右美托咪定对肺部手术患者抗氧化能力、NO水平及心肺功能的影响

[目的]探讨右美托咪定对肺部手术患者抗氧化能力、一氧化氮(NO)水平及心肺功能的影响.[方法]择期全麻肺部手术患者76例随机分为对照组(C组)和右美托咪定组(D组),各38例.开胸前(T0)、单肺通气(OLV)后60 min(T1)、术毕即刻(T2)检测肿瘤坏死因子(TNF-α)、白介素6(IL-6)、NO、丙二醛(MAD)、超氧化物歧化酶(SOD),并于T0~T2时测定心搏指数(SI)、心脏指数(CI)、气道平台压、气道阻力和肺顺应性;记录两组围手术期不良反应.[结果]与T0时相比,两组T1、T2时TNF-α、IL-10、TNF-α、IL-10、NO、MDA均升高,SOD降低(P<0.05);与C组T1、T2时相比,D组TNF-α、IL-10、NO、MDA较低,SOD较高(P<0.05).与T0时相比,D组T1、T2时SI、CI、气道平台压、气道阻力、肺顺应性无明显变化(P>0.05),C组T1时上述指标无变化(P>0.05),T2时SI、CI均降低,气道平台压、气道阻力、肺顺应性均升高(P<0.05);与C组T2时比较,D组SI、CI较高,气道平台压、气道阻力、肺顺应性较低(P<0.05).D组围手术期不良反应发生率为7.89%明显低于C组的26.32%(P<0.05).[结论]肺部手术患者围手术期给予右美托咪定,可降低炎性水平,减轻氧化应激损伤,有利于心肺功能恢复.     

Neurogenesis is required for behavioral recovery after injury in the visual system of Xenopus laevis

Nonmammalian vertebrates have a remarkable capacity to regenerate brain tissue in response to central nervous system (CNS) injury. Nevertheless, it is not clear whether animals recover lost function after injury or whether injury‐induced cell proliferation mediates recovery. We address these questions using the visual system and visually‐guided behavior in Xenopus laevis tadpoles. We established a reproducible means to produce a unilateral focal injury to optic tectal neurons without damaging retinotectal axons. We then assayed a tectally‐mediated visual avoidance behavior to evaluate behavioral impairment and recovery. Focal ablation of part of the optic tectum prevents the visual avoidance response to moving stimuli. Animals recover the behavior over the week following injury. Injury induces a burst of proliferation of tectal progenitor cells based on phospho‐histone H3 immunolabeling and experiments showing that Musashi‐immunoreactive tectal progenitors incorporate the thymidine analog chlorodeoxyuridine after injury. Pulse chase experiments indicate that the newly‐generated cells differentiate into N‐β‐tubulin‐immunoreactive neurons. Furthermore, in vivo time‐lapse imaging shows that Sox2‐expressing neural progenitors divide in response to injury and generate neurons with elaborate dendritic arbors. These experiments indicate that new neurons are generated in response to injury. To test if neurogenesis is necessary for recovery from injury, we blocked cell proliferation in vivo and found that recovery of the visual avoidance behavior is inhibited by drugs that block cell proliferation. Moreover, behavioral recovery is facilitated by changes in visual experience that increase tectal progenitor cell proliferation. Our data indicate that neurogenesis in the optic tectum is critical for recovery of visually‐guided behavior after injury. J. Comp. Neurol. 521:2262–2278, 2013. © 2012 Wiley Periodicals, Inc.     

超声检测妊娠晚期脐动脉血流速度（S／D）1908例临床分析

【目的】了解妊娠晚期脐动脉血流收缩期峰值流速与舒张末期流速比值（S／D）的异常发生率。【方法】妊娠28周以上单胎孕妇1908例,应用MFM—OBS型产科综合诊断监护系统（脐血流）进行脐动脉血流速度测定,并计算出S／D、PI、RI、FVR及胎心率,分析不同妊娠周数异常S／D值的发生率。【结果】随着妊娠周数的增加,S／D均值由孕28周时的2．98下降至孕40周时的2．22,平均每周下降0．063;各孕周S／D异常值发生率平均为5．5％。【结论】妊娠晚期监测脐动脉血流速度的变化,有利于判断及随访胎儿宫内缺氧状态,能为正确的产科处理提高依据。     

