A mononuclear nine-coordinated Dy(iii) complex exhibiting field-induced single-ion magnetism behaviour

A new mononuclear Dy(iii) complex, with the formula [Dy(Hcpt)₃]·2H₂O (1), has been successfully prepared via self-assembly between Dy(iii) ions and 2-cyano-N′-(1-(pyridin-2-yl)amido)acetyl (Hcpt) ligand. X-ray diffraction study shows that the Dy(iii) ion is nine-coordinated by three Hcpt ligands with a tridentate chelating mode, leading to an approximately monocapped square-antiprismatic (C_4v) geometry. Magnetic data analysis demonstrates that 1 performs field-induced slow magnetic relaxation with a relaxation barrier of 97.90 K, due to the quantum tunneling effect suppressed upon a static dc field of 2000 Oe. To deeply understand the magnetic behaviors, the relaxation mechanisms and magneto-structure relationship are rationally discussed using ab initio calculations as well.

Reaction of Dy(iii) ion with tridentate acylhydrazone ligand leads to a field-induced Dy(iii) SIM, of which the magneto-structural correlation is elucidated by the magnetic and theoretical studies.     

乌头碱中毒所致心律失常20例抢救体会

本文报道了我院于1966年11月～1983年4月共抢救乌头碱中毒所致各种心律失常20例,全部治愈,无1例死亡,抢救方法如下: 1.立即洗胃,导泻及大量静脉输液,以加速毒物从体内排泄。2.在无特殊拮抗剂的情况下,乌头碱中毒所引起的各种缓慢型心律失常,主要为迷走神经强烈兴奋所致,应选用阿托品,以阻断迷走神经对窦房结及房室结兴奋性的抑制。对于窦房结功能低下而出现的室性心律失常,应用阿托品亦可使其消失。3.患者若出现呼吸抑制,休克或心脏停搏者,均提示中毒严重,应紧急治疗。4.室性心律失常,应立即静脉注射利多卡因。5.乌头碱中毒在体内无蓄积作用,如用阿托品治疗,心律失常消失后,即可停用,以免发生中毒。     

Toripalimab combined with docetaxel and cisplatin neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma: a single-center,single-arm clinical trial (ESONICT-2)

BackgroundMore and more evidence has confirmed the efficacy and safety of immunotherapy drugs, such as camrelizumab and pembrolizumab. There are several phase-I/II studies showing that toripalimab has an acceptable safety profile and promising clinical activity in patients with advanced solid tumors. To further confirm its efficacy and safety, the aim of the study was to evaluate toripalimab combined with docetaxel and cisplatin neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma (ESCC).MethodsThis study was an investigator-initiated, open-label, non-randomized, single-arm, single-center phase II trial (registration number: ChiCTR2100052784). The patients eligible for inclusion criteria at Fujian Medical University Union Hospital from October 2019 to October 2020 were included in this study. Patients who were suitable for surgery underwent minimally invasive esophagectomy (MIE) within 4–6 weeks after neoadjuvant therapy. Pathological complete response (pCR) and adverse events (AEs) were the primary end points. Secondary endpoints included R0 resection rate, major pathological response (MPR), interval to surgery, and 30-day complications.ResultsA total of 20 patients were enrolled from October 2019 to October 2020. All patients successfully completed 2 cycles of neoadjuvant therapy. Treatment-related AEs were common during neoadjuvant therapy, with leucopenia the most frequently occurring AE (4/20, 25%). With respect to immune-related AEs, immune dermatitis occurred in 2 patients, including 1 patient with grade I and 1 patient with grade III. Based on radiologic evaluation, the objective response rate (ORR) was 70% (14/20). Twelve patients underwent McKeown MIE. The pCR rate of the primary tumor was 16.7% (2/12), and the MPR rate of the primary tumor was 5/12 (41.7%). The mean interval to surgery was 33.2 days, and no patients experienced delayed surgery due to treatment-related AEs. Pneumonia was the most common 30-day postoperative complication (3/12, 25%). Anastomotic leakage (AL) only occurred in 1 patient during the hospital stay. There were no treatment- or surgery-related deaths.ConclusionsBased on our results, toripalimab combined with docetaxel and cisplatin as a novel neoadjuvant therapy was safe and effective in locally advanced ESCC.     

