丙泊酚对脓毒性休克患者舌下微循环的影响

目的 探讨丙泊酚对脓毒性休克患者舌下微循环的影响。 方法 选取需要机械通气的脓毒性休克患者30例,所有患者依据病情给予经口气管插管并接呼吸机辅助通气治疗。在接受机械通气前及应用丙泊酚镇静后监测患者舌下微循环参数。同时记录患者血流动力学及氧代谢指标进行比较。 结果 所有脓毒性休克患者镇静目标达到Ramsay评分3~4分时平均丙泊酚应用剂量为1.2mg/(kg·h)。镇静后微循环指标出现不同程度改变, 总血管密度TVD(P>0.05)无明显改变;灌注血管密度 PVD(P<0.05)、灌注血管比例PPV(P<0.05)及微血管流动指数MFI(P<0.05)较镇静前下降明显。镇静后去甲肾上腺素泵入剂量较镇静前轻度增加,血流动力学参数CI及MAP较镇静前亦有轻度下降,但二者相比差值无统计学意义(P>0.05)。反应组织灌注指标血乳酸(LAC)及氧代谢指标中心静脉氧饱和度(SvO₂)在镇静后升高(P<0.05)。 结论 脓毒性休克患者应用丙泊酚镇静可以使微循环及氧利用障碍加重。     

子宫内膜制备染色体新方法的研究

对72例月经周期正常的健康妇女,分别按月经周期的不同时间,取子宫内膜,以直接法制备染色体标本。结果表明,①子宫内膜中期分裂相,于月经周期的第5～10d即达高峰,持续到月经周期第16d;于周期第17～22d,分裂相明显减少;至月经第23d以后,内膜细胞的有丝分裂活动几近停止。②在正常月经周期的第14d左右可发生排卵,排卵后内膜初受孕酮影响的时间至少在排卵后36～48h,不会严重干扰中期分裂相的出现。③从子宫前壁或后壁内膜取材直接制备染色体标本进行比较,二者无显著性差异(P>0.05)。④所取组织量与获得中期分裂相数目间呈正相关,有极显著意义(P<0.01)。     

Circulating cell‐free circRNA panel predicted tumorigenesis and development of colorectal cancer

BackgroundColorectal cancer (CRC) is reported with high morbidity and mortality. Currently, the sensitivity of diagnostic markers for colorectal cancer is low. Therefore, further exploration of new plasma diagnostic markers for early detection of colorectal cancer is of great value. We aimed to explore potential circRNAs in plasma as biomarkers for early diagnosis of CRC.MethodsWe employed the circRNA microarray to investigate dysregulated circRNAs in plasma samples of CRC patients, colorectal adenoma patients (CRA), and healthy controls. Through in‐depth analysis, significantly differentially expressed circRNAs were screened as candidate targets.ResultsEight circRNAs (hsa_circ_104885, hsa_circ_100185, hsa_circ_103171, hsa_circ_001978, hsa_circ_105039, hsa_circ_103627, hsa_circ_101717, and hsa_circ_104192) were obtained as candidate circRNAs with upregulation in CRC comparing with both CRA and healthy control. Through detecting the plasma expression levels of eight candidate targets, we identified three circRNA (hsa_circ_001978, hsa_circ_105039, and hsa_circ_103627) with increased level which were consistent with the microarray results in training set. Further validation found the circRNA panel was consistent with training set. The ROC curve also revealed a high diagnostic ability of hsa_circ_001978, hsa_circ_105039, and hsa_circ_103627 in predicted the CRC from CRA patients (AUC = 0.966) as well as healthy controls (AUC = 0.969).ConclusionOur data suggest that hsa_circ_001978, hsa_circ_105039, and hsa_circ_103627 might be a CRC‐specific biomarker for early diagnosis.     

