AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranso...AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein > 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP.展开更多
从花生种子中分离纯化花生过敏原Ara h 2,采用酶联免疫吸附试验(ELISA)、圆二色谱(CD)、ANS荧光探针及紫外可见(UV-Vis)光谱等方法,系统研究热加工对Ara h 2抗原性和结构的影响。结果表明:Ara h 2蛋白经55或70℃处理后其抗原性略有升高,...从花生种子中分离纯化花生过敏原Ara h 2,采用酶联免疫吸附试验(ELISA)、圆二色谱(CD)、ANS荧光探针及紫外可见(UV-Vis)光谱等方法,系统研究热加工对Ara h 2抗原性和结构的影响。结果表明:Ara h 2蛋白经55或70℃处理后其抗原性略有升高,经85,100或115℃处理后,其抗原性显著降低,且随着温度和时间的增加其抗原性均不断降低。CD色谱分析表明,Ara h 2经热处理后其二级结构发生变化;ANS荧光探针光谱显示,不同的热处理均导致Ara h 2表面疏水性增加。紫外光谱显示,不同温度对Ara h 2处理30 min后(除55℃外),其紫外吸收值均升高。Ara h 2经100℃处理不同时间后,其紫外吸收值均有增加。由此推断,花生过敏原Ara h 2的构象改变导致了其抗原性的降低。展开更多
近似数量系统(Approximate Number System,ANS)指个体在不需要依赖于计算和数量符号的情况下,对一组数量进行近似表征的系统。通过总结近十年来研究者们在ANS的遗传和神经基础、干预训练等方面取得的新进展,指出未来应综合运用各种认知...近似数量系统(Approximate Number System,ANS)指个体在不需要依赖于计算和数量符号的情况下,对一组数量进行近似表征的系统。通过总结近十年来研究者们在ANS的遗传和神经基础、干预训练等方面取得的新进展,指出未来应综合运用各种认知神经科学研究手段立足于ANS的基因和脑生理基础研究,进一步揭示ANS的本质和内在发生发展机制,并将有关研究发现运用到教育教学中,对数学困难儿童进行干预,以提高其数学能力和适应社会的能力。展开更多
基金Supported by a research grant of the University Hospitals of Geneva(to Bühler L)
文摘AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein > 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP.
文摘从花生种子中分离纯化花生过敏原Ara h 2,采用酶联免疫吸附试验(ELISA)、圆二色谱(CD)、ANS荧光探针及紫外可见(UV-Vis)光谱等方法,系统研究热加工对Ara h 2抗原性和结构的影响。结果表明:Ara h 2蛋白经55或70℃处理后其抗原性略有升高,经85,100或115℃处理后,其抗原性显著降低,且随着温度和时间的增加其抗原性均不断降低。CD色谱分析表明,Ara h 2经热处理后其二级结构发生变化;ANS荧光探针光谱显示,不同的热处理均导致Ara h 2表面疏水性增加。紫外光谱显示,不同温度对Ara h 2处理30 min后(除55℃外),其紫外吸收值均升高。Ara h 2经100℃处理不同时间后,其紫外吸收值均有增加。由此推断,花生过敏原Ara h 2的构象改变导致了其抗原性的降低。
文摘近似数量系统(Approximate Number System,ANS)指个体在不需要依赖于计算和数量符号的情况下,对一组数量进行近似表征的系统。通过总结近十年来研究者们在ANS的遗传和神经基础、干预训练等方面取得的新进展,指出未来应综合运用各种认知神经科学研究手段立足于ANS的基因和脑生理基础研究,进一步揭示ANS的本质和内在发生发展机制,并将有关研究发现运用到教育教学中,对数学困难儿童进行干预,以提高其数学能力和适应社会的能力。
