无症状脑梗死患者血清高敏C反应蛋白和肿瘤坏死因子-α水平的变化及其临床意义

目的：探讨无症状脑梗死（SCI）患者血清高敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）水平的变化及其在发病机制中的作用。方法：分别检测40例SCI、40例脑梗死（CI）患者、40例健康对照者血清hs-CRP和TNF-α含量。结果：SCI组和cI组hs—CRP含量分别为（8．86±0．96）和（16．32±1．88）mg／L，均显著高于对照组的（1．69±0．56）mg／L（P〈0．01），CI组hs—CRP含量亦显著高于SCI组（P〈0．05）；SCI组和CI组TNF-α含量分别为（1．92±0．73）和（2．56±0．91）ng／mL，显著高于对照组的（1．13±0．42）ng／mL（P〈0．01），CI组TNF-α含量亦显著高于SCI组（P〈0．05）。在SCI患者中，梗死灶数〉2个组（n=19）hs-CRP为（9．45±0．97）mg／L，显著高于梗死灶数≤2个组（n=17）的（7．21±0．75）mg／L（P〈0．01），两组TNF-α含量分别为（1．97±0．83）和（1．66±0．56）ng／mL，无显著差异。血压测定值越高，腔隙性梗死灶数量越多，未服降压药者梗死灶数量显著多于正规降压治疗者（P〈0．05）。结论：炎症过程参与了脑小血管病变；hs—CRP和TNF-α水平与脑缺血程度、神经功能缺损程度以及脑的小血管病变范围密切相关。高血压是腔隙性SCI最常见的病因，未降压治疗的重度高血压更易引起多发性腔隙性脑梗死。从预防再发的角度看，对SCI应尽早采取积极有效的治疗措施，高血压患者应尽早正规服用降压药。     

三角函数法计算套管安全活动角度在23G双通道硅油取出术的应用

目的：使用UBM在术前测量巩膜前表面到硅油泡的距离,利用三角函数的计算公式,从而计算出23G套管的安全活动角度,最大限度避免术中取油时损伤视网膜。

方法：从2017/03-2017/09,共选取15例硅油眼患者,年龄32～69岁,首次手术均为视网膜脱离,左眼10例,右眼5例,均采用23G套管通过23G灌注管连接5 mL注射器,直接取油的方法。术前均通过UBM测量角膜缘后4 mm,2：00和10：00位的巩膜壁前表面到硅油泡的距离,定义为 “A”; 23G套管的长度为4 mm,定义为 “C”; 将巩膜套管最大活动角度时的巩膜内壁的宽度定义为 “B”; “A”,“B”,“C”构成直角三角形。利用三角函数计算出最大活动角度时“A”和“C”的正弦值,参考三角函数表得出23G套管的安全活动角度。根据此角度指导术中硅油取出时23G套管的活动范围,同时观察取油时间和穿刺口视网膜情况。

结果：所有患者均顺利取出硅油,所用时间平均为4.78±0.13min。穿刺管口处视网膜未见任何新发视网膜裂孔和其他损伤。2：00位巩膜壁前表面到硅油泡的距离为0.82～2.81(1.62±0.41)mm,10：00位为0.98～2.19(1.71±0.34)mm,2：00位巩膜套管的安全活动角度(指套管和巩膜壁的角度)不能低于11～44(24.14±6.95)°,10：00巩膜套管的安全活动角度不能低于14～33(25.45±5.41)°。模拟图形构建,计算穿刺套管安全活动角度为不低于52°。

结论：利用三角函数的方法,结合UBM测量数据,计算套管安全活动角度可以有效的指导23G硅油取出术中套管针的活动范围,本研究建议套管移动角度不要低于50°,可以最大限度的避免医源性裂孔的发生。     

RNA interference targeting NOX4 protects visual function in an experimental model of retinal detachment by alleviating blood-retinal barrier damage

AIM:To observe the effects of the inhibition of NADPH oxidase 4(NOX4)expression on the retinal vascular barriers and visual function after retinal detachment(RD).METHODS:RD model was established 3 wk after adenoassocianed virus vector injection.The retinal tissue was harvested 3 d after RD,and the death of retinal vascular endothelial cells and photoreceptors was observed using electron microscopy.The NOX4 expression was detected by Western blot.Confocal microscopy was used to observe a retinal patch that had been perfused with Evans blue.A modified water maze test was used to detect the time required to find the platform on the water surface.The visual function of the rats was evaluated and reactive oxygen species(ROS)expression was detected by a fluorescence microplate reader.RESULTS:The retinal patch showed that NOX4 interference significantly reduced the destruction of the tight junctions between the retinal endothelium of RD rats and reduced leakage.Western blotting showed decreased expression of the NOX4 protein and decreased expression of ROS in retinal tissue;the Morris water maze test results showed that NOX4 interference significantly decreased the escape latency of the rats.CONCLUSION:NOX4 interference reduces the production of ROS in retinal vascular endothelial cells after experimental RD,thereby protecting the blood-retinal barrier and protecting visual function.     

