Efficacy of the WINROP algorithm for retinopathy of prematurity screening in Southern China

AIM:To evaluate the predicting efficacy of severe retinopathy of prematurity(ROP)by the WINROP algorithm(http://winrop.com)in Southern China.METHODS:All preterm infants with the gestational age(GA)less than 32 wk were included.Their ROP screening results and serial postnatal body weight were analysed retrospectively.Weekly body weight was entered into and measured by the WINROP system.The outcomes were analysed,and the sensitivity,specificity,positive predictive value and negative predictive value(NPV)were calculated.RESULTS:Totally 432 infants with a median GA of 30.0(24.0-31.9)wk,and a median birth weight(BW)of 1360(540-2700)g were included.Among these 432 infants,50 were diagnosed as type 1 ROP but only 28 were identified by the WINROP algorithm.The sensitivity was 56%(28/50)and the NPV was 92%(252/274).However,for infants with BW<1000g or GA<28 wk,the sensitivity was 93.8%(15/16)and 93.3%(14/15),respectively.Meanwhile,with several postnatal complications added as additional risk factors,the sensitivity was increased to 96%(48/50).CONCLUSION:The sensitivity of the WINROP algorithm from the Southern Chinese cohort is not as high as that reported in developed countries.This algorithm is effective for detecting severe ROP from extremely small or preterm infants.Modification of the algorithm with additional risk factors could improve the predictive value for infants with a GA>28 wk in China.     

人工冬虫夏草在大鼠慢性阻塞性肺疾病中的治疗作用和机制研究

目的 研究人工冬虫夏草对香烟烟雾所致慢性阻塞性肺疾病(COPD)大鼠模型的治疗和作用机制.方法 SD健康雄性大鼠随机分为对照组、COPD组、造模前给药组、造模后给药组、中剂量(2.5 g·kg-1·d-1)和高剂量(5 g·kg-1·d-1)治疗组共6组,每组10只.动物连续烟熏90 d造模.造模前给药组于造模前两周开始给药,治疗组在造模前给药的基础上持续给药直至造模结束.造模后给药组为在造模结束后给药两周.测定各组大鼠肺功能,观察肺组织病理学变化,提取肺组织总蛋白进行双向电泳,对表达差异显著的蛋白点进行鉴定分析.结果 气道阻力均值COPD组(0.386 9 cm H2O·ml-1·s)明显高于对照组(0.263 0 cm H2O·ml-1·s)(P ＜0.05);造模前给药组(0.252 5 cm H2O·ml-1·s)、中剂量治疗组(0.223 3 cm H2O·ml-1·s)、高剂量治疗组(0.184 6cm H2O· ml-1·s)、造模后给药组(0.301 1 cm H2O·ml-1·s)均明显低于COPD组(P＜0.05),与对照组相比差异无统计学意义.给药各组特别是高剂量组与COPD组相比支气管和肺部病理情况均有明显改善,结果差异有统计学意义(P＜0.05).与对照组相比有14种蛋白质的表达量在COPD组中显著下降.谷胱甘肽过氧化物酶、醛脱氢酶及线粒体醛脱氢酶前体等三种蛋白则在高剂量治疗组中表达量得到恢复和改善.结论 人工冬虫夏草对大鼠COPD有明确的治疗作用,推测与抑制或改善肺部组织氧化与抗氧化失衡以及改善全身状况有关.     

Comb-shaped cardo poly(arylene ether nitrile sulfone) anion exchange membranes: significant impact of nitrile group content on morphology and properties

A series of comb-shaped cardo poly(arylene ether nitrile sulfone) (CCPENS-x) materials were synthesized by varying the content of nitrile groups as anion exchange membranes (AEMs). The well-designed architecture of cardo-based main chains and comb-shaped C10 long alkyl side chains bearing imidazolium groups was responsible for the clear microphase-separated morphologies, as confirmed by atomic force microscopy. The ion exchange capacity (IEC) of the AEMs ranged from 1.56 to 1.65 meq. g⁻¹. With strong dipole interchain interactions, the effects of nitrile groups on the membrane morphology and properties were investigated. With the nitrile group content increasing from CCPENS-0.2 to CCPENS-0.8, CCPENS-x revealed larger and more interconnected ionic domains to form more efficient ion-transport channels, thus increasing the corresponding ionic conductivity from 25.8 to 39.5 mS cm⁻¹ at 30 °C and 58.6 to 83 mS cm⁻¹ at 80 °C. Furthermore, CCPENS-x with a higher content of nitrile groups also exhibited lower water uptake (WU) and swelling ratio (SR), and better mechanical properties and thermal stability. This work presents a promising strategy for enhancing the performance of AEMs.

