Ambient mass spectrometry for rapid diagnosis of psychoactive drugs overdose in an unstable patient

A 25-year-old man suffered from consciousness change was sent to our emergency department by friends who reported that they were not sure what had happened to him. Physical examination revealed bilateral pupils dilatation, lethargy, slurred speech, and ataxia. Computer-aided tomographic scan of the brain revealed no definite evidence of intracranial lesions. Routine laboratory tests revealed total physiological turmoil. Despite immediate commencement of aggressive treatment, the patient's condition deteriorated long before the traditional drug screen provided an answer for the identities of the multiple drugs overdose. It ended up with the need for cardiopulmonary resuscitation, but in vain. At the end of the tragic event, under the suggestion of a colleague, a portion of the patient's urine specimen was sent to our university esoteric laboratory for rapid analysis by means of a newly-developed thermal desorption-electrospray ionization-mass spectrometry. Ketamine, 3,4-methylenedioxymethamphetamine, and 3,4-methylenedioxyamphetamine were identified in the urine sample within 30 s. Conventional toxicological testing techniques like gas chromatography–mass spectrometry or liquid chromatography-mass spectrometry are currently used for identifying abused drugs. One concern is their time-consuming sample pretreatment which leads to relatively low efficiency in terms of turnaround time for revealing the identity of the consumed drugs particularly when the patients are severely overdosed. We learned a lesson from this case that a more efficient toxicological identification technique is essential to expedite the process of emergency care when the patients are so heavily overdosed that they are under critical life-threatening conditions.     

管通汤对射血分数保留的心力衰竭患者运动耐量和生活质量的影响

目的 观察在现代医学治疗的基础上联合管通汤治疗对射血分数保留的心力衰竭(HFpEF)患者运动耐量和生活质量的影响.方法 选取气虚血瘀、痰浊内阻型HFpEF患者共80例,随机分为管通组和对照组,每组均观察40例;对照组在观察期间予以依那普利、酒石酸美托洛尔、螺内酯,有水钠潴留症状时予以呋塞米利尿;管通组在对照组基础上予以...     

生草乌及配伍诃子的整合TK-TD模型研究

目的:应用整合的毒物代谢动力学(TK)-毒物效应动力学(TD)模型作为一种新的定量框架来评估生草乌引起的异常心率(HR)合并QT间期变化.初步应用于探讨草乌诃子1∶1、1∶3、3∶1配伍后的TK-TD拟合,进一步研究诃子草乌配伍减毒存效可能的机制.方法:建立TK-TD结构模型和原假设H0:Σ=S,采用Amos 24...     

反射式共聚焦显微镜在炎症性皮肤病诊疗中的应用

反射式共聚焦激光扫描显微镜(RCM)作为一种在体无创性皮肤检查设备,能够实时动态反应细胞形态及皮肤结构的变化,在某些皮肤病中其图像特征与组织病理学检查结果具有高度的一致性,本文就RCM在炎症性皮肤病的诊断、疗效评价和疾病进展中的应用作一综述。     

Effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer

AIM:To investigate the effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer.METHODS: Sprague-Dawley rats were randomly divided into four groups: sham operation without ginkgo, sham operation with ginkgo, duodenal ulcer without ginkgo, and duodenal ulcer with ginkgo. Rats with duodenal ulcer were induced by 500mL/L acetic acid. Rats with ginkgo were intravenously injected with Ginkgo biloba extract from the tail at a dose of 0.5mg/(kg·d) for 7 and 14 days.RESULTS:Pathological result showed that duodenal ulcer rats with ginkgo improved mucosal healing and inflammation compared with those without ginkgo after 7d treatment. After 14d treatment, duodenal ulcer rats with ginkgo significantly increased weight gain (34.0±4.5g versus 24.5±9.5g,P<0.05) compared with those without ginkgo. Duodenal ulcer rats significantly increased cell proliferation (27.4±4.0 and 27.8±2.3 BrdU-labeled cells in duodenal ulcer rats with and without ginkgo versus 22.4±3.5 and 20.8±0.5 BrdUlabeled cells in sham operation rats with and without ginkgo,P<0.05) compared with sham operation rats.Mucosal prostaglandin E2 concentration significantly increased by 129% (P<0.05) in duodenal ulcer rats with ginkgo compared with that in those without ginkgo. Duodenal ulcer rats without ginkgo significantly decreased superoxide dismutase activity in the duodenal mucosa and erythrocytes (19.4±6.7U/mg protein versus 38.1±18.9U/mg protein in the duodenal mucosa,and 4.87±1.49 U/rng protein versus 7.78±2.16U/rng protein in erythroo/tes, P<0.05) compared with sham operation rats without ginkgo. However, duodenal ulcer rats with ginkgo significantly increased erythrocyte superoxide dismutase activity (8.22±1.92 U/mg protein versus 4.87±1.49U/mg protein,P<0.05) compared with those without ginkgo. Duodenal ulcer rats without ginkgo significantly increased plasma lipid peroxides (4.18±1.12 μmol/mL versus 1.60±1.10μmol/mL and 1.80±0.73μmol/mL, P<0.05) compared with sham operation rats without ginkgo and duodenal ulcer rats with ginkgo during the experimental period.CONCLUSION: Ginkgo biloba extract can improve weight gain and mucosal healing in duodenal ulcer rats by the actions of cytoprotection and antioxidation.     

