Shortened erythrocyte sedimentation rate evaluation is applicable to hospitalised patients

BackgroundWestergren method, commonly used for erythrocyte sedimentation rate (ESR) determination, is simple and inexpensive. However, the 60 min required for the test are disadvantageous, especially for those departments/facilities where prompt evaluation is necessary. We investigated the possibility that earlier ESR recordings might correlate with standard 60-minute ESR and/or be predictive of the latter.MethodsDemographic and clinical data were collected from 220 randomly chosen adult patients hospitalised for various diseases in a medical department. ESR, determined by slightly modified Westergren method, was recorded at 15, 30 and 60 min. Correlation coefficients (r) between the standard and early ESR measurements were calculated for the entire group and for the separate subgroups divided according to patient age, sex and presence of anaemia or of inflammation.ResultsMean ± SD age of the patients was 61.3 ± 19.6, 55% were males; 45% had some inflammatory condition. Mean ± SD ESR values (mm) at 15, 30 and 60 min were 9.0 ± 12.1, 21.4 ± 21.8 and 35.9 ± 27.5, respectively. A statistically significant correlation was found between ESR measurements at 15 and 60 min (r = 0.833, p < 0.001). However, the strongest correlation was observed between 30 and 60 min measurements (r = 0.926, p < 0.001), irrespective of age, sex and presence of anaemia or of inflammation. Based on the ESR determination at 30 min (X), the predicted ESR value at 60 min (Y) could be calculated by a simple equation: Y = 10.7 + 1.2X.ConclusionSixty-minute ESR values can be predicted by the 30-minute estimation. Shortening the test by half an hour might bear practical importance.     

Calcium sulfide (CaS), a donor of hydrogen sulfide (H2S): A new antihypertensive drug?

Hypertension is the leading cause of cardiovascular diseases, and an estimated 972 million people in the world are suffering from this problem. Indubitably, hypertension is an important worldwide public-health challenge. In recent years many efforts have been made to devise novel therapies involving new targets implicated in cardiovascular diseases. Hydrogen sulfide (H₂S) is a member of a growing family of “gasotransmitters”. It is clear that H₂S plays a pivotal role in the basal regulation of vessels tone. Also studies demonstrate that intravenous sodium hydrosulfide (NaHS), a donor of H₂S, dose-dependently decreases systolic blood pressure. However, because of its active chemical property, NaHS can be easily oxidized, even spontaneously ignited in the open air. Moreover, its solution is not stable. So the pharmacal use of NaHS is limited by its properties. Calcium sulfide (CaS), one of the effective components in a traditional herb, is another donor of H₂S. It has more stable chemical properties than NaHS. We hypotheses that CaS might be given by mouth as a new antihypertensive drug through certain dosage form designing. To test this hypothesis, we should establish animal models for studies including drug efficacy, drug safety, drug toxicology, drug metabolism and drug kinetics.     

重组腺病毒TGF-β的扩增及病毒滴度检测

目的：探讨高效扩增腺病毒载体的方法。方法：用人胚胎肾细胞株扩增重组腺病毒，并测定病毒滴度。结果：扩增病毒滴度约为5×10^8pfu／mL。结论：用人胚胎肾293细胞株扩增重组腺病毒，在不进行任何浓缩时可达到较高病毒滴度，为腺病毒介导的基因转载提供了有效途径。     

Shh信号通路成员Shh蛋白在胃癌细胞SGC-7901中的表达

目的：研究Shh信号通路成员Shh蛋白在胃癌细胞中的表达，探讨其与胃癌发生的关系。方法：培养胃癌细胞（SGC-7901）和正常肠上皮细胞（IEC-6），用免疫细胞化学法检测两种细胞中Shh蛋白的表达，用RT—PCR法检测Shh mRNA在两种细胞中的表达。结果：Shh蛋白在正常肠上皮细胞中表达阳性率为15％，在胃癌细胞中表达阳性率为70％，Shh蛋白在正常肠上皮细胞中的表达明显低于胃癌细胞（P〈0．05）。Shh mRNA在正常肠上皮细胞中不表达或低表达，在胃癌细胞中明显表达（P〈0.05）。结论：Shh信号通路可能与胃癌发生有关。     

Coaching older adults discharged home from the emergency department: The role of competence and emotion in following up with outpatient clinicians

