Biomarkers in veterinary medicine: establishing a new international forum for veterinary biomarker research

Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) increases with severity in community-acquired pneumonia (CAP). We investigated whether changes of MR-proANP correlated to bacteremia.

Methods: 392 adult patients with CAP visiting emergency department from a prospective observational multicenter study.

Results: MR-proANP levels increased in patients with positive bacteremia (92.8 pmol/L vs. 84.3 pmol/L, p?=?0.04). Performance of MR-proANP to detect bacteremia (0.60) was equivalent to CRP (0.59) but less accurate than PCT (0.69).

Conclusion: MR-ANP poorly predicts bacteremia in CAP patients.     

N末端脑钠肽前体在围冠状动脉搭桥术期的变化及意义

N-末端脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP)是体内脑钠肽前体(proBNP)裂解成脑钠肽(brain natriuretic peptide,BNP)时的产物,NT-proBNP的血浆浓度及稳定性比BNP更高,半衰期更长,属于钠尿肽系统的重要一员,本身无生物学活性。NT-proBNP主要由正常的心肌细胞合成和分泌,在心肌损伤或坏死后迅速升高,可反映机体代偿病理改变和恢复循环的能力,是心功能障碍性疾病,如心力衰竭、左室肥厚等诊断、疗效监测和预后评估等最佳的心肌标志物,临床通过测定血浆NT-proBNP水平用于急慢性充血性心力衰竭(congestive heart failure,CHF)的诊治及预后,本文主要就NT-proBNP在围冠状动脉搭桥术(Coronary Artery Bypass Grafting,CABG)期的变化及临床意义的新进展进行综述。     

Assessing the public health impacts of legalizing recreational cannabis use: the US experience

The sale of cannabis for adult recreational use has been made legal in nine US states since 2012, and nationally in Uruguay in 2013 and Canada in 2018. We review US research on the effects of legalization on cannabis use among adults and adolescents and on cannabis‐related harms; the impact of legalizing adult recreational use on cannabis price, availability, potency and use; and regulatory policies that may increase or limit adverse effects of legalization. The legalization of recreational cannabis use in the US has substantially reduced the price of cannabis, increased its potency, and made cannabis more available to adult users. It appears to have increased the frequency of cannabis use among adults, but not so far among youth. It has also increased emergency department attendances and hospitalizations for some cannabis‐related harms. The relatively modest effects on cannabis use to date probably reflect restrictions on the number and locations of retail cannabis outlets and the constraints on commercialization under a continued federal prohibition of cannabis. Future evaluations of legalization should monitor: cannabis sales volumes, prices and content of tetrahydrocannabinol; prevalence and frequency of cannabis use among adolescents and adults in household and high school surveys; car crash fatalities and injuries involving drivers who are cannabis‐impaired; emergency department presentations related to cannabis; the demand for treatment of cannabis use disorders; and the prevalence of regular cannabis use among vulnerable young people in mental health services, schools and the criminal justice system. Governments that propose to legalize and regulate cannabis use need to fund research to monitor the impacts of these policy changes on public health, and take advantage of this research to develop ways of regulating can­nabis use that minimize adverse effects on public health.     

太原北齐徐显秀墓壁画可培养真菌多样性及危害防治

【背景】原址保护的墓葬壁画普遍存在着有害微生物的威胁,对壁画菌害的长效防治是文物保护领域久未解决的难题。【目的】确定太原北齐徐显秀墓墓道霉变壁画上可培养真菌多样性,分离优势菌株,并筛选长效的生物杀灭剂,为墓葬壁画菌害的抢救性防治提供科学依据。【方法】利用无菌棉签采集壁画表面白色菌丝体样品,使用扫描电子显微镜分析病害菌微观形貌特征;通过培养、分离及纯化获得真菌菌株,运用形态学和分子技术鉴定种属;结合实验室抑菌圈测试和原位杀菌试验,分析不同生物杀灭剂的抑菌圈大小、杀菌后原位可培养微生物浓度以及ATP荧光值差异,以期找到长效的生物杀灭剂。【结果】霉变壁画表面有大量菌丝体并伴有分生孢子,白色菌丝体样品中可培养真菌属于子囊菌门(Ascomycota)的6个属,其中白色侧齿霉菌(Parengyodontium album)相对丰度最高(98.13%),为优势病害菌。经实验室和原位试验筛选评估,确定了双氯酚复配型杀灭剂(0.5%双氯酚+75%乙醇)对该病害真菌杀灭效果最好,在7年连续监测期内未出现病害菌的复发。【结论】白色侧齿霉菌是引起徐显秀墓墓道壁画霉变的主要可培养病害菌;双氯酚复配型杀菌剂用于该病害菌防治的时效性最长;建议后期结合抢救性防治、环境调节和跟踪监测,以达到墓葬壁画微生物危害的长效防控。     

医疗紧急情况下知情同意的代理相关法律问题

传统的知情同意原假设是,如果病人没有充分的自主,医疗干预便不能实施,医师在知情同意中的重心是建议者而非治疗者的角色。但是在医疗紧急情况下,为着生命优先、救死扶伤的原则,知情同意严格程序形式需要作出让步,病人的昏迷状态或者濒危状态使得其无法具有自主的能力,就需要通过代理实现同意功能的延伸。紧急情况下将会遇到的非本人的其他主体能否代理、有无能力代理、会否滥用代理权等一系列相关的法律问题。     

Viruses and asthma

Background

Viral respiratory infection has long been known to influence the occurrence of asthma exacerbations. Over the last 20 years much effort has been put into clarifying the role that viral respiratory infections play in the eventual development of asthma.

