Trends in Long-Term Mortality After Congenital Heart Surgery

Background

Congenital heart surgery has improved the survival of patients with even the most complex defects, but the long-term survival after these procedures has not been fully described.

颈痛颗粒联合替扎尼定治疗神经根型颈椎病的疗效观察

目的 探讨颈痛颗粒联合盐酸替扎尼定片治疗神经根型颈椎病的临床疗效。方法 选取2021年1月—2022年12月漯河市郾城区中医院收治的82例神经根型颈椎病患者作为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各41例。对照组口服盐酸替扎尼定片,3次/d,2片/次。治疗组患者在对照组基础上餐后半小时开水冲服颈痛颗粒,1袋/次,3次/d。两组患者连续治疗6周。观察两组的临床疗效,比较两组患者的手臂疼痛程度、颈椎功能障碍程度、颈部活动度和全血比黏度、血浆比黏度、纤维蛋白原水平。结果 治疗后,治疗组的总有效率为95.12%,明显高于对照组的总有效率78.05%,组间差异显著（P<0.05）。治疗后,两组的VAS、NDI评分均明显降低（P<0.05）,治疗组的VAS、NDI评分低于对照组（P<0.05）。治疗后,两组患者的颈部左右旋转、左右侧屈的活动度显著升高（P<0.05）,且治疗组颈部左右旋转、左右侧屈的活动度较对照组升高更明显（P<0.05）。治疗后,两组的全血比黏度、血浆比黏度、纤维蛋白原低于治疗前（P<0.05）,且治疗后治疗组的全血比黏...     

Acute inhalation studies with irritant aerosols: technical issues and relevance for risk characterization

Current testing conventions for inhalation toxicity studies require that solid and non-volatile liquid compounds are converted to respirable aerosol, which is often achieved by laboratory-specific technical methodologies. So far, internationally harmonized approaches are lacking that would allow comparison of results from inhalation studies with contrived test aerosols taking into account the actual particle size of the product as it might be encountered in normal handling and use. The focus of this paper is to consider aerosols of irritant substances eliciting their mode of action on sites of initial deposition within the respiratory tract of rats. Assessment is based on conventional endpoints, such as mortality (LC₅₀), and sublethal endpoints that include an analysis for the concentration–effect relationship of protein in bronchoalveolar lavage fluid (BAL-protein) as a sensitive, early marker of lung edema. This retrospective analysis also addresses whether common denominators can be found for different aerosol sizes of direct and indirect irritants, such as monomeric and polymeric diphenylmethane-4,4-diisocyanate (mMDI and pMDI), naphthylene diisocyanate (NDI), dicyclohexylmethane-4,4-diisocyanate (HMDI), 2,4-triisopropyl-benzene-diisocyanate (TRIDI) and substances (e.g., chlorofluoroalkyl side-chain fungicides) known to decompose to irritant intermediates in the lining fluids of the airways. Collectively, this analysis shows that for irritant aerosols both the concentration and the particle size are equally important for the outcome of the test, independent of whether the endpoint chosen is lethality or BAL protein. The scientific value of 1-h exposures to high aerosol concentrations, as required by some regulations, could be challenged because high concentrations and high respirability of aerosol appear to be mutually exclusive, as shown for mMDI and NDI (LC₅₀ >2000 mg/m³). Thus, for a meaningful risk characterization, test results from inhalation studies with contrived properties due to the specific techniques employed need to be compared with the real properties of substances as marketed, handled and used.     

Measurement of outcomes for patients with centralising versus non-centralising neck pain

Objective: The purpose of this study is to determine whether individuals with neck pain who demonstrate centralisation of symptoms have more favourable outcome than individuals who do not demonstrate centralisation.

Methods: Eleven subjects with neck pain were evaluated and treated by two physical therapists certified in Mechanical Diagnosis and Therapy (MDT). Eleven physical therapy patients underwent a routine initial evaluation and were treated 2–3 times per week using MDT principles and other physical therapy interventions. The Neck Disability Index (NDI) tool was administered at the initial examination, approximately 2?weeks following the initial examination, each subsequent re-evaluation, and at discharge from the study to measure changes in functional outcomes for each subject. Patients continued with treatments until they were discharged or removed from the study. Four subjects were referred back to their physician by treating physical therapist secondary to non-centralisation (NC) and worsening of symptoms.

Results: Of the 11 subjects, six demonstrated centralisation (CEN) and five demonstrated NC. At initial evaluation, the average NDI score for the CEN group was 51.0 (SD?±?19.4) and 56.4 (SD?±?17.6) for the NC group. For the CEN group, the average change in NDI score between initial evaluation and discharge was 41.2 (SD?±?13.2 and 12.2 (SD?±?13.0) for the NC group. The correlation coefficient of CEN and change in NDI score was 0.772 and was statistically significant (P?=?0.005).

Conclusions: In this limited sample, people with neck pain demonstrated more favourable outcomes when the CEN phenomenon was observed. Future research on CEN should be investigated with a larger sample size and with a greater number of clinicians trained in the MDT approach.     

Genotoxic and mutagenic effects of erythrosine B,a xanthene food dye,on HepG2 cells

Erythrosine (ErB) is a xanthene and an US Food and Drug Administration approved dye used in foods, drugs and cosmetics. Although its utilization is permitted, ErB is described as inhibitor of enzymes and protein–protein interactions and is toxic to pituitary and spermatogenesis processes. However, the genotoxicity and mutagenicity of ErB is inconclusive in the literature. This study aimed to analyze the genotoxicity of this dye using the alkaline comet assay and is the first investigation to evaluate ErB mutagenicity using the cytokinesis block micronucleus cytome (CBMN-Cyt) assay in HepG2 cells. These cells were chosen because they produce phase I and phase II enzymes that can mimic in vivo metabolism. The cells were treated with seven concentrations (0.1–70.0 μg mL⁻¹) of ErB, and the results showed genotoxicity at the two highest concentrations and mutagenicity at six concentrations. Furthermore, as micronuclei result from clastogenic and aneugenic processes, while comet assay is often considered more sensitive and detects DNA single strain breaks, we suggest that an aneugenic is responsible for the observed damage. Although ErB is approved for use in the food, cosmetic and pharmaceutical industries, it must be used carefully because it damages the DNA structure.     

Effects of orally administered antioxidants on micronuclei and sister chromatid exchange frequency in workers professionally exposed to antineoplastic agents

The widespread use of antineoplastic drugs in cancer treatment increased concern about possible hazard to workers involved in the preparation and administration of these drugs. In the present study, the effects of commercial antioxidative drug Oligogal Se® on genome protection were analyzed in 15 nurses handling the antineoplastic drugs at the Oncology Department in comparison to twenty healthy volunteers. The nurses took antioxidant mixture Oligogal Se®, consisting of vitamins C, E, A and selenium, one capsule per day, over a period of 6 months. Genome damage was measured in peripheral blood lymphocytes by usage of sister chromatid exchange test and the cytokinesis-block micronuclei test. The frequency of sister chromatid exchange (SCE) and micronuclei (MN) in the exposed group was significantly higher when compared to the control group (SCE, p < 0.05; MN, p < 0.01 respectively). After antioxidant supplementation, the frequency of sister chromatid exchange and micronuclei decreased (p < 0.05) when compared with the values from the beginning of the study, but were still above the values of the control group. The effects of confounding factors such as cigarette smoking and cytostatics exposure time were also evaluated. The data indicated that Oligogal Se® contributed to the decreasing of genome damages in workers handling the cytostatics.