• 【急性肝衰竭的辅助部分原位肝移植。】 复制标题 收藏 收藏
    DOI:10.1016/s0168-8278(97)80109-2 复制DOI
    作者列表:Pereira SP,McCarthy M,Ellis AJ,Wendon J,Portmann B,Rela M,Heaton N,Williams R
    BACKGROUND & AIMS: BACKGROUND/AIMS:Auxiliary partial orthotopic liver transplantation holds potential advantages over conventional orthotopic liver transplantation, but experience with the technique in acute liver failure is limited.

    METHODS:We describe our initial experience in seven patients (4 men, 3 women; mean age 28, range 14-35 years) with acute liver failure (paracetamol 3, non A-E 2, autoimmune 1, Ecstasy 1) who fulfilled criteria for emergency transplantation. Preoperatively, the median international normalised ratio was seven (range 3.4-15), with a creatinine of 123 microM (51-389 microM) and bilirubin 320 microM (61-572 microM). The reasons for performing an auxiliary transplant were the patients' young age and stable preoperative condition (n = 5), or a significant psychiatric history precluding conventional transplantation (n = 2).

    RESULTS:All patients received blood group-matched left (n = 2) or right (n = 5) auxiliary grafts. Median duration of surgery was 8.5 h (7.3-10 h), with blood loss of 8.3 litres (4.6-14.6 litres). Post-transplant, the international normalised ratio and aspartate aminotransferase fell progressively in all patients, with median values at day 7 of 1.4 (1.0-2.4) and 108 IU/1 (78-910 IU/1). Three patients died from sepsis within the first postoperative month. At 2 weeks, four of six patients had partial regeneration of the native liver, which became complete in two of the survivors by 1 year.

    CONCLUSIONS:Although patient selection remains poorly defined, auxiliary partial orthotopic liver transplantation in acute liver failure is technically feasible and, in some patients, allows native liver regeneration and eventual immunosuppression withdrawal.

    背景与目标: 背景/目的 : 辅助部分原位肝移植比常规原位肝移植具有潜在的优势,但在急性肝衰竭方面的技术经验有限。
    方法 : 我们描述了7例急性肝衰竭 (扑热息痛3,非A-E 2,自身免疫性1,摇头丸1) 符合标准的患者 (4名男性,3名女性; 平均年龄28岁,范围14-35岁) 的初步经验。紧急移植。术前,国际标准化比率中位数为7 (范围3.4-15),肌酐为123微米 (51-389微米),胆红素320微米 (61-572微米)。进行辅助移植的原因是患者的年龄较小且术前状况稳定 (n = 5),或者有明显的精神病史而无法进行常规移植 (n = 2)。
    结果 : 所有患者均接受了血型匹配的左 (n = 2) 或右 (n = 5) 辅助移植物。手术的中位持续时间为8.5小时 (7.3-10小时),失血量为8.3升 (4.6-14.6升)。移植后,所有患者的国际标准化比率和天冬氨酸转氨酶均逐渐下降,在1.4第7天 (1.0-2.4) 和108 IU/1 (78-910 IU/1) 的中位数。术后第一个月内有3名患者死于败血症。在2周时,六名患者中有四名患者的天然肝脏部分再生,其中两名幸存者在1年内完全再生。
    结论 : 尽管患者选择的定义仍然很差,在急性肝衰竭中进行辅助部分原位肝移植在技术上是可行的,并且在某些患者中,允许天然肝脏再生并最终退出免疫抑制。
  • 【大量摄入硬币后的锌毒性。】 复制标题 收藏 收藏
    DOI:10.1097/00000433-199706000-00008 复制DOI
    作者列表:Bennett DR,Baird CJ,Chan KM,Crookes PF,Bremner CG,Gottlieb MM,Naritoku WY
    BACKGROUND & AIMS: This is the first reported case of human fatality associated with zinc intoxication following a massive ingestion of coins. Four hundred and sixty-one coins were removed form the gastrointestinal tract of a schizophrenic patient during the course of hospitalization. Many of the post-1981 pennies, which consist primarily of zinc, showed severe corrosion due to their prolonged contact with acidic gastric juice. The patient presented with clinical manifestations consistent with the local corrosive as well as systemic effects of zinc intoxication and died 40 days after admission with multi-system organ failure. Tissue samples of the kidneys, pancreas, and liver obtained at autopsy revealed acute tubular necrosis, mild fibrosis, and acute massive necrosis, respectively, and contained high levels of zinc. The overall effects of zinc intoxication on the various organ systems, possible hematological derangement, and the impairment of copper absorption as well as the outcome with treatment are discussed.

