Resuscitation of Preterm Infants with Reduced Oxygen Results in Less Oxidative Stress than Resuscitation with 100% Oxygen

The objective of this study was to determine the effects of the level of inhaled oxygen during resuscitation on the levels of free radicals and anti-oxidative capacity in the heparinized venous blood of preterm infants. Forty four preterm infants <35 weeks of gestation with mild to moderate neonatal asphyxia were randomized into two groups. The first group of infants were resuscitated with 100% oxygen (100% O₂ group), while in the other group (reduced O₂ group), the oxygen concentration was titrated according to pulse oximeter readings. We measured total hydroperoxide (TH) and redox potential (RP) in the plasma within 60 min of birth. The integrated excessive oxygen (∑(FiO₂-0.21) × Time(min)) was higher in the 100% O₂ group than in the reduced O₂ group (p<0.0001). TH was higher in the 100% O₂ group than in the reduced O₂ group (p<0.0001). RP was not different between the 100% O₂ and reduced O₂ groups (p = 0.399). RP/TH ratio was lower in the 100% O₂ group than in the reduced O₂ group (p<0.01). We conclude that in the resuscitation of preterm infants with mild to moderate asphyxia, oxidative stress can be reduced by lowering the inspired oxygen concentration using a pulse oximeter.     

Microproteinuria for detecting calcineurin inhibitor-related nephrotoxicity after liver transplantation

AIM： To investigate whether microproteinuria could be used as an early and sensitive indicator to detect calcineurin inhibitor （CNI）-related nephrotoxicity after liver transplantation.
METHODS： All liver transplant recipients with normal serum creatinine （SCr） and detectable microproteinuria at baseline were included in this study. The renal function was monitored by the blood clearance of 99mTc-diethylenetriaminepentaacetic acid every 6 mo. Microproteinuria, SCr and blood urea nitrogen （BUN） were measured at entry and at subsequent follow-up visits. The patients were divided into different groups according to the mean values of glomerular filtration rate （GFR） at the follow-up time points： Group 1, GFR decreased from baseline by 0%-10%; Group 2, GFR decreased from baseline by 11%-20%; Group 3, GFR decreased from baseline by 21%-40%; Group 4, GFR decreased from baseline by 〉 40% and/or SCr was increasing.
RESULTS： A total of 143 patients were enrolled into this study （23 females and 120 males）. The mean follow-up was 32 mo （range 16-36 mo）. Downward trends in renal function over time were observed in the study groups. SCr and BUN increased significantly only in Group 4 patients （P 〈 0.001）. β2-microglobulin （β2m） and al-microglobulin （αlm） significantly increased with the subtle change of renal function in recipients who were exposed to CNI-based immunosuppression regimens. The reductions in GFR were closely correlated with elevated cclm （P = -0.728, P 〈 0.001） and β2m （r2 = -0.787, P 〈 0.001）.
CONCLUSION： β2m and α1m could be useful as early and sensitive indicators of CNI-induced nephrotoxicity.     

汶川地震致头皮伤口感染细菌谱及耐药性分析

目的探讨地震灾害引起的开放性头皮损伤伤121感染的病原菌分布,耐药性特点及抗生素治疗措施。方法回顾分析5·12汶川地震后,四川大学华西医院神经外科收治的38例开放性颅伤患者头皮伤口感染的病原学资料。结果全组38例开放性头皮伤口感染的病原菌菌株51株,革兰阳性菌35株（68．63％）,分别是金黄色葡萄球菌21株（41．18％）,表皮葡萄球菌14株（27．45％）;革兰阴性菌16株（31．37％）,分别是阴沟肠杆菌8株（15．69％）,肺炎克雷伯杆菌4株（7．84％）,绿脓杆菌2株（3．92％）,深红沙雷氏菌2株（3．92％）。这些菌株对临床常用抗生素都有不同程度的耐药。经彻底清创及应用敏感抗生素,能有效控制感染。结论地震引起的开放性头皮伤口感染的病原菌,多以革兰阳性的金黄色葡萄球菌感染为主。早期彻底清创,营养支持,应用敏感抗生素能提高治疗效果。     

Effects of different concentrations of formalin on paw edema and pain behaviors in rats

The aim of this study was to determine whether formalin reliably provokes a paw edema and pain behavior. The paw of male Sprague-Dawley rats were injected with 100 microliter of formalin with 2.5% (F2.5), 5% (F5), and 10% (F10) concentrations. Following the formalin (n=8) or saline (control, n=6) injection, the flinching or licking of the paw was recorded for the phase 1 response (0-5 min after injection) and phase 2 response (20-60 min). The formalin-induced paw edema was assessed by measuring the diameters of the injected paws at 4 hr after injection. As for flinching, phase 1 and 2 of all three groups showed higher frequency than those of the control group (p<0.05). As for licking, phase 1 cumulative time of the F2.5 and F10 groups, and phase 2 cumulative time of the F2.5 and F5 groups showed a longer duration than those in the control group (p<0.05). The diameters of the paw in the F10 group were significantly larger than those in the control group (p<0.05). Flinching behavior was more reliably expressed the biphasic response than licking response at all formalin concentrations. Peak of the licking was reached at 2.5% and that of flinching was reached at 5%, whereas the paw edema peaked at 10% concentration. This suggests that there may be some dissociation of nociception from the edema formation.     

