持续镇痛分娩对产妇分娩结局和新生儿评分的影响

目的:研究持续镇痛分娩对产妇分娩结局和新生儿评分的影响。方法:选择2018年7月～2019年7月中国医科大学航空总医院(本院)采取硬膜外分娩镇痛的101例产妇,将其随机分为两组。当产生确切的镇痛效果,进入第二产程后,观察组的51例产妇采用0.4μg/m L舒芬太尼以及0.08%罗哌卡因进行持续镇痛分娩;对照组的50例产妇则在宫口开全后,使用生理盐水替代泵内的局麻药物,直到分娩结束。比较两组产妇催产素的使用率,宫口扩张度和第一、第二产程按压硬膜外自控镇痛泵的次数,分娩方式,新生儿的体质量,脐动脉血pH值,出生后1 min和5 min Apgar评分,产妇修复会阴部时的视觉模拟评分(visual analogue scale, VAS)评分及产妇对于第二产程镇痛的满意度评分。结果:两组产妇催产素的使用率、宫口扩张度和第一、第二产程按压硬膜外自控镇痛泵的次数、分娩方式(剖宫产率、器械助产率、自然分娩率)、第一产程镇痛时间、第一以及第二产程时间相比均无显著差异(P0.05);两组新生儿的体质量,脐动脉血pH值,出生后1 min和5 min Apgar评分小于8分的新生儿所占的比例相比没有明显的差异(P0.05);观察组产妇修复会阴部时的VAS评分明显低于对照组(P0.05),产妇对于第二产程镇痛的满意度评分明显高于对照组(P0.05)。结论:持续镇痛分娩对产妇分娩结局和新生儿评分无明显的影响,但可显著提高产妇对第二产程镇痛和修复会阴部时镇痛的满意度。     

阿加曲班抗凝对连续血液净化患儿凝血功能及单核细胞TLR2rMnX、TLR4rMnX表达水平的影响

目的:探讨阿加曲班抗凝治疗连续血液净化患儿的疗效及对凝血功能及单核细胞TLR2rMnX、TLR4rMnX表达水平的影响。方法:选取从2017年3月至2018年10月于我院儿童重症医学科接受连续血液净化治疗的患儿86例进行研究,将其按照随机抽签法分成研究组与对照组。对照组予以普通肝素抗凝治疗,研究组予以阿加曲班抗凝治疗。分别比较两组的28 d死亡率、治疗前后凝血功能血小板计数(PLT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和单核细胞TLR2rMnX、TLR4rMnX表达水平、治疗过程中滤器与管路凝血程度、使用寿命以及穿刺部位出血情况的差异。结果:研究组28d死亡率(2.33%)比对照组(9.30%)低,但差异无统计学意义(x2=0.849,P=0.357)。治疗后研究组APTT(31.61±1.26)s、FIB水平(6.61±1.80)g/L较对照组的(27.92±1.44)s、(5.58±1.72)g/L明显更高(t=12.646、2.713,P=0.000、0.008)。研究组治疗过程中滤器与管路凝血程度0级人数占比(93.02%)相比对照组(76.74%)较高,而Ⅱ级人数占比(0.00%)相比对照组(9.30%)较低(x2=4.440、4.195,P=0.035,0.041)。研究组穿刺部位出血等级为0级人数占比(93.02%)高于对照组(74.42%),而Ⅱ级人数占比(0.00%)低于对照组(9.30%)(x2=5.460,4.195;P=0.019,0.041)。研究组管路、滤器使用寿命(18.73±7.74)h、(20.84±8.01)h相比对照组的(14.57±6.88)h、(16.20±7.15)h均较长(t=2.634、2.834,P=0.010,0.006)。治疗后研究组单核细胞TLR2rMnX、TLR4rMnX表达水平为(4.72±1.39)、(3.22±0.82),均低于对照组的(8.30±1.44)、(5.11±0.94)(t=11.729、9.936,P=0.000、0.000)。结论:阿加曲班抗凝应用于连续血液净化患儿中的疗效相比普通肝素抗凝更佳,且有利于改善凝血功能和单核细胞TLR2rMnX、TLR4rMnX表达水平,能够降低滤器或管路凝血发生风险,同时有效降低穿刺部位出血风险,增加管路、滤器使用寿命。     

Dosimetric effect of intrafraction motion and different localization strategies in prostate SBRT

