阿莫西林氨溴索胶囊治疗急性轻度细菌性下呼吸道感染的多中心研究

目的评价阿莫西林氨溴索胶囊治疗我国成人急性轻度细菌性下呼吸道感染伴痰液黏稠患者的临床疗效和安全性。方法采用多中心、随机、双盲双模拟、阳性药物平行对照的研究设计,给予试验组患者口服阿莫西林氨溴索胶囊和阿莫西林胶囊的模拟剂各1粒,对照组患者口服阿莫西林胶囊和阿莫西林氨溴索胶囊的模拟剂各1粒,每日3次,疗程7¹4 d,治疗前后对患者的症状、体征以及血常规、痰培养等实验室指标进行评估和比较。结果实际入选病例268例;纳入全分析集(FAS)255例,对照组128例,试验组127例;纳入符合方案集(PPS)243例。根据PPS分析,对照组和试验组祛痰有效率分别为63.6%和90.2%,临床治愈率分别为63.6%和88.5%,细菌培养阳性病例的痊愈率分别为55%和78%,试验组在祛痰疗效、临床总体疗效和综合疗效上均明显优于对照组(P<0.05)。药物不良事件主要表现为丙氨酸转氨酶升高、呕吐、尿蛋白阳性、白细胞计数下降、腹泻,程度均为轻度,对照组和试验组不良事件的发生率无显著差异(2.3%vs.0.8%,P>0.05)。结论阿莫西林氨溴索胶囊治疗我国成人急性轻度细菌性下呼吸道感染安全、有效,其祛痰疗效优势明显。     

Effects of systemically applied nAChRα7 agonists and antagonists on light-induced phase shifts of hamster circadian activity rhythms

Many physiological systems in mammals are linked to the body’s master circadian rhythm in the sleep/wake cycle and dysfunctions in this rhythm has been associated with neurological diseases such as major depression, Alzheimer’s Disease and schizophrenia. There is some evidence that nicotinic cholinergic input to the master circadian pacemaker, the suprachiasmatic nucleus, may modulate circadian activity rhythms, but data employing in vivo preparations is sparse. Therefore we examined the ability of intraperitoneally applied nicotinic agonists and antagonists relatively selective for the α7 nicotinic receptor to modulate light-induced phase shifts of hamster circadian wheel running rhythms. Hamsters were maintained in constant darkness and exposed to light pulses early and late in their active period, mimicking dusk and dawn respectively, which elicited phase delays and advances of their circadian wheel running rhythms. The α7 receptor antagonists bPiDDB (0.03–3 mg/kg) and methyllacaconitine (0.1–1 mg/kg) inhibited both light- induced phase advances and delays of circadian wheel running rhythms by as much as 75% versus vehicle injections. In contrast, systemic injections of the α7 agonists PHA 543613 and ABT107, both at 0.156–2.5 mg/kg, had no effect on light induced phase advances or delays. Further, α7 nicotinic receptors were identified in the hamster suprachiasmatic nucleus using an antibody that recognizes α7 nicotinic receptors. These results clearly identify the ability of α7 nicotinic receptor antagonists to inhibit light-entrainment of the hamster circadian pacemaker. Therefore, nicotinic compounds may be useful for the treatment of circadian dysfunction associated with neurological diseases.     

miR-593-5p inhibit cell proliferation by targeting PLK1 in non small cell lung cancer cells

Worldwide, lung cancer has the highest rates of mortality and morbidity, with the majority of its pathology attributable to non-small cell lung cancer (NSCLC). MicroRNAs are pivotal in the occurrence and development of cancer. However, the role of miRNA-593-5p in the progression of NSCLC is not clear. In this study, we investigate, in vitro, whether miRNA-593-5p inhibits NSCLC cell proliferation. To clarify its specific mechanism of inhibition, we used bioinformatics to predict its target genes and identified PLK1. Luciferase reporter assay confirmed the binding of miR-593-5p to the PLK1 3′-UTR in a sequence-specific manner in NSCLC cells. Additionally, we also found through Western blot and quantitative RT-PCR that miR-593-5p down-regulates the expression of PLK1 protein. Finally, PLK1 overexpression was shown to disinhibit NSCLC cell proliferation. Taken together, this evidence suggests that miR-593-5p inhibits NSCLC cell proliferation by inhibiting PLK1 expression.     

