Cardiac tamponade due to systemic lupus erythematosus in a 7-year-old boy with selective IgG subclass deficiency

Systemic lupus erythematosus (SLE) was observed in a 7-year-old boy with IgG₂ and IgG₄ subclass deficiencies who had been treated with immunoglobulin (100–200 mg/kg/4 weeks) since 2 years of age. The mother and the half-brother displayed the same deficiency. Serum IgG mainly consisted of IgG₁ (98.9%) during the acute phase of SLE due to transient IgG₃ deficiency. While he had no common manifestations of SLE such as arthritis or nephropathy, he developed cardiac tamponade due to massive pericardial effusion. Conclusion The clinical features of SLE in the present case such as the development of cardiac tamponade and the absence of renal involvement may result from the markedly imbalanced IgG subclass distribution among auto-antibodies. Received: 20 May 1997 and in revised form: 7 October 1997 / Accepted: 21 October 1997     

单层斜口吻合加盖大网膜治疗贲门癌200例临床分析

目的 探讨贲门癌的手术治疗方案。方法 1999年6月至2003年10月本科手术治疗贲门癌200例．采用单层斜口吻合加盖大网膜，对术后并发症及生活质量进行评价。结果 200例均手术治愈。吻合口瘘1例．占0．5％；吻合狭窄2例，占1％。多数患者术后生活质量良好，少数患者术后进食量减少、进食后返流及腹泻，对症治疗后好转。结论 单层斜口吻合加盖大网膜是一种有效治疗贲门癌的手术方式。     

认知负荷理论在医疗护理领域中应用的研究进展

从认知负荷的定义、分类、测量方法以及在医疗护理领域中的应用等方面对国外最新研究进展进行综述,旨在为我国医院管理者在改善医护人员实施治疗与护理措施时认知负荷的水平发挥积极作用提供理论依据。     

Contribution Ratio Assessment of Process Parameters on Robotic Milling Performance

Robotic milling has broad application prospects in many processing fields. However, the milling performance of a robot in a certain posture, such as in face milling or grooving tasks, is extremely sensitive to process parameters due to the influence of the serial structure of the robot system. Improper process parameters are prone to produce machining defects such as low surface quality. These deficiencies substantially decrease the further application development of robotic milling. Therefore, this paper selected a certain posture and carried out the robotic flat-end milling experiments on a 7075-T651 high-strength aeronautical aluminum alloy under dry conditions. Milling load, surface quality and vibration were selected to assess the influence of process parameters like milling depth, spindle speed and feed rate on the milling performance. Most notably, the contribution ratio based on the analysis of variance (ANOVA) was introduced to statistically investigate the relation between parameters and milling performance. The obtained results show that milling depth is highly significant in milling load, which had a contribution ratio of 69.25%. Milling depth is also highly significant in vibration, which had a contribution ratio of 51.41% in the X direction, 41.42% in the Y direction and 75.97% in the Z direction. Moreover, the spindle speed is highly significant in surface roughness, which had a contribution ratio of 48.02%. This present study aims to quantitatively evaluate the influence of key process parameters on robotic milling performance, which helps to select reasonable milling parameters and improve the milling performance of the robot system. It is beneficial to give full play to the advantages of robots and present more possibilities of robot applications in machining and manufacturing.     

Efficacy of the Sentinox Spray in Reducing Viral Load in Mild COVID-19 and Its Virucidal Activity against Other Respiratory Viruses: Results of a Randomized Controlled Trial and an In Vitro Study

