江滩地区纳潮引水药浸法杀灭钉螺的现场评价

［摘要］　目的　比较江滩地区纳潮引水药浸法与单纯喷洒法现场灭螺效果。方法　在2块相邻有螺江滩上分别采用纳潮引水药浸法灭螺（灭螺药为26%四聚·杀螺胺乙醇胺盐悬浮剂）与单纯26%四聚·杀螺胺乙醇胺盐悬浮剂喷洒法灭螺，在灭螺前后分别进行螺情调查并计算灭后活螺密度。结果　纳潮引水药浸法灭螺后1年和2年活螺密度下降率分别为72.19%和100.00%，单纯喷洒法灭螺后1年和2年活螺密度下降率分别为5.93%和18.15%。结论　有螺江滩纳潮引水药浸法灭螺效果明显优于单纯喷洒法灭螺，纳潮引水药浸法灭螺持续开展2年以上效果更佳。     

Osteoarthritic human chondrocytes proliferate in 3D co‐culture with mesenchymal stem cells in suspension bioreactors

Osteoarthritis (OA) is a painful disease, characterized by progressive surface erosion of articular cartilage. The use of human articular chondrocytes (hACs) sourced from OA patients has been proposed as a potential therapy for cartilage repair, but this approach is limited by the lack of scalable methods to produce clinically relevant quantities of cartilage‐generating cells. Previous studies in static culture have shown that hACs co‐cultured with human mesenchymal stem cells (hMSCs) as 3D pellets can upregulate proliferation and generate neocartilage with enhanced functional matrix formation relative to that produced from either cell type alone. However, because static culture flasks are not readily amenable to scale up, scalable suspension bioreactors were investigated to determine if they could support the co‐culture of hMSCs and OA hACs under serum‐free conditions to facilitate clinical translation of this approach. When hACs and hMSCs (1:3 ratio) were inoculated at 20,000 cells/ml into 125‐ml suspension bioreactors and fed weekly, they spontaneously formed 3D aggregates and proliferated, resulting in a 4.75‐fold increase over 16 days. Whereas the apparent growth rate was lower than that achieved during co‐culture as a 2D monolayer in static culture flasks, bioreactor co‐culture as 3D aggregates resulted in a significantly lower collagen I to II mRNA expression ratio and more than double the glycosaminoglycan/DNA content (5.8 vs. 2.5 μg/μg). The proliferation of hMSCs and hACs as 3D aggregates in serum‐free suspension culture demonstrates that scalable bioreactors represent an accessible platform capable of supporting the generation of clinical quantities of cells for use in cell‐based cartilage repair.     

Efficacy and safety of ciprofloxacin oral suspension versus trimethoprim-sulfamethoxazole oral suspension for treatment of older women with acute urinary tract infection

OBJECTIVES: To compare the efficacy and safety of ciprofloxacin (CIP) oral suspension to trimethoprim/sulfamethoxazole (TMP/SMX) oral suspension among older women with acute urinary tract infections (UTIs). DESIGN: Prospective, randomized, open-label, multicenter study of older women (age 65 and older). SETTING: Community and nursing home. PARTICIPANTS: A total of 261 older women were evaluable for safety. Of these, 172 (86 community, 86 nursing home) were evaluable for clinical and bacteriological efficacy. INTERVENTION: Patients were randomized to a 10-day regimen of either CIP (250 mg/5 mL twice daily) or TMP/SMX (160/800 mg/20 mL twice daily). MEASUREMENTS: Clinical response 4 to 10 days posttherapy. RESULTS: For the efficacy-valid population, posttherapy clinical resolution was statistically superior following CIP (97%) versus TMP/SMX (85%) (95% CI=2.0-21.3; P= .009). Eradication of pretreatment bacterial isolates posttherapy was also higher following CIP (95%) versus TMP/SMX (84%) (95% CI=2.7-21.3; P= .019). For the intent-to-treat population, posttherapy clinical resolution was significantly higher in the CIP group (96%) than in the TMP/SMX group (87%) (95% CI=0.2-16.7; P= .025). Safety was assessed in the intent-to-treat population and the incidence of drug-related adverse events were significantly lower following CIP (17%) than following TMP/SMX (27%) (P= .047). Premature discontinuation due to these events was also less prevalent with CIP than with TMP/SMX (2% vs 11%, respectively) (P= .004). CONCLUSION: CIP suspension showed higher clinical success and bacteriological eradication rates than did TMP/SMX for both community-based and nursing home-residing older women with acute UTIs. Furthermore, CIP suspension was associated with significantly lower rates of adverse events and premature discontinuations compared with TMP/SMX suspension.     

