早发冠心病患者的危险因素及冠脉病变特点研究

目的:探讨早发冠心病(PCAD)患者的危险因素及冠脉病变特点。方法:收集2014年8月至2015年2月北京安贞医院急诊科行冠状动脉造影的1000例患者为研究对象,根据冠状动脉造影结果和临床资料分为早发冠心病(PCAD)组(男55岁,女65岁,n=340)、晚发冠心病组(n=300)和对照组(非冠心病者,n=360)。对三组患者的临床资料进行统计学分析,采用logistic回归分析PCAD患者的危险因素,并比较PCAD组与晚发冠心病组的冠状动脉病变特点。结果:Logistic回归分析结果提示:吸烟、早发冠心病家族史、高血压病及2型糖尿病是PCAD的独立危险因素(P0.001)。PCAD组单支病变比例显著高于晚发冠心病组(P0.05);回旋支、右冠状动脉病变比例低于晚发冠心病组(P0.05)。结论:吸烟、早发冠心病家族史、高血压病及2型糖尿病是PCAD的独立危险因素。早发冠心病患者冠脉病变主要累及前降支,单支病变多于晚发冠心病患者。     

Host factors associated with serologic inflammatory markers assessed using multiplex assays

Chronic systemic inflammation contributes to the development of adverse health conditions, yet the influence of fixed and modifiable risk factors on many serologic biomarkers of inflammation remains largely unknown. Serum concentrations of twenty-three biomarkers, including C-reactive protein (CRP), cytokines (CXCL11, CXCL8, CXCL10, CCL2, CCL13, CCL4, CCL17, CXCL13, IL-10, IL-12p70, IL-6, TNF-α, IL-2, IFN-γ, IL-1β, GM-CSF, BAFF), and soluble immune receptors (sCD14, sIL-2Rα, sCD27, sgp130, sTNF-R2) were measured longitudinally using multiplexed immunometric assays in 250 HIV-uninfected men followed in the Multicenter AIDS Cohort Study (1984–2009). Generalized gamma regression was used to determine the statistical significance of factors associated with each biomarker. After accounting for age, race, and education, and for analysis of multiple biomarkers, higher concentrations of specific individual biomarkers were significantly (P < 0.002) associated with hypertension, obesity, hepatitis C infection, stimulant use, and diabetes and lower concentrations with hypercholesterolemia. These associations should be taken into account in epidemiological studies of these biomarkers, and may provide potential targets for disease prevention and treatment.     

内镜黏膜下剥离术和挖除术治疗上消化道肿瘤的疗效及安全性分析

目的:分析内镜黏膜下剥离术(ESD)和黏膜下挖除术(ESE)治疗上消化道肿瘤的疗效及安全性。方法:回顾性分析2017年1月至2019年4月我院消化内科接受ESD或ESE治疗的68例上消化道肿瘤住院患者的临床资料,收集患者基础疾病、手术时间、病变部位大小、整块切除率、并发症等资料,同时采用Logistic回归分析对术中穿孔进行危险因素分析。结果:64例患者完整切除瘤体(94.12%),肿瘤平均直径(16.98±8.29)mm。食管病灶病理类型以高级别上皮内瘤变为主,有15例(22.06%);胃部病灶分布以胃体、胃底和胃窦居多,分别有18例(26.47%)、16例(23.53%)和12例(17.65%),病理类型以间质瘤最多,占36.76%;11例患者发生并发症(16.18%),4例患者出现术后出血(5.88%),经过内镜下止血后好转,8例患术中穿孔(11.76%),均行内镜下尼龙绳联合钛夹行荷包缝合,其中1例患者术中穿孔合并术后迟发性出血;病灶最大直径(≥25 mm,P=0.036)和病灶部位(胃底,P=0.015)是导致ESD或ESE术中穿孔的独立危险因素。结论:ESD和ESE治疗上消化道肿瘤安全有效,但需注意病灶大小和胃底病变,因其是导致术中穿孔的独立危险因素。     

