Ketamine inhibits LPS-induced calcium elevation and NF-kappa B activation in monocytes

Objective:To investigate whether ketamine could inhibit lipopolysaccharide (LPS)-induced intracellular calcium elevation and NF-kappa B activation in monocytes. Materials and methods:Isolated rat monocytes were challenged with 10 g/ml LPS with or without the presence of various concentrations of ketamine (10, 100, 1000 M). Intracellular calcium was monitored by laser confocal microscopy. NF-kappa B activity of the nuclear extracts of monocytes was analyzed by electrophoretic mobility shift assay (EMSA). Results:LPS provoked a significant calcium elevation and enhanced NF-kappa B activity in monocytes. Ketamine above concentration of 100 M inhibited endotoxin-induced intracellular calcium elevation and NF-kappa B activity. Ketamine itself had no effect on either of them. Conclusions:These findings suggest that ketamine could suppress NF-kappa B in monocytes exposed to endotoxin, and this anti-inflammatory effect might act through attenuating intracellular calcium elevation.Received 31 October 2003; returned for revision 18 December 2003; accepted by I. Ahnfelt-Rønne 26 Januaryy 2004     

Prevalence and Associated Factors of Sarcopenia in Singaporean Adults—The Yishun Study

ObjectivesTo describe the normative values of sarcopenia among community-dwelling adults (≥21 years of age); compare the prevalence of sarcopenia using Asian Working Group for Sarcopenia criteria, 2014 (AWGS2014), Asian Working Group for Sarcopenia criteria, 2019 (AWGS2019), and European Working Group on Sarcopenia in Older People criteria, 2018 (EWGSOP2) guidelines; and identify factors associated with sarcopenia.DesignParticipants were recruited through random sampling. Sarcopenia assessments were performed using a dual-energy x-ray absorptiometry scan (muscle mass), handgrip test (muscle strength), and usual walking test (physical performance). Questionnaires were administered to evaluate lifestyle and cognition.Setting and ParticipantsIn total, 542 community-dwelling Singaporeans were recruited (21?90 years old, 57.9% women).MethodsWe assessed anthropometry, body composition, and questionnaire-based physical and cognitive factors, and estimated sarcopenia prevalence according to the AWGS2014, AWGS2019, and EWGSOP2 recommendations, and examined associations using logistic regression.ResultsAccording to AWGS2019, the Singapore population-adjusted sarcopenia prevalence was 13.6% (men 13.0%; women 14.2%) overall, and 32.2% (men 33.7%, women 30.9%) in those aged 60 years and above. The cut-offs derived from young adult reference group for low appendicular lean mass index were 5.28 kg/m2 for men and 3.69 kg/m2 for women (lower than AWGS recommended cut-off); for gait speed it was 0.82 m/s, (AWGS2019 recommended cut-off 1.0 m/s, AWGS2014 cut-off was 0.8 m/s); and for handgrip strength it was 27.9 kg/m2 for men and 16.7 kg/m2 for women (close to AWGS2019 recommendation). Age, sex, marital status, alcoholism, physical activity, body mass index, waist circumference, and global cognition were associated with sarcopenia (P < .05).Conclusions and ImplicationsThis is the first study to provide reference values of muscle mass, strength, and gait speed across the adult lifespan of Singaporeans. Using AWGS2019 criteria, sarcopenia is prominent in older age (32.2% in ≥60 years old), but it is already nontrivial (6.9%) among young and middle-age persons. Multidomain lifestyle modifications addressing muscle strength, cognition, and nutrition over the adult lifespan are important to delay the development of sarcopenia.     

