标准外伤大骨瓣开颅术与常规骨瓣开颅术治疗重型颅脑损伤的疗效对比

目的:探讨标准外伤大骨瓣开颅术与常规骨瓣开颅术治疗重型颅脑损伤的临床疗效。方法:收集我院2011年1月到2015年1月收治的重型颅脑损伤患者80例,按照随机数字表法分为观察组和对照组,每组40例,患者术前均给予常规护理,观察组给予标准外伤大骨瓣开颅术,对照组给予常规骨瓣开颅术,采用格拉斯哥预后评分(GOS)法评价两组术后12个月疗效,比较两组术前和术后7 d患者颅内压变化,记录两组患者并发症发生情况。结果:观察组疗效、良好率、存活率均显著高于对照组(P0.05)。治疗后7 d两组颅内压差异具有统计学意义(P0.05),并且两组术后7d与治疗前相比差异均具有统计学意义(P0.05)。观察组脑切口疝发生率为2.5%,明显低于对照组的20.0%,差异具有统计学意义(P0.05)。结论:标准外伤大骨瓣开颅术治疗效果优于常规骨瓣开颅术,具有一定安全性,值得临床推荐。     

金葡菌类肠毒素K原核表达载体构建及其生物学活性分析

目的:金葡菌类肠毒素K(SElK)原核表达载体构建及其生物学活性初步分析。方法:通过常规分子生物学技术将SElK基因片段插入载体p ET-28a中,阳性单菌落扩大培养,诱导目的基因表达后通过Ni+亲和层析纯化SElK重组蛋白;小鼠脾淋巴细胞增殖实验及尾静脉注射后血常规检测SElK超抗原活性;进一步通过检测血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)和肌酸激酶(CK)活性及尿素(Urea)和肌酐(CR)含量来评价SElK潜在肠毒性。结果:成功构建SElK原核表达载体,并通过Ni~+亲和层析获得高纯度SElK重组蛋白(95%);随后的超抗原活性检测发现SElK能够在体外刺激小鼠脾淋巴细胞显著增殖,尾静脉注射后能够有效地刺激血液中淋巴细胞增殖;最终的肠毒性检测结果发现SElK能够显著增加血清中AST活性及Urea含量。结论:成功构建并纯化获得高纯度SElK重组蛋白,并对其超抗原活性及潜在肠毒性进行初步分析,为开发更优的抗肿瘤制剂提供备选药物。     

Patterns of routine swimming and metabolic rate in juvenile cyyprinids at three temperatures: analysis with a respirometer-activity-monitoring system

Summary The spontaneous swimming activity and oxygen consumption of juvenile roach (Rutilus rutilus (L.)), were monitored for 48–72 h at 8, 15 and 20°C and a photoperiod (L:D) of 11:13. At low levels of activity metabolic cost is constant and thus corresponds to the standard rate of metabolism (low cost activity). At higher levels of activity metabolic cost increases in proportion with the degree of activity. The slope for this high cost activity indicates an expenditure of 0.4–1.3 mol O₂·g^-1·h^-1 per arbitrary activity unit at the three experimental temperatures. Extrapolation of this relationship to zero activity would underestimate the measured standard metabolic rate. High cost activity occurred in only one experiment out of three at 8°C, low cost activity hardly at all at 20°C, whereas at 15°C both forms of activity were present in five of the seven experiments conducted. Thus, not only the intensity but also the pattern of activity is affected by environmental temperature.     

血栓弹力图评价心力衰竭合并肺部感染患者凝血状态的价值研究

摘要 目的：探讨血栓弹力图（TEG）评价心力衰竭合并肺部感染患者凝血状态的价值。方法：选取来我院就诊的心力衰竭合并肺部感染患者70例作为研究组,同时选取非心力衰竭合并肺部感染并且无凝血相关疾病患者70例作为对照组。检测常规凝血相关指标、血小板指标以及TEG相关参数,分析TEG相关参数与常规凝血检查指标和血小板指标之间的相关性。以超声检查血栓是否发生为判断标准,对常规凝血检查指标、血小板指标和TEG参数分别进行回归分析,得到回归分析方程后绘制ROC曲线,比较TEG、常规凝血检查和血小板指标评价心力衰竭合并肺部感染患者凝血状态的效能。结果：研究组PT、TT和APTT、PLT水平较对照组显著降低,FIB和D-D较对照组显著升高,差异均具有统计学意义（P<0.05）。研究组中R值、K值较对照组显著下调,而α角和MA值较对照组显著上调,差异具有统计学意义（P<0.05）。R值与PT、 TT以及APTT呈正相关（P<0.05）;K值与FIB呈负相关,与APTT、PLT呈正相关（P<0.05）;α角与FIB、D-D呈正相关,与PLT呈负相关（P<0.05）;MA值与PT、 PLT呈负相关,与FIB呈正相关（P<0.05）。ROC曲线显示,APTT、 D-D、PLT诊断血栓的曲线下面积、特异度和灵敏度均小于TEG。结论：相比于传统常规凝血检查和血小板检查,TEG可以更加全面反映心力衰竭合并肺部感染患者的凝血状态,快速准确地判断心力衰竭合并肺部感染患者是否发生血栓。     

