Computer analysis system of blood oxygen saturation in an animal hypoxia model

An experimental animal hypoxia model has been developed. It consists of two sensors (an in vitro and in vivo model), an experimental device and a computer signal processing system. This method can easily be applied to determine and analyse blood oxygen saturation at various hypoxia levels. It can also be used to evaluate the accuracy of pulse oximetry over a wide range of oxyhemoglobin desaturation levels. The DC and AC components of recorded red and infra-red signals, the dual-wavelength ratio R₁₂ and the reading of a pulse oximeter (SpO₂) can be automatically calculated and displayed on a computer screen. Preliminary results of the animal hypoxia test indicate that the measurements made by the instrument correlate well with the oxygen saturation readings of the automatic blood gas analyser AVL945. The computer analysis system is suitable for repeated estimations in the animal model.     

医院实施ISO9001质量管理体系内部审核的探讨

医疗机构实施ISO9001,其目的是为了提高医疗服务质量,满足病人一切明确和隐含的需求。那么,内审是否发挥作用,直接关系管理体系的有效性。文章对此进行了初步的探讨,即:①明确内审的目的是检查体系满足标准要求的程度;②建立正规的内审机构,要选拔责任心强、综合素质高的人担任内审员;③编制合理且有特色的内审计划,是内审有效性的关键;④适当增加专题审核;⑤医院最高管理者应重视内审结果。     

磷酸钙人工骨(CPC)在颈前路椎间融合的临床应用

目的探讨磷酸钙人工骨(CPC)在颈椎前路椎间融合手术中的应用效果。方法2001年4月至2003年10月颈前路手术中应用磷酸钙人工骨栓椎间融合结合钛钢板固定治疗颈椎病17例,颈椎间盘突出症5例,颈椎外伤脱位2例,共24例35个节段。采用JOA评分评价神经功能,X线片判定融合效果。结果随访18±6.5个月,术后无感染,无过敏或毒性反应。JOA评分由术前9.28±2.15分增加到14.65±2.18分(P<0.001)。术后X线片未见CPC骨栓塌陷或移位,钛板和螺钉无松动及折断。术后16.5±6.8个月均获得椎间融合。结论颈椎前路椎间融合手术应用磷酸钙人工骨替代自体骨,经济、安全、简便、效果可靠。     

IL-17 Eliminates the Therapeutic Effects of Myelin Basic Protein-Induced Nasal Tolerance in Experimental Autoimmune Encephalomyelitis by Activating IL-6

Interleukin (IL)-17 is a proinflammatory cytokine primarily secreted by Th17 cells, which are a CD4⁺ T-cell subset. Th17 cells and IL-17 are important in the pathogenesis of multiple sclerosis and in its established animal model, experimental autoimmune encephalomyelitis (EAE). However, it is unclear whether IL-17 contributes to EAE immune tolerance. We used the myelin basic protein (MBP) peptide MBP 68–86 to induce nasal tolerance to EAE, and simultaneously interfered with the tolerance by treatment with different doses of IL-17. We found that IL-17 dramatically interfered with MBP 68–86-induced immune tolerance. IL-17 administration increased IL-6 release, skewing T cell differentiation towards Th17 cells and decreasing the number of Treg cells. This led to an imbalance between Treg cells and Th17 cells and spurred the development of EAE.     

Ketamine inhibits LPS-induced calcium elevation and NF-kappa B activation in monocytes

Objective:To investigate whether ketamine could inhibit lipopolysaccharide (LPS)-induced intracellular calcium elevation and NF-kappa B activation in monocytes. Materials and methods:Isolated rat monocytes were challenged with 10 g/ml LPS with or without the presence of various concentrations of ketamine (10, 100, 1000 M). Intracellular calcium was monitored by laser confocal microscopy. NF-kappa B activity of the nuclear extracts of monocytes was analyzed by electrophoretic mobility shift assay (EMSA). Results:LPS provoked a significant calcium elevation and enhanced NF-kappa B activity in monocytes. Ketamine above concentration of 100 M inhibited endotoxin-induced intracellular calcium elevation and NF-kappa B activity. Ketamine itself had no effect on either of them. Conclusions:These findings suggest that ketamine could suppress NF-kappa B in monocytes exposed to endotoxin, and this anti-inflammatory effect might act through attenuating intracellular calcium elevation.Received 31 October 2003; returned for revision 18 December 2003; accepted by I. Ahnfelt-Rønne 26 Januaryy 2004     