Sentinox (STX) is an acid-oxidizing solution containing hypochlorous acid in spray whose virucidal activity against SARS-CoV-2 has been demonstrated. In this paper, results of a randomized controlled trial (RCT) on the efficacy of STX in reducing viral load in mild COVID-19 patients ({"type":"clinical-trial","attrs":{"text":"NCT04909996","term_id":"NCT04909996"}}NCT04909996) and a complementary in vitro study on its activity against different respiratory viruses are reported. In the RCT, 57 patients were randomized (1:1:1) to receive STX three (STX-3) or five (STX-5) times/day plus standard therapy or standard therapy only (controls). Compared with controls, the log₁₀ load reduction in groups STX-3 and STX-5 was 1.02 (p = 0.14) and 0.18 (p = 0.80), respectively. These results were likely driven by outliers with extreme baseline viral loads. When considering subjects with baseline cycle threshold values of 20–30, STX-3 showed a significant (p = 0.016) 2.01 log₁₀ reduction. The proportion of subjects that turned negative by the end of treatment (day 5) was significantly higher in the STX-3 group than in controls, suggesting a shorter virus clearance time. STX was safe and well-tolerated. In the in vitro study, ≥99.9% reduction in titers against common respiratory viruses was observed. STX is a safe device with large virucidal spectrum and may reduce viral loads in mild COVID-19 patients.     

Impact of the COVID-19 Pandemic on Patient Delay and Clinical Outcomes for Patients With Acute Myocardial Infarction

BackgroundIt has been known that the fear of contagion during the coronavirus disease 2019 (COVID-19) creates time delays with subsequent impact on mortality in patients with acute myocardial infarction (AMI). However, difference of time delay and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI between the COVID-19 pandemic and pre-pandemic era has not been fully investigated yet in Korea. The aim of this study was to investigate the impact of COVID-19 pandemic on time delays and clinical outcome in patients with STEMI or non-STEMI compared to the same period years prior.MethodsA total of 598 patients with STEMI (n = 195) or non-STEMI (n = 403) who underwent coronary angiography during the COVID-19 pandemic (February 1 to April 30, 2020) and pre-pandemic era (February 1 to April 30, 2017, 2018, and 2019) were analyzed in this study. Main outcomes were the incidence of time delay, cardiac arrest, and in-hospital death.ResultsThere was 13.5% reduction in the number of patients hospitalized with AMI during the pandemic compared to pre-pandemic era. In patients with STEMI, door to balloon time tended to be longer during the pandemic compared to pre-pandemic era (55.7 ± 12.6 minutes vs. 60.8 ± 13.0 minutes, P = 0.08). There were no significant differences in cardiac arrest (15.6% vs. 10.4%, P = 0.397) and in-hospital mortality (15.6% vs. 10.4%, P = 0.397) between pre-pandemic and the pandemic era. In patients with non-STEMI, symptom to door time was significantly longer (310.0 ± 346.2 minutes vs. 511.5 ± 635.7 minutes, P = 0.038) and the incidence of cardiac arrest (0.9% vs. 3.5%, P = 0.017) and in-hospital mortality (0.3% vs. 2.3%, P = 0.045) was significantly greater during the pandemic compared to pre-pandemic era. Among medications, angiotensin converting enzyme inhibitors/angiotensin type 2 receptor blockers (ACE-I/ARBs) were underused in STEMI (64.6% vs. 45.8%, P = 0.021) and non-STEMI (67.8% vs. 57.0%, P = 0.061) during the pandemic.ConclusionDuring the COVID-19 pandemic, there has been a considerable reduction in hospital admissions for AMI, time delay, and underuse of ACE-I/ARBs for the management of AMI, and this might be closely associated with the excess death in Korea.     

