Averaged axillary F-loop latency of median and ulnar nerves

Axillary F-loop latencies (AFLL) were measured on median and ulnar nerves of 54 normal volunteers. The median and ulnar nerves were stimulated at the wrist and at the axilla 25cm distal to the sternal notch. The compound muscle action potentials were recorded from thenar and hypothenar muscles. Averaged tracings from 32 consecutive stimuli at the wrist were obtained. The averaged F-wave latencies were measured to the peak (Fwp) of the averaged F-wave. The M-wave latencies from wrist and axilla stimulation were measured to the onset of the wave (Mw and Ma, respectively). The averaged AFLL (a-AFLL) was calculated as (Fwp + Mw)-2 Ma. The average values of a-AFLL were 14.12 +/- 0.88msec for median nerve, and 13.97 +/- 0.90msec for ulnar nerve. There was no significant difference between male and female subjects, nor between the right and left sides. Seven subjects with EMG evidence of C8 or C8 to T1 radiculopathy, although manifesting normal AFLL gauged by the regular method (ie, measured to the onset of the shortest F-wave latency among eight tracings), had significantly longer "averaged AFLL" in both median and ulnar nerves of the affected side than the a-AFLL obtained from the normal side. It is concluded that the a-AFLL is a more sensitive measure than the "regular AFLL" in the assessment of proximal nerve lesion (especially C8 or C8 to T1 radiculopathy).     

消炎痛对hCG诱发家兔排卵抑制的形态学研究

应用非甾体抗炎药消炎痛(20mg/kg)抑制hCG 诱发的家兔排卵,注射后的6、9、12、72小时剖腹观察排卵数,并取材进行透射电镜观察和酶组织化学观察。甾体激素合成酶类的组织化学和颗粒细胞内某些细胞器的电镜立体定量学测定结果表明:消炎痛抑制了排卵,却不影响颗粒细胞向黄体细胞的转变。透射电镜观察表明:在排卵前,实验组和对照组最明显的不同是:实验组的外膜和白膜很少见到胶原溶解现象,且表面上皮细胞内含的致密小体不释放其内容物。结果提示:消炎痛主要作用于排卵前卵泡顶部的成纤维细胞和表面上皮细胞,这可能与其抑制了某些与排卵有关的酶的释放有关。     

Monoamine oxidase-B inhibition: a comparison of in vivo and ex vivo measures of reversible effects

Summary A behavioural test involving potentiation of the effects of an acute injection of -phenylethylamine (10 mg kg^–1 i.p.) was used to assess the time-course of type-B MAO inhibition after administration of (–)deprenyl (5 mg kg^–1 i.p.) and of MD 240928 (20 mg kg^–1 i.p.) respectively. Potentiation of the effects of -phenylethylamine was observed 1 h after injection of (–)deprenyl or MD 240928. This effect was still evident 120 h after administration of (–)deprenyl but not 24 h after administration of MD 240928. Comparisons of ex vivo estimates of MAO activity yielded a corresponding time-course for the recovery of this enzyme. The extent of MAO inhibition required for potentiation of the effects of -phenylethylamine was inferred from a comparison of the behavioural test results and the ex vivo MAO activity observed after (–)deprenyl administration. These comparisons indicate a significant underestimation of MD 240928-induced MAO inhibition using ex vivo measures. This underestimation is interpreted as evidence fordilution effects in the ex vivo assay of MAO inhibition. The potentiation of effects of -phenylethylamine under the present conditions is proposed as a useful and simple test for effects of reversible type-B MAO inhibitors.     

Inapparent infection of hepatitis A virus

To detect inapparent infection with hepatitis A virus, serial sera were collected from patients with hepatitis A and their contacts in two waterborne epidemics in China. Epidemic 1 occurred in a rural village near Hangzhou during August 1978-January 1979, and epidemic 2 took place in a rural primary school in Pinghu County in Zhejiang in April-May 1985. These sera were tested for antibodies against hepatitis A virus (anti-HAV), serum glutamic pyruvic transaminase (SGPT) activity, and icteric index. Feces also were collected in epidemic 1 to test for hepatitis A virus antigen. Both anti-HAV immunoglobulin M (IgM) and total anti-HAV were assayed in sera from "healthy persons" (symptomless persons without icterus and with normal SGPT level) who were in close contact with hepatitis A patients. In epidemic 1, among 18 "healthy persons", 12 were anti-HAV IgM positive, two were immune, and four susceptibles escaped infection. In epidemic 2, among 32 "healthy children", three were anti-HAV IgM positive, five had been infected by hepatitis A virus in the past, and 24 were not infected. These results demonstrate that inapparent infections occur along with overt and subclinical infections during epidemics of hepatitis A. The proportions of inapparent, subclinical, and overt infections were, respectively, 34.3%, 45.7%, and 20% in epidemic 1, and 25%, 50%, and 25% in epidemic 2. In addition, hepatitis A virus particles were demonstrated in the feces of all infected subjects who were examined and who included all levels of clinical response. These particles were identified with immuno-electron microscopy and enzyme-linked immunoassay.     

