甲钴胺对大鼠受损背根节A-类神经元自发放电的抑制作用

目的:研究甲钴胺(methylcobalamin,Methyl B12)对损伤背根节(dorsal root ganglion,DRG)A-类神经元的不同模式自发放电的作用。方法:在大鼠L5椎间孔植入不锈钢柱制备大鼠DRG慢性压迫模型(chronic com-pression of DRG,CCD)上,利用在体单纤维细胞外记录方法研究Methyl B12对受损DRG神经元自发放电的影响。结果:(1)CCD模型大鼠出现明显的双侧机械刺激引起缩足反应阈值降低(P<0.001);(2)Methyl B12(300μmol/L)对受损A-类DRG神经元自发放电具有显著的抑制作用(n=13,P<0.05);(3)Methyl B12(300μmol/L)对受损A-类DRG神经元非周期和周期放电模式自发放电均有抑制作用,且两者之间没有明显差异。结论:Methyl B12(300μmol/L)对受损DRG A-类神经元产生的异位自发放电具有抑制作用,且对于非周期和周期放电模式的抑制作用没有差异。     

奥塔戈运动在预防出院后老年脑卒中患者跌倒中的应用效果

目的 研究奥塔戈运动对出院后老年脑卒中患者跌倒效能、平衡能力、生活自理能力和跌倒发生情况的影响。方法 选取我院神经内科2018.7.1～2020.6.30符合研究标准的出院患者80例随机分为观察组和对照组,每组40例,在院期间对2组患者均进行常规防跌倒措施,出院后均进行常规电话、微信及门诊随访,观察组在对照组基础上接受6个月的奥塔戈运动（OEP）干预。比较两组患者在干预前后跌倒效能、平衡能力、生活自理能力和跌到发生的情况,评价奥塔戈运动在预防出院后老年脑卒中患者跌倒中的效果。结果 干预前两组患者跌倒效能、平衡能力、Barthel生活自理能力评分及跌倒发生率比较,均无差异(P>0.05),干预6个月后,观察组与对照组,跌倒效能、平衡能力、Barthel生活自理能力评分与干预前比较,均有改善(P<0.05),且观察组的改善更为明显(P<0.05),而跌倒发生率无明显差异（P>0.05）。结论 6个月的奥塔戈运动干预,能够提高出院后老年脑卒中患者的跌倒效能、平衡能力和生活自理能力,但能否降低跌倒发生率,有待进一步研究。     

Neurotoxicity of prenatal alcohol exposure on medullary pre-B?tzinger complex neurons in neonatal rats

Prenatal alcohol exposure disrupts the development of normal fetal respiratory function, but whether it perturbs respiratory rhythmical discharge activity is unclear. Furthermore, it is un-known whethe...     

The association of gasping and outcome,in out of hospital cardiac arrest: A systematic review and meta-analysis

ObjectiveGasping is common after cardiac arrest, and its frequency decreases over time. The aim of this study was to conduct a meta-analysis to evaluate the association of gasping and survival to discharge in patients who suffered out-of-hospital cardiac arrest.MethodsRelevant studies were identified by searching in PubMed, Medline, Embase, OVID, Web of Science and Google Scholar. Risk ratios (RR) and 95% confidence intervals (CI) were calculated to assess the association of gasping and on out-of-hospital cardiac arrest outcomes. Heterogeneity, subgroup analysis, sensitivity analysis and publication bias were explored.ResultsIndividual patient data was obtained from 10,797 participants suffered out-of-hospital cardiac arrest in five cohort studies of 4 articles. A fixed effects model suggested that patients with gasping were 3.525 times (95% CI: 3.028–4.104; P < 0.01) more likely to survive to discharge than those without gasping, and there was no heterogeneity among studies (P = 0.564). Also it may be a favorable factor for return of spontaneous circulation (RR: 2.170; 95% CI: 1.691, 2.785) with high heterogeneity (Q = 5.26; P = 0.022).ConclusionsFindings of this meta-analysis demonstrated that gasping is common after cardiac arrest, and is associated with increased survival to discharge. Patients who are cardiac arrest with gasping should be promptly resuscitated.     

双侧乳腺导管内癌并乳头溢液4例临床分析

目的 探讨以乳头溢液为主要症状的双侧乳腺导管内癌临床诊疗方法.方法 回顾性分析4例双侧乳腺导管内癌合并乳头溢液患者的临床资料.结果 4例均行彩超检查,3例行乳管镜检查,2例行乳腺钼靶检查;其中1例彩超检查发现双侧肿块;1例彩超发现双侧肿块同时乳管镜发现双侧乳头状瘤样改变;1例彩超发现左侧肿块、钼靶提示双侧钙化,而乳管镜发现左侧乳头状瘤样改变;1例彩超未见肿块,钼靶提示右侧钙化,乳管镜发现双侧乳头状瘤样改变.结论 在超声基础上加行钼靶、乳管镜检查有助于以乳头溢液为主要症状的双侧乳腺导管内癌的检出.     

Can frailty predict complicated care needs and length of stay?

The Reported Edmonton Frail Scale was used to describe the prevalence of frailty in an acute general medical unit. The relationship between frailty, discharge destination, mortality and length of hospital stay was explored. We found that age was associated with frailty, and frailty correlated to an increasing length of hospital stay. Significantly, frailty was associated with complexity in discharge, and this process created a longer length of hospital stay.     

White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care.Digestive diseases were the first or second cause of hospitalizations in Italy in 1999–2009, with more than 1,500,000 admissions/year; however only 5–9% of these admissions was in specialized Gastroenterology units.Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16–25% versus 29–87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies’ official report, which constitutes the “White paper of Italian Gastroenterology”.