• 【1998-2004年美国风疹和先天性风疹综合征的流行病学特征:没有地方性传播的证据。】 复制标题 收藏 收藏
    DOI:10.1086/505944 复制DOI
    作者列表:Reef SE,Redd SB,Abernathy E,Zimmerman L,Icenogle JP
    BACKGROUND & AIMS: :In 1969, the United States established its national rubella vaccination program. With the success of the program, 32 years later, reports of rubella reached record low numbers. To assess the achievement of elimination of rubella and congenital rubella syndrome (CRS) in the United States, 7 epidemiological criteria were used. Rubella cases reported to the National Notifiable Diseases Surveillance System from 1998 through 2004 and CRS cases reported to the National Congenital Rubella Syndrome Registry from 1998 through 2004 were analyzed. During 1998-2000, the median number of reported rubella cases was 272, whereas, during 2001-2004, the median number reported was 13. The incidence of rubella decreased significantly, from 0.1/100,000 population in 1998 to 0.005/100,000 population in 2004. Since 2001, 5 infants with CRS have been reported--3 were born in 2001, 1 was born in 2003, and 1 was born in 2004. The epidemiological evidence strongly supports the claim that rubella is no longer endemic in the United States. To prevent future rubella outbreaks and CRS cases, current strategies must be maintained.
    背景与目标: :1969年,美国制定了国家风疹疫苗接种计划。随着该计划的成功,在32年后,风疹的报告数量达到了创纪录的低水平。为了评估在美国消除风疹和先天性风疹综合症(CRS)的成就,使用了7种流行病学标准。分析了1998年至2004年向国家法定传染病监测系统报告的风疹病例和1998年至2004年向国家先天性风疹综合症登记处报告的CRS病例。在1998-2000年期间,报告的风疹病例中位数为272,而在2001-2004年期间,报告的风疹病例中位数为13。风疹的发病率显着下降,从1998年的0.1 / 100,000人口下降到2004年的0.005 / 100,000人口自2001年以来,已有5例CRS婴儿被报告为-3出生于2001年,1出生于2003年,1出生于2004年。流行病学证据强烈支持风疹在美国不再流行的说法。为了防止未来的风疹暴发和CRS病例,必须保持当前的策略。
  • 【具有三倍体胎儿的严重先兆子痫患者在20周时表现出明显的四重筛查异常。】 复制标题 收藏 收藏
    DOI:10.1080/14767050600553084 复制DOI
    作者列表:Barsoom MJ,McEntaffer A,Fleming A,Nipper HC
    BACKGROUND & AIMS: :Severe preeclampsia rarely occurs prior to 20 weeks of gestation except in pregnancies with triploidy. The patient reported herein is a 29-year-old primigravida who developed severe preeclampsia at 20 weeks of gestation. Evaluation of the pregnancy demonstrated a markedly abnormal quadruple screen. Amniocentesis demonstrated a fetus with triploidy, despite a normal appearance.
    背景与目标: :严重的先兆子痫很少在妊娠20周之前发生,除非是三倍体妊娠。本文报道的患者是29岁的初产妇,在妊娠20周时发生了严重的先兆子痫。妊娠评估显示出明显的四重筛查异常。羊膜穿刺术显示胎儿具有三倍体,尽管外观正常。
  • 【[青春期女孩淋球菌性阴道炎:性虐待还是意外传播?]。】 复制标题 收藏 收藏
    DOI:10.1016/j.arcped.2012.10.011 复制DOI
    作者列表:Daval-Cote M,Liberas S,Tristan A,Vandenesch F,Gillet Y
    BACKGROUND & AIMS: :Vulvovaginitis is the most frequent gynecologic pathology among prepubertal females. An infectious cause is found in 30% of cases and is highly associated with the presence of vaginal discharge upon examination. Neisseria gonorrhoeae may be one of the causative agents. Since N. gonorrhoeae is a common sexually transmitted disease, sexual abuse should be considered in the pediatric setting. We report the case of a 5-year-old girl with N. gonorrhoeae vulvovaginitis. Her previous history, multiple interviews with the patient and her parents, and clinical examination showed no evidence or signs of sexual abuse. Both parents presented gonorrhea, urethritis for the father and vaginitis for the mother. The discrepancy between pediatric evaluation and the presence of a bacterium associated with sexually transmitted disease led us to consider other means of contamination. Previous studies have shown that other routes of transmission are possible but are often neglected. Hence, contamination can be transmitted by the hands or mostly through passive means (towels, rectal thermometer, etc.). Many epidemics have been noted in group settings with young girls with no evidence of sexual transmission. Therefore, we concluded that this patient's infection was likely an accidental transmission within her family. The acknowledgement of these transmission routes is very important in order to avoid misguided suspicion of sexual abuse and the possible traumatic family and psychosocial consequences.