“医院-社区网络化”健康教育路径模式对左右侧基底节区脑卒中疗效分析

目的：对比研究“医院-社区网络化”健康教育路径模式与传统健康教育对左右基底节区脑卒中患者入院治疗及出院后的康复效果,探讨适合左右侧基底节区脑卒中患者康复的健康教育模式.方法：研究对比采用“医院-社区网络化”健康教育路径模式组与传统健康教育组左、右侧基底节区脑梗死、脑出血患者入组1d、入组后至出院前10 d、出院时、出院3个月、出院6个月时MBI（改良巴氏指数评分表）、FCA（功能综合评定表）、QOL-BREF（生存质量测定量简表）、NIHSS（美国国立卫生院神经功能缺损评分）、ZUNG焦虑自我评价表、抑郁自我评价表得分,分析2组之间及同组内患者左右基底节区脑梗死、脑出血的疗效.结果：右侧脑卒中病灶患者出院3个月后,“医院-社区网络化”健康教育路径模式康复效果开始明显优于传统健康教育康复模式,而左侧则要晚于右侧.脑卒中患者出院6个月后“医院-社区网络化”健康教育路径模式的康复效果优于传统健康教育方法.结论：“医院-社区网络化”健康教育路径模式具有明显的康复优势,值得在社区内推广.     

快速解剖标测方式构建肺静脉对环肺静脉电隔离术中主要质量指标的影响

目的 探讨快速解剖标测方式构建肺静脉在环肺静脉电隔离术中应用价值.方法 收集2016年2月至2016年10月在皖南医学院弋矶山医院心内科接受导管消融治疗的60例房颤患者,依据肺静脉造影方式分为快速解剖标测组30例和非选择性肺静脉造影组30例.评价两组患者总手术时间、X线曝光时间、预定消融径线外消融点数、肺静脉隔离率等方面差异.结果快速解剖标测组与非选择性肺静脉造影组相比:曝光时间减少[(16.18±4.26)min vs(45.64±6.48)min,P<0.05],总手术时间降低[(122.34±13.82)min vs(180.19±12.56)min,P<0.05)],预定消融径线外消融点数减少[(3±1)个vs(16±4)个,P<0.05],肺静脉隔离率差异无统计学意义(96.67％vs 93.33％,P>0.05).结论 快速解剖标测方式构建肺静脉能明显提高肺静脉隔离术的手术质量.     

The Low Submuscular Reservoir Placement With Transfascial Fixation for Inflatable Penile Prostheses

BackgroundSeveral techniques have been described for placement of inflatable penile prostheses (IPP) reservoirs, with variable satisfaction. Standard placement in the Space of Retzius can present with several complications and may be technically difficult in patients with a violated space. Concerns with ectopic reservoir placement have included reservoir herniation and lack of reservoir concealability.AimTo present a novel technique to achieve reservoir concealment with decreased postoperative complications as an alternative to standard approaches of ectopic reservoir placement.MethodsWe describe our novel low submuscular reservoir (LSM) placement with transfascial fixation (TFF) for inflatable penile prostheses.OutcomesPatient satisfaction with reservoir concealment, complication rate or need for additional surgeries.ResultsA total of 31 cases successfully underwent our technique. The low submuscular placement with TFF of the IPP reservoir offers an optimal approach for reservoir placement with a high degree of patient satisfaction with significant ease of placement compared to alternative methods.Clinical ImplicationsPenile prosthetic surgeons should be familiar with several techniques for concealment of reservoir as an option to improve patient satisfaction.Strengths and LimitationsGiven the small sample size of patients who have undergone this novel technique, current literature regarding the topic is limited.ConclusionLow submuscular reservoir placement with transfascial fixation for IPPs is a technically feasible approach that can be employed to achieve patient satisfaction and decrease the risk of reservoir herniation.Khoei A, Racik N, Bansal U, et al. The Low Submuscular Reservoir Placement With Transfascial Fixation for Inflatable Penile Prostheses. J Sex Med 2022;19:1309–1312.     

