MEASURING AMBULATION,MOTOR, AND BEHAVIORAL OUTCOMES WITH POST-STROKE FLUOXETINE IN TANZANIA: THE Phase II MAMBO TRIAL

We test the safety of fluoxetine post-ischemic stroke in Sub-Saharan Africa. Adults with acute ischemic stroke, seen <14 days since new-onset motor deficits, were enrolled from 11/2019– 10/2020 in a single-arm, open-label phase II trial of daily fluoxetine 20mg for 90 days at Muhimbili National Hospital, Dar es Salaam, Tanzania. The primary outcome was safety with secondary outcomes of medication adherence and tolerability. 34 patients were enrolled (11 female; mean age 52.2 years, 65% <60 years old; mean 3.3 days since symptom onset). Participants had hypertension (74%), diabetes (18%), and smoked cigarettes (18%). The median National Institutes of Health Stroke Scale score at enrollment was 10.5. The median Fugl Meyer Motor Scale score was 28.5 (upper extremity 8, lower extremity 17.5). 32/34 participants (91%) survived to 90 days. There were 8 serious and 2 non-serious adverse events. Deaths occurred due to gastrointestinal illness with low serum sodium (nadir 120 mmol/L) with seizure and gastrointestinal bleed from gastric cancer. The average sodium level at 90 days was 139 mmol/L (range 133–146) and alanine transaminase was 28 U/L (range 10–134). Fluoxetine adherence was 96%. The median mRS among survivors at 90 days was 2 and Fugl Meyer Motor Scale score was 66 (upper extremity 40, lower extremity 27). Median 90-day Patient Health Questionnaire-9 and Montgomery-Åsberg scores were 3.5 and 4 (minimal depression). Fluoxetine administration for 90 days post-stroke in Sub-Saharan Africa was generally safe and well-tolerated, but comorbid illness presentations were fatal in 2/34 cases, even after careful participant selection.     

膳食营养素与肝癌关系研究进展

肝癌的发病机制较复杂，主要包括遗传、环境和饮食因素，其中饮食因素对肝癌的发生、发展的影响一直是研究的热点。 不良的饮食习惯和不合理的膳食搭配都有可能通过改变代谢途径而导致肿瘤的发生。此外，手术、放化疗、局部消融被认为是肝癌最 有效的治疗途径，但营养不良、不良反应和耐药性等限制了其临床疗效。营养干预对肿瘤放化疗效果具有重要影响。合理的膳食营养 及部分天然食物活性成分可提高抗癌药物的疗效，具有增效减毒的效果。因此，膳食营养干预不仅能有效预防肝癌的发生，也可提高 治疗耐受性和治疗效果。研究膳食因素和营养因素与肝癌关系有利于了解食物营养在肝癌发生、发展中的作用，本文对近年来膳食脂 肪、蛋白质、碳水化合物三大营养素以及部分微量营养素对肝癌影响方面的研究进行综述，并从膳食营养素的角度综合分析肝癌的饮 食营养干预策略。     

睫状体冷凝联合全结膜瓣遮盖术治疗并发角膜溃疡的绝对期青光眼

目的探讨睫状体冷凝联合全结膜瓣遮盖术治疗并发角膜溃疡的绝对期青光眼的临床疗效。方法并发角膜溃疡的绝对期青光眼18例（18眼）施行睫状体冷凝联合全结膜瓣遮盖术。术后观察眼部症状，角膜、结膜愈合情况及眼压等。结果随访平均（9．4±1．9）个月。所有患眼球结膜瓣与角膜牢固贴附。术后2d眼压开始下降，而后呈逐渐下降的趋势，至术后1个月时基本稳定。结论在严格病例选择的基础上，睫状体冷凝联合全结膜瓣遮盖术治疗并发角膜溃疡的绝对期青光眼的初步效果良好。     

Hes1基因启动子的克隆及活性研究

目的:获取人Hes1基因的启动子并对其进行活性分析。方法:以人Hela细胞基因组DNA为模板,利用PCR技术扩增Hes1基因5’侧翼序列,将扩增的片段与pMD18-T载体连接,然后利用双酶切进行鉴定,并送测序;将测序正确的启动子插入pGL3-Basic,双酶切并测序鉴定。将测序正确的重组DNA质粒瞬时转染宫颈癌细胞,运用双荧光素酶报告基因检测系统检测其启动子的活性。结果:PCR扩增到的人Hes1基因启动子与基因库的序列完全一致,双荧光素酶报告基因检测系统显示其在宫颈癌细胞中具有启动子活性。结论:成功得到人Hes1基因启动子并且其具有活性。     