    背景与目标: :阴道炎是青春期前女性中最常见的妇科病理学。在30%的病例中发现了感染原因,并且与检查时是否存在白带高度相关。淋病奈瑟菌可能是其病原体之一。由于淋病奈瑟氏球菌是一种常见的性传播疾病,因此在儿科环境中应考虑性虐待。我们报告了一名5岁女孩患有淋病奈瑟菌性阴道炎的病例。她以前的病史,与患者及其父母的多次访谈以及临床检查均未发现任何性虐待迹象或迹象。父母双方均表现为淋病,父亲为尿道炎,母亲为阴道炎。儿科评估和与性传播疾病相关的细菌的存在之间的差异,导致我们考虑其他污染手段。先前的研究表明,其他传播途径也是可能的,但常常被忽略。因此,污染物可以通过手传播,或者主要通过被动方式(毛巾,直肠温度计等)传播。在没有女孩发生性传播迹象的年轻女孩的集体场合中,已经注意到许多流行病。因此,我们得出的结论是,该患者的感染很可能是其家庭内部的意外传播。为了避免误导性怀疑性虐待以及可能造成的家庭和社会心理后果,对这些传播途径的认识非常重要。
  • 【靶向Pfs25的新的基于腺病毒的疫苗载体引发了抑制恶性疟原虫传播的抗体。】 复制标题 收藏 收藏
    DOI:10.1186/s12936-017-1896-7 复制DOI
    作者列表:McGuire KA,Miura K,Wiethoff CM,Williamson KC
    BACKGROUND & AIMS: BACKGROUND:An effective malaria transmission-blocking vaccine (TBV) would be a major advance in the current efforts to eliminate and, ultimately, eradicate malaria. Antibodies against Plasmodium falciparum surface protein, Pfs25, are known to block parasite development in the mosquito vector. However, in initial clinical trials the limited immunogenicity of recombinant Pfs25 protein-in-adjuvant vaccines has been a challenge. METHODS:Novel human adenovirus type 5 (Ad5) vectors were used in heterologous prime boost vaccination strategies to augment the immune response against Pfs25. Specifically, an Ad5 vector that directs expression of full-length, membrane-bound Pfs25 was used as a priming immunization followed by a boost with Ad5 viral particles displaying only the Pfs25 epitope targeted by transmission-blocking antibodies 4B7 and 1D2 (Pfs25 aa 122-134) in hypervariable region 5 of the hexon capsid protein. RESULTS:This heterologous prime-boost vaccine strategy induced antibodies that significantly inhibit P. falciparum transmission to mosquitoes in a standard membrane-feeding assay. Further, immunized mice generated a robust anti-Pfs25 antibody response characterized by higher titer, higher relative avidity and a broader IgG subclass profile than observed with a homologous prime-boost with recombinant Pfs25/alum. CONCLUSION:The data suggest that focusing the immune response against defined epitopes displayed on the viral capsid is an effective strategy for transmission-blocking vaccine development.
    背景与目标: 背景:有效的阻断疟疾传播的疫苗(TBV)将是当前消除并最终消除疟疾的努力中的一项重大进展。已知针对恶性疟原虫表面蛋白Pfs25的抗体可阻断蚊媒中的寄生虫发育。然而,在最初的临床试验中,重组Pfs25蛋白佐剂疫苗的有限的免疫原性一直是一个挑战。
    方法:将新型人类5型腺病毒(Ad5)载体用于异源初免疫苗接种策略,以增强针对Pfs25的免疫应答。具体而言,将指导全长,与膜结合的Pfs25全长表达的Ad5载体用作初免免疫,然后用Ad5病毒颗粒加强免疫,仅显示被传递阻断抗体4B7和1D2靶向的Pfs25表位(Pfs25 aa 122- 134)在六邻体衣壳蛋白的高变区5中。
    结果:这种异源的初免-加强疫苗策略诱导的抗体在标准的膜喂养试验中可显着抑制恶性疟原虫向蚊子的传播。此外,与用重组Pfs25 / alum的同源初免-加强免疫所观察到的相比,免疫的小鼠产生了强大的抗Pfs25抗体应答,其特征在于更高的滴度,更高的相对亲和力和更宽的IgG亚类谱。
    结论:数据表明,针对病毒衣壳上展示的确定表位的免疫反应是阻止传播疫苗发展的有效策略。
  • 【在与未成熟绵羊胎儿长期低氧血症相关的酸血症期间,脑氧输送减少。】 复制标题 收藏 收藏
    DOI:10.1159/000244440 复制DOI
    作者列表:McCrabb GJ,Harding R
    BACKGROUND & AIMS: Our aim was to determine the effects of 12 h of hypoxaemia on cerebral blood flow (CBF) and cerebral O2 delivery in ovine fetuses at 0.6 gestation. During fetal hypoxaemia, induced by reduced uterine blood flow, fetal SaO2 and PaO2 were reduced (p < 0.01) from control values of 77.0 +/- 1.6% and 27.3 +/- 1.0 mm Hg, respectively, to 28.4 +/- 3.4% and 15.6 +/- 0.6 mm Hg; fetal pHa decreased from control values of 7.37 +/- 0.01 to 7.20 +/- 0.02 at 3 h, but returned to control values before 12 h. CBF (ml/min/100 g) was 2.0- to 2.6-fold higher (p < 0.01) than control values during hypoxaemia, but only 1.7-fold higher (p < 0.01) at 3 h when pHa was lowest. Cerebral O2 delivery (ml/min/100 g) was lower (p < 0.01) than control values of 3.15 +/- 0.29 at 1.5h (2.09 +/- 0.36) and 3h (1.84 +/- 0.22) of hypoxaemia and higher 1 h after hypoxaemia had ceased (3.81 +/- 0.22, p < 0.01). We conclude that the ovine fetus at 0.6 gestation is unable to sustain increased CBF and hence maintain cerebral O2 delivery during the first 6 h of hypoxaemia, a time which coincides with acidaemia; in contrast, at 6 and 12 h of hypoxaemia, when pHa was normal, cerebral O2 delivery was similar to control values. Reduced cerebral O2 delivery during the early, acidaemic, stages of hypoxaemia may lead to impaired neural development.

