A case report of primary cardiac capillary hemangioma

Background: Hemangioma of the heart, presenting as a primary cardiac tumor is extremely rare. Methods: We present a 20-year-old male with a cardiac tumor which was incidentally discovered during routine clinical examination. Results: Echocardiography showed a large intramyocardial mass attached to the left ventricle, close to the apex. A tumor was shown near the apex of the left ventricle by Cardiac CT. We performed a total resection surgery of the tumor one week after admission and the patient recovered well and discharged from hospital 7 d after surgery. Conclusion: The pathological diagnosis was primary cardiac capillary hemangioma. No tumor recurrence was shown by echocardiography after 20 months follow-up visits.     

低剂量瑞芬太尼分娩镇痛联合水中分娩对母婴的影响

目的:探索低剂量瑞芬太尼分娩镇痛联合水中分娩在全程分娩镇痛中的可行性,评价其对产妇和新生儿的影响。方法:选择阴道分娩初产妇160例,ASAⅠ-Ⅱ级,产妇无静脉分娩及水中分娩禁忌证。160例产妇随机分为四组:A组产妇未行镇痛处理,B组单纯静脉自控泵注低剂量瑞芬太尼[0.02μg/(kg·min)],C组静脉自控泵注低剂量瑞芬太尼[0.02μg/(kg·min)]联合水中分娩,D组单纯静脉自控泵注瑞芬太尼[0.04μg/(kg·min)],除C组外,均为自然分娩。观察产妇宫缩时疼痛视觉模拟评分(VAS)、产妇第一产程平均时间、第二产程平均时间、会阴侧切率、剖宫产率以及产后2h出血量。记录分娩镇痛期间产妇的副作用和瑞芬太尼使用总量,记录新生儿娩出后Apgar评分和脐动脉血气分析、新生儿纳洛酮使用情况。结果:与A组比较,C组、D组三组产妇宫缩时VAS均明显降低(P<0.01),C组产妇在宫口开5.0cm至开全时间显著缩短(P<0.05),瑞芬太尼使用总剂量和产后2h平均出血量均显著低于其他三组产妇(P<0.05)。四组新生儿Apgar评分和新生儿脐血气分析差异比较无统计学意义(P>0.05),均在正常范围内。结论:产妇自潜伏期静脉输注低剂量瑞芬太尼[0.02μg/(kg·min)]联合水中分娩可减少瑞芬太尼静脉分娩镇痛药物的总剂量,并使第一产程活跃期时间缩短,减少产后出血和临产产妇的剖宫产率,对新生儿脐血气分析及Apgar评分无影响。     

“临床早期接触”对医学生关怀能力养成的效果分析——以汕头大学医学院“医者之心（HEART）”课程为例

目的探讨医者之心（HEART）课程中“临床早期接触社会实践环节”对关怀能力养成的效果，对该课程纳入“临床早期接触”的教学设计做小结。方法编纂临床早期接触中的“隐性课程”体验问卷，对参加医者之心（HEART）课程的临床早期接触社会实践环节的学生进行事后访问及问卷调查，以此评估“隐形课程”对医学生关怀能力养成的初步情况。 结果医学实习生对各种具有隐性课程内涵举措的各个维度对其关怀能力培育的帮助，均呈偏正向的态度。“带教教师教学示范”“关怀展现”“专业胜任能力对学生关怀能力影响”这3个构面的强弱程度，会因“学生临床早期接触时长”“带教教师年资”“临床早期接触过程满意程度”的不同而呈现显著差异。结论“临床早期接触各类组织形式”对第一次进入临床体验的医学生关怀能力认知有重要影响，典范学习及同伴影响对医学生关怀能力认知有正向影响。     

Melatonin mediates protective effects on inflammatory response induced by interleukin‐1 beta in human mesenchymal stem cells