快速康复外科理念在膀胱癌患者根治性全膀胱切除术围术期护理中的应用效果

目的 分析快速康复外科(FTS)理念在膀胱癌(BC)患者根治性全膀胱切除术围术期护理中的应用效果。方法 回顾性收集我院147例BC患者,均接受根治性全膀胱切除术治疗,将2017年1月～2018年10月在围术期接受常规护理干预的73例作为对照组,将2020年1月～2021年10月在围术期接受FTS理念干预的74例作为观察组,比较两组围术期情况、不同时间点(术前1d、术后1h、1d)疼痛程度、并发症。结果 观察组术后首次下床活动、术后首次排气以及住院时间均短于对照组(P＜0.05);两组不同时间、组间、交互作用下视觉模拟疼痛评分(VAS评分)比较,差异具有统计学意义(P＜0.05),两组术前1d VAS评分比较,无明显差异(P＞0.05);而与对照组术后1h、1d VAS评分相比,观察组均较低(P＜0.05);观察组、对照组并发症发生率分别为31.08%、41.10%,组间比较,无明显差异(P＞0.05)。结论 FTS理念应用于BC患者,能减轻疼痛程度,缩短术后首次下床活动、术后首次排气时间,促进术后恢复。     

硬膜外镇痛联合应用乙酰氨基酚在剖宫产术后的镇痛效果

目的：比较对乙酰氨基酚联合自控硬膜外镇痛的多模式术后镇痛与单纯自控硬膜外镇痛用于剖宫产产妇术后镇痛效果。方法：200名行剖宫产的产妇随机分为实验组（S组）和对照组（C组）,S组产妇在术前15min静脉注射对乙酰氨基酚1g,C组产妇在术前15min静脉注射安慰剂（生理盐水）。两组产妇均采用腰硬联合麻醉方案,缝合切口时启动自控硬膜外镇痛泵。术前、术后即刻、术后1天、术后2天观察疼痛强度和血清IL-6、IL -10水平;记录新生儿出生Apgar评分、术后阿片类药物使用量及术后不良反应、产妇满意度和对母乳喂养的影响程度。结果：术后1天疼痛评分S组显著低于C组。术后即刻、术后1天S组IL-6表达水平低于C组,而该时点S组IL-10表达水平高于C组（P＜0.05）。两组间不良反应、新生儿出生Apgar评分、产妇满意度和母乳喂养情况无统计学差异（P＞0.05）。结论：剖宫产术前静脉注射对乙酰氨基酚联合自控硬膜外镇痛比单独应用自控硬膜外镇痛能够为产妇提供更好的术后疼痛管理。     

消化道肿瘤免疫相关不良事件的临床分析

目的探讨消化系统恶性肿瘤中免疫检查点抑制剂(immune checkpoint inhibitors, ICIs）导致免疫相关不良事件(immune-related adverse events, irAEs)的特征及危险因素。方法 回顾性分析2019年4月至2021年10月北京大学肿瘤医院诊治的95例接受ICIs治疗的消化系统恶性肿瘤患者的临床资料和irAEs发生情况。irAEs、内分泌irAEs危险因素分析采用二元Logistic回归分析。结果 95例患者共应用ICIs治疗458例次,中位应用3例次(范围：1~33例次）。irAEs的发生率为55.8%,3~4级irAEs发生率为9.5%。最常见的irAEs为皮肤irAEs(27.4%）和内分泌irAEs(22.1%）。内分泌irAEs中甲状腺功能减退最常见(16.8%）,肾上腺皮质功能减退(2.1%）和垂体炎(1.1%）少见。多数irAEs发生于免疫治疗初期,78.2%发生于12周内。过敏反应、皮肤irAEs最早发生,中位发生时间分别为2周(范围：0.9～3.1周）和3.8周(范围：0.9～17.9周）,内分泌irAEs中位发生时间为6.9周(范围：3.0～52.1周）。多因素分析显示,女性(OR=5.197, 95%CI：1.166～23.154, P=0.031)和微卫星高度不稳定(microsatellite instability-high,MSI-H） (OR=35.048, 95%CI：2.756～445.787, P=0.006)是内分泌irAEs发生风险增加的独立危险因素,免疫治疗联合化学药物治疗(OR=0.107, 95%CI：0.021～0.412, P=0.001）是内分泌irAEs的独立保护性因素。结论在消化系统恶性肿瘤中应用ICIs具有较好的安全性。女性和MSI-H患者出现内分泌irAEs风险增加,联合化学药物治疗可能降低内分泌irAEs发生风险。     