关节镜下经髌腱入路空心拉力螺钉复位固定治疗胫骨髁间嵴撕脱骨折*

目的探讨在关节镜下经髌腱入路,利用空心拉力螺钉复位固定胫骨髁间嵴撕脱骨折(TEFx)的安全性和有效性。方法选取2014年1月-2015年12月23例TEFx的患者,均在关节镜下经髌腱入路,用空心拉力螺钉复位固定。术前Meyers-McKeever分型:Ⅱ型8例,Ⅲ型10例,Ⅳ型5例;男17例,女6例;年龄16～53岁,平均27.8岁。术前前抽屉试验、Lachman试验均阳性。比较术前术后的视觉模拟评分(VAS)、Lysholm、Tegner和国际膝关节文献委员会(IKDC)评分评价患侧膝关节功能。结果 23例患者均得到随访,随访时间30～40个月,平均36个月。术后即刻X线片示TEFx均复位良好,术后3个月骨折均愈合。无1例感染、关节僵硬、伸直受限、复位丢失及神经血管损伤等并发症。最终随访患侧膝关节活动度均恢复正常,前抽屉试验、Lachman试验均阴性。VAS评分术前(4.8±1.2)分,最终随访为(1.2±0.8)分,术前术后比较,差异有统计学意义(t=18.72,P=0.003);Lysholm评分术前为(50.8±6.2)分,最终随访为(90.8±5.4)分,术前术后比较,差异有统计学意义(t=-42.64,P=0.000);Tegner评分术前为(4.0±1.0)分,最终随访为(5.1±1.2)分,术前术后比较,差异有统计学意义(t=-16.82,P=0.005);IKDC主观评分术前为(52.5±7.4)分,最终随访为(91.5±5.7)分,术前术后比较,差异有统计学意义(t=-40.58,P=0.000)。结论膝关节镜下经髌腱入路空心拉力螺钉内固定治疗TEFx具有微创、操作简捷、固定可靠和恢复快的优点。     

吻内侧被盖核(RMTg)参与吗啡引起的大鼠睡眠紊乱

 目的 旨在阐明吻内侧被盖核(rostromedial tegmental nucleus,RMTg)是否参与吗啡引起的大鼠睡眠障碍。方法 将雄性SD大鼠随机分为溶剂对照组和吗啡组,每组7只,对照溶剂为人工脑脊液(artificial cerebrospinal fluid,ACSF)。采用脑立体定位、核团微量注射和睡眠记录与解析等技术观察RMTg内给予吗啡对大鼠睡眠-觉醒周期的影响。结果 与对照组相比,双侧RMTg 给予吗啡(16 mmol/L,每侧0.5 μL)可以引起大鼠长达4 h的觉醒,期间非快动眼(non-rapid eye movement,NREM)睡眠深度降低、快动眼(REM)睡眠减少的现象与吗啡临床用药所引起的睡眠障碍的表现相一致。结论 RMTg参与吗啡引起的大鼠睡眠紊乱。     

以“芪英三两三”组方经验为指导治愈顽固慢性再生障碍性贫血1例

慢性再生障碍性贫血属于临床血液系统常见疾病之一，发病率呈逐年升高趋势，病程长，易反复，对患者的生活质量形成严重影响。姜苗教授认为慢性再生障碍性贫血不仅与肾虚相关，且与脾胃升降功能联系密切，强调从脾论治，抓住“虚”“瘀”“毒”3个病理因素，活用“芪英三两三”组方加减，健脾益肾，化瘀解毒。文章以完全治愈1则顽固慢性再障合并继发血小板减少病案为例，探讨姜教授治疗慢性再生障碍性贫血思路及用药方案。     

