合并室间隔缺损及粗大体肺侧支的肺动脉闭锁的选择性侧支融合术及粗大体肺侧支的再认识

目的探讨选择性侧支融合术或单源化治疗(unifocalization,UF)在室间隔缺损(VSD)及粗大体肺侧支(MAPCAs)的肺动脉闭锁(PA)患儿中的应用,并从组织病理学角度深入剖析不同解剖形态的MAPCAs。方法2017年6月至2018年12月,6例合并粗大体肺侧支及室间隔缺损的肺动脉闭锁(MAPCAs/VSD/PA)患儿实施选择性UF术加一期根治术,男4例,女2例;年龄6~96个月;体质量5.0~23.0 kg。术前均行心导管、选择性体肺侧支造影及心脏CTA检查,明确体肺侧支种类及解剖分布。对造影提示参与肺"气血交换"的粗大体肺侧支实行选择性UF,对不参与肺"血气交换"的功能性体肺侧支术中结扎或不处理。术中留取不同种类粗大体肺侧支的组织行病理检查,根据组织病理学结果明确侧支类型。结果围术期及随访期间无死亡。术前心导管、选择性侧支检查及术中组织病理学检查证实,参与肺"血气交换"的功能性MAPCAs具有肺动脉壁结构,属于弹性动脉;不参与肺"血气交换"的非功能性MAPCAs为小动脉壁结构,属于肌型动脉。结论术前可通过选择性MAPCAs造影检查明确参与肺"血气交换"功能性侧支,功能性侧支属于弹性动脉,具有肺动脉壁结构,术中对功能性侧支进行UF术可取得良好的手术效果。     

Raloxifene adjunctive therapy for postmenopausal women suffering from chronic schizophrenia: a randomized double-blind and placebo controlled trial

Background

Cumulative evidence from epidemiological, preclinical and clinical studies suggests estrogens may have psychoprotective effects in schizophrenic patients. Selective Estrogen Receptor Modulators could have therapeutic benefits in schizophrenia for both sexes without being hazardous to gynecological tissues or having feminizing effects. Few studies have been conducted regarding the effects of raloxifene on postmenopausal women suffering from schizophrenia. We conducted this placebo-controlled trial to compare the add-on effect of raloxifene to risperidone versus risperidone with placebo.

Methods

This was an 8-week, parallel-group, placebo-controlled trial undertaken at two universities affiliated psychiatric Hospitals in Iran. Forty-six postmenopausal women with the definite diagnosis of schizophrenia were enrolled in the study. Patients received risperidone (6 mg/day in 3 divided doses) combined with either placebo (N = 23) or 120 mg/day of raloxifene (N = 23) for 8 weeks. Patients were assessed by a psychiatrist at baseline and at 2 and 8 weeks after the start of medical therapy. Efficacy was defined as the change from baseline to endpoint in score on Positive and Negative Syndrome Scale (PANSS).

Results

For PANSS scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 1.77, p = 0.18]. For positive subscale scores, there was marginal significant interaction between intervention type and time [F (2, 47) = 2.93, p = 0.06] and there was substantial main effect for time [F (2, 47) = 24.39, p = 0.001] within both groups showing reduction in positive subscale scores across the three time periods. In addition, the main effect comparing two types of intervention was significant [F (1, 48) = 3.78, p = 0.02]. On the other hand, for negative subscale scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 1.43, p = 0.23]. For general subscale scores, the main effect comparing two types of intervention was not significant [F (1, 48) = 0.03, p = 0.86].

Conclusions

According to our findings, raloxifene as an adjunctive treatment to risperidone was only superior in improvement of positive symptoms and it was not effective in treating negative and general psychopathology symptoms.