A series of comb-shaped cardo poly(arylene ether nitrile sulfone) (CCPENS-x) materials were synthesized by varying the content of nitrile groups as anion exchange membranes (AEMs).     

A tumor-microenvironment-responsive nanomaterial for cancer chemo-photothermal therapy

Taxol (TAX) is a typical anticancer drug that is widely used in clinical treatment of cancer, while gold nanorods (AuNRs) are a kind of well-known material applied for photothermal therapy (PTT). The therapeutic outcome of TAX in chemotherapy is however limited by drug resistance, while AuNRs often show poor accuracy in PTT. To optimize the functions of TAX and AuNRs, we developed a hydrogen peroxide (H₂O₂)-triggered nanomaterial (LV–TAX/Au@Ag) for combined chemo-photothermal therapy. In normal tissues, TAX is protected in the lipid bilayer and isolated from the surrounding normal cells, while AuNRs are coated with silver shells and show low photothermal capacity. However, after reaching the tumor tissues, the silver shells can be etched by endogenous H₂O₂ in the tumor microenvironment, and the photothermal properties of AuNRs are then recovered. Meanwhile, the generated oxygen destabilizes the LV, which makes the 100 nm sized nanosystems disassemble into the smaller sized TAX and AuNRs, leading to the deep penetration and direct interaction with tumor tissues. The related in vitro experiments proved the validity of this “turn off/on” effect. Extensive necrosis and apoptosis were observed in the tumor tissues and the proliferation of solid tumor was greatly suppressed due to this combined chemo-photothermal therapy. In addition, no significant damage was found in normal tissues after the treatment of LV–TAX/Au@Ag. Therefore, the strategy to achieve environmental response by modifying the photothermal agents enhanced the efficiency and safety of nanomedicine, which may help improve cancer treatment.

Endogenous hydrogen peroxide was utilized to control the release of agents for better tumor therapeutic effect and safety.     

慢性疼痛患者疼痛程度及应对策略的调查

目的了解慢性疼痛患者的疼痛程度及应对策略,并探讨两者之间的相关性。方法采用随机抽样方法抽取武汉市11所三级甲等医院住院的慢性疼痛患者270例,采用数字疼痛强度量表及自行设计的慢性疼痛应对策略问卷进行调查。结果患者近1周的疼痛评分为0～10(6.39±2.49);近1周无疼痛1例(0.37%),轻度疼痛44例(16.30%),中度疼痛122例(45.18%),重度疼痛68例(25.18%),剧烈疼痛35例(12.96%)。其应对策略各维度中,积极心态评分(2.99±1.10)、忽视疼痛(2.61±1.11)、分散注意力(3.21±1.06)、行动解决(2.77±0.73)、寻求帮助(2.99±0.86)、消极心态(2.57±1.01)、限定活动(4.12±1.01)。患者疼痛强度与应对策略中的忽视疼痛呈负相关(r=-0.208,P<0.01)。结论慢性疼痛患者的疼痛程度多处于中重度,其疼痛程度与应对策略相关。医护人员应重视和规范慢性疼痛的管理,采取相应措施提高患者应对策略,以减轻其疼痛程度。     

改进腹腔镜与开腹大子宫全切术的比较

目的 探讨双极联合超声刀腹腔镜下大子宫全切除术的安全性和可行性.方法 2009年2月～2012年7月145例因子宫良性病变行大子宫(子宫12～ 20孕周大小)切除术,按患者意愿分为腹腔镜组(n=78)和开腹组(n=67),比较2组患者手术情况、术后恢复、住院时间、并发症及随访情况.结果 腹腔镜组术中出血少[(102.7 ±35.6)ml vs.(125.4±23.7)ml,t=-4.441,P=0.000],术后肠道恢复快[(45.6±6.8)h vs.(67.4±8.5)h,t=-17.149,P=0.000],住院时间短[(5.5±0.5)d vs.(7.7±0.6)d,t=-24.083,P=0.000],切口非甲级愈合率低[0 vs.7.5％ (5/67),P=0.019].2组并发症发生率比较无统计学差异[2.6％ (2/78) vs.4.5％(3/67),x2=0.030,P=0.863].腹腔镜组随访74例,随访时间5～32个月,(28.7±6.2)月,术后1～3个月左下腹最大穿刺孔轻微疼痛2例,3个月后无不适;开腹组随访64例,随访时间5～ 36个月,(30.5±5.8)月,术后1～6个月腹部切口疼痛4例,6个月后无不适.结论 腹腔镜下大子宫全切术是安全、可行的,较开腹手术具有出血少、恢复快、住院时间短的优势.     

