锥形束CT诊断颌面部异物1例

<正>张口受限为颌面外科的常见疾患,但颌面部异物引起张口受限多为个案报道[1-3]。准确定位异物位置及其形状大小,是外科手术取出异物,保证手术成功的关键。锥形束CT(cone beam computed tomography,CBCT)因其独特的三维成像特点,可以精确定位,更好地引导外科手术的顺利进行[4-6]。现对我院收治的1例颌面部异物引起的张口受限患者的临床资料进行报道,并结合文献回顾对CBCT在颌面异物诊断中的应用价值进行讨论。     

食管嵌顿性异物内镜治疗分析

目的 评价内镜治疗嵌顿性食管异物的有效性和安全性.方法 回顾性总结78例嵌顿性食管异物患者的病例资料,收集食管异物的种类、数量、嵌顿部位、滞留时间,相关食管病变,内镜治疗方法、治疗时间以及并发症发生情况,并对影响并发症发生及治疗时间相关因素进行统计分析.结果食管上段最易发生嵌顿(80.8％,63/78)和穿孔(66.7％,8/12);11例异物滞留时间超过24 h,其余67例不足24 h;所有患者经内镜成功取出异物(只有2例穿孔患者取出异物后转耳鼻喉科或胸外科接受进一步治疗),治疗过程中无一例死亡,主要并发症为出血(13例,16.7％),其次为黏膜撕裂伤(7例,9.0％)和穿孔(1例,1.3％),总的并发症发生率为26.9％(21/78);异物形状、滞留时间及是否穿孔是影响内镜治疗时间和并发症发生率的主要因素(P＜0.05).结论 内镜治疗嵌顿性食管异物是安全和有效的方法.已造成食管穿孔的异物,滞留时间不超过24h且CT提示食管管腔外无脓肿形成者,可首选内镜治疗.     

Endoscopic Management for Delayed Diagnosis of a Foreign Body Penetrating the Esophagus into the Lung

A 31-year-old male presented with chest pain started after eating chicken about 2 weeks earlier. Upper endoscopy and Computed tomography scan of the chest revealed a sharp chicken bone penetrating the esophageal wall into the right lung. The foreign body was removed endoscopically using a rat-tooth forceps, followed by prophylactic placement of a metal stent across the esophageal perforation site. Foreign body-induced perforation is one of the common etiologies of benign esophageal perforations. Although the primary treatment is surgery, endoscopic therapy may be appropriate in individualized cases like our patient.     

28例路易体痴呆患者的视频-多导睡眠图分析

目的研究路易体痴呆（DLB）患者的视频～多导睡眠图,探讨路易体痴呆患者的睡眠结构。方法对临床诊断DLB28例及正常对照28人进行研究。所有入组者均进行简易精神状态检查量表（MMSE）和视频～多导睡眠图（Video-PSG）监测。结果（1）睡眠结构分析：与对照组相比,DLB组总睡眠间期时间（SPT）减少,差异具有统计学意义（P〈0．05）;总睡眠时间（TST）减少、睡眠效率（SE）下降、总醒觉时间（TWT）、入睡后清醒时间（WASO）增多、1期睡眠时间（TS1）、2期睡眠时间（TS2）、NREM睡眠时间（TNREMS）和REM睡眠时间（TREMS）均明显减少,差异具有统计学意义（P〈0．01）;（2）睡眠呼吸事件分析：DLB组与对照组相比,各项指标差异均无统计学意义（P〉0．05）;（3）其他睡眠事件分析：与对照组相比,DLB组睡眠期周期性肢体运动次数（PLMS）、快动眼睡眠行为异常（RBD）明显增多,差异具有统计学意义（P〈0．01）。结论DLB患者存在睡眠结构紊乱,睡眠异常行为亦很常见。视频-多导睡眠图对于研究DLB患者的睡眠障碍很有帮助。     

Focus on germ-layer markers: A human stem cell-based model for in vitro teratogenicity testing

Human induced pluripotent stem cells (hiPSC) were used to develop an assay format that may deliver information on teratogenicity of drugs. A human pluripotent stem cell scorecard panel was used to monitor the expression of 96 marker genes that are indicative of the stem cell state or differentiation into the ectoderm, mesoderm and endoderm lineages. We selected a human episomal iPS cell line for the assay based on karyotype stability, initial pluripotency, differentiation capacity and overall gene expression variability. The assay is based on embryoid body formation and was developed to be simply automated. In this proof of concept study, we used eight reference compounds (valproic acid, all-trans-retinoic acid, thalidomide, methotrexate, hydroxyurea, ascorbic acid, penicillin G and ibuprofen) to test the technical performance of the assay (readout stability) in concentration-response and time-course experiments. We also found that each compound affected marker gene expression in a different way. Various forms of data analysis identified 19 out of 96 early developmental genes as potential predictive markers for teratogenicity. Machine-learning models were run to exemplify how the assay will be developed further. The preliminary results from these analyses suggest that the assay could be suitable for the pre-screening of candidate pharmaceutical compounds. The approach presented here points a way towards development of a human cell-based assay that could replace the murine EST currently used to screen for early indications of potential teratogenicity of drug candidates.     