    背景与目标: 这是首次报道的大量摄入硬币后与锌中毒相关的人类死亡病例。在住院期间,从精神分裂症患者的胃肠道中取出了四百六十一枚硬币。许多主要由锌组成的1981后便士由于长时间与酸性胃液接触而显示出严重的腐蚀。患者的临床表现与锌中毒的局部腐蚀性和全身作用一致,入院后40天死于多系统器官衰竭。尸检时获得的肾脏,胰腺和肝脏的组织样本分别显示急性肾小管坏死,轻度纤维化和急性大面积坏死,并且含有高水平的锌。讨论了锌中毒对各种器官系统的总体影响,可能的血液学紊乱以及铜吸收的障碍以及治疗结果。
  • 【通过血管内超声记录不稳定型心绞痛和急性心肌梗死中冠状动脉小动脉粥样硬化斑块上的血栓。】 复制标题 收藏 收藏
    DOI:10.1016/s0002-9149(97)00199-9 复制DOI
    作者列表:Birnbaum Y,Luo H,Fishbein MC,Samuels B,Siegel RJ
    BACKGROUND & AIMS: Rupture of atheromatous plaques leading to acute coronary syndromes usually occur in lipid-reach and well-developed coronary lesions. We describe 2 unusual patients with acute coronary syndromes in whom there was angiographic and intravascular ultrasound evidence of an intraluminal thrombus overlying a small, nonocclusive plaque in an enlarged coronary artery.

    背景与目标: 导致急性冠状动脉综合征的动脉粥样硬化斑块破裂通常发生在脂质到达和发达的冠状动脉病变中。我们描述了2例不寻常的急性冠状动脉综合征患者,其中有血管造影和血管内超声证据表明腔内血栓覆盖了扩大的冠状动脉中的一个小的非闭塞斑块。
  • 【在急性护理环境中,护士在照顾病态肥胖患者时面临的挑战。】 复制标题 收藏 收藏
    DOI:10.1016/j.soard.2005.06.003 复制DOI
    作者列表:Drake D,Dutton K,Engelke M,McAuliffe M,Rose MA
    BACKGROUND & AIMS: BACKGROUND:Despite increasing numbers of morbidly obese patients admitted to acute care facilities for surgery or treatment of nonsurgical conditions, there is little evidence of the problems nurses face in providing care to these patients. Anecdotal evidence suggests that the care of these patients is more demanding than the care of nonobese patients. The objective of this study was to describe nurses' perceptions of the challenges that they face when caring for morbidly obese patients. METHODS:Focus groups of nurses from a tertiary care facility were convened. A trained facilitator posed questions to the group concerning various aspects of care for morbidly obese patients. Comments of respondents were categorized using NVIVO software. RESULTS:Nurses reported concerns about the increased staffing needs required for care of these patients and the particular challenges of the physical care. Concerns also included the availability, placement, and use of specialized equipment. Room size and the absence of some equipment were also problematic. Finally, nurses perceived safety issues, both for themselves and their patients. CONCLUSIONS:Morbidly obese patients in the acute care setting require specialized nursing care in terms of techniques, levels of staffing required, and the use of specialized equipment.
