基于网络药理学和分子对接技术探讨雷公藤卵巢毒性的机制

目的：通过网络药理学和分子对接技术探讨雷公藤卵巢毒性的作用机制。方法：通过中药系统药理数据库及分析平台（TCMSP）和比较毒理基因组学数据库（CTD）收集雷公藤的候选毒性化合物和靶点,从CTD中获得雷公藤潜在的卵巢毒性靶点,并利用STRING数据库对雷公藤卵巢毒性的靶点基因进行分析。用Cytoscape软件构建蛋白质-蛋白质相互作用（PPI）网络,用cytoHubba插件鉴定核心基因。此外,利用R软件对雷公藤卵巢毒性的靶点基因进行基因本体（GO）和京都基因与基因组百科全书（KEGG）富集分析。最后,使用Discovery Studio软件对核心毒性化合物和核心基因进行分子对接验证。结果：共获得9个雷公藤候选毒性化合物和56个潜在的卵巢毒性靶点。网络分析结果,雷公藤甲素、山柰酚和雷公藤红素是雷公藤的关键卵巢毒性化合物,核心卵巢毒性基因包括TP53、MYC、PTEN、MAPK3、MTOR、STAT3、EGFR、KRAS、CDH1和AKT1。GO和KEGG分析显示,雷公藤通过氧化应激、生殖系统发育和功能、细胞周期调节、对内源性激素和外源性刺激的反应、细胞凋亡调节、衰老等途径引起卵巢毒性。分子对接研究显示,雷公藤的3个关键卵巢毒性化合物可与10个核心基因的对接口袋相匹配。结论：雷公藤可能通过作用于10个核心基因和140条信号通路而导致卵巢毒性。     

Editorial for the special issue of the Chinese Association for the Study of Pain

The Ministry of Health of China officially issued a document, adding the first level diagnosis and treatment discipline “Algology” in the list of diagnosis and treatment subjects of medical institutions on July 16, 2007. As the most important pain academic organization in China, the Chinese Association for the Study of Pain has made outstanding contributions in promoting the development of pain discipline and in establishing pain standards and disease diagnosis and treatment guidelines. In this special issue, under the leadership of Yan-Qing Liu, Chairman of the 7^th Committee of the Chinese Association for the Study of Pain, nine consensus and one guideline were included.     

Paediatric family activated rapid response interventions; qualitative systematic review

BackgroundFailure to recognise deterioration early which results in patient death, is considered failure to rescue and it is identified as one of the leading causes of harm to patients. It is recognised that patients and their families can often recognise changes within the child’s condition before healthcare professionals. To mitigate the risk of failure to rescue and promote early intervention, family-activated rapid response systems are becoming widely acknowledged and accepted as part of family integrated care.ObjectiveTo identify current family-activated rapid response interventions in hospitalised paediatric patients and understand mechanisms by which family activation works.MethodsA narrative systematic review of published studies was conducted. Seven online databases; AMED, CINHAL, EMBASE, EMCARE, HMIC, JBI, and Medline were searched for potentially relevant papers. The critical appraisal skills programme tool was used to assess methodological rigor and validity of included studies.ResultsSix studies met the predefined inclusion criteria. Five telephone family activation interventions were identified; Call for Help, medical emergency-teams, Condition HELP, rapid response teams, and family initiated rapid response. Principles underpinning all interventions were founded on a principal of granting families access to a process to escalate concerns to hospital emergency teams. Identified interventions outcomes and mechanisms include; patient safety, empowerment of families, partnership working/ family centred care, effective communication and better patient outcomes. Interventions lacked multi-lingual options.ConclusionFamily activation rapid response system are fundamental to family integrated care and enhancing patient safety. Underlying principles and concepts in delivering interventions are transferable across global healthcare system.     