The routine metabolic rate of mulloway (Argyrosomus japonicus: Sciaenidae) and yellowtail kingfish (Seriola lalandi: Carangidae) acclimated to six different temperatures

This study compared the mass-specific routine metabolic rate (RMR) of similar sized mulloway (Argyrosomus japonicus), a sedentary species, and yellowtail kingfish (Seriola lalandi), a highly active species, acclimated at one of several temperatures ranging from 10–35 °C. Respirometry was carried out in an open-top static system and RMR corrected for seawater–atmosphere O₂ exchange using mass-balance equations. For both species RMR increased linearly with increasing temperature (T). RMR for mulloway was 5.78T − 29.0 mg O₂ kg^− 0.8 h^− 1 and for yellowtail kingfish was 12.11T − 39.40 mg O₂ kg^− 0.8 h^− 1. The factorial difference in RMR between mulloway and yellowtail kingfish ranged from 2.8 to 2.2 depending on temperature. The energetic cost of routine activity can be described as a function of temperature for mulloway as 1.93T − 9.68 kJ kg^− 0.8 day^− 1 and for yellowtail kingfish as 4.04T − 13.14 kJ kg^− 0.8 day^− 1. Over the full range of temperatures tested Q₁₀ values were approximately 2 for both species while Q₁₀ responses at each temperature increment varied considerably with mulloway and yellowtail kingfish displaying thermosensitivities indicative of each species respective niche habitat. RMR for mulloway was least thermally dependent at 28.5 °C and for yellowtail kingfish at 22.8 °C. Activation energies (E_a) calculated from Arrhenius plots were not significantly different between mulloway (47.6 kJ mol^− 1) and yellowtail kingfish (44.1 kJ mol^− 1).     

GCS评分联合血清TSPO、RANTES对重型颅脑损伤患者去骨瓣减压术后短期死亡的预测价值

摘要 目的：探讨格拉斯哥昏迷量表（GCS）评分联合血清转位蛋白（TSPO）、受激活调节正常T细胞表达和分泌因子（RANTES）对重型颅脑损伤（sTBI）患者去骨瓣减压术（DC）后短期死亡的预测价值。方法：选取2019年1月～2022年7月新疆医科大学第四附属医院重症医学科收治的102例接受DC的sTBI患者,根据30 d（短期）预后情况分为死亡组和存活组。计算GCS评分和检测血清TSPO、RANTES水平。采用多因素Logistic回归分析sTBI患者DC后短期死亡的影响因素,采用受试者工作特征（ROC）曲线分析GCS评分和血清TSPO、RANTES水平对sTBI患者DC后短期死亡的预测价值。结果：102例sTBI患者DC后30 d死亡率为30.39%（31/102）。与存活组比较,死亡组GCS评分降低,血清TSPO、RANTES水平升高（P＜0.05）。死亡组合并多发伤、受伤至手术时间≥6 h、瞳孔散大、颅内血肿量≥40 mL、中线移位≥5 mm比例高于存活组（P＜0.05）。多因素Logistic回归分析显示,受伤至手术时间≥6 h、瞳孔散大、中线移位≥5 mm、TSPO和RANTES升高为sTBI患者DC后短期死亡的独立危险因素,GCS评分增加为其独立保护因素（P＜0.05）。ROC曲线分析显示,GCS评分联合血清TSPO、RANTES预测sTBI患者DC后短期死亡的曲线下面积大于GCS评分和血清TSPO、RANTES单独预测（P＜0.05）。结论：GCS评分和血清TSPO、RANTES水平与sTBI患者DC后短期死亡独立相关,GCS评分联合血清TSPO、RANTES预测sTBI患者DC后短期死亡的价值较高,可能成为sTBI患者DC后短期死亡的辅助预测指标。     

Concordance of cancer drug therapy information derived from routinely collected hospital admissions data and the Systemic Anti-Cancer Therapy (SACT) dataset,for older women diagnosed with early invasive breast cancer in England

