稳定层流剪应力对内皮细胞骨架调节蛋白VASP表达的影响

为探讨生理强度的稳定层流剪应力对内皮细胞骨架actin相关蛋白VASP特征影响规律，我们采用胰蛋白酶消化法分离人脐静脉内皮细胞(HUVECs)，模拟体内流动环境，建立平行板流动腔模型。利用细胞图像分析系统和ALEXA488—若丹明一次毒蕈环肽双标记法，观察内皮细胞在稳态层流下形态、actin排列变化与VASP分布变化之间的规律。采用Western blot定量动态检测细胞内VASP表达及磷酸化的水平。结果表明，内皮细胞在10dyn／cm^2剪切作用后，随时间细胞逐渐延长，长轴趋于剪应力作用方向排列，细胞与静息态的细胞相比，细胞内骨架沿剪应力方向重组，与此同时VASP表达增强，沿着actin纤维呈点状分布，尤其集中在细胞膜下actin末端区域；Western blot检测显示在剪切后，细胞内VASP出现快速磷酸化，VASP总体表达量增加，2h达高峰后逐渐恢复，8h后再次逐渐升高。以上结果提示血流动力学特性中剪应力引起了细胞胞质内骨架蛋白分子重组，血管内皮细胞形态改变，在此过程中，VASP发挥骨架调节蛋白的作用。     

高脂血症患者血流剪切率的变化及对血管功能的影响

目的：观察高脂血症患者血流剪切率的变化特点及探讨非诺贝特提高血管舒张功能的机制。方法:以20例正常人、62例高甘油三酯血症病人(其中30例予以饮食治疗、32例予非诺贝特治疗)为观察对象，以肱动脉B超测量血流、血管弹性和舒张功能等指标，检测血浆一氧化氮(NO)、氧化型低密度脂蛋白(Ox-LDL)、血脂的变化。结果:高甘油三酯血症病人超声显示平均血流剪切率（MSR）、血流介导的扩张效应(FMD)和血管弹性指标Da、Dr显著小于正常对照组，而平均血管壁紧张度(MCWT)显著大于正常对照组；血Ox-LDL浓度高于、NO水平低于正常对照组，且NO与MSR、 FMD水平呈正相关，与甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和Ox-LDL浓度呈负相关。8周的低脂饮食治疗可使TC、TG水平下降，但NO、Ox-LDL和血管超声指标未见显著改变；非诺贝特治疗组血管超声MSR 、FMD显著高于对照组，血TG、TC、LDL-C和Ox-LDL浓度低于、NO水平高于对照组。结论:高甘油三酯血症时MSR的下降和氧化因子Ox-LDL的升高共同参与内皮的损伤机制，导致NO水平下降，表现为血管舒张功能的下降和弹性下降，MSR的上升和Ox-LDL的下降有利于内皮功能的修复。     

A Negative Slow Wave Related to Conceptual Load Which Vanishes if the Amount of Load is Increased? A Reply to Ruchkin and Johnson

Ruchkin and Johnson (1991) claim that the mode of responding used by Rösler & Heil (1991) may have camouflaged effects of a negative slow wave that Ruckin et al. (1988) had found to be related to the difficulty of mental calculation problems. This criticism is addressed by three arguments which support the interpretation of Rösler and Heil (1991). According to this view, the negative slow wave in question is more likely related to unspecific processing factors, such as effort and event expectation, than to specific processing demands such as these induced by mental arithmetic.     

Comparison of electrical field plethysmography with electrical impedance plethysmography

As a means for assessing cardiac function, electrical field plethysmography (EFP) has been shown to have some features quite different from electrical impedance plethysmography (EIP). Here the two techniques are compared by using the two systems simultaneously on a subject and also with independent use in different electrode configurations. The results conform with the view that EIP is related primarily to volumetric changes of the aorta, whereas EFP is affected predominantly by changes in cardiac dimensions and orientation. Because of this difference, the standard time differential formula used for EIP is not applicable for the computation of cardiac output from the EFP waveforms. An alternative method of computation based on the amplitude of the EFP waveform is suggested.     

