长QT间期扭转型室性心动过速发病机制探讨

狗静脉注射氯化铯(CsCl)所致的多形性室性心动过速(室速)基本符合长QT间期扭转型室速(TdP)的特点。右室心内膜单相动作电位(MAP)记录表明,CsCl可诱发早期后除极电位(EAD),TdP发作与EAD密切相关,硫酸镁(MgSO_4)可使EAD消失,TdP也获控制,提示TdP为EAD触发活性所致。Cs~ 为细胞膜K~ 通道阻滞剂,延长复极时间,增加内向Na~ /Ca~(2 )流,由此产生EAD,而Mg~(2 )为细胞膜K~ 通道激动剂,因此,Mg~(2 )对Cs~ 具对抗作用。     

哮喘宁颗粒联合复方硫酸沙丁胺醇治疗支气管哮喘慢性持续期的临床研究

目的 探讨哮喘宁颗粒联合硫酸沙丁胺醇气雾剂治疗支气管哮喘慢性持续期患者的临床疗效。方法 选取2017年9月—2019年11月郑州大学第五附属医院收治的98例支气管哮喘慢性持续期患者为研究对象,根据抽签法将患者分为对照组（49例）和治疗组（49例）。对照组吸入复方硫酸沙丁胺醇气雾剂,早晚各1吸。治疗组在对照组治疗的基础上口服哮喘宁颗粒,25 g/次,2次/d。两组均治疗12周。观察两组的临床疗效,比较两组的肺功能、血清炎性因子。结果 治疗后,治疗组的总有效率为93.88%,高于对照组的75.51%（P<0.05）。治疗后,两组用力肺活量（FVC）、第一秒用力呼气量（FEV₁）、最大呼气峰流速（PEF）均升高（P<0.05）,且治疗组肺功能高于对照组（P<0.05）。治疗后,两组干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）、白细胞介素-17（IL-17）水平降低,白细胞介素-10（IL-10）水平升高（P<0.05）,且治疗组IFN-γ、IL-4、IL-17水平低于对照组,IL-10水平高于对照组（P<0.05）。结论 哮喘宁颗粒联合硫酸沙丁胺醇气雾剂治疗支气管哮喘慢性持续期具有较好的疗效,可明显改善肺功能,减轻炎症反应,且安全性较好。     

硫酸镁对急性脑梗死患者NIHSS评分及NSE的影响

目的观察硫酸镁治疗急性脑梗死的疗效,分析镁离子对急性脑梗死患者美国国立卫生研究院卒中量表评分(NIHSS)及神经元特异性烯醇化酶(NSE)的影响。方法选择2016年3月-2019年9月在广东省潮州市人民医院住院治疗的急性脑梗死患者100例,根据掷币法随机分为观察组50例和对照组50例。对照组采用综合治疗,观察组在对照组治疗基础上联合硫酸镁治疗。比较2组患者治疗前后NIHSS评分、NSE水平及临床疗效和不良反应发生情况。结果2组治疗后NIHSS评分均低于治疗前(P<0.05),且观察组NIHSS评分低于对照组(P<0.05)。治疗第5天,2组NSE均升高(P<0.05),但观察组低于对照组(P<0.05);治疗第10天,2组NSE均低于治疗前和治疗第5天(P<0.05),且观察组低于对照组(P<0.05)。观察组总有效率为88.0%高于对照组的70.0%(P<0.05)。2组均未见严重不良反应发生。结论硫酸镁可为急性脑梗死的辅助治疗提供新的方法。     

Effect of Decorin and Dermatan Sulfate on the Mechanical Properties of a Neocartilage

Decorin is known to influence the size of collagen fibrils in ligaments and tendons and it has been hypothesized to provide a structural link between collagen fibrils in connective tissues, including cartilage. Coincidently, mechanical properties of skin, ligament, and tendons are altered in decorin knockout mice, suggesting it may influence the structural properties of tissue or tissue matrix organization. To further examine the role of decorin in the extracellular matrix development and subsequent material properties of cartilage, tissue (neocartilage) was grown in a 3D culture model using a pure population of genetically modified chondrocytes stably overexpressing decorin (DCN) or decorin lacking dermatan sulfate (MDCN). An empty vector (CON) served as a virus control. Following generation of the cartilage-like tissues, mechanical properties in tension and compression, collagen fibril diameter, matrix organization, and biochemistry of the tissue were determined. There were no differences between CON and DCN tissues in any parameter measured. In contrast, tissue generated in MDCN cultures was thinner, had higher collagen density, and higher elastic moduli as compared to both CON and DCN tissues. Considering there was no difference in stiffness between CON and DCN tissues, the notion that decorin contributes to the mechanical properties via load transfer was refuted in this model. However, contrasts in the mechanical properties of the MDCN tissue suggest that the dermatan sulfate chains on decorin influences the organization/maturation and resultant mechanical properties of the matrix by as an yet-unidentified regulatory mechanism.     

In vivo Heparan Sulfate Treatment Alters the Immune Response of Normal and LLC-Bearing Mice

Despite the large amount of research dedicated to the understanding and treatment of tumor growth, the majority of cancers continue to lack effective therapeutic options. As in the case of most solid tumors, growth requires evasion of the host immune system. Our previous work using the Lewis Lung Carcinoma (LLC) model of tumor bearing (TB)-mice has shown several tumor-induced immune suppressing effects to be present. These effects include a decreased T-cell proliferative response to Con A and altered cytokine secretion patterns that favor neither a Th1 nor a Th2 response. To address these immune alterations, immune modulating approaches have been a central area of study. Of the many potential immune modulating compounds, we believe promising therapeutic potential lies in the heparin family. Heparan sulfate (HS), in particular, has been shown to increase T-cell proliferative response in non TB-mouse splenocytes as well as promotion of a beneficial Th1 response. In this paper, we studied the potential of HS to decrease tumor burden via in vivo treatment of TB-mice. Results showed both normal and TB-mice splenocytes had a dose response change in proliferation as a result of HS treatment. Furthermore, splenocytes from HS treated TB-mice showed a potentially beneficial decrease in basal level proliferation. On gross examination, HS treatment produced a decrease in tumor surface necrosis with a visible (2 ± 1.8%) surface necrotic area in treated mice as opposed to a (43 ± 16%) surface necrotic area in untreated mice. HS treatment decreased TB-mice splenomegaly when comparing mice spleen weights in treated (0.3 ± 0.05 g) vs. untreated (0.14 ± 0.02 g) groups. These results show a potential role of HS as an immune modulating agent with antitumor properties.     

