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Do Nucleic Acid–Binding Polymers (Nabps) May Be Reduce Proinflammatory Nucleic Acids Among Trauma-Associated Hemorrhagic Shock? 核酸结合聚合物(Nabps)是否可减少创伤性失血性休克中的促炎性核酸?
Pub Date : 2024-05-15 DOI: 10.33140/mcr.09.05.01
Trauma-associated hemorrhagic shock (THS) is the major leading cause of death worldwide with 1.9 million deaths per year. THS accounts for 30–40% of deaths of the patients brought to the emergency room do not survive the first 24 hours [1].
创伤相关性失血性休克(THS)是导致全球每年 190 万人死亡的主要原因。在被送入急诊室的患者中,30%-40%的患者在最初的 24 小时内无法存活,而失血性休克就占了其中的 30%-40%[1]。
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引用次数: 0
Complex Treatment of A Rare Non-Germinomatous Germ Cell Optic-Chiasmal Brain Tumor In An Adolescent Child-A Clinical Case With Literature Review 青少年罕见非肉芽肿性芽胞视神经乳头状脑瘤的复杂治疗--临床病例与文献综述
Pub Date : 2024-04-20 DOI: 10.33140/mcr.09.04.01
L. Marinova, V. Vasileva, N. Kahchiev, Katia Sergieva
Non-germ cell tumours (NGCTs) are rare intracranial neoplasms occurring in adolescents and young adults. A multidisciplinary team including a neurosurgeon, oncologist, radiologist, pathohistologist, ophthalmologist, pediatric oncohematologist, neurologist and endocrinologist is required for diagnosis and treatment. We present a rarely diagnosed optic-chiasmal non-germinomatous germ cell tumour (NGGCT) in a 16-year-old boy, accompanied by pituitary insufficiency (diabetes insipidus and central hypothyroidism) and severely impaired vision bilaterally. The immunohistochemistry (IHC) of the tumor biopsy, as well as the level of tumor markers (human chorionic gonadotropin and alpha-fetoprotein) in the serum and cerebrospinal fluid are significant factors for determining the diagnosis-cranial GCT or cranial NGCT. Because the tumor was inoperable, we performed 3 courses of neoadjuvant chemotherapy followed by definitive radiotherapy to a total tumor dose of 55 Gy. In such rare childhood brain tumors, complex treatment achieves long-term local tumor control, requiring long-term monitoring by an ophthalmologist and endocrinologist.
非胚胎细胞肿瘤(NGCTs)是一种罕见的颅内肿瘤,多发于青少年和年轻成年人。诊断和治疗需要一个多学科团队,包括神经外科医生、肿瘤科医生、放射科医生、病理科医生、眼科医生、儿科肿瘤科医生、神经科医生和内分泌科医生。我们报告的是一名16岁男孩罕见的视桥非绒毛膜生殖细胞瘤(NGGCT),伴有垂体功能不全(糖尿病性尿崩症和中枢性甲状腺功能减退症)和双侧视力严重受损。肿瘤活检的免疫组化(IHC)以及血清和脑脊液中肿瘤标志物(人绒毛膜促性腺激素和甲胎蛋白)的水平是确定诊断(颅内 GCT 或颅内 NGCT)的重要因素。由于肿瘤无法手术,我们进行了 3 个疗程的新辅助化疗,随后进行了肿瘤总剂量为 55 Gy 的确定性放疗。对于这种罕见的儿童脑肿瘤,复杂的治疗可实现长期的局部肿瘤控制,需要眼科医生和内分泌科医生的长期监测。
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引用次数: 0
Musculoskeletal Ultrasound to Identify Changes in Obliquus Capitis Inferior Muscle & Position of Atlas After a Manual Stretch 用肌肉骨骼超声波识别手动拉伸后肩胛下部肌肉和寰椎位置的变化
Pub Date : 2024-04-10 DOI: 10.33140/mcr.09.04.02
Allison Burek, Hannah Jacobs, Rob Sillevis
Introduction: Cervicogenic headache (CGH) is a prevalent condition caused by a disorder of the cervical spine that is commonly accompanied by neck pain and headaches. There is limited research regarding interventions benefiting CGH long-term. Interventions geared toward the suboccipital musculature may be used to improve CGH symptoms due to their anatomical connection to the cervical spine. Purpose: To determine if an isolated manual stretch of the obliquus capitis inferior will create a change in muscle diameter and length and position of atlas relative to axis. Methods: This quasi-experimental study used a single group of 36 subjects. Pre- and post-test measurements of the muscle diameter and length of the obliquus capitis inferior and the distance between atlas and axis were obtained using musculoskeletal ultrasound before and after our manual stretching intervention. Results: The results showed a significant increase in both measures, indicating increased length of the right Obliquus Capitis Inferior and the distance between the transverse process of C1 and spinous process of C2 after the manual stretch was applied. The average width of the right Obliquus Capitis Inferior was found to be 1.01 cm prior to applying the manual stretch and 1.99 cm after applying the manual stretch, demonstrating an increase in the width of the R OCI pre- and post-stretch. Conclusion: The results of this study indicate that the application of a manual static stretch held for 2x30 seconds will produce and immediate and significant increases in muscle length and width of the right Obliquus Capitis Inferior. Further research should be conducted to establish validated stretching parameters targeting the suboccipital muscles and further examine the effects of these muscles on CGH symptoms
