超声心动图诊断小儿原发性心脏肿瘤及其对心功能的评估

目的探讨超声心动图诊断小儿原发性心脏肿瘤的临床价值,并对其心功能进行评估。方法60例原发心脏肿瘤患儿为肿瘤组,体检健康小儿60例为对照组,超声测量心肌工作指数（MPI）,并与手术后病理结果比较。结果肿瘤组60例患儿,超声诊断58例,诊断符合率为96．67％,2例误诊。肿瘤组术前左右心室的MPI均高于对照组（P〈0．05）;肿瘤组术后MPI较术前降低（P〈0．05）,与对照组比较差异无统计学意义。结论超声心动图能够准确诊断小儿原发性心脏肿瘤,而且通过分析MPI可以准确地反映原发性心脏肿瘤患儿的心功能变化情况。     

Microfluidic-based fabrication and characterization of drug-loaded PLGA magnetic microspheres with tunable shell thickness

To overcome the shortcoming of conventional transarterial chemoembolization (cTACE) like high systemic release, a novel droplet-based flow-focusing microfluidic device was fabricated and the biocompatible poly(lactic-co-glycolic acid) (PLGA) magnetic drug-eluting beads transarterial chemoembolization (TACE) microspheres with tunable size and shell thickness were prepared via this device. Paclitaxel, as a model active, was loaded through O/O/W emulsion method with high efficiency. The size and the shell thickness vary when adjusting the flow velocity and/or solution concentration, which caters for different clinical requirements to have different drug loading and release behavior. Under the designed experimental conditions, the average diameter of the microspheres is 60 ± 2 μm and the drug loading efficiency has reached 6%. The drug release behavior of the microspheres shows the combination of delayed release and smoothly sustained release profiles and the release kinetics differ within different shell thickness. The microspheres also own the potential of magnetic resonance imaging (MRI) visuality because of the loaded magnetic nanoparticles. The microsphere preparation method and device we proposed are simple, feasible, and effective, which have a good application prospect.     

烟草烟雾暴露对哮喘小鼠肺组织NF-κB p65表达的影响

目的 探讨烟草烟雾暴露对支气管哮喘小鼠气道炎性细胞浸润及肺组织核转录因子-κB p65（NF-κB p65）表达的影响。方法 将雌性无特定病原体级（specific pathogen free, SPF）级BALB/c纯系小白鼠40只随机分为4组,即正常对照组、哮喘组、烟草烟雾暴露组和烟草烟雾暴露+哮喘组,每组各10只。正常对照组给予雾化吸入生理盐水,哮喘组给予雾化吸入卵蛋白（OVA）致敏从而复制模型,烟草烟雾暴露组则在正常对照组基础上予以烟草烟雾暴露1 h,而烟草烟雾暴露+哮喘模型组则在哮喘模型组的基础上给予同样的烟草烟雾暴露1 h。28 d后采集支气管肺泡灌洗液（BALF）,测定BALF中白细胞(WBC)、嗜酸性粒细胞（EOS）及中性粒细胞（NEU)计数。用蛋白质免疫印迹法（Western-blot）检测肺组织NF-κB p65蛋白表达水平。结果 哮喘组、烟草烟雾暴露+哮喘组小鼠BALF中白细胞总数、嗜酸粒细胞、中性粒细胞均高于对照组及烟草烟雾暴露组,烟草烟雾暴露+哮喘组BALF中白细胞总数和中性粒细胞计数高于哮喘组,嗜酸粒细胞计数低于哮喘组（P<0.05);哮喘组、烟草烟雾暴露+哮喘组小鼠肺组织NF-κB p65蛋白表达均上升,但烟草烟雾暴露+哮喘组小鼠升高更明显,与哮喘组相比差异有统计学意义（P<0.05)。烟草烟雾暴露+哮喘组白细胞计数与肺组织NF-κB p65表达水平呈正相关（r=0.781,P=0.008）。结论 烟草烟雾暴露可能通过上调NF-κB p65蛋白表达,促进支气管哮喘气道炎性细胞浸润。     