    背景与目标: 我们的目的是确定低氧血症12 h对0.6胎的绵羊胎儿脑血流量(CBF)和脑O2输送的影响。在因子宫血流量减少而引起的胎儿低氧血症期间,胎儿的SaO2和PaO2从对照值分别从控制值77.0 /-1.6%和27.3 /-1.0 mm Hg降低(p <0.01)分别降至28.4 /-3.4%和15.6 / -0.6毫米汞柱;胎儿pHa在3 h时从7.37 /-0.01的控制值降低到7.20 /-0.02,但在12 h之前恢复到控制值。低氧血症期间的CBF(ml / min / 100 g)比对照值高2.0到2.6倍(p <0.01),但在pHa最低的3 h时,CBF仅高1.7倍(p <0.01)。低氧血症1.5h(2.09 /-0.36)和低氧血症3h(1.84 /-0.22)时,脑氧输送量(ml / min / 100 g)低于(3.15 /-0.29)对照值(p <0.01),高于1 h后的对照值低氧血症已经停止(3.81 / 0.22,p <0.01)。我们得出的结论是,妊娠0.6的绵羊胎儿不能维持增加的CBF,因此在低氧血症的前6小时(与酸血症相吻合的时间)内不能维持脑氧的输送。相反,在低氧血症的6小时和12小时,当pHa正常时,脑中O2的输送与对照值相似。低氧血症早期,酸性血症阶段的大脑O2输送减少可能导致神经发育受损。

  • 【在抗微生物耐药性生物的传播研究中定义关联性:研究间定义的差异以及不同方法对研究结论的影响。】 复制标题 收藏 收藏
    DOI:10.1086/668780 复制DOI
    作者列表:Greenblatt RM,Han JH,Nachamkin I,Tolomeo P,Lautenbach E
    BACKGROUND & AIMS: OBJECTIVE:Comparison of studies evaluating patient-to-patient transmission of organisms is difficult, given the lack of standardized criteria. We used fluoroquinolone-resistant Escherichia coli (FQREC) as a model to characterize variability in definitions of relatedness across studies and to evaluate the resultant impact on study conclusions. DESIGN:Narrative review and cohort study. METHODS:The narrative review compared relatedness criteria across studies of FQREC. Additionally, an existing database was used to compare relatedness of isolates on the basis of molecular criteria alone versus molecular plus clinical criteria with different temporal cutoffs (hospitalization overlap of ≥1 day or allowance for nonoverlap of hospitalization dates of ≤7 days or ≤30 days). RESULTS:Forty-six articles met narrative review inclusion criteria. Sixteen studies exclusively utilized molecular criteria to define relatedness. Thirty studies included molecular and clinical criteria. Of these, 6 included temporal data (ie, time period of isolate identification), 10 included patient location, and 14 included proximity and temporal criteria. For the database analysis, 353 patients were colonized with FQREC. There were 2 main clusters containing 48 and 17 related isolates within 49 pulsed-field gel electrophoresis types. Among the clusters, 18.4% of isolates were related by molecular criteria. Incorporating clinical criteria, fewer isolates were considered related: 5.7% of isolates using 30-day criteria, 3.1% using 7-day criteria, and 1.4% using 1-day overlap. CONCLUSIONS:There is considerable variability in definitions of relatedness of FQREC. Utilizing molecular criteria alone to define relatedness overestimates transmission compared with definitions including clinical criteria. Standard definitions of relatedness in studies of antimicrobial-resistant organisms are needed.
    背景与目标: 目的:由于缺乏标准化的标准,很难进行评估患者之间患者对生物体传播的研究。我们使用耐氟喹诺酮的大肠杆菌(FQREC)作为模型来表征研究之间相关性定义的变异性,并评估其对研究结论的影响。
    设计:叙述性回顾和队列研究。
    方法:叙述性回顾比较了FQREC研究中的相关性标准。此外,现有数据库被用来比较分离物的相关性,这些分离物是根据单独的分子标准与具有不同时间界限(住院重叠度≥1天或住院时间不重叠≤7天或≤30天的分子加临床标准)的分子标准与临床标准进行比较的)。
    结果:46篇文章符合叙述性评论纳入标准。十六项研究专门利用分子标准来定义相关性。 30项研究包括分子和临床标准。其中,6个包括时间数据(即,分离株鉴定的时间段),10个包括患者位置,14个包括接近度和时间标准。为了进行数据库分析,将353名患者定植为FQREC。在49个脉冲场凝胶电泳类型中,有2个主要簇,分别包含48个和17个相关分离株。在这些簇中,有18.4%的分离物与分子标准有关。结合临床标准,较少的分离株被认为是相关的:使用30天标准的分离株占5.7%,使用7天标准的分离株占3.1%,使用1天重叠的分离株占1.4%。
    结论:FQREC相关性的定义存在很大差异。与包括临床标准在内的定义相比,仅使用分子标准来定义相关性就高估了传播。在抗药性微生物研究中需要相关性的标准定义。
  • 【在计算机和体外筛选与Tenofovir,Darunavir和Dapivirine的P-糖蛋白相互作用:用于局部预防结直肠HIV传播的抗逆转录病毒药物组合。】 复制标题 收藏 收藏
    DOI:10.1021/acs.molpharmaceut.7b00133 复制DOI
    作者列表:Swedrowska M,Jamshidi S,Kumar A,Kelly C,Rahman KM,Forbes B
