聚谷氨酸苄酯/聚乙二醇/聚谷氨酸苄酯嵌段共聚物膜的生物降解性

以木瓜蛋白酶(papain)做蛋白水解酶,通过测定酶解前后聚谷氨酸苄酯/聚乙二醇/聚谷氨酸苄酯(PBLG/PEG/PBLG)嵌段共聚物膜的重量和分子量的变化来研究其体外生物降解规律.结果表明,共聚物的分子量及PEG嵌段的含量影响它们的降解速度.共聚物的分子量越大,其降解速度越慢.PEG含量越高,共聚物的水溶胀率越大,而共聚物的水溶胀率越大,其降解速度越快.通过调节共聚物中PEG的含量和共聚物的分子量可以控制共聚物的降解速度.     

mPEG表面修饰的PLGA嵌段共聚物的血液相容性评价

本实验室设计合成了三种不同LA／GA比例的mPEG修饰PLGA（PELGA，含15％mPEG），为了评价它们的血液相容性，我们以硅化玻璃试管为阴性对照，未硅化的试管为阳性对照，参照国际标准（ISO10993）和《中华人民共和国国家标准GB／T16886医疗器械生物学评价》方法进行了体外评价实验。试验包括溶血率实验，血小板黏附实验，动态凝血时间实验，凝血时间实验，血浆复钙时间实验和凝血酶原时间实验等综合评价指标。结果表明，合成材料具有优良的血液相容性，材料制成的纳米粒有望应用于静脉注射。     

舌咽神经阻滞入路相关结构的应用解剖

目的 :为舌咽神经阻滞的进针入路和预防并发症的发生提供解剖学基础。方法 :观测了30侧成人头、颈部标本舌咽神经的毗邻结构。结果 :舌咽神经阻滞进针的深度 :乳突尖端与下颌角之间连线的中点至颈静脉孔的距离 ,左侧为 (2 3 .2± 0 .4)mm(17.0～ 30 .1mm) ,右侧为 (2 3.0± 0 .4)mm(16 .5～33 .3mm)。获得了舌咽神经的毗邻结构的观测结果。结论 :为舌咽神经阻滞的进针深度和预防并发症提供了解剖学依据。     

Do doctors’ attachment styles and emotional intelligence influence patients’ emotional expressions in primary care consultations? An exploratory study using multilevel analysis

Objective

To investigate whether and how doctors’ attachment styles and emotional intelligence (EI) might influence patients’ emotional expressions in general practice consultations.

Identification of homogeneous genetic architecture of multiple genetically correlated traits by block clustering of genome‐wide associations

Genome‐wide association studies (GWAS) using high‐density genotyping platforms offer an unbiased strategy to identify new candidate genes for osteoporosis. It is imperative to be able to clearly distinguish signal from noise by focusing on the best phenotype in a genetic study. We performed GWAS of multiple phenotypes associated with fractures [bone mineral density (BMD), bone quantitative ultrasound (QUS), bone geometry, and muscle mass] with approximately 433,000 single‐nucleotide polymorphisms (SNPs) and created a database of resulting associations. We performed analysis of GWAS data from 23 phenotypes by a novel modification of a block clustering algorithm followed by gene‐set enrichment analysis. A data matrix of standardized regression coefficients was partitioned along both axes—SNPs and phenotypes. Each partition represents a distinct cluster of SNPs that have similar effects over a particular set of phenotypes. Application of this method to our data shows several SNP‐phenotype connections. We found a strong cluster of association coefficients of high magnitude for 10 traits (BMD at several skeletal sites, ultrasound measures, cross‐sectional bone area, and section modulus of femoral neck and shaft). These clustered traits were highly genetically correlated. Gene‐set enrichment analyses indicated the augmentation of genes that cluster with the 10 osteoporosis‐related traits in pathways such as aldosterone signaling in epithelial cells, role of osteoblasts, osteoclasts, and chondrocytes in rheumatoid arthritis, and Parkinson signaling. In addition to several known candidate genes, we also identified PRKCH and SCNN1B as potential candidate genes for multiple bone traits. In conclusion, our mining of GWAS results revealed the similarity of association results between bone strength phenotypes that may be attributed to pleiotropic effects of genes. This knowledge may prove helpful in identifying novel genes and pathways that underlie several correlated phenotypes, as well as in deciphering genetic and phenotypic modularity underlying osteoporosis risk. © 2011 American Society for Bone and Mineral Research.     