简介颈源性头痛(Cervicogenic headache,CGH)是由颈椎病引起的一种常见病,通常伴有颈部疼痛和头痛。有关长期干预对颈椎源性头痛有益的研究十分有限。由于枕下肌与颈椎在解剖学上的联系,针对枕下肌的干预措施可用于改善 CGH 症状。目的:确定单独手动拉伸斜方肌下部是否会改变肌肉直径和长度以及寰枢椎相对于轴线的位置。方法:这是一项准实验研究:这项准实验研究以 36 名受试者为一组。在手动拉伸干预前后,使用肌肉骨骼超声波对下斜方肌的肌肉直径和长度以及寰枢轴与轴线之间的距离进行了测试前和测试后测量。结果显示结果显示,这两项指标均有明显增加,表明在进行人工拉伸后,右侧下斜方肌的长度和 C1 横突与 C2 棘突之间的距离均有所增加。人工拉伸前,右侧肩胛下缘的平均宽度为 1.01 厘米,人工拉伸后为 1.99 厘米,表明拉伸前后右侧肩胛下缘的宽度均有所增加。结论本研究结果表明,保持 2x30 秒的徒手静态拉伸可立即显著增加右腿下斜方肌的长度和宽度。应开展进一步研究,确定针对枕下肌的有效拉伸参数,并进一步研究这些肌肉对 CGH 症状的影响。
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引用次数: 0
Demographic Incidence of Cutaneous Leishmaniasis in Patients of Wasit Province, Iraq 伊拉克瓦西特省皮肤利什曼病患者的人口统计学发病率
Pub Date : 2024-04-09 DOI: 10.33140/mcr.09.04.03
G. J. Al-Abedi, Tabarak H. Jendeel, Bent Al-Huda, K. Owed, Baneen S. Howedi, Baneen S Qomar, Baneen A. Turkey, Baneen E. Najem
Background: Leishmaniasis is a chronic disease caused by flagellate protozoa of the genus Leishmania, which remains uncontrolled and neglected transmissible disease in many countries including Iraq. Aim: Estimating the incidence rate and association of cutaneous leishmaniasis (CL) to different demographic risk factors including season, geographic area, gender, age, and distribution of lesions on different body’s regions. Materials and methods: Totally, 224 individuals who diagnosed as patients with CL were attended to the governmental hospitals in Wasit province (Iraq) during the year of 2023, and subjected for this questionnaire to collect the required data. Results: The findings of demographic risk factors were showed a significant variation (P<0.05) in their values. Concerning season, significant highest levels of CL (P<0.0357) was recorded in February 29.91% and January 24.11%, while the lowest values were seen in December (0%), September (1.97%), June (2.23%), April (3.13%), August (3.57%), July (4.02%), October (4.91%), and November (6.25%) in comparison to March (14.73%). Significantly (P<0.0185), the higher rate for incidence of leishmaniasis was seen in AlAziziyah (46.43%); whereas, the lower rates were observed in An Numaniyah (2.68%), Al-Hai (5.8%) and Al-Suwaira (759%) in comparison with Kut (37.5%) district. For gender of study patients, males were showed a significant increase (P<0.0442) in incidence rate of leishmaniasis (58.93%) when compared to females (41.07%). Regarding age, significant increases (P<0.0422) in incidence rate of leishmaniasis was reported in patients aged ≤ 20 years (57.14%) and lowest in patients aged ≥ 40 years (31.25%); while in patients of 21-39 years old, it was 11.61%. Distribution of lesions on the body of study patients showed that the incidence of disease was increased significantly (P<0.0278) in legs and abdomen (38.39%) and arms (32.59%); and reduced significantly in all the body (0.45%), back (0.45%), chest (0.89% (2/224)), abdomen (1.34%), and neck (3.13%) when compared to face (22.77%). According to type of lesion, the dry lesions (97.32%) were increased significantly (P<0.0122) when compared to wet lesions (2.68%). Conclusion: This might represent the first recent retrospective study for analysis of documented cases of CL in Wasit province (Iraq). This study concludes that the CL disease is sex, age, seasonal and geographical dependent and it is with continuously increasing in Iraq. To further contain CL incidence and morbidity, there is a need for more intensified preventive research programs into improved vector control, vaccines, and diagnostics.