Maintenance of integrity and function of isolated hepatocytes during extended suspension culture at 25°C

Abstract: Isolated hepatocytes in suspension provide a number of advantages for use in bioartificial liver device, however, poor stability of this cell preparation at physiological temperatures is an apparent barrier preventing their use. We therefore investigated the integrity and differentiated function of isolated rat hepatocytes under conditions of mild hypothermia. Isolated hepatocytes were suspended in a bicarbonate buffered saline medium, supplemented with glucose and bovine serum albumin (BSA), and maintained for 48 h at 25 °C on a rotary shaker under an atmosphere of 95% O₂ and 5% CO₂. Under these conditions there was no significant decline in cell viability and good preservation of cellular morphology on transmission electron microscopy for at least 24 h. Isolated hepatocytes in suspension at 25 °C were also able to maintain normal Na ⁺ and K ⁺ ion gradients. The cellular energy status ([ATP], ATP/ADP ratio, cytoplasmic and mitochondrial redox potentials), metabolic function (urea synthesis and ammonia removal), albumin synthesis and phase I and phase II drug detoxification activity of these cells were also maintained for at least 24 h post isolation. These observations demonstrate the robust nature of mildly hypothermic isolated hepatocytes in suspension and encourage further studies re‐examining the feasibility of using this cell preparation in bioartificial livers.     

肠炎宁糖浆联合头孢克肟治疗小儿急性肠胃炎的临床研究

目的探讨肠炎宁糖浆联合头孢克肟干混悬剂治疗小儿急性肠胃炎的临床疗效。方法选取2017年7月—2019年7月在宝鸡市妇幼保健院治疗的急性肠胃炎患儿82例,根据用药的差别分为对照组(41例)和治疗组(41例)。对照组口服头孢克肟干混悬剂,1.5～3 mg/kg,2次/d;治疗组在对照组基础上口服肠炎宁糖浆,10 mL/次,3次/d。两组患儿均经7 d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善时间,以及血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和降钙素(PCT)水平。结果治疗后,对照组临床有效率为80.49%,显著低于治疗组的97.56%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患儿腹痛缓解时间、发热缓解时间、呕吐缓解时间、腹泻缓解时间均明显短于对照组(P0.05)。治疗后,两组患者血清hs-CRP、IL-6、PCT水平均明显下降(P0.05),且治疗组患者明显低于对照组(P0.05)。结论肠炎宁糖浆联合头孢克肟干混悬剂治疗小儿急性肠胃炎可有效改善患儿临床症状,降低机体炎症反应,具有一定的临床推广应用价值。     

流道型轴流血泵支承结构设计与分析

目的:为了改善电磁轴承结构复杂、体积偏大,液力轴承承载力小、不能在较大负载下工作的弊端,提出一种流道型磁液悬浮轴流血泵,提高血泵承载能力。方法:流道型轴流血泵轴向采用永磁力进行支承,径向采用转子叶轮的流道结构产生的液力悬浮;利用Ansys对轴向瞬态磁场进行仿真,对磁力变化进行研究,利用Fluent对不同开槽方向、角度、深度的径向液力进行仿真,对液力变化进行研究。结果:根据轴向磁力随位移的变化,得出磁力最大为2.9 N,楔形开槽结构倾斜角为28°,开槽数为5,槽深0.36 mm,叶顶间隙为0.40 mm,性能达到最优,能满足人体使用。结论:流道型轴流血泵相对于普通磁液悬浮血泵有更高的承载力,较好的悬浮性能,为轴流血泵的优化研究提供了新的思路。     

Fatal and non-fatal injuries due to suspension trauma syndrome: A systematic review of definition,pathophysiology, and management controversies

