玻璃化冷冻胚胎和新鲜胚胎移植的临床结局比较

目的 探讨玻璃化冷冻胚胎移植(FET)和新鲜胚胎移植(NET)的临床结局。方法回顾性分析2013年1月至2014年3月在中山大学孙逸仙纪念医院行体外受精-新鲜胚胎移植(IVF-NET)577个周期及单精子卵细胞浆内显微注射-新鲜胚胎移植(ICSI-NET)118个周期、FET 175个周期共870个周期的临床资料,比较NET组和FET组(曾经NET未成功妊娠,后行FET者)的临床特征和助孕结局,再将FET组分为妊娠亚组和未妊娠亚组进一步分析比较。采用二分类logistic回归分析影响妊娠结局的因素。结果 FET组的种植率(26.27% vs. 31.98%,P=0.01)、临床妊娠率(47.43% vs. 65.18%,P<0.001)均明显低于NET组,差异均有统计学意义;FET组的流产率(P=0.63)、生化妊娠率(P=0.17)和胎儿出生体重(P=0.33)与NET组相比差异均无统计学意义。FET组中妊娠亚组与未妊娠亚组女方年龄(30.69岁±3.37岁 vs. 32.00岁±5.09岁,P=0.03)的差异有统计学意义;BMI、不孕年限、基础内分泌等指标的差异均无统计学意义。二分类logistic回归分析显示是否行FET(P<0.001)、女方年龄(P<0.001)、BMI(P=0.011)和优质胚胎数(P<0.001)为影响妊娠结局的因素。结论 曾经行NET未成功的妊娠者,随后使用FET者其种植率和妊娠率均较低,但不增加流产率,未影响胎儿出生体重,未发现FET对妊娠结局有不良影响。     

北京、苏州和广州女性产后体重滞留现况与影响因素调查分析

目的了解中国女性产后体重滞留的现况并探索其影响因素。方法采用整群抽样,分别选取北京、苏州、广州产后第0~1、1~2、2~4、4~8个月的女性共578名。通过身体测量记录身高、体重。通过问卷调查并结合医疗记录收集调查对象的一般人口学资料和孕前体重、分娩时体重及相关孕产信息。结果调查对象孕前BMI为(20.8±2.7),产后BMI为(23.4±3.2),体重滞留数随时间逐渐减小。但至产后第4~8个月,仍有78.4%的女性体重滞留,且有53.4%的女性体重滞留数超过5 kg。孕期增重与产后体重滞留相关(P=0.015)。体重滞留者中学历较高者比例较大(P=0.044)。结论中国产后女性存在较为严重的体重滞留问题,孕期过度增重与产后体重滞留关系密切,对围产期女性从怀孕伊始即进行全方位的指导有助于改善体重滞留的现状。     

基于“(3+X)+1”模式的研究生思政课教学创新改革与实践研究

目的:增强研究生思政课教学效果,提高研究生培养质量,同时为高校研究生思政课教学改革提供借鉴。方法:对高校研究生思想政治理论课进行创新改革与实践,分析高校研究生思想政治理论课教学现状,提出高校研究生思政课程"(3+X)+1"教学创新模式的构建。通过实施合班上大讲坛、邀请专家专题讲座、引入多样化实践环节和论文学术不端检测、建立保障机制等手段,总结创新改革取得的成效。结果:"(3+X)+1"模式的研究生思政课教学改革改变了传统理论授课模式,丰富了教学内容,改变了老师强制灌输、研究生被动接受的局面,增进了教、学双方的积极性,有利于教学相长;新模式引入了丰富多彩地实践环节,加深了理论内化,有助于培养研究生的自主学习能力,激发其思维灵活性;论文写作引入论文学术不端检测,端正了研究生学习态度;建立了工作量和津贴计算等有效保障机制,激励教师全身心投入教学。结论:基于"(3+X)+1"模式的高校研究生思政课教学创新改革实践,对增强研究生思政课的教学效果和提高研究生培养质量有着积极促进意义,教改经验可操作性强,继续完善教改模式后将持续实施,亦可向其它高校推广。     

Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre,randomised, double-blinded trial

Purpose

Recent clinical data suggest that terlipressin, a vasopressin analogue, may be more beneficial in septic shock patients than catecholamines. However, terlipressin’s effect on mortality is unknown. We set out to ascertain the efficacy and safety of continuous terlipressin infusion compared with norepinephrine (NE) in patients with septic shock.