立体定向适形放疗对中晚期肝癌的疗效观察

目的评价立体定向适形放疗对中晚期肝癌的治疗效果。方法对中晚期肝癌患者经立体定向适形放疗及肝动脉 栓塞化疗（ＴＡＥ）后癌块最大直径、血清甲胎蛋白（ＡＦＰ）及血白细胞、肝功能的变化情况进行对比分析。立体定向适形放 疗组（Ａ组）２１例,其中肝功能Ｃｈｉｌｄ Ａ级１３例、Ｂ级８例,癌块直径小于５ ｃｍ ２例、大于１０ ｃｍ ６例、５～１０ ｃｍ １３例。 ＴＡＥ组（Ｂ　组）２０例,Ｃｈｉｌｄ Ａ级 １２例、Ｂ级 ８例,癌块直径小于 ５ ｃｍ ５例、大于 １０ ｃｍ ３例、５～１０ ｃｍ １２例。结果两组 瘤体平均直径缩小值、瘤体直径缩小率、血ＡＦＰ降低率、白细胞减少发生率及肝功能改变发生率分别为,Ａ组：（２．５８±１．８０）ｃｍ、 ６６．６７％、８６．６％、１９．０５％和９．５２％;Ｂ组：（１．２０±０．６８）ｃｍ、３０％、４３．７５％、５０％和６０％。两组差异有显著性意义。结论立体定 向适形放疗是治疗不能手术的中晚期肝癌较好的方法之一,且副反应发生率低。     

Pyriform sinus fistula in children: A comparison of endoscopic-assisted surgery and endoscopic radiofrequency ablation

BackgroundPyriform sinus fistula (PSF) is a rare congenital anomaly, and the preferred definitive treatment is yet to be verified. In this study, we investigated the treatment outcomes of PSF specifically comparing endoscopic-assisted surgery and endoscopic radiofrequency ablation (RA).MethodsThe medical records of patients treated for PSF at the Shanghai Children's Hospital between October 2016 and September 2019 were retrospectively evaluated.ResultsThere were 93 girls and 98 boys. The median age at onset and operation was 3 years and 5 years, respectively. Endoscopic-assisted surgery was performed in 143 patients. During the same period, RA was performed in 48 patients, and 10 of them concurrently underwent incision and drainage of neck abscesses. Longer hospital stay was found in the endoscopic-assisted surgery group than in the RA group (10.50 ± 3.93 vs. 5.02 ± 3.30 days, P < 0.001). Postoperative complications were not significantly different between the two groups, except for neck infection (0 vs. 8.3%, P = 0.004). After a median follow-up period of 21 months, no significant difference was found between the two groups in terms of recurrence (1.4% vs. 0, P = 0.560).ConclusionPatients treated with RA had a significantly shorter hospital stay than those treated with endoscopic-assisted surgery. Outcomes of endoscopic-assisted surgery and RA were not significantly different for the management of PSF and treatment method should be tailored to the patient.Level of evidenceIV.     

Retrospective study of functional outcomes and disability after non-ischaemic vascular causes of spinal cord dysfunction

Objective: Describe demographic characteristics, functional outcomes and disability following rehabilitation for non-ischemic vascular spinal cord dysfunction (SCDys).Design: Retrospective, open cohort, case series.Setting: Tertiary rehabilitation unit, Victoria, Australia.Participants: Patients with non-ischemic vascular SCDys admitted over a 21-year-period (01/01/1995–31/12/2015) were identified using International Classification of Diseases codes.Outcome Measures: Demographic characteristics, etiology, neurologic classification, length of stay (LOS), and complications. On admission and discharge, the following were collected: functional independence measure (FIM) motor subscale, details on bowel, bladder, mobility, living arrangement, and support services.Results: 36 patients (female 58%; mean age 69 ± 16 years) were identified. The main causes of non-ischemic vascular SCDys were epidural hematoma (39%), dural arteriovenous fistula (17%), and arteriovenous malformation (11%). 22 cases (61%) were iatrogenic. Most (86%) had incomplete paraplegia. Urinary tract infection was the most common complication (64%). Median LOS in rehabilitation was 68 days. Significant improvement in FIM motor scores was observed from admission (median 25, interquartile range [IQR] 20–38) to discharge (median 69, IQR 38–77) (P < 0.001). On discharge, 4 patients (11%) walked >100 m unaided, 6 (17%) walked >100 m with assistive device, 10 (28%) walked >10 m with assistive device, 15 (41%) were wheelchair dependent and 1 (3%) patient remained non-mobile. 20 patients (56%) were discharged home, 8 (22%) to nursing home, and 8 (22%) transferred to another hospital.Conclusion: Most patients returned home with significantly improved functional outcomes compared to rehabilitation admission, but with the majority having ongoing major disabilities based on FIM motor scores.     