分娩衣的应用对正常分娩初产妇舒适状况影响的研究

增进病人的舒适度是护理所要达到的目的之一[1]。随着社会的发展,如何降低初产妇正常分娩时的痛苦,提高产妇的舒适状况已逐渐引起人们的重视。舒适护理是指使人在生理、心理、灵魂上达到最愉快的状态,或缩短、降低其不愉快的程度,并认为舒适护理应作为整体化护理艺术的过程和追求的结果[2,3]。     

Intradermal injection of a fractional dose of an inactivated HFMD vaccine elicits similar protective immunity to intramuscular inoculation of a full dose of an Al(OH)3-adjuvanted vaccine

Enterovirus 71 (EV71) and Coxsackievirus A16 (CVA16) are the two major causative agents of hand, foot and mouth disease (HFMD), which erupts in the Asia-Pacific regions. A bivalent vaccine against both EV71 and CVA16 is highly desirable. In the present study, on the bases that an experimental bivalent vaccine comprising of inactivated EV71 and CVA16 induces a balanced protective immunity against both EV71 and CVA16, we compare the immunogenicity and reactogenicity of one fourth of a full dose of an intradermal vaccine administered by needle-free liquid jet injector with a full dose of an intramuscular vaccine administered by needle-syringe in monkeys. The results suggest that intradermal injection of a fractional dose of an inactivated HFMD vaccine elicits similar immunogenicity and reactogenicity to intramuscular inoculation of a full dose of an Al(OH)₃-adjuvanted vaccine, regardless of whether monovalent or bivalent vaccines were used. Our results support the use of an intradermal bivalent vaccine strategy for HFMD vaccination in order to satisfy the requirements and reduce the costs.     

XHA600D加速器电离室故障分析与处理

本文介绍了XHA600D加速器电离室的结构、原理及其故障的分析、处理和应急使用方法。     

三维超声血管斑块定量分析技术评价颈动脉斑块易损性的价值

目的探讨三维超声血管斑块定量分析技术评估颈动脉斑块性质的价值及可行性。方法回顾性分析经颈动脉内膜剥脱术的47个颈动脉斑块,术前行三维超声血管斑块定量分析检查,与术后病理对照,比较各参数的差异并构建灰阶中位数及标准化管壁指数的受试者工作特征(Receiver Operating Characteristic,ROC)曲线,评价其诊断价值。结果易损斑块组低密度脂蛋白高于与稳定斑块组(t=1.581,P<0.001)。易损斑块的灰阶中位数明显低于稳定斑块(t=5.076,P<0.001);易损斑块的标准化管壁指数高于稳定斑块(t=2.314,P=0.025);易损斑块与稳定斑块的最大面积狭窄率、厚度及体积差异无统计学意义。灰阶中位数值34诊断易损斑块的敏感性68.0%、特异性81.8%、准确性74.5%、阳性预测值81.0%、阴性预测值69.2%,ROC曲线下面积为0.749。标准化管壁指数0.645诊断易损斑块的敏感性60.0%、特异性81.8%、准确性70.2%、阳性预测值78.9%、阴性预测值64.3%,ROC曲线下面积为0.709。结论三维超声血管斑块定量分析技术利用灰阶中位数及标准化管壁指数定量评估斑块成分、血管负荷,对诊断易损斑块具有重要价值。     

Increased active von Willebrand factor during disease development in the aging diabetic patient population

Type 2 diabetes is known to cause endothelial activation resulting in the secretion of von Willebrand factor (VWF). We have shown that levels of VWF in a glycoprotein Ib-binding conformation are increased in specific clinical settings. The aim of the current study is to investigate whether active VWF levels increase during aging and the development of diabetes within the population of patients suffering from type 2 diabetes. Patients and controls were divided into two groups based on age: older and younger than 60 years of age. VWF antigen, VWF propeptide, VWF activation factor and total active VWF were measured. Patients older than 60 years of age had increased levels of total active VWF, VWF activation factor and VWF propeptide compared to younger patients and controls. All measured VWF parameters were associated with age in diabetic patients. Total active VWF and VWF propeptide correlated with the period of being diagnosed with diabetes. Regression analyses showed that especially the VWF activation factor was strongly associated with diabetes in patients older than 60 years of age. In conclusion, we found that the conformation of VWF could be involved in the disease process of diabetes and that the VWF in a glycoprotein Ib-binding conformation could play a role as risk marker during the development of diabetes in combination with an increase in age. Our study shows that the active quality of VWF was more important than the quantity.