经鼻高流量预充氧可保障老年患者全麻气管插管诱导期的安全

目的评估经鼻高流量预充氧在老年患者全麻气管插管诱导期的安全性研究。方法56例非困难气道老年患者，采用随机数字表法分为经鼻高流量吸氧组（HF组）和传统面罩经口鼻吸氧组（M组），28例/组。全麻气管插管诱导给药前预充氧5 min，HF组喉镜检查期间维持给氧，M组通气持续到喉镜检查。观察并记录两组患者基本资料，预充氧前（T1）、预充氧5 min（T2）及插管成功即刻（T3）的超声下胃窦横截面积（CSA）和动脉血气分析指标：PaO₂、PaCO₂、cSO₂，窒息安全时间，插管时间，面罩通气的次数及术后并发症。结果两组患者的基本资料差异无统计学意义。预充氧5 min，两组患者的PaO₂和cSO₂均明显升高，且HF组PaO₂较M组明显（F=118.108vs 9.511，P < 0.05），插管成功后PaO₂和cSO₂均下降，HF组的PaO₂值较M组下降缓慢，且仍高于其T1时点，而M组的cSO₂值下降显著，低于其T1时点值。HF组窒息安全时间显著高于M组（t=5.305，P < 0.05），且HF组面罩通气次数少于M组（χ²=6.720，P < 0.05）。两组插管后的PaCO₂值均增高，但两组比较差异无统计学意义（F=3.138，P > 0.05），其余结果差异也无统计学意义（P > 0.05）。结论经鼻高流量吸氧是一种安全简单有效的预充氧方式，与传统的面罩预充氧相比，能提高老年患者的动脉氧分压，延长患者窒息安全时间，可保障老年患者全麻诱导插管时气道管理的安全。     

激肽释放酶14在卵巢癌组织中的表达及临床意义

目的探讨激肽释放酶14（kallikrein14）在卵巢癌组织的表达及临床意义。方法应用SP和ELISA法检测不同卵巢患者KLK14蛋白的表达和KLK14血清学的浓度。结果卵巢癌组KLK14蛋白表达阳性率／血清学浓度明显高于卵巢良性上皮肿瘤组和正常卵巢组。KLK14蛋白表达与卵巢癌患者的临床分期,组织学分级有关。结论KLK14过表达与卵巢癌的发生、侵袭相关,提示其可能成为卵巢癌的标志物。     

MMP-14和TIMP-2在甲状腺乳头状癌组织中的表达及其临床意义

目的：研究甲状腺乳头状癌组织中 MMP －14和 TIMP －2的表达及临床意义。方法：检测甲状腺乳头状癌组织和甲状腺良性病变组织中MMP －14和 TIMP －2的表达水平。结果：MMP －14和 TIMP －2在甲状腺乳头状癌组织中阳性率明显高于甲状腺良性病变组织中阳性率。结论：MMP －14和 TIMP －2在甲状腺乳头状癌中表达呈负相关,临床价值较高。     

可溶性和膜结合性CD14在类风湿关节炎患者外周血中的表达及临床意义

目的:探讨类风湿关节炎(RA)患者血清中可溶性CD14(sCD14)的水平及血浆单核细胞膜结合性CD14(mCD14)的表达与RA的关系。方法:收集78例RA患者和50名健康对照者(对照组)的外周血,酶联免疫吸附试验法检测血清中sCD14的表达,同时分离RA患者和对照组外周血单个核细胞,通过流式细胞术检测mCD14的表达水平,分析CD14的表达水平与RA的关系。结果:RA患者血清中的sCD14与mCD14表达水平均明显高于对照组(P<0.01),RA活动期患者sCD14与mCD14表达水平亦均明显高于RA缓解期患者(P<0.01)。结论:sCD14与mCD14在RA外周血中表达水平异常增高,它们可能参与了RA的发病或病情进展。     

脓毒症患者调节性T细胞与CD64指数的相关性研究

目的 探讨CD4+ CD25+/highCD127low/-、CD14+ HLA-DR+在脓毒症发生发展中的作用.方法 流式细胞术检测脓毒症患者(其中生存组17例,死亡组11例)CD4+ CD25+/highCD127low/-、CD14+ HLA-DR+、CD64指数,同时测定白细胞数(WBC)和C-反应蛋白(CRP)的水平,并与正常对照组比较.结果 脓毒症组CD4+ CD25+/highCD127 low/-、CD64指数均明显高于正常对照组,CD14+ HLA-DR+明显低于正常对照组;动态观察结果显示,随着疾病的进展,生存组CD4+ CD25+highCD127low/-、CD64指数均明显回落,而死亡组两者却持续升高;而CD14+ HLA-DR+刚好相反,生存组CD14+HLA-DR+逐渐升高,死亡组CD14+ HLA-DR+明显低于存活组,且持续处于低水平状态;相关性分析显示,CD4+ CD25+/high CD127low/-与CD64指数、CRP正相关;CD14+ HLA-DR+与CD64指数、CRP明显负相关;CD54指数与WBC、CRP正相关.结论 CD4+CD25+/highCD127low/-、CD14+ HLA-DR+与疾病感染和炎症严重程度密切相关,可作为疾病严重程度及预后的指标.     

