The role of melatonin and cortisol circadian rhythms in the pathogenesis of infantile colic

Background

Despite the high prevalence of infantile colic, the pathogenesis remains incompletely understood. Cortisol and melatonin hormones affect gastrointestinal system development in several ways, and interestingly, both cortisol and melatonin’s circadian rhythms begin around the 3rd month in which infantile colic symptoms start to decrease. We hypothesized that infantile colic might associate with desynchronization of normal circadian rhythms of these hormones. In this study, we aimed to investigate the role of melatonin and cortisol in the pathogenesis of infantile colic.

Methods

Patients who were diagnosed as infantile colic according to Wessel’s “rule of three” were enrolled in the colic group. We measured the saliva melatonin and cortisol levels of colic group and control group infants. In both groups, the saliva samples were taken in mornings and at evenings, at the time of diagnosis and 6th month.

Results

Fifty-five infants finished the study. Melatonin circadian rhythm developed earlier in the control group than the infantile colic group in our study. We found no significant difference between the daily mean cortisol levels. However, infants with colic had flatter daily cortisol slope than controls which pointed out the probability that they had a less clearly defined cortisol rhythm than infants without colic.

Conclusions

We found an association between melatonin levels and infantile colic. However, more research is needed to fully understand the role of hypothalamic–pituitary–adrenal axis and hormone’s role on infantile colic physiopathology.

     

The finite element analysis of the effect of ferrule height on stress distribution at post-and-core-restored all-ceramic anterior crowns

The purpose of this study was to compare the effect of ferrule with different heights on the stress distribution of dentin and the restoration-tooth complex, using the finite element stress analysis method. Three-dimensional finite element models simulating an endodontically treated maxillary central incisor restored with an all-ceramic crown were prepared. Three-dimensional models were varied in their ferrule height (NF: no ferrule, 1F: 1-mm ferrule, and 2F: 2-mm ferrule). A 300-N static occlusal load was applied to the palatal surface of the crown with a 135° angle to the long axis of the tooth. In addition, two post and core materials with different elastic modulus were evaluated. The differences in stress transfer characteristics of the models were analyzed. Maximum stresses were concentrated on force application areas (32.6–32.8 MPa). The stress values observed with the use of a 2-mm ferrule (14.1/16.8 MPa) were lower than the no-ferrule design (14.9/17.1 MPa) for both the glass fiber-reinforced and zirconium oxide ceramic post systems, respectively. The stress values observed with zirconium oxide ceramic were higher than that of glass fiber-reinforced post system. The use of a ferrule in endodontically treated teeth restored with an all-ceramic post-and-core reduces the values of von Mises stresses on tooth-restoration complex. At rigid zirconium oxide ceramic post system, stress levels, both at dentin wall and within the post, were higher than that of fiber posts.     

自助推药器在子宫输卵管造影中的应用

目的探讨将自助推药器应用于数字X射线机下,取代人工推注造影剂行子宫输卵管造影术的可行性。 方法采用最新自制的自助推药器对270例不孕症患者进行输卵管造影术（本研究遵循的程序符合安徽医科大学附属安庆医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象知情同意,并与之签署临床研究知情同意书）。 结果本组270例患者全部获得满意的实时图像。 结论自助推药器构造简单、成本低、操作简单、安全可行、能避免医务人员受到辐射,值得在临床推广。     

Slow Pathway Radiofrequency Ablation in Patients with AVNRT: Junctional Rhythm is Less Frequent during Magnetic Navigation Ablation Than with the Conventional Technique

Introduction: The occurrence of accelerated junctional rhythm (JR) during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT) is frequent. The aim of the present study was to compare the occurrence of JR during magnetic remote catheter ablation to the conventional manual ablation.
Methods and Results: Twenty six patients (males: seven; age: 51 ± 15 years) underwent slow pathway ablation with magnetic navigation (MN) system (Niobe, Stereotaxis Inc., St. Louis, MO, USA) and were compared to a control group of 11 patients (males: three; age: 53 ± 16 years) treated with conventional manual ablation. A 4-mm nonirrigated tip catheter was used in both groups with a maximum of 30 W and 60°C. Acute success was obtained in all patients. In the MN group, three patients out of 24 had no junctional beat (JB) at all and seven patients had 10 or less JB. In contrast, in the conventional group no patient had less than 10 JB. The mean number of JB in the MN group was 66 ± 94.9 (0–410) and 200 ± 243.1 (43–914) in the control group (P = 0.019). In the MN group one patient had a first-degree atrioventricular block. No other complication occurred.
Conclusions: Magnetic remote catheter ablation of AVNRT is effective and is associated with less JB than the manual conventional technique. Therefore, JB may not be considered as a mandatory indicator for successful AVNRT ablation with MN system. (PACE 2010; 11–15)     

北京市托幼机构卫生质量调查

目的了解北京市托幼机构卫生质量情况,为加强托幼机构卫生管理提供依据。方法采用现场调查和采样检测方法,依据相关法规要求对北京市1059所托儿所、幼儿园进行了卫生质量调查。结果北京市托幼机构室内空气卫生质量合格率平均在87%以上。工作人员手和物体表面卫生质量合格率平均在80%以上。幼儿用餐饮具合格率平均在93%以上。结论北京市托幼机构整体卫生质量较好,幼儿餐饮具细菌检验卫生合格率达到93%以上,室内空气、工作人员手和物体表面卫生质量平均合格率呈逐年上升趋势。     

Noise levels in neonatal intensive care unit and use of sound absorbing panel in the isolette

Objective

The purposes of this study were to measure the noise level of a busy neonatal intensive care unit (NICU) and to determine the effect of sound absorbing panel (SAP) on the level of noise inside the isolette.

