脑囊虫病患者脑CT检查与脑脊液循环抗原和抗体检测的比较研究

本文报道了408例脑囊虫病患者脑CT检查、脑脊液中循环抗原和抗体(IHA)检测结果的比较.脑CT反映脑部有较多新鲜囊尾蚴或脑室系统有囊尾蚴寄生者.脑脊液中循环抗原阳性率达98.80%和96.67%,明显高于只有少量新鲜病灶(70.67%)、有多个陈旧病灶(75.56%)、CT未发现异常(57.58%)或少量新鲜、陈旧病灶混合的患者(69.49%).脑脊液中抗体阳性率以有较多陈旧病灶者最高,达91.11%,依次是有少量新鲜病灶(64.00%)、CT未发现异常(57.58%)或少量新鲜、陈旧病灶混合的患者(74.58%).     

The relationship between visfatin and HOMA-IR in hypertensive patients, and the effect of antihypertensive drugs on visfatin and HOMA-IR in hypertensive patients with insulin resistance

Objective

To investigate the correlation between serum visfatin and insulin resistance (IR) in non-diabetic essential hypertensive (EH) patients with and without IR, and to evaluate the effect of antihypertensive treatment on serum visfatin and IR in these patients.

Methods

A total of 81 non-diabetic EH patients, including 54 with IR and 27 without IR, were enrolled. After two weeks wash-out, patients with IR were randomly assigned to telmisartan (group T) or amlodipine (group A) for 6 months. Blood samples were taken before and after treatment for measurement of routine biochemical parameters, visfatin and insulin resistance (measured by HOMA-IR).

Results

Visfatin was independently correlated with HOMA-IR (r = 0.845, P = 0.000). After 6 months of treatment, both drugs lowered HOMA-IR, more significantly so in group T than group A (P = 0.010). Serum visfatin levels increased in group T but decreased in group A.

Conclusion

Serum visfatin levels were higher in non-diabetic EH patients with IR compared with those without IR. Visfatin is independently correlated with HOMA-IR. Telmisartan lowers HOMA-IR to a greater extent than amlodipine. Interestingly, serum visfatin increased with telmisartan yet decreased with amlodipine treatment.     

Dual-field-of-view high-spectral-resolution lidar: Simultaneous profiling of aerosol and water cloud to study aerosol–cloud interaction

Aerosol–cloud interaction (ACI) is complex and difficult to be well represented in current climate models. Progress on understanding ACI processes, such as the influence of aerosols on water cloud droplet formation, is hampered by inadequate observational capability. Hitherto, high-resolution and simultaneous observations of diurnal aerosol loading and cloud microphysical properties are challenging for current remote-sensing techniques. To overcome this conundrum, we introduce the dual-field-of-view (FOV) high-spectral-resolution lidar (HSRL) for simultaneously profiling aerosol and water cloud properties, especially water cloud microphysical properties. Continuous observations of aerosols and clouds using this instrument, verified by the Monte Carlo simulation and coincident observations of other techniques, were conducted to investigate the interactions between aerosol loading and water cloud microphysical properties. A case study over Beijing highlights the scientific potential of dual-FOV HSRL to become a significant contributor to the ACI investigations. The observed water cloud profiles identify that due to air entrainment its vertical structure is not perfectly adiabatic, as assumed by many current retrieval methods. Our ACI analysis shows increased aerosol loading led to increased droplet number concentration and decreased droplet effective radius—consistent with expectations—but had no discernible increase on liquid water path. This finding supports the hypothesis that aerosol-induced cloud water increase caused by suppressed rain formation can be canceled out by enhanced evaporation. Thus, these observations obtained from the dual-FOV HSRL constitute substantial and significant additions to understanding ACI process. This technique is expected to represent a significant step forward in characterizing ACI.

