萨提亚团体干预模式在老年肺癌根治术后患者中的应用

目的探讨萨提亚团体干预模式在老年肺癌根治术后患者中的应用效果。方法采用便利抽样法,选择2017年6月—2018年6月郑州大学第一附属医院收治的老年肺癌根治术患者82例为研究对象。随机分为观察组和对照组,每组各41例。对照组术后接受常规护理,观察组采用萨提亚团体干预模式。干预前后采用社会回避与苦恼量表(SADS)、Rosenberg自尊量表(RSES)和欧洲癌症研究所癌症患者生命质量测定量表(EORTC QLQ-C30)比较干预效果。结果干预后观察组患者SADS评分低于对照组,RSES评分高于对照组,差异均有统计学意义(P<0.05)。干预后观察组患者躯体功能、角色功能、情绪功能、社会功能、疲乏感、恶心呕吐、疼痛、呼吸困难、睡眠障碍、食欲丧失、便秘、腹泻、经济困难及整体生活质量评分均高于对照组,差异有统计学意义(P<0.05)。结论萨提亚团体干预模式用于老年肺癌根治术患者,有助于提高患者自尊,纠正不良情绪,改善生活质量,值得推广应用。     

Primary Conservative Therapy for Symptomatic Isolated Mesenteric Artery Dissection with Severely Compressed True Lumen or Large Dissecting Aneurysm

PurposeTo investigate the safety and effectiveness of primary conservative therapy for patients with symptomatic isolated mesenteric artery dissection (IMAD) with a severely compressed true lumen and/or a large dissecting aneurysm.Materials and MethodsA total of 35 consecutive patients (all men; median age, 53 y) with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture who were treated with primary conservative therapy between November 2018 and February 2020 were assessed. A severely compressed true lumen was defined as luminal stenosis > 70%. A large dissecting aneurysm was defined as dissecting aneurysm diameter ≥ 1.5 times larger than the normal mesenteric artery diameter.ResultsThere was a strong positive relationship among abdominal pain, degree of luminal stenosis, and length of dissection (R = 0.811; P < .001). Conservative treatment was successful in all patients. Abdominal pain was eliminated within 4.7 d ± 4.8 (range, 2–31 d) in all patients, within 3.6 d ± 1.2 (range, 2–6) in the 31 patients with minor or moderate abdominal pain, and within 13.3 d ± 11.9 (range, 6–31 d) in the 4 patients with severe abdominal pain. Complete or partial remodeling of the mesenteric artery was achieved in 6 (17.1%) and 29 (82.9%) patients, respectively, during 8.6 mo ± 4.3 of follow-up.ConclusionsPrimary conservative therapy can be used safely and effectively in patients with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture.     

Clinical study of transcatheter occlusion in treating ventricular septal defect combined with right coronary cusp bulge

Background: Perimembranous ventricular septal defect combined with right coronary cusp bulge generally should be treated with surgical thoracotomy, owing to the potential aortic regurgitation. However, the minimally invasive method of transcatheter closure has always attracted the attention of cardiologists and patients. The present study aimed to apply transcatheter occlusion in treating ventricular septal defect with right coronary cusp bulge and further evaluate the clinical effect through follow-up.Materials and methods: A total of 40 children diagnosed as having a ventricular septal defect with right coronary cusp bulge, examined using transthoracic echocardiography and cardiovascular angiography, were enrolled in this study. The ventricular septal defects were closed by placing occluders through transcatheter occlusion treatment. During the operation process, the children underwent angiography and transthoracic echocardiography examinations to check the position of the occlude and the extent of aortic regurgitation. The influence of occlusion on the conduction system was evaluated using a surface electrocardiogram. The children were followed up after their procedures.Results: All 40 patients were immediately and successfully occluded. Three patients with filament residual shunts were observed during the operations. No major surgical complications occurred during the perioperative period. During the follow-up period, the positions of all the occluders were good, the residual shunts in the three patients disappeared, and no new or aggravated aortic regurgitation occurred. Electrocardiogram did not reveal any atrioventricular blocks. Only one patient suffered from an incomplete right bundle branch block.Conclusions: Children diagnosed with ventricular septal defect combined with right coronary cusp bulge could be considered for transcatheter occlusion. With appropriate indications and methods, the effect may be favorable.     

