腹膜透析治疗对先天性心脏病患儿术后血清因子水平及预后的影响

目的:探讨腹膜透析治疗对先天性心脏病患儿术后血清因子水平及预后的影响。方法:选择2013年11月～2016年11月我院收治的96例小儿先天性心脏病,按治疗方式分为对照组与研究组,每组48例,两组均接受手术治疗。对照组于术后采用常规治疗,研究组在常规治疗基础上加以腹膜透析治疗,观察并比较两组治疗前后血清β2微球蛋白、24 h尿蛋白、血尿素氮、血肌酐、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、碳酸氢盐、钙离子、钾离子水平的变化及死亡情况。结果:治疗后,两组血清β2微球蛋白、24 h尿蛋白、血尿素氮、血肌酐、IL-6、IL-8、TNF-α、钾离子水平均较治疗前显著降低,且研究组以上指标均明显低于对照组;两组碳酸氢盐、钙离子水平均较治疗前明显上升,且研究组以上指标明显高于对照组(P0.05)。此外,研究组死亡率明显低于对照组(P0.05)。结论:腹膜透析治疗先天性心脏病患儿术后能够降低病死率,改善肾功能、炎症因子及电解质平衡紊乱。     

先天性心脏病患儿围术期输血与术后肺损伤的相关性研究

目的:研究先天性心脏病患儿围术期输血与术后发生肺损伤的相关性。方法:选择我院诊治的120例先天性心脏病患儿,均在体外循环下进行手术矫治。根据患儿术后是否出现肺损伤分为无肺损伤组(n=97例)与肺损伤组(n=23例)。比较两组一般资料,比较不同围术期输血浆量及输血量患儿的术后肺损伤发病率;采用多因素logistic回归对术后肺损伤与围术期输血浆量、围术期输血量、最低红细胞压积(30%)、体外循环时间(80 min)、年龄(≤1岁)以及最低温度之间的相关性进行分析。结果:无肺损伤组与肺损伤组患儿性别间无显著差异(P0.05);肺损伤组患儿年龄、体质量均显著低于无肺损伤组患儿(P0.05),而围术期输血浆量、围术期输血量、最低血红积压、体外循环时间均显著高于无肺损伤组患儿(P0.05)。随着患儿围术期输血浆量及输血量的增加,患儿术后肺损伤的发病率越高(P0.05);多因素logistic回归分析显示围术期输血浆量、围术期输血量、最低红细胞压积(30%)、体外循环时间(80 min)以及年龄(≤1岁)是患儿发生术后肺损伤的独立危险因素(P0.05)。结论:围术期输血浆量以及输血量与先天性心脏病患儿术后肺损伤的发生紧密相关,围术期输血浆量以及输血量越多,肺损伤的发生风险就越高,建议临床上开展多种节约用血措施。     

四肢骨折矫形术后患者慢性手术后疼痛的发生率及其危险因素分析

目的:研究四肢骨折矫形术后患者慢性手术后疼痛的发生率及其危险因素。方法:以2014年12月-2017年10月于我院接受四肢骨折矫形术患者300例为研究对象,于术后6个月分析慢性手术后疼痛的发生率。收集所有患者年龄、性别、体重、术前疼痛程度、二次手术、麻醉方式、术后镇痛、术后引流、合并骨质疏松、骨折类型以及骨折部位等资料,并采用单因素以及多因素Logistic回归分析术后疼痛的危险因素。结果:术后6个月内有96名患者术后发生慢性手术后疼痛,发生率为32.00%(96/300)。单因素分析结果显示:慢性手术后疼痛患者与术前疼痛程度、是否二次手术、麻醉方式、术后有无镇痛、是否合并骨质疏松、骨折类型、骨折部位有关(P0.05),与患者的性别、年龄、体重、术后是否引流无关(P0.05)。多因素Logistic回归分析结果显示:术前重度疼痛、二次手术、麻醉方式为非全麻、术后无镇痛、合并骨质疏松、开放性骨折以及下肢骨折均是四肢骨折矫形术后发生慢性手术后疼痛的独立危险因素(P0.05)。结论:四肢骨折矫形术后患者慢性手术后疼痛的发生率较高,术前重度疼痛、二次手术、麻醉方式为非全麻、术后无镇痛、合并骨质疏松、开放性骨折以及下肢骨折均增加了慢性手术后疼痛的发生风险,临床应根据危险因素给予针对性的干预措施。     

靶向 Toll 样受体的免疫调节剂研究进展

Toll 样受体是一类相对保守的模式识别受体,可以识别损伤相关分子模式和病原相关分子模式,从而启动天然免疫应答,在天然免 疫过程中发挥非常重要的作用。其介导的信号通路失调会引发各种炎症反应、癌症和自身免疫病等疾病。综述近年与 Toll 样受体有关的免 疫调节剂的研究进展,并概括与之相关的疾病,为靶向 Toll 样受体的免疫调节剂的研发提供一定参考。     

