Clioquinol and vitamin B12 (cobalamin) synergistically rescue the lead-induced impairments of synaptic plasticity in hippocampal dentate gyrus area of the anesthetized rats in vivo

Lead (Pb(2+)) exposure in development induces impairments of synaptic plasticity in the hippocampal dentate gyrus (DG) area of the anesthetized rats in vivo. The common chelating agents have many adverse effects and are incapable of alleviating lead-induced neurotoxicity. Recently, CQ, clioquinol (5-chloro-7-iodo-8-hydroxy-quinoline), which is a transition metal ion chelator and/or ionophore with low affinity for metal ions, has yielded some promising results in animal models and clinical trials related to dysfunctions of metal ions. In addition, CQ-associated side effects are believed to be overcome with vitamin B12 (VB12) supplementation. To determine whether CQ treatment could rescue impairments of synaptic plasticity induced by chronic Pb(2+) exposure, we investigated the input/output functions (I/Os), paired-pulse reactions (PPRs) and long-term potentiation (LTP) of different treatment groups in hippocampal DG area of the anesthetized rat in vivo by recording field potentials and measured hippocampal Pb(2+) concentrations of different treatment groups by PlasmaQuad 3 inductive coupled plasma mass spectroscopy. The results show: CQ alone does not rescue the lead-induced impairments of synaptic plasticity in hippocampal DG area of the anesthetized rats in vivo; VB12 alone partly rescues the lead-induced impairments of LTP; however the co-administration of CQ and VB12 totally rescues these impairments of synaptic plasticity and moreover, the effects of CQ and VB12 co-administration are specific to the lead-exposed animals.     

Actin, a reliable marker of internal control?

Beta-actin is commonly used to normalize molecular expression studies due to its high conservation as an endogenous housekeeping gene. However, recent studies have shown that beta-actin expression can change in response to biochemical stimuli, during growth and differentiation, and in disease states. As can be expected, these phenomena substantially compromise the use of beta-actin as an internal reference marker. Under these conditions, varying expression of beta-actin likely indicates changed function for this maintenance molecule. Further studies exploring the function of actin in these environments will probably lead to a new integrative understanding of the roles of this housekeeping gene.     

动物模型中人骨形态发生蛋白2重组腺病毒活性观测

目的:利用基因工程技术构建人骨形态发生蛋白2重组腺病毒,并进行体内表达,测定活性;为深入开展的基因治疗研究创造条件。方法:实验于2000-05/2002-06在西安交通大学第一附属医院骨科实验室完成。应用PCR技术扩增出人骨形态发生蛋白2全长基因,体外同源重组构建重组腺病毒后,随机将30只SD大鼠分为治疗组和对照组,每组15只,将纯化后的重组腺病毒50μL注入SD大鼠股部肌肉陷窝病损处,通过组织学染色、X射线片对动物模型的组织变化进行观测。结果:6周后治疗组可见明显骨诱导形成,2周时治疗组碱性磷酸酶活性明显高于对照组,重组腺病毒治疗组有明显的诱导成骨活性。结论:应用于动物实验中目的基因表达,并具有生物学活性。本研究是在骨缺损基因治疗的一次尝试,且人骨形态发生蛋白2重组腺病毒的构建成功,也为国内骨科疾病基因治疗的进一步研究提供了基础。     

