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1.
目的构建鸡胚背根节细胞3D生长模型,观察CSPG对不同浓度的琼脂糖水溶胶培养基对鸡胚背根节神经突起生长的影响。方法①利用多肽缩合剂1’1羰基二咪唑介导CS-B长链与琼脂糖凝胶共价结合。②分别配制0.5%、0.75%、1%、1.25%、1.5%的SeaPrep琼脂糖凝胶溶液和共价结合了CS-B多糖长链的琼脂糖凝胶溶液。取孵育9~10天后鸡胚背根节加入上述凝胶溶液加培养液培养。③培养24小时之后在24 h、48 h7、2 h、96 h进行观察拍照。观察各时间点神经突起生长情况。结果①鸡胚背根节神经突起在1.25%的琼脂糖凝胶溶液中开始呈3D生长,在小于1%的琼脂糖溶液中只能2D生长。②在同一时间点,呈2D生长的背根节突起和呈3D生长的背根节突起在突起长度方面没有统计学差异(P>0.05)。③3D生长的DRG神经突起在共价结合了CS-B的琼脂糖凝胶中生长长度明显短于普通琼脂糖水凝胶(P<0.05),并且可观察到部分突起长出短而直的成束突起。但是对于呈2D生长的DRG突起长度在两种培养基中却未见差异(P>0.05)。结论鸡胚背根节神经元周围突起生长长度在3D培养中与在2D培养中有没有明显的差异。硫酸软骨素能够有效抑制呈3D生长的神经节突起生长,并且影响到神经突起的生长方式。但是在2D培养基中,未能看到上述的抑制作用。 相似文献
2.
Emmanuel Nwachuku Yizhi Shan Prabhu Senthil-Kumar Todd Braun Ryan Shadis Orlando kirton Thai Q. Vu 《American journal of surgery》2021,221(1):240-242
BackgroundClostridioides difficile infection (CDI) is traditionally taught to be an antibiotic associated diarrheal infection. This diagnosis is based on the presence of clinical symptoms (usually defined as more than 3 watery, loose or unformed stool within 24 h) coupled with a diagnostic test. There is now a new presentation of CDI, including progression to toxic megacolon, in patients without diarrhea.MethodsWe report a case series of 9 surgical patients from a single institution who developed CDI without preceding diarrhea.ResultAll 9 patients had CDI with positive laboratory testing for C. difficile toxin. They, however, presented with a lack of or minimal bowel movements. Six patients had rapid development of abdominal distention, 1 patient had a single episode of watery stool in 3 days, while the other 2 patients presented with constipation. Seven patients received stool softeners, suppositories and/or enemas for presumed constipation. Four patients had a mild course of infection and were successfully treated medically. The other 5 patients developed toxic megacolon, and eventually required total abdominal colectomy. Out of the 5 patients that required total colectomy, 2 expired.ConclusionCDI must be suspected in patients who rapidly develop abdominal distention, vague abdominal complaints or change in bowel function even in the absence of diarrhea, especially if coupled with multi-system organ failure. 相似文献
3.
《Mayo Clinic proceedings. Mayo Clinic》2014,89(11):1525-1536
ObjectivesTo evaluate the clinical burden of extraintestinal Clostridium difficile infection (CDI) seen at a single institution and to characterize the management and outcomes of these rare infections.Patients and MethodsA retrospective medical record review was conducted to identify patients with isolation of C difficile from extraintestinal sites from January 1, 2004, through December 31, 2013. Medical records were reviewed and data, including demographic characteristics, microbiology, clinical associations, management, and infection outcomes, were abstracted.ResultsOverall, 40 patients with extraintestinal CDI were identified: 25 had abdominopelvic infections, 11 had bloodstream infections, 3 had wound infections, and 1 had pulmonary infection. C difficile was isolated with other organisms in 63% of cases. A total of 85% of infections were nosocomial. Factors associated with extraintestinal CDI included surgical manipulation of the gastrointestinal tract (88%), recent antibiotic exposure (88%), malignant tumors (50%), and proton pump inhibitor use (50%). Diarrhea was present in 18 patients (45%), 12 of whom had C difficile polymerase chain reaction (PCR)–positive stool samples. All isolates tested were susceptible to metronidazole and piperacillin-tazobactam. Management included both antimicrobial therapy and guided drainage or surgical intervention in all but one patient. The infection-associated mortality rate was 25%, with death a median of 16 days (range, 1-61 days) after isolation of C difficile.ConclusionExtraintestinal CDI is uncommon and often occurs in patients with surgical manipulation of the gastrointestinal tract and well-recognized risk factors for intestinal CDI. Management of extraintestinal CDI includes both antimicrobial and surgical therapies. Extraintestinal CDI is characterized by poor outcome with high mortality. 相似文献
4.