    BACKGROUND & AIMS: :The aim of the study was to use in silico and in vitro techniques to evaluate whether a triple formulation of antiretroviral drugs (tenofovir, darunavir, and dapivirine) interacted with P-glycoprotein (P-gp) or exhibited any other permeability-altering drug-drug interactions in the colorectal mucosa. Potential drug interactions with P-gp were screened initially using molecular docking, followed by molecular dynamics simulations to analyze the identified drug-transporter interaction more mechanistically. The transport of tenofovir, darunavir, and dapivirine was investigated in the Caco-2 cell models and colorectal tissue, and their apparent permeability coefficient (Papp), efflux ratio (ER), and the effect of transporter inhibitors were evaluated. In silico, dapivirine and darunavir showed strong affinity for P-gp with similar free energy of binding; dapivirine exhibiting a ΔGPB value -38.24 kcal/mol, darunavir a ΔGPB value -36.84 kcal/mol. The rank order of permeability of the compounds in vitro was tenofovir < darunavir < dapivirine. The Papp for tenofovir in Caco-2 cell monolayers was 0.10 ± 0.02 × 10-6 cm/s, ER = 1. For dapivirine, Papp was 32.2 ± 3.7 × 10-6 cm/s, but the ER = 1.3 was lower than anticipated based on the in silico findings. Neither tenofovir nor dapivirine transport was influenced by P-gp inhibitors. The absorptive permeability of darunavir (Papp = 6.4 ± 0.9 × 10-6 cm/s) was concentration dependent with ER = 6.3, which was reduced by verapamil to 1.2. Administration of the drugs in combination did not alter their permeability compared to administration as single agents. In conclusion, in silico modeling, cell culture, and tissue-based assays showed that tenofovir does not interact with P-gp and is poorly permeable, consistent with a paracellular transport mechanism. In silico modeling predicted that darunavir and dapivirine were P-gp substrates, but only darunavir showed P-gp-dependent permeability in the biological models, illustrating that in silico modeling requires experimental validation. When administered in combination, the disposition of the proposed triple-therapy antiretroviral drugs in the colorectal mucosa will depend on their distinctly different permeability, but was not interdependent.
    背景与目标: :该研究的目的是使用计算机模拟和体外技术评估抗逆转录病毒药物(替诺福韦,达那那韦和达匹韦林)的三重制剂是否与P-糖蛋白(P-gp)相互作用或表现出其他改变通透性的药物药物在大肠黏膜中的相互作用。最初使用分子对接筛选与P-gp的潜在药物相互作用,然后进行分子动力学模拟,以更机械地分析已识别的药物-转运蛋白相互作用。在Caco-2细胞模型和结直肠组织中研究了Tenofovir,darunavir和dapivirine的转运,并评估了它们的表观通透性系数(Papp),流出比(ER)和转运蛋白抑制剂的作用。在计算机模拟中,达匹韦林和达那韦韦对P-gp具有很强的亲和力,并具有类似的结合自由能。达匹韦林的ΔGPB值为-38.24 kcal / mol,达拉韦韦的ΔGPB值为-36.84 kcal / mol。化合物在体外的通透性等级为替诺福韦<达鲁那韦<达匹韦林。 Caco-2细胞单层中替诺福韦的Papp为0.10±0.02×10-6 cm / s,ER =1。对于达匹韦林,Papp为32.2±3.7×10-6 cm / s,但ER = 1.3低于根据计算机分析结果预期。替诺福韦和达匹韦林的转运均不受P-gp抑制剂的影响。达那那韦的吸收渗透率(Papp = 6.4±0.9×10-6 cm / s)与浓度有关,ER = 6.3,维拉帕米将其降至1.2。与作为单一药剂给药相比,组合给药与改变通透性没有关系。总之,计算机模拟,细胞培养和基于组织的分析表明,替诺福韦不与P-gp相互作用且渗透性差,与细胞旁运输机制一致。计算机模拟预测,darunavir和dapivirine是P-gp底物,但只有darunavir在生物学模型中显示P-gp依赖性渗透性,这说明计算机模拟需要实验验证。当联合给药时,拟议的三联疗法抗逆转录病毒药物在结直肠粘膜中的分布将取决于它们明显不同的渗透性,但不是相互依赖的。
  • 【营养性不相容的寄生虫隐孢子虫原位配对重新探讨了分枝杆菌病毒的传播。】 复制标题 收藏 收藏
    DOI:10.1016/j.jviromet.2012.11.025 复制DOI
    作者列表:Brusini J,Robin C
    BACKGROUND & AIMS: :In disease ecology, parasite transmission is a key parameter important at both epidemiological and evolutionary scales. Mycoviruses can be transmitted both horizontally and vertically. Their horizontal transmission is strongly restricted by the host vegetative compatibility system, which controls the outcome of somatic fusion in fungi, and by the same way, may limit mycovirus transmission. However, most of current knowledge and predictive capabilities regarding these host/pathogen systems are derived from studies pairing fungal mycelia on artificial medium. An original bioassay method, using infected mycelia as well as asexual spores, had been developed to assess in situ transmission of Cryphonectria Hypovirus-1 (CHV1), a mycovirus of Cryphonectria parasitica that causes chestnut blight. For every pair of different vegetative compatibility types tested, rates of CHV1 transmission were always superior in situ than in vitro. This study supports the hypothesis that the natural ability of CHV1 to migrate within a fungal population composed of different vegetative compatible types may have been underestimated by in vitro essays. This result offers opportunities for a biological control of fungal diseases with mycoviruses.
