Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.     

Advancing the use of Lactobacillus acidophilus surface layer protein A for the treatment of intestinal disorders in humans

Intestinal immunity is subject to complex and fine-tuned regulation dictated by interactions of the resident microbial community and their gene products with host innate cells. Deterioration of this delicate process may result in devastating autoinflammatory diseases, including inflammatory bowel disease (IBD), which primarily comprises Crohn's disease (CD) and ulcerative colitis (UC). Efficacious interventions to regulate proinflammatory signals, which play critical roles in IBD, require further scientific investigation. We recently demonstrated that rebalancing intestinal immunity via the surface layer protein A (SlpA) from Lactobacillus acidophilus NCFM potentially represents a feasible therapeutic approach to restore intestinal homeostasis. To expand on these findings, we established a new method of purifying bacterial SlpA, a new SlpA-specific monoclonal antibody, and found no SlpA-associated toxicity in mice. Thus, these data may assist in our efforts to determine the immune regulatory efficacy of SlpA in humans.     

改良V-Y外眦开大成形术的临床应用

目的：探讨改良V-Y外眦开大成形新术式。方法：将Y形切口线设计在睑缘灰线，板层劈开上下睑，并在切口末端增加两条垂直于睑缘的辅助切口线，切开睑板及睑结膜；部分或完全切断外眦韧带，充分分离使外眦呈“游离状态”。在无张或微张力的情况下外移外眦。结果：102例外眦开大成形术99例达到预期效果，开大外眦达1．5～5mm。结论：改良V-Y外眦开大成形术相比传统手术，保留了外眦外形结构，术后外眦无变形，远期回缩轻微，是目前比较理想的合乎美学原理的外眦开大成形术式。     

双台阶水平井钻井实时跟踪系统应用研究——以哈得油田HD10-HX井为例

哈得油田石炭系中泥岩段薄砂层油藏埋藏深、油层薄,且受岩性控制层状边水未饱和,采用以地质导向为基础的双台阶水平井钻井技术。 为了对双台阶水平井钻井质量进行有效评价,研制了一套完善的双台阶水平井钻井实时跟踪系统。该系统充分结合导眼井及邻井的地质、钻井、录井、测井及随钻测井等多种资料,实现双台阶水平井钻井的实时跟踪,对井眼轨迹位移及钻遇地层进行实时分析,计算钻遇率。利用该系统在哈得油田某井区双台阶水平注水井HD10-HX井现场进行了初步的钻井实时跟踪分析应用,获得了较好的应用效果。     

PROFILE ANALYSIS FOR ASSESSING IN VITRO BIOEQUIVALENCE

For locally acting drug products such as nasal aerosols and nasal sprays, therapeutic equivalence between two drug products may be established by in vitro bioequivalence studies based on measurements intended to reflect the rate and extent to which the active ingredient becomes available at the site of action. For cascade impaction or multistage liquid impinger for particle size distribution, profile analysis is required. However, we find that the analysis procedure described in the 1999 FDA guidance lacks statistical justification. In this article, we explain why FDA's approach is incorrect and propose a correct statistical method for profile analysis using the basic ideas in the FDA guidance.     

腭 肺及鼻咽上皮克隆蛋白和Toll样受体-4在鼻息肉组织中的表达及相关性分析

目的运用蛋白印迹法明确腭、肺及鼻咽上皮克隆(PLUNC)蛋白和TLR-4在鼻息肉和正常鼻黏膜组织之间的表达差异和相关性,进一步探讨二者在鼻息肉病因学及疾病进展中的作用。方法采用蛋白印迹法分别半定量检测45例鼻息肉和15名正常鼻黏膜组织中PLUNC蛋白和TLR-4的表达情况,并分析二者在鼻息肉组织中表达的相关性。结果①鼻息肉组与对照组鼻黏膜组织之间PLUNC蛋白和TLR-4表达差异均有统计学意义(P<0.05),鼻息肉组织中TLR-4高表达,PLUNC蛋白低表达;②鼻息肉组PLUNC蛋白和TLR-4表达呈负相关性(r=-0.384,P<0.05)。结论感染性因素在鼻息肉的发病过程中起着重要的作用,感染性因素的存在(特别是革兰阴性菌)使得鼻黏膜TLR-4表达量增高,鼻黏膜长期处于慢性炎症反应使得PLUNC表达分泌下降,可能促进了鼻息肉形成。     

Staphylococcus aureus nasal and pharyngeal carriage in Senegal

Nasal and pharyngeal swabs were collected from 132 patients admitted to the Principal Hospital in Dakar (Senegal), in January and February 2012. The prevalence of Staphylococcus aureus carriage was 56.1% (n = 74): 40.2% for pharyngeal samples and 36.4% for nasal samples. None of the isolates was methicillin-resistant. Carriage was independently associated with being female (p <0.01) and large households (≥15 members) (p 0.04). The luk-PV genes encoding Panton–Valentine leukocidin (PVL) were present in 26.2% of the isolates. These data highlight the importance of the oropharynx as a site of colonization, and the high prevalence of PVL-positive isolates in Senegal as compared with industrialized countries.     

�������ܳ�ϴ��е�Ը��ܱ����۲�����Ч�������о�

??Objective    To study the effect of different irrigation regimens and methods of activation on smear layer removal in root canals. Methods    Thirty-two mandibular premolar roots were divided into 4 groups??with 8 teeth in each . In group A??the teeth were instrumented and irrigated by lateral opening syringe. In group B??irrigation was done using passive ultrasonic irrigation??PUI?? system. In group C RinsEndo root canal irrigation system was used and in group D??Vibringe sonic irrigation system. Scanning electron microscope evaluation was done for assessment of smear layer removal in the coronal??middle??and apical thirds. Results    In each group??there was a smear layer covering the dentinal tubule in apical thirds??and the score was higher than that in the coronal and middle ??P??0.05??. The scores of B??C and D groups were lower than those in group A??P??0.05??. Among A??B??C??D groups in the area of the root canal wall??difference of smear layer score was not statistically significant. Conclusion    Better removal of smear layer of the middle and apical thirds of root canal can be achieved by using RinsEndo??Vibringe and PUI system than by lateral opening syringe.