Joint diseases like osteoarthritis usually are accompanied with inflammatory processes, in which pro‐inflammatory cytokines mediate the generation of intracellular reactive oxygen species (ROS) and compromise survival of subchondral osteoblasts. Melatonin is capable of manipulating bone formation and osteogenic differentiation of mesenchymal stem cells (MSCs). The aim of this work was to investigate the anti‐inflammatory effect of melatonin on MSC proliferation and osteogenic differentiation in the absence or presence of interleukin‐1 beta (IL‐1β), which was used to induce inflammation. Our data showed that melatonin improved cell viability and reduced ROS generation in MSCs in a dose‐dependent manner. When exposed to 10 ng/mL IL‐1β, various concentrations of melatonin resulted in significant reduction of ROS by 34.9% averagely. Luzindole as a melatonin receptor antagonist reversed the anti‐oxidant effect of melatonin in MSCs with co‐exposure to IL‐1β. Real‐time RT‐PCR data suggested that melatonin treatment up‐regulated the expression of CuZnSOD and MnSOD, while down‐regulated the expression of Bax. To investigate the effect of melatonin on osteogenesis, MSCs were cultured in osteogenic differentiation medium supplemented with IL‐1β, melatonin, or luzindole. After exposed to IL‐1β for 21 days, 1 μm melatonin treatment significantly increased the levels of type I collagen, ALP, and osteocalcin, and 100 μm melatonin treatment yielded the highest level of osteopontin. Our study demonstrated that melatonin maintained MSC survival and promoted osteogenic differentiation in inflammatory environment induced by IL‐1β, suggesting melatonin treatment could be a promising method for bone regenerative engineering in future studies.     

Association between the NBS1 Glu185Gln polymorphism and breast cancer risk: a meta-analysis

Nijmegen breakage syndrome 1 (NBS1), a vital DNA repair protein in the homologous recombination repair pathway and a signal modifier in the intra-S phase checkpoint, plays a critical role in cellular response to DNA damages and the maintenance of genomic stability. The NBS1 Glu185Gln (NBS1 E185Q, NBS1 8360G>C, rs1805794) polymorphism has been indicated to be involved in the development of cancer, but results of previous individual studies on the association between NBS1 Glu185Gln polymorphism and breast cancer risk remain controversial and inconclusive. Our meta-analysis investigated this association for the first time by pooling the odds ratios with corresponding 95 % confidence intervals (95 % CIs) of all individual publications available to date. Overall, 14 separate studies with 6,642 cases and 7,138 controls were finally included into the present meta-analysis after a comprehensive literature search of the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases up to October 21, 2012. Overall analysis and subgroup analyses by ethnicity and source of controls were performed. Meta-analysis of total studies showed that the NBS1 Glu185Gln variant carriers were not susceptible to breast cancer (OR_{Gln vs. Glu}?=?1.05, 95 % CI 0.80–1.39, P _OR?=?0.719; OR _{Gln/Gln vs. Glu/Glu}?=?0.82, 95 % CI 0.62–1.08, P _OR?=?0.154; OR _{Glu/Gln vs. Glu/Glu}?=?1.00, 95 % CI 0.90–1.13, P _OR?=?0.939; OR_{Gln/Gln + Glu/Gln vs. Glu/Glu}?=?0.96, 95 % CI 0.83–1.11, P _OR?=?0.551; OR_{Gln/Gln vs. Glu/Glu + Glu/Gln}?=?0.84, 95 % CI 0.67–1.05, P _OR?=?0.134). Similar results were observed in heterogeneity-adjusted meta-analysis of all studies. Furthermore, subgroup analyses by ethnicity and source of controls did not identify any appreciable relationship of the NBS1 Glu185Gln polymorphism with breast cancer susceptibility in any populations. Sensitivity analysis by sequentially omitting individual studies confirmed the stability and reliability of our results. Our meta-analysis of currently available data shows no association between the NBS1 Glu185Gln polymorphism and breast cancer risk.     

二氢埃托啡依赖80例临床分析

目的：分析二氢埃托啡依赖者的临床表现。方法：对80例二氢埃托啡依赖者的临床资料进行分析，并分析这80例依赖者所填写的药物依赖性调查表的结果。在患者入院后的第一周开始给予支持疗法进行治疗。结果：80例二氢埃托啡依赖者中男女比例为4：1，初中文化程度的人最多，32人、个体户、无业人员占82％；大多数患者不知道二氢埃托啡可以成瘾。滥用二氢埃托啡的平均时间是（3．1±2．4）月，用量为（6．4±4．6）片。停用药物后，患者全部出现戒断症状。二氢埃托啡的戒断症状比较轻，出现早，消失快，容易戒断。联合疗法治疗二氢埃托啡依赖的效果明显。结论：联合疗法治疗二氢埃托啡依赖效果明显，值得推广。     