Methods

In this multicentre, randomised, double-blinded trial, patients with septic shock recruited from 21 intensive care units in 11 provinces of China were randomised (1:1) to receive either terlipressin (20–160 µg/h with maximum infusion rate of 4 mg/day) or NE (4–30 µg/min) before open-label vasopressors. The primary endpoint was mortality 28 days after the start of infusion. Primary efficacy endpoint analysis and safety analysis were performed on the data from a modified intention-to-treat population.

Results

Between 1 January 2013 and 28 February 2016, 617 patients were randomised (312 to the terlipressin group, 305 to the NE group). The modified intention-to-treat population comprised 526 (85.3%) patients (260 in the terlipressin group and 266 in the NE group). There was no significant difference in 28-day mortality rate between the terlipressin group (40%) and the NE group (38%) (odds ratio 0.93 [95% CI 0.55–1.56]; p?=?0.80). Change in SOFA score on day 7 was similar between the two groups: ??7 (IQR ??11 to 3) in the terlipressin group and ??6 (IQR ??10 to 5) in the NE group. There was no difference between the groups in the number of days alive and free of vasopressors. Overall, serious adverse events were more common in the terlipressin group than in the NE group (30% vs 12%; p?<?0.001).

Conclusions

In this multicentre, randomised, double-blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of serious adverse events.

Trial registration

This trial is registered at ClinicalTrials.gov: ID NCT01697410.

     

心脑宁片对小鼠急性毒性作用的实验研究

目的:观察大剂量心脑宁片对小鼠是否有急性毒性作用。方法:取40只小鼠,雌雄各半,体质量19~22 g,随机分为心脑宁片组和空白对照组,每组20只。心脑宁片组按小鼠最大可给药浓度(0.045 g·L-1),按最大可灌服体积(0.04 m L·g-1)灌服心脑宁片浓缩液;空白对照组按最大可灌服体积(0.04 m L·g-1)灌服生理盐水。并于24 h之内连续给药3次,每次间隔8h。观察14 d内小鼠饮食、毛色、二便、自主活动等一般情况,记录小鼠第7天、第14天小鼠体质量。然后处死小鼠,解剖,观察心、肝、脾、肺、肾、胃、肠、脑等脏器。结果:观察期间小鼠未出现死亡;心脑宁片组仅见小鼠初给药后活动稍有减少,一般给药2 h后小鼠活动恢复正常,第1天可见小鼠小便稍有发黄,饮食和饮水减少,第2天恢复正常;实验第7天、第14天,两组小鼠体质量无显著差异(P>0.05);肉眼未见心、肝、脾、肺、肾、胃、肠、脑等脏器明显异常;小鼠每日积累最大耐受量相当于54g·kg-1,该量为临床用量的600倍。结论:心脑宁片毒性很小,临床用药安全无毒。     

Flake-like InVO4 modified TiO2 nanofibers with longer carrier lifetimes for visible-light photocatalysts

Highly efficient solar light absorption capabilities and quantum yields in photocatalysts are key to their application in photocatalytic fields. Towards this end, TiO₂/InVO₄ nanofibers (NFs) have been designed and fabricated successfully by a one-pot electrospinning process. The resulting TiO₂/InVO₄ NFs display excellent visible-light photocatalytic activity, owing to their prominent visible-light absorption and electron–hole separation properties. Time-resolved transient PL spectroscopy demonstrated that the TiO₂/InVO₄ NFs display longer emission decay times (22.0 ns) compared with TiO₂ NFs (15.5 ns), implying that the heterojunction can remarkably suppress the electron–hole recombination and promote the carrier transfer efficiency. With tailored heterostructure features, TiO₂/InVO₄ NFs exhibit superior visible-light photodegradation activity, and after 80 min of visible-light irradiation, almost 95% of RhB molecules can be decomposed by TiO₂/InVO₄ NFs, while only 18% of RhB molecules can be decomposed by pure TiO₂ NFs.