吴军教授治疗银屑病经验

吴军教授认为银屑病的根本病因病机是热壅血络。临证应以清热凉血为要,并需注重解毒散结,养血滋阴,内外同治。     

Cardiomyocyte-targeted siRNA delivery by prostaglandin E(2)-Fas siRNA polyplexes formulated with reducible poly(amido amine) for preventing cardiomyocyte apoptosis

A cardiomyocyte-targeted Fas siRNA delivery system was developed using prostaglandin E(2) (PGE(2))-modified siRNA polyplexes formed by a reducible poly(amido amine) to inhibit cardiomyocyte apoptosis. PGE(2), which was used as a specific ligand for cardiomyocyte targeting, was conjugated to the terminal-end of the sense siRNA (PGE(2)-siRNA). The reducible cationic copolymer, synthesized via Michael-type polyaddition of 1,6-diaminohexane and cystamine bis-acrylamide (poly(DAH/CBA)), tightly condensed the PGE(2)-siRNA conjugate to form nanosize polyplexes having a diameter of 100-150nm. The PGE(2)-siRNA/poly(DAH/CBA) polyplexes decomplexed to release PGE(2)-siRNA in a cytosolic reducing environment due to the degradation of the reducible poly(DAH/CBA). The cellular uptake of the PGE(2)-siRNA/poly(DAH/CBA) polyplex was increased in rat cardiomyocytes (H9C2 cells) due to PGE(2) receptor-mediated endocytosis. When H9C2 cells were transfected with siRNA against Fas, a key regulator of ischemia-induced apoptosis, the PGE(2)-Fas siRNA/poly(DAH/CBA) polyplex delivery system led to a significant increase in Fas gene silencing, resulting in inhibition of cardiomyocyte apoptosis. The PGE(2)-Fas siRNA/poly(DAH/CBA) polyplex did not induce interferon-alpha in peripheral blood mononuclear cells. These results suggest that the PGE(2)-Fas siRNA/poly(DAH/CBA) polyplex formulation may be clinically applicable as a cardiomyocyte-targeted Fas siRNA delivery system to inhibit apoptosis in cardiovascular disease.     

Increases in quantities consumed in drinking occasions in New Zealand 1995-2004

Introduction and Aims. Significant changes have occurred in the alcohol environment in New Zealand recently and there has been debate about how trends in alcohol consumption may currently look. This paper reports trends in drinking over three general population samples in New Zealand. Design and Methods. Three nationally representative comparable surveys were analysed for trends in: prevalence of drinking, typical occasion quantity, annual frequency and heavier drinking (5+ drinks). Analyses assessed the mean difference of the measures at each year point. Adjustments for multiple comparisons were made. Analysis was undertaken for age and separately for gender. Results. Increases in quantities consumed on a typical occasion occurred for the majority of age groups between 1995 and 2000. Women were as likely as men to increase the quantities they consumed. Observing differences between age groups found that young people tended to show the greatest increases in quantity (including heavier drinking) and frequency of consumption between 1995 and 2000. Drinking levels remained relatively stable between 2000 and 2004 with the exception of increases in abstention for some of the younger groups and increases in quantities consumed and heavier drinking among some of the older men. Discussion and Conclusions. Increases in quantities consumed per occasion have occurred almost across the board between 1995 and 2000 in New Zealand. Women were as likely as men to increase the quantities they consumed. Young people tended to show the greatest increases in quantity (including heavier drinking) and frequency of consumption between 1995 and 2000. Drinking remained relatively stable between 2000 and 2004.[Huckle T, You RQ, Casswell S. Increases in quantities consumed in drinking occasions in New Zealand 1995–2004. Drug Alcohol Rev 2011;30:366–371]     

Continuous dosing of a novel contraceptive vaginal ring releasing Nestorone® and estradiol: pharmacokinetics from a dose-finding study

Background

As part of a program to develop a novel estradiol-releasing contraceptive vaginal ring (CVR), we evaluated the pharmacokinetic (PK) profile of CVRs releasing segesterone acetate (Nestorone® (NES)) combined with one of three different estradiol (E₂) doses.