Inhibitory effects of erythromycin on wear debris-induced VEGF/Flt-1 gene production and osteolysis

Objectives  A highly vascularized and inflammatory periprosthetic tissue augments the progress of aseptic loosening, a major clinical problem after total joint replacement. The purpose of this study is to investigate the effect of erythromycin (EM) on ultra high molecular weight polyethylene (UHMWPE) particle-induced VEGF/VEGF receptor 1 (Flt-1) gene production and inflammatory osteolysis in a mouse model. Methods  UHMWPE particles were introduced into established air pouches on BALB/c mice, followed by implantation of calvaria bone from syngeneic littermates. EM treatment started 2 weeks after bone implantation (5 mg/kg day, i.p. injection). Mice without drug treatment as well as mice injected with saline alone were included. Pouch tissues were harvested 2 weeks after bone implantation. Expression of VEGF, Flt-1, RANKL, IL-1, TNF and CD68 was measured by immunostain and RT-PCR, and implanted bone resorption was analyzed by micro-CT (μCT). Results  Exposure to UHMWPE induced pouch tissue inflammation, increase of VEGF/Flt-1 proteins, and increased bone resorption. EM treatment significantly improved UHMWPE particle-induced tissue inflammation, reduced VEGF/Flt-1 protein expression, and diminished the number of TRAP⁺ cells, as well as the implanted bone resorption. Conclusion  This study demonstrated that EM inhibited VEGF and Flt-1 gene expression. The molecular mechanism of EM action on VEGF/Flt-1 signaling-mediated osteoclastogenesis warrants further investigation.     

体外膜肺氧合在危重心肺疾患的临床应用体会

目的总结危重心肺疾病患者实施体外膜肺氧合支持方法和效果。方法对5例患者实施体外膜肺氧合支持,年龄27-82岁（平均年龄47岁）,体质量53～87kg（平均体质量69．6kg）。5例患者病因不同,分别为：例1,男性,29岁,爆炸伤,心肺功能衰竭：例2,男性,82岁,急性心肺功能衰竭;例3,女性,34岁,急性心源性休克复苏后支持;例4,男性,27岁,心脏外伤,心脏手术后低心排血量;例5,女性,63岁,联合瓣膜置换术后低心排血量。采用静脉-动脉转流,辅助流量40～70ml／（kg·min）;间断检测激活凝血时间（ACT）160～200s。结果体外膜肺氧合支持时间22～61h（平均39．4h）。1例未能脱机而死亡,4例成功脱机,3例康复出院。结论体外膜肺氧合支持是抢救危重心肺功能衰竭及心脏手术心功能支持有效方法。     

Decline in βhCG levels between days 0 and 4 after a single dose of methotrexate for ectopic pregnancy predicts treatment success: a retrospective cohort study

In current protocols for the medical management of ectopic pregnancies, the first indication of treatment response is obtained no sooner than day 7. We examined whether human chorionic gonadotrophin (βhCG) trends between days 0 and 4 after methotrexate provide an earlier indication of the likely outcome. Of 33 patients where serum βhCG dropped between days 0 and 4 after methotrexate, the ectopic pregnancy was resolved in 88% of cases without further treatment. Of 12 women where serum βhCG rose between days 0 and 4, only 42% had treatment success. A fall in βhCG between days 0 and 4 after treatment with methotrexate for ectopic pregnancy predicts a high likelihood of treatment success.     

Effect of vitrification and thawing on human oocyte ATP concentration

Vitrification/thawing has a significant negative impact on oocyte ATP concentration. However, incubating oocytes up to 180 minutes after thawing allowed oocytes to regain some ATP level.     

Placental expression of a novel primate-specific splice variant of sFlt-1 is upregulated in pregnancies complicated by severe early onset pre-eclampsia

sFlt-1 is increased in the placenta and serum of women with pre-eclampsia. A novel primate-specific splice variant has recently been discovered, but its expression in severe pre-eclampsia has yet to be reported. We investigated placental expression of the previously described variant, sFlt-1/sFlt-i13, and the novel variant, sFlt-e15a, in pregnancies complicated by severe early onset pre-eclampsia (n = 14) and HELLP (haemolysis, elevated liver enzymes and a low platelet count) syndrome (n = 8). There was significant upregulation of both variants in pre-eclampsia and HELLP syndrome compared with normotensive term (n = 35) and preterm controls (n = 8). We conclude that the novel primate-specific splice variant of sFlt-1 is highly expressed in both severe pre-eclampsia and HELLP.     

导师负责制在护理专职教师参加临床实践中的应用

随着社会科学技术和人类文明的发展,临床护理事业也发展迅速,加上新知识、新设备、新技术的不断更新,要求护理专职教师参加临床实践,防止学校教育与临床实际脱节。本文提出运用导师负责制保证护理专职教师在临床实践中的质量。     

A modified inexpensive transobturator vaginal tape inside-out procedure versus tension-free vaginal tape for the treatment of SUI: a prospective comparative study

Purpose  

To prospectively compare, in terms of efficacy and safety, the tension-free vaginal tape (TVT) and our modified transobturator vaginal tape inside-out (TVT-O) procedure with self-tailored monofilament macroporous polypropylene mesh for stress urinary incontinence (SUI).     

生长激素释放肽对心衰大鼠植物神经重构的影响

本研究观察了生长激素释放肽(GHRP)的应用对心衰动物胆碱能神经和肾上腺素能神经支配的影响。Wistar大鼠50只,随机分为:假手术组10只;GHRP组30只;模型组10只。心衰模型成功后4周,Karnovsky-Roots法及免疫组织化学方法分别显示心肌胆碱能神经纤维及肾上腺素能免疫阳性纤维,应用多功能真彩色病理图像分析系统分析两种神经纤维密度。结果显示,模型组大鼠心肌中胆碱能神经纤维和肾上腺素能神经纤维密度明显低于假手术组(P<0.01);GHRP组大鼠心肌中两种神经纤维密度较模型组明显增高(P<0.01),但略低于假手术组神经纤维密度(P<0.05)。上述研究表明GHRP可延缓大鼠心衰后的去神经支配,改善神经重构。