肢体远隔缺血期适应联合后适应促进大鼠缺血性脑卒中模型神经发生的作用及机制

目的 探讨肢体远隔缺血期适应(per-conditioning,PerC)联合后适应(post-conditioning,PostC)对缺血性脑卒中后神经再生的作用,并明确PerC联合PostC对脂肪酸β-氧化(fatty acid β-oxidation,FAO)限速酶——肉毒碱棕榈酰转移酶(carnitine palmitoyl transferase 1A,CPT1A)的影响。方法 对成年雄性SD大鼠进行大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)造模,MCAO模型后30 min进行肢体远隔缺血期适应治疗(PerC),再灌注24 h后重复进行肢体远隔缺血适应(PostC),1次/d,直到取材。再灌注14 d后对大鼠进行神经功能评分,通过免疫组织化学染色检测室管膜下区(subependymal ventricular zone, SVZ)神经再生情况,通过酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)法检测CPT1A的表达。结果 与MCAO组及PerC/PostC组比较,PerC+PostC组大鼠,身体不对称运动行为评分降低,神经干细胞的数量以及向梗死区迁移的细胞数量增加。Pearson相关性分析显示,神经干细胞的数量与神经功能呈负相关(r=-0.917 9, P<0.0001)。然而,迁移到基底节区的神经干细胞的凋亡数量在各组之间差异无统计学意义。机制研究显示,PerC+PostC组CPT1A的蛋白水平显著增加。结论 PerC联合PostC治疗能够通过增加神经干细胞的数量改善神经功能,神经干细胞的脂肪酸氧化可能是其促进神经干细胞迁移的机制之一。     

基于支持向量机的脊柱离体组织电阻抗识别

目的 测量不同脊柱组织的电阻抗,基于支持向量机建立电阻抗数据的组织分类算法并验证算法的准确性,寻找不同组织电阻抗分类阈值。 方法 取离体脊柱组织,应用电化学分析仪采集10~100 kHz频率范围内皮质骨、松质骨、脊髓、肌肉、髓核的电阻抗。将两只猪采集的数据集分别作为训练集和测试集,应用主成分分析降维至二维数据,训练和验证基于支持向量机(SVM)建立的分类算法,应用集成学习的方法计算不同组织分类的电阻抗阈值。 结果 5种组织在10~100 kHz的测量频率内,电阻抗值差异有统计学意义(P<0.001)。应用主成分分析降维的数据集建立的支持向量机分类算法识别不同组织的准确率为100%。应用集成学习建立的多个分类器计算出了不同组织的电阻抗分类阈值。 结论 基于支持向量机可以实现脊柱术区组织电阻抗的准确识别,有望应用于临床协助医生提升组织识别准确率。     

新冠疫情期间家庭环境对初中生非自杀性自伤的影响:抑郁的中介作用

  目的  了解新型冠状病毒感染疫情（新冠疫情）期间成都市初中生非自杀性自伤（non-suicidal self-injury, NSSI）的发生现状,探讨抑郁在家庭环境与NSSI间的作用机制。  方法  数据来源于成都儿童正向成长队列（Chengdu Positive Child Development, CDPD）,于2020年6–7月成都市中小学因新冠疫情关闭解封后,采用蓄意自伤量表（Deliberate Self-Harm Inventory, DSHI）、中国家庭评估测量工具（Chinese Family Assessment Instrument, C-FAI）、流调中心儿童抑郁量表（Center for Epidemiologic Studies Depression Scale for Children, CES-DC）进行现场问卷获得3595名初中生调查资料。采用两样本t检验和χ2检验,比较不同年级和性别初中生的NSSI发生率,利用SPSS PRECESS组件Model 58检验分析性别调节下抑郁的中介作用。  结果  ①新冠疫情期间成都市初中生的NSSI发生率为49.67%,九年级学生的NSSI发生率（80.70%）,高于八年级（33.82%）和七年级（32.32%）,初中女生的NSSI发生率（54.75%）高于男生（44.52%）;②家庭环境（r=0.34, P<0.001）、抑郁（r=0.50, P<0.001）与NSSI呈正相关;③抑郁在家庭环境对NSSI的影响中起部分中介作用,中介效应占总效应的64.64%;与男生相比,初中女生在家庭环境与抑郁、抑郁与NSSI的正向预测作用更加显著。  结论  新冠疫情期间,成都市初中生NSSI发生率较高,提示应改善家庭环境,关注性别差异,加强抑郁的早期筛查和干预,以减少NSSI发生。