal differences in diurnal D-UVB dose were even more pronounced, with a median 36-fold difference between annual peak and trough depending on a location (range: 10- to 525-fold). The mean duration of “vitamin D winter” was 126 days but varied widely (4 to 215 days). Monthly CW-D-UVB and 25(OH)D changes were very strongly correlated: the changes in 25(OH)D concentration increased by 12.6 nmol/L for every 100 kJ/m² increment of CW-D-UVB in population-based studies (r² = 0.79, p-value = 1.16 × 10⁻³⁷). Understanding the differences in D-UVB radiation can help understand determinants of vitamin D status and guide region- and season-specific safe and effective sunlight exposure recommendations and vitamin D supplementation guidelines.     

NT-Pro-BNP and echocardiography for the early assessment of cardiovascular dysfunction in neonates with sepsis

To investigate the predictive manner of N-terminal fragment of brain natriuretic peptide (NT-Pro-BNP) and echocardiography in the early assessment of cardiovascular dysfunction (CVD) in neonates with sepsis, we recruited 108 neonates with sepsis in intensive care units and divided them into a sepsis with CVD (sepsis + CVD) group (n = 48) and a sepsis only group (n = 60). Neonates with other infections (n = 65) constituted the control group. Clinical, laboratory, and bedside echocardiography findings were evaluated. Compared to both the sepsis only and control groups, the sepsis + CVD group showed an earlier onset of symptoms [52.94 (0–185.6) h], higher NT-Pro-BNP levels (P = .02), a higher Tei index (0.52 + 0.03; P = .03), and lower ejection fraction (62.61% ± 12.31%, P < .05). Compared to the control group, the sepsis + CVD group exhibited hematogenous etiology (P < .05), lower albumin (ALB) levels (P = .04), lower white blood cell counts (P = .03), a higher high-sensitivity C-reactive protein/ALB ratio, and a larger right-ventricle-inner diameter (10.74 + 2.42 mm; P = .01). CVD in the septic neonates could be predicted by either NT-Pro-BNP levels (cut-off: 12,291.5 pg/L; sensitivity, 80%; specificity, 79%; area under the curve-receiver operating characteristic, 0.81) or Tei index (cut-off: 0.45; sensitivity, 74%; specificity, 77%; area under the curve-receiver operating characteristic, 0.78). NT-Pro-BNP levels and echocardiography can be used to determine early onset of CVD in neonatal sepsis, which facilitates timely pharmacological interventions and treatment.     

Age-specific associations between underlying health conditions and hospitalisation,death and in-hospital death among confirmed COVID-19 cases: a multi-country study based on surveillance data,June to December 2020

BackgroundUnderlying conditions are risk factors for severe COVID-19 outcomes but evidence is limited about how risks differ with age.AimWe sought to estimate age-specific associations between underlying conditions and hospitalisation, death and in-hospital death among COVID-19 cases.MethodsWe analysed case-based COVID-19 data submitted to The European Surveillance System between 2 June and 13 December 2020 by nine European countries. Eleven underlying conditions among cases with only one condition and the number of underlying conditions among multimorbid cases were used as exposures. Adjusted odds ratios (aOR) were estimated using 39 different age-adjusted and age-interaction multivariable logistic regression models, with marginal means from the latter used to estimate probabilities of severe outcome for each condition–age group combination.ResultsCancer, cardiac disorder, diabetes, immunodeficiency, kidney, liver and lung disease, neurological disorders and obesity were associated with elevated risk (aOR: 1.5–5.6) of hospitalisation and death, after controlling for age, sex, reporting period and country. As age increased, age-specific aOR were lower and predicted probabilities higher. However, for some conditions, predicted probabilities were at least as high in younger individuals with the condition as in older cases without it. In multimorbid patients, the aOR for severe disease increased with number of conditions for all outcomes and in all age groups.ConclusionWhile supporting age-based vaccine roll-out, our findings could inform a more nuanced, age- and condition-specific approach to vaccine prioritisation. This is relevant as countries consider vaccination of younger people, boosters and dosing intervals in response to vaccine escape variants.     

Application of the Kaiser score by MRI in patients with breast lesions by ultrasound and mammography