高原地区老年患者手术麻醉中芬太尼与瑞芬太尼静脉麻醉的应用探讨

目的探讨高原地区老年患者手术麻醉中芬太尼与瑞芬太尼静脉麻醉的应用效果及其不良反应。方法选取我院自2010年1月—2012年10月收治的142例进行手术的老年患者进行分析研究,随机分为2组,每组71例,观察组患者采用瑞芬太尼进行麻醉,对照组患者采用芬太尼进行麻醉,观察两组患者的麻醉结果以及不良反应。结果观察组患者插管后收缩压为（113.2±15.1）,舒张压为（77.2±10.6）,术中收缩压为（121.3±10.3）,舒张压为（79.6±10.5）;对照组患者插管后收缩压为（135.1±16.9）,舒张压为（89.3±14.6）,术中收缩压为（136.2±20.5）,舒张压为（88.7±12.6）。两组患者在插管后、术中血压、心率等较麻醉前有明显差异,P〈0.05,具有统计学意义。观察组患者不良反应发生率为5.63%,对照组患者不良反应发生率为21.13%,差异具有统计学意义,P〈0.05。结论芬太尼和瑞芬太尼都能应用于老年患者手术麻醉,但相对而言,瑞芬太尼的麻醉效果更好,不良反应更小,安全、有效,值得临床推广应用。     

环境化学物暴露对2型糖尿病基因的富集进程和通路影响研究

目的 探讨2型糖尿病（T2DM）共同差异表达基因的富集进程和通路，并进一步发现影响T2DM的环境化学物质。方法 通过比较毒理基因组学数据库（CTD）中获取直接作用的T2DM相关基因及化学物质，从GEO数据库中获取T2DM关联的基因。对T2DM关联的共同关键基因进行富集分析，获取共同基因/蛋白可能参与的生物进程或信号通路。结果 共有469个与T2DM关联的基因，200个关键基因/蛋白富集发现，这些关键基因/蛋白参与了MAPK级联正调控、细胞因子介导的信号通路、ER到高尔基体的顺行转运、细胞外刺激应答等信号通路。结论 环境化学物质能在基因水平上影响T2DM的发生发展。     

产β 内酰胺酶葡萄球菌在临床标本中的检出及耐药性

目的了解某院产β 内酰胺酶葡萄球菌在临床标本中的检出及耐药现状，为防治葡萄球菌感染提供依据。方法回顾性分析该院2005-2010年临床各科送检标本分离的1 725株产β 内酰胺酶葡萄球菌的临床和实验室资料。结果近6年产β 内酰胺酶葡萄球菌总检出率为94.83%（1 725/1 819），各年度（2005-2010年）检出率分别为88.68%（94/106）、89.69%（174/194）、91.72%（155/169）、97.58%（242/248）、96.10%（591/615）、96.30%（469/487），有逐年上升趋势（χ2=51.11, P<0.01）；各菌种以松鼠葡萄球菌β 内酰胺酶阳性率最高（99.50%，198/199），耳葡萄球菌最低（80.37%，86/107），种间差异有统计学意义（χ2＝58.08，P<0.01）。药敏结果显示，除万古霉素、利奈唑烷、呋喃妥因和利福平外，产β 内酰胺酶葡萄球菌对青霉素、氨苄西林、氨苄西林/舒巴坦、苯唑西林、头孢唑林、环丙沙星、四环素、克林霉素、红霉素、庆大霉素和复方磺胺甲口恶唑呈高度耐药（耐药率51.74%～100.00%）和多重耐药，且产酶菌的耐药性均高于非产酶菌（χ2在7.00～485.39之间，P<0.01）。苯唑西林耐药菌株占产β 内酰胺酶金黄色葡萄球菌和凝固酶阴性葡萄球菌的72.86%和78.30%，是产酶葡萄球菌的主要组成菌群。结论产β 内酰胺酶葡萄球菌的高检出率和对临床常用抗菌药物的高耐药率形势严峻，加强对产酶细菌的监测，遏制其快速增长非常必要。