背景:利什曼病是一种由利什曼原虫属鞭毛虫引起的慢性疾病,在包括伊拉克在内的许多国家仍是不受控制和被忽视的传播疾病。目的:估算皮肤利什曼病(CL)的发病率以及与不同人口风险因素的关联,包括季节、地理区域、性别、年龄以及不同身体部位的病变分布。材料与方法:2023 年期间,瓦西特省(伊拉克)政府医院共收治了 224 名被诊断为皮肤利什曼病的患者,并对其进行了问卷调查,以收集所需数据。结果:人口统计学风险因素的研究结果显示,这些因素的数值存在显著差异(P<0.05)。在季节方面,与 3 月(14.73%)相比,2 月(29.91%)和 1 月(24.11%)的 CL 值最高(P<0.0357),而 12 月(0%)、9 月(1.97%)、6 月(2.23%)、4 月(3.13%)、8 月(3.57%)、7 月(4.02%)、10 月(4.91%)和 11 月(6.25%)的 CL 值最低。与库特区(37.5%)相比,阿齐兹耶区的利什曼病发病率较高(46.43%),而安努曼尼亚区(2.68%)、阿尔海区(5.8%)和苏韦拉区(759%)的发病率较低(P<0.0185)。就研究患者的性别而言,男性利什曼病发病率(58.93%)比女性(41.07%)显著增加(P<0.0442)。在年龄方面,20 岁以下患者的利什曼病发病率明显增加(P<0.0422)(57.14%),40 岁以下患者的发病率最低(31.25%);21-39 岁患者的发病率为 11.61%。研究显示,与面部(22.77%)相比,腿部和腹部(38.39%)和手臂(32.59%)的发病率明显增加(P<0.0278);而全身(0.45%)、背部(0.45%)、胸部(0.89%(2/224))、腹部(1.34%)和颈部(3.13%)的发病率明显降低。根据皮损类型,干性皮损(97.32%)比湿性皮损(2.68%)显著增加(P<0.0122)。结论这可能是近期对瓦西特省(伊拉克)有记录的 CL 病例进行分析的首次回顾性研究。这项研究的结论是,CL 疾病与性别、年龄、季节和地域有关,并且在伊拉克呈持续上升趋势。为了进一步控制CL的发病率和死亡率,有必要加强预防性研究计划,改进病媒控制、疫苗和诊断方法。
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引用次数: 0
Research of the Potential Radioprotective Activity of Trimethyl Glycine and N-Acetyl-L-Cysteine with Quantitative Analysis Using Real-Time Polymerase Chain Reaction (QRT-PCR) 利用实时聚合酶链式反应 (QRT-PCR) 定量分析三甲基甘氨酸和 N-乙酰-L-半胱氨酸的潜在辐射防护活性研究
Pub Date : 2024-04-01 DOI: 10.33140/mcr.09.04.04
The irradiation exposure could affect the cellular genome and specifically target genes, such as TP53 gene. The TP53 gene is known as a “guardian of the genome” and is a tumor suppressor gene. Its role is to keep the cell of malignant transformation. After ionizing radiation exposure, the TP53 could mutate and the cell could continue to active proliferation (tumor cellular transformation). It has been noticed that different type of substances could have radioprotective effect and to protect the cell of malignant transformation, apoptosis, genome injuries or necrosis. Some of the natural metabolites that are proven antioxidants, show significant ability of radiation protection of the cells. The aim of that study is to analyze the possible radioprotection ability of two origin metabolites (amino acids)–trimethyl glycine (betaine) and N-acetyl-L-cysteine, applied together and in combination, first before irradiation (preventive treatment) and then 2 hours after irradiation (as a therapeutic agents). The research work is done as invitro analysis to peripheral blood cell cultures. Conclusion: The conclusion of the study is that both amino acids showed good radiation protection activity after in-vitro performed analysis. The most significant results showed the combination of both natural metabolites.