艾蒿化学成分研究

目的研究艾蒿Artemisia argyi的化学成分。方法采用溶剂萃取、硅胶柱色谱、高效液相色谱等方法进行分离纯化,通过理化性质及波谱数据分析鉴定结构。结果从艾蒿中分离得到34个化合物,分别鉴定为5-羟基-6,7,3′,4′-四甲氧基黄酮(1)、半齿泽兰素(2)、对羟基苯乙酮(3)、覆盆子酮(4)、姜酮(5)、7-羟基香豆素(6)、对羟基苯甲酸(7)、脱氢去乙酰氧母菊素(8)、3α-羟基-1(10),4,11(13)-吉马三烯-12,6α-内酯(9)、棕矢车菊素(10)、7-羟基松油醇(11)、顺-2,8-二羟基-对薄荷-1(7)-烯(12)、反-2,8-二羟基-对薄荷-1(7)-烯(13)、艾黄素(14)、东莨菪内酯(15)、艾蒿内酯C(16)、去乙酰母菊酮素(17)、1-表-4,5-二氢灰蒿素C(18)、11,13-脱氢去乙酰母菊酮素(19)、1,9-壬二酸(20)、3-methoxy-tanapartholide(21)、红花菜豆酸(22)、断愈创木酸(23)、5,3′,4′-三羟基-6,7-二甲氧基黄酮(24)、1,7-庚二酸(25)、10-epi-ajafinin(26)、3-epi-iso-seco-tanapartholide(27)、austroyunnane C(28)、刘寄奴内酯(29)、川芎内酯A(30)、seco-tanapartholide B(31)、3-dehydroxy-iso-seco-tanapartholide(32)、3α-hydroxyreynosin(33)、二氢红花菜豆酸(34)。结论化合物4、22、25、30、33、34为首次从蒿属植物中分离得到,化合物5、7、8、11～13、21、23、24、26～28为首次从艾蒿中分离得到。     

Infectious Agents as Potential Drivers of α-Synucleinopathies

α-synucleinopathies, encompassing Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy, are devastating neurodegenerative diseases for which available therapeutic options are scarce, mostly because of our limited understanding of their pathophysiology. Although these pathologies are attributed to an intracellular accumulation of the α-synuclein protein in the nervous system with subsequent neuronal loss, the trigger(s) of this accumulation is/are not clearly identified. Among the existing hypotheses, interest in the hypothesis advocating the involvement of infectious agents in the onset of these diseases is renewed. In this article, we aimed to review the ongoing relevant factors favoring and opposing this hypothesis, focusing on (1) the potential antimicrobial role of α-synuclein, (2) potential entry points of pathogens in regard to early symptoms of diverse α-synucleinopathies, (3) pre-existing literature reviews assessing potential associations between infectious agents and Parkinson's disease, (4) original studies assessing these associations for dementia with Lewy bodies and multiple system atrophy (identified through a systematic literature review), and finally (5) potential susceptibility factors modulating the effects of infectious agents on the nervous system. © 2022 International Parkinson and Movement Disorder Society     

M-30 and 4HNE are sequestered in different aggresomes in the same hepatocytes

M-30 and 4HNE adducts are two markers of active liver disease. M-30 is a serologic marker and 4HNE adducts are histologic markers. M-30 is a marker for apoptosis because it is a fragment of cytokeratin-18 left over from proteolysis by caspase 3. 4HNE is a marker of oxidative stress because it results from lipid peroxidation. Both markers are commonly found in nonalcoholic steatohepatitis and in alcoholic hepatitis. Liver biopsies from patients with steatohepatitis, 11 alcoholic and 11 non-alcoholics were stained for 4HNE and M-30. Almost all of the biopsies in both groups showed 4HNE- and M-30-positive aggresomes in hepatocytes. Mallory Denk bodies (MDB) stained variably positive for M-30, whereas 4HNE was present in aggresomes independent of MDBs. However, they were sometimes located in hepatocytes which also contained MDBs as shown by confocal microscopy of double stained biopsies. The results indicate that the formation of M-30 and 4HNE aggresomes occurs through different pathways of liver cell injury in both types of steatohepatitis.     

Side‐effects of thiamethoxam on the brain andmidgut of the africanized honeybee Apis mellifera (Hymenopptera: Apidae)

The development of agricultural activities coincides with the increased use of pesticides to control pests, which can also be harmful to nontarget insects such as bees. Thus, the goal of this work was assess the toxic effects of thiamethoxam on newly emerged worker bees of Apis mellifera (africanized honeybee—AHB). Initially, we determined that the lethal concentration 50 (LC₅₀) of thiamethoxam was 4.28 ng a.i./μL of diet. To determine the lethal time 50 (LT₅₀), a survival assay was conducted using diets containing sublethal doses of thiamethoxam equal to 1/10 and 1/100 of the LC_50. The group of bees exposed to 1/10 of the LC₅₀ had a 41.2% reduction of lifespan. When AHB samples were analyzed by morphological technique we found the presence of condensed cells in the mushroom bodies and optical lobes in exposed honeybees. Through Xylidine Ponceau technique, we found cells which stained more intensely in groups exposed to thiamethoxam. The digestive and regenerative cells of the midgut from exposed bees also showed morphological and histochemical alterations, like cytoplasm vacuolization, increased apocrine secretion and increased cell elimination. Thus, intoxication with a sublethal doses of thiamethoxam can cause impairment in the brain and midgut of AHB and contribute to the honeybee lifespan reduction. © 2013 Wiley Periodicals, Inc. Environ Toxicol 29: 1122–1133, 2014.