Risk factors for sensorineural hearing loss in extremely premature infants

Objective: To identify potentially preventable risk factors for sensorineural hearing loss (SNHL) in extremely premature infants.
Methodology A case control study of survivors with gestational age (GA) <28 weeks or birthweight (BW) <1000 g using data collected prospectively in our Neonatal Intensive Care Unit database. Each subject with bilateral SNHL >40dB was matched according to GA, BW and sex with two controls who had neither sensorineural nor conductive hearing loss.
Results Infants with SNHL had increased mean (±s.d.) days ventilated (53 ± 21 vs 37±23 days, P = 0.006) and in oxygen (107±44 vs 69±28 days, P = 0.02) compared with controls. The risk for SNHL was increased for infants who spent >90 days in oxygen (OR 4.0 [95% Cl 1.1-15.6]), had maximum FiO₂ >0.90 (5.6 [1.2-26.9]), minimum plasma Na <125mmol/L (5.6 [1.1-27.8] or maximum pH >7.60 (5.6 [1.1-89.0]). Neither maximum serum bilirubin nor exposure to ototoxic drugs was associated with SNHL.
Conclusions: Avoidance of severe hyponatraemia and extreme alkalosis, as well as use of surfactant to minimize the severity of hyaline membrane disease, may result in a decreased incidence of SNHL in extremely premature infants.     

丙谷胺对急性胰腺炎大鼠的治疗作用

观察CCK受体拮抗剂丙谷胺对急性胰腺炎(AP)大鼠治疗作用。应用胰胆管内注射5％牛磺胆酸钠溶液诱发大鼠急性胰腺炎模型,术后腹腔内注射丙谷胺溶液(剂量400mg/kg);观察术后6h各组腹水量、胰重、血清脂肪酶活性和病理变化,计算大鼠24h内死亡率。丙谷胺治疗组鼠腹水量、胰重、脂肪酶活性分别为2.04±0.39(g)、1.57±0.38(g)、577.97±8.38(U),均显著低于非治疗组(9.34±2.04、2.04±0.39、715.38±44.76),P<0.05;鼠死亡率由非治疗组的100％降至40％;病理损害程度减轻。丙谷胺对牛磺胆酸钠诱发的大鼠急性胰腺炎有一定治疗作用。     

Correction of immune disorders with neoselenium in patients with chronic bronchitis

The examination covered 55 patients with chronic bronchitis (mean age 58 +/- 4.2 years, mean duration of the disease 11.2 +/- 5.2 years). All the patients were in remission and received broncholytics. In 32 of them, basic treatment was combined with a course of immunorehabilitation with neoselenium. The effect of the latter was assessed at immunological examination of the patients before and after the treatment with indirect immunofluorescence with monoclonal antibodies. Neoselenium appeared to have an immunomodulating action on all immunity links, it enhanced functional activity and bactericidity of antigen-presenting cells and cytotoxic activity of natural killers, diminished the tension in the function of endogenic antioxidant systems.     

Comprehensive review into the challenges of gastrointestinal tumors in the Gulf and Levant countries

Although gastrointestinal stromal tumors(GISTs)are rare,with an incidence of 1/100000 per year,they are the most common sarcomas in the peritoneal cavity.Despite considerable progress in the diagnosis and treatment of GIST,about half of all patients are estimated to experience recurrence.With only two drugs,sunitinib and regorafenib,approved by the Food and Drug Administration,selecting treatment options after imatinib failure and coordinating multidisciplinary care remain challenging.In addition,physicians across the Middle East face some additional and unique challenges such as lack of published local data from clinical trials,national disease registries and regional scientific research,limited access to treatment,lack of standardization of care,and limited access to mutational analysis.Although global guidelines set a framework for the management of GIST,there are no standard local guidelines to guide clinical practice in a resource-limited environment.Therefore,a group of 11 experienced medical oncologists from across the Gulf and Levant region,part of the Rare Tumors Gastrointestinal Group,met over a period of one year to conduct a narrative review of the management of GIST and to describe regional challenges and gaps in patient management as an essential step to proposing local clinical practice recommendations.     

Hemodilution and intravenous perflubron emulsion as an alternative to blood transfusion: effects on tissue oxygenation during profound hemodilution in anesthetized dogs

BACKGROUND: Intravenously administered perfluorocarbon (PFC) emulsions increase oxygen solubility in plasma. PFC might therefore temporarily replace red cells (RBCs) lost during intraoperative hemorrhage. In patients who have undergone hemodilution, the return of autologous blood may be delayed by the administration of PFC, and autologous RBCs may be saved for transfusion after surgical bleeding is stopped and PFC is cleared by the reticuloendothelial system. STUDY DESIGN AND METHODS: In 22 anesthetized, hemodiluted dogs (hemoglobin [Hb] 7 g/dL) breathing 100-percent O2, an intraoperative volume-compensated blood loss was simulated. The efficacy of three therapeutic regimens in maintaining tissue oxygenation was compared: 1) RBC group (n = 7): maintenance of a Hb > 7 g per dL by transfusion of autologous RBCs; 2) PFC group (n = 7): bolus application of a second-generation PFC emulsion (60% wt/vol perflubron) and further acute normovolemic hemodilution (ANH) to a Hb of 3 g per dL; and 3) control group (n = 7): further ANH alone to a Hb of 3 g per dL. Systemic and myocardial oxygenation status and tissue oxygenation were assessed. RESULTS: Autologous RBCs transfused to maintain a Hb of 7 g per dL preserved hemodynamics and tissue oxygenation during blood loss. In the PFC and control groups, heart rate and cardiac index increased significantly in response to further ANH. Tissue oxygenation was not different in the PFC and the RBC groups. Direct comparison of the PFC and control groups revealed better tissue oxygenation in the PFC group, as reflected by significantly higher mixed venous, coronary venous, and local tissue pO2 on liver and skeletal muscle. CONCLUSION: Bolus intravenous administration of 60- percent (wt/vol) perflubron emulsion and further hemodilution from a Hb of 7 g per dL to one of 3 g per dL were as effective as autologous RBC transfusion in maintaining tissue oxygenation during volume-compensated blood loss designed to mimic surgical bleeding.     

认知行为干预对乳腺癌外科手术患者认知水平、自护能力及心理状态的影响

目的 探讨认知行为干预对乳腺癌外科手术患者认知水平、自护能力及心理状态的影响.方法 选择2018年6月至2020年6月我院进行乳腺癌外科手术的50例患者作为研究对象,按照护理模式将其分为对照组和观察组,各25例.对照组给予常规护理干预,观察组在对照组的基础上采用认知行为干预.比较两组的干预效果.结果 干预后,观察组的认...     

ELISA法检测不育男子精浆中抗人精浆免疫抑制因子IgG和IgA

本文首次建立了抗人精浆免疫抑制因子（ＳＰＩＦ）ＩｇＧ和ＩｇＡ的ＥＬＩＳＡ测定法，用其对５０例生育男子和１００例不育男子精浆中抗ＳＰＩＦＩｇＧ和ＩｇＡ进行了测定。结果显示：精浆中抗ＳＰＩＦＩｇＧ和ＩｇＡ的阳性率在生育男子分别为６％和４％；在不育男子分别为３４％和２８％。不育组抗ＳＰＩＦＩｇＧ和ＩｇＡ阳性率均显著高于生育组（Ｐ＜０．０１）。本文就抗ＳＰＩＦＩｇＧ和ＩｇＡ在抗生育及生殖道感染方面的可能作用进行了讨论。