辐照会影响细胞基因组,并特别针对基因,如 TP53 基因。TP53 基因被称为 "基因组的守护者",是一种肿瘤抑制基因。它的作用是防止细胞恶性转化。电离辐射照射后,TP53 基因可能发生突变,细胞可能继续活跃增殖(肿瘤细胞转化)。人们注意到,不同类型的物质都具有辐射防护作用,能保护细胞不发生恶性转化、凋亡、基因组损伤或坏死。一些被证明是抗氧化剂的天然代谢物显示出了对细胞的显著辐射防护能力。这项研究的目的是分析两种来源的代谢物(氨基酸)--三甲基甘氨酸(甜菜碱)和 N-乙酰-L-半胱氨酸--在辐照前(预防性治疗)和辐照后 2 小时(作为治疗剂)同时或联合使用可能产生的辐射防护能力。研究工作是在外周血细胞培养物中进行体外分析的。研究结论这项研究的结论是,经过体外分析,两种氨基酸都显示出良好的辐射防护活性。最重要的结果显示了两种天然代谢物的结合。
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引用次数: 0
Why Humans are Better Endurance Runners than Any Other Animal? 为什么人类比其他任何动物都更擅长耐力跑?
Pub Date : 2024-03-01 DOI: 10.33140/mcr.09.03.01
It is well known that only man is capable of endurance running and in this sense he has no equal among animals. Why do other animals have us beat over short distances, but are not able to run long distances as long as humans? There are different answers. Walking upright has allowed us to become some of the best distance runners in the world, but at the expense of speed. It is also believed that to run long distances on the African savannah man needed to have an effective cooling system and it is believed that man has developed one. Firstly, heat exchange improved due to the disappearance of fur. Secondly, humans learned to sweat intensively. They also attach importance to the diet and the lifestyle. There are other answers, but they have little relevance to the question discussed here. Can the above answers be considered exhaustive? We believe that there is another important factor unique to man, which ultimately allowed him to occupy the top of the food chain. This factor is the peculiarity of the heat-conducting ability of the human body. Man became a good long-distance runner because among animals he has the most highly heat-conducting body, which allowed him to effectively dissipate excess heat outside the body.
众所周知,只有人类能够进行耐力跑,从这个意义上讲,人类在动物中是无与伦比的。为什么其他动物在短距离上能胜过我们,而在长距离上却不能像人类一样跑得那么长呢?答案不一而足。直立行走使我们成为世界上最优秀的长跑运动员,但却牺牲了速度。人们还认为,要在非洲大草原上进行长距离奔跑,人类需要有一个有效的冷却系统,而且人们相信人类已经开发出了这样一个系统。首先,由于毛皮的消失,热交换得到了改善。其次,人类学会了大量出汗。他们还重视饮食和生活方式。还有其他答案,但与本文讨论的问题关系不大。上述答案是否可以认为是详尽无遗的呢?我们认为,还有一个人类独有的重要因素,使人类最终占据了食物链的顶端。这个因素就是人体导热能力的特殊性。人类之所以能成为长跑健将,是因为在动物中,人类的身体导热能力最强,可以有效地将多余的热量散发到体外。
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引用次数: 0
Neurodevelopmental Outcome at Preschool Age 38-months and Full-Scale Intelligence Quotient Evaluation at Age 7.2-years: In Children Treated for Persistent Pulmonary Hypertension of Newborn 学龄前 38 个月时的神经发育结果和 7.2 岁时的全面智商评估:接受新生儿持续性肺动脉高压治疗的儿童
Pub Date : 2024-02-04 DOI: 10.33140/mcr.09.02.01
Background: There is lack of literature on long-term neurodevelopmental outcome in children who have survived persistent pulmonary hypertension of newborn (PPHN). Objective: To evaluate neurodevelopmental outcomes at preschool age 38 months and subsequently, assess full scale intelligence quotient (FSIQ) at 86 months in children post therapy for severe PPHN. Methods: Study of 81 children successfully treated with high frequency oscillatory ventilation, exogenous surfactant, inhaled nitric oxide (n=37) and intragastric sildenafil (n=44) for severe PPHN. Developmental assessment was performed at age 38 months with Bayley Scales of Infant and Toddler Development–Third EditionUK (Bayley-III). Intellectual ability was evaluated at age 86 months with Wechsler Intelligence Scale for Children-Fourth EditionUK (WISC-IV FSIQ). Composite scores are presented as mean with standard deviation (SD) in parenthesis. Results: Bayley-III scores in sixty-six (81%) children at age 38 months, for developmental