Sedation with sufentanil and midazolam decreases pain in patients undergoing upper limb surgery under multiple nerve block

Multiple nerve blocks may be painful and a source of discomfort. We assessed the efficacy of sufentanil 5 microg combined with midazolam 1 mg in decreasing pain in outpatients after a midhumeral multiple nerve stimulation technique. Visual analog scores for pain were significantly lower in those patients who received sedation before the block, both at the time of block performance (14 +/- 1 vs 27 +/- 2 mm, P < 0.0001) and at discharge (11 +/- 1 vs 24 +/- 2 mm, P < 0. 0001). We conclude that the association of sufentanil and midazolam produced minimal sedation while significantly reducing pain experienced by patients undergoing multiple nerve stimulation.     

中医疾病证候学研究方法初探

此次调查在西医辨病的基础上,以中医辨证理论方法为核心,按照事先设计的方案,收集特定时间内膝关节骨关节炎患者的病状,先进行计量诊断确立辨证要素,再进行聚类分析及logistic回归分析等筛选出特异性较高的症状,为疾病辨证分型、辨证标准的阐明提供依据.是一种值得介绍的中医证候研究方法.     

弦滑脉辨析--与傅文胜、薄震东、孙建中商榷

《中医杂志》1991年第2期薄震东、孙建中的《“弦滑”脉之管见》(以下简称《管见》)，与2000年第9期傅文胜的《脉弦滑质疑》(以下简称《质疑》)，从不同角度论述了相同的观点：弦、滑脉不能相兼。细阅两文，笔者发现两文中颇多错讹之处。两文作者对弦、滑两种脉象都尚未了解清楚。王叔和说脉诊是“在心易了，指下难明。”倘若在心还尚未“了”，指下又岂能“明”?为免贻误后学，不能不就弦、滑脉象作进一步辨析。     

Different classes of antibiotics exhibit disparate negative impacts on the therapeutic efficacy of immune checkpoint inhibitors in advanced non-small cell lung cancer patients

It has been reported that antibiotics (ATBs) have adverse effect on the efficacy of treatment with immune checkpoint inhibitors (ICIs) in cancer patients. Since different classes of ATBs have different antibacterial spectrum, we aimed to study whether all ATBs had similar or different negative effects on the clinical outcomes of ICIs in patients with advanced non-small cell lung cancer (NSCLC). Patients with advanced NSCLC who received ICIs were included in this retrospective study and grouped by the class of ATBs they had used around the ICIs treatment time. The overall survival (OS) and the progression free survival (PFS) of patients among these groups were compared using Kaplan-Meier method and Cox proportional hazards model. A total of 148 eligible patients were enrolled, and 80 patients used ATBs. The results indicated that quinolones had no significant negative consequence on the clinical outcomes, while β-lactams significantly shortened the OS and PFS of patients. Furthermore, patients exposed to the combination of β-lactams and quinolones suffered the worst OS and PFS. Moreover, the subgroup analysis of β-lactams revealed that only penicillins, but not carbapenems and cephalosporins, markedly reduced both OS and PFS. In addition to the class of ATBs used, the time frame of ATBs used also affected the clinical outcomes of ICIs therapy. Patients receiving ATBs within 60 days prior to and 30 days after the initiation of ICI treatment had significantly shorter OS and PFS compared with those who did not use ATBs. This study demonstrated that different classes of ATBs had disparate negative impacts on the clinical outcomes, and the use of β-lactams, especially penicillins, should be avoided in advanced NSCLC patients who are receiving or scheduled to receive ICIs within 60 days.     