Synergistic effects of ischemic preconditioning and immediate post‐conditioning in the protection against ischemia/reperfusion injury in rabbit submandibular glands

Submandibular gland autotransplantation is an effective approach for treating severe keratoconjunctivitis sicca. However, ischemia/reperfusion (I/R) injury, which inevitably occurs during transplantation, is involved in the hypofunction and structural damage that occur early after transplantation. Therefore, it is critical to identify effective strategies to ameliorate I/R injury in submandibular glands. In this study, we investigated the ability of immediate post‐conditioning combined with ischemic preconditioning to attenuate I/R injury. We observed that after I/R injury, the level of reactive oxygen species was increased, inflammatory response was strengthened, and severe apoptosis had occurred. In addition, the salivary flow rate was greatly decreased. However, the pathogenesis of I/R injury was significantly ameliorated by ischemia post‐conditioning or ischemia preconditioning treatments. In addition, the combination of ischemia preconditioning and post‐conditioning achieved synergistic protective effects against I/R injury compared with ischemia preconditioning or ischemia post‐conditioning alone. The secretion function was restored in the combination group. Furthermore, the combination treatment involved the same mechanisms of ischemia preconditioning or ischemia post‐conditioning, including suppression of the inflammatory reaction and neutrophil accumulation, attenuation of oxidation stress, and inhibition of apoptosis. In conclusion, the combination of ischemia preconditioning and ischemia post‐conditioning treatment is a simple and effective approach for treating I/R injury in submandibular glands.     

NOISE INDUCED HEARING LOSS IN CHINA:A POTENTIALLY COSTLY PUB-LIC HEALTH LSSUE

Hearing loss and tinnitus are among the most common consequences of long term noise exposure and re-main an under-addressed heath issue in most developing nations including China. The rapid industrializa-tion and life style changes in China increase the concern over noise exposure and noise induced hearing loss (NIHL). Research on NIHL in China is limited. The current paper reviews studies published in English and Chinese language literatures regarding noise exposure and NIHL in China. Their implication on the Chi-nese population is discussed. The possible utility of a research model such as the Dangerous Decibels? as a means to increase understanding of the scope of NIHL among the Chinese population, to educate the gener-al public in China (especially the young) about NIHL and its prevention, and to study effects of language and cultural factors on international information dissemination and behavioral interventions is proposed.     

Analyzing the cancer methylome through targeted bisulfite sequencing

Bisulfite conversion of genomic DNA combined with next-generation sequencing (NGS) has become a very effective approach for mapping the whole-genome and sub-genome wide DNA methylation landscapes. However, whole methylome shotgun bisulfite sequencing is still expensive and not suitable for analyzing large numbers of human cancer specimens. Recent advances in the development of targeted bisulfite sequencing approaches offer several attractive alternatives. The characteristics and applications of these methods are discussed in this review article. In addition, the bioinformatic tools that can be used for sequence capture probe design as well as downstream sequence analyses are also addressed.     

电脑控温毯对重症手足口病患儿的控温效果

目的探讨电脑控温毯对重症手足口病患儿体温的控制效果。方法将2011年6月至2012年1月儿科重症监护室收治的68例重症手足口病患儿按照随机数字表法分为研究组和对照组各34例，对照组在体温〉39℃时使用布洛芬混悬滴剂降温；研究组在体温〉39℃时使用布洛芬混悬滴剂联合电脑控温毯降温。观察两组患儿在采用降温措施后1、2、3、4、6h的体温变化及全天呼吸、心率的波动幅度，高热持续时间。结果研究组的降温效果明显优于对照组（P〈0．01）；研究组全天呼吸、心率波动幅度明显小于对照组（P〈0．01），高热持续时间较对照组明显缩短（P〈0．01）。结论使用电脑控温毯能有效控制重症手足口病患儿的体温，缩短病程，有效防止并发症。     