Intravaginal electrical stimulation as a monotherapy for female stress urinary incontinence: A systematic review and meta-analysis

Background and purposeSince patients, physiotherapists and gynaecologists continue to seek effective conservative treatments for stress urinary incontinence (SUI), the aim of this systematic review and meta-analysis was to determine the therapeutic efficacy of intravaginal electrical stimulation (ES) in women with SUI.MethodsWe searched PubMed, Embase, EBSCOHost and Ovid for randomized controlled trials. For dichotomous data, we calculated the risk ratio (RR) and 95% confidence interval (CI). For continuous data, we calculated the mean difference (MD) and 95% CI. Heterogeneity was assessed with I² statistics.ResultsOf the 686 records identified, a total of 10 articles met the inclusion criteria. A meta-analysis revealed significant differences between the ES and no active treatment groups in the pooled objective cure rates (RR: 4.20; 95% CI: 1.70 to 10.40; p = 0.001; I² = 0%) and subjective cure or improvement rates (RR: 4.96; 95%: 1.01 to 24.37; p = 0.04; I² = 0%). No significant differences were found in the pooled number of incontinence episodes per 24 h (MD: 0.16; 95% CI: 0.68 to 0.37; p = 0.56; I² = 0%), the pooled Incontinence Quality of Life Questionnaire scores (MD: 1.84; 95% CI: 2.11 to 5.80; p = 0.36; I² = 0%) or the pooled number of adverse effects (RR: 0.69; 95% CI: 0.38 to 1.27; p = 0.23; I² = 0%) between the ES and other conservative treatment groups.ConclusionThere was insufficient evidence for or against the use of intravaginal ES therapy for women with SUI, partly due to the variability in the interventions of the included trials and the small number of trials included.     

Complementary/integrative healthcare utilization in US Gulf-War era veterans: Descriptive analyses based on deployment history,combat exposure,and Gulf War Illness

Complementary and integrative health (CIH) approaches have gained empirical support and are increasingly being utilized among veterans to treat a myriad of conditions. A cluster of medically unexplained chronic symptoms including fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems, often referred to as Gulf War Illness (GWI) prominently affect US Gulf War era (GWE) veterans, yet little is known about CIH use within this population. Using data collected as part of a larger study (n = 1153), we examined the influence of demographic characteristics, military experiences, and symptom severity on CIH utilization, and utilization differences between GWE veterans with and without GWI. Over half of the sample (58.5%) used at least one CIH modality in the past six months. Women veterans, white veterans, and veterans with higher levels of education were more likely to use CIH. GWE veterans with a GWI diagnosis and higher GWI symptom severity were more likely to use at least one CIH treatment in the past six months. Over three quarters (82.7%) of veterans who endorsed using CIH to treat GWI symptoms reported that it was helpful for their symptoms. Almost three quarters (71.5%) of veterans indicated that they would use at least one CIH approach if it was available at VA. Results provide a deeper understanding of the likelihood and characteristics of veterans utilizing CIH to treat health and GWI symptoms and may inform expansion of CIH modalities for GWE veterans, particularly those with GWI.     

转基因番茄可食用防龋疫苗免疫BALB/c小鼠的实验研究

目的: 观察含PAcA/CTB的转基因番茄可食用防龋疫苗的免疫原性及免疫反应性。方法: 将18只6~8周龄的雄性BALB/c小鼠,随机分为3组,每周分别灌胃含有PAcA/CTB嵌合蛋白的转基因番茄果汁(实验组)、非转基因番茄果汁(阴性对照组)、灭活全菌疫苗(阳性对照组)。于首次免疫前和免疫后第1、2、3、4周采集血液、唾液样品。ELISA检测其血清和唾液样本中的抗变异链球菌PAcA的IgG、IgA抗体效价。结果: 阳性对照组和实验组小鼠血液和唾液中特异性抗体从免疫后1周开始升高,初始免疫后第4周达高峰,分别与阴性对照组比较存在统计学差异(P<0.05或P<0.01)。免疫后第2、3、4周阳性对照组与实验组差异有统计学意义(P<0.05)。结论: 转基因番茄所表达的外源目的蛋白具有抗原性,能够诱导BALB/c小鼠产生免疫应答。     