小脑参与认知功能机制的研究进展

认知是指人脑为获取和应用知识,将外界信息转化成内在心理活动的复杂过程。自 1998年Schmahmann和Sherman提出“小脑认知-情感综合征”起,小脑认知功能的研究越来越受到关注。 本文通过回顾国内外相关研究,从小脑的解剖与认知功能、小脑的神经网络机制以及交叉性小脑神经 机能联系不能 3 个角度探讨了小脑在认知神经网络中的作用及机制,旨在提高对小脑参与认知功能的 认识。     

腓骨髓内钉与切开复位钉板系统治疗腓骨远端骨折的疗效分析

目的 比较腓骨髓内钉与切开复位钉板系统治疗腓骨远端骨折的疗效.方法 回顾性分析2017年10月至2019年10月于锦州医科大学附属第一医院采用手术治疗腓骨骨折的患者,按照纳入、排除标准筛选病例,最终A组髓内钉组25例纳入研究、B组钉板内固定组35例纳入研究.比较两组入院至行腓骨手术的时间,手术时长,腓骨术口总长度,AO...     

Identification of Inhibitors and Drug Targets for Human Adenovirus Infections

Adenoviruses can cause infections in people of all ages at all seasons of the year. Adenovirus infections cause mild to severe illnesses. Children, immunocompromised patients, or those with existing respiratory or cardiac disease are at higher risk. Unfortunately, there are no commercial drugs or vaccines available on the market for adenovirus infections. Therefore, there is an urgent need to discover new antiviral drugs or drug targets for adenovirus infections. To identify potential antiviral agents for adenovirus infections, we screened a drug library containing 2138 compounds, most of which are drugs with known targets and past phase I clinical trials. On a cell-based assay, we identified 131 hits that inhibit adenoviruses type 3 and 5. A secondary screen confirmed the antiviral effects of 59 inhibitors that inhibit the replication of adenoviruses type 3 or 5. Most of the inhibitors target heat shock protein, protein tyrosine kinase, the mTOR signaling pathway, and other host factors, suggesting that these host factors may be essential for replicating adenoviruses. Through this study, the newly identified adenovirus inhibitors may provide a start point for developing new antiviral drugs to treat adenovirus infections. Further validation of the identified drug targets can help the development of new therapeutics against adenovirus infections.     

Early Age Shrinkage and Mechanical Effect of Ultra-High-Performance Concrete Composite Deck: A Case Study with In Situ Test and Numerical Simulation

For the Honghe Bridge project located in Yunnan Province, Southwest China, a steel/ultrahigh-performance concrete (UHPC) composite deck is used in the suspension bridge with a 700 m main span, and the steel stud connectors are used in the 50 mm–thick UHPC layer. To investigate the shrinkage behavior of UHPC and the relevant influence, the in situ time-dependent strain is measured continuously, and within the 20-day curing time, the material behavior is summarized based on test results. This paper proposes a prediction model for UHPC shrinkage which is refined from the widely used B3 model for normal concrete material, and the parameter values are modified and optimized by experimental comparison. Combining the numerical model and the finite element analysis model of the composite deck, the detailed mechanical state in structural parts is studied. For the practical construction, the simulation results indicate that the small thickness of UHPC above the stud and weak bond strength can influence the eventual structural performance greatly. In the discussion of stress distribution at different locations of the deck, the potential crack on the edge and the corner of the UHPC–steel interface and the mechanical damage on the stud connector around are also indicated.     

酸枣仁中黄酮类镇静催眠有效成分的研究

本文对辽宁产的酸枣仁中的黄酮类成分进行了初步研究,从中分离出一种淡黄色无定形粉末,经鉴定为黄酮碳甙(spinosin)。动物实验证明,酸枣仁中镇静催眠作用的成分不仅是皂甙成分,黄酮也是主要成分之一。     

驳骨煎剂促进骨折愈合的实验研究

为探讨驳骨煎剂促进骨折愈合的作用机理。选用体重２０－３０ｇ的ＮＩＨ小白鼠１２０只,雌雄各半,随机分为正常组,给药组、对照组。除正常组外,其它各组均采用定点手法折骨术造成小鼠右下肢胫骨中段闭合性骨折,术后７、１４、２１、２８天分批处死小鼠,处死前４８小时,经腹腔注射同一批号０．２ｍｌ＾４５Ｃａ－ＣａＣｌ２溶液,４８小时后,断头取向,并解剖出左右胫骨,测定骨痂生长状况及钙沉 积量的变化。结果显示,给药