Numerical Analysis of Physical Characteristics and Heat Transfer Decoupling Behavior in Bypass Coupling Variable Polarity Plasma Arc

A novel bypass coupling variable polarity plasma arc was proposed to achieve the accurate adjusting of heat and mass transfer in the welding and additive manufacturing of aluminum alloy. However, the physical characteristics and decoupled transfer behavior remain unclear, restricting its application and development. A three-dimensional model of the bypass coupling variable polarity plasma arc was built based on Kirchhoff’s law, the main arc and the bypass arc are coupled by an electromagnetic field. The model of current attachment on the tungsten electrode surface is included for simulating different heating processes of the EP and EN phases in the coupling arc. The distribution of temperature field, flow field, and current density of the bypass coupling variable polarity plasma arc was studied by the three-dimensional numerical model. The heat input on the base metal under different current conditions is quantified. To verify the model, the arc voltages are compared and the results in simulation and experiment agree with each other well. The results show that the radius of the bypass coupling arc with or without bypass current action on the base metal is different, and the flow vector of the bypass coupling arc plasma with bypass current is larger than the arc without bypass current. By comparing the heat transfer on the electrodes’ boundary under different current conditions, it is found that increasing the bypass current results in the rise in heat input on the base metal. Therefore, it is concluded that using bypass current is unable to completely decouple the wire melting and the heat input of the base metal. The decoupled degree of heat transfer is one of the important factors for accurate control in the manufacturing process with this coupling arc.     

经前路行颈椎后纵韧带骨化切除33例

对Ｃ_４水平以下节段性颈椎后纵韧带骨化（ＯＰＬＬ）３３例行前路骨化韧带切除术。２９例随访１～１０ａ，按ＪＯＡ标准评定疗效。结果：优（术后改善率８０％以上）１３例；良（５０％～７９％）１０例；改进（５％～４９％）３例；无变化（５％以下）２例；加重１例，有效率８９．６％。提示：Ｃ_４以下节段性ＯＰＬＬ适合前路开槽切除；Ｃ_４以上的节段性ＯＰＬＬ或连续型ＯＰＬＬ适合后路椎板成形椎管扩大术。充分暴露骨化灶的范围，才能将其完整切除。     

持续腰大池引流在颅内动脉瘤术后的临床应用价值

目的:探讨持续腰大池引流在颅内动脉瘤术后的临床应用价值.方法:颅内动脉瘤术后,治疗组72例行持续腰大池引流,对照组49例每天腰椎穿刺,通过比较两组并发症及预后评定疗效.结果:经过持续腰大池引流后,有症状性脑血管痉挛的发生率从34.69%降低为18.31%,脑积水的发生率从26.53%降低为11.27%,脑梗塞的发生率从20.4%降低为7.04%,出院时恢复良好者占76.06%,而对照组为57.14%,以上均有统计学意义(P＜0.05),治疗组并发症的发生率为5.63%,死亡率为零,对照组并发症的发生率为零,两组之间并发症的发生无统计学意义.结论:持续腰大池引流能够减少蛛网膜下腔中的痉挛因素,减轻脑血管痉挛的发生,减少并发症,改善预后.     

Novel insights into the consequences of obesity: a phenotype-wide Mendelian randomization study

Obesity is thought to significantly impact the quality of life. In this study, we sought to evaluate the health consequences of obesity on the risk of a broad spectrum of human diseases. The causal effects of exposing to obesity on health outcomes were inferred using Mendelian randomization (MR) analyses using a fixed effects inverse-variance weighted model. The instrumental variables were SNPs associated with obesity as measured by body mass index (BMI) reported by GIANT consortium. The spectrum of outcome consisted of the phenotypes from published GWAS and the UK Biobank. The MR-Egger intercept test was applied to estimate horizontal pleiotropic effects, along with Cochran’s Q test to assess heterogeneity among the causal effects of instrumental variables. Our MR results confirmed many putative disease risks due to obesity, such as diabetes, dyslipidemia, sleep disorder, gout, smoking behaviors, arthritis, myocardial infarction, and diabetes-related eye disease. The novel findings indicated that elevated red blood cell count was inferred as a mediator of BMI-induced type 2 diabetes in our bidirectional MR analysis. Intriguingly, the effects that higher BMI could decrease the risk of both skin and prostate cancers, reduce calorie intake, and increase the portion size warrant further studies. Our results shed light on a novel mechanism of the disease-causing roles of obesity.Subject terms: Lifestyle modification, Genetic predisposition to disease     