domains were between 106 and 114 (normal: ≥ 85). Ten percent had mild neurological impairment (70-84) and 9% showed moderate to severe delay (55 -69). Neurologically normal children (81%) at age 86 months scored either average (90-109) or high-average (110-119) with WISC-IV. FSIQ was 112.09 (13.20). Mild severity of neurological disability occurred in 10% with FSIQ: 64.19 (8.79). Moderate severity of impairment was observed in 9% with FSIQ: 46.44 (8.52). Conclusions: Qualitatively, eighty-one percent of neurologically normal children at age 7.2 years showed average to high-average intelligence. Incidence of normal neurological development and intelligence quotient was 81% in children treated for severe PPHN
背景:关于新生儿持续性肺动脉高压(PPHN)患儿的长期神经发育结果,目前尚缺乏相关文献。研究目的评估重症新生儿持续性肺动脉高压(PPHN)治疗后儿童在学龄前 38 个月时的神经发育结果,随后评估 86 个月时的全量表智商(FSIQ)。方法: 对 81 名成功接受高剂量治疗的儿童进行研究:研究对象为81名成功接受高频振荡通气、外源性表面活性物质、吸入一氧化氮(37人)和胃内西地那非(44人)治疗的重度PPHN患儿。38个月大时使用贝利婴幼儿发育量表-第三版UK(Bayley-III)进行发育评估。智力测验是在婴儿 86 个月大时采用韦氏儿童智力量表-第四版英国(WISC-IV FSIQ)进行的。综合得分以平均值表示,括号内为标准差(SD)。结果有 66 名儿童(81%)在 38 个月大时的 Bayley-III 发展领域得分介于 106 分和 114 分之间(正常值:≥ 85 分)。10%的儿童有轻度神经功能障碍(70-84分),9%的儿童有中度至重度发育迟缓(55-69分)。86 个月大时神经系统正常的儿童(81%)在 WISC-IV 中的得分为平均分(90-109)或高平均分(110-119)。FSIQ为112.09(13.20)。10%的儿童患有轻度神经系统残疾,其 FSIQ 为 64.19 (8.79)。9% 的患者出现中度障碍,FSIQ 为 46.44 (8.52)。结论从定性角度看,在 7.2 岁的神经系统正常儿童中,81%的儿童表现出中等至中等偏上的智力水平。在接受严重 PPHN 治疗的儿童中,神经系统发育和智商正常的比例为 81
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引用次数: 0
Histological Evaluation of Arthritis in Mice 小鼠关节炎的组织学评估
Pub Date : 2023-12-20 DOI: 10.33140/mcr.08.12.04
Arthritis is one the almost commonly prevalent painful diseases which cause limit the movement of joints. This study conducts to investigate histological alterations resulted in rheumatoid arthritis (RA)-induced in mice and estimating the levels of some serum biomarkers including serum IL-6, CRP and RF. Totally, 30 were purchased, acclimated, and divided into two groups; control that injected distilled water, and arthritis that injected adjuvant (CFA). Post the 25th day of experiment, all study mice of both groups were subjected for collection of blood and right ankle joints. Serologically, the findings of IL-6, CRP and RF of arthritis group were elevated significantly when compare to control mice. Histologically, the findings observed in mice of control group were included the proliferation of chondrocytes of articular cartilage with moderate cellular and subchondral marrow space, infiltration few inflammatory cells in dermis, proliferation of chondrocytes in articular cartilage with absence of inflammatory reaction in synovial cavity, moderate infiltration of inflammatory cells in subcutaneous tissue, nearly normal articular cartilage with regular tidemark and absence of sclerosis in marrow spaces, regenerative articular cartilage and regular tidemark line with presence of very narrow distance between articular cartilage and marrow bone, and existence of normal bone trabeculae. In arthritis mice, there were an infiltration of inflammatory cells in subcutaneous tissues and dermis, marked increases in numbers of osteoclasts, sclerosis, regular tidemark and proliferation of chondrocytes, low amonunt of abscesses in subcutaneous tissue, thickness of bone trabeculae, fragments of bone, subchondral sclerosis, moderate distance between bone and articular cartilage. In conclussion, RA causes severe impacts on tissues of affected joints. Studying the mechanism of inhibition during different inflammatory process appear needed.