Aerosol–cloud interaction (ACI) is a crucial aspect of atmospheric research and one of the primary sources of uncertainties in climate predictions (1–3). To assess the credibility of climate projections, it is imperative to improve our understanding of how aerosols interact with clouds (4–6). It has been well known that aerosols can serve as cloud condensation nuclei (CCN) to form cloud droplets, which can further influence the initiation of precipitation (7). However, quantifying the impact of natural and anthropogenic aerosols on the growth and the evolution of water clouds is still challenging (8, 9). The short lifetime, high temporal variability, and complex vertical structure of water cloud layers lead to a major difficulty for ACI studies (3, 10, 11). Despite the advances in the characterization of ACI by ground-based measurements (12–21), satellite retrieved products (22–25), and airborne in situ measurements (26–28), uncertainties remain in the effects of the aerosols on the water cloud properties. The reason for this gap in our knowledge is closely linked to the inadequate observations of the water cloud microphysical properties under various aerosol conditions (3). Current satellites can estimate cloud properties but not the typical aerosol nucleation region beneath clouds (22–25). Moreover, they also bring challenges for ACI studies that the typical revisit time of satellite-based sensors is much longer than the temporal scales of cloud variability (29, 30). Quintessential ground-based remote-sensing techniques for retrieving cloud properties, such as the cloud radar and the microwave radiometer, cannot provide simultaneous aerosol observations for ACI studies. Therefore, ground-based measurements commonly combine those with other remote-sensing or in situ aircraft instruments for characterizing aerosol loading beneath clouds (12–20). However, given the high variability of clouds, differences in perspective or mismatched sampling in space and time would raise uncertainty and bias in the characterization of ACI (15).Lidar, a powerful tool for profiling optical properties of aerosols and clouds, has been widely used in atmospheric studies (31–33). Yet, further progress with lidar-based techniques for ACI studies is hampered by limited observations of the water cloud microphysical properties, mainly due to the difficulties of quantifying the multiple scattering within water clouds (34). The multiple scattering has a significant impact on the water cloud observations of the extinction as well as the depolarization ratio, which is related to the receiver field of view (FOV). In brief, a retrieval of water cloud microphysical properties for lidar-based techniques relies on utilizing different receiver FOVs to provide the necessary observations for characterizing the multiple-scattering effect caused by the water droplets (34, 35). The first multiple-FOV lidars were aimed at investigating the multiple-scattering effect and measured Mie scattering by water droplets (36). However, a complicated behavior of the Mie phase function makes the quantifying of the multiple scattering become an arduous task. It naturally leads to the use of Raman scattering of atmospheric nitrogen, which has an isotropic phase function practically in the backward direction, to allow developing a feasible algorithm for the retrieval of water cloud microphysical properties (35). Moreover, the dual-FOV Raman lidar technique for profiling cloud properties has been experimentally demonstrated (37). With this technique in conjunction with an incoherent Doppler lidar, the ACI findings have been obtained with an ACI index versus vertical air motion (21, 38). However, nitrogen Raman signals are so weak that the observations are usually restricted to nighttime hours, and the signal has to be averaged over tens of minutes to deliver reliable lidar products, while the typical temporal scale of cloud variability is much shorter than that (29). Recently, a dual-FOV polarization lidar technique was reported, which continued and further developed the concept of the dual-FOV Mie lidar (39). However, to assess ACI this method requires a priori assumptions about the lidar ratio and subadiabatic cloud conditions. The impact of the a priori assumptions on the aerosol and cloud retrievals has been widely discussed (10, 40, 41). In general, all existing multiple-FOV lidar-based techniques have their advantages and also limitations.To overcome this conundrum, a dual-FOV high-spectral-resolution lidar (HSRL) technique for profiling aerosol and cloud properties simultaneously is introduced here. It provides lateral observations of aerosols and clouds with high vertical and temporal resolutions during daytime and nighttime. Neither assumptions on thermodynamic conditions nor lidar ratio are required. This work benefited from the range-resolved observations of water clouds with high resolution, revealing that the observed profiles of low-level water cloud microphysical properties are not perfectly adiabatic as assumed by many current retrievals (42–46). Furthermore, the ACI analysis supports the hypothesis that aerosol-induced water decrease by enhanced evaporation can cancel out the increase caused by suppressed rain formation (6, 47), while most current global general circulation models (GCMs) suggest that increased aerosol loading typically causes increased cloud water content (19, 48). Thus, these observations obtained from the dual-FOV HSRL can constitute a substantial and significant addition to our understanding of ACI studies. We believe that this versatile system will not only benefit the quality monitoring of aerosol and cloud properties but also serve as a powerful tool for ACI studies.     

CX26基因在非综合征型耳聋中的产前诊断及早期干预

目的：对非综合征型耳聋家系进行CX26基因的突变检测,对检测出CX26基因突变的家系进行产前诊断并实施早期干预。方法：对来自国内十多个省份的100个非综合征型耳聋家系中的先证者通过聚合酶链反应、单链构像多态性分析以及直接测序法进行CX26基因的突变检测,对确诊为CX26基因所致的遗传性耳聋家系中的一成员在妊娠时通过脐静脉穿刺术抽取脐胎血进行产前诊断及早期干预。结果：①发现CX26基因的致病性突变1种：cDNA编码区233～235位点c的纯合缺失;多态6种：G79A、G109A、A341G、G442A、G506A和T608C;②对一个确诊为CX26基因233~235delC的遗传性聋家系的成员于第2次妊娠时进行产前诊断,发现胎儿具有同种致病性突变。结论：①CX26基因cDNA编码区233～235位点C的杂合缺失不致聋,纯合缺失可导致非综合征型常染色体隐性遗传性聋;②产前诊断和早期干预可预防遗传性聋。这是我国首次确诊携带耳聋致病基因的胎儿并实施早期干预。     

电子胎心监护Ⅱ类图形反复性变异减速产妇分娩终止时限对新生儿结局的影响

目的 探讨电子胎心监护(EFM)Ⅱ类图形反复性变异减速(VD)产妇的分娩终止时限对新生儿结局的影响.方法 选择2015年1月1日至2018年12月31日在北京市通州区妇幼保健院住院分娩,并且胎儿心率出现EFMⅡ类图形反复性VD的829例产妇为研究对象.其中,胎儿心率发生轻、中、重度反复性VD的产妇分别为392、246及...     

