Prenatal diagnosis of pulmonary artery sling associated with tracheal agenesis: A case report

Pulmonary artery sling (PAS) and tracheal agenesis (TA) are rare diseases, and most cases of PAS are associated with tracheal bronchial malformations. However, PAS associated with TA is yet to be reported. We report a case of PAS with TA diagnosed prenatally. Due to the extremely low incidence, physicians do not have sufficient understanding of these diseases and it is challenging to diagnose these diseases by prenatal ultrasound, with high rates of misdiagnosis. Prenatal examination of the pulmonary artery branches, trachea, and esophagus is useful; therefore, improving the accuracy of prenatal diagnosis will help in perinatal management and counseling.     

Individualized diet care for patients scheduled for transurethral resection of the prostate and with diabetes

目的 提高经尿道前列腺电切术(TURP)并存糖尿病患者的血糖控制效果,降低手术风险,缩短住院时间.方法 根据入院日单双将106例TURP并存糖尿病患者分为观察组(单日入院者,62例)和对照组(双日入院者,44例).对照组按常规进行饮食护理；观察组患者在常规护理的基础上,依据患者身高、理想体质量、BMI(体重指数)、手术创伤应激及术后伤口修复额外所需营养制定饮食处方,并实施个体化饮食护理.结果 观察组术后第2天、第5天、第8天空腹血糖和餐后2h血糖及术后血尿时间、住院时间显著低于和短于对照组(均P＜0.01).结论 个体化饮食护理能提高患者的血糖控制效果,缩短术后血尿时间及住院时间,体现了以患者为中心的护理理念.     

手术室护士实施综合性护理干预对腹腔镜胆总管切开探查取石术患者心理状况及并发症的影响

目的探讨手术室护士实施综合性护理干预对腹腔镜胆总管切开探查取石术患者的心理状况及并发症的影响。方法全部入选病例均为本院2013年1月~2014年3月期间择期行腹腔镜胆总管切开探查取石术患者,根据护理方法不同分为干预组和对照组各40例,两组患者均由手术室护士进行围术期护理,其中对照组实施常规护理及随机对症护理,干预组手术室护士着重实施包括心理干预、T形管的护理、并发症的护理等综合性护理干预措施,比较两组患者术前和术后的焦虑心理状况SAS评分、两组患者的术中出血量、手术时间、术后排气时间、住院时间及两组患者的并发症情况。结果干预组和对照组的SAS评分术后与术前比较差异有统计学意义(P<0.05),且干预组患者术后的SAS评分显著低于对照组(P<0.05)。干预组患者的术中出血量、术后排气时间与对照组比较,差异有统计学意义(P<0.05),干预组患者的手术时间、住院时间略短于对照组,组间比较差异无统计学意义(P>0.05)。两组均未发生胆道狭窄,干预组患者术后发生胆石残留1例,术后出血1例,其并发症发生率达5.0%,显著低于对照组患者术后的并发症发生率27.5%(P<0.05)。其中干预组患者术后出血的发生率达2.5%,显著低于对照组的12.5%(P<0.05)。结论手术室护士对腹腔镜胆总管切开探查取石术患者通过实施综合性护理干预,有利于减轻患者的焦虑心理,减少并发症的发生率,从而明显提高手术治疗效果。     

The value of melanoma inhibitory activity and LDH with melanoma patients in a Chinese population

Malignant melanoma is a highly malignant tumor originating from the melanocytes of the neural crest, which is prone to metastasis and has a poor prognosis. Previous research demonstrated that melanoma inhibitory activity (MIA) and lactate dehydrogenase (LDH) could serve as serum markers in malignant melanoma and indicate prognosis in the Caucasian race. Researchers suspected that both MIA and LDH could prompt the prognosis of malignant melanoma in the Chinese population. This study aimed to investigate the value of MIA and LDH in the prognosis of acral malignant melanoma.From January 1, 2014, to December 31, 2017, in Jiangsu Province, 44 acral malignant melanoma patients with complete data were chosen from the clinic. The LDH levels were extracted from their clinical data, and MIA levels were measured by enzyme-linked immunosorbent assay method. 8 paired advancing samples before and after metastasis were examined. 22 health donors were matched to the patient group. Receiver operating characteristic (ROC) curves of MIA and LDH were drawn to determine acral malignant melanoma tumorigenesis and metastasis and finally got the cut-off value. Cumulative survival was illustrated with the Kaplan-Meier plot, and factors were compared using the Log-rank test.Compared with age-matched healthy donors, MIA was significantly high in patients (P < .001). Moreover, serum MIA was significantly higher in III-IV stage patients than I-II stage patients (P < .001). However, there was no such association between LDH and melanoma stage and risk. Further study indicated that the MIA cut-off > 914.7pg/mL predicted disease progression with 86.4% specificity and 95.5% sensitivity. In the Kaplan-Meier analysis, MIA levels were independent risk factors for long-term mortality of acral malignant melanoma patients.It concluded that the quantification of MIA in the serum should be performed as a general standard of care in patients at risk of developing metastatic melanoma.     