阴部神经阻滞麻醉的解剖学基础

目的:为阴部神经阻滞麻醉提供解剖学证据。方法:利用10例低位直肠癌患者腹会阴联合切除做会阴解剖时,以两侧坐骨结节前缘为参照基点,解剖出双侧阴部神经及其分支。后3例患者用亚甲蓝标记阴部神经封闭位点。结果:阴部神经在Alcock管出口处位于阴部内动脉、静脉下方,分出会阴神经和肛神经,左侧有个别散发肛神经。经皮穿刺至坐骨结节,再垂直其内侧进针26mm注射亚甲蓝,可见阴部神经周围被蓝染。结论:距坐骨结节前缘内侧26mm是阴部神经阻滞麻醉的恰当位点。     

Comparison between continuous posterior and lateral interscalene brachial plexus blockades for major shoulder surgery

Background

Postoperative pain relief after major shoulder surgery is extremely challenging. Continuous interscalene blockade is considered a well suited pain management technique for this type of surgery, but with technical difficulties. The aim of this study was to compare the efficacy and safety of continuous posterior and conventional lateral interscalene brachial plexus blockades.

Methods

This prospective randomized study included 40 patients who were radomally allocated into two equal groups (n = 20 patients), in the first group, continuous lateral interscalene blockade was done (Lateral Group), while continuous posterior interscalene was performed in the second group (Posterior Group). The measurement data were patient characteristics and surgical data, easiness of catheter insertion, onset of blockade, catheter insertion and total blockade times. Side effects encountered during blockade and postoperative efficacy of analgesia as well as patients satisfaction were also measured.

Results

There was no significant difference as regards the onset of anesthesia in both groups. Block procedure time and catheter placement times were faster in the posterior group (6.6 ± 0.64 vs 9.6 ± 1.1 min; P < .05 and 1.6 ± 0.7 vs 4.3 ± 0.7 min; P < 0.05 respectively). Successful catheter insertion was higher in the posterior group (19 patients vs 15 patients in the lateral group). Easy catheter insertion were significantly higher in the posterior group (16 patients vs eight patients In the lateral group; P < 0.05).Technical adverse effects related to catheter insertion were significantly higher in the lateral group (nine patients vs only one patient in the posterior group; P < 0.05). Complications were comparable in both groups. Postoperative efficacy of analgesia and Patient’s satisfaction about catheter placement was higher in the posterior group.

Conclusion

In conclusion, we demonstrated a high success rate, low systemic and technical adverse effects, and better catheter compliance with continuous posterior interscalene blockade.     

亚甲蓝切缘封闭在环状混合痔手术中的应用

为探讨亚甲蓝切缘封闭在环状混合痔手术中的临床应用价值,将72例手术治疗的环状混合痔患者随机分为治疗组和对照组,各36例,对照组采用保留齿状线、分段外切内扎术治疗,治疗组在对照组手术的基础上加行亚甲蓝切缘封闭注射。观察两组治愈率、创面愈合时间、术后肛门疼痛、肛缘水肿、术后早期排尿及排便功能等情况。结果显示,在治愈率方面,两组差异无统计学意义,P〉0．05;但在创面愈合时间、术后肛门疼痛、肛缘水肿、排尿困难及排便困难等方面,治疗组明显优于对照组,P〈0．05。结果表明,在环状混合痔手术中加行亚甲蓝切缘封闭注射,可以显著减少术后并发症的发生,减轻患者痛苦,缩短创面愈合时间。     

Amphiphilic block copolymer delivery of a DNA vaccine against Zika virus

Zika virus (ZIKV) is a mosquito-borne flavivirus that was first discovered in 1947. Since then, outbreaks have been reported in tropical Africa, Southeast Asia, the Pacific Islands, and, in 2015, in the Americas. Since 2013, many countries have reported cases of microcephaly and other central nervous system malformation associated with ZIKV. Because the initial target population for a ZIKV vaccine is expected to be women of child-bearing age, including those who may be pregnant, it is necessary to develop safe, easily administered, and non-viral vaccines. Here, we show that a single tetrafunctional Amphiphilic Block Copolymer (ABC) delivers DNA that encodes the full natural sequence of prM-E, among other antigen designs tested, induces the highest antibody titer and neutralization activity against three divergent ZIKV isolates. Vaccination with a single tetrafunctional block copolymer delivering low dose (10 µg) DNA plasmid rapidly induces protection from detectable viremia during acute infection in mice challenged by ZIKV more than 7 months after their first vaccination and boosted 2 weeks before challenge. This use of tetrafunctional ABCs is a new approach to deliver DNA antigens against flaviviruses. The data demonstrate that DNA formulated by a tetrafunctional block copolymer rapidly elicits protective responses against multiple diverse ZIKV isolates. This represents potential for an easy-to-administer and simple to manufacture vaccine candidate against ZIKV and possibly other emerging threats to global health.