ObjectiveMotivating older adults to follow up with an outpatient clinician after discharge from emergency departments (ED) is beneficial yet challenging. We aimed to answer whether psychological needs for motivation and discrete emotions observed by care transition coaches would predict this behavioral outcome.MethodsCommunity-dwelling older adults following ED discharge were recruited from three EDs in two U.S. states. We examined home visit notes documented by coaches (N = 725). Retrospective chart reviews of medical records tracked participants’ health care utilization for 30 days.ResultsObserved knowledge-based competence predicted higher likelihood of outpatient follow-up within 30 days, while observed sadness predicted a lower likelihood of follow-up within seven days following discharge. Moreover, participants who demonstrated happiness were marginally more likely to have an in-person follow-up within seven days, and those who demonstrated knowledge-based competence were more likely to have an electronic follow-up within 30 days.ConclusionsKnowledge-based competence and emotions, as observed and documented in coach notes, can predict older adults’ subsequent outpatient follow-up following their ED-discharge.Practice implicationsIntervention programs might encourage coaches to check knowledge-based competence and to observe emotions in addition to delivering the content. Coaches could also customize strategies for patients with different recommended timeframes of follow-up.     

异种骨软骨移植免疫反应及愈合特点的实验研究

目的了解异种骨软骨移植免疫反应及愈合的特点。方法取成年新西兰白兔36只作为实验动物以及自体骨软骨移植和同种异体骨软骨移植的供体,健康家猪1只作为异种骨软骨移植的供体。将实验动物随机分为A、B、C三组,每组12只,分别为自体组、同种异体组和异种组,在实验动物右股骨滑车部制造骨软骨缺损模型,分别进行柱状自体、同种异体和异种骨软骨移植。分别于术后2周、4周、12周取外周血进行IL-2、IL-4和IFN-γ检测。分别于术后4周及12周随机处死每组中的6只实验动物,取其股骨远端骨软骨、滑膜组织以及关节液标本,进行大体观察、组织学检查和IL-2、IL-4和IFN-γ检测。结果 Moran大体观察评分结果显示,C组在4周时评分低于A组及B组;在术后12周时低于A组,但与B组的评分差异无显著性。血清及关节液中细胞因子检测结果显示,术后2周时,C组血清的IFN-γ浓度低于A组及B组;C组血清的IL-4浓度高于A组及B组。术后4周时,C组关节液中的IFN-γ浓度高于A组;C组关节液中的IL-2浓度高于A组及B组;C组血清的IL-4浓度高于B组,关节液中的IL-4浓度高于A组,但低于B组。术后12周时,C组血清的IFN-γ浓度高于A组及B组,关节液中的IFN-γ浓度高于A组;C组血清的IL-2浓度高于A组及B组,关节液中的IL-2浓度高于A组及B组;C组关节液中的IL-4浓度高于A组。组织学检查结果显示,术后4周时,B组术侧膝关节滑膜组织中有炎细胞浸润,至术后12周时组织学表现基本正常。C组在术后4周时术侧膝关节滑膜组织中有大量炎细胞浸润,12周时炎细胞数量减少,但仍然明显多于B组。同时在A组中也发现个别滑膜标本中存在少量炎细胞浸润。结论异种骨软骨移植的免疫反应特点与同种异体骨软骨移植不同,其早期排斥反应强,后期弱,早期以Th2反应为主,而同种异体骨软骨移植免疫排斥以Th1反应为主。愈合过程则是骨吸收发生较晚,而同种异体移植骨吸收发生较早。     

伤害控制骨科学在脊柱损伤多发伤中的应用

"伤害控制骨科学"的理念源于伤害控制外科发展而来并且成功应用到四肢骨折的治疗上。伤害控制骨科学是一种稳定骨科损伤以使患者全身生理状态提高的方法。它的目的是避免由于"二次打击"造成患者病情恶化并且延迟确定性骨折修复直到患者全身情况达最佳状态。近来这个理念扩展到脊柱损伤合并严重损伤的患者中。本文综述了脊柱损伤多发伤手术时机、"伤害控制骨科学"应用的适应证、二次手术时机和微创技术的研究进展。     

脊髓型颈椎病的后路手术治疗

脊髓型颈椎病后路手术方法主要有椎板切除和椎板成形术,近年来各种改良的和新增的手术方法不断地得以设计和描述来进一步提高减压的安全性和有效性,同时出现了侧块钢板、椎弓根螺钉的应用。但每种手术都有其优缺点及各自的适应证和并发症。本文综述了手术方法及其优缺点、并发症及影响疗效的因素等研究进展。