Subakute Verlegung der Atemwege infolge eines retropharyngealen H?matoms nach Halstrauma

Mechanical airway obstruction secondary to retropharyngeal bleeding is rare. In most cases such a complication is described after head and neck trauma. Complicating factors include anticoagulant therapy, tumour, aneurysm, infection or major cervical spine injury. A precise initial diagnosis is necessary to avoid a life-threatening situation. Lateral X-ray and computed tomography is essential for safe management. Treatment depends upon size of the haematoma as well as the clinical course of the patient. Smaller haematomas may be observed. Lager haematomas and those that fail to reabsorb should undergo drainage.      

Heligmosomoides polygyrus inhibits established colitis in IL-10-deficient mice

Inflammatory bowel disease (IBD) is prevalent in industrialized countries, but rare in less-developed countries. Helminths, common in less-developed countries, may induce immunoregulatory circuits protective against IBD. IL-10(-/-) mice given piroxicam develop severe and persistent colitis. Lamina propria mononuclear cells from colitic IL-10(-/-) mice released IFN-gamma and IL-12. The ongoing piroxicam-induced colitis could be partially blocked with anti-IL-12 monoclonal antibody suggesting that the inflammation was at least partly IL-12 dependent. Colonization of piroxicam-treated colitic IL-10(-/-) mice with Heligmosomoides polygyrus (an intestinal helminth) suppressed established inflammation and inhibited mucosal IL-12 and IFN-gamma production. H. polygyrus augmented mucosal IL-13, but not IL-4 or IL-5 production. Transfer of mesenteric lymph node (MLN) T cells from IL-10(-/-) animals harboring H. polygyrus into colitic IL-10(-/-) recipients inhibited colitis. MLN T cells from worm-free mice did not. Foxp3 (scurfin) drives regulatory T cell function. H. polygyrus enhanced Foxp3 mRNA expression in MLN T cells that had regulatory activity. This suggests that H. polygyrus inhibits ongoing IL-10(-/-) colitis in part through blocking mucosal Th1 cytokine production. Resolution of inflammation is associated with increased IL-13 production and can be adoptively transferred by MLN T cells.     

Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease

In a prospective study, the relationship between the clinical severity of dengue haemorrhagic fever (DHF) and the sonographic findings was examined. The study comprised 73 cases classified as mild (grades I–II) and 75 as severe (grades III–IV). Ultrasonography in the mild group revealed pleural effusions in 30 %, ascites in 34 %, gallbladder wall thickening in 32 %, hepatomegaly in 49 %, splenomegaly in 16 %, and pancreatic enlargement in 14 %. In the severe group, pleural effusions, ascites and gallbladder wall thickening were found in 95 %, pararenal and perirenal fluid collections in 77 %, hepatic and splenic subcapsular fluid collections in 9 %, pericardial effusion in 8 %, hepatomegaly in 56 %, splenomegaly in 16 %, and pancreatic gland enlargement in 44 %. Ultrasound may be useful for early prediction of the severity of DHF in children. Received: 15 January 1997 Accepted: 2 June 1997     

“One Degree of Separation”: A Mixed-Methods Evaluation of Canadian Mental Health Care User and Provider Experiences With Remote Care During COVID-19

ObjectivesThe COVID-19 pandemic has contributed to a shift from in-person to remote mental health care. While remote care methods have long existed, their widespread use is unprecedented. There is little research about mental health care user and provider experiences with this transition, and no published studies to date have compared satisfaction between these groups.MethodsCanadian mental health care users (n = 332) and providers (n = 107) completed an online self-report survey from October 2020 to February 2021 hosted by the Canadian Biomarker Integration Network in Depression. Using a mixed-methods approach, participants were asked about their use of remote care, including satisfaction, barriers to use, helpful and unhelpful factors, and suggestions for improvement.ResultsOverall, 59% to 63% of health care users and 59% of health care providers were satisfied with remote care. Users reported the greatest satisfaction with the convenience of remote care, while providers were most satisfied with the speed of provision of care; all groups were least satisfied with therapeutic rapport. Health care providers were less satisfied with the user-friendliness of remote care (P < 0.001) than users, while health care users were less satisfied than providers with continuity of care (P < 0.001). The use of a video-based platform was associated with remote care satisfaction among health care users (P < 0.02), and qualitative responses support the importance of visual cues in maintaining therapeutic rapport remotely. The majority of users (55%) and providers (87%) reported a likelihood of using remote care after the pandemic.ConclusionsRemote mental health care is generally accepted by both users and providers, and the majority would consider using remote care following the pandemic. Suggestions for improvement include greater use of video, increased attention to body language and eye contact, consistency with in-person care, as well as increased provider training and administrative support.     

