血清淀粉样蛋白A联合C反应蛋白检测在手足口病患儿中的临床应用研究

目的:分析血清淀粉样蛋白A(SAA)与C反应蛋白(CRP)联合检测在手足口病患儿诊断中所发挥的价值.方法:选择我院在2019年1月~2019年12月诊治的手足口病患儿200例作为检测对象,设定为研究组,同期选择健康体检儿童200例进行对照检测,设定为对照组,对比两组SAA、CRP相关指标,研究组患儿不同严重程度的指标水平.结果:研究组患儿的SAA、CRP、SAA/CRP比值数据均明显高于对照组,数据对比P<0.05;随着疾病严重,研究组患儿的SAA、CRP、SAA/CRP的数据不断上升.结论:SAA和CRP是小儿手足口病的重要检测指标,发病后患儿的指标水平明显提升,根据数值可评估患儿疾病的严重程度,在疾病的诊断和治疗中均发挥了重要价值,值得应用.     

以专培学员为主导的CBL教学对心血管专培学员自身综合能力提升的影响

心血管专科医师规范化培训目标要求高于住院医师培训，完成心血管专培的医生应能在医疗、教学、科研能力上明显提高，达到心血管专科主治医师水平。如何提高心血管专培学员教学能力是专培中的难点。将专培学员随机分为两组,分别采用案例教学法（case-based learning, CBL）和传统教学法进行带教,课程结束后通过测验和调查问卷两种方式对教学效果进行考察。旨在探讨由心血管专培学员主导CBL教学法在实施过程中是否对其自身综合能力有所提升。结果显示，CBL教学法组学生临床理论及病例分析考试分数均高于对照组；心血管专培学员通过主导CBL教学，在教学能力、组织能力和学科协调均有提升；相较传统教学法,CBL教学法的教学效果更佳,有利于心血管专培学员自身综合能力提升。     

Transplantation of an eight-organ multivisceraI graft in a patient with frozen abdomen after complicated Crohn's disease

To report an extended multivisceral transplantation (MVTx) including right kidney and ascending colon in a patient with complicated Crohn's disease (CD). A 36-year old female suffering from short bowel syndrome and frozen abdomen due to fistulizing CD after multiple abdominal operations underwent MVTx of eight organs including stomach, pancreatoduodenal complex, liver, intestine, ascending colon, right kidney, right adrenal gland, and greater omentum in November 2003. Immunosuppression consisted of alemtuzumab, tacrolimus and steroids. The patient was off parenteral nutrition by postoperative wk 3. She experienced one episode of pneumonia. The patient recovered completely and discharged 2.5 mo and was doing well 30 mo after MVTx. This is one of the very rare cases in which a complete mulitivisceral graft of eight abdominal organs was transplanted orthotopically.     

Ligustrazine inhibits high voltage-gated Ca~(2+) and TTX-resistant Na~+ channels of primary sensory neuron and thermal nociception in the rat:a study on peripheral mechanism

Objective Ligustrazine, also named as tetramethylpyrazine, is a compound purified from Ligusticum chuanxiong hort and has ever been testified to be a calcium antagonist. The present investigation was to determine the antinoci-ceptive effect of ligustrazine and, if any, the peripheral ionic mechanism involved. Methods Paw withdrawal Latency ( PWL) to noxious heating was measured in vivo and whole-cell patch recording was performed on small dorsal root ganglion (DRG) neurons. Results Intraplantar injection of ligustrazine (0.5 mg in 25μl) significantly prolonged the withdrawal latency of ipsilateral hindpaw to noxious heating in the rat. Ligustrazine not only reversibly inhibited high-voltage gated calcium current of dorsal root ganglion (DRG) neuron in dose-dependent manner with IC50 of 1.89 mmol/L, but also decreased tetrodotoxin (TTX) -resistant sodium current in relatively selective and dose-dependent manner with IC50 of 2.49 mmol/L. Conclusion The results suggested that ligustrazine could elevate the threshold of thermal nociception through inhibiting the high-voltage gated calcium current and TTX-resistant sodium current of DRG neuron in the rat.     

关于司法精神病学鉴定结论的"错误"问题探讨

全国人大常委会于2005年2月28日通过的《关于司法鉴定管理问题的决定》第十三条规定:"因严重不负责任给当事人合法权益造成重大损失的"要追究鉴定人的法律责任.司法部颁布的《司法鉴定人登记管理办法》(2005年)第二十一条规定:"司法鉴定人在执业活动中,因故意或者重大过失行为给当事人造成损失的,其所在的司法鉴定机构依法承担赔偿责任后,可以向有过错行为的司法鉴定人追偿."     

Poly-lactic acid and agarose gelatin play an active role in the recovery of spinal cord injury

Objective To investigate the role of poly-lactic acid and agarose gelatin in promoting the functional recovery of the injured spinal cord. Methods Poly-lactic acid ( PLA) or agarose was embedded in the space between two stumps of the hemisectioned spinal cord. Immunohistochemistry was used to show astroglia proliferation and the infiltration of RhoA-positive cells. Locomotor activity recovery was evaluated by testing the function of hindlimbs. Results Astrogli-as and RhoA labeled non-neuronal cells accumulated in the area adjacent to the implant, while the number of RhoA-positive cells was decreased dramatically in the absence of implant. Animals implanted with agarose gelatin recovered more quickly than those with PLA, concomitant with a higher survival rate of the neurons. Conclusion Both PLA and agarose gelatin benefited the recovery of spinal cord after injury by providing a scaffold for astroglia processes. Modulation of the rigidity, pore size and inner structure of PLA and agarose gelatin might make these biodegradable materials more effective in the regeneration of the central nervous system (CNS).     

N-Phenylethyl Amitriptyline in Rat Sciatic Nerve Blockade

Background: The antidepressant amitriptyline is commonly used orally for the treatment of chronic pain, particularly neuropathic pain, which is thought to be caused by high-frequency ectopic discharge. Among its many properties, amitriptyline is a potent Na+ channel blocker in vitro, has local anesthetic properties in vivo, and confers additional blockade at high stimulus-discharge rates (use-dependent blockade). As with other drug modifications, adding a phenylethyl group to obtain a permanently charged quaternary ammonium derivative may improve these advantageous properties.

Methods: The electrophysiologic properties of N-phenylethyl amitriptyline were assessed in cultured neuronal GH3 cells with the whole cell mode of the patch clamp technique, and the therapeutic range and toxicity were evaluated in the rat sciatic nerve model.

Results: In vitro, N-phenylethyl amitriptyline at 10 [mu]m elicits a greater block of Na+ channels than amitriptyline (resting block of approximately 90%vs. approximately 15%). This derivative also retains the attribute of amitriptyline in evoking high-degree use-dependent blockade during repetitive pulses. In vivo, duration to full recovery of nociception in the sciatic nerve model was 1,932 +/- 72 min for N-phenylethyl amitriptyline at 2.5 mm (n = 7) versus 72 +/- 3 min for lidocaine at 37 mm (n = 4; mean +/- SEM). However, there was evidence of neurotoxicity at 5 mm.