BACKGROUND: Suspension trauma syndrome is a life-threatening event that occurs when a person is “trapped” in a prolonged passive suspension. It is most commonly seen in people who engage in occupational or sport activities that require harness suspension. The aim of this study is to identify the predisposing factors, pathophysiology, and management of suspension trauma. METHODS: A review and analysis of the literature published in English and Spanish from 1972 to 2020 on suspension trauma were performed. Search sources were PubMed, Medline, Cochrane Library, MeSH, UpToDate, and Google Scholar. Articles referring to suspension trauma associated with other injury mechanisms (traumatic impact injuries, drowning, asphyxiation, or bleeding), case reports, and pediatric population were excluded. RESULTS: Forty-one articles were identified. Of these, 29 articles related to mechanism, pathophysiology, and management of individuals who suffered prolonged suspension trauma without associated traumatic injuries were included in the study. We encountered several controversies describing the putative pathophysiology, ranging from blood sequestration in the lower extremities versus accumulation of metabolic waste and hyperkalemia to dorsal hook-type harness as a trigger cause of positional asphyxia; to vascular compression of femoral vessels exerted by the harness causing decreased venous return. Pstients suspended in a full-body harness with dorsal hook showed more hemodynamic alterations in response to the compressive effect on the rib cage, causing a reduction in perfusion by presenting a decrease in pulse pressure. Management strategies varied across studies. CONCLUSIONS: Progress has been made in individualizing the population at risk and in the management of suspension trauma. We recommend the formation of consensus definitions, larger cohort or registry studies to be conducted, and experimental animal models to better understand the mechanisms in order to develop management and life support guidelines from a trauma and emergency medicine perspective.     

乳房下垂采用垂直切口法乳房悬吊术的临床效果及安全性评价

目的探讨乳房下垂采用垂直切口法乳房悬吊术的临床效果及安全性。方法:选择2019年4月-2020年7月进行治疗的乳房下垂患者84例作为研究对象,根据手术治疗方法将所有患者分成对照组和观察组。每组患者各为42例。给予对照组进行传统的双环形切口手术治疗,观察组采用垂直切口法乳房悬吊术治疗,术后3个月对患者效果进行评估,比较乳房形态情况、对乳房形态的满意度及术后并发症。结果两组治疗后乳房下皱襞中点至乳头距离、胸骨上凹至乳头距离、过乳头胸围及乳晕直径均低于治疗前(P<0.05);经过治疗后,观察组患者的乳房下皱襞中点至乳头距离、胸骨上凹至乳头距离、过乳头胸围及乳晕直径均低于对照组(P<0.05);两组治疗后乳房形态满意度均高于治疗前(P<0.05);治疗后观察组患者对乳房对称性、乳房形态、乳房大小及松弛状态的满意度均高于对照组(P<0.05);观察组患者出现血肿、皮瓣坏死、伤口愈合不良、血压波动并发症总发生率为4.76%,低于对照组26.19%(P<0.05)。结论乳房下垂采用垂直切口法乳房悬吊术的临床效果较好,有效改善患者的乳房形态,提高患者满意度,减少并发症的发生,值得推广应用。     

腹壁自体筋膜盆底悬吊术治疗盆底器官脱垂40例

目的探讨腹壁自体筋膜盆底悬吊术治疗盆底器官脱垂的临床疗效和应用价值。方法对40例经腹壁自体筋膜盆底悬吊术治疗的盆底器官脱垂患者进行回顾性分析,术后1个月门诊随访,了解术后近期情况,以后每半年随访1次,随访1年。结果40例患者腹壁自体筋膜盆底悬吊术均在全麻下进行,整体手术时间平均为（133.41±56.57）min（含妇科其他操作,如子宫切除术、卵巢囊肿剥除术、阴道后壁修补术等,单独行盆底悬吊术2例）,平均失血量为（109.71±70.71）mL,术后平均住院时间为（8.94±0.71）d,其中2例因腹部切口液化,术后尿管保留时间为（4.26±1.41）d,其中1例术中膀胱损伤,术后保留导尿14 d。随访1年,2例术后阴道后壁膨出。生活质量未受影响。结论腹壁自体筋膜盆底悬吊术是一种治疗子宫阴道脱垂的简单、有效、容易掌握的手术方式,可以进行临床术式的推广。