强化极化液治疗冠心病并心功能不全的疗效观察

目的探索强化极化液治疗冠心病并心功能不全的临床价值。方法观察17例接受强化极化液治疗的冠心病并心功能不全患者的血压、心率、心功能的变化并设对照组。结果治疗组用药前后血压、心率、心功能变化明显(P<0.05或P<0.01)。对照组用药前后血压、心率、心功能变化亦显著(P<0.01或P<0.05)。两组治疗后疗效比较差异显著(P<0.05或P<0.01)。治疗组出现疗效时间为(2.5±0.7)d,对照组(10±2.5)d,治疗组明显短于对照组(P<0.01)。结论强化极化液对冠心病并心功能不全患者有良好的临床治疗效果。     

心肌肌钙蛋白T在川崎氏病早期的诊断意义

目的　探索心肌肌钙蛋白T(cTnT)在川崎氏病早期的意义。方法　应用ELISA方法对25例川崎氏病早期的病人血清中cTnT、CPK、CKMB进行监测,观察其对心肌缺氧的敏感性,并选择cTnT与心脏扇扫提示的冠状动脉改变情况进行对比。结果　25例中14例cTnT,1例CPK,1例CKMB升高,21例冠状动脉有改变,冠状动脉无改变4例中2例cTnT升高且同时伴有心电图改变。结论　①在川崎氏病早期cTnT的敏感性高于CPK和CKMB;②CTnT可以提示一些扇扫中无法发现的冠状动脉异常所致的心肌缺血     

老年类风湿关节炎患者心功能变化及其相关性研究

目的:研究老年类风湿关节炎(RA)患者心功能变化及与他指标的相关性。方法:将68例类风湿关节炎(RA)患者按年龄分为中青年类风湿关节炎(YMRA)、老年类风湿关节炎(ERA)两组,采用超声心动图(UCG)检测两组RA患者的心功能,并与20例健康对照(NC)组比较;观察两组RA患者的疾病活动度评分(DAS-28)及临床症状、体征及实验室指标的变化。结果:①与NC组相比,两组RA患者舒张早期血流峰值(E峰)、短轴缩短率(FS,%)、E/A比值均显著降低(P<0.05或P<0.01);与YMRA组相比,ERA组患者E峰、E/A比值显著降低(P<0.05或P<0.01),舒张晚期血流峰值(A峰)显著升高(P<0.05)。②与YMRA组相比,ERA组病程、收缩压、DAS-28积分、关节肿胀积分、关节压痛积分、PLT、PCT、UA、α-AGP、hs-CRP、ESR显著升高(P<0.05或P<0.01);双手握力、CD4+CD25+Treg、CD4+CD25+CD127-Treg显著降低(P<0.05)。③Spearman相关分析显示,ERA组心功能参数E峰与年龄、DAS-28、α-AGP、CRP,E/A比值与收缩压,(EF,%)与类风湿因子,ST段压低数与年龄均呈呈显著负相关(P<0.05)。E峰与CD4+CD25+Treg,A峰与舒张压、15m步行时间,E/A比值与CD4+CD25+Treg均呈显著正相关(P<0.05)。结论:RA患者存在心功能下降,ERA患者心功能水平下降更为显著;UCG下表现为E峰、E/A、(EF,%)、(FS,%)的显著降低,A峰显著升高;ERA患者心功能参数与年龄、血压、实验室指标等相关。     

A Study on the Design Depth of Permeable Road Pavement through Dynamic Load Experiment

This study investigated vertical strain and stress through a dynamic load experiment at the testing area of Ke-Da Road, Pingtung, Taiwan. A thirty-five-ton truck was moved at constant speeds of 40, 60, and 80 km/h to simulate heavy load conditions to study the mechanical variations. From the results, it was found that the strain and stress curves of the permeable road pavement showed asymmetry due to the viscoelastic property of the open-grade friction course. The results showed that vertical strains and vertical stresses of permeable road pavement were greatly affected by the axle configuration and the change in traffic speed. Furthermore, to propose the design thickness of a permeable road pavement, the pavement strain and stress were modelled with respect to depth using regression based on these collected data. According to the stress regression models and considering the construction uncertainty, the recommend design depth of a permeable pavement is 30 cm. The findings of this study would be helpful in determining the permeable road pavement depth when subjected to heavy traffic load, and the material combination of open-graded friction concrete, porous asphalt concrete, and permeable cement concrete was proposed in this study during the design period.