关节炎是一种几乎常见的疼痛性疾病,会导致关节活动受限。本研究旨在调查类风湿性关节炎(RA)诱导的小鼠的组织学变化,并估算一些血清生物标志物的水平,包括血清 IL-6、CRP 和 RF。小鼠共 30 只,经适应性训练后分为两组:注射蒸馏水的对照组和注射佐剂(CFA)的关节炎组。实验第 25 天后,对两组所有研究小鼠进行采血和右踝关节采血。从血清学角度看,与对照组小鼠相比,关节炎组小鼠的 IL-6、CRP 和 RF 均明显升高。组织学方面,对照组小鼠的结果包括:关节软骨的软骨细胞增生,细胞和软骨下骨髓间隙适中;真皮层有少量炎症细胞浸润;关节软骨的软骨细胞增生,滑膜腔无炎症反应、皮下组织有中度炎症细胞浸润;关节软骨接近正常,有规则的胫骨痕,骨髓间隙无硬化;关节软骨再生,有规则的胫骨痕线,关节软骨与骨髓之间的距离很窄;存在正常的骨小梁。在关节炎小鼠中,皮下组织和真皮中有炎性细胞浸润,破骨细胞数量明显增加,软骨硬化,有规则的钙化线,软骨细胞增生,皮下组织脓肿数量少,骨小梁厚度大,骨碎片多,软骨下硬化,骨与关节软骨之间的距离适中。总之,RA 会对受影响关节的组织造成严重影响。因此,有必要对不同炎症过程中的抑制机制进行研究。
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引用次数: 0
Bacteriocin-Producing Probiotic Lactic Acid Bacteria against Hospital Strains of Staphylococcus aureus and Escherichia coli 产生细菌素的益生乳酸菌对金黄色葡萄球菌和大肠杆菌医院菌株的抗菌作用
Pub Date : 2023-12-15 DOI: 10.33140/mcr.08.12.03
It is now accepted that the human microbiome plays a key role in human health, and disturbances in the microbiome can cause or aggravate a range of diseases, from metabolic to immune disorders and mood disorders [1]. In addition, microbiota imbalance or dysbiosis may arise due to careless use of antibiotics in humans and animals, leading to the emergence of antibiotic-resistant bacteria that may compromise the effectiveness of antibiotics, so there is an urgent need to identify and develop new strategies to combat antibiotics resistance [2,3]. So far, probiotics are considered as perspective alternatives to antibiotics [4]. Probiotics are defined by the FAO/WHO as “Live microorganisms which when administered in adequate amounts confer a health benefit on the host” and they are successfully used for preservation of the microbial community [5].Moreover, bacteriocin-producing commensal microbes have the capacity to eliminate specific colonizing pathogens from various human body sites, and, as many bacteriocins have only narrow activity ranges they can be used for precision therapy and infections prevention [6]. Lactic acid bacteria, particularly lactobacilli, are the best known probiotics that modulate the immune system, and produce significant amounts of bioactive compounds, including bacteriocins, to eliminate pathogens and limit the clinical effects of antibiotic use [7, 8].