Con: Colloids should not be added to the pump prime

It is concluded that there is good scientific basis for an approach that avoids colloid priming solutions as routine for all adult CPB patients. There may be selected individual who might benefit from colloid therapy; for instance, patients who are predicted to require high left atrial pressure postbypass, those who are borderline for getting through their surgical experience without a homologous red cell transfusion, and patients coming for surgery with a clinically important lung water elevation. In this time of cost constraints there are many more scientifically worthy therapies that could be made available to patients. We should focus on these and resist “luxury items” like routine colloid CPB priming solutions.     

糖尿病足合并类鼻疽伯克霍尔德菌感染64例临床特征、药敏特点和治疗分析

目的 总结糖尿病足（DF）合并类鼻疽伯克霍尔德菌（BP）感染的临床特征、药敏特点和治疗方法。方法 回顾分析2012年1月至2022年3月海南医学院第二附属医院收治的64例DF合并BP感染病人的临床表现、微生物抗菌药物敏感性及治疗手段。结果 64例DF合并BP感染病人中,60例有发热症状、34例有白细胞升高、均有C反应蛋白（CRP）和降钙素原（PCT）升高、14例合并肝或脾脓肿、30例出现肝功能不全、20例出现肾功能不全、18例合并感染性休克。64株BP对大多数常见的抗生素敏感性较差,但均对亚胺培南、美罗培南和复方磺胺甲唑敏感。所有病人均使用胰岛素积极控制血糖,大多数静脉应用碳青霉素烯类抗菌素约6周,出院后继续使用复方磺胺甲唑治疗。最终22例治愈,30例好转,8例未愈,4例死亡。死亡病例均合并多器官功能障碍。结论 DF合并BP主要表现为发热、CRP和PCT明显升高、合并肝或脾脓肿和肝肾功能不全,易出现感染性休克。对高度怀疑BP感染病人应多次进行培养,并及早静脉应用碳青霉素烯类抗菌素可能有助于改善预后。     

Metabolism and kinetics of parenterally administered ornithine and α-ketoglutarate in healthy and burned animals

To improve our understanding of the metabolism of ornithine α-ketoglutarate (OKG), used as an adjuvant of parenteral nutrition, we studied the plasma kinetics, localisation of target tissues and metabolism of α ketoglutarate (αKG) and ornithine (Orn) in healthy and burned animals. After parenteral administration, the kinetics of plasma disappearance of the two labelled compounds showed a biphasic decrease reflecting an open two-compartmental model of elimination, with the exception of Orn in burned rats. The appearance of metabolites in the plasma was rapid, particularly with regard to glutamate, proline and, following ornithine administration, glutamine. This witnessed the engagement of the substrates in multiple metabolic pathways. The study of tissular distribution by autoradiography demonstrated certain target tissues in common for αKG and Orn such as the liver, intestinal mucosa, salivary glands, kidney and muscle. This is consistent with a possible synergic action of these two compounds. The identification of labelled amino-acids and aliphatic polyamines was also performed in the tissues. Two major observations were made, which could be of interest in further work concerning cellular mechanisms of OKG action. Firstly, after αKG administration, labelled Glu and αKG were detected simultaneously in muscle; this would render possible the local biosynthesis of the anticatabolic compound α ketoisocaproate. Secondly, the injection of ¹⁴C-ornithine was followed by the appearance in the intestinal mucosa and salivary glands of labelled aliphatic polyamines, which possess an anabolic effect.