伤科洗方熏洗治疗软组织损伤的临床研究

目的：为了验证伤科洗方的最佳熏洗组合，改进伤科洗方剂型，探讨伤科洗方治疗软组织损伤的部分作用机理。方法：以本院门诊和住院软组织损伤病例120例被随机均分为6组，其中4个试验组(A组：熏洗时间30分 酒 浓缩剂；B组：熏洗时间30分 醋 散剂；C组：熏洗时间60分 酒 散剂；D组：熏洗时间60分 醋 浓缩剂。)和1个空白对照组(E组0．9％生理盐水)，1个最佳熏洗组合组(F组：由试验组得出)；试验组采用3因素2水平正交设计，分别进行熏洗治疗，每日1次，每连续7天为1个疗程，治疗后分别观察症状和体征，6—酮—前列腺素F1a和血栓素B2的变化。结果：最佳熏洗组合：熏洗时间60分 酒 浓缩剂，浓缩剂优于散剂；结论：伤科洗方治疗软组织损伤有临床效果。     

儿科重症监护病房中影响机械通气成功的相关因素

目的 探讨儿科重症监护病房(PICU)中影响机械通气成功的相关因素。方法 将lll例行机械通气的危重病儿分成治疗成功组与失败组，对其相关因素进行回顾性分析。结果两组患儿在上机前危重病例评分、是否伴有心跳呼吸骤停和(或)休克及并发多系统器官功能衰竭(MODS)等方面差异有权显著意义(P＜0．001)；超过48h的机械通气患儿是否继发呼吸机相关肺炎(VAP)亦有显著意义(P＜0.05)。结论 PICU中影响机械通气成功率的因素主要是原发病的性质及严重程度，并与MODS与VAP有密切关系。     

rs1840680 single nucleotide polymorphism in Pentraxin 3: a potential protective biomarker of severe community-acquired pneumonia

ObjectiveSingle nucleotide polymorphisms (SNPs) of pentraxin 3 (PTX3) are associated with various outcomes of lung infections. This study aimed to analyze the relationship between PTX3 polymorphisms and the severity of community-acquired pneumonia (CAP).MethodsThis is a retrospective case-control study comprising 43 patients with severe CAP (SCAP) and 97 patients with non-severe CAP. Three SNPs in the PTX3 gene (rs2305619, rs3816527, and rs1840680) from peripheral blood samples were genotyped by real-time polymerase chain reaction. The association between each SNP and the CAP severity was analyzed by logistic regression analysis.ResultsWe found that the rs1840680 polymorphism was significantly associated with CAP clinical severity. However, no such association was observed for the genotypes and allele frequencies of rs2305619 or rs3816527. The PTX3 rs1840680 AG genotype was an independent factor for a lower risk of SCAP after multivariate logistic regression analysis. Male sex and coronary heart disease were associated with an increased risk of SCAP.ConclusionsThe PTX3 rs1840680 AG genotype was found to be associated with a lower risk of SCAP, and may serve as a potential protective biomarker to help clinical judgment and management.     

Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension.

AIMS: To describe the long-term clinical efficacy of inhaled iloprost as first-line vasodilator mono-therapy in patients with idiopathic pulmonary arterial hypertension (IPAH). METHODS AND RESULTS: Seventy-six IPAH patients were prospectively identified and treated with inhaled iloprost. Clinical, haemodynamic, and exercise parameters were obtained at baseline, after 3 and 12 months of therapy and yearly thereafter. Four endpoints were prospectively defined as follows: (i) death, (ii) transplantation, (iii) switch to intravenous (i.v.) therapy, or (iv) addition of or switch to other active oral therapy. During follow-up (535+/-61 days), 11 patients died, six were transplanted, 25 were switched to i.v. prostanoids, 16 received additional or other oral therapy, and 12 patients discontinued iloprost inhalation for other reasons. Event-free survival at 3, 12, 24, 36, 48, and 60 months was 81, 53, 29, 20, 17 and 13%, respectively. Among haemodynamic and exercise parameters, mixed venous oxygen saturation (P<0.001), right atrial pressure (P<0.001), and peak oxygen uptake (P=0.002) were associated with event-free survival. CONCLUSION: In this study, only a minority of patients could be stabilized with inhaled iloprost mono-therapy during a follow-up period of up to 5 years. In the presence of multiple treatment options, chronic iloprost inhalation as mono-therapy appears to have a limited role.     

Investigation of the urge-to-cough sensation in healthy volunteers

Background and objective: Recently, there has been interest in the sensation of irritation that precedes the motor act of coughing, which has been termed the urge‐to‐cough (UTC). The aim of this study was to perform the largest evaluation to date of the UTC threshold (C_u) in a healthy population. The specific aims were to investigate the relationship between C_u and cough reflex sensitivity, to evaluate gender differences in the UTC and to assess the reproducibility of measurements of C_u. Methods: Standard capsaicin cough challenge methodology was employed to measure cough reflex sensitivity in 100 healthy adult non‐smokers (50 females) with the additional measurement of C_u. A subgroup of 40 subjects (20 males) underwent repeat cough challenges after 1 week to examine the reproducibility of the measurements. Results: All 100 subjects demonstrated motor cough in response to capsaicin. Twenty‐one subjects (10 females) did not show a discernible C_u, as the motor cough event preceded a UTC sensation unaccompanied by cough. Although cough reflex sensitivity, as measured by the concentration of capsaicin inducing five or more coughs (C₅), was enhanced in women, there was no gender difference in C_u. Similar to standard cough reflex sensitivity measurements, the measurement of C_u was highly reproducible. Conclusions: These results demonstrate that the UTC threshold can be effectively and reproducibly measured using a modification of standard cough challenge methodology. Given its clinical significance as a prevalent symptom, UTC, as measured by C_u, represents an additional relevant end point for studies investigating the effects of pharmacological and other interventions in cough and cough reflex sensitivity.     

