降钙素原监测在心脏围手术期抗感染中的临床应用

目的探讨降钙素原(PCT)监测在缩短心脏手术抗菌药物疗程的有效性及安全性,以期为临床合理使用抗菌药物提供参考。 方法采用随机对照试验(RCT)设计,纳入心脏手术患者共计120例,使用随机数字表法将患者分为试验组(降钙素原监测组)与对照组(常规方法监测组)。其中试验组共61例,对照组共59例。试验组以降钙素原指导抗菌药物使用,对照组以常规方法指导抗菌药物使用。比较这两组患者抗菌药物使用时间、住院天数、抗菌药物费用、住院费用及肺部感染发生率等指标。 结果所有患者术后均预防性使用抗菌药物,第1、3、7天白细胞、中性粒细胞百分率、降钙素原水平逐渐下降,其中白细胞、降钙素原前3天显著下降,而中性粒细胞呈持续下降趋势;两组患者降钙素原术后第3天恢复至接近正常水平,第7天完全恢复至正常水平,中性粒细胞百分比第7天恢复正常。两组各时间点白细胞、中性粒细胞百分率、降钙素原水平无统计学差异(P>0.05)。试验组与对照组抗菌药物使用时间分别为9 d和12 d、住院天数分别为18 d和19 d、抗菌药物费用分别为1.16千元和1.45千元、总住院费用分别为11.10万元和12.71万元。P值均<0.05,差异有统计学意义。试验组和对照组分别有两例患者发生肺部感染,无统计学差异(P>0.05)。 结论对于心脏手术,依据降钙素原水平指导抗菌药物的预防使用,可缩短抗菌药物疗程、减少患者住院天数并节约抗菌药物费用和住院费用并且不增加肺部感染发生率。     

支气管扩张剂雾化吸入在支气管镜检查患者肺功能保护中的临床应用

目的探索操作前应用短效支气管扩张剂雾化吸入对接受支气管镜检查的患者肺功能的保护作用。 方法分析我院2019年2月至2019年4月收治的拟行气管镜检查的患者36例,随机分为对照组和观察组：对照组患者接受操作前常规的丁卡因压缩空气雾化机雾化吸入,观察组患者接受操作前丁卡因联合短效支气管扩张剂压缩空气雾化机雾化吸入;比较两组患者支气管镜检查前、后生命征、氧饱和度、肺功能指标变化。 结果操作前两组患者生命征、氧饱和度、通气功能指标等均无统计学差异,支气管镜检查后患者的收缩压、氧饱和度、通气功能指标等较操作前明显变化,而接受操作前短效支气管扩张剂雾化吸入的患者通气功能、氧饱和度等指标明显优于对照组患者,而且心率更加稳定。 结论支气管镜操作可导致操作后患者通气功能指标下降,支气管镜操作前应用短效支气管扩张剂雾化吸入治疗可有效保护患者肺功能,提高了围操作期的安全性。     

异种去抗原松质骨成骨效能的实验研究

 目的：研究异种去抗原松质骨与基因重组人骨形成蛋白2 (recombinant human bone morphogenetic protein 2, rhBMP-2)复合后的生物相容性和成骨效能。方法：28只新西兰大白兔28处颌骨缺损完全随机分为3组：异种去抗原松质骨/rhBMP-2组（A组）、异种去抗原松质骨组（B组）和空白对照组（C组）。A组和B组每组12处骨缺损,于4、8和12周分别进行大体观察、X线检查、HE染色和新生骨量测定;C组共4处骨缺损于12周时进行大体观察、X线检查和HE染色。结果：X线显示,随着时间的增长,2组的植入骨逐渐降解吸收,由自体骨替代,A组较B组显著;C组12周时无法完成愈合。骨密度测量显示,随着时间的增长,A和B组的骨密度值增加,2组之间存在显著差异（P<0.05）。HE染色可见A组的新生血管、纤维组织和新生骨均较B组多;植入骨降解速度快于B组;A组新生骨面积大于B组（P<0.05）。结论：异种去抗原松质骨是rhBMP-2的良好载体;异种去抗原松质骨/rhBMP-2复合材料能持续成骨,可加速骨缺损修复的速度,是一种较好的骨修复材料。     