    背景与目标: :在疾病生态学中,寄生虫传播是在流行病学和进化尺度上均重要的关键参数。霉菌病毒可以水平和垂直传播。它们的水平传播受到宿主植物相容性系统的强烈限制,该系统控制真菌中体细胞融合的结果,并且以同样的方式可能会限制霉菌病毒的传播。但是,有关这些宿主/病原体系统的大多数当前知识和预测能力均来自在人工培养基上配对真菌菌丝体的研究。已经开发出了一种原始的生物测定方法,该方法利用被感染的菌丝体和无性孢子来评估Cryphonectria Hypovirus-1(CHV1)的原位传播,Cryphonectria Hypovirus-1(CHV1)是一种导致栗枯萎病的寄生性Cryphonectria parasitica的分枝病毒。对于所测试的每对不同的营养相容性类型,CHV1的传播率始终在原位优于在体外。这项研究支持以下假设:体外杂文可能低估了CHV1在由不同营养相容类型组成的真菌种群中迁移的天然能力。该结果提供了用分枝杆菌病毒对真菌疾病进行生物学控制的机会。
  • 【一种创新的流式视频系统,带有视点摄像头,可将手术传输至智能手机和平板电脑:一种教育工具。】 复制标题 收藏 收藏
    DOI:10.1177/1553350617715162 复制DOI
    作者列表:Chaves RO,de Oliveira PAV,Rocha LC,David JPF,Ferreira SC,Santos AASD,Melo RMDS,Yasojima EY,Brito MVH
    BACKGROUND & AIMS: PURPOSE:In order to engage medical students and residents from public health centers to utilize the telemedicine features of surgery on their own smartphones and tablets as an educational tool, an innovative streaming system was developed with the purpose of streaming live footage from open surgeries to smartphones and tablets, allowing the visualization of the surgical field from the surgeon's perspective. The current study aims to describe the results of an evaluation on level 1 of Kirkpatrick's Model for Evaluation of the streaming system usage during gynecological surgeries, based on the perception of medical students and gynecology residents. METHODS:Consisted of a live video streaming (from the surgeon's point of view) of gynecological surgeries for smartphones and tablets, one for each volunteer. The volunteers were able to connect to the local wireless network, created by the streaming system, through an access password and watch the video transmission on a web browser on their smartphones. Then, they answered a Likert-type questionnaire containing 14 items about the educational applicability of the streaming system, as well as comparing it to watching an in loco procedure. This study is formally approved by the local ethics commission (Certificate No. 53175915.7.0000.5171/2016). RESULTS:Twenty-one volunteers participated, totalizing 294 items answered, in which 94.2% were in agreement with the items affirmative, 4.1% were neutral, and only 1.7% answers corresponded to negative impressions. Cronbach's α was .82, which represents a good reliability level. Spearman's coefficients were highly significant in 4 comparisons and moderately significant in the other 20 comparisons. CONCLUSIONS:This study presents a local streaming video system of live surgeries to smartphones and tablets and shows its educational utility, low cost, and simple usage, which offers convenience and satisfactory image resolution, thus being potentially applicable in surgical teaching.
    背景与目标: 目的:为了吸引来自公共卫生中心的医学生和居民在他们自己的智能手机和平板电脑上利用外科手术的远程医疗功能作为教育工具,开发了一种创新的流媒体系统,其目的是将现场录像从开放式手术流向智能手机。和平板电脑,可以从外科医生的角度看到手术区域。本研究旨在根据医学生和妇科住院医师的看法,描述对柯克帕特里克妇科手术流系统使用率评估模型第1级的评估结果。
    方法:由智能手机和平板电脑的妇科手术的实时视频流(从外科医生的角度来看)组成,每位志愿者一个。志愿者们能够通过访问密码连接到流系统创建的本地无线网络,并在智能手机的网络浏览器上观看视频传输。然后,他们回答了一个Likert型问卷,其中包含14个有关流系统的教育适用性的项目,并将其与观看本地程序进行了比较。这项研究已获得当地伦理委员会的正式批准(证书编号53175915.7.0000.5171 / 2016)。
    结果:21名志愿者参加,总共回答294项,其中94.2%与肯定的回答相符,中立的占4.1%,只有1.7%的回答与负面印象相对应。 Cronbach的α为0.82,表示良好的可靠性水平。 Spearman系数在4个比较中高度显着,在其他20个比较中适度。
    结论:本研究为智能手机和平板电脑提供了实时手术的本地流式视频系统,并显示了其教育实用性,低成本和简单易用的特点,提供了便利和令人满意的图像分辨率,因此有可能应用于外科教学。
  • 【越南多代家庭儿童的幽门螺杆菌感染的家族内传播。】 复制标题 收藏 收藏
    DOI:10.1007/s10654-006-9016-y 复制DOI
    作者列表:Nguyen VB,Nguyen GK,Phung DC,Okrainec K,Raymond J,Dupond C,Kremp O,Kalach N,Vidal-Trecan G
    BACKGROUND & AIMS: :This community-based cross-sectional study in 533 participants from 135 households with multiple generations living in the same household aimed at investigating the relationship between Helicobacter pylori infection in children and the other household members. H. pylori infection in children was found significantly associated with the infection in mothers [OR (95% CI): 2.50 (1.19-5.26)], even after being adjusted for sex, age group and sibling number [adjusted OR (95% CI): 2.47 (1.12-5.47)]. It was also significantly associated with the infection in both parents [adjusted OR (95% CI): 4.14 (1.29-13.23)]. No significant association between H. pylori infection in the father, grandparent(s), uncle or aunt with that in their children was found. Results from the present study showed intra-familial transmission in a multi-generation population and supported the hypothesis of person-to-person transmission of H. pylori infection.
