住院精神病人自杀的临床特点及护理

据统计,因精神疾病导致自杀者占全部自杀者的30%~40%,其中精神分裂症自杀者又占全部精神疾病自杀者的30%,是普通人群的20倍~45倍,且约10%的精神分裂症病人最终死于自杀。因此,了解精神分裂症病人自杀的临床特征,对于预防和减少自杀的发生具有重要意义。1临床资料分析1.1对象选择及分析方法对我院2001年5月—2004年12月住院的23例有自杀行为的精神病人,采用回顾性查阅病历的方法,对性别、年龄、职业、病程、自杀原因及时间、住院时间等等进行统计。1.2一般资料23例病人中,男17例,女6例,年龄18岁~62岁,<20岁的3例,21岁~50岁18例,50岁以上2例;…     

Polyoxymethylene/silica/polylactic acid-grafted polyethylene glycol nanocomposites: structure,morphology, and mechanical properties and ozone and UV durability

Polyoxymethylene (POM) is a semicrystalline thermoplastic that displays high tensile strength, thermal stability, and chemical durability. However, its widespread application is limited by its low elongation at break and thermal durability. In the present study, nanosilica (NS) and polylactic acid-grafted polyethylene glycol (PELA) were used as enhancement additives to improve the performance of POM homopolymer. Specifically, the POM/PELA/NS nanocomposites with a fixed NS content and varying PELA contents were prepared by a melt mixing method. The influence of the additives on the processability, and dynamic thermo-mechanical and tensile properties of the nanocomposites was evaluated by comparing the torque, mixing energy at melt state, storage modulus, shear stress, loss modulus, tan δ, tensile strength, elongation at break and thermal degradation of the nanocomposites. The results showed that the combined addition of NS and PELA enhanced the thermal stability, tensile strength, elongation at break and chemical stability of the POM/PELA/NS nanocomposites owing to the good compatibility between PELA and the POM matrix. Furthermore, the morphology, and UV and ozone durability of POM and the nanocomposites were assessed and discussed.

The combined addition of nanosilica (NS) and polylactic acid-grafted polyethylene glycol (PELA) enhanced some properties of polyoxymethylene (POM).     

黑色先端帽联合窄带光成像在结肠镜检查中的作用

目的评估黑色先端帽辅助结肠镜联合窄带光成像（narrow band imaging,NBI）技术对腺瘤/息肉检出效能的影响。方法连续纳入2016年10月—2018年10月行结肠镜检查的患者,采用随机数字表法分为黑色先端帽组和对照组,黑色端帽组采用黑色先端帽辅助结肠镜联合NBI技术,对照组采用标准白光结肠镜,比较两组的息肉检出率、腺瘤检出率等指标,并进行亚组分析。结果共1 000例患者纳入本研究（每组500例）,黑色先端帽组和对照组近端结肠腺瘤检出率分别为24.2%(121/500)和17.2%(86/500),近端结肠息肉检出率分别为28.8%(144/500)和21.4%(107/500),平均腺瘤检出数分别0.41±0.94和0.26±0.68,平均息肉检出数为0.63±1.16和0.40±0.85,差异均有统计学意义（P均<0.05）,但该联合技术对于远端结直肠病变的检出率相较对照组无明显优势。结论黑色先端帽辅助结肠镜联合NBI能显著提高近端结肠腺瘤和息肉等微小病变的检出效能。     

The effect of short‐term intensive insulin therapy on inflammatory cytokines in patients with newly diagnosed type 2 diabetes