Epidemiologic investigation of burns in the elderly in Sichuan Province

Objective

This study analysed the epidemiology of burns in the elderly in Sichuan Province, China, with the objective of formulating a prevention programme.

Methods

A retrospective review of elderly patients admitted to the Burn Centre of West China Hospital during 2003–2009 was performed, including patient demographics, education and burn aetiology.

Results

A total of 103 patients, mean age 69.5 years (range 60–95 years; 58 male, 45 female) were admitted. The most common causes of burn were flames (51.5%), scalding (37.9%), electrical (4.9%) and chemical (2.9%), respectively. The majority occurred at home (68.9%), principally in the kitchen (35.9%), while 19.4% occurred in the workplace. Burns with total body surface area (TBSA) of 0–10% accounted for 52.5% of those admitted for treatment; 10–30% TBSA burns accounted for 20.3%; 30–50% TBSA burns accounted for 15.5%; and burns with a TBSA >50% accounted for 11.7%. Only 6% of patients received appropriate first aid, and 32% did not receive treatment until more than 24 h after injury. The education level was lower in the rural group. Both urban and rural groups had little knowledge of first aid for burns.

Conclusions

Burn-prevention programmes should promote improved living conditions and medical insurance, with prevention education for the elderly, especially in rural areas.     

腹腔镜技术在胃肠外科急腹症中的应用

目的探讨腹腔镜技术在腹部外科急腹症诊断和治疗中的应用。方法回顾性分析2008年10月至2011年10月问解放军总医院普通外科收治的因诊断不明确而接受腹腔镜探查术44例急腹症患者的临床资料。并与同期行急诊剖腹探查术的65例患者资料进行比较分析。结果经腹腔镜探查的44例患者中,有42例患者（95．5％,42／44）在腹腔镜下明确诊断,其中34例（77．3％）患者在明确诊断的同时于腹腔镜下完成手术治疗,全腔镜下处理20例,小切口辅助14例。与传统剖腹探查术患者相比,腹腔镜探查术手术切口长度明显缩短[（6．7±2．2）cm比（15．8±3．4）cm]、术中出血明显减少[（51．4±303）ml比（117．9±49．5）m1]、术后胃肠功能恢复明显加快[术后进食时间（15．0±6．1）d比（30．5±8.4）d]和术后住院时间明显缩短[（5．6±4．2）d比（8．4±4．8）d],差异均具有统计学意义（均P〈O．05）,而且手术费用也并未见明显增加[（1．2±0．8）万元比（1．4±0．5）万元,P〉O．05]。结论腹腔镜探杏技术在腹部外科急腹症患者中的应用安全、有效．可在明确病因的同时实施治疗。     

595 nm与1064 nm双波长激光治疗溃疡性婴儿血管瘤的疗效

目的 探讨595 nm与1064 nm双波长激光治疗溃疡性婴儿血管瘤的疗效及安全性.方法 选择40例患者进行治疗,包括臀部、肛周13例,阴唇7例,腹股沟、股内侧5例,阴囊4例,颈部3例,头皮2例,唇部2例,躯干、四肢4例.所有溃疡及非溃疡皮损第1次均选择595 nm染料激光治疗,以后依皮损厚度继续选择595 nm激光治疗或选择双波长模式脉冲组1或脉冲组2参数治疗,直至结束.治疗1～6次,间隔为4周.结果 39例(97.5％)患者经1次治疗后1～2周,平均9.5d溃疡面逐渐愈合;第1次治疗后4周溃疡面完全愈合,痊愈率97.5％.非溃疡皮损经过1～6次治疗后,痊愈13例(32.5％),显效19例(47.5％),有效率(痊愈十显效)80.0％.35例(87.5％)伴疼痛,患儿于第1次激光术后2～7 d,平均3.5d疼痛缓解,疼痛评分从治疗前平均1.875分下降为治疗后0.125分,差异有统计学意义(P＜0.05).患者对治疗耐受性好,未见明显不良反应.结论 595 nm与1064 nm双波长激光治疗溃疡性婴儿血管瘤疗效好,不良反应小.