Stuart Chalew Ricardo Gomez Alfonso Vargas Jodi Kamps Brittney Jurgen Richard Scribner James Hempe 《Journal of diabetes and its complications》2018,32(12):1085-1090
Introduction
Black youth with type 1 diabetes (T1D) have higher HbA1c than whites. To understand HbA1c differences, we examined the relationship of psycho-social factors and glucose testing with HbA1c.Methods
Glucose tests per day (BGs/d) and mean blood glucose (MBG) were calculated from meter data of youth self-identified as black (n?=?33) or white (n?=?53) with T1D. HbA1c, family income, insurance status, concentrated disadvantage (CDI), psychological depression (DSC), mother educational attainment (MEA), and insulin delivery method (IDM) data was were analyzed.Results
Black patients had significantly higher HbA1c, MBG and disadvantage measures compared to whites. BGs/d correlated with HbA1c, MBG, age and CDI. Race (p?<?0.0158), age (p?<?0.0001) and IDM (p?<?0.0036) accounted for 50% of the variability (R2?=?0.5, p?<?0.0001) in BGs/d. Regardless of age, black patients had lower BGs/d than whites. MBG (p?<?0.0001) and BGs/d (p?<?0.0001) accounted for 61% of the variance in HbA1c (p?<?0.0001).Conclusions
BGs/d is easily assessed and closely associated with HbA1c racial disparity. BGs/d is intricately linked with greater social disadvantage. Innovative management approaches are needed to overcome obstacles to optimal outcomes. 相似文献5.
6.
目的探讨神经外科病人水电解质失衡的临床特点和处理。方法回顾分析108例我科住院并伴有水电解质紊乱的病人的临床资料,治疗方法和效果。结果46例诊断为中枢性尿崩症(CDU,27例为抗利尿激素分泌不当综合征(SIADH),20例为脑性盐耗综合征(CSWS),15例为脑性潴盐综合征。其中101例治愈,另有3例中枢性尿崩症需要长期替代治疗,1例抗利尿激素分泌不当综合征患者死亡,3例CSWS患者需长期高钠饮食以维持正常血钠。结论108例病人中水电解质紊乱原因有:CDI,SIADH,CSWS,脑性潴盐综合征,但无论哪种水电解质紊乱在早期明确诊断后积极治疗,绝大多数患者是可以治愈的。 相似文献
7.
《中国现代医生》2017,55(17):73-81
目的探讨艾司西酞普兰联合心理干预治疗青少年抑郁症的临床效果。方法本次纳入研究患者为2014年4月~2016年4月间在我院确诊并治疗的青少年抑郁患者250例,采用随机数字表法随机分为两组,每组各125例,两组均予艾司西酞普兰治疗,观察组同时联合心理干预,连续治疗8周。对两组患者治疗后的临床治疗效果及两组患者治疗前、治疗4周后、治疗8周后的CDI评分进行对比分析。结果两组患者治疗后,观察组的总有效率为91.2%,显著高于对照组,差异有统计学意义(P0.05)。治疗前,观察组与对照组患者的CDI评分比较,差异无统计学意义(P0.05),治疗4周后,观察组与对照组患者的CDI评分分别较治疗前明显降低,存在显著性差异(P0.05),且观察组显著低于对照组,两组比较,差异有统计学意义(P0.05),治疗后8周,观察组与对照组患者的CDI评分分别较治疗前及治疗4周后明显降低,差异有统计学意义(P0.05),观察组患者的CDI评分为(10.3±2.7)分,显著低于对照组的(15.6±3.8)分,两组比较,差异有统计学意义(P0.05)。结论对青少年抑郁症患者在应用药物艾司西酞普兰治疗的同时联合针对性的心理干预,临床疗效确切,能够显著改善患者的抑郁症状,缓解患者的消极心理状态,具有重要的临床应用价值。 相似文献
8.
9.
Hanna Pituch Piotr Obuch-Woszczatyński Dominika Lachowicz Robert Kuthan Katarzyna Dzierżanowska-Fangrat Agnieszka Mikucka Katarzyna Jermakow Aleksandra Pituch-Zdanowska Kerrie Davies 《Advances in medical sciences》2018,63(2):290-295
Purpose
We aimed to measure the underdiagnosis of Clostridium difficile infection across Poland and the distribution of PCR-ribotypes of C. difficile.Material and methods
Twenty seven Polish healthcare facilities (HCFs) participated in this prospective study. Each HCF systematically sent all diarrhoeal stools received from inpatients at their laboratories on two days (one in January 2013 and one in July 2013), independently of CDI test request, to the National Coordinating Laboratory (NCL) for standardized testing of CDI. Positive samples (using two-stage algorithm), had CDI, confirmed by qPCR and toxigenic culture. C. difficile isolates were characterized by PCR-ribotyping. Hospitals were questioned about their methods and testing policy for CDI during the study period: September 2011 to August 2013.Results
During the study period, participating hospitals reported a mean of 33.2 tests for CDI per 10 000 patient-days and a mean of 8.4 cases of CDI per 10 000 patient-days. The overall prevalence of positive CDI patients at NCL was 16.5%. Due to absence of clinical suspicion, 19.1% of these patients were not diagnosed by the local diagnostic laboratory. We identified 23 different PCR-ribotypes among 87C. difficile strains isolated from patients. PCR-ribotype 027 (48%) was the most prevalent.Conclusions
The incidence of CDI in Poland in study period was very high. It should be noted however, that there is a lack of clinical suspicion and underestimation of the need to perform diagnostic tests for CDI in hospitalized patients. This will have an impact on the reported epidemiological status of CDI in Poland. 相似文献10.