    背景与目标:
  • 【穿孔素介导的急性心肌炎心肌损伤。】 复制标题 收藏 收藏
    DOI:10.1016/0140-6736(90)92486-2 复制DOI
    作者列表:Young LH,Joag SV,Zheng LM,Lee CP,Lee YS,Young JD
    BACKGROUND & AIMS: :Endomyocardial specimens were obtained from 7 patients with acute myocarditis. Immunohistochemical examination of the mononuclear infiltrate showed mainly cytotoxic T lymphocytes and natural killer cells. Perforin (a pore-forming protein found in cytotoxic lymphocytes) was identified in this myocardial lymphocytic infiltrate and electron microscopy showed myocardial cell damage that may have been associated with these perforin containing lymphocytes. The results indicate that in acute idiopathic and viral myocarditis, myocardial damage may be due to the action of perforin-secreting lymphocytes.
    背景与目标: : 从7例急性心肌炎患者中获得心内膜心肌标本。对单核浸润的免疫组织化学检查显示主要是细胞毒性T淋巴细胞和自然杀伤细胞。在这种心肌淋巴细胞浸润中鉴定出穿孔素 (一种在细胞毒性淋巴细胞中发现的成孔蛋白),电子显微镜显示心肌细胞损伤可能与这些含有穿孔素的淋巴细胞有关。结果表明,在急性特发性和病毒性心肌炎中,心肌损伤可能是由于穿孔素分泌淋巴细胞的作用所致。
  • 【压力限制通气期间持续气管气吹入对急性肺损伤家兔肺表面活性物质的影响。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Zhu GF,Zhang W,Zong H,Liang Y
    BACKGROUND & AIMS: BACKGROUND:Pulmonary surfactant dysfunction may contribute to the development of ventilator induced lung injury (VILI). Tracheal gas insufflation (TGI) is a technique in which fresh gas is introduced into the trachea and augment ventilation by reducing the dead space of ventilatory system, reducing ventilatory pressures and tidal volume (V(T)) while maintaining constant partial arterial CO2 pressure (PaCO(2)). We hypothesised that TGI limited peak inspiratory pressure (PIP) and V(T) and would minimize conventional mechanical ventilation (CMV) induced pulmonary surfactant dysfunction and thereby attenuate VILI in rabbits with acute lung injury (ALI). METHODS:ALI was induced by intratracheal administration of lipopolysaccharide in anaesthetized, ventilated healthy adult rabbits randomly assigned to continuous TGI at 0.5 L/min (TGI group) or CMV group (n = 8 for each group), and subsequently ventilated with limited PIP and V(T) to maintain PaCO(2) within 35 to 45 mmHg for 4 hours. Physiological dead space to V(T) ratio (V(D)/V(T)), dynamic respiratory compliance (Cdyn) and partial arterial O(2) pressure (PaO(2)) were monitored. After ventilation, lungs were analysed for total phospholipids (TPL), total proteins (TP), pulmonary surfactant small to large aggregates ratio (SA/LA) in bronchoalveolar lavage fluid (BALF) and for determination of alveolar volume density (V(V)), myeloperoxidase and interleukin (IL)-8. RESULTS:TGI resulted in significant (P < 0.05 or P < 0.01) decrease in PIP [(22.4 +/- 1.8) cmH2O vs (29.5 +/- 1.1) cmH2O], V(T) [(6.9 +/- 1.3) ml/kg vs (9.8 +/- 1.11) ml/kg], V(D)/V(T) [(32 +/- 5)% vs (46 +/- 2)%], TP [(109 +/- 22) mg/kg vs (187 +/- 25) mg/kg], SA/LA (2.5 +/- 0.4 vs 5.4 +/- 0.7), myeloperoxidase [(6.2 +/- 0.5) U/g tissue vs (12.3 +/- 0.8) U/g tissue] and IL-8 [(987 +/- 106) ng/g tissue vs (24 +/- 3) mN/m] of BALF, and significant (P < 0.05) increase in Cdyn [(0.47 +/- 0.02) ml.cmH2O(-1).kg(-1) vs (0.31 +/- 0.02) ml.cmH2O(-1).kg(-1)], PaO(2) [(175 +/- 24) mmHg vs (135 +/- 26) mmHg], TPL/TP (52 +/- 8 vs 33 +/- 11) and Vv (0.65 +/- 0.05 vs 0.44 +/- 0.07) as compared with CMV. CONCLUSIONS:In this animal model of ALI, TGI decreased ventilatory requirements (PIP, V(T) and V(D)/V(T)), resulted in more favourable alveolar pulmonary surfactant composition and function and less severity of lung injury than CMV. TGI in combination with pressure limited ventilation may be a lung protective strategy for ALI.