胃大部切除术后消化性溃疡患者残胃癌危险因素分析及其干预措施

目的:探究消化性溃疡患者胃大部切除术后发生残胃癌的危险因素,并提出相应干预措施。方法:选取我院收治的行胃大部切除术治疗后的消化性溃疡患者180例作为研究对象,将其随机分为两组,每组90例。对照组给予常规干预,观察组给予综合干预,观察两组的干预效果,同时将发生残胃癌患者与未发生残胃癌患者各项资料进行对比,分析影响残胃癌发生的危险因素。结果:观察组中没有患者发生残胃癌,对照组中有10例患者发生残胃癌,发生率为11.11%,显著高于观察组(P0.05);两组患者在首次手术年龄、性别、HP感染上进行对比差异无统计学意义(P0.05);两组患者在首次手术吻合方式、首次手术溃疡位置上对比具有统计学意义(P0.05),残胃癌组组采用毕Ⅰ式2例,毕Ⅱ式7例,Roux-Y式1例;未发生残胃癌组采用毕Ⅰ式82例,毕Ⅱ式74例,Roux-Y式14例,残胃癌组首次手术溃疡位置以十二指肠球部为主,未发生残胃癌组以十二指肠球部、胃体部为主;Logistics回归分析结果证实首次手术吻合方式、首次手术溃疡位置属于残胃癌发生的主要危险因素。结论:术后残胃癌发生危险因素包括首次手术吻合方式、首次手术溃疡位置,同时相关并发症的发生同样会增加术后残胃癌发生风险,应加强引流管干预、并发症干预,并将此作为基础制定综合干预方案。     

Foraging theory provides a useful framework for livestock predation management

A societal shift toward plant dominant diets and a reduction in livestock rearing could have broad social, environmental and conservation benefits. Livestock husbandry, however, has a wealthy cultural history, strong support and high consumer demand. It is therefore likely to continue as a major land use and conservation issue for predators. From a producer’s perspective, the primary goals of livestock protection are maximising, or at least maintaining, production by minimising losses and mitigating detriment to stock welfare. Lethal removal of predators remains a commonplace solution. Such management measures are questionable as they raise animal welfare and conservation concerns, risk inhibiting ecological processes, are often expensive, and in some circumstances, exacerbate livestock predation problems. Non-lethal alternatives can facilitate co-existence between livestock farmers and predators, ideally reducing the ecological impact of pastoralism and achieving conservation goals. The need for rigorous study of non-lethal approaches has however been recently highlighted. Tools and methods involved in livestock protection, as well as the theoretical basis of how we perceive and manage the problem, require deeper consideration. Non-lethal approaches require knowledgeable implementation and an effective decision making system is a prerequisite for successful practice. Livestock predation and its prevention are fundamentally influenced by the underlying principles of foraging ecology and risk theory. We propose that manipulating elements of Brown’s (1988) quitting harvest rate model provides a useful conceptual framework for reducing livestock predation and encouraging coexistence.     

重症监护病房长期机械通气患者撤机困难的原因及死亡影响因素分析

目的:探讨重症监护病房(ICU)长期机械通气患者撤机困难的原因及撤机死亡的影响因素。方法:对2015年6月至2018年10月我院收治的80例长期机械通气患者的临床资料进行回顾性分析,按照患者撤机结果分为撤机成功组52例和撤机困难组28例,根据患者存活情况分为存活组59例和死亡组21例。比较各组临床资料,分析撤机困难的原因及撤机死亡的影响因素。结果:撤机困难组年龄、心功能不全比例、多器官功能障碍(MODS)比例、呼吸机相关肺炎(VAP)比例、肝功能不全比例、肾功能不全比例、血尿素氮显著高于撤机成功组,机械通气时间、气管切开时间显著长于撤机成功组,血清白蛋白显著低于撤机成功组(P0.05)。死亡组年龄、合并糖尿病比例、心功能不全比例、MODS比例、VAP比例、肝功能不全比例、肾功能不全比例、血尿素氮显著高于存活组,机械通气时间、气管切开时间显著长于存活组,血清白蛋白显著低于存活组(P0.05)。多因素Logistic回归分析显示:年龄、合并糖尿病、MODS、VAP、机械通气时间、气管切开时间、血清白蛋白是ICU长期机械通气患者撤机死亡的影响因素(P0.05)。结论:患者治疗期间发生脏器功能不全或器官功能衰竭、机械通气时间较长、气管切开时间较长、营养状态较差是长期机械通气患者撤机困难的主要原因,年龄、合并糖尿病、MODS、VAP、机械通气时间、气管切开时间、血清白蛋白是ICU长期机械通气患者撤机死亡的影响因素。     