BackgroundDiabetes mellitus was a chronic low‐grade inflammatory disease and had increased circulating inflammatory cytokines and acute phase proteins. We aimed to identify the changes of inflammatory cytokines in newly diagnosed type 2 diabetic patients after short‐term intensive insulin therapy using continuous subcutaneous insulin infusion (CSII).MethodsThirty‐three newly diagnosed type 2 diabetic patients were enrolled between September 2020 to December 2020. Expression of 40 inflammatory cytokines of the patients were tested with RayBiotech antibody array before and after 1 week of intensive insulin therapy of CSII. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was carried out to explore the signaling pathway involved in the therapy.ResultsFive inflammatory cytokines were downregulated significantly after 1 week of CSII therapy. They were interleukin‐6 receptor (IL‐6R), regulated upon activation normal T‐cell expressed and secreted (RANTES), intercellular adhesion molecule‐1 (ICAM‐1), tissue inhibitor of metalloproteinase‐1 (TIMP‐1), and platelet‐derived growth factor type BB (PDGF‐BB) (p < 0.05 and foldchange <0.83). Among patients with baseline glycated hemoglobin (HbA1c) < 10%, three proinflammatory cytokines were decreased significantly after therapy: IL‐6R, RANTES, and ICAM‐1. As for the patients with baseline HbA1c ≥ 10%, eight inflammatory cytokines were inhibited significantly after the treatment, including ICAM‐1, IL‐6R, RANTES, TIMP‐1, TIMP‐2, macrophage inflammatory protein‐1 beta (MIP‐1β), PDGF‐BB, and tumor necrosis factor receptor type II (TNF RII). No matter which subgroup of baseline HbA1c level was considered, the decreased cytokines after CSII therapy were significantly involved in TNF signaling pathway. Nuclear factor‐kappa B (NF‐κB) signaling pathway was mainly enriched in patients with baseline HbA1c ≥ 10%.ConclusionsA panel of 40 inflammatory cytokines, measured by protein microarray, were evaluated for 1 week of CSII treatment in newly diagnosed type 2 diabetic patients. After treatment, many proinflammatory cytokines decreased. In the higher baseline HbA1c subgroup, more proinflammatory cytokines improved. No matter which subgroup of HbA1c level was considered, IL‐6R, RANTES, and ICAM‐1, which were involved in TNF signaling pathway, decreased significantly after CSII therapy. This was the first report showing that the cytokines of IL‐6R, TIMP‐2, PDGF‐BB, and TNF RII decreased after the CSII therapy.     

Automated interpretation of the pulmonary function test by a portable spirometer in Chinese adults

IntroductionA portable spirometer is a promising alternative to a traditional pulmonary function test (PFT) spirometer for respiratory function evaluation.ObjectivesThis study aimed to investigate the accuracy of automated interpretation of the PFT measured by a portable Yue Cloud spirometer in Chinese adults.MethodsThe PFT was performed to evaluate subjects prospectively enrolled at Ruijin Hospital (n = 220). A Yue Cloud spirometer and a conventional Jaeger MasterScreen device were applied to each patient with a 20‐min quiescent period between each measurement. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), maximal expiratory flow at 25%, 50%, and 75% of the FVC (MEF25, MEF50, and MEF75, respectively), and maximal mid‐expiratory flow (MMEF), were compared by correlation analyses and Bland–Altman methods. The Yue Cloud spirometer automatically interpreted the PFT results, and a conventional strategy was performed to interpret the PFT results obtained by the Jaeger machine. Concordance of the categorization of pulmonary dysfunction, small airway dysfunction, and severity was analyzed by the kappa (κ) statistic.ResultsSignificantly similar correlations of all variables measured with the two spirometers were observed (all p < 0.001). No significant bias was observed in any of the measured spirometer variables. A satisfactory concordance of pulmonary function and severity classification was observed between the automated interpretation results obtained with the Yue Cloud spirometer vs. a conventional spirometer interpretation strategy (all κ > 0.80).ConclusionThe portable Yue Cloud spirometer not only yields reliable measurements of pulmonary function but also can automatically interpret the PFT results.     

肺动脉高压发病机制研究进展

肺动脉高压主要与血管效应器失调、环境因素、相关疾病及遗传因素有关.最近出现了许多关于肺动脉高压的分子遗传学和细胞生物学相关的研究,结合这些最新的研究对肺动脉高压病因及发病机制予以综述.     