    背景与目标:
  • 【在体内31P MRS评估更昔洛韦对稳定表达单纯疱疹胸苷激酶基因的C6神经胶质瘤的毒性。】 复制标题 收藏 收藏
    DOI:10.1002/(SICI)1099-1492(199612)9:8<364::AID-NBM436 复制DOI
    作者列表:Stegman LD,Ben-Yoseph O,Freyer JP,Ross BD
    BACKGROUND & AIMS: :Phosphorus MRS was evaluated as a monitor of tumour therapeutic response to the herpes simplex virus thymidine kinase suicide gene therapy paradigm. In vivo 31P spectra were obtained from subcutaneous rat C6 gliomas constitutively expressing the HSVtk gene post treatment with ganciclovir (GCV, 15 mg/kg i.p., twice-daily). Significant regression (p < 0.1) of tumour volume was observed 10 days after beginning GCV administration. However, no changes in tumour pH or energy metabolites from pre-treatment values were observed. High-resolution 31P spectra of tumour extracts revealed a statistically significant reduction in the phosphocholine to phosphoethanolamine ratio six days post-GCV administration. These results indicate that the HSVtk/GCV-induced killing of tumours is not associated with corresponding changes in 31P MRS-observable energy metabolites and pH. The observed reduction in the PE/PC ratio may provide a non-invasive in vivo indicator of therapeutic efficacy.
    背景与目标: : 磷MRS被评估为对单纯疱疹病毒胸苷激酶自杀基因治疗范例的肿瘤治疗反应的监测仪。体内31p光谱是从用更昔洛韦治疗后组成性表达HSVtk基因的皮下大鼠C6神经胶质瘤获得的 (GCV,15 mg/kg i.P.,每天两次)。在开始GCV给药10天后观察到肿瘤体积的显著回归 (p <0.1)。然而,未观察到肿瘤pH或能量代谢物与治疗前值的变化。肿瘤提取物的高分辨率31p光谱显示,GCV给药六天后,磷酸胆碱与磷酸乙醇胺的比率在统计学上显着降低。这些结果表明,HSVtk/GCV诱导的肿瘤杀伤与31P MRS可观察到的能量代谢产物和pH的相应变化无关。观察到的PE/PC比率的降低可能提供治疗功效的非侵入性体内指标。
  • 【儿童急性囊尾性脑膜炎: 对吡喹酮的反应。】 复制标题 收藏 收藏
    DOI:10.1080/02724936.1997.11747856 复制DOI
    作者列表:Visudhiphan P,Chiemchanya S
    BACKGROUND & AIMS: :Acute purulent meningitis as a manifestation of cerebral cysticercosis is uncommon. We report two children aged 12 months and 3 years who presented with clinical signs of acute meningitis and whose initial cerebrospinal fluid (CSF), except for negative culture, was typical of purulent meningitis. However, eosinophils were present in subsequent examinations of the CSF and the haemagglutination titre for cysticercus rose. Praziquantel was given to both children with dramatic improvement in clinical and CSF findings.
