不同剂量瑞芬太尼复合小剂量艾司氯胺酮用于腹腔镜妇科手术患者的效果及对麻醉效能、疼痛的影响

摘要 目的：研究不同剂量瑞芬太尼复合小剂量艾司氯胺酮对腹腔镜妇科手术患者麻醉效果的影响。方法：选取2020年4月～2023年2月在本院接受腹腔镜妇科手术治疗的60例患者进行研究,根据瑞芬太尼静脉输注剂量将其分为小剂量组、中剂量组和大剂量组,每组各20例。三组均给予患者小剂量艾司氯胺酮（0.1 μg?kg）,小剂量组给予患者0.1 μg/（Kg?min）瑞芬太尼,中剂量组给予患者0.3 μg/（Kg?min）瑞芬太尼,大剂量组给予患者0.5 μg/（Kg?min）瑞芬太尼。记录三组患者的麻醉起效时间、麻醉诱导时间、拔管时间和不良反应发生率,并检测其不同时间段的血流动力学和疼痛。结果：麻醉起效、麻醉诱导拔管时间比较,三组无显著差异（P＞0.05）。平均动脉压（MAP）和心率（HR）比较,大剂量组和中剂量组T1、T2时间段均低于小剂量组,中剂量组T1、T2时间段低于大剂量组;三组T2时间段MAP、HR水平低于T0、T1时间段,T1时间段低于T0时间段（P＜0.05）。疼痛视觉模拟量表（VAS）评分比较,大剂量组和中剂量组T1、T2时间段均低于小剂量组,中剂量组T1、T2时间段低于大剂量组;三组T2时间段MAP、HR水平低于T0、T1时间段,T1时间段低于T0时间段（P＜0.05）。不良反应发生率比较,三组无显著差异（P＞0.05）。结论：不同剂量瑞芬太尼复合小剂量艾司氯胺酮均能保障腹腔镜妇科手术的麻醉效果和安全性,但中剂量瑞芬太尼的应用更有利于稳定血流动力学,并减轻患者的疼痛程度。     

齿痛消炎灵颗粒联合牙周激光对牙周炎的应用效果及对口气和舌苔指标的影响

摘要 目的：探讨齿痛消炎灵颗粒联合牙周激光对牙周炎的应用效果及对口气和舌苔指标的影响。方法：选取我院2020年7月到2023年7月收治的80例牙周炎患者,分为观察组与对照组,各40例。对照组采取常规治疗与口服齿痛消炎灵颗粒,观察组以对照组为基础,增加牙周激光治疗。对比两组患者临床疗效,对比其治疗前与治疗4周后菌斑指数（PLI）,出血指数（BI）、探诊深度（PD）、临床附着丧失（CAL）相关牙周健康指标,口气感官值（OS）、口腔挥发硫化物（VSCs）相关口气指标以及舌苔厚度（Tt）、舌苔面积（Ta）相关舌苔指标变化。结果：观察组治疗总有效率较对照组高（P＜0.05）;治疗前两组患者CAL、PD、BI、PLI水平对无差异（P＞0.05）,治疗后两组均降低,且与对照组相比,观察组较低（P＜0.05）;治疗前两组患者OS、VSCs水平对比无差异（P＞0.05）,治疗后两组均降低,且与对照组相比,观察组较低（P＜0.05）;治疗前两组患者Tt、Ta评分对比无差异（P＞0.05）,治疗后两组均降低,且观察组较对照组低（P＜0.05）。结论：齿痛消炎灵颗粒联合牙周激光治疗牙周炎效果较好,改善患者牙周健康程度,减少舌苔情况,改善口气情况。     

Laser-heated needle for biopsy tract ablation: In vivo study of rabbit liver biopsy

