高频振荡通气治疗新生儿气胸及潮气肺功能随访

目的探讨高频振荡通气(HFOV)治疗新生儿气胸的疗效及其对婴儿期呼吸道疾病和潮气肺功能的影响。 方法选择2012年1月至2015年6月,扬州市第一人民医院收治的需进行机械通气治疗的22例新生儿气胸患儿为研究对象。根据机械通气治疗策略不同,将其分为常频机械通气(CMV)组(n＝12,使用常频呼吸机治疗)及HFOV组(n＝10,使用高频呼吸机治疗)。回顾性分析2组患儿临床资料,并对存活患儿进行定期随访至校正年龄达12个月时。比较2组患儿胸腔闭式引流、机械通气治疗、吸高浓度氧及用氧总时间,以及住院时间等;机械通气治疗前(0 h)及治疗后不同时间点(8、24、48 h)血气分析及氧合功能指标差异;校正年龄达12个月时潮气肺功能参数及呼吸道疾病随访结果。2组患儿性别构成比、胎龄、体重、分娩方式等一般临床资料比较,差异均无统计学意义(P>0.05)。 结果①HFOV组患儿胸腔闭式引流、机械通气治疗及吸高浓度氧时间均较CMV组短,且差异有统计学意义(P<0.05)。2组新生儿用氧总时间、住院时间、支气管肺发育不良(BPD)发生率、颅内出血发生率及病死率分别比较,差异均无统计学意义(P>0.05)。②机械通气治疗前(0 h),2组患儿pH值、动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、氧合指数(OI)、动脉血氧分压/肺泡氧分压比值(PaO₂/PAO₂)及呼吸指数(RI)水平比较,差异均无统计学意义(P>0.05);机械通气治疗后8、24及48 h,HFOV组患儿pH值、PaO₂及PaO₂/PAO₂水平均高于CMV组,PaCO₂、OI及RI水平则均低于CMV组,且差异均有统计学意义(P<0.05)。除CMV组治疗后8 h的PaCO₂水平与该组治疗前(0 h)比较,差异无统计学意义(P>0.05)外,2组患儿治疗后8、24及48 h,其余各指标分别与本组治疗前(0 h)比较,均显著改善,并且差异均有统计学意义(P<0.05)。③2组存活并随访的19例患儿在校正年龄达12个月时,潮气肺功能参数每分通气量(MV)、呼吸频率(RR)、潮气量(TV)、达峰时间比(TPEF/TE)及达峰容积比(VPEF/VE)比较,以及任何原因住院率、上呼吸道感染次数构成比、下呼吸道感染次数构成比、呼吸道感染住院率及支气管扩张剂使用率分别比较,差异均无统计学意义(P>0.05)。 结论HFOV治疗可以有效改善新生儿气胸患儿的血气分析指标和氧合功能参数,缩短胸腔闭式引流、机械通气治疗及吸高浓度氧时间,对婴儿期潮气肺功能及呼吸道疾病的影响与CMV比较,无明显差异。     

Ghrelin 对先天性心脏病患儿生长发育和心脏功能的影响及意义

生长激素释放肽(ghrelin)是生长激素(GH)释放激素受体的内源性配体,可调节GH分泌、刺激食欲、调节能量代谢、改善心血管功能。先天性心脏病(CHD)患儿常常存在营养不良、生长发育迟缓,这与能量摄入不足、吸收差,而需要量增加、解剖及血流动力学的改变有关。多数CHD患儿在婴幼儿期就逐渐出现心功能不全以及生长发育受限,从而出现严重的并发症。Ghrelin对早期发现潜在的CHD患儿,改善其营养不良状态及保护其心脏功能发挥重要作用,对探索CHD新型的药物治疗方法提供重要参考。文章综述ghrelin对CHD患儿生长发育和心脏功能的影响及意义。     

N6-甲基腺苷修饰与心血管疾病关系研究

N⁶-甲基腺苷(m⁶A)修饰是一种原核生物和真核生物中广泛存在的转录后RNA修饰,涉及多种类型的RNA。在信使RNA中,m⁶A修饰可以影响包括二级结构、亚细胞定位、核转运、翻译和降解等信使RNA的加工和代谢。m⁶A修饰在疾病诊断、疗效评估和预后判断等方面具有突出优势。现总结当前文献对于m⁶A修饰的认识,简述其在心血管疾病中的最新研究进展。     

多发性肺结节影像学管理现状及进展

低剂量CT(low-dose computed tomography,LDCT)在肺癌筛查中的广泛应用使越来越多的肺结节得以发现,而其中超过20％的结节是多发性肺结节.目前对于多发性肺结节尚无统一指南,主要是以影像学检查为主的诊断和管理策略.本文从影像学检查技术、多发性肺结节的特征以及随访管理等方面综述多发性肺结节的影...     