Scope of review

In this review we give a general background of the role of viruses in the processes of asthma exacerbation and asthma induction. We review recent additions to the literature in the last 3 years with particular focus on clinical and epidemiologic investigations of influenza, rhinovirus, bocavirus, respiratory syncytial virus, and metapneumovirus.

Major conclusions

The development of asthma emerges from a complex interaction of genetic predisposition and environmental factors with viral infection likely playing a significant role in the effect of environment on asthma inception. This article is part of a Special Issue entitled: Biochemistry of Asthma.

General significance

Further understanding of the role that viruses play in asthma exacerbation and inception will contribute to decreased asthma morbidity in the future. This article is part of a Special Issue entitled: Biochemistry of Asthma.     

Just add water: sources of chironomid drift in a large river floodplain

Although seasonal floodplains represent one of the most dynamic and productive of aquatic ecosystems, the sources of this productivity are poorly understood. We examined composition and sources of chironomid drift in the Yolo Bypass, the primary floodplain of the Sacramento River. We found that invertebrate drift during winter floodplain inundation is dominated by a single species, the newly identified chironomid Hydrobaenus saetheri (Diptera: Chironomidae). In order to determine sources of chironomids in the Yolo Bypass, invertebrates were sampled from several potential sources prior to and during initial floodplain inundation. Rehydration of dried floodplain sediments from several locations showed that H. saetheri dominated insect emergence from this colonization pathway. By contrast, H. saetheri was not a substantial component of inundated floodplain ponds or of tributary inputs to the floodplain. We conclude that the initial pulse of invertebrate abundance in Yolo Bypass floodwaters is dominated by chironomid emergence from sediments in multiple regions of the floodplain. Handling editor: S. Declerck     

大鼠体外循环模型的建立

目的建立大鼠体外循环实验模型。方法雄性成年SD大鼠10只(450～550g),麻醉后给予气管切开,呼吸机辅助通气,股动脉置管接监护仪实时监测动脉血压并按时采集动脉血标本,股静脉置管用于持续补液和静脉血样采集。经右颈静脉置多孔引流管至右心房行中心静脉引流,血液经特制微型膜肺氧合后,由蠕动泵经右颈动脉实施灌注。本模型采用林格氏液和贺斯进行无血预充,总量为16ml,晶胶比为1∶1,灌注流量100～150ml(kg·min),转流时间60min。结果实验中膜肺氧合满意,血流动力学稳定,所有动物都成功脱机。结论利用大鼠可以建立简单、廉价的体外循环动物模型。本模型适用于研究与体外循环相关的全身炎症反应和多脏器功能损伤的病理生理机制及其防治策略。     

急诊断流术在门静脉高压症并食道胃底静脉出血的疗效观察

目的观察急诊断流术在门静脉高压症并食道胃底静脉出血的临床疗效。方法选取我院收治的门静脉高压症并食道胃底静脉出血患者103例,随机分为两组。对照组52例,在患者入院后先采取保守止血治疗,再择期进行断流术;观察组51例,在患者入院后立即采取急诊断流术治疗。观察比较两组的临床疗效。结果观察组患者术后死亡率为11.76%,对照组为25.00%,两组比较差异有统计学意义(P0.05)。观察组患者住院时间短于对照组,差异有统计学意义(P0.05)。经随访3~4年,观察组再次出血发生率为12.76%,对照组再次出血发生率为13.46%,两组比较差异无统计学意义(P0.05)。结论急诊断流术在门静脉高压症并食道胃底静脉出血的临床疗效显著,可降低患者死亡率,缩短住院时间,值得临床应用。     

Wireless vitals—Proof of concept for wireless patient monitoring in an emergency department setting

Vital sign assessment is a common task in emergency medicine, but resources for continuous monitoring are restricted, data is often recorded manually, and entangled wires cause frustration. Therefore, we designed a small, wireless photoplethysmographic device capable of continuously assessing pulse, respiratory frequency and oxygen saturation on the sternum and tested the performance and feasibility in an emergency department setting. Fifty (56.3 ± 20.2 years), consenting emergency patients (29 male) were recruited. Heart rate, respiratory rate and oxygen saturation were recorded simultaneously using the device and standard monitoring equipment. Data was compared using Bland‐Altman plotting (heart rate, respiratory rate) and mean difference (oxygen saturation). The bias for heart‐ and respiratory rate was 0.4 (limits of agreements ?11.3, 12.2 and ?6.1, 7.0). Mean difference for oxygen saturation was ?0.21 ± 2.35%. This may be the first wireless device to use photoplethysmography on the sternum for vital sign assessment. We noted good agreement with standard monitors, but lack of standardization in data processing between monitoring systems may limit the generalizability of these findings. Although further improvements are needed, the feasibility of this approach provides proof of concept for a new paradigm of large scale, wireless patient monitoring.