SARS-CoV-2 virus NSP14 Impairs NRF2/HMOX1 activation by targeting Sirtuin 1

Most deaths from the COVID-19 pandemic are due to acute respiratory distress syndrome (ARDS)-related respiratory failure. Cytokine storms and oxidative stress are the major players in ARDS development during respiratory virus infections. However, it is still unknown how oxidative stress is regulated by viral and host factors in response to SARS-CoV-2 infection. Here, we found that activation of NRF2/HMOX1 significantly suppressed SARS-CoV-2 replication in multiple cell types by producing the metabolite biliverdin, whereas SARS-CoV-2 impaired the NRF2/HMOX1 axis through the action of the nonstructural viral protein NSP14. Mechanistically, NSP14 interacts with the catalytic domain of the NAD-dependent deacetylase Sirtuin 1 (SIRT1) and inhibits its ability to activate the NRF2/HMOX1 pathway. Furthermore, both genetic and pharmaceutical evidence corroborated the novel antiviral activity of SIRT1 against SARS-CoV-2. Therefore, our findings reveal a novel mechanism by which SARS-CoV-2 dysregulates the host antioxidant defense system and emphasize the vital role played by the SIRT1/NRF2 axis in host defense against SARS-CoV-2.     

期门穴在数字人体上的可视化研究

目的:建立期门穴三维形态结构的可视化人体模型。方法:以VOXEL-MAN为操作平台,结合腧穴解剖学知识,利用计算机图形图像学技术进行期门穴相关解剖结构的辨认、分割以及可视化。结果:实现了期门穴在可视人体中的定位与表达,完成了相关解剖结构的分割与可视化,建立了相关医学知识库,生成了QTVR格式的智能动画。结论:期门穴三维形态能多层次、多角度显示期门穴的解剖结构和针刺全过程,有助于提高针刺疗效和安全性。     

Exploring the intergenerational persistence of mental health: Evidence from three generations

This paper uses data from the 1970 British Cohort Study to quantify the intergenerational persistence of mental health, and the long-run economic costs associated with poor parental mental health. We find a strong and significant intergenerational correlation that is robust to different covariate sets, sample restrictions, model specifications and potential endogeneity. Importantly, the intergenerational persistence is economically relevant, with maternal mental health associated with lasting effects on the child's educational attainment, future household income and the probability of having criminal convictions. These results do not disappear after controlling for children's own childhood and adulthood mental health.     

Imaging and retention measurements of selenium 75 homocholic acid conjugated with taurine,and the carbon 14 glycochol breath test to document ileal dysfunction due to late radiation damage

In order to assess ileal dysfunction in patients with complaints after pelvic radiation therapy, retention measurements and scintigraphic imaging with selenium 75 homocholic acid conjugated with taurine (⁷⁵Se-HCAT), combined with the carbon 14 glycochol breath test, were evaluated in 39 patients. In 22 patients without ileal resection the results of the⁷⁵Se-HCAT test and the breath test differentiated between a normal functioning ileum (both tests negative) and ileal dysfunction as a cause of complaints (one or both tests positive). Among the patients with ileal dysfunction, the combination of both tests permitted those with bacterial overgrowth (breath test positive,⁷⁵Se-HCAT negative) to be separated from patients with evidence of bile acid malabsorption (⁷⁵Se-HCAT positive, breath test positive or negative). In 17 patients with small-bowel resection, the⁷⁵Se-HCAT test helped to estimate the severity of bile acid malabsorption with implications for therapy. In this group the breath test was false-negative in 7 cases with abnormal⁷⁵Se-HCAT. Additional systematically performed scintigraphic imaging improved the accuracy of the⁷⁵Se-HCAT test, revealing cases with prolonged colonic accumulation of the radiopharmaceutical, causing spurious retention values. In conclusion, assessment of ileal dysfunction by nuclear medicine techniques in post-irradiation conditions provides information about the aetiology and therefore the possibility of adjustment in the clinical management. Offprint requests to: R.A. Valdes Olmos     

The effect of apolipoprotein A on in vitro apolipoprotein C binding and in vivo removal of artificial triacylglycerol-rich particles

Although the presence of apolipoprotein A on the surface of chylomicrons and its exchange for apolipoprotein C in the mesenteric lymph is known, the functional role of apolipoprotein A in triacylglycerol transport has not been elucidated. Mimicking the in vivo situation, artificial triacylglycerol rich particles (TGRP) with which apolipoprotein AI had been associated, were incubated with high-density lipoproteins (HDL). It was found that apo AI-TGRP bound approximately twice as much apolipoprotein C from HDL as nonprotein-containing TGRP, losing 75% of the apolipoprotein AI originally present. To test whether an increased apolipoprotein C binding in vitro implicated an increased removal rate in vivo, boluses of apolipoprotein AI preincubated and control TGRP were given intravenously (IV) to six hypertriacylglycerolemic patients. The fractional catabolic rate was 35% (range 6% to 65%) higher for apolipoprotein AI preincubated TGRP than for control TGRP. In accordance with the in vitro incubations, the molar ratio of apolipoprotein C to phospholipid on TGRP reisolated 30 minutes after injection was 39% (range 12% to 115%) higher for apo AI triacylglycerol rich particles (TRP) than for control TGRP. The maximal removal capacity of apo AI-TRP, tested in one patient by constant infusion, was increased 53% as compared to control TGRP. Thus, the function of apolipoprotein AI in triacylglycerol transport may be to enhance apolipoprotein C binding to chylomicrons, which are comparable to TRP, and in doing so to enhance their removal from the plasma compartment.