BackgroundEvaluating uptake of oncological treatments, and subsequent outcomes, depends on data sources containing accurate and complete information about cancer drug therapy (CDT). This study aimed to evaluate the consistency of CDT information in the Hospital Episode Statistics Admitted Patient Care (HES-APC) and Systemic Anti-Cancer Therapy (SACT) datasets for early invasive breast cancer (EIBC).MethodsThe study included women (50 + years) diagnosed with EIBC in England from 2014 to 2019 who had surgery within six months of diagnosis. Concordance of CDT recorded in HES-APC (identified using OPCS codes) and SACT was evaluated at both patient-level and cycle-level. Factors associated with CDT use captured only in HES-APC were assessed using statistical models.ResultsThe cohort contained 129,326 women with EIBC. Overall concordance between SACT and HES-APC on CDT use was 94 %. Concordance increased over the study period (91–96 %), and there was wide variation across NHS trusts (lowest decile of trusts had concordance≤77 %; highest decile≥99 %). Among women receiving CDT, 9 % (n = 2781/31693) of use was not captured in SACT; incompleteness was worst (18 %=47/259) among women aged 80 + and those diagnosed in 2014 (21%=1121/5401). OPCS codes in HES-APC were good at identifying patient-level and cycle-level use of trastuzumab or FEC chemotherapy (fluorouracil, epirubicin, cyclophosphamide), with 89 % and 93 % concordance with SACT respectively (patient-level agreement). Among cycles of solely oral CDT recorded in SACT, only 24 % were captured in HES-APC, compared to 71 % for intravenous/subcutaneous CDT.ConclusionsCombining information in HES-APC and SACT provides a more complete picture of CDT treatment in women aged 50 + receiving surgery for EIBC than using either data source alone. HES-APC may have particular value in identifying CDT use among older women, those diagnosed less recently, and in NHS trusts with low SACT data returns.     

Temperature preferences and oxygen consumption of three species of sculpin (Cottus) from the Pit River drainage,California

Synopsis I examined the temperature preferences and routine metabolic rates of Pit sculpin, Cottius pitensis, marbled sculpin, C. klamathensis macrops, and rough sculpin, C. asperrimus, of the Pit River drainage of California to determine if the distributional patterns of these species can be explained on the basis of physiological or behavioral responses to temperature. The routine metabolic rates of these species did not increase significantly between 10 and 15°C, indicating an area of thermal compensation. Metabolic rates then rapidly increased between 15 and 20°C (Q₁₀ values>4.0) followed by little increase between 20 and 25°C (Q₁₀ values >2.0), indicating another area of thermal compensation. The final temperature preferenda of Pit, marbled and rough sculpin were 11.2, 12.1 and 13.5°C, respectively. Marbled and rough sculpin appear to be more stenothermal than Pit sculpin. At acclimation temperatures of 10, 15 and 20°C the acute preferred temperatures of marbled and rough sculpin ranged from 11.1 to 14.7° C and 13.3 to 14.4°C, respectively. Values for Pit sculpin ranged from 9.9 to 16.4°C at acclimation temperatures of 10, 15 and 20°C. The distributions of marbled and rough sculpin are consistent with their behavioral and metabolic responses to temperature. The widespread distribution of Pit sculpin is consistent with its greater tolerance of high temperatures and eurythermal behavior, but the absence of Pit sculpin from habitats dominated by marbled and rough sculpin is not consistent with a temperature related explanation.     

Temperature-dependent physiological and biochemical responses of the marine medaka Oryzias melastigma with consideration of both low and high thermal extremes

This study aimed to investigate temperature effect on physiological and biochemical responses of the marine medaka Oryzias melastigma larvae. The fish were subjected to a stepwise temperature change at a rate of 1 °C/h increasing or decreasing from 25 °C (the control) to six target temperatures (12, 13, 15, 20, 28 and 32 °C) respectively, followed by a 7-day thermal acclimation at each target temperature. The fish were fed ad libitum during the experiment. The results showed that cumulative mortalities were significantly increased at low temperatures (12 and 13 °C) and at the highest temperature (32 °C). For the survivors, their growth profile closely followed the left-skewed ‘thermal performance curve’. Routine oxygen consumption rates of fish larvae were significantly elevated at 32 °C but suppressed at 13 and 15 °C (due to a high mortality, larvae from 12 °C were not examined). Levels of heat shock proteins and activities of malate dehydrogenase and lactate dehydrogenase were also measured in fish larvae exposed at 15, 25 and 32 °C. The activities of both enzymes were significantly increased at both 15 and 32 °C, where the fish larvae probably suffered from thermal discomfort and increased anaerobic components so as to compensate the mismatch of energy demand and supply at these thermal extremes. Coincidently, heat shock proteins were also up-regulated at both 15 and 32 °C, enabling cellular protection. Moreover, the critical thermal maxima and minima of fish larvae increased significantly with increasing acclimation temperature, implying that the fish could develop some degrees of thermal tolerance through temperature acclimation.