The aim of this study was to evaluate the dosimetric effect of continuous motion monitoring based localization (Calypso, Varian Medical Systems), gating and intrafraction motion correction in prostate SBRT. Delivered doses were modelled by reconstructing motion inclusive dose distributions for different localization strategies. Actually delivered dose (strategy A) utilized initial Calypso localization, CBCT and additional pre-treatment motion correction by kV-imaging and Calypso, and gating during the irradiation. The effect of gating was investigated by simulating non-gated treatments (strategy B). Additionally, non-gated and single image-guided (CBCT) localization was simulated (strategy C). A total of 308 fractions from 22 patients were reconstructed. The dosimetric effect was evaluated by comparing motion inclusive target and risk organ dose-volume parameters to planned values. Motion induced dose deficits were seen mainly in PTV and CTV to PTV margin regions, whereas CTV dose deficits were small in all strategies: mean ± SD difference in CTVD99% was –0.3 ± 0.4%, −0.4 ± 0.6% and –0.7 ± 1.2% in strategies A, B and C, respectively. Largest dose deficits were seen in individual fractions for strategy C (maximum dose reductions were −29.0% and –7.1% for PTVD95% and CTVD99%, respectively). The benefit of gating was minor, if additional motion correction was applied immediately prior to irradiation. Continuous motion monitoring based localization and motion correction ensured the target coverage and minimized the OAR exposure for every fraction and is recommended to use in prostate SBRT. The study is part of clinical trial NCT02319239.     

Chlorophyll a fluorescence kinetics of mung bean (Vigna radiata L.) grown under artificial continuous light

Continuous light can be used as a tool to understand the diurnal rhythm of plants and it can also be used to increase the plant production. In the present research, we aimed to investigate the photosynthetic performance of V. radiata under continuous light as compared with the plants grown under normal light duration. Chlorophyll a fluorescence transient (OJIP test) technique was used to understand the effect on various stages of photosynthesis and their consequences under continuous light condition. Various Chl a Fluorescence kinetic parameters such as Specific energy fluxes (per Q_A-reducing PSII reaction center (RC)) (ABS /RC; TR₀/RC; ET₀/RC; DI₀/RC), phenomenological fluxes, leaf model, (ABS/CSm; TR/CSm; ETo/CSm), Quantum yields and efficiencies (φPo; φEo; Ψo) and Performance index (PI_abs) was extracted and analysed in our investigation. Conclusively, our study has revealed that continuous light alters the photosynthetic performance of V. radiata at a different point but also improve plant productivity.     

Early social contact alters the community structure and functions of the faecal microbiome in suckling-growing piglets

Social contact during suckling, in an enriched social environment, can reduce the aggressive behaviours of piglets during regrouping at weaning, and improve their production performance and welfare. The aim of this study was to determine the possible impact of suckling social contact on gut microbes. We performed 16S rRNA sequencing to measure the faecal microbial structure and function in piglets experiencing social contact. Eighteen-litter piglets were allocated to two treatments: an early continuous social contact (CSC) group where piglets from adjacent pens shared a mutual pen starting at 14 days postpartum and a control (CON) group where piglets had no contact with individuals from adjacent pens during the suckling period. The piglets were regrouped at 36 days of age. The litter weights at 35 and 63 days of age were measured. Faecal samples were randomly collected at 16, 35, 42, and 63 days of age and faecal DNA was determined. The results showed that the litter weight of piglets in the CSC group was significantly decreased at 63 days compared with the CON group. Continuous social contact also significantly decreased the microbial richness at 16 and 35 days of age (P < 0.05). Firmicutes was the most abundant bacterial phylum in both groups at all detected time-points and the abundance increased with social contact. At the genus level, Lactobacillus was the most abundant bacterium after weaning and the abundance increased in the piglets with social contact. Compared with the faecal microbiota of control piglets, a total of 22 genera at 16 days, 20 genera at 35 days, 12 genera at 42 days, and 27 genera at 63 days in the faeces of CSC piglets were observed to be significantly different in abundance (linear discriminant analysis score > 3, P < 0.05). Furthermore, functional analysis of the microbial composition showed that the changes induced by early CSC mainly altered the relative abundance of metabolic and related pathways. The social contact notably had an effect on the abundance of microbial pathways for amino acid and carbohydrate metabolism. In conclusion, CSC changed the microbial composition in the faeces of piglets, which might have a negative effect on nutrient metabolism for the suckling-growing piglets. Our study provided new insight into the influence of social contact on the suckling-growing piglets.     

Optimization of Lipase Purification by Rotating Annular Size-exclusion Chromatography

Crude porcine lipase was purified by continuous rotating annular size-exclusion chromatography. Sephadex G-75 was used as the size-exclusion packing material. Initial studies by this group on a similar unit have been reported [Genest et al. (1998) "Continuous purification of porcine lipase by rotating annular size-exclusion chromatography", Appl. Biochem. Biotechnol. 73, 215-230]. This article presents the results of optimization studies carried out on a modified unit. These modifications resulted in a better performance of the column and a higher throughput. Purification fold values of around 11 were achieved in most runs. The activity recovered was around 99% and the productivity was around 3 mg lipase/mg gel h.     