大骨节病区儿童血清硒与硫酸化因子活性关系的初步研究

为进一步阐明大骨节病患儿血清硫酸化因子活性降低的原因,本文在牛关节软骨稳态培养的基础上,加入服硒与未服硒大骨节病患儿血清及正常儿童对照组血清进行培养。培养5天后测定硫酸化因子活性及血清硒的水平。结果表明,服硒后能明显提高血清硒的水平,而血清硫酸化因子活性无改善。初步显示出,服硒不能有效地改善大骨节病区患儿硫酸化因子的活性。     

地佐辛复合硫酸镁治疗腰硬联合麻醉中寒颤反应的观察

目的：观察地佐辛复合硫酸镁在治疗腰硬联合麻醉中寒颤反应的效果。方法以发生寒颤反应的60例患者随机分组以实验组（地佐辛复合硫酸镁）与常规治疗对照组（曲马多复合氟哌利多）进行疗效比较。结果实验组与对照组疗效接近,但不良反应较少。结论佐辛复合小剂量硫酸镁可安全用于治疗腰硬联合麻醉后患者发生寒颤且具有镇静作用较好、恶心、呕吐发生率较低等优点。     

雷公藤多甙联合异甘草酸镁治疗儿童自身免疫性肝炎疗效及其对血清IL-17和CXCL10水平的影响

目的 探讨应用雷公藤多甙联合异甘草酸镁治疗自身免疫性肝炎(AIH)儿童的疗效及对血清白介素-17(IL-17)和趋化因子10(CXCL10)水平的影响。方法 2018年1月~2019年3月我院儿科收治的AIH患儿57例,随机分为观察组29例和对照组28例。给予对照组异甘草酸镁注射液静脉滴注治疗,观察组在对照组治疗的基础上加用雷公藤多苷片口服治疗,两组均持续治疗8周。采用ELISA法检测血清IL-17、趋化因子8(CXCL8)和CXCL10水平。结果 治疗后,观察组和对照组血清谷草转氨酶(AST)水平分别为(48.4±9.3)U/L和(61.2±12.5) U/L (P＜0.05)、丙氨酸氨基转移酶(ALT)水平分别为[(59.3±7.6)U/L和(66.4±9.7)U/L (P＜0.05)、碱性磷酸酶(ALP)水平分别为(60.2±5.1)U/L和(75.7±6.4)U/L(P＜0.05);两组血清免疫球蛋白G(IgG)水平分别为(13.8±2.9)mg/L和(16.3±3.4)mg/L(P＜0.05)、IgA水平分别为(2.4±0.3)mg/L和(2.9±0.5)mg/L(P＜0.05)、IgM水平分别为(2.6±0.3)mg/L和(3.1±0.4)mg/L (P＜0.05);血清IL-17水平分别为(6.8±0.7)ng/ml和(7.3±0.9)ng/ml (P＜0.05)、CXCL8水平分别为(10.4±1.2)pg/ml和(13.8±1.6) pg/ml (P＜0.05)、CXCL10水平分别为(16.3±2.5) pg/ml和(22.6±3.7)pg/m (P＜0.05);治疗后,观察组患儿不良反应发生率为12.5%,与对照组的7.5%比,差异无统计学意义(P＞0.05)。结论 在异甘草酸镁治疗的基础上加用雷公藤多甙治疗儿童AIH疗效较好,安全性高,可有效改善肝功能和免疫功能,降低机体炎症反应,值得临床进一步验证。     

Aluminum phosphide (celphos) poisoning in children: A 5-year experience in a tertiary care hospital from northern India

Background:

Aluminum phosphide (ALP) (celphos) is an agricultural pesticide commonly implicated in poisoning. Literature pertaining to the clinical manifestations and treatment outcome of its poisoning among children is limited.

Materials and Methods:

A retrospective chart review was conducted of the medical records of 30 children aged less than 14 years admitted to pediatric intensive care unit (PICU) of a tertiary care hospital in northern India. Demographic, clinical, and laboratory parameters were recorded. The outcome was categorized into “survivors” and “nonsurvivors.”

Results:

The Mean (SD) age of the enrolled children [19 males (63.3%)] was 8.55 (3.07) years. Among the 30 children, 14 (46.67%) were nonsurvivors and the rest 16 (53.33%) were survivors. Nonsurvivors had ingested significantly higher doses of ALP (P < 0.001), and showed higher time lag to PICU transfer (P 0.031), presence of abnormal radiological findings on chest skiagram (P = 0.007), and a higher Pediatric Risk of Mortality (PRISM) III score (P < 0.001) at admission. Use of magnesium sulfate was associated significantly with survival [odds ratio (OR) (95% CI): 0.11 (0.02-0.66); P 0.016].

Conclusion:

The present study highlights that survival among children with ALP poisoning is predicted by dose of ALP ingestion, time lag to medical attention, and higher PRISM score at admission. Use of magnesium sulfate could be associated with better survival among them.