Strabismus genetics across a spectrum of eye misalignment disorders

Eye misalignment, called strabismus, is amongst the most common phenotypes observed, occurring in up to 5% of individuals in a studied population. While misalignment is frequently observed in rare complex syndromes, the majority of strabismus cases are non‐syndromic. Over the past decade, genes and pathways associated with syndromic forms of strabismus have emerged, but the genes contributing to non‐syndromic strabismus remain elusive. Genetic testing for strabismus risk may allow for earlier diagnosis and treatment, as well as decreased frequency of surgery. We review human and model organism literature describing non‐syndromic strabismus, including family, twin, linkage, and gene expression studies. Recent advances in the genetics of Duane retraction syndrome are considered, as relatives of those impacted show elevated familial rates of non‐syndromic strabismus. As whole genome sequencing efforts are advancing for the discovery of the elusive strabismus genes, this overview is intended to support the interpretation of the new findings.     

Optimization of the thermoelectric performance of layer-by-layer structured copper-phthalocyanine (CuPc) thin films doped with hexacyano-trimethylene-cyclopropane (CN6-CP)

Copper-phthalocyanine (CuPc), as a classical small molecular organic semiconductor, has been applied in many fields. However, the low intrinsic conductivity limits its application in thermoelectricity. Here, hexacyano-trimethylene-cyclopropane (CN6-CP), a strong electron acceptor, is synthesized as dopant for CuPc thin films to improve their conductivities. Multilayer thin films constructed from alternate thermally evaporated CuPc and CN6-CP thin layers are investigated. Under the optimized condition, the doped CuPc film with a conductivity of 0.76 S cm⁻¹ and a Seebeck coefficient of 130 μV K⁻¹, shows a high power factor of 1.3 μW m⁻¹ K⁻² and the carrier concentration is estimated to be 2.8 × 10²⁰ cm⁻³. Considering the relatively superior performance, the CN6-CP doped CuPc film is a promising small molecular organic thermoelectric (OTE) material. In addition, for those highly crystalline materials with poor solubility, the layer-by-layer structure offers a general strategy for investigation and optimization of their TE performance.

The alternately deposited multilayer structure of a small molecular semiconductor and dopant molecules offers a general strategy for investigating their TE performance.     

DhhP,a Cyclic di-AMP Phosphodiesterase of Borrelia burgdorferi,Is Essential for Cell Growth and Virulence

Cyclic di-AMP (c-di-AMP) is a recently discovered second messenger in bacteria. Most of work on c-di-AMP signaling has been done in Gram-positive bacteria, firmicutes, and actinobacteria, where c-di-AMP signaling pathways affect potassium transport, cell wall structure, and antibiotic resistance. Little is known about c-di-AMP signaling in other bacteria. Borrelia burgdorferi, the causative agent of Lyme disease, is a spirochete that has a Gram-negative dual membrane. In this study, we demonstrated that B. burgdorferi BB0619, a DHH-DHHA1 domain protein (herein designated DhhP), functions as c-di-AMP phosphodiesterase. Recombinant DhhP hydrolyzed c-di-AMP to pApA in a Mn²⁺- or Mg²⁺-dependent manner. In contrast to c-di-AMP phosphodiesterases reported thus far, DhhP appears to be essential for B. burgdorferi growth both in vitro and in the mammalian host. Inactivation of the chromosomal dhhP gene could be achieved only in the presence of a plasmid-encoded inducible dhhP gene. The conditional dhhP mutant had a dramatic increase in intracellular c-di-AMP level in comparison to the isogenic wild-type strain. Unlike what has been observed in Gram-positive bacteria, elevated cellular c-di-AMP in B. burgdorferi did not result in an increased resistance to β-lactamase antibiotics, suggesting that c-di-AMP''s functions in spirochetes differ from those in Gram-positive bacteria. In addition, the dhhP mutant was defective in induction of the σ^S factor, RpoS, and the RpoS-dependent outer membrane virulence factor OspC, which uncovers an important role of c-di-AMP in B. burgdorferi virulence.