Continuous countercurrent salting-out extraction of 1,3-propanediol from fermentation broth in a packed column

The possibility of continuous extraction of 1,3-propanediol in a experimental packed column was investigated using a salting-out extraction system of dipotassium phosphate/ethanol. Mass transfer of 1,3-propanediol takes place from the dispersed phase (salt-rich solution) to the continuous phase (ethanol). The influences of flow rate of dispersed phase and size of packing material on partition coefficient and recovery of 1,3-propanediol were investigated and the results were compared with those obtained in spray column and test tube. Furthermore, the influences of various system compositions on hold up of dispersed phase, mass transfer coefficient, and system stability were also studied in the column packed by stainless steel Dixon 3 × 3 mm. It was found that the packed column showed a good extraction efficiency and stability. Besides, 1,3-propanediol recovery of 90.30% was obtained during a 11 h continuous operation when the real fermentation broth was used. At the same time, 94.4% of phosphate could be recovered when 0.2 volume of anhydrous ethanol was added into the raffinate phase at pH 4.0.     

Continuous production of selenomethionine-enriched Chlorella sorokiniana biomass in a photobioreactor

This article describes the enrichment of the fresh-water green microalga Chlorella sorokiniana in selenomethionine (SeMet). The microalga was cultivated in a 2.2 L glass-vessel photobioreactor, in a culture medium supplemented with selenate (SeO₄^2?) concentrations ranging from 5 to 50 mg L^?1. Although selenate exposure lowered culture viability, C. sorokiniana grew well at all tested selenate concentrations, however cultures supplemented with 50 mg L^?1 selenate did not remain stable at steady state. A suitable selenate concentration in fresh culture medium for continuous operation was determined, which allowed stable long-term cultivation at steady state and maximal SeMet productivity. In order to do that, the effect of dilution rate on biomass productivity, viability and SeMet content of C. sorokiniana at several selenate concentrations were determined in the photobioreactor. A maximal SeMet productivity of 21 μg L^?1 day^?1 was obtained with 40 mg L^?1 selenate in the culture medium. Then a continuous cultivation process at several dilution rates was performed at 40 mg L^?1 selenate obtaining a maximum of 246 μg L^?1 day^?1 SeMet at a low dilution rate of 0.49 day^?1, calculated on total daily effluent volume. This paper describes for the first time an efficient long-term continuous cultivation of C. sorokiniana for the production of biomass enriched in the high value amino acid SeMet, at laboratory scale.     

不同胰岛素给药方式救治糖尿病酮症酸中毒临床研究

目的：比较不同胰岛素给药方式治疗糖尿病酮症酸中毒（DKA）的临床疗效。方法：82例DKA患者随机分为胰岛素泵持续皮下输液胰岛素（CSⅡ）组和微量泵持续静脉泵入胰岛素（CXqI）组各41例,分别给予胰岛素泵持续皮下输注胰岛素和小剂量胰岛素持续微量泵静脉泵入不同胰岛素给药方式,观察两组治疗后血糖变化、血糖达标时间、尿酮体变化、pH值变化、胰岛素平均日用量、平均低血糖次数及平均住院时间。结果：两组治疗后空腹血糖、餐后血糖显著下降及血糖达标时间显著缩短差异无统计学意义（P〉0．05）;CSII组尿酮体转阴时间（22．3±7．4）h短于CVII组（32．1±12．1）h（P〈0．01）;CSII组PH值恢复时间（9．4±2．5）h短于CVII组（15．7±3．5）h（P〈0．01）;CSII组平均胰岛素日用量为（47±5）U比CVII组（58＋7）U少（P〈0．01）;CSII组人均低血糖次数为（0．6±O．5）次／人。少于CVII组（1．5±0．8）次／人（P〈O．01）;CSII组住院时间（9．8±1．2）天明显比CVII组（12．5±2．0）天短（P〈0．01）。结论：CSII相较于CVII能更快更有效的纠正代谢紊乱,减少胰岛素日用量,缩短住院时间,从而提高临床疗效。具有较高的安全性及患者依从性。     

结构方程混合模型在SNP分析中的应用

采用结构方程混合模型(SEMM)对实际SNP数据进行分析,为遗传统计学提供一种新的有效的分析方法。本研究的数据是由GAW17提供的,包含697个个体的22条常染色体的上万个SNP和根据这些SNP所模拟的697个个体的性状特点。随机挑选了1号染色体上的4个SNP和3个定量性状作为研究变量,分别进行潜在类别分析和结构方程混合模型分析。根据4个SNP数据,人群被分为3个潜在类别,概率分别为0.53,0.34,0.13。潜在类别1、2和3中的因子均值Q分别为-4.029、-2.052和0,潜在类别1、2的因子均值均低于3(<0.001)。研究表明:结构方程混合模型(SEMM)综合了结构方程模型和潜在类别模型的思想,形成了自己的优势,可用于处理同时包含分类潜变量和连续潜变量的数据。