结直肠癌RAS、BRAF基因状态与临床病理特征的关系

目的分析中国人群结直肠癌患者中KRAS、NRAS及BRAF基因突变状态与临床病理特征之间的关系。方法回顾性分析2018年1月—2020年11月于福建省肿瘤医院接受治疗的370例结直肠癌患者的肿瘤组织标本,检测KRAS、NRAS、BRAF基因突变状态及MMR蛋白表达状态,分析基因突变状态与结直肠癌临床病理特征的关系。结果370例患者中存在KRAS基因突变155例(41.9%),NRAS基因突变19例(5.1%),BRAF基因突变40例(10.8%),其中1例患者突变类型为G469V,其他均为V600E突变。KRAS基因在女性、高中分化患者中突变率高(P<0.05)。NRAS基因突变多见于低分化、浸润型患者(P<0.05)。BRAF V600E突变在右半结肠癌、年龄小于50岁、低分化、浸润型、淋巴结及远处转移患者中的突变率高(P<0.05)。结论KRAS基因突变与性别、分化程度有关,NRAS基因突变与分化程度、肿瘤大体分类有关,BRAF基因V600E突变与肿瘤原发部位、年龄、分化程度、肿瘤大体分类、区域淋巴结及远处转移有关。对结直肠癌患者进行KRAS、NRAS及BRAF基因的检测,为了解中国患者热点基因突变分布情况和临床精准诊疗提供理论依据。     

面肌痉挛行微血管减压术并发远隔部位出血患者的护理

总结9例面肌痉挛行微血管减压术并发远隔部位出血患者的护理经验.护理要点包括:警惕远隔部位出血的高危人群,早期识别术后远隔部位出血的先兆,紧急处置不同类型的远隔部位出血患者,实施医护一体化的目标血压管理,做好硬膜下引流管的护理,落实个性化心理护理.本组患者经过积极处理,神经功能逐渐恢复,均好转出院.     

Pyriform sinus fistula in children: A comparison of endoscopic-assisted surgery and endoscopic radiofrequency ablation

BackgroundPyriform sinus fistula (PSF) is a rare congenital anomaly, and the preferred definitive treatment is yet to be verified. In this study, we investigated the treatment outcomes of PSF specifically comparing endoscopic-assisted surgery and endoscopic radiofrequency ablation (RA).MethodsThe medical records of patients treated for PSF at the Shanghai Children's Hospital between October 2016 and September 2019 were retrospectively evaluated.ResultsThere were 93 girls and 98 boys. The median age at onset and operation was 3 years and 5 years, respectively. Endoscopic-assisted surgery was performed in 143 patients. During the same period, RA was performed in 48 patients, and 10 of them concurrently underwent incision and drainage of neck abscesses. Longer hospital stay was found in the endoscopic-assisted surgery group than in the RA group (10.50 ± 3.93 vs. 5.02 ± 3.30 days, P < 0.001). Postoperative complications were not significantly different between the two groups, except for neck infection (0 vs. 8.3%, P = 0.004). After a median follow-up period of 21 months, no significant difference was found between the two groups in terms of recurrence (1.4% vs. 0, P = 0.560).ConclusionPatients treated with RA had a significantly shorter hospital stay than those treated with endoscopic-assisted surgery. Outcomes of endoscopic-assisted surgery and RA were not significantly different for the management of PSF and treatment method should be tailored to the patient.Level of evidenceIV.