非综合征型聋患儿及其家庭成员常见耳聋基因变异分析

目的分析深圳地区非综合征型耳聋患者及其相关高危人群中常见耳聋基因变异位点的分布，为分子诊断、遗传咨询及流行病学研究提供依据。方法应用基质辅助激光解析电离飞行质谱方法，对深圳地区1~6岁语前聋患儿71例及其听力正常的家庭成员（耳聋高危人群）145例，和作为对照听力的正常人群200例进行GJB2、SLC26A4、GJB3及MT RNR1基因的20个变异位点的检测。结果常见耳聋基因热点变异的检出率在语前聋患儿中为37%（26/71），在高危人群中为28%（40/145），在正常健康人群中为4.5%（9/200）；GJB2热点变异检出率在语前聋患儿中为18%（13/71），在高危人群中为12%（17/145），在正常人群中为2%（4/200）；SLC26A4检出率在语前聋患儿中为18%（13/71），在高危人群中为16%（23/145），在正常人群中为2.5%（5/200）。语前聋患儿组和耳聋高危人群组之间GJB2和SLC26A4变异检出率没有统计学意义（P=0.209），但两者都显著比正常人群高（P均<0.0001）；语前聋患儿中GJB2和SLC26A4变异纯合子和复合杂合子占18%（13/71），耳聋高危人群和正常人群中均未发现纯合子和复合杂合子，与语前聋患儿组比较有统计学意义（P<0.0001）。GJB3和MT RNR1变异在语前聋患儿、高危人群和正常人群中均未发现。结论GJB2和SLC26A4纯合和复合杂合变异是深圳地区语前聋患儿的重要致病原因，其中最常见的变异位点是GJB2:c.235delC和SLC26A4:c.919 2A>G。对于仅检出单杂合变异的耳聋患儿，可进行相应基因的测序，进一步明确分子诊断。     

Determination of plasma antiglycan autoantibodies in patients with IgA nephropathy and the correlation with clinical characteristics

Objective To establish the measurement of IgA1 O-glycan-specific antiglycan autoantibodies in patients with IgA nephropathy (IgAN), and evaluate their role in the development and progression of IgAN. Methods In the IgAN regular follow-up cohort of Peking University Institute of Nephrology from January 2006 to December 2015, 170 patients drawn by stratified randomization were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of plasma galactose-deficient IgA1 (Gd-IgA1) and antiglycan autoantibody (IgG and IgA1). The correlation between antiglycan autoantibodies and clinicopathological parameters was analyzed by linear correlation and multiple linear regression analysis. The receiver operating characteristic curve (ROC) was used to evaluate the value of plasma anti glycide antibodies in the diagnosis of IgAN. Results IgG and IgA1 antiglycan autoantibodies that specifically recognized Fab-hinge region (Fab-HR) antigens could be detected in both IgAN and healthy control group. Agglutinin inhibition test showed that the specific antigen epitope was N-acetylgalactosamine (GalNAc) residue exposed to galactose deficiency in IgA1 hinged region. There was no significant difference in the absolute levels of plasma IgG antiglycan autoantibodies between IgAN and healthy controls (P=0.963). After adjustment of the plasma level of IgG, the normalized antiglycan autoantibody (ln[IgG antiglycan antibody/IgG]) in patients with IgAN was significantly higher than that in healthy controls (0.58±0.31 vs 0.37±0.11, P﹤0.01). The normalized level of IgG antiglycan autoantibody in IgAN patients was positively correlated with 24 h urine protein level during renal biopsy (Spearman r=0.183, P﹤0.05), and was also significantly correlated with 24 h urinary protein level after adjusting for baseline clinical and pathological factors (β=0.713, 95%CI 0.323-1.102, P﹤0.01). The area under ROC curve (AUC) of normalized IgG antiglycan autoantibody in the diagnosis of IgAN was 0.764 (95% CI 0.682-0.845, P﹤0.05). Using the cut-off value of 0.396, the sensitivity and specificity of normalized IgG antiglycan autoantibody for IgAN were 0.729 and 0.700 respectively. There was no significant difference in the absolute or normalized levels of IgA1 antiglycan autoantibodies between IgAN patients and healthy controls. Conclusions Gd-IgA1-specific antiglycan autoantibodies can be detected both in IgAN patients and healthy controls. They are elevated in some patients with IgAN and possibly involved in the development of IgAN.