不同免疫吸附方法治疗系统性红斑狼疮的对比研究

目的比较A蛋白免疫吸附、PH350免疫吸附、DNA免疫吸附对系统性红斑狼疮的治疗效果。方法 98例系统性红斑狼疮患者,根据选择免疫吸附治疗的方式分为3组,观察治疗前后患者尿蛋白定量、血肌酐、尿素氮、白蛋白、免疫球蛋白、补体、自身抗体(抗核抗体、抗双链DNA抗体)、活动指数、器官功能等。结果治疗前后比较,患者尿蛋白定量、血肌酐、尿素氮、免疫球蛋白、自身抗体显著下降(均P0.05),其中A蛋白吸附与其他两种治疗方法免疫球蛋白清除率差异有统计学意义(均P0.05)。随观察时间的延长,不同方法的狼疮活动控制情况差异无统计学意义(P0.05)。结论不同免疫吸附治疗方法均可对系统性红斑狼疮取得较好的病情控制效果,但A蛋白对自身抗体清除更彻底。在临床实践中应综合考虑,选择最佳治疗方案。     

CLONING AND CHARACTERIZATION OF TEMPERATURE-RELATED GENE TRS1

To investigate the mechanism of spermatogenesis arrest derived from heat treatment and to screen temperature-related genes involved in spermatogenesis, the authors analyzed the differences in gene expression between cryptorchid and scrotal testes in rats, and cloned a full-length cDNA named TRS1. In situ hybridization showed that TRS1 mRNA was mainly expressed in spermatocyte and round spermatids in testis. The expression level decreased in cryptorchid testis, suggesting that the lower scrotal temperature is a key factor in keeping the normal expression of TRS1. At the N-terminal of TRS1, there was a plecstrin homology (PH) domain signature. This PH domain has high similarity to that in PEPP2, a homosapien protein, which has a characteristic of binding phosphatidylinositol 3-phosphate via its PH domain in vitro. These findings suggest that TRS1 may be important in spermatogenesis and give clues for further research on the function of TRS1.     

Novel therapeutic approaches in primary hyperoxaluria

ABSTRACT

Introduction: Currently, three types of primary hyperoxaluria (PH I–III) are known, all based on different gene-mutations affecting the glyoxylate metabolism in the liver. Disease hallmark is an increased endogenous oxalate production and thus massively elevated urinary excretion of oxalate and other type-specific metabolites. Hyperoxaluria induces the formation of calcium-oxalate kidney stones and/or nephrocalcinosis. In addition to that, a chronic inflammasome activation by hyperoxaluria per se, often leads to an early deterioration of kidney function, regularly resulting in end-stage renal disease (ESRD) at least in patients with type I PH. Except for vitamin B6 treatment in PH I, therapeutic regimen nowadays consists only of supportive measures, like significantly increased fluid intake and medication increasing the urinary solubility like alkaline citrate.

Areas covered: Disease burden can be severe, and both clinicians and scientist are eager in finding new therapeutic approaches. The currently ongoing clinical studies and promising research in this field are reported in this paper. To present a complete overview, we searched electronic databases, like Clinical trial gov, National Center for Biotechnology Information PubMed, congress reports, press releases and personal information acquired at congresses and conventions. Searches were conducted using the following medical headings: (primary) hyperoxaluria, PH, therapy, treatment and research.

Expert opinion: There is light on the horizon that new treatment options will be available in due time, as there are several promising therapeutic agents currently under investigation, some being at the first levels of drug development, but some already in ongoing clinical trials (phase I-III).     

韧粘素在先天性心脏病合并肺高压患儿肺血管中的表达

为探讨韧粘素（ＴＮ）在先天性心脏病（先心病）合并肺高压发病机制中的作用及其其调节因素,采用免疫组化方法观察不同肺血清和／或不同肺动脉压力下,先心病患儿肺小动脉中ＴＮ的表达情况。图像分析结果表明,高肺血流伴肺高压时ＴＮ表达阳性面积比例明显高于高肺血流不伴肺高压和对照组（Ｐ均〈０．０１）,ＴＮ表达与肺动脉压力升高显著相关（ｒ＝０．７５,Ｐ〈０．０１）,与肺血流增多无关（ｒ＝－０．４８,Ｐ〉０．０５）。     

Palliative care approaches to neonates with chronic respiratory failure

Neonates with chronic respiratory failure have uncertain prognosis and can face significant treatment burden. As the trajectory of the illness becomes more concerning, consultation with a pediatric palliative service should be considered, especially as therapeutic options shift from standard to “innovative.” Benefits include as follows: supporting emotionally conflicted providers and parents, maintaining transparency in determination of goals, and balancing medical progress with each individual patient’s and family’s best interests.     

异常胎心监护及脐带血pH值与新生儿缺血缺氧性脑损伤

胎儿电子监护是评估胎儿安危最常用的监测方法,是产程中区别胎儿处于生理性应激状态还是窘迫的主要手段。出生时脐带血pH值检测是判断新生儿酸碱状况、窒息程度、指导复苏及评估预后的重要依据。正确判读胎儿电子监护图形、精准评估、动态观察和及时干预是预防新生儿缺血缺氧性脑损伤的重要举措。