沙利度胺联合地塞米松对多发性骨髓瘤KM3细胞的作用

为了探讨沙利度胺（thalidomide,THD）联合地塞米松（Dx）对多发性骨髓瘤KM3细胞的作用及其可能的机制,采用细胞毒性试验（MTT法）观察不同浓度、不同作用时间的THD或THD＋地塞米松（Dx）作用于KM3细胞后细胞的抑制率,以选取最佳药物干预条件。使用该条件处理KM3细胞,并采用间接ELISA法检测细胞上清中IL-6、肿瘤坏死因子-α（TNF—α）、血管内皮细胞生长因子（VEGF）、内皮抑素（ES）、凋亡抑制蛋白survivin的表达。结果表明：随着THD浓度的加大、作用时间的延长,KM3细胞生长的抑制也呈增强的趋势,同时THD与Dx联用可显著提高药物对KM3细胞的生长抑制作用。80μg／ml或100μg／mlTHD联合Dx（4μg/ml）可使KM3细胞IL-6、TNF-α、survivin表达下降,ES表达增加,而对VEGF的表达无影响,结论：THD联合Dx对KM3细胞有协同抑制作用,THD联合Dx可能通过下调KM3细胞IL-6、TNF-α、survivin的表达,上调ES的表达而发挥抗多发性骨髓瘤的作用。     

A novel pentacyclic triterpenoid,Ilexgenin A,shows reduction of atherosclerosis in apolipoprotein E deficient mice

Ilexgenin A (IA), a novel pentacyclic triterpenoid, is a compound extracted from leaves of Ilex hainanensis Merr. In this study, we explored the efficacy of IA on atherosclerosis and its underlying mechanism. We determined that treatment with IA attenuated atherosclerosis in high-fat diet-induced apolipoprotein E deficient mice via a series of effects involving regulation of lipid parameters, decrease of atherosclerosis-related indexes, inhibition of inflammatory cytokines secretion and pathological changes of main organs. Furthermore, the underlying mechanism of IA was investigated on oxidized low-density lipoprotein (Ox-LDL)-induced THP-1 cells. We showed that pre-treatment with IA decreased active inflammation cytokines involving interleukin-6 (IL-6), IL-1 and tumor necrosis factor-α (TNF-α) expression in a concentration-dependent manner. In addition, we confirmed that IA inhibited the phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), IKKα phosphorylation and NF-κB activity induced by Ox-LDL. Overall, these findings define IA as a novel drug candidate for anti-atherosclerotic therapy.     

Dendrobium orchid polysaccharide extract: Preparation, characterization and in vivo skin hydrating efficacy

Objective: Dendrobium spp., the major globally commercializing tropical orchid, has been continuously used in Chinese medicine. However, preparation and standardization of this therapeutic orchid including its clinical evidence for topical application are sparely to be exploited.Methods: Maceration of the white orchid(Dendrobium cv. Khao Sanan) in water was varied on the extraction time. The extraction yields and total polysaccharide content of the extracts were compared. The best extract condition was selected, standardized, and evaluated on safety and skin hydrating efficacy in human volunteers.Results: The extraction for 3 h gave the extract with polysaccharide content that significantly(P 0.001)greater than the other extraction times with the following specification: yield [(35.60 ± 2.51)%], moisture content [(7.65 ± 0.21)%], total polysaccharide, sugar, reducing sugar and ash content [(72.95 ± 2.37)%,(34.38 ± 0.00)%,(16.28 ± 0.00)%, and(0.12 ± 0.00)%], p H(4.42 ± 0.01), viscosity [(15.07 ± 0.12) cps]swelling and water absorption capacities [(10.00 ± 0.00)%,(1.19 ± 0.24) g/g]. This antioxidative polysaccharide caused no skin irritation with a better skin hydrating efficacy than the untreated skin and the benchmark as examined in 22 Thai volunteers.Conclusion: White Dendrobium is ready to be supplied as a specialty ingredient with a safe and efficient profile for skin dryness therapy. This innovative application of the identified traditional Chinese medicinal herb flows in the main stream of the consumers' preferences and demand upon natural derived products.     

The effect of arbutin and aerobic training on plasma leptin and adiponectin concentrations in alloxan-induced diabetic rats

BackgroundLeptin and adiponectin are cytokines produced excessively by adipocytes, which are related to metabolic disorders. This study aimed to compare the effect of aerobic training (AT) and arbutin on leptin and adiponectin in alloxan-induced diabetic rats.MethodsEighty male Wistar rats were divided into ten groups including: (1) healthy control, (2) diabetic control, (3) healthy + arbutin, (4) diabetic + arbutin, (5) healthy + AT, (6) healthy + arbutin + AT, (7) diabetic + arbutin + AT, (8) diabetic + glibenclamide, (9) diabetic + AT, and (10) diabetic + glibenclamide + AT. Diabetes was induced in rats through the injection of 90 mg/kg saline-diluted alloxan. The AT was performed by swimming fosix weeks (five days a week). Arbutin was injected at 50 mg/kg, and glibenclamide was gavaged at 0.5 mg/kg per meal.ResultsImprovements of leptin, glucose, adiponectin and leptin to adiponectin ratio were different (P ≤ 0.05). Despite the significant effect of arbutin and its interaction with AT, in all cases, the effect of glibenclamide consumption was greater compared to arbutin (P = 0.001). Interaction of AT with glibenclamide also increased this effect (P = 0.001).ConclusionRehabilitation exercise and arbutin may offer a solution for the treatment of diabetes. However, the effect of this treatment is less than compared to glibenclamide, which may be further improved through changing the dose of arbutin or AT.