    背景与目标: :这项基于社区的横断面研究从135个多代同住家庭中的533名参与者中进行,旨在调查儿童幽门螺杆菌感染与其他家庭成员之间的关系。即使在针对性别,年龄组和同胞人数进行调整后,儿童的幽门螺杆菌感染也与母亲的感染显着相关[OR(95%CI):2.50(1.19-5.26)] [校正后的OR(95%CI ):2.47(1.12-5.47)]。这也与父母双方的感染都显着相关[校正OR(95%CI):4.14(1.29-13.23)]。父亲,祖父母,叔叔或姨妈的幽门螺杆菌感染与子女的幽门螺杆菌感染之间没有显着关联。本研究的结果表明,在多代人群中进行了家族内传播,并支持了幽门螺杆菌感染人际传播的假说。
  • 【体树突状多巴胺传递中的物种差异决定了D2自体受体介导的腹侧被盖区神经元放电的抑制作用。】 复制标题 收藏 收藏
    DOI:10.1523/JNEUROSCI.2745-12.2012 复制DOI
    作者列表:Courtney NA,Mamaligas AA,Ford CP
    BACKGROUND & AIMS: :The somatodendritic release of dopamine within the ventral tegmental area (VTA) and substantia nigra pars compacta activates inhibitory postsynaptic D2-receptors on dopaminergic neurons. The proposed mechanisms that regulate this form of transmission differ between electrochemical studies using rats and guinea pigs and electrophysiological studies using mice. This study examines the release and resulting dopamine D2-autoreceptor-mediated IPSCs (D2-IPSCs) in the VTA of mouse, rat, and guinea pig. Robust D2-IPSCs were observed in all recordings from neurons in slices taken from mouse, whereas D2-IPSCs in rat and guinea pig were observed less frequently and were significantly smaller in amplitude. In slices taken from guinea pig, dopamine release was more persistent under conditions of reduced extracellular calcium. The decline in the concentration of dopamine was also prolonged and not as sensitive to inhibition of reuptake by cocaine. This resulted in an increased duration of D2-IPSCs in the guinea pig. Therefore, unlike the mouse or the rat, the time course of dopamine in the extracellular space of the guinea pig determined the duration the D2-IPSC. Functionally, differences in D2-IPSCs resulted in inhibition of dopamine neuron firing only in slices from mouse. The results suggest that the mechanisms and functional consequences of somatodendritic dopamine transmission in the VTA vary among species. This highlights the complexity that underlies dopamine-dependent transmission in one brain area. Differences in somatodendritic transmission would be expected in vivo to affect the downstream activity of the mesocorticolimbic dopamine system and subsequent terminal release.
    背景与目标: 多巴胺在腹侧被盖区(VTA)和黑质致密部中的体树突状释放可激活多巴胺能神经元上的抑制性突触后D2受体。在使用大鼠和豚鼠进行的电化学研究与使用小鼠进行的电生理研究之间,调节这种传输形式的拟议机制有所不同。这项研究检查了小鼠,大鼠和豚鼠的VTA中多巴胺D2自身受体介导的IPSC(D2-IPSC)的释放和产生。在从小鼠采集的切片中的神经元的所有记录中均观察到了健壮的D2-IPSC,而在大鼠和豚鼠中观察到的D2-IPSC频率较低,并且振幅明显较小。在豚鼠的切片中,在细胞外钙减少的条件下,多巴胺的释放更为持久。多巴胺浓度的下降也延长了,对可卡因抑制再摄取的敏感性不高。这导致豚鼠中D2-IPSC的持续时间增加。因此,与小鼠或大鼠不同,豚鼠细胞外空间中多巴胺的时程决定了D2-IPSC的持续时间。在功能上,D2-IPSC的差异仅导致小鼠切片中多巴胺神经元放电的抑制。结果表明,树突状多巴胺在VTA中传播的机制和功能后果因物种而异。这突显了在一个大脑区域中依赖多巴胺传播的基础的复杂性。预计体内树突状传递的差异会影响中皮层皮质多巴胺系统的下游活性和随后的末端释放。
  • 【在μ阿片受体上抑制阿片类药物的传播会阻止食物寻找和暴饮暴食。】 复制标题 收藏 收藏
    DOI:10.1038/npp.2012.128 复制DOI
    作者列表:Giuliano C,Robbins TW,Nathan PJ,Bullmore ET,Everitt BJ
    BACKGROUND & AIMS: :Endogenous opioids, and in particular μ-opioid receptors, have been linked to hedonic and rewarding mechanisms engaged during palatable food intake. The aim of this study was to investigate the effects of GSK1521498, a novel μ-opioid receptor antagonist, on food-seeking behavior and on binge-like eating of a highly preferred chocolate diet. Food seeking was measured in rats trained to respond for chocolate under a second-order schedule of reinforcement, in which prolonged periods of food-seeking behavior were maintained by contingent presentation of a reward-associated conditioned reinforcer. After reaching a stable baseline in both procedures, animals were treated with GSK1521498 (0.1, 1, and 3 mg/kg; IP) or naltrexone (NTX, 0.1, 1, and 3 mg/kg; SC). The binge eating model was characterized by four temporally contiguous phases: 1-h chow access, 2-h food deprivation, 10-min chow access, and 10-min access to either chocolate-flavoured food or standard chow. During training the rats developed binge-like hyperphagia of palatable food and anticipatory chow hypophagia (anticipatory negative contrast). Both compounds reduced binge-like palatable food hyperphagia. However, GSK1521498 reduced the impact of high hedonic value on ingestion more specifically than NTX, abolishing anticipatory chow hypophagia. GSK1521498 also dose-dependently reduced food seeking both before and after food ingestion, whereas NTX reduced food seeking only after food ingestion. Thus, while both drugs affected the hedonic value of the preferred food, GSK1521498 also directly decreased incentive motivation for chocolate. Selective μ-opioid receptor antagonism by GSK1521498 may have utility as a treatment for reducing maladaptive, palatability-driven eating behavior by reducing the motivational properties of stimuli that elicit the binge eating commonly associated with obesity.