PurposeTo investigate the efficacy of a newly-developed laser-heated core biopsy needle in the thermal ablation of biopsy tract to reduce hemorrhage after biopsy using in vivo rabbit’s liver model.Materials and methodsFive male New Zealand White rabbits weighed between 1.5 and 4.0 kg were anesthetized and their livers were exposed. 18 liver biopsies were performed under control group (without tract ablation, n = 9) and study group (with tract ablation, n = 9) settings. The needle insertion depth (~3 cm) and rate of retraction (~3 mm/s) were fixed in all the experiments. For tract ablation, three different needle temperatures (100, 120 and 150 °C) were compared. The blood loss at each biopsy site was measured by weighing the gauze pads before and after blood absorption. The rabbits were euthanized immediately and the liver specimens were stained with hematoxylin-eosin (H&E) for further histopathological examination (HPE).ResultsThe average blood loss in the study group was reduced significantly (p < 0.05) compared to the control group. The highest percentage of bleeding reduction was observed at the needle temperature of 150 °C (93.8%), followed by 120 °C (85.8%) and 100 °C (84.2%). The HPE results show that the laser-heated core biopsy needle was able to cause lateral coagulative necrosis up to 14 mm diameter along the ablation tract.ConclusionThe laser-heated core biopsy needle reduced hemorrhage up to 93.8% and induced homogenous coagulative necrosis along the ablation tract in the rabbits’ livers. This could potentially reduce the risk of tumor seeding in clinical settings.     

Progress of Gastric Cancer Surgery in the era of Precision Medicine

With the development of genomics, the update of modern imaging technology and the advent of artificial intelligence and big data, the surgical treatment of gastric cancer has gradually stepped into precision medicine. Precision surgery treatment of gastric cancer is based on accurate molecular typing and staging using modern molecular diagnostic technology and imaging, and the formulation of precise and individualized surgical treatment plans, with the concept of minimally invasive and accelerated rehabilitation surgery running through it. For intermediate-stage gastric cancer, we have adopted a comprehensive treatment approach including traditional radiotherapy and chemotherapy, targeted therapy and immunotherapy. Utilize artificial intelligence and big data technology to improve the standardization and interconnectivity of specialty data and realize the transformation of evidence-based medicine. Promoting the standardization, standardization and individualization of gastric cancer surgical treatment, providing patients with precise diagnosis and treatment, and further improving patients'' prognosis are the opportunities and challenges in the development of gastric cancer surgery.     

Design of a resilient ring for middle ear’s chamber stapes prosthesis

Abstract

This paper presents the process of designing a new elastic element replacing a membrane in the chamber stapes prosthesis (ChSP). The results of the study are volume displacement characteristics obtained for the prosthesis and physiological stapes. Simulation tests on a 3D CAD model have confirmed that a properly designed ring can stimulate perilymph with the same or greater efficacy as the physiological stapes footplate placed on the elastic annular ligament. The ChSP with a new elastic element creates a good chance of improving hearing in patients suffering from otosclerosis.     

Role of oncoproteomics in the personalized management of cancer

Oncoproteomics is the term used to describe the application of proteomic technologies in oncology and parallels the related field of oncogenomics. It is now contributing to the development of personalized management of cancer. Proteomic technologies are used for the identification of biomarkers in cancer, which will facilitate the integration of diagnosis and therapy of cancer. Molecular diagnostics, laser capture microdissection and protein biochips are among the technologies that are having an important impact on oncoproteomics. The discovery of protein patterns developed by the US Food and Drug Administration/National Cancer Institute Clinical Proteomics Program is capable of distinguishing cancer and disease-free states with high sensitivity and specificity and will also facilitate the development of personalized therapy of cancer. Examples of application are given for breast and prostate cancer and a selection of companies and their collaborations that are developing application of proteomics to personalized treatment of cancer are discussed. Continued refinement of techniques and methods to determine the abundance and status of proteins in vivo holds great promise for the future study of normal cells and the pathology of associated neoplasms. Personalized cancer therapy is expected to be in the clinic by the end of the first decade of the 21st century.     

Reverse-phase protein microarray highlights HER2 signaling activation in immunohistochemistry/FISH/HER2-negative breast cancers

Evaluation of: Wulfkuhle JD, Berg D, Wolff C et al. Molecular analysis of HER2 signaling in human breast cancer by functional protein pathway activation mapping. Clin. Cancer Res. 18(23), 6426–6435 (2012).

