常见药物23种的毛细管气相色谱分析法

目的　建立临床急诊急救中药物中毒发生率最高的 2 3种药物在血液、胃液或呕吐物样品中的毛细管气相色谱分析法。方法　血液、胃液或呕吐物样品经处理后 ,以溴己新为内标 ,采用SP 5 0 2型气相色谱仪、SE 5 4型毛细管色谱柱、氢焰检测器检测巴比妥、对乙酰氨基酚、异戊巴比妥、苯海拉明、苯巴比妥、氯苯那敏 (扑尔敏 )、普萘洛尔 (心得安 )、阿米替林、多赛平 (多虑平 )、安坦、异丙嗪、苯妥英钠、罗拉、安定、氯丙嗪、甲氧氯普胺 (胃复安 )、三氟拉嗪、硝西泮 (硝基安定 )、思诺思、氯氮平、艾司唑仑、氟哌啶醇、阿普唑仑等 2 3种药物。结果　该方法在选定条件下 ,能将样品中 2 3种药物成分分离 ,线性范围为 0 .0 2～ 30 .0 0mg L ,最低检出浓度为 0 .0 2～ 0 .5 0mg L ,平均回收率为 86 .8%～10 2 .8% ,相对标准偏差为 2 .8%～ 6 .2 %。结论　该方法操作简便 ,灵敏度高 ,可快速、准确地为临床提供诊断依据。     

The clinical significance of thyroid hormone-responsive in thyroid carcinoma and its potential regulatory pathway

The study aimed to evaluate the clinical significance of thyroid hormone-responsive (THRSP) and explore its relevant pathways in thyroid carcinoma (THCA).The gene expression data of THRSP were obtained and the prognostic significance of THRSP in THCA was analyzed through various bioinformatics databases. Then, the factors influencing THRSP mRNA expression were explored, and the function of THRSP in predicting the lymph node metastasis (LNM) stage was determined. We further performed the enrichment analysis and constructed a protein–protein interaction (PPI) network to examine potential regulatory pathways associated with THRSP.THRSP gene expression was significantly increased in THCA compared with the normal tissues. High THRSP mRNA expression had a favorable overall survival (OS) in THCA patients (P < .05). Additionally, the mRNA expression of THRSP was related to stage, histological subtype, and methylation among THCA patients (all P < .05). Besides, THRSP served as a potent predictor in discriminating the LNM stage of thyroid cancer patients. According to Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene set enrichment analysis (GSEA) on THRSP-associated genes, THRSP was positively related to metabolic pathways.The upregulation of THRSP predicted a good OS in THCA patients. Furthermore, THRSP might inhibit THCA progression through positive regulation of metabolism-associated pathways.     

Intraoperative choroidal detachment during small-gauge vitrectomy: analysis of causes,anatomic, and visual outcomes

IntroductionTo investigate the incidence and causes of intraoperative choroidal detachment (CD) during small-gauge vitrectomy, as well as the anatomic and visual outcomes.MethodsWe retrospectively reviewed the medical records of 1026 consecutive patients who underwent small-gauge vitrectomy from June 2017 to December 2018 at Zhongshan Ophthalmic Centre, Guangzhou, China. Data on the presence, location, and extent of intraoperative CD and its relationship to the infusion cannula were collected. Patient demographic characteristics and postoperative anatomic and visual outcomes were also assessed.ResultsA total of six cases were found to have intraoperative CD, including two with serous CD, three with limited haemorrhagic CD, and one with CD caused by inadvertent perfusion of gas during air/fluid exchange. Retraction of the infusion cannula and acute ocular hypotony were found to be the main causes of intraoperative CD in five out of the six cases. The best-corrected visual acuity of all cases significantly improved after the surgery.ConclusionThe incidence of intraoperative CD during small-gauge vitrectomy is low; the predominant causes are retraction of the infusion cannula and acute ocular hypotony. Immediate awareness and timely closure of the incision may contribute to a better surgical prognosis.Subject terms: Uveal diseases, Diseases     

Multi-Step Forming Simulation and Quality Control of Aluminum Alloy Automobile Rear Upper Control Arm

Aluminum alloy is widely used in automobile parts because of its light weight and good process performance. In view of the complex structure of aluminum alloy automobile rear upper control arms, multiple forming processes and the difficulty in quality control, in this paper, we propose a rolling-forging composite process to produce a rear upper control arm. Based on the reasonable volume distribution of the blank by cross-wedge rolling, multi-step forging was carried out. Finite element simulation of thermomechanically coupled multi-step forming was carried out using DEFORM software. Based on a comparison of the traditional process and the proposed rolling-forging composite forming process, we concluded that the rolling-forging composite process can greatly reduce the material cost and the forming force, resulting in superior product performance. The coarse-grain structure of products at different process temperatures was analyzed by a crystal-phase experiment. The results show that the process temperature of the multi-step process, as well as the heat treatment temperature and time have an important influence on the coarse-grain structure of the product. The optimal preheating temperatures for preforging and final forging dies were determined to be 335 °C and 350 °C, respectively; a preheating temperature of 530 °C and a solution time of 45 min resulted in the least coarse-grain surface structure. The research results provide a theoretical basis for improving the multi-step forming quality of automobile rear upper control arms.     