    背景与目标: :内源性阿片类药物,尤其是μ阿片类药物受体,已与可口食物摄入中所享享的享乐和奖励机制有关。这项研究的目的是研究一种新型的μ阿片受体拮抗剂GSK1521498对寻求食物的行为以及暴饮暴食的巧克力饮食的影响。在训练后对巧克力有反应的大鼠中测量食物的觅食能力,其中通过与奖励相关的条件增强剂的偶然性表现来维持长时间的食物寻找行为。在两种方法中均达到稳定的基线后,用GSK1521498(0.1、1和3μmg/ kg; IP)或纳曲酮(NTX,0.1、1和3μmg/ kg; SC)治疗动物。暴饮暴食模型的特征在于四个时间上连续的阶段:1-h饮食,2-h食物匮乏,10分钟的饮食和10分钟的巧克力味食品或标准食物。在训练过程中,大鼠出现了可口食物的暴食状食欲过大和预期的食物不足(预期的负对比)。两种化合物均减少了暴食样可食性食物过多症。但是,GSK1521498比NTX更能降低高享乐值对摄入的影响,从而消除了预期食物的吞咽不足。 GSK1521498还可以在食物摄取之前和之后剂量依赖性地减少食物摄取,而NTX仅在食物摄取之后减少食物摄取。因此,尽管两种药物都影响首选食品的享乐价值,但GSK1521498也直接降低了巧克力的诱因。 GSK1521498的选择性μ阿片类药物受体拮抗作用可通过减少引起肥胖症的暴食饮食的动机来减少不良适应性,适口性驱动的饮食行为。
  • 【胞浆内精子注射后完整的葡萄胎和共存的活胎儿:病例报告和文献复习。】 复制标题 收藏 收藏
    DOI:10.1080/15513815.2019.1710790 复制DOI
    作者列表:Alpay V,Kaymak D,Erenel H,Cepni I,Madazli R
    BACKGROUND & AIMS: :Introduction: Twin pregnancy with complete hydatidiform mole and co-existing fetus (CHMCF) is an uncommon obstetric entity and may occur after assisted reproductive technologies. These pregnancies are associated with severe complications for both mother and fetus and the management is challenging. Case Report: We report a twin pregnancy after intracytoplasmic sperm injection (ICSI) treatment with CHMCF which delivered at 26 gestation weeks due to severe preeclampsia. The 625g neonate survived without any complication. The woman had persistent trophoblastic disease with lung metastasis and was treated with single agent methotrexate. We also present a brief review of the literature about the outcomes of CHMCF after ICSI. Conclusion: CHMCF may occur after ICSI treatment. Pregnancies with CHMCF are associated with severe complications however under close follow-up successful outcomes could be achieved in such pregnancies.