药品标准中替代对照品研究技术要求探讨

近年来,以标准物质为对照而建立的各种色谱技术在中药和天然药物分析方面有广泛的应用,但是对照物质的缺乏严重妨碍了中药及天然药物质量控制工作的顺利开展。研究并寻找适当的替代品是解决以上问题的有效途径之一。为了统一并规范药品标准中替代对照品的研究,本文对对照品替代法的应用情况及相关技术要求进行了探讨,以供开展此项研究工作参考。     

国家药品标准物质协作标定的技术要求与管理程序

目的 规范国家药品标准物质协作标定的技术要求与管理程序,保证国家药品标准物质特性量值的准确性.方法 详细介绍协作标定的技术要求与管理程序.结果与结论 建立国家药品标准物质协作标定的技术要求与管理程序有助于协作标定参加实验室正确实施与理解药品标准物质的协作标定工作.     

医护一体化防栓体系在骨科病房临床应用的研究

目的探讨骨科医护一体化静脉血栓栓塞症(VTE)防控体系的临床应用价值。 方法收集暨南大学附属顺德医院2015年10月至2019年3月收治的骨科患者临床病历资料,纳入受伤至入院时间≤24 h、于骨科行手术治疗且病历资料完整、年龄≥ 18岁的患者;排除入院前已患有VTE、正在使用抗凝药物、有严重精神障碍的患者、以及有VTE药物和物理防治禁忌的患者。选取2017年12月至2019年3月实施VTE防控体系后收治的215例患者作为研究组,选取2015年10月至2017年11月实施VTE防控体系前收治的180例患者作为对照组,所有患者均获得3个月以上的随访,对两组患者VTE防治的依从性,下肢深静脉血栓形成(DVT)、肺血栓栓塞症(PTE)的发生率和死亡率,大出血事件的发生率,与VTE相关的医疗纠纷发生率均采用χ²检验进行比较分析;住院时间采用t检验进行比较分析。 结果研究组VTE防治的依从性为93.0%,对照组为5.0%(χ²＝304.680,P<0.05)。研究组DVT、PTE发生率、死亡率分别为2.8%、0、0,对照组DVT、PTE发生率、死亡率分别为16.1%、3.3%、2.8%(χ²＝21.526、5.219、4.030,P<0.05)。研究组大出血事件的发生率两组比较差异无统计学意义(χ²＝0.106,P>0.05)。研究组VTE相关的医疗纠纷发生率为0,对照组为2.8%,两组比较差异有统计学意义(χ²＝4.030,P<0.05)。研究组患者住院时间(14.0±3.0)d少于对照组的(15.7±3.4)d(t＝2.622,P<0.05)。 结论骨科医护一体VTE防控体系的实施可有效提高患者VTE防治的依从性,降低VTE、PTE发生率、死亡率及VTE相关的医疗纠纷发生率,缩短住院时间,不增加大出血事件的发生率,具有良好的临床应用价值。     

Edaravone inhibits procaspase-3 denitrosylation and activation through FasL-Trx2 pathway in KA-induced seizure

Previous studies have demonstrated that excessive free radicals play an essential role in the initiation and progression of epilepsy and that a novel exogenous free radical scavenger edaravone (Ed) exerts some neuroprotective effects on seizure-induced neuronal damage. The purpose of this study was to elucidate the possible molecular mechanisms of Ed associated with procaspase-3 denitrosylation and activation through the FasL-Trx2 pathway in seizures rats. In this study, we investigated the effects of Ed on the regulation of the combination of Fas ligand/Fas receptor and the major components of the death-inducing signaling complex (DISC) in the hippocampus of kainic acid (KA)-treated Sprague Dawley (SD) rats. Treatment with Ed can attenuate the increased expression of FasL induced by KA and prevent procaspase-3 denitrosylation and activation via suppression of the FasL-Trx2 signaling pathway, which alleviates the neuronal damage in seizures. These results provide experimental evidence that Ed functions by preventing the denitrosylation and activation of procaspase-3 and that Ed acts as a therapeutic option for epilepsy.     

雷公藤多苷联合泼尼松治疗IgA肾病的临床疗效及其对尿Smad2和TGF-β1的影响

目的 探讨雷公藤多苷联合泼尼松治疗IgA肾病的临床效果及其对尿Smad2和TGF-β1的影响.方法 选取于福建医科大学附属泉州第一医院就诊的IgA肾病患者共155例,随机分为3组,分别为雷公藤多苷组51例、泼尼松组52例和联合组52例,其中雷公藤多苷组失访1例,泼尼松组因严重感染退出研究2例,联合组因严重感染退出研究2...