Maze model to study spatial learning and memory in freely moving monkeys

Many types of mazes have been used in cognitive brain research and data obtained from those experiments, especially those from rodents' studies, support the idea that the hippocampus is related to spatial learning and memory. But the results from non-human primates researches regarding the role of the hippocampus in spatial learning and memory are controversial and inconsistent with those obtained in rodents. This might be due to the differences of the methods used in non-human primates and rodents. Several kinds of maze models including two-dimensional computerized visual maze models and three-dimensional maze models have been developed for non-human primates, but they all have some defects. Therefore, development of a maze model for non-human primates that is comparable with those used in rodents is necessary to solve the controversy. This paper describes a large-scale, three-dimensional outdoor maze model for non-human primates which can be used to study spatial learning and memory. Monkeys learn to use the maze quickly compared with two-dimensional computerized visual mazes. It has many advantages which could make up the limits of the existing three-dimensional mazes in non-human primates, and can be comparable with radial arm mazes used in rodents. Based on the results, we believe that the new maze model will be valuable in many research areas, especially in studies involving spatial learning and memory in freely moving monkeys.     

Dissociation of egocentric and allocentric spatial processing in prefrontal cortex

Monkeys with lesions of areas 9 and 46 performed three variants of the spatial delayed response (SDR) task. There were no impairments in allocentric spatial memory in which geometrical relationships between environmental cues were used to identify spatial location; thus, memory of a 3D environmental map is intact. In contrast, there were severe impairments in egocentric spatial memory guided by visual or tactile cues that monkeys can relate to their viewing perspective during testing. These results strongly suggest that dorsolateral prefrontal cortex selectively mediates spatial memory tasks that are solved by referencing the location of targets to the body's orientation.     

Antipsychotic drug research and resting-state brain activity in normal adults

In the field of functional MRI,compared to observations of task-related brain activity,a growing number of studies have shown that spontaneous brain activity during the resting state may be more sensitive to defects in the cognitive functions of our brain.In this issue,Zhu et al.[1]report that methylphenidate (MPH),one of the most commonly-used stimulants for the     

2016—2020年肿瘤专科医院血流感染的病原菌分布及耐药分析

目的分析某肿瘤专科医院血流感染的病原菌分布及耐药性,为临床选用抗菌药物提供依据。方法采用回顾性方法,对郑州大学附属肿瘤医院2016年11月—2020年10月住院患者送检的29546份血培养结果进行分析,利用WHONET5.6软件统计血培养的阳性率,病原菌分布及耐药特点。结果共检出病原菌3111株,阳性率为10.5%,其中革兰阴性菌2009株(占64.6%),革兰阳性菌931株(占29.9%),真菌171株(占5.5%)。病原菌以肠杆菌目细菌为主,前五位的病原菌是大肠埃希菌(27.0%)、肺炎克雷伯菌(13.0%)、金黄色葡萄球菌(6.56%)、表皮葡萄球菌(5.60%)和铜绿假单胞菌(5.14%)。送检科室排在前五位的是血液科、肝胆外科、普外科、妇瘤科和介入科。大肠埃希菌和肺炎克雷伯菌ESBL检出率分别为41.1%和36.6%,大肠埃希菌对亚胺培南和美罗培南的耐药率为2.9%和3.5%,肺炎克雷伯菌对亚胺培南和美罗培南的耐药率为10.9%和12.8%。葡萄球菌中MRSA和MRCNS的检出率分别是39.2%和61.8%。结论肿瘤患者血流感染的病原菌以革兰阴性杆菌为主,各病原菌对常用抗生素存在不同程度耐药,临床应根据药敏结果合理选择抗生素。     

Facilitation of tactile working memory by top-down suppression from prefrontal to primary somatosensory cortex during sensory interference

Tactile working memory (WM) is improved by increasing top-down suppression of interfering sensory processing in S1 via a link from the middle frontal gyrus (MFG) to S1. Here we studied in healthy subjects whether the efficacy of top-down suppression varies with submodality of sensory interference. Navigated stimulation of the MFG-S1 link significantly improved tactile WM performance when accompanied by tactile but not visual interference of memory maintenance.     

病毒复制“微丝网控”与肿瘤转移效应

通过30 mL/L H2O2临床分层治疗100例多发性寻常疣患者,观察发现:治愈母疣,子疣无需治疗自然枯萎脱落痊愈;单一治愈子疣,对其余子疣和母疣形态无影响。揭示:母疣通过微丝网,控制播散"卫星"样子疣;子疣个体间无微丝网链接,单体子疣生长状态均司命于母疣,且以微丝网为载体传输信息码;人乳头瘤病毒复制存在"微丝网",属于厌氧病毒。这一研究表明肿瘤发生临界点与肿瘤发生、转移效应机制,进而我们提出了筛选抗病毒药物的新视野与临床治疗肿瘤靶标的新取向。