培菲康联合马来酸曲美布丁早期治疗对脓毒症患者肠黏膜屏障功能的影响

目的探讨培菲康联合马来酸曲美布丁早期治疗对脓毒症患者肠黏膜屏障功能的影响。方法将92例入住综合性ICU未出现肠功能障碍的脓毒症患者随机分成治疗组和对照组,每组46例。治疗组有4例及对照组有5例因不符合病例研究标准,最终被剔除本研究。除接受基础治疗外,治疗组患者入组第1天开始,鼻饲或者口服培菲康及马来酸曲美布丁,连用7 d以上,对照组则给生理盐水。采用酶联免疫吸附法(ELISA法)测定治疗前及第3、5、7天血浆二胺氧化酶(DAO)活性及D-乳酸浓度。在治疗后第5、7天评定2组肠功能。结果治疗前2组患者DAO活性及D-乳酸浓度比较差异均无统计学意义(t=0.802 9、0.340 3,P>0.05),治疗第7天,治疗组DAO活性及D-乳酸浓度均低于对照组(t=7.560 8、5.502 3,P<0.05)。2组组内比较,治疗前DAO活性及D-乳酸浓度最高,随着时间的推移,2项指标均逐渐下降(P<0.01,P<0.05)。治疗后第5、7天,治疗组肠功能评分均低于对照组[(0.485±0.312)分vs.(0.634±0.363)分;(0.216±0.354)分vs.(0.425±0.367)分,P<0.05]。而组内比较,2组第7天肠功能评分均低于第5天(P<0.05)。结论培菲康联合马来酸曲美布丁早期治疗有助于保护脓毒症患者肠黏膜屏障功能。     

Enhanced functional DNA biosensor for distance-based read-by-eye quantification of various analytes based on starch-hydrolysis-adjusted wettability change in paper devices

Low-cost, equipment-free and quantitative detection of a wide range of analytes of interest at home and in the field holds the potential to revolutionize disease diagnosis, environmental pollution monitoring, and food safety analysis. Herein, we describe a functional DNA biosensor for the first time that integrates analyte-directed assembly of enzyme-coated microbead probes for robust yet efficient signal amplification with a simple quantitative detection motif of distance measurement on portable paper devices based on starch-hydrolysis-adjusted wettability change of paper. Its utility is well demonstrated with highly sensitive and specific detection of model analytes ranging from adenosine (an important small biomolecule; 1.6 μM detection limit) to interferon-γ (a protein marker; 0.3 nM detection limit) and Pb²⁺ (a highly toxic metal ion; 0.5 nM detection limit) by simply using an inexpensive, ubiquitous ruler. The developed general method with the distance-measuring readout should be easily tailored for the portable, read-by-eye, quantitative detection of many other types of analytical targets by taking advantage of their specific functional DNA partners like aptamers and DNAzymes.

A functional DNA sensor was initially developed for the distance-measuring quantification of various analytes based on the starch-hydrolysis-adjusted wettability change of paper.     