Magnetization of Bauxite Residue to Enhance the Removal Efficiency Towards Heavy Metals

Bauxite residues are a mass of industrial wastes derived from aluminum metallurgy. This work provided a simple pyrolysis method to magnetize the bauxite residue to serve as a magnetic adsorbent towards heavy metals removal. The X-ray diffraction patterns and Mossbauer spectrum results confirmed the partial reduction of iron species with an obvious enhancement in magnetization. The magnetized bauxite residue exhibited excellent removal efficiencies for Cu²⁺, Cd²⁺ and Pb²⁺ with maximum adsorption capacities of 219.0 mg g^?1, 275.4 mg g^?1, and 100.4 mg g^?1, which could be quickly separated through a magnet. The adsorption equilibrium data were fitted to the Langmuir isotherm model, while the adsorption kinetics followed a pseudo-first-order model. According to the characterization results, chemical precipitation and sorption was the major mechanism for the removal of Cu²⁺, Pb²⁺, and Cd²⁺. Thus, the magnetized bauxite residue exhibited promising applications for heavy metals removal in wastewater.

     

胰肾联合移植长期存活的临床研究（附5例报告）

目的 提高糖尿病、糖尿病肾病患者的生活质量,方法 于1998-12/2000-01对5例糖尿病、糖尿病肾病患者施行了胰肾联合移植术,结果 5例患者肾功能恢复正常;其中2例患者分别于8wk,23wk发生急性排斥反应一次,经抗排斥治疗后逆转,2例术后2wk发生纯红再障（pure red cell aplasia,PRCA),1例手术后第15日供胰动脉血栓形成,切除胰腺,经1a以上观察,4例患者健康存活,胰肾功能良好。结论 胰肾联合移植是目前治疗糖尿病、糖尿病肾病最有效的手段。     

p53基因表达，细胞增殖抗原Ki—67与下咽癌关系的探讨

目的 :探讨p53基因、细胞增殖抗原Ki 67在下咽癌临床分期、淋巴结转移及预后中的作用。方法 :应用免疫组织化学LASB法检测 84例下咽鳞癌石蜡标本 ,研究p53蛋白、细胞增殖抗原Ki 67的表达并与临床因素进行统计分析。结果 :下咽癌中p53阳性率为 52 4 % ;Ki 67标示率为 0～ 7% ,平均为 10 63% ,中位数为 7 2 5%。淋巴结转移组与非转移组Ki 67表达差异有显著性 (P <0 0 1)。结论 :p53基因表达可作为下咽癌诊断的标志物之一 ,Ki 67可作为临床预测下咽癌颈淋巴结转移及预后的重要参考指标。     

不育男性精浆转铁蛋白含量与精子顶体形态的关系

目的 :探讨不育男性精浆转铁蛋白 (Tf)含量与精子顶体完整性的关系。方法 :149例不育男性患者按精子密度≥ 2 0× 10 6 / ml和 <2 0× 10 6 / ml分正常精子密度组和少精子组 ,同时进行精浆 Tf和精子顶体完整率 (PIA)分析。结果 :不育男性少精子组精浆 Tf含量显著低于正常精子密度组 (P<0 .0 1) ;正常精子密度的不育男性精子 PIA<80 %组精浆 Tf含量显著低于精子 PIA≥ 80 %组 (P<0 .0 1)。结论 :正常精子密度的不育男性精子 PIA下降与精浆 Tf水平有密切的关系