早期自然流产患者绒毛滋养细胞中CXCL14的表达及其临床意义

目的研究正常早孕妇女和早期自然流产妇女之间绒毛滋养细胞中CXCL14的表达情况,探讨其表达的临床意义。方法选取33例正常早孕妇女绒毛组织和37例早期自然流产妇女绒毛组织,HE染色后光镜下观察两组绒毛组织的形态学变化;采用免疫组化SP三步法检测两组绒毛滋养细胞中CXCL14的表达。结果HE染色下两组绒毛滋养细胞形态对比,见早期自然流产组绒毛组织滋养细胞层变薄、滋养细胞变性甚至坏死、滋养细胞嗜酸性增强、绒毛间质水肿坏死;免疫组化示正常早孕组绒毛滋养细胞CXCL14的表达量为0.07±0.05,自然流产组绒毛滋养细胞CXCL14的表达量为0.12±0.02,两组比较差异具有统计学意义（P＜0.01）;首次流产组CXCL14表达量0.116±0.067,多次流产组CXCL14表达量0.086±0.127,两组比较差异无统计学意义（P＞0.01）。结论早期自然流产绒毛滋养细胞中CXCL14表达升高,可能在自然流产的发生中起着重要作用。     

唑来膦酸在骨质疏松性椎体压缩骨折经皮椎体成形术后的临床应用

目的：通过对比研究,观察骨质疏松性椎体压缩骨折的患者在经皮椎体成形术后应用唑来膦酸的临床治疗效果。方法2010年7月至2013年2月,将中山市中医院骨一科240例椎体压缩性骨折行PVP手术治疗的患者随机分成两组,治疗组在术后3日予以静滴唑来膦酸针;对照组单纯予以椎体成形术。两组患者自入院起均予以口服碳酸钙／维生素D3片,600 mg／d。分别于术前1周及术后1月、3月、6月、9月、一年行腰椎骨密度、血清PINP及β－CTX浓度检查,并进行统计分析。结果随访1年,两组患者共240例获得随访,治疗后治疗组患者在VAS评分、腰椎骨密度、血清PINP及β－CTX浓度等的变化与对照组相比均具有显著性差异,且治疗组患者的依从性较好,新发椎体骨折少。结论唑来膦酸治疗骨质疏松性椎体压缩骨折可增加患者椎体骨密度、改善患者疼痛、预防新发椎体骨折、提高患者生活质量,可用于骨质疏松性椎体压缩骨折患者PVP术后的巩固治疗。     

阿霉素导致兔血清肌钙蛋白T变化的实验研究

目的 观察逐渐增量注射阿霉素(ADR)对兔血清心肌肌钙蛋白T(cTnT)动态变化的影响,籍以了解ADR对心脏毒性的量效关系.方法 将新西兰兔18只,随机分成阿霉素(ADR)组(10只)和对照组(8只).ADR组每周从兔耳静脉注射ADR 1次(2mg/kg,用生理盐水配制成1mg/ml),共6次.对照组注射生理盐水.两组分别在第1、28、35、42天(ADR累积量为0、8、10、12 mg/kg)抽血检测cTnT.结果 当阿霉素的累积达到10mg/kg后,cTnT明显升高,且与ADR的累积量正相关(P＜0.005,r=0.79).结论 动态检测血清cTnT的变化可以反映阿霉素对心脏毒性的严重程度.     

Elephant Endotheliotropic Herpesvirus 1, 4 and 5 in China: Occurrence in Multiple Sample Types and Implications for Wild and Captive Population Surveillance

Elephant endotheliotropic herpesviruses (EEHVs) are important causes of death in both captive and wild Asian elephants (Elephas maximus). Nothing is known about the prevalence of EEHVs in wild or domestic elephants in China. To determine if EEHVs are present in elephants in China, 126 wild elephants from three populations and 202 captive individuals from zoos (n = 155) and the Wild Elephant Valley (n = 47) were screened using semi-nested polymerase chain reaction assays with EEHV-redundant and EEHV1/4/5-specific primers. EEHV1B and EEHV4 were detected in samples from both wild (EEHV1B:8/126; EEHV4:2/126) and captive (EEHV1B:5/155; EEHV4:9/155) elephants, while EEHV1A (six cases) and EEHV5 (one case) were only present in the captive elephants from the Wild Elephant Valley. EEHV1 was detected in blood and trunk and oral swabs; EEHV4 was detected in trunk and oral swabs as well as feces; EEHV5 was found in trunk and oral swabs. No significant age or sex association with EEHV1A, EEHV1B, or EEHV5 positivity was observed. An age association with EEHV4 positivity was found, with all unweaned elephants being EEHV4 positive, but an association with the sex of the elephant was not observed. These findings represent the first documentation of EEHV presence in captive and wild elephants in China. These findings also document EEHV1B and EEHV4 shedding in feces and demonstrate the utility of fecal screening as a tool for investigating EEHV4 infection in wild populations of elephants. It is recommended that EEHV testing be included in surveillance programs for captive and wild elephants in China.