冠心病心力衰竭病人胸段硬膜外阻滞后心功能变化

目的：观察冠心病心力衰竭（CHF）病人高位胸段硬膜外阻滞（HTEA）前后脂质过氧化物和左心室舒缩功能的变化，方法：选择48例冠心病心力衰竭病人均分为HTEA组（n=24)及常规治疗组（n=24),观察治疗前后心功能，丙二醛（MDA），超氧化物歧化酶（SOD）的变化。结果：治疗后CHF病人心脏舒缩功能的改善；HTEA组明显优于常规治疗组（P＜0．05），MDA含量HTEA组明显低于常规治疗组（P＜0．01），SOD则明显高于常规治疗组（P＜0．05），结论：HTEA治疗CHF病人对心脏舒缩功能的改善明显优于常规法，其增强抵抗自由基的能力是可能的机制之一。     

带蒂大转子骨瓣修复股骨头生物力学研究

目的探讨带血管蒂大转子骨瓣转移治疗股骨头缺血性坏死的生物力学特点。方法比格犬22只,8—12个月龄,雌、雄各11例,体重7—10kg;分为3组,A组2只（4髋）作为正常对照组,B组右侧股骨头坏死组（20髋）,C组左侧带血管蒂大转子骨瓣修复组（20髋）。分别于术后3、6、10、12、18、24周行CT扫描,24周后行生物力学测试和股骨头三维有限元分析。结果24周后影像学检查发现C组大转子骨瓣与周围骨组织有很好的相融性,C组再造的股骨头抗压强度与A组正常接近,而与坏死股骨头统计学有明显的差异（P〈0．05）,三维有限元分析修复的股骨头最大应变和应力接近正常,而与坏死有显著的差别。结论带血管蒂大转子骨瓣修复股骨头能恢复其生物力学     

预产期前音乐干预缓解产妇分娩疼痛

目的探讨音乐无痛分娩法对缓解产妇分娩过程中疼痛的效果。方法将在我院产科行围产期保健并分娩的孕产妇140例随机分为观察组和对照组各70例。对照组接受常规围产保健及产程护理;观察组在此基础上,于预产期的前8周开始应用音乐干预疗法。包括采用音乐处方,引导产妇将注意力聚集在音乐上,以及在临产后自带音乐CD或MP3进入待产室,为其播放熟悉音乐。对两组产程各个阶段的疼痛程度、分娩方式及产程时间进行比较。结果两组产程不同阶段(除第三产程)疼痛评分比较,差异有统计学意义(P0.05,P0.01);观察组第一产程、第二产程及总产程时间较对照组显著缩短,剖宫产率显著降低(P0.05,P0.01)。结论音乐无痛分娩法可明显缓解产妇分娩过程中的疼痛,缩短产程,降低剖宫产率。     

后方稳定型全膝人工关节置换术疗效随访分析

目的探讨后方稳定型全膝人工关节置换术(PSKA)治疗膝关节疾患的临床应用价值. 方法 1995年7月～2000年7月 ,共计PSKA (Insall-Burstein II)18例(19膝),男2 例(3膝),女16例(16膝),其中双侧 1例.年龄44～78岁,平均62.5岁.术前诊断膝关节骨性关节炎15膝,类风湿关节炎 4膝,伴有骨质缺损4膝.术前X线测量膝内翻畸形16膝,膝外翻畸形3膝,屈曲畸形8膝,, 有膝关节手术史2膝.17(18膝)例随访41～60个月,平均49个月.根据HSS膝关节百分评分系统进行评估. 结果术前平均62分,术后平均89分 ,活动范围(ROM)术前平均91°,术后平均115°,其中优11膝,良5膝,中1膝,差 1膝,手术优良率88.9%. 结论 PSKA可增加膝关节R OM和最大屈曲度,并限制其向后半脱位.它不但用于原发的膝关节疾病,还应用于膝关节翻修术的患者.髌骨并发症在PSKA最常见,应给予重视.