Classification of phytoplankton cells as live or dead using the vital stains fluorescein diacetate and 5‐chloromethylfluorescein diacetate

Regulations for ballast water treatment specify limits on the concentrations of living cells in discharge water. The vital stains fluorescein diacetate (FDA) and 5‐chloromethylfluorescein diacetate (CMFDA) in combination have been recommended for use in verification of ballast water treatment technology. We tested the effectiveness of FDA and CMFDA, singly and in combination, in discriminating between living and heat‐killed populations of 24 species of phytoplankton from seven divisions, verifying with quantitative growth assays that uniformly live and dead populations were compared. The diagnostic signal, per‐cell fluorescence intensity, was measured by flow cytometry and alternate discriminatory thresholds were defined statistically from the frequency distributions of the dead or living cells. Species were clustered by staining patterns: for four species, the staining of live versus dead cells was distinct, and live‐dead classification was essentially error free. But overlap between the frequency distributions of living and heat‐killed cells in the other taxa led to unavoidable errors, well in excess of 20% in many. In 4 very weakly staining taxa, the mean fluorescence intensity in the heat‐killed cells was higher than that of the living cells, which is inconsistent with the assumptions of the method. Applying the criteria of ≤5% false negative plus ≤5% false positive errors, and no significant loss of cells due to staining, FDA and FDA+CMFDA gave acceptably accurate results for only 8–10 of 24 species (i.e., 33%–42%). CMFDA was the least effective stain and its addition to FDA did not improve the performance of FDA alone.     

用荧光染色技术标记生活花粉管的研究

在金鱼草和(或)烟草上试验了三种荧光染料对花粉管进行荧光活体染色与标记的效果。花粉管在异硫氰酸荧光素(FITC,12.5μg/ml)中染色5—6小时,原生质呈绿黄色荧光;换入无染料的培养基后可继续生长并保持荧光标记,但后期生长受抑。罗丹明B(RB,10μg/nl)染色的效果与上相近,花粉管呈红色荧光;换入无染料培养基后生长正常,唯后期荧光减弱。荧光素二醋酸酯(FDA,10μg/ml)染花粉粒40分钟,换入无染料培养基后正常萌发与生长,花粉管原生质呈明亮的绿色荧光。FDA方法具有染色时间短,荧光明亮,兼有活染与生活力鉴定双重功效等优点。     

DAPI as a Useful Stain for Nuclear Quantitation

A simple-to-use fluorescent stain, 4',6-diamidino-2-phenylindole (DAPI), visualizes nuclear DNA in both living and fixed cells. DAPI staining was used to determine the number of nuclei and to assess gross cell morphology. Following light microscopic analyses, the stained cells were processed for electron microscopy. Cells stained with DAPI showed no ultrastructural changes compared to the appearance of cells not stained with DAPI. DAPI staining allows multiple use of cells eliminating the need for duplicate samples.     

STANDARD CIRCUMSTANCES AND VITAL GOALS: COMMENTS ON VENKATAPURAM'S CRITIQUE

This article is a reply to Venkatapuram's critique in his article Health, Vital Goals, Capabilities, this volume. I take issue mainly with three critical points put forward by Venkatapuram with regard to my theory of health. (1) I deny that the contents of my vital goals are relative to each community or context, as Venkatapuram claims. There is no conceptual connection at all between standard circumstances and vital goals, as I understand these concepts. (2) Venkatapuram notes that I stop short of filling the framework of vital goals with any content and thereby make my concept of health less concrete. I reply that some vital goals are indeed universal, viz. the ones which are necessary conditions for survival. Many other vital goals are individual and cannot therefore be included in a universal list. (3) Venkatapuram claims that my definition of vital goals is too broad, since it entails that some persons without any disease can be regarded as ill. However, in my understanding health is a relational concept from a state of complete health to a state of maximal illness. In this framework, a minor reduction of a state of complete health does not entail illness. This article also contains a comparison between my theory of health and Martha Nussbaum's theory of capabilities for dignity.     

Studies on oestrous symptoms of buffalo heifers

Studies based on frequent daily observations for nine months, encompassing 92 oestrous periods in 31 Murrah buffalo heifers, revealed that the vulval discharge of clear mucus in varying quantities in a recumbent animal, even in silent heat, was the most reliable single sign of heat in buffalo heifers. Of the other signs observed, wall walking (segregation) and bellowing confirmed oestrus in 83.69% and 80.43%, respectively, while placid response of the animal to the placing of palm of hand on the rump ano response to light massage of vulval lips were seen in 86.95% and 83.69%, respectively. Based upon the degree of manifestation of oestrous symptoms, intensity of oestrus was divided into four categories. Four daily observations of the animal for important symptoms of heat a few days before the expected oestrus could make oestrous detection a sure success.