The effect of abdominal massage on enteral nutrition tolerance in patients on mechanical ventilation: A Randomized Controlled Study

ObjectiveTo assess whether abdominal massage impacts enteral feeding tolerance in mechanically ventilated patients.MethodsPatients were randomized to receive standard or intervention care (standard care plus a 15-minute abdominal massage twice daily) for three days. We recorded the vomiting, reflux, gastric retention, aspiration, diarrhea, abdominal distension, gastric residual volume and abdominal circumference from days one to three. A P-value of less than 0.05 was statistically significant.ResultsSeventy-four patients (37 per group) were recruited (intervention vs control: age 58.03 ± 10.44 vs 55.33 ± 12.45 years; %M: 69.70 % vs 69.70 %). The aspiration, gastric retention and abdominal distension incidence in the intervention group was 3.03 %, 6.06 % and 9.09 %, whereas in the control group it was 24.24 %, 30.30 % and 27.27 % (P <.05). The vomiting, reflux and diarrhea incidence for patients in the intervention group were all 3.03 %, whereas in the control group they were 3.03 %, 9.09 % and 9.09 % (P >.05). From day 1 to day 3, the gastric residual volume decreased from 87.23 ± 3.29 mL to 72.59 ± 5.40 mL in the intervention group and increased from 91.94 ± 3.45 mL to 105.00 ± 6.94 mL in the control group. Similarly, the abdominal circumference decreased from 84.41 ± 1.73 cm to 82.44 ± 1.73 cm in the intervention group and increased from 87.90 ± 1.60 cm to 88.90 ± 1.75 cm in the control group. The differences in time, group, and interaction effects between the two groups were statistically significant for abdominal circumference and gastric residual volume (P <.05).ConclusionsAbdominal massage can effectively reduce gastric retention, abdominal distension, aspiration, gastric residual volume and abdominal circumference in mechanically ventilated patients, but not the incidence of vomiting, reflux and diarrhea.     

The effect of interventions made in intensive care units to reduce alarms: A systematic review and meta-analysis study

ObjectivesThis study examines the effects of the interventions in alarm management in intensive care units on reducing alarms on the basis of current evidence.MethodologyThis systematic review and meta-analysis study was conducted between January 1, 2010 and October 31, 2021 by searching 16 databases through an independent search by three researchers. The acronym of PICOS was used and the keywords as well as inclusion/exclusion criteria were determined. The Joanna Briggs Institute meta-Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI) were used to assess methodological quality. Professional meta-analysis Software (ProMeta 3) statistical software package was used for data analysis. The study is preregistered on PROSPERO (CRD42021286770).SettingIntensive care units.ResultsThe systematic review included 25 studies, whereas the meta-analysis included 15. According to the heterogeneity test in the study, alarm-reducing interventions yielded a heterogeneous distribution. The overall effect size value of all studies, which was found using the random-effects model, was determined to be −0.03 [95 % confidence interval (CI)], a value between −0.16 and 0.10 CI. Based on the results, individual studies showed that the strategies suggesting to ensure alarm safety were effective in reducing the number of alarms; the combined results of the studies in this meta-analysis showed that the interventions made to reduce alarms had too little effect.ConclusionThis study showed that the interventions have a very weak effect size on reducing the number of alarms.     

Combination Radiofrequency Ablation and Percutaneous Osteoplasty for Palliative Treatment of Painful Extraspinal Bone Metastasis: A Single-Center Experience