Methods

The sound pressure levels (SPL) of background noise, baby crying, alarms and closing of isolette's door/portholes were measured by a 2235-Brüel&Kjaer Sound Level Meter. Readings were repeated after applying SAP (3D pyramidal shaped open cell polyurethane foam) to the three lateral walls and ceiling of the isolette.

Results

The median SPL of background noise inside the NICU was 56 dBA and it decreased to 47 dBA inside the isolette. The median SPL of monitor alarms and baby crying inside the isolette were not different than SPL measured under radiant warmer (p > 0.05). With SAP, the median SPL of temperature alarm inside the isolette decreased significantly from 82 to 72 dBA, monitor alarm from 64 to 56 dBA, porthole closing from 81 to 74 dBA, and isolette door closing from 80 to 68 dBA (p < 0.01). There was a significant reduction in the noise produced by baby crying when SAP was used in the isolette (79 dBA vs 69 dBA, respectively) (p < 0.0001). There was also significant attenuation effect of panel on the environmental noise.

Conclusions

The noise level in our NICU is significantly above the universally recommended levels. Being inside the isolette protects infants from noise sources produced outside the isolette. However, very high noises are produced inside the isolette as well. Sound absorbing panel can be a simple solution and it attenuated the noise levels inside the isolette.     

Selective activation, expansion, and monitoring of human iNKT cells with a monoclonal antibody specific for the TCR alpha-chain CDR3 loop

A significant fraction of CD1d-restricted T cells express an invariant T cell receptor (TCR) alpha-chain. These highly conserved invariant NKT (iNKT) populations are important regulators of a wide spectrum of immune responses. The ability to directly identify and manipulate iNKT cells is essential to understanding their function and to exploit their therapeutic potential. To this end, we sought monoclonal and polyclonal antibodies specific for iNKT cells by immunizing CD1d KO mice, which lack iNKT cells, with a cyclic peptide modeled after the TCRalpha CDR3 loop. One mAb (6B11) was specific for cloned and primary human but not rodent iNKT cells and the human invariant TCRalpha, as shown by transfection and reactivity with human invariant TCRalpha transgenic T cells ex vivo and in situ. 6B11 was utilized to identify, purify, and expand iNKT cells from an otherwise minor component of human peripheral blood lymphocytes and to specifically identify human iNKT cells in tissue. Thus, we report a novel and general strategy for the generation of mAb specific for the CDR3 loop encoded by the TCR of interest. Specifically, an anti-Valpha24Jalpha18 CDR3 loop clonotypic TCR mAb is available for the enumeration and therapeutic manipulation of human and non-human primate iNKT populations.     

早产儿早期振幅整合脑电图特点的分析

目的 探讨早产儿早期振幅整合脑电图(aEEG)背景波的活动特点,为早产儿脑成熟度的判断提供一定的参考。方法 选取胎龄为25~36+6周早产儿160例为研究组,根据胎龄分为＜28周组,28~30+6周组,31~33+6周组,34~36+6周组4个组;无颅脑疾病的足月新生儿40例为对照组。应用Olympic CFM 6000在两组新生儿出生后72h内进行脑功能监测。分析指标包括电压的连续性、睡眠周期、波谱带下界振幅值及宽度、一个睡眠周期的时程。将早产儿不同胎龄组结果进行对比分析,并分别与对照组结果进行对比分析,比较不同胎龄早产儿aEEG背景波活动的特点。结果 随着胎龄的增加,研究组aEEG背景波中连续性电压所占的比例逐渐增大(P＜0.01),而对照组均呈连续性图形,两组间差异有统计学意义(P＜0.01);研究组周期出现率逐渐增加(P＜0.01),对照组均出现成熟的周期变化,两组间差异有统计学意义(P＜0.05);随着胎龄的增加,波谱带下界振幅有升高趋势,早产儿各胎龄组间比较,下界振幅值在活动睡眠(AS)期差异有统计学意义(P＜0.01);带宽趋于变窄,早产儿各胎龄组间差异有统计学意义(P＜0.01);一个睡眠周期的时程趋于变短,早产儿各胎龄组间差异有统计学意义(P＜0.01);早产儿各胎龄组相关值分别与对照组比较,差异有统计学意义(P＜0.05)。结论 胎龄越大的早产儿,其aEEG背景波越趋于成熟,说明aEEG能够较好的反映早产儿的脑成熟度,应用于临床早产儿脑功能的监测。