    背景与目标: : 急性化脓性脑膜炎作为脑囊虫病的表现并不常见。我们报告了两名年龄分别为12个月和3岁的儿童,他们表现出急性脑膜炎的临床症状,除阴性培养外,其初始脑脊液 (CSF) 是化脓性脑膜炎的典型表现。然而,在随后的CSF检查中存在嗜酸性粒细胞,并且囊尾蚴的血凝滴度上升。对两名临床和CSF表现均显着改善的儿童均给予吡喹酮。
  • 【JTE-607是一种多种细胞因子产生抑制剂,可改善SCID小鼠异种移植急性髓细胞性白血病模型中的疾病。】 复制标题 收藏 收藏
    DOI:10.1016/j.exphem.2006.05.016 复制DOI
    作者列表:Uesato N,Fukui K,Maruhashi J,Tojo A,Tajima N
    BACKGROUND & AIMS: OBJECTIVE:Accumulating findings suggest that in acute myeloid leukemia (AML) patients, proinflammatory cytokines and growth factors play important roles in the proliferation and survival of AML cells in an autocrine and paracrine manner, leading to deterioration of AML. JTE-607 is a multiple cytokine inhibitor that potently suppresses production of proinflammatory cytokines. In the present study, we investigated the potency of JTE-607 as an antileukemic agent by exploiting a SCID mouse acute leukemia model. METHODS:SCID mice injected with anti-asialo-GM1 antibody were exposed to sublethal total-body irradiation at a dose of 3 Gy and then inoculated intravenously with AML cells. JTE-607 was administered using osmotic minipumps. The effects of JTE-607 on mouse survival time, human interleukin (IL)-8 levels in mouse plasma, and proportion of human CD45(+) cells in the bone marrow were studied. RESULTS:The survival time of the mice was strictly dependent on the number of U-937 cells proliferating in vivo. Administration of JTE-607 during the initial 7 days significantly prolonged survival of the mice, suggesting killing activity of JTE-607 against AML cells in vivo. Delayed administration of JTE-607 also prolonged the survival of mice bearing established leukemia with an effect comparable to the maximum tolerable dose of cytarabine. Flow cytometer analysis of bone marrow cells revealed decreased number of human CD45(+) cells. Human IL-8 level was also reduced by JTE-607. CONCLUSION:Our results indicate that JTE-607 has potential to be a new class of antileukemic drug that exerts inhibitory activities against both the proliferation and proinflammatory cytokine production of AML cells.
    背景与目标:
  • 【神经细胞粘附分子 (CD56) 阳性急性骨髓性白血病和骨髓增生异常综合征。】 复制标题 收藏 收藏
    DOI:10.1093/ajcp/107.6.653 复制DOI
    作者列表:Mann KP,DeCastro CM,Liu J,Moore JO,Bigner SH,Traweek ST
    BACKGROUND & AIMS: The CD56 antigen is normally expressed on natural-killer cells but has additionally been shown to be present on a variety of hematologic malignancies, including a subset of acute myelogenous leukemia (AML). There is disagreement, however, about its prognostic significance and its association with specific cytogenetic abnormalities. All clinical samples from June 1994, through September 1995, with increased myeloblasts were analyzed by multiparameter flow cytometry for anomalous expression of CD56. Patients with CD56+ blast cells were selected, and morphologic review was performed. Clinical information was obtained, and cytogenetic data were reviewed. Southern blot analysis to detect rearrangement of the mixed lineage leukemia (MLL) gene was performed when possible. The samples from 23 of 114 patients studied demonstrated anomalous expression of CD56 on myeloblasts, including patients with AML, myelodysplastic syndromes (MDS), and chronic myelogenous leukemia in blast crisis. The samples from 10 of 15 patients with CD56+ AML demonstrated at least partial monocytic differentiation. Dysplastic features were displayed in the samples of 12 patients. Correlation with specific cytogenetic abnormalities was not found. The MLL gene was rearranged in five of 18 patients. Seventeen patients have died, with a median survival of 4.6 months for patients with AML. Three have sustained a complete remission. One has findings of high-grade myelodysplastic syndrome. Two were unavailable for follow-up. Expression of CD56 was found in 20% of patients with increased myeloblasts, including patients with high-grade MDS, chronic myelogenous leukemia in blast crisis, and AML. This phenotype was associated with dysplasia, monocytic differentiation, and rearrangement of the MLL gene.