Trial registration

The trial was registered at the Iranian registry of clinical trials: IRCT201205131556N42     

Functional differentiation of cytotoxic cancer drugs and targeted cancer therapeutics

There is no nationally or internationally binding definition of the term “cytotoxic drug” although this term is used in a variety of regulations for pharmaceutical development and manufacturing of drugs as well as in regulations for protecting medical personnel from occupational exposure in pharmacy, hospital, and other healthcare settings. The term “cytotoxic drug” is frequently used as a synonym for any and all oncology or antineoplastic drugs. Pharmaceutical companies generate and receive requests for assessments of the potential hazards of drugs regularly – including cytotoxicity. This publication is intended to provide functional definitions that help to differentiate between generically-cytotoxic cancer drugs of significant risk to normal human tissues, and targeted cancer therapeutics that pose much lesser risks. Together with specific assessments, it provides comprehensible guidance on how to assess the relevant properties of cancer drugs, and how targeted therapeutics discriminate between cancer and normal cells. The position of several regulatory agencies in the long-term is clearly to regulate all drugs regardless of classification, according to scientific risk based data. Despite ongoing discussions on how to replace the term “cytotoxic drugs” in current regulations, it is expected that its use will continue for the near future.     

A short physical activity break from cognitive tasks increases selective attention in primary school children aged 10–11

ImportanceEvidence for an acute effect of physical activity on cognitive performance within the school setting is limited. The purpose of this study was to gain insight into acute effects of a short physical activity bout on selective attention in primary school children, specifically in the school setting.MethodsHundred and twenty three 10–11 years old children, 49.6% girls, engaged in four experimental breaks in random order: 1 h of regular cognitive school tasks followed by a 15 min episode with the following conditions 1) ‘no break’ (continuing a cognitive task), 2) passive break (listening to a story), 3) moderate intensity physical activity break (jogging, passing, dribbling) and 4) vigorous intensity physical activity break (running, jumping, skipping). Selective attention in the classroom was assessed by the TEA-Ch test before and after the 15 min break in each condition.ResultsAfter the passive break, the moderate intensity physical activity break and the vigorous intensity physical activity break attention scores were significantly better (p < 0.001) than after the ‘no break’ condition. Attention scores were best after the moderate intensity physical activity break (difference with no break = −0.59 s/target, 95% CI: −0.70; −0.49).ConclusionThe results show a significant positive effect of both a passive break as well as a physical activity break on selective attention, with the largest effect of a moderate intensity physical activity break. This suggests that schools could implement a moderate intensity physical activity break during the school day to optimize attention levels and thereby improve school performance.Trial registrationNTR2386.     

抗抑郁药的研究新进展

抑郁症正成为一个严重的全球问题。目前抗抑郁药物分四大类：单胺氧化酶抑制剂（Monoamine oxidase inhibitors,MAOIs）、三环类药物（Tricyclicantide pressants,TCAs）、选择性5-色胺再摄取抑制剂（Selective serotonin reuptake inhibitors,SSRIs）、新型抗抑郁药。     

双胎选择性生长受限危险因素分析及胎盘血管内皮生长因子的表达

目的 研究双胎选择性宫内生长受限（selective intrauterine growth restriction,sIUGR）胎盘血管内皮生长因子（VEGF）的表达并探讨影响妊娠结局的危险因素.方法 2010年6月至2013年6月深圳市人民医院产科分娩双胎妊娠590例,单绒毛膜双羊膜囊（monochorionic diamnotic,MCDA）双胎sIUGR 42例作为病例组,双绒毛膜双胎sIUGR 47例作为对照A组,同期分娩的无sIUGR单绒毛膜双羊膜囊双胎42例作为对照B组.分娩后收集胎盘并分别称重、检测胎盘份额、脐带插入情况.记录新生儿出生体重及围产儿结局.运用免疫组织化学法分别检测病例组和对照组胎盘组织中VEGF的表达,半定量测其表达强度.体重轻者称小胎,体重重者称大胎.结果 病例组、对照A组及对照B组围产儿死亡率分别为17.8％ （15/84）、6.4％（6/94）、1.2％（1/84）,脐带异常插入率分别为48.8％、10.6％、14.3％.病例组大、小胎胎盘重量为（521±149）g vs.（258±53）g.VEGF在病例组、对照A组大婴胎盘组织中的表达强度高于小婴（P＜0.01）.结论 单绒毛膜双羊膜囊双胎sIUGR围产儿死亡率明显升高.双胎sIUGR危险因素主要有胎盘份额分配不均衡、脐带帆状插入、胎盘血管内皮生长因子表达下降等.     