十二味疏肝利胆冲剂联合ERCP治疗胆总管结石30例临床分析

目的观察十二味疏肝利胆冲剂联合ERCP治疗胆总管结石的临床疗效。方法将60例胆总管结石的患者采用随机按数字表法分成对照组30例和研究组30例,对照组予以ERCP治疗,术后常规抑酶、抑酸、抗感染;研究组在对照组治疗的基础上给予十二味疏肝利胆冲剂口服。观察比较2组患者右上腹部疼痛、发热和黄疸的临床症状积分的改善情况及治疗前后血常规指标（白细胞、中性粒细胞、中性粒细胞百分比）、肝功能指标（谷丙转氨酶、谷草转氨酶、AKP）、血淀粉酶（AMY）、血清胆石形成生化指标（总胆汁酸、总胆红素、直接胆红素、间接胆红素）、鼻胆管引流量的变化。结果2组的症状积分较治疗前均明显好转（P<0.05）,研究组优于对照组（P<0.05）;2组能降低血常规指标、肝功能指标、血清胆汁生化指标和提高胆汁引流量,均较治疗前明显好转（P<0.05）,研究组较对照组差异显著（P<0.05）。结论疏肝利胆冲剂联合ERCP治疗胆总管结石可以明显改善临床症状、控制术后胆总管炎症、促进肝功能早日恢复、降低术后淀粉酶和增加胆汁引流量,防治术后结石再生。     

Expression of cancer stem cell markers and their correlation with pathogenesis in vascular tumors

Objective: Vascular tumor, which belongs to a kind of complicated lesion in soft tissue tumor, is derived from mesenchymal tissue. Although many studies have been focused on the pathogenesis of vascular tumors in human, the specific mechanism of the vascular tumors was currently unclear. Previous studies have reported an association of cancer stem cells with the development of tumor in many solid tumors. Thus the purpose of this study was to explore whether different expression level of cancer stem cell markers including CD29, CD44, CD133, nestin and ALDH1 in vascular tumor may help to elucidate the possible pathogenesis of vascular tumor. In present study, tissues of 9 cases of hemangioma, 22 cases of hemangiosarcoma, 3 cases of Kaposi’s sarcoma, and 5 cases of hemangioendothelioma were immunostained for CD29, CD44, CD133, nestin and ALDH1. Of the 39 vascular tumor cases included in the current study, CD29, CD133 and nestin were positive in most vascular tumor cases. Although CD44 and ALDH1 were observed in vascular tumor cases, the percentage of cells staining for the two markers was less than 2% in all cases of vascular tumor. Capillary hemangiomas exhibited significantly higher expression rate of CD29 and nestin compared with malignant vascular tumors and hemangioendotheliomas (P<0.05, Fisher’s exact test), while CD44, CD133 and ALDH1 exhibited no statistically significant difference between these two groups. Pearson correlation analysis exhibited that CD29 expression and nestin expression in vascular tumor were no statistically significant relationship (C=0.288, P=0.063>0.05). Our findings confirmed that the five cancer stem cells markers, including CD29, CD44, CD133, nestin and ALDH1, exhibited different expression levels in vascular tumors and demonstrated that immonhistochemical analysis for cancer stem cells markers may provide useful information for studying the pathogenesis of vascular tumors.     

阿胶对免疫低下模型小鼠免疫功能的影响

目的 研究阿胶对免疫低下小鼠免疫功能的影响。方法 小鼠ip环磷酰胺或氢化可的松建立免疫低下模型,高、中、低（3.00、1.50、0.75 g/kg）剂量阿胶ig给予小鼠14 d后,测定血清溶血素水平,观察阿胶对体液免疫的影响;进行二硝基氯苯诱导的小鼠耳廓肿胀实验,检测小鼠耳廓肿胀度,观察阿胶对细胞免疫的影响;流式细胞术检测阿胶对淋巴细胞亚群的影响;进行碳廓清实验,检测廓清指数K和吞噬指数α,观察阿胶对非特异性免疫的影响。结果 与模型组比较,阿胶3.0、1.5、0.75 g/kg均可显著提高免疫功能低下小鼠血清溶血素含量（P<0.001）;3.0、1.5 g/kg能明显提高小鼠耳廓肿胀度（P<0.01、0.001）;3 g/kg能显著提高小鼠CD3⁺（T淋巴细胞）、CD3⁺CD4⁺（辅助性和迟发超敏性T细胞）占淋巴细胞百分比（P<0.05）;阿胶对小鼠的碳粒廓清指数K和吞噬指数α无显著影响。结论 阿胶能显著提高免疫低下小鼠的体液免疫和细胞免疫,提高CD3⁺、CD3⁺CD4⁺阳性细胞比例,对非特异性免疫无明显影响。