    背景与目标: CD56抗原通常在自然杀伤细胞上表达,但另外已显示出存在于多种血液系统恶性肿瘤中,包括急性骨髓性白血病 (AML) 的一部分。然而,关于其预后意义及其与特定细胞遗传学异常的关联存在分歧。通过多参数流式细胞术分析了所有来自1995年9月的成髓细胞增加的1994年6月的临床样本中cd56的异常表达。选择CD56 + 原始细胞的患者,并进行形态学检查。获得临床信息,并回顾细胞遗传学数据。在可能的情况下,进行Southern印迹分析以检测混合谱系白血病 (MLL) 基因的重排。来自114例患者中的23例的样本显示出CD56在成髓细胞上的异常表达,包括患有AML,骨髓增生异常综合征 (MDS) 和处于爆炸危机中的慢性粒细胞性白血病的患者。来自15例CD56 AML患者中的10例的样本显示出至少部分单核细胞分化。在12例患者的样本中显示出发育异常的特征。未发现与特定细胞遗传学异常的相关性。18例患者中有5例重排了MLL基因。17名患者死亡,AML患者的中位生存期为4.6个月。三个已经完全缓解。有人发现了高度骨髓增生异常综合征。两个无法进行随访。在20% 的成髓细胞增加的患者中发现了CD56的表达,包括患有高级别MDS,处于爆炸危机中的慢性粒细胞性白血病和AML的患者。这种表型与发育异常,单核细胞分化和MLL基因的重排有关。
  • 【农村综合医院治疗急性精神疾病: 必要性还是选择?】 复制标题 收藏 收藏
    DOI:10.1111/j.1440-1584.2006.00789.x 复制DOI
    作者列表:Hungerford C
    BACKGROUND & AIMS: OBJECTIVE:To identify reasons why rural general practitioners (GPs) treat a large proportion of patients with a primary psychiatric diagnosis in general beds of their local hospitals, and the barriers encountered when providing this treatment. DESIGN:A postal questionnaire was developed and distributed to a sample of rural GPs, asking about the treatment of patients with an acute mental illness in their local hospital. RESULTS:The majority of GPs agreed that they treat the acutely mentally ill in general beds of their local hospital due to lack of availability of, and inability to gain access to, mental health beds in the larger centres; and also to enable ongoing family involvement and continuity of care. Distance factors were identified as least significant. Barriers to providing care to this group of patients included a perceived lack of support by consultant psychiatrists, confidentiality issues, lack of community mental health workers to provide assistance, aggression levels of patients, inappropriate local hospital setting, and lack of confidence of GPs and general hospital nursing staff. CONCLUSION:Addressing these barriers is necessary if rural Australians are to receive a quality of care that is equal to that received by those located in metropolitan Australia. Continuing research in this area is crucial.
    背景与目标:
  • 【急性缺氧对椎动脉和颈内动脉血流的影响。】 复制标题 收藏 收藏
    DOI:10.1113/expphysiol.2012.068015 复制DOI
    作者列表:Ogoh S,Sato K,Nakahara H,Okazaki K,Subudhi AW,Miyamoto T
    BACKGROUND & AIMS: :Hypoxia changes the regional distribution of cerebral blood flow and stimulates the ventilatory chemoreflex, thereby reducing CO2 tension. We examined the effects of both hypoxia and isocapnic hypoxia on acute changes in internal carotid (ICA) and vertebral artery (VA) blood flow. Ten healthy male subjects underwent the following two randomly assigned respiratory interventions after a resting baseline period with room air: (i) hypoxia; and (ii) isocapnic hypoxia with a controlled gas mixture (12% O2; inspiratory mmHg). In the isocapnic hypoxia intervention, subjects were instructed to maintain the rate and depth of breathing to maintain the level of end-tidal partial pressure of CO2 ( ) during the resting baseline period. The ICA and VA blood flow (velocity × cross-sectional area) were measured using Doppler ultrasonography. The was decreased (-6.3 ± 0.9%, P < 0.001) during hypoxia by hyperventilation (minute ventilation +12.9 ± 2.2%, P < 0.001), while was unchanged during isocapnic hypoxia. The ICA blood flow was unchanged (P = 0.429), while VA blood flow increased (+10.3 ± 3.1%, P = 0.010) during hypoxia. In contrast, isocapnic hypoxia increased both ICA (+14.5 ± 1.4%, P < 0.001) and VA blood flows (+10.9 ± 2.4%, P < 0.001). Thus, hypoxic vasodilatation outweighed hypocapnic vasoconstriction in the VA, but not in the ICA. These findings suggest that acute hypoxia elicits an increase in posterior cerebral blood flow, possibly to maintain essential homeostatic functions of the brainstem.