丹参酮ⅡA通过抑制HDAC3影响巨噬细胞极化的作用研究

目的 探讨丹参酮ⅡA(TanⅡA)通过抑制组蛋白去乙酰化酶3(HDAC3)影响巨噬细胞极化的作用.方法 应用中药系统药理学数据库与分析平台(TCMSP)筛选TanⅡA药效靶点和动脉粥样硬化作用靶点,并将二者的交集基因进行KEGG通路分析,采用Cytoscape 3.7.1软件对主要交集基因-信号通路进行可视化分析.选用...     

靶向抑制miR-155增加骨髓瘤细胞对化疗药物的敏感性

目的:探讨靶向抑制miR-155对骨髓瘤细胞化疗敏感性的影响,并研究其分子作用机制.方法:利用qRT-PCR测定人骨髓瘤细胞株及耐药株中miR-155的表达水平;利用LipofectamineTM 2000将miR-155 inhibitor和阴性对照转染至人骨髓瘤耐药细胞株中;利用MTT法检测转染后人骨髓瘤耐药细胞对...     

A causal relationship between childhood obesity and risk of osteoarthritis: results from a two-sample Mendelian randomization analysis

PurposeIt has been found that childhood obesity (CO) may play an important role in the onset and progression of osteoarthritis (OA). Thus we conducted this mendelian randomisation analysis (MR) to evaluate the causal association between childhood obesity and osteoarthritis.MethodsInstrumental variables (IVs) were obtained from publicly available genome-wide association study datasets. The leave-one-out sensitivity test, MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO), and Cochran’s Q test were used to confirm the heterogeneity and pleiotropy of identified IVs, then five different models, including the inverse variance weighted model (IVW), weighted median estimator model (WME), weighted model-based method (WM), MR-Egger regression model (MER), and MR-Robust Adjusted Profile Score (MRAPS) were applied in this MR analysis.ResultsAfter excluding all outliers identified by the MR-PRESSO test, no evident directional pleiotropy was found. Significant heterogeneity was found in the secondary MR and as a result, the multiplicative random-effect model was used. Significant causal association between CO and OA (OR 1.0075, 95% CI [1.0054, 1.0010], p = 8.12 × 10⁻¹³). The secondary MR also revealed that CO was causally associated with knee OA (OR 1.1067, 95% CI [1.0769, 1.1373], p = 3.30 × 10⁻¹³) and hip OA (OR 1.1272, 95% CI [1.0610, 1.1976], p = 1.07 × 10⁻⁴). The accuracy and robustness of these findings were confirmed by sensitivity tests.ConclusionThere appears to be a causal relationship between childhood obesity and OA. Our results indicate that individuals with a history of childhood obesity require specific clinical attention to prevent the development of knee and hip OA.     

恩格列净及达格列净对棕榈酸诱导的心肌细胞损伤的保护作用及其机制

目的 探讨钠-葡萄糖共转运蛋白-2抑制剂恩格列净（empagliflozin,EMPA）及达格列净（dapagliflozin,DAPA）对棕榈酸（palmitic acid,PA）诱导H9c2心肌细胞损伤的保护作用及其可能机制。方法 采用PA诱导H9c2心肌细胞损伤,CCK-8法筛选PA、EMPA及DAPA的最佳给药浓度;Western blotting检测TLR4、p-AKT、p-mTOR、Nrf2和HO-1的蛋白表达水平;ELISA法检测IL-1β、IL-6和TNF-α的含量;荧光显微镜和流式细胞术检测PA诱导H9c2心肌细胞中ROS水平。结果 PA 100 μmol·L^–1刺激24 h可诱导H9c2心肌细胞存活率明显下降（P<0.01）,IL-1β、IL-6、TNF-α、TLR4蛋白表达、p-mTOR蛋白表达及ROS水平明显增加（P<0.01）,p-AKT、Nrf2和HO-1蛋白表达显著降低（P<0.01）;与模型组比较,经EMPA及DAPA处理后,细胞存活率明显增加（P<0.01）,IL-1β、IL-6、TNF-α、TLR4蛋白表达、p-mTOR蛋白表达及ROS水平明显降低（P<0.05或P<0.01）,p-AKT、Nrf2和HO-1蛋白表达显著上调（P<0.05或P<0.01）。结论 EMPA及DAPA对PA诱导的心肌细胞损伤均具有保护作用,其机制可能与下调TLR4、p-mTOR蛋白表达,增强AKT蛋白磷酸化,激活Nrf2/HO-1通路,抑制ROS的生成有关。