选择性逆向冠状静脉搭桥术后一氧化氮和内皮素的变化

目的探讨选择性逆向冠状静脉搭桥术对犬心肌缺血模型一氧化氮和内皮素的影响及其意义。方法16只健康成年杂种犬,随机分成缺血组(n=8)和选择性逆向冠状静脉搭桥组(n=8),观察不同时段两组血浆一氧化氮和内皮素含量的变化。并在选择性逆向冠状静脉搭桥组经静脉桥在体灌注墨汁,石蜡包埋后切片观察。结果后降支结扎前,两组血浆一氧化氮和内皮素含量无显著性差异(P>0.05),但结扎后两组血浆一氧化氮和内皮素含量在不同时段比较差异有统计学意义(P<0.01)。显微镜下,经静脉桥灌注的墨汁能在心肌组织间均匀分布。结论选择性逆向冠状静脉搭桥能使心肌得到有效灌注,通过维持犬心肌缺血模型血浆一氧化氮及内皮素水平,从而减轻心肌内皮细胞损害,保护心脏功能。     

河南和新疆地区HIV-1毒株gp120和gag基因的变异分析

目的分析中国河南和新疆地区艾滋病病毒Ⅰ型(HIV-1)毒株gp120和gag基因全长序列的变异特征。方法PCR扩增河南和新疆HIV-1确认阳性样本前病毒DNA gp120和gag全长基因,测序得到40份gp120和41份gag基因序列,用GCG软件包等软件进行分析。结果河南省HIV-1毒株为B′亚型,新疆维吾尔自治区HIV-1毒株为CRF07 BC亚型。B′亚型毒株gp120基因中变异程度最大的区段是V5区段,最小的是C1区段;CRF07BC亚型毒株中变异最大的是V1区段,最小的是C4区段。两种亚型毒株gp120和gag基因的Ks/Ka值<1(P<0.05)。结论对于病毒基因全长序列的分析可以更多地反映病毒的特性。gp120基因各个区段在B′和CRF07BC亚型毒株中的变异程度不一致。B′和CRF07 BC亚型毒株的gp120基因和gag基因都受到正向选择压力的作用。     

Wolbachia infection status and genetic structure in natural populations of Polytremis nascens (Lepidoptera: Hesperiidae)

The maternally inherited obligate bacteria Wolbachia is known for infecting the reproductive tissues of a wide range of arthropods. In this study, we surveyed Wolbachia infections in Polytremis nascens (Lepidoptera: Hesperiidae) from 14 locations in China by amplifying the 16S rRNA gene with a nested PCR method and revealed the effect of Wolbachia on host mitochondrial DNA. The results show that 31% (21/67) are Wolbachia positive among all specimens and mainly prevails in southern populations in China. No significant difference in the prevalence is found between the sexes. Notably, the nucleotide diversity of Wolbachia infected butterflies is smaller compared to that of uninfected butterflies. The mitochondrial DNA of infected group appear to be not evolving neutrally (Tajima’s D value = −2.3303 and Fu’s F values = −3.7068). The analysis of molecular variance shows significant differentiation of mitochondrial haplotypes between infected and uninfected specimens (FST = 0.6064). The mismatch analysis speculated the different expansion pattern in Wolbachia infected specimens and all P. nascens specimens. These results suggest that the populations of P. nascens may have recently been subjected to a Wolbachia-induced sweep. Additionally, phylogenetic analysis differentiated the mitochondrial haplotypes of P. nascens into three major clades. The clades are in perfect agreement with the pattern of Wolbachia infection. One of the clades grouped with the butterflies infected with Wolbachia. The remaining two clades grouped with uninfected butterflies from the central-west of China populations and Eastern and Southern China populations respectively, which are isolated mainly by the Yangtze River. The analysis of haplotype networks, geographic distribution and population size change shows that Haplotype 1 in central-west of China is the ancestral haplotype and the populations of P. nascens are expanded.