Azone预处理对抗病毒药Ara-ADA穿透无毛小鼠皮肤的持续影响

本文用两个半池组成的扩散池测定4～6周无毛小鼠腹部皮肤用1-十二烷基氮杂环庚烷2酮(Azone)预处理24h后,对抗病毒药2′,3′-双乙酰阿糖腺苷(2′,3′-di-O-acetyl-3-βD arabinofuranosyl adenine简称Ara ADA)透过皮肤促进作用的持续效应。皮肤经Azone处理后,立即或分别测定经历4,5…8d后的穿透系数。结果表明,经Azone处理后的无毛小鼠皮肤可使Ara ADA的穿透系数提高44倍,皮肤经Azone处理一次后,药物透过皮肤的促进作用至少可持续8d,药物通过皮肤的扩散时滞明显缩短。     

Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions

Background  Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates. Objectives  This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions. Methods  Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden. Results  A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents. Conclusion  Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.     

Pseudoaneurysm and deep vein thrombosis complicating femoral osteochondroma: Multimodality imaging

A case of a femoral osteochondroma complicated by pseudoaneurysm and deep venous thrombosis is presented. Multimodality imaging contributed crucial information to allow successful diagnosis and preoperative planning.     

聚焦超声与低温等离子治疗后兔鼻黏膜形态学分析

目的 观察聚焦超声与低温等离子对鼻黏膜形态学的影响程度及意义.方法 运用聚焦超声技术,在设定的剂量参数下对兔鼻甲进行直线扫描;运用低温等离子射频消融术对免鼻甲进行处理,在1个月及3个月后对两种方法处理后兔鼻甲切片及正常兔鼻甲切片进行对比观察,通过大体形态、光镜下观察对两种治疗方法兔鼻黏膜组织形态学的改变进行比较.结果 两种方法处理后1个月及3个月后兔鼻甲在外观和色泽无明显改变,光镜下显示兔鼻黏膜上皮层完整;运用低温等离子射频消融术处理后兔鼻甲外观较正常缩小,色泽灰白,且有分泌物存在,光镜下显示兔鼻黏膜上皮层断裂,部分切片上皮层完全消失.结论 在设定参数下聚焦超声可不破坏鼻黏膜上皮,可使鼻黏膜黏液纤毛系统功能得以完全保留.     

Household Effects of School Closure during Pandemic (H1N1) 2009, Pennsylvania, USA

To determine the effects of school closure, we surveyed 214 households after a 1-week elementary school closure because of pandemic (H1N1) 2009. Students spent 77% of the closure days at home, 69% of students visited at least 1 other location, and 79% of households reported that adults missed no days of work to watch children.     

Effects of alcohol on histone deacetylase 2 (HDAC2) and the neuroprotective role of trichostatin A (TSA)

Background: Previous studies have implicated histone deacetylases (HDACs) and HDAC inhibitors (HDIs) such as trichostatin A (TSA) in the regulation of gene expression during drug addiction. Furthermore, an increase in HDAC activity has been linked to neurodegeneration. Alcohol has also been shown to promote abundant generation of reactive oxygen species (ROS) resulting in oxidative stress. TSA inhibits HDACs and has been shown to be neuroprotective in other neurodegenerative disease models. Although HDACs and HDIs have been associated with drug addiction, there is no evidence of the neurodegenerative role of HDAC2 and neuroprotective role of TSA in alcohol addiction. Therefore, we hypothesize that alcohol modulates HDAC2 through mechanisms involving oxidative stress. Methods: To test our hypothesis, the human neuronal cell line, SK‐N‐MC, was treated with different concentrations of ethanol (EtOH); HDAC2 gene and protein expression were assessed at different time points. Pharmacological inhibition of HDAC2 with TSA was evaluated at the gene level using qRT‐PCR and at the protein level using Western blot and flow cytometry. ROS production was measured with a fluorescence microplate reader and fluorescence microscopy. Results: Our results showed a dose‐dependent increase in HDAC2 expression with EtOH treatment. Additionally, alcohol significantly induced ROS, and pharmacological inhibition of HDAC2 with TSA was shown to be neuroprotective by significantly inhibiting HDAC2 and ROS. Conclusions: These results suggest that EtOH can upregulate HDAC2 through mechanisms involving oxidative stress and HDACs may play an important role in alcohol use disorders (AUDs). Moreover, the use of HDIs may be of therapeutic significance for the treatment of neurodegenerative disorders including AUDs.