Transient pancytopenia preceding T lineage acute lymphoblastic leukemia

Transient pancytopenia preceding acute lymphoblastic leukemia (pre-ALL) is a rare occurrence usually affecting children with subsequent development of B lineage ALL. We report a case of pre-ALL characterized by a T cell immunophenotype and abnormal karyotype t (11; 14) (q10; q10). The patient achieved a transient complete remission after initial therapy, but relapsed within a few months and died of leukemic encephalopathy. To the best of our knowledge, this is the first report of T lineage pre-ALL.     

MicroRNA‐7 negatively regulates Toll‐like receptor 4 signaling pathway through FAM177A

Toll‐like receptor (TLR) 4 signalling is critical for innate immunoinflammatory response and widely triggers the development of various types of clinical diseases. MicroRNA‐7 (miR‐7) is well documented to play an important regulatory role in various biological events. However, the exact role of miR‐7 in TLR4 signalling pathway remains to be fully elucidated. In the present study, we found that miR‐7 expression in TLR4 signalling‐activated bone marrow‐derived macrophages (BMDMs) stimulated by LPS was dramatically increased. Importantly, miR‐7 deficiency significantly enhanced the production of related inflammatory cytokines including IL‐1β, IL‐6 and IL‐12, as well as TNF‐α, on LPS‐activated BMDMs, accompanied by elevated transduction of TLR4 signalling including Myd88‐dependent and Myd88‐independent pathways, whereas miR‐7 overexpression significantly decreased the transduction of TLR4 signalling and the production of related inflammatory cytokines. Mechanistically, we identified family with sequence similarity 177, member A (FAM177A) as a novel target molecule of miR‐7. Furthermore, down‐regulation of FAM177A using RNAi could impair the transduction of TLR4 signalling. Finally, down‐regulation of FAM177A also reversed the effect of miR‐7 deficiency on TLR4 signalling transduction and production of related inflammatory cytokines on BMDMs. Therefore, we provide the new evidence that miR‐7 acts as a novel negative fine‐tuner in regulating TLR4 signalling pathways by targeting FAM177A, which might throw light on the basal understanding on the regulatory mechanism of TLR4 signalling and benefit the development of therapeutic strategies against related clinical diseases.     

54例原发ANCA相关性小血管炎的肾脏病理及预后的分析

目的探讨原发小血管炎肾脏病理特点及与肾功能预后的关系。方法 54例确诊并行肾活检的原发AN-CA相关小血管炎患者,分别按年龄及性别分组,对比统计各组病理类型和病理特点并随访。结果①肾脏病理类型检出率最高的是硬化性和轻度系膜增生性肾炎各占22.2%,其次是局灶节段硬化性肾炎（18.5%）;60岁以上组轻度系膜增生的患者比例偏高,P=0.05;②肾脏病理急慢性损害检出率较高为：中重度间质炎细胞浸润（48.1%）,中重度间质小管损害（46.3%）,纤维新月体（38.9%）,中重度增生硬化（35.2%）,细胞性新月体（24.1%）,袢坏死检出率（14.8%）;各年龄段相比,中重度增生硬化在30岁以下检出率相对较高,差异有统计学意义,P〈0.05;③随访1年,9例进入尿毒症期（16.7%）。发生尿毒症的相关风险是肾脏慢性指数,P〈0.05。结论肾小球硬化及严重的肾脏病理损害发生率高尤以年轻患者多见;发生终末期肾的相关风险因素是肾脏慢性指数。     

门诊高血压病患者的认知行为调查和分析

目的 了解门诊高血压病患者的认知及自我管理水平.方法 自行设计调查表,包括高血压病相关知识10条目、自我管理行为7条目.对本院门诊高血压病患者500例进行问卷调查.结果 回收有效问卷474份,门诊高血压病患者对高血压病相关知识的知晓率为20.04％～89.03％,自我管理行为能做到的为16.24％～81.01％.结论 ...