TiO₂/InVO₄ nanofibers have been designed and fabricated successfully by one-pot electrospinning process, which display longer carrier lifetime (22 ns) and enhanced visible-light photocatalytic activity.     

HSP60 overexpression increases the protein levels of the p110α subunit of phosphoinositide 3‐kinase and c‐Myc

Heat shock protein 60 (HSP60) is a chaperone protein which plays an essential role in facilitating the folding of many newly synthesized proteins to reach their native forms. Increased HSP60 expression is observed in various types of human cancers. However, proteins induced by HSP60 to mediate transformation remain largely unknown. Here we show that HSP60 overexpression increases the protein levels of the p110α subunit of phosphoinositide 3‐kinase (PI3K). The amino acid domain 288‐383 of HSP60 is used to increase the protein levels. Overexpression of HSP60 also induces the levels of phosphorylated Akt. In addition, the amino acid domain 288‐383 of HSP60 is used to induce c‐Myc expression. Finally, a mono‐ubiquitinated form of β‐catenin has a higher activity to activate β‐catenin downstream targets compared to wild‐type β‐catenin. These results indicate that HSP60 overexpression induces the levels or activity of multiple oncogenic proteins to mediate transformation.     

盐城市小学生抑郁症状及相关行为研究

目的：了解盐城市小学生抑郁症状发生现况,探讨相关的影响因素。方法采用儿童抑郁量表(CDI)及自编问卷对盐城市2362名小学生进行抑郁症状及其行为生活方式等情况调查。结果盐城市小学生的抑郁症状总体检出率为10.7%,其中男生12.0%,女生10.1%,男生高于女生。多因素 Logistic 分析结果显示,男性、睡眠质量差、不是每天吃早餐、课外学习时间≥2 h/d、每次电脑游戏≥2 h 以及不锻炼是抑郁症状发生的危险因素,OR 值分别为1.34,2.04,4.05,1.65,1.90,1.45。结论合理安排小学生课外学习时间、增加体育锻炼、加强心理疏导以及避免沉溺电脑游戏是避免和预防小学生抑郁症状发生的有效途径。     

18F-FDG PET/CT plays a unique role in the management of Takayasu arteritis patients with atypical manifestations

Clinical Rheumatology - The present study aimed to evaluate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) aiding in diagnosing and evaluating...     

心肾综合征低钠血症患者抗利尿激素测定及高渗盐水强化利尿的疗效

目的:探讨抗利尿激素(ADH)在心肾综合征(CRS)伴低钠血症中的作用及高渗盐水强化利尿(HS aggDiu)对心肾功能和ADH释放的影响。方法:CRS伴低钠血症患者25例,测定其血浆ADH水平。将患者随机分为(HS aggDiu)13例和单纯强化利尿组(aggDiu组)12例,分别给予高渗盐水并大剂量呋塞米静脉滴注和单纯大剂量呋塞米静脉滴注,记录2组患者心肾功能、水钠潴留和血钠的变化。结果:HS aggDiu组尿量增加、体重减轻、血肌酐下降、NYHA心功能分级改善等方面显著改善、水钠潴留减轻,血钠水平升高,其疗效显著优于aggDiu组。同时,血ADH水平并未随着血钠和渗透压的恢复而明显升高,说明HS aggDiu减少了ADH的非渗透性释放。结论:CRS伴低钠血症与ADH的非渗透性释放有关;可有效减轻水钠潴留,改善心肾功能,并减轻ADH的非渗透性释放。