    背景与目标: : 缺氧改变脑血流的区域分布,刺激通气化学反射,从而降低CO2张力。我们检查了缺氧和异血管缺氧对颈内动脉 (ICA) 和椎动脉 (VA) 血流急性变化的影响。10名健康男性受试者在静息基线期后接受了以下两种随机分配的呼吸干预措施: (i) 缺氧; 和 (ii) 用受控气体混合物 (12% O2; 吸气mmHg) 进行等缺血缺氧。在等缺血缺氧干预中,指导受试者在静息基线期间维持呼吸速率和呼吸深度以维持CO2 () 的潮气末分压水平。使用多普勒超声检查测量ICA和VA血流 (速度 × 横截面积)。在过度通气 (分钟通气 + 12.9 ± 2.2%,P <0.001) 的缺氧期间降低 (-6.3 ± 0.9%,P <0.001),而在等缺血缺氧期间保持不变。缺氧时ICA血流量不变 (P = 0.429),VA血流量增加 (+ 10.3 ± 3.1%,P = 0.010)。相反,等缺血缺氧增加了ICA (14.5 ± 1.4%,P <0.001) 和VA血流 (10.9 ± 2.4%,P <0.001)。因此,在VA中,低氧的血管舒张作用超过了低碳酸的血管收缩,但在ICA中却没有。这些发现表明,急性缺氧会引起大脑后部血流量的增加,可能会维持脑干的基本稳态功能。
  • 【羊膜移植治疗急性stevens-johnson综合征和中毒性表皮坏死松解症的适应症和结果: 病例对照研究。】 复制标题 收藏 收藏
    DOI:10.1097/ICO.0b013e31823d02a8 复制DOI
    作者列表:Hsu M,Jayaram A,Verner R,Lin A,Bouchard C
    BACKGROUND & AIMS: PURPOSE:To evaluate the indications and outcomes of amniotic membrane transplantation (AMT) performed within the first 2 weeks of presentation in the management of patients with acute Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). METHODS:A retrospective chart review from January 1998 to May 2011 identified 128 SJS/TEN patients admitted to Loyola University Medical Center Burn intensive care unit. The degree of initial ocular surface inflammation was graded as mild, moderate, or severe within the first 2 weeks of admission. Patients were managed either medically or with amniotic membrane (AM). Outcomes were graded as good [best-corrected visual acuity (BCVA)>20/40], fair (BCVA 20/40 to 20/200 or with ocular surface discomfort, requiring contact lens or reconstructive surgeries), or poor (BCVA<20/200). RESULTS:Of the 182 eyes (91 patients) with documented inpatient eye examinations, 108 eyes (59.4%) had mild or no initial ocular involvement, 37 eyes (20.3%) had moderate, and 37 eyes (20.3%) had severe inflammation. Of the 29 patients (58 eyes) with greater than 1 month of follow-up, 17 patients (33 eyes) were treated with medical management and 13 patients (25 eyes) were treated with early AM. One of the 23 eyes with moderate or severe presentation treated with early AMT (4.3%) resulted in a poor outcome within 3 months compared with 8 of 23 eyes (34.8%) that were medically managed (P=0.022). CONCLUSIONS:We present the first case-control study of the use of AM in the management of acute SJS/TEN. Early use of AMT prevents severe vision loss in SJS/TEN patients with initial moderate or severe ocular surface inflammation.