新型糖皮质激素在炎症性肠病治疗中有效性和安全性的研究现状

炎症性肠病包括溃疡性结肠炎和克罗恩病,全世界约有2 500 000人患有此病.其病因可能是基因易感人群对肠道菌群的免疫应答失调.传统糖皮质激素能有效诱导活动期疾病缓解,但同时伴有诸多全身副作用.新型糖皮质激素如布地奈德和倍氯米松,粘膜吸收、灭活迅速,起效快,抗炎作用强且全身副作用少.这些新型制剂口服后被小肠的吸收,特异地释放于肠道粘膜,发挥其强大的抗炎作用.就新型糖皮质激素在炎症性肠病治疗中的有效性和安全性做简要评估和总结.     

肝再生增强因子在急性肾衰大鼠模型肾组织中的表达及意义

目的 探讨在庆大霉素所致急性肾衰大鼠肾组织中肝再生增强因子(ALR)的表达部位、表达量变化及其与肾小管上皮细胞增生的关系。方法 建立由庆大霉素所致的中毒性急性肾衰大鼠模型，采用免疫组织化学方法检测实验第4、6、8、12、16、21天肾组织中肝再生增强因子的表达和分布情况以及小管上皮细胞增生程度。结果 ALR在正常肾组织内主要表达于髓质区的髓襟、远曲小管和集合管；在实验第4天除了在上述部位表达增强外，在皮质区损伤和再生的近端小管上皮细胞有弱表达，第8天在上述部位表达最强，第12天在皮、髓质区表达开始下降，至21d几乎恢复到正常水平；在正常及肾衰大鼠肾小球内未见ALR表达。对照组肾小管上皮细胞增生指数(PI)为0．6％，实验组第4、6、8、12、16、21天的PI分别为10．4％、17．4％、34．2％、19．2％、8．4％、3．8％。皮质、髓质区ALR表达阳性的面积与小管上皮细胞PI成正相关(r分别为0．913和0．954，P＜0．01)。结论 ALR在庆大霉素所致中毒性急性肾衰大鼠肾脏组织表达明显增强，且与肾小管上皮细胞增生程度成正相关。提示肝再生增强因子参与了中毒性急性肾衰的病理改变过程，其作用可能与肾小管上皮细胞再生有关。     

Rational design of M–N4–Gr/V2C heterostructures as highly active ORR catalysts: a density functional theory study

Inspired by the composites of N-doped graphene and transition metal-based materials as well as MXene-based materials, heterostructures (M–N₄–Gr/V₂C) of eight different transition metals (M = Ti, Cr, Mn, Fe, Co, Ni, Cu, and Zn) doped with nitrogen-coordinated graphene and V₂C as potential catalysts for the oxygen reduction reaction (ORR) using density functional theory (DFT) were designed and are described herein. The calculations showed that the heterostructure catalysts (except for Zn–N₄–Gr/V₂C) were thermodynamically stable. Ni–N₄–Gr/V₂C and Co–N₄–Gr/V₂C showed higher activities towards the ORR, with overpotentials as low as 0.32 and 0.45 V, respectively. Excellent catalytic performance results were observed from the change in electronic structure caused by the strong interaction between V₂C and the graphene layers as well as the synergistic effect between the MN₄ groups and the graphene layers. This study further provides insights into the practical application of ORR catalysts for MXene systems through the modulation of the electronic structure of two-dimensional materials.

Heterostructures (M-N₄-Gr/V₂C) of eight different transition metals (M = Ti, Cr, Mn, Fe, Co, Ni, Cu and Zn) were designed as potential catalysts for oxygen reduction reactions (ORR).