利妥昔单抗治疗难治性激素耐药型肾病综合征的疗效和安全性

目的:探讨利妥昔单抗(RTX)治疗儿童难治性激素耐药型肾病综合征(SRNS)的疗效和安全性。方法:回顾性分析2013年9月至2018年3月东部战区总医院儿科收治并接受RTX治疗的10例难治性SRNS患儿的临床资料。结果:10例患儿发病年龄(4.47±2.75)岁,男女各5例;5例(50%)肾活检为局灶节段性肾小球肾炎,...     

面颈部静脉畸形的综合治疗

目的:探讨多种方法综合治疗口腔及面颈部大面积静脉畸形的临床效果。方法:根据患者的年龄、病变部位、病变大小制订个体化治疗方案,采用多种药物联合注射,结合病变周围环形缝扎、激光、手术等方法综合治疗口腔颌面部大面积静脉畸形134例。结果:134例中治疗效果优79例(58.96%),良45例(33.58%),显效10例(7.46%),差0例。结论:采用多种方法综合治疗口腔颌面部大面积静脉畸形,对提高疗效、改善面部形态、维持局部功能、减少不良反应具有重要意义。     

Risk factors of young males with physically demanding occupations having accumulated damage of anterior cruciate ligament

ObjectiveTo present the clinical characteristics of accumulated anterior cruciate ligament (ACL) damage among young male patients undergoing routine exercise, and to evaluate the related risk factors.MethodsA retrospective study involving ACL‐accumulated damage from June 2015 to December 2019 was conducted. Baseline characteristics, such as age, body mass index (BMI), training parameters, and clinical signs, were recorded. The results of the radiologic examinations and related standardized tests were obtained to evaluate the research outcomes. These results were compared using Student''s t‐test or Chi‐square test, and the impact of risk factors on the patient''s injury were analyzed.ResultsA total of 86 men with accumulated ACL damage were included in this study. Exercise pain (86 [100%]), synovitis (80 [93.0%]), and intra‐articular effusion (79 [91.9%]) were the most common clinical symptoms. Loosening of ligaments, decreased tension, mild hyperplasia, and intercondylar fossa effusion were observed using radiography, magnetic resonance imaging, and arthroscopy. Age, BMI, training intensity, length of training, and knee hyperextension were identified as risk factors for accumulated ACL damage.ConclusionThis study suggests that accumulated ACL damage has differentiated clinical symptoms, imaging features, and risk factors compared to common ACL injuries.     

应用siRNA敲低TPM3基因表达后对大鼠胰腺癌细胞侵袭转移能力的影响

目的：探究原肌球蛋白3（tropomyosin alpha-3 chain,TPM3）在大鼠胰腺癌细胞中对其侵袭转移能力的影响并初步阐述其可能的分子机制。方法：（1）将70只大鼠随机分为手术组40只[将7,12-二甲基苯并蒽（7,12-dimethyl-1,2-benzanthracene,DMBA]植入大鼠胰腺被膜下后荷包缝合被膜）,假手术组15只（只对胰腺进行荷包缝合而后关腹,不置入DMBA）,阴性对照组15只（不做任何处理）,建立大鼠胰腺癌模型。（2）通过组织免疫组化染色的方法对差异蛋白TPM3进行验证。（3）通过机械分离和酶阶段消化法分离胰腺癌组织的方法获取大鼠胰腺癌细胞,体外传代培养获得纯度较高的细胞后,应用siRNA敲低大鼠胰腺癌细胞中TPM3基因的表达;通过RT-PCR技术检测其沉默效果。（4）通过Transwell实验和平板克隆实验分别对细胞的侵袭、迁移能力及生长增殖能力进行观察。结果：（1）经病理验证模型组有37.83%（14/37）形成胰腺癌,证明大鼠胰腺癌模型建立成功。（2）免疫组化验证胰腺癌组织中TPM3阳性率（92.8%）明显高于正常胰腺组织（6.7%）。（3）RT-PCR结果显示,转染TPM3-siRNA的细胞中TPM3的表达量（0.31±0.02）明显低于其余各组,脂质体组（0.45±0.02）,阴性对照组（0.45±0.02）,空白对照组（0.43±0.02）（P＜0.05）,其余各组之间TPM3表达量差异无统计学意义（P ＞0.05）。（4）转染TPM3-siRNA的细胞其侵袭[（161.63±4.94）个]、迁移能力[（206.87±4.21）个]及生长增殖能力[（51.5±2.327）个]较对照组明显降低[分别为（39.7±1.40）个,（67.27±1.76）个,（5.900±0.767）个]（P＜0.05）。结论：体外化学合成的TPM3-siRNA可有效的抑制大鼠胰腺细胞TPM3的表达,TPM3表达降低后其侵袭能力、迁移能力及生长增殖能力下降。