    背景与目标: :简介:双胎妊娠伴完全葡萄胎和胎儿共存(CHMCF)是罕见的产科实体,可能在辅助生殖技术后发生。这些怀孕会给母亲和胎儿带来严重的并发症,并且管理难度很大。病例报告:我们报道,由于严重的先兆子痫,在妊娠26周时分娩了CHMCF的胞浆内单精子注射(ICSI)治疗后双胎妊娠。 625g新生儿存活下来,没有任何并发​​症。该妇女患有持续的滋养细胞疾病,并有肺转移,并接受单药甲氨蝶呤治疗。我们还提供了有关ICSI后CHMCF结局的文献的简要回顾。结论:ICSC治疗后可能发生CHMCF。患有CHMCF的孕妇伴有严重的并发症,但是在密切随访下,此类孕妇可以取得成功的预后。
  • 【与2019年新型冠状病毒相关的家族性肺炎,表明人与人之间的传播:一项家庭聚类的研究。】 复制标题 收藏 收藏
    DOI:10.1016/S0140-6736(20)30154-9 复制DOI
    作者列表:Chan JF,Yuan S,Kok KH,To KK,Chu H,Yang J,Xing F,Liu J,Yip CC,Poon RW,Tsoi HW,Lo SK,Chan KH,Poon VK,Chan WM,Ip JD,Cai JP,Cheng VC,Chen H,Hui CK,Yuen KY
    BACKGROUND & AIMS: BACKGROUND:An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. METHODS:In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. FINDINGS:From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36-66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3-6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6-10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. INTERPRETATION:Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. FUNDING:The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
    背景与目标: 背景:在中国湖北省武汉市,据报道正在发生与新型冠状病毒有关的肺炎暴发。受影响的患者在地理上与当地的潜在市场联系在一起,成为潜在的来源。迄今为止,尚未发布有关人与人或医院间传播的数据。
    方法:在这项研究中,我们报告了五名家庭聚类的流行病学,临床,实验室,放射学和微生物学发现,这些患者在回到中国广东省深圳后,在访问武汉后,出现了不明原因的肺炎。没有去武汉的其他家庭成员。对这些患者的遗传序列进行了系统进化分析。
    结果:从2020年1月10日开始,我们纳入了一个在2019年12月29日至2020年1月4日之间从深圳前往武汉的六名患者的家庭。在前往武汉的六名家庭成员中,有五名被确定感染了新型冠状病毒。此外,一名未去武汉的家庭成员与四名家庭成员接触几天后被该病毒感染。尽管有两个人去过武汉的一家医院,但他们的家人都没有与武汉的市场或动物有任何接触。暴露后3-6天,有5名家庭成员(年龄在36-66岁之间)出现发烧,上呼吸道或下呼吸道症状或腹泻,或出现这两种情况的组合。他们在症状发作后6-10天到我院(香港大学深圳医院,深圳)就诊。他们和一名无症状的儿童(10岁)有放射性玻璃底肺混浊。年龄较大的患者(年龄> 60岁)具有更多的全身症状,广泛的放射学玻璃样肺改变,淋巴细胞减少症,血小板减少症以及C反应蛋白和乳酸脱氢酶水平升高。通过即时点多重RT-PCR,这6例患者的鼻咽或咽拭子对已知的呼吸道细菌呈阴性,但是5例(4个成年人和1个孩子)对编码内部RNA依赖性RNA的基因呈RT-PCR阳性Sanger测序证实了这种新型冠状病毒的聚合酶和表面穗蛋白。通过下一代测序对这五位患者的RT-PCR扩增子和两个完整基因组进行的系统进化分析表明,这是一种新型冠状病毒,最接近于中国马蹄蝠中发现的与蝙蝠严重急性呼吸系统综合症(SARS)相关的冠状病毒。
    解释:我们的发现与这种新型冠状病毒在医院和家庭环境中的人际传播以及在其他地理区域感染旅行者的报告一致。
    资金来源:香港邵逸夫基金会,汤兆坚,呼吸道病毒研究基金会有限公司,许明,许浩和周善兰慈善基金有限公司,李敏慧,香港海南商会华南微生物研究基金,深圳三明医药专案和广东省高等医院计划。
  • 【斑马鱼脊髓运动神经根的透射电子显微镜。】 复制标题 收藏 收藏
    DOI:10.1002/dvdy.24529 复制DOI
    作者列表:Morris AD,Erisir A,Criswell SJ,Kucenas S
    BACKGROUND & AIMS: BACKGROUND:Spinal motor nerves are essential for relaying information between the central and peripheral nervous systems. Perturbations to cell types that comprise these nerves may impair rapid and efficient transmission of action potentials and alter nerve function. Identifying ultrastructural changes resulting from defects to these cellular components via transmission electron microscopy (TEM) can provide valuable insight into nerve function and disease. However, efficiently locating spinal motor nerves in adult zebrafish for TEM is challenging and time-consuming. Because of this, we developed a protocol that allows us to quickly and precisely locate spinal motor nerve roots in adult zebrafish for TEM processing. RESULTS:Following fixation, a transverse slab of adult zebrafish dissected from the trunk region was mounted in embedding media, sectioned, and secondary fixation with osmium tetroxide performed. Transverse sections containing motor nerves were selected for TEM ultrathin sectioning and imaging. CONCLUSIONS:We developed an efficient protocol for locating spinal motor nerves in adult zebrafish to allow for ultrastructural characterization. Although our work focuses on spinal motor nerves, this protocol may be useful for efficiently identifying other discrete, repeated structures within the developing and mature nervous system that are difficult to find via traditional, whole organism TEM processing. Developmental Dynamics 246:956-962, 2017. © 2017 Wiley Periodicals, Inc.
    背景与目标: 背景:脊髓运动神经对于在中枢神经系统和周围神经系统之间传递信息至关重要。对包含这些神经的细胞类型的干扰可能会损害动作电位的快速有效传递并改变神经功能。通过透射电子显微镜(TEM)识别出这些细胞成分的缺陷所导致的超微结构变化,可以为神经功能和疾病的诊断提供有价值的信息。然而,有效地定位成年斑马鱼中的脊髓运动神经以进行TEM既具有挑战性又耗时。因此,我们开发了一种协议,该协议使我们能够快速而精确地定位成年斑马鱼中的脊髓运动神经根,以进行TEM处理。
    结果:固定后,将成年斑马鱼从躯干区域切下的横板固定在包埋介质中,切片,并用四氧化进行二次固定。选择含有运动神经的横断面进行TEM超薄切片和成像。
    结论:我们开发了一种有效的协议,用于定位成年斑马鱼的脊髓运动神经,以便进行超微结构表征。尽管我们的工作集中在脊髓运动神经上,但该协议可能对有效识别发育中和成熟的神经系统中其他离散的,重复的结构非常有用,而这些结构很难通过传统的全机体TEM处理找到。 Developmental Dynamics 246:956-962,2017.©2017 Wiley Periodicals,Inc.

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