目前,人们普遍认为人类微生物群对人类健康起着关键作用,微生物群紊乱可导致或加重一系列疾病,从代谢紊乱到免疫紊乱和情绪失调[1]。此外,由于人类和动物不慎使用抗生素,可能会导致微生物群失衡或菌群失调,从而出现耐抗生素细菌,损害抗生素的有效性,因此迫切需要确定和开发对抗耐抗生素的新策略[2,3]。迄今为止,益生菌被认为是抗生素的前景替代品[4]。益生菌被联合国粮农组织/世界卫生组织定义为 "活的微生物,当给宿主施用足够量的益生菌时,会给宿主带来健康益处",益生菌被成功地用于保护微生物群落[5]。此外,产生细菌素的共生微生物有能力消灭人体各个部位的特定定植病原体,由于许多细菌素的活性范围很窄,它们可用于精准治疗和预防感染[6]。乳酸菌,尤其是乳酸杆菌,是最著名的益生菌,可调节免疫系统,并产生大量生物活性化合物,包括细菌素,以消灭病原体,限制抗生素使用的临床效果[7, 8]。
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引用次数: 0
From Innocuous Contact to Sudden Death in Sports: An Overview of Commotio Cordis 从运动中的无害接触到猝死:脐带损伤概述
Pub Date : 2023-12-04 DOI: 10.33140/mcr.08.12.02
Commotio Cordis (CC) is a rare but potentially fatal condition that occurs when a blunt impact to the chest causes ventricular fibrillation (VF) and sudden cardiac death. CC is most common in teenage males who participate in sports, but it can occur in people of all ages. The mechanical distortion of the myocardium caused by trauma can lead to inappropriate depolarization and myocardial firing, which can cause arrhythmias. Immediate identification and defibrillation are crucial to reducing mortality rates. Currently available screening tools for CC, such as the electrocardiogram (EKG), stress EKG, or echocardiogram, lack sensitivity for primary prevention. The pathogenesis of CC is influenced by a variety of factors, including the location, velocity, shape, and hardness of the impact object, as well as biological characteristics like gender, chest wall flexibility, and genetic susceptibility. The ion channels involved in arrhythmia generation in CC are thought to be stretch-activated channels (SACs). Diagnosis is based on a history of chest wall blunt trauma, and treatment includes immediate supportive care and defibrillation according to BLS and ACLS protocols. The currently available chest wall protectors have not been shown to prevent CC, and improving sports equipment may help reduce the incidence of CC. A famous American football player incident in which he collapsed after making a tackle during the first quarter of the Bills' game against the Cincinnati Bengals on January 2, 2023, is a notable case of commotio cordis (CC) in a football player. This incident is unusual because helmets are not typically associated with CC, which is usually caused by external blunt force trauma to the chest with small balls, hockey pucks, or even a blow. The player, who fortunately survived the event, was relatively older than the recorded mean age for CC and has a more rigid chest wall. It is unclear whether this case is an exception or if helmets can pose a risk for CC in certain circumstances. The case highlights the need for continued research and awareness of CC to improve prevention and management strategies for sudden cardiac arrest in sports. Despite being an ancient condition, CC remains a tragic event, and further research is needed to improve preventive measures and reduce mortality rates.
心梗性震颤(CC)是一种罕见但潜在致命的疾病,当钝性撞击胸部导致心室颤动(VF)和心源性猝死时发生。CC最常见于参加体育运动的青少年男性,但它可以发生在所有年龄段的人身上。外伤引起的心肌机械变形可导致不适当的去极化和心肌放电,从而引起心律失常。立即识别和除颤对降低死亡率至关重要。目前可用的CC筛查工具,如心电图(EKG)、应激心电图或超声心动图,对初级预防缺乏敏感性。CC的发病机制受多种因素影响,包括撞击物体的位置、速度、形状、硬度,以及性别、胸壁柔韧性、遗传易感性等生物学特征。参与CC心律失常产生的离子通道被认为是拉伸激活通道(SACs)。诊断是基于胸壁钝性创伤的历史,治疗包括根据BLS和ACLS协议的即时支持护理和除颤。目前可用的胸壁保护器尚未被证明可以预防CC,改进运动设备可能有助于减少CC的发病率。2023年1月2日,在比尔队与辛辛那提猛虎队的比赛中,一名著名的美国橄榄球运动员在第一节进行铲球后倒地,这是一名著名的橄榄球运动员的CC案例。这一事件是不寻常的,因为头盔通常与CC无关,CC通常是由外部钝器对胸部造成的创伤,包括小球,冰球,甚至是打击。幸运地幸存下来的玩家比CC记录的平均年龄要大,胸壁也更坚硬。目前尚不清楚这一情况是否例外,或者头盔在某些情况下是否会造成CC风险。该病例强调了对心脏骤停的持续研究和意识的需要,以改善运动中心脏骤停的预防和管理策略。尽管CC是一种古老的疾病,但它仍然是一种悲剧性事件,需要进一步研究以改进预防措施并降低死亡率。
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