输尿管软镜碎石术治疗上尿路结石的疗效和安全性

目的探讨输尿管软镜碎石术(retrograde intrarenal stone surgery,RIRS)治疗上尿路结石的疗效和安全性。方法回顾性分析2016年4月至2019年1月武汉大学人民医院行RIRS的640例上尿路结石患者的临床资料。男424例,女216例。年龄(46.2±12.8)岁。结石最大径(1.4±0.7)cm。肾下盏结石126例,非肾下盏结石514例。单侧输尿管上段结石196例,单侧输尿管上段结石合并肾结石118例,单侧肾结石236例,双肾结石90例。104例术前留置双J管。马蹄肾8例,孤立肾合并肾功能不全30例,盆腔异位肾合并旋转不良4例,先天性输尿管畸形6例,海绵肾2例。术前血红蛋白(133.2±5.6)g/L,血清肌酐(84.4±12.2)μmol/L。手术均采用全麻,患者取截石位。采用输尿管软镜联合钬激光碎石,软镜顺利进入肾盂后首先观察肾盂及各肾盏并寻及结石。使用200μm光纤碎石,钬激光功率为12~45 W(0.5~1.5 J/10~30 Hz),根据实际情况辅助取石网篮套取结石。术中检查各肾盂、肾盏,确保结石已完全粉末化(结石最大径<0.3 cm),留置双J管和尿管。手术均由同等资历的术者完成。结果所有手术均顺利完成,手术时间(45.6±14.6)min。术后第1天复查血清肌酐(76.0±10.6)μmol/L,与术前比较差异有统计学意义(t=64.76,P<0.05);血红蛋白(126.4±9.6)g/L,与术前比较差异无统计学意义(t=2.02,P=0.064)。术后住院时间(4.8±1.5)d。术后3例(0.9%)发生严重并发症,分别为2例脓毒血症,1例包膜下血肿。术后3个月596例获得随访,其中552例达到结石清除标准,结石清除率(stone-free rate,SFR)为92.6%;余44例未达到结石清除标准者采用体外冲击波碎石、再次输尿管软镜手术或拔除双J管后观察。结石大小(χ^2=29.569,P<0.05)和位置(χ^2=44.949,P<0.05)是SFR的影响因素。多因素回归分析结果显示结石大小不是影响SFR的独立危险因素(P=0.639),结石位置是影响SFR的独立危险因素(P=0.013)。结论RIRS对于上尿路中小结石患者是一种可靠的治疗方式,疗效确切,并发症少,安全性高。但对于大结石及肾下盏结石的治疗还存在一定的局限性。肾下盏结石是影响RIRS疗效的独立危险因素。     

碘伏治疗鼻咽癌放疗后口腔溃疡的护理

放射治疗(简称放疗)是目前治疗鼻咽癌的首选治疗方法,而大剂量的放疗对口腔黏膜有直接损伤作用,特别是同时接受化学疗法的病人,极易发生口腔溃疡,影响进食。加之病人免疫力降低,易发生严重感染,从而影响病人的正常治疗,导致治疗中断乃至失败。自2001年7月—2005年7月作者采用碘     

Radiological studies on the best entry point and trajectory of anterior cervical pedicle screw in the lower cervical spine

Objective

To explore the best entry point and trajectory of anterior cervical transpedicular screws in the lower cervical spine by radiological studies, and provide reference for clinical application.

Methods

Fifty patients were scanned by computed tomography and confirmed no obvious defect of the cervical spine. On horizontal axis, camber angle (α) and axial length (AL) were measured from C₃ to C₇. On sagittal view, the cranial or caudal angle (β) and sagittal length (SL) were also measured from C₃ to C₇. On the sagittal and horizontal planes vertebrae were respectively divided into four areas, ordered 1–4, on the anterior side of the pedicle. The areas and angles of pedicle intersect into the vertebral body were recorded. We inserted six anterior pedicle screws into the lower cervical spine of three patients by this technique.

Results

On transverse plane, camber angle (α) of C₃–C₅ increased gradually, while it decreased from C₅ to C₇. On sagittal view, C₃ and C₄ pedicles showed cranial tilting, while C₅ to C₇ were caudally tilted. AL and SL values increased gradually from C₃ to C₇. The number of the intersections of C₃–C₇ in each area was also different. Six pedicle screws of three cases were inserted into the lower cervical spine with proper placement and no complications.

Conclusion

Anterior transpedicular screw (ATPS) is a theoretically feasible option for internal fixation. The technique described in this paper was subsequently used in three patients without complication. Future improvement of ATPS insertion remains necessary for this technically demanding procedure.     

Intelligent detection endoscopic assistant: An artificial intelligence-based system for monitoring blind spots during esophagogastroduodenoscopy in real-time

BackgroundObservation of the entire stomach during esophagogastroduodenoscopy (EGD) is important; however, there is a lack of effective evaluation tools.AimsTo develop an artificial intelligence (AI)-assisted EGD system able to automatically monitor blind spots in real-time.MethodsAn AI-based system, called the Intelligent Detection Endoscopic Assistant (IDEA), was developed using a deep convolutional neural network (DCNN) and long short-term memory (LSTM). The performance of IDEA for recognition of gastric sites in images and videos was evaluated. Primary outcomes included diagnostic accuracy, sensitivity, and specificity.ResultsA total of 170,297 images and 5779 endoscopic videos were collected to develop the system. As the test group, 3100 EGD images were acquired to evaluate the performance of DCNN in recognition of gastric sites in images. The sensitivity, specificity, and accuracy of DCNN were determined as 97.18%,99.91%, and 99.83%, respectively. To assess the performance of IDEA in recognition of gastric sites in EGD videos, 129 videos were used as the test group. The sensitivity, specificity, and accuracy of IDEA were 96.29%,93.32%, and 95.30%, respectively.ConclusionsIDEA achieved high accuracy for recognition of gastric sites in real-time. The system can be applied as a powerful assistant tool for monitoring blind spots during EGD.