PURPOSEThis study aimed to verify whether the use of the Kaiser score can improve the diagnostic performance in breast magnetic resonance imaging (MRI) for suspicious lesions and avoid further invasive diagnostic approaches.METHODSThis retrospective study enrolled 97 patients who underwent breast MRI before undergoing breast biopsy or surgery. Evaluations were conducted on all MRI images individually by 2 radiologists using the Kaiser score. Neither radiologist had the knowledge of the final histopathological diagnosis. The ability of the Kaiser score in diagnosis was established via a receiver performing characteristic (ROC) analysis, which was measured by the area under the ROC curve (AUC). Youden index was used to define the optimal cutoff value. Kaiser score categories were dichotomized into positive (cutoff score > 4) and negative scores (cutoff score ≤ 4). Cohen’s kappa coefficient was used to analyze the inter-rater agreement.RESULTSHistopathology revealed 56 malignant and 41 benign lesions. The AUC for all lesions evaluated by the Kaiser score was 0.992 (95% CI: 0.981-1.0) and 0.958 (95% CI: 0.920-0.996) for 2 radiologists, respectively. Inter-rater agreement of the dichotomized Kaiser score was excellent (κ = 0.894, P < .001). A total of 20 lesions (33.8%) previously categorized as BI-RADS 4 were reduced to BI-RADS 2/3 (19 benign lesions and 1 malignant lesion).CONCLUSIONThe Kaiser score is a valuable auxiliary diagnostic tool for improving the diagnostic ability of radiologists, whose experiences in breast MRI are diverse. In some cases, the application of the Kaiser score could possibly avoid unnecessary breast biopsies.     

Timing and Identification of the Cause and Treatment of a Cardiac Arrest: A Potential Survival Benefit

ObjectiveThe aim of this study was to evaluate how mobile medical teams (MMTs) search for the etiology of a cardiac arrest (CA) and to investigate the association between the discovery of etiology and patient outcome.Subjects and MethodsResuscitations of all adult patients who experienced an in- or out-of-hospital CA between 2016 and 2018 were video recorded. All video recordings were reviewed. The time to start of “cause analysis” and time to treatment by the MMT were analyzed. Also, investigations performed during etiologic evaluation were examined: heteroanamnesis, medical history-taking, clinical examinations, technical investigations, and the use of the 4Hs and 4Ts method.ResultsOf the 139 CA events included in this study, the MMTs performed etiologic evaluation in only 75% of the resuscitations, and in 20% of the evaluations, they did not use the recommended 4Hs and 4Ts method. Medical history-taking and heteroanamnesis were performed in the large majority, but often without clear cause. A presumptive etiology was found in 46.8% of out-of-hospital CAs and 65.2% of in-hospital CAs. A significant association was found between return of spontaneous circulation and the discovery of presumable etiology for out-of-hospital CAs (p < 0.001). The median time to treatment was 492 s (recommended: 130–250 s) for nonshockable rhythms and 422 s (recommended: 270–390 s) for shockable rhythms, up to twice the time advised according to the guidelines.ConclusionThe current approach for etiologic evaluation is not ideal. Further research is needed to establish a more structured and simplified approach.     

新冠肺炎疫情期间护士睡眠及健康状况调查与分析

目的 通过调查我院护理人员的睡眠现状和身心健康问题,探讨影响因素,为提高和改善护理人员睡眠质量,促进护理人员身心健康提供依据.方法 以我院参与临床及相关工作的532名护理人员为研究对象,自行拟定具有特色的调查问卷,调查新冠肺炎疫情期间睡眠情况、存在的睡眠问题及身体和精神状况.结果 多数护士在新冠肺炎疫情期间睡眠时间及睡...     

不同产地青风藤中青藤碱的含量比较

目的比较不同产地青风藤的青藤碱含量。方法采用高效液相色谱法测定青风藤饮片中青藤碱含量。色谱柱为Lichrospher C18柱（150 mm×4.6 mm,5μm）,流动相为甲醇-水-乙二胺（40∶60∶0.2）,检测波长为262 nm,流速1.0 mL/min。结果青藤碱进样量在1～10μg范围内与峰面积呈良好的线性关系（r=0.999 8）,平均回收率为99.56%,RSD为0.81%（n=6）;江苏（三批）、湖南、湖北产青风藤药材的青藤碱含量分别为0.83%,1.11%,1.02%,1.90%,0.58%。结论不同产地青风藤药材的青藤碱含量差异显著。     

胰岛素和亚硒酸钠最佳配比组方研究

目的 确定普通胰岛素与亚硒酸钠降血糖作用的最佳组方配比.方法 采用小剂量链脲佐菌素腹腔注射联合高糖高脂饲养的大鼠模型,以血糖降低百分率为考察指标,根据权重配方法设不同配比组方6组,分析结果得出最佳理论配比,并进一步做确证性试验考察二者的相互关系.结果 胰岛素与亚硒酸钠对血糖的控制为协同作用,二者比例为1 U:5μg时可显著降低血糖.结论 胰岛素和亚硒酸钠的最佳配比为1 U:5μg.     

高糖环境对胰岛β细胞系转录组表达谱的影响

目的 研究高浓度葡萄糖刺激因素对1型糖尿病(type 1 diabetes,T1D)模型小鼠来源的胰岛p细胞系全转录组表达谱的影响,探讨高糖环境因素参与T1D发病的可能机制.方法 将处于对数生长期的非肥胖糖尿病(non-obese diabetic,NOD)小鼠来源的胰岛β细胞系NIT-1细胞分为对照组(NIT1)和高...