Risk factors associated with E. coli causing neonatal calf diarrhea

Calf diarrhea is one of the major health challenges in cattle herds. The bacteriological examination of fecal samples collected from apparently healthy and diarrheic calves' revealed isolation of 26 E. coli isolates out of 56 calves with an incidence of 46.4%. Serogroups O1, O26, O44, O55, O115, O119, O125, O146, and O151 were identified from the collected fecal samples. Using PCR all isolates was positive for ompA gene species specific for E. coli. While stx1 and eaeA genes detected with incidence of 3.8 and 19.2% respectively from the isolates. The presence of stx2 gene was negative in the fecal isolates. Among colostrum samples 4 E. coli isolates were detected and serogrouped to O26, O55 and O119. They were negative for eaeA, stx1 and stx2 except strain number 4 (O55) was positive for stx1. E. coli strains were sensitive to norfloxacin (80.7%) and resistant to ampicillin and cefotaxime (100% each). Based on our findings, there was no association between occurrence of E. coli and age of calf (2–14 days), while bottle feeding calf colostrum may be a source of E. coli contamination.     

Synthesis and elaboration of N-methylpyrrolidone as an acetamide fragment substitute in bromodomain inhibition

N-Methylpyrrolidone is a solvent molecule which has been shown to compete with acetyl-lysine-containing peptides for binding to bromodomains. From crystallographic studies, it has also been shown to closely mimic the acetamide binding motif in several bromodomains, but has not yet been directly pursued as a fragment in bromodomain inhibition. In this paper, we report the elaboration of N-methylpyrrolidone as a potential lead in fragment-based drug design. Firstly, N-methylpyrrolidone was functionalised to provide points for chemical elaboration. Then, the moiety was incorporated into analogues of the reported bromodomain inhibitor, Olinone. X-ray crystallography revealed that the modified analogues showed comparable binding affinity and structural mimicry to Olinone in the bromodomain binding site.     

Semisynthesis of epoxy-pimarane diterpenoids from kirenol and their FXa inhibition activities

Kirenol is one of the biologically active diterpenoids from Siegesbeckia pubescens. In terms of the high content and typical structure, many ent-diterpenoids separated from S. pubescens were presumed to be biologically related to kirenol. Among them, epoxy-pimarane diterpenoids are belonging to a special family of naturally occurring compounds that attracted our attentions on their putative biosynthesis pathway and biological activities. Here, we designed and synthesized two known 14,16-epoxy-pimarane diterpenoids (2 and 3) and five 8,15-epoxy-pimarane diterpenoids (4–8) from kirenol. Their absolute structures were determined by 1D and 2D NMR data and the absolute configurations of 4 were confirmed by X-ray crystallographic data. Their inhibition effects on factor Xa (FXa) were evaluated to assess the potentiality of epoxy-pimarane diterpenoids as FXa inhibitor agents.     

CONTAMINATED LEVEL AND RISK ASSESSMENT OF PAES IN THE UPPER REACHES OF THE YANGTZE RIVER北大核心CSCD

PAEs have been proved to be one of the major organic pollutants. The present study determined the level of PAEs using surface water samples from the upper reaches of the Yangtze River. The results showed that DEHP contributed the most to PAEs pollution, followed by DBP. Risk Quotients of PAEs were used for preliminary screening, and DEHP and BBP were identified as potential risk factors with RQ of 310 and 70.7. The MOS10 of DEHP and BBP were 1.40 and 1.32×105, respectively, indicating that BBP may pose little risk to aquatic organisms. The potential risk of DEHP was further analyzed with joint probabilistic curves. Among different biological groups, fish and zoobenthos were two major groups sensitive to DEHP-induced damage under current concentrations with 99.4% and 98.3% for 5% species of each group. While among the toxicity endpoints, reproduction may be more sensitive than others. The 5% and 10% aquatic species were suffered from reproductive damages by 100% and 97.8%, respectively. Overall, our results indicated that DEHP in the surface water of the upper Yangtze River may pose potential risk to aquatic organisms, especially on their reproduction. Therefore, more concerns should be paid in species protection and environmental management. © 2019, Institute of Hydrobiology, Chinese Academy of Sciences. All rights reserved.