高压氧修复缺血再灌注损伤大鼠血脑屏障的自噬机制

目的 观察高压氧舱治疗对缺血再灌注损伤大鼠脑血管内皮细胞微管相关蛋白1轻链3 (LC3)和Beclin-1表达的影响,探究高压氧修复缺血再灌注损伤大鼠血脑屏障的机制。方法 54只成年雌性Sprague-Dawley大鼠随机分为假手术组(n=12)、缺血再灌注损伤模型组(n=18)、高压氧组(n=12)和抑制剂组(n=12)。模型组、高压氧组和抑制剂组采用线栓法建立大鼠大脑中动脉缺血2 h再灌注损伤模型。高压氧组和抑制剂组建模后予高压氧舱治疗;抑制剂组治疗前侧脑室注射3-甲基腺嘌呤。损伤后72 h,各组进行伊文思蓝染色,观察梗死区伊文思蓝含量;模型组采用免疫荧光双标法观察LC3在CD₃₁⁺血管内皮细胞的表达;采用Western blotting检测各组梗死区皮质微血管段LC3-Ⅱ和Beclin-1的表达水平。结果 与假手术组相比,模型组梗死区伊文思蓝含量明显升高(P < 0.01);与模型组相比,高压氧组梗死区伊文思蓝含量明显降低(P < 0.01);与高压氧组相比,抑制剂组梗死区伊文思蓝含量增高(P<0.05)。模型组损伤区CD₃₁⁺血管内皮细胞可见LC3表达;模型组梗死区微血管段Beclin-1和LC3-Ⅱ的表达水平均明显高于假手术组(P < 0.01);高压氧组的LC3-Ⅱ和Beclin-1蛋白表达水平较模型组均升高(P<0.05);抑制剂组较高压氧组和模型组均明显下降(P<0.01)。结论 缺血再灌注损伤大鼠损伤区的血管内皮细胞存在自噬现象,高压氧舱治疗能够上调梗死区血管内皮细胞自噬蛋白LC3-Ⅱ和Beclin-1的表达,从而促进血脑屏障修复。     

互联网+护理服务护士岗位胜任力评价指标体系的构建

目的 构建互联网+护理服务护士岗位胜任力评价指标体系。方法 以角色理论、护理程序、整体护理等为理论依据,采用文献分析、小组讨论、德尔菲法、层次分析法构建并确立互联网+护理服务护士岗位胜任力评价指标体系及各级指标权重。结果 确立的互联网+护理服务护士岗位胜任力评价指标体系包括6个一级指标,17个二级指标,60个三级指标。结论 互联网+护理服务护士岗位胜任力评价指标体系内容完整,结构合理,科学性好,对互联网+护理服务护士的培养和管理有一定的指导意义。     

Pituitary enlargement following ipilimumab without long term endocrine dysfunction

Ipilimumab, a monoclonal antibody against CTLA-4, is used in the treatment of melanoma and renal cell cancer. Hypophysitis is one of the more common adverse events, usually presenting with headache, pituitary enlargement and hypopituitarism, mostly ACTH deficiency, which is usually permanent. We describe a series of 3 cases developing pituitary enlargement in keeping with hypophysitis after ipilimumab without any long-term pituitary hormone deficiencies. This illustrates that a comprehensive endocrine assessment is required even when pituitary enlargement is present.