PurposeTo evaluate combined radiofrequency (RF) ablation and percutaneous osteoplasty (POP) in patients with painful extraspinal bone metastases.Materials and MethodsIn a retrospective study, 38 patients with 54 extraspinal bone metastases (ilium, n = 24; acetabulum, n = 21; femur, n = 7; ischium, n = 1; tibia, n = 1) were treated with RF ablation and POP. All patients had pain refractory to analgesic medication with intensity > 3 on a visual analog scale (VAS). Changes in quality of life were evaluated based on pain relief (VAS score), function on a Karnofsky performance scale, and analgesic dose before and immediately after the procedure and during follow-up. VAS score was the primary outcome, and the others were secondary outcomes.ResultsTechnical success was achieved in 37 patients (97.4%). Mean VAS score declined significantly from 7.1 ± 1.5 before treatment to 2.2 ± 2.0 at 24 hours after treatment (P < .05), 1.6 ± 1.8 at 3 months after treatment (P < .05), and 1.3 ± 1.8 at 6 months after treatment (P < .05). Pain relief immediately after the procedure was reported by 35 patients (92.1%); pain regressed completely in 7 (18.4%) patients. After 6 months, narcotic analgesia had been suspended in 32 of 33 patients (97.0%). Pain was controlled by nonsteroidal antiinflammatory drugs in 8 patients (24.2%), and no analgesia was necessary in 24 patients (72.7%). Mean Karnofsky performance scale score after treatment was higher than before treatment (P < .05). The major complication rate was 2.6% (1 of 38 patients), with one case of vasovagal shock. The minor complication rate was 23.7% (9 of 38 patients).ConclusionsRF ablation with POP is effective for pain relief and functional recovery in patients with painful extraspinal bone metastases and can significantly improve quality of life.     

Boron nitride nanosheets modified with zinc oxide nanoparticles as novel fillers of dental resin composite

ObjectiveThe purpose of this study was to synthesize boron nitride nanosheets modified with zinc oxide nanoparticles (BNNSs/ZnO) and incorporate them as a novel inorganic filler to get an antibacterial dental resin composite.MethodsThe BNNSs/ZnO nanocomposites were synthesized via the hydrothermal method and characterized by Field Emission Scanning Electron Microscope (FESEM), Transmission Electron Microscopy (TEM), Energy Dispersive Spectrometer (EDS), X-ray Diffraction (XRD) and Fourier Transform-Infrared (FTIR) Spectroscopy. The BNNSs/ZnO or BNNSs were added into the experimental dental composite with different proportions, respectively. The mechanical and physical properties of the modified dental composite were evaluated. Their antibacterial activities were also assessed by quantitative analysis using Streptococcus mutans (S. mutans).ResultsThe BNNSs/ZnO nanocomposites were successfully synthesized, and the growth of ZnO nanoparticles (ZnO NPs) on boron nitride nanosheets was confirmed. The flexural strength (FS), flexural modulus (FM) and the compressive strength (CS) of all modified resin composites showed no change compared to the control group. The curing depth, degree of conversion, water absorption and solubility of the modified composites were still within the clinical requirement. The antibacterial rates of the modified composites were significantly increased compared to the control group, which can reach 98 % when 0.5 % BNNSs/ZnO was added.SignificanceThe modified dental resin composite with novel BNNSs or BNNSs/ZnO fillers shows significantly high antibacterial activity with suitable physicochemical and mechanical properties.     

眶上外侧入路与翼点入路手术治疗急性期颅内前循环破裂动脉瘤的临床对比分析

目的研究急性期颅内前循环破裂动脉瘤患者采用眶上外侧入路与翼点入路手术治疗的效果。 方法选择2017年11月至2019年6月于廊坊爱德堡医院神经外科就诊的急性期颅内前循环破裂动脉瘤患者84例作为研究对象,根据手术入路方法不同分为观察组（眶上外侧入路手术）与对照组（翼点入路手术）,每组42例,评估2组患者的临床指标变化与有效率。 结果2组患者术前生存质量差异无统计学意义（P>0.05）;术后观察组生理领域、躯体限制、社会领域与精神状态评分较对照组高（P<0.05）。手术时间与住院时间较对照组短,切口长度较对照组小,术中出血量较对照组少（P<0.05）。观察手术有效率（97.61%）高于对照组（85.71%）,观察组并发症发生率（9.52%）低于对照组（28.57%）（P<0.05）。术前,2组患者的炎性因子IL-12p70、IFN-γ和TNF-α水平比较差异无统计学意义（P>0.05）,2组术后IL-12p70、IFN-γ和TNF-α水平均较术前明显升高（P<0.05）,而观察组炎性因子IL-12p70、IFN-γ和TNF-α水平明显低于对照组（P<0.05）。 结论对急性期颅内前循环破裂动脉瘤患者采用眶上外侧入路手术治疗改善手术效果,提高生存质量。