Lysophosphatidic acid transactivates both c-Met and epidermal growth factor receptor, and induces cyclooxygenase-2 expression in human colon cancer LoVo cells

AIM: To examine whether lysophosphatidic acid (LPA) induces phosphorylation of c-Met and epidermal growth factor receptor (EGFR), both of which have been proposed as prognostic markers of colorectal cancer, and whether LPA induces cyclooxygenase-2 (COX-2) expression in human colon cancer cells. METHODS: Using a human colon cancer cell line, LoVo cells, we performed immunoprecipitation analysis, followed by Western blot analysis. We also examined whether LPA induced COX-2 expression, by Western blot analysis. RESULTS: Immunoprecipitation analysis revealed that 10 umol/L LPA induced tyrosine phosphorylation of c-Met and EGFR in LoVo cells within a few minutes. We found that c-Met tyrosine phosphorylation induced by LPA was not attenuated by pertussis toxin or a matrix metalloproteinase inhibitor, in marked contrast to the results for EGFR. In addition, 0.2-40 umol/L LPA induced COX-2 expression in a dose-dependent manner. CONCLUSION: Our results suggest that LPA acts upstream of various receptor tyrosine kinases (RTKs) and COX-2, and thus may act as a potent stimulator of colorectal cancer.     

CD+14单核细胞人类白细胞抗原-DR预测脓毒症预后及指导免疫调理治疗的初步临床研究

目的：验证CD14^ 单核细胞人类白细胞抗原－DR（HLA－DR）对于评估严重脓毒症患者免疫功能的作用；探讨胸腺5肽（TP－5）治疗免疫抑制的有效性。方法：符合严重脓毒症标准，CD14^ 单核细胞HLA－DR＜30％的患者被定义为脓毒症免疫抑制和代偿性抗炎症反应综合征（CARS）者纳入本研究，并接受1mg TP-5肌肉注射，1次／d，直至CD14^ 单核细胞HLA－DR＞50％或死亡。在TP－5治疗前及结束治疗时分别测量CD14^ 单核细胞HLA－DR和肿瘤坏死因子－α（TNF－α）、白介素－6（IL－6）、IL－10和IL－13。结果：15例患者存活，5例死亡。经TP－5治疗后所有患者的CD14^ 单核细胞HLA－DR均有不同程度提高，但仅存活者有显著差异。所有患者细胞因子均高于健康对照，治疗后存活患者的TNF－α、IL－6明显下降；死亡者各种细胞因子变化不明显。结论：用CD14^ 单核细胞HLA－DR鉴别脓毒症免疫抑制并指导免疫刺激治疗是安全可靠的，且对评估预后有重要价值；TP－55可能对逆转免疫抑制有效，但需要严格的对照治疗研究确认；脓毒症的免疫抑制发生和逆转与促炎／抗炎细胞因子平衡无关，确切机制有待深入探讨。     

烫伤延迟复苏后肠上皮细胞凋亡诱导肠道内毒素和细菌移位

目的 :探讨烫伤延迟复苏后肠上皮细胞凋亡对肠道内毒素和细菌移位的影响。方法 :Wistar大鼠 110只 ,30 %总体表面积 ( STBA) 度烫伤 ,立即或伤后 6 h进行复苏。观察伤后肠上皮细胞凋亡率 ( ap% )变化 ,并测定了门静脉和体循环内毒素及肠系膜淋巴结 ( ML N)细菌移位率和移位量变化。结果 :电泳、原位末端标记( TU NEL )法和电镜均观察到伤后肠上皮凋亡梯形带和凋亡阳性细胞增多。延迟复苏组肠上皮细胞凋亡发生早且更严重 ;其门静脉内毒素水平及 ML N细菌移位量均显著高于立即复苏组 ( P<0 .0 1) ;门静脉内毒素变化与肠黏膜 ap%成显著正相关 (烫伤后立即复苏组 r=0 .936 ,P<0 .0 1;烫伤后延迟复苏组 r=0 .899,P<0 .0 5 )。结论 :烫伤后延迟复苏使肠黏膜上皮发生病理性凋亡 ,可能导致肠道细菌和内毒素移位增加。