Exhaustive characterization and mapping of pivotal molecules and downstream effectors deregulated in breast cancer is of fundamental clinical value to define the most effective therapy. Wulfkuhle et al. applied reverse-phase protein microarray, a highly sensitive immunoassay able to perform quantitative and multiplexed analysis of total and/or modified cellular proteins, to assess protein levels and activation/phosphorylation status of the HER family (EGFR, HER2, HER3) and downstream signaling molecules in HER2⁺ and HER2^- breast cancers. The research was performed using laser capture microdissected tumor epithelial cells from frozen samples and formalin-fixed paraffin embedded specimens, which were also analyzed by immunohistochemistry (IHC) and FISH. This study identified a subgroup of IHC/FISH/HER2^- patients with HER2 activation/phosphorylation levels comparable with those obtained from IHC/FISH/HER2⁺ tumors. HER2 signaling activation was independent from total HER2 expression and involved HER3 and EGFR activation. These findings indicate that molecular characterization by reverse-phase protein microarray of HER2 and its partners/effectors in the signaling cascade enables the identification of a subgroup of IHC/FISH/HER2^- patients showing HER2 signaling activation. These patients, currently excluded from targeted therapy administration, could potentially benefit from this and it could improve prognosis and survival.     

Biological insights from hydrogen exchange mass spectrometry

Over the past two decades, hydrogen exchange mass spectrometry (HXMS) has achieved the status of a widespread and routine approach in the structural biology toolbox. The ability of hydrogen exchange to detect a range of protein dynamics coupled with the accessibility of mass spectrometry to mixtures and large complexes at low concentrations result in an unmatched tool for investigating proteins challenging to many other structural techniques. Recent advances in methodology and data analysis are helping HXMS deliver on its potential to uncover the connection between conformation, dynamics and the biological function of proteins and complexes. This review provides a brief overview of the HXMS method and focuses on four recent reports to highlight applications that monitor structure and dynamics of proteins and complexes, track protein folding, and map the thermodynamics and kinetics of protein unfolding at equilibrium. These case studies illustrate typical data, analysis and results for each application and demonstrate a range of biological systems for which the interpretation of HXMS in terms of structure and conformational parameters provides unique insights into function. This article is part of a Special Issue entitled: Mass spectrometry in structural biology.     

A novel immunoproteomics method for identifying in vivo-induced Campylobacter jejuni antigens using pre-adsorbed sera from infected patients

Background

Campylobacter jejuni is an important food-borne and zoonotic pathogen with a worldwide distribution. Humans and chickens are hosts of this pathogen. At present, there is no ideal vaccine for controlling human campylobacteriosis or the carriage of C. jejuni by chickens. Bacterial in vivo-induced antigens are useful as potential vaccine candidates and biomarkers of virulence.

Methods

In this study, we developed a novel systematic immunoproteomics approach to identify in vivo-induced antigens among the total cell proteins of C. jejuni using pre-adsorbed sera from patients infected with C. jejuni.

Results

Overall, 14 immunoreactive spots were probed on a PVDF membrane using pre-adsorbed human sera against C. jejuni. Then, we excised these protein spots from a duplicate gel and identified using MALDI–TOF MS. In total, 14 in vivo-induced antigens were identified using PMF and BLAST analysis. The identified proteins include CadF (CadF-1 and CadF-2), CheW, TufB, DnaK, MetK, LpxB, HslU, DmsA, PorA, ProS, CJBH_0976, CSU_0396 and hypothetical protein cje135_05017. Real-time RT-PCR was performed on 9 genes to compare their expression levels in vivo and in vitro. The data showed that 8 of the 9 analyzed genes were significantly upregulated in vivo relative to in vitro.

Conclusion

We successfully developed a novel immunoproteomics method for identifying in vivo-induced Campylobacter jejuni antigens by using pre-adsorbed sera from infected patients.

General significance

This new analysis method may prove to be useful for identifying in vivo-induced antigens within any host infected by bacteria and will contribute to the development of new subunit vaccines.