超声彩色脉搏波技术在定量评价2型糖尿病患者颈动脉弹性变化中的应用

目的 探讨超声彩色脉搏波(UFPWV)技术在定量评价2型糖尿病患者颈动脉血管管壁弹性变化中的应用价值。方法 回顾性研究。纳入2018年7月-2019年3月蚌埠医学院第一附属医院收治的97例2型糖尿病患者为观察组,其中男47例、女50例,年龄20~74(46.6±9.3)岁;根据颈动脉内中膜厚度(IMT)将观察组分为颈动脉粥样斑块组(A组)、颈动脉内中膜增厚组(B组)和颈动脉内中膜正常组(C组),依据下肢动脉有无斑块将C组分为下肢动脉斑块组(C1组)、下肢动脉无斑块组(C2组)。选取2017年12月-2018年12月在蚌埠医学院第一附属医院体检中心血糖及颈动脉IMT正常的健康体检者64人为对照组,其中男25人、女39人,年龄20~74(44.3±12.0)岁。运用UFPWV采集脉搏波速度 (PWV),计算颈动脉收缩早期PWV(PWV-BS)及收缩晚期PWV(PWV-ES),分析各项参数组间的差异。结果 观察组中,A组颈动脉PWV-BS、PWV-ES分别为(9.51±1.25)m/s、(10.79±1.64)m/s,B组分别为(8.47±0.91)m/s、(9.81±1.05)m/s,C组分别为(7.97±0.77)m/s、(9.07±0.74)m/s,对照组颈动脉PWV-BS、PWV-ES分别为(6.10±1.00)m/s、(7.40±1.20)m/s,A组、B组、C组及对照组间颈动脉PWV-BS、PWV-ES测量值依次降低,差异均有统计学意义(P值均<0.05)。C组中,C1组颈动脉PWV-BS、PWV-ES分别为(7.83±0.85)m/s、(8.82±0.59)m/s,C2组分别为(8.14±0.64)m/s、(9.34±0.79)m/s, C1组PWV-ES显著高于C2组,差异有统计学意义(t=3.402,P＜0.01),而两组间PWV-BS的差异无统计学意义(P>0.05)。结论 UFPWV技术可定量评价2型糖尿病患者颈动脉弹性变化,并可通过PWV-ES的改变评估颈动脉形态学正常的患者动脉粥样硬化的进展程度,对临床诊疗具有一定意义。     

U波倒置40例临床分析

U波倒置40例,其中孤立性U倒16例(40％),复合性U倒24例(60％)。U波倒置常见于左心前导联V_5V_6,呈现左室肥厚及负荷加重,心电图示“左室劳损”型。U波倒置严重合并症,除心力衰竭外,还有急性心肌梗塞和室性期前收缩。笔者认为,通过本文分析,UV_5倒置对临床诊断冠心病,高血压等是有价值的。     

An Overview of the Treatment Options Used for the Management of COVID-19 in Pakistan: Retrospective Observational Study

BackgroundSince the first reports of COVID-19 infection, the foremost requirement has been to identify a treatment regimen that not only fights the causative agent but also controls the associated complications of the infection. Due to the time-consuming process of drug discovery, physicians have used readily available drugs and therapies for treatment of infections to minimize the death toll.ObjectiveThe aim of this study is to provide a snapshot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the period from May to July 2020, when the first wave of COVID-19 peaked in Pakistan.MethodsA retrospective observational study was performed to provide an overview of the major drugs used in a cohort of 1562 patients with COVID-19 admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan during the peak of the first wave of COVID-19 in the country (May-July 2020).ResultsAntibiotics were the most common choice out of all the therapies employed, and they were used as first line of treatment for COVID-19. Azithromycin was the most prescribed drug for treatment. No monthly trend was observed in the choice of antibiotics, and these drugs appeared to be a random but favored choice throughout the months of the study. It was also noted that even antibiotics used for multidrug resistant infections were prescribed irrespective of the severity or progression of the infection. The results of the analysis are alarming, as this approach may lead to antibiotic resistance and complications in immunocompromised patients with COVID-19. A total of 1562 patients (1064 male, 68.1%, and 498 female, 31.9%) with a mean age of 47.35 years (SD 17.03) were included in the study. The highest frequency of patient hospitalizations occurred in June (846/1562, 54.2%).ConclusionsGuidelines for a targeted treatment regime are needed to control related complications and to limit the misuse of antibiotics in the management of COVID-19.     

肾盂肾下盏夹角对结石清除率的影响

目的：观察肾盂肾下盏夹角及结石大小对结石排净率的影响。方法：选择68例肾下盏结石患者,通过IVU影像,测量夹角与结石直径,并经ESWL治疗,随访2月,观察结石排空情况。结果：68例患者,结石完全排出42例,总的排石排空率为61．7％。结论：提示肾盂肾下盏夹角,结石直径对结石排净率有重要影响。     

Role of shear wave elastography measured in the flaccid state in predicting arteriogenic erectile dysfunction

The gold-standard method for diagnosing arteriogenic erectile dysfunction (AED) is the penile Doppler ultrasonography. We proposed a novel method for predicting AED using ultrasonic shear wave elastography (SWE) considering that the former was invasive and variable. A total of 98 male patients were enrolled in our study, referred for ED between December 2018 and October 2020. For comparison, we also included 42 volunteers from the Healthy Physical Examination Center of our hospital. The Penile Doppler Ultrasonography (PDU) and SWE were performed for all patients with the intracavernosal injection (ICI). We named three groups as AED group, nonvascular ED group and healthy controls group. No statistically significant differences were found among the three groups in terms of demographic and clinical characteristics. There were no significant differences in IIEF-5 between AED and nonvascular ED. A significant (r = 0.642, p < 0.0001) positive correlation between flaccid and erectile SWE was observed. With a cut-off value of 13.45 KPa, the area under curve, specificity, and sensitivity of the SWE values under the flaccid state in distinguishing AED from healthy subjects were 0.867, 0.786 and 0.896 respectively. The SWE value in the flaccid state can distinguish the AED from healthy subjects.