    背景与目标:
  • 【血清补体C1q在急性缺血性脑卒中诊断中的价值】 复制标题 收藏 收藏
    DOI:10.7754/Clin.Lab.2016.161033 复制DOI
    作者列表:Zhao X,Wang C,Pang B,Zhu Y,Zhang Y
    BACKGROUND & AIMS: BACKGROUND:To investigate the relationship between the levels of serum complement C1q and the risk and severity of acute ischemic stroke, a total of 154 patients with acute ischemic stroke and 42 healthy volunteers as normal controls were enrolled in the present study. METHODS:According to the onset time of stroke, patients were divided into three groups. Using an immune transmission turbidity method, the levels of serum complement C1q were detected to investigate the relationship between the level of serum complement C1q and the incidence and severity of acute ischemic stroke. The risk factors of these groups were calculated using a conditional logistic regression model. The assessment of neurological function impairment was carried out according to the National Institute of Health Stroke Scale. Then correlation anal- ysis was carried out between the level of serum complement C1q among patients with acute ischemic stroke and the degree of neurological function impairment. RESULTS:The results showed that the level of serum complement C1q was higher in the ischemic stroke group than in the control group. Using a conditional logistic regression model it was discovered that serum complement C1q was the independent pathogenic factor of cerebral infarction. There also was a decreasing trend in the level of serum complement C1q with the extension of the onset time and an increasing trend in the level of serum complement C1q with the increase in the maximum diameter of infarction volume. CONCLUSIONS:Serum complement C1q is an independent risk factor for acute outbreak of ischemic stroke, whose level is closely related to the outbreak and infarct size and neurological function impairment.
    背景与目标:
  • 【rooibos (Aspalathus linearis) 中的aspalathin对秀丽隐杆线虫急性氧化应激的改善作用。】 复制标题 收藏 收藏
    DOI:10.1016/j.phymed.2012.10.006 复制DOI
    作者列表:Chen W,Sudji IR,Wang E,Joubert E,van Wyk BE,Wink M
    BACKGROUND & AIMS: :Rooibos leaves and fine stems (Aspalathus linearis; Fabaceae) are increasingly enjoyed as herbal tea, largely in fermented (oxidised) red-brown form, but also in unfermented (unoxidised) green form. Rooibos is rich in antioxidant polyphenols, with the dihydrochalcone, aspalathin, as a major active ingredient. We used Caenorhabditis elegans as model organism to investigate the effect of rooibos extracts against oxidative stress in vivo. In a high glucose environment, C. elegans treated with rooibos extract exhibited an extended lifespan. Furthermore, green rooibos was a more potent antioxidant than red rooibos, probably due to its substantially higher aspalathin content. In addition, rooibos decreased acute oxidative damage caused by the superoxide anion radical generator, juglone, with aspalathin playing a major role in improving the survival rate of C. elegans. Quantitative real-time PCR results demonstrated that aspalathin targets stress and ageing related genes, reducing the endogenous intracellular level of ROS. These findings suggest that rooibos increases stress resistance and promotes longevity under stress, probably mediated via a regulation of the DAF-16/FOXO insulin-like signalling pathway, supporting some of the health claims put forward for rooibos tea.
    背景与目标: : Rooibos的叶子和细茎 (Aspalathus linearis; Fabaceae) 作为凉茶越来越受到欢迎,主要以发酵 (氧化) 的红棕色形式,但也以未发酵 (未氧化) 的绿色形式。Rooibos富含抗氧化剂多酚,其中二氢查耳酮,aspalathin是主要的活性成分。我们使用秀丽隐杆线虫作为模型生物,研究了rooibos提取物对体内氧化应激的影响。在高葡萄糖环境中,用rooibos提取物处理的秀丽隐杆线虫的寿命延长。此外,绿色rooibos是比红色rooibos更有效的抗氧化剂,这可能是由于其aspalathin含量高得多。此外,rooibos降低了由超氧阴离子自由基发生器juglone引起的急性氧化损伤,而aspalathin在提高秀丽隐杆线虫的存活率中起着重要作用。实时定量PCR结果表明,aspalathin靶向应激和衰老相关基因,降低了细胞内ROS的内源性水平。这些发现表明,rooibos可能通过调节DAF-16/FOXO胰岛素样信号通路介导,可以提高应激抵抗力并促进应激状态下的寿命,从而支持rooibos茶提出的一些健康要求。

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