氦氖激光对体外人肝癌和胃癌细胞增殖的影响

目的：研究氦氖激光的生物学效应。方法：用３４．５～１３８Ｊ／ｃｍ２的氦氖激光照射体外培养的人肝癌ＳＭＭＣ７７２１和人胃癌ＳＧＣ７９０１细胞，间日１次，共６次。结果：６９Ｊ／ｃｍ２和１３８Ｊ／ｃｍ２的氦氖激光照射人肝癌细胞后７２小时和９６小时内、３４．５～１３８Ｊ／ｃｍ２的氦氖激光照射人胃癌细胞后７２小时内有促进增殖的作用（Ｐ＜０．０５）。结论：较大剂量的氦氖激光照射人癌细胞后在一定时间内有促进其生长的作用，在临床应用上应避免该副作用的发生。     

氦氖激光照射对豚鼠表皮郎格尔汉斯细胞免疫功能的影响

目的：观察不同剂量氦氖激光照射豚鼠表皮郎格尔汉斯细胞后对其抗原提呈功能的影响。方法：用耳肿试验和同种异体表皮淋巴细胞混合培养反应方法观察氦氖激光照射对豚鼠表皮郎格尔汉斯细胞抗原提呈功能的影响。结果：在耳肿试验中，１．１６Ｊ／ｃｍ２，２．３２Ｊ／ｃｍ２和４．６５Ｊ／ｃｍ２剂量均增加豚鼠的耳叶厚度，以２．３２Ｊ／ｃｍ２最显著。在同种异体表皮淋巴细胞混合培养反应中，０．５９Ｊ／ｃｍ２，１．１９Ｊ／ｃｍ２和２．３７Ｊ／ｃｍ２剂量均增强郎格尔汉斯细胞刺激Ｔ细胞增殖的能力。结论：一定剂量的低能量氦氖激光照射可增强郎尔汉斯细胞的抗原提呈功能     

氦—氖激光照射对脾T细胞转化及T细胞亚群的影响

以能量密度分别为３．９Ｊ／ｃｍ＾２、７．８Ｊ／ｃｍ＾２、１９．５Ｊ／ｃｍ＾２和Ｈｅ－Ｎｅ激光照射小鼠脾区，观察其脾Ｔ淋巴细胞转化率和Ｔ细胞亚群的变化。结果表明，Ｈｅ－Ｎｅ激光照射小鼠脾区后，脾Ｔ淋巴细胞转化率、辅助性Ｔ细胞（ＴＨ）均显著增加，抑制性Ｔ细胞（Ｔｓ）显著减少，尤以７．８Ｊ／ｃｍ＾２、１９．５Ｊ／ｃｍ＾２组最显著（Ｐ〈０．０５）。     

氦—氖激光对小鼠脑组织5—羟色胺含量的影响

目的：探讨氦－氖激光直接照射对小鼠脑组织５－羟色胺含量的影响。方法：在麻醉状态下,切开小鼠头部皮肤,暴露颅骨及脑组织,用氦－氖激光仪垂直照射小鼠额叶皮质,采用高效液相色谱－电化学检测方法测定不同剂量氦－氖激光照射后小鼠脑组织５－羟色胺含量的变化。结果：激光照射各组可明显增加小鼠脑组织５－羟色胺含量,以剂量为５５．１Ｊ／ｃｍ＾２和２７．６Ｊ／ｃｍ＾２组最明显,差异有高度统计学意义。结论：氦－氖激光脑     

氦—氖激光对人大颗粒淋巴细胞内嗜天青颗粒影响的图像分？…

目的 探讨氦－氖（Ｈｅ－Ｎｅ）激光对人体的免疫刺激作用的机理。方法 用３．１Ｊ／ｃｍ＾２、９．４Ｊ／ｃｍ＾２、２５．０Ｊ／ｃｍ＾２和４９．９Ｊ／ｃｍ＾２剂量的Ｈｅ－Ｎｅ激光分别在体外辐射人外周血，细胞化学方法显示大鼠粒淋巴细胞内嗜天青颗粒，产用图像分析系统对嗜天青颗粒作定量分析。结果 ３．１Ｊ／ｃｍ＾２辐照组的嗜天青颗粒数目、颗粒面积、颗粒面积与细胞面积比值和颗粒积分光密度四项参数值与对照组比较无     

氦氖激光对兔胫骨骨折愈合微血管重建的影响

目的：探讨氦氖激光对兔胫骨骨折愈合的作用。方法：家兔２０只，双侧胫骨中段制作骨折模型，术后第２天开始，左侧采用氦氖激光照射，功率密度６．３７ｍＷ／ｃｍ２，能量密度３．８２Ｊ／ｃｍ２，１０分钟，每日１次，连续１０日，右侧不予照射为对照组。于术后第５，１０，２０，３０天分４批处死动物，每批５只，采用血管墨汁灌注切片法，光镜观察。结果：实验组微血管重建比对照组加快。结论：氦氖激光照射可促进骨折愈合。     

氦—氖激光对离体宫颈癌细胞增殖的影响

目的：全面认识氦－氖激光的生物效应。方法：分别用１７．２７Ｊ／ｃｍ＾２，３４．５４Ｊ／ｃｍ＾２，６９Ｊ／ｃｍ＾２剂量的氦－氖激光照射人宫颈癌ＨｅＬａ细胞，隔天１次，共６次。照射结束后４７，７２，９６小时对８组细胞进行增殖实验分析。结果：３组细胞增殖加快（Ｐ〈０．０５），１组降低（Ｐ〈０．０１），４组无差异（Ｐ〉０．１），所有数据经秩和检验表明，氦－氖激光照射对细胞增殖无明显影响（ｕ＝１．６１５８，     

氦－氖激光照射对脾T细胞转化及T细胞亚群的影响

以能量密度分别为３．９Ｊ／ｃｍ２、７．８Ｊ／ｃｍ２、１９．５Ｊ／ｃｍ２的Ｈｅ－Ｎｅ激光照谢小鼠脾区，观察其脾Ｔ淋巴细胞转化率和Ｔ细胞亚群的变化。结果表明，Ｈｅ－Ｎｅ激光照射小鼠脾区后，脾Ｔ淋巴细胞转化率、辅助性Ｔ细胞（ＴＨ）均显著增加，抑制性Ｔ细胞（Ｔｓ）显著减少，尤以７．８Ｊ／ｃｍ２、１９．５Ｊ／ｃｍ２组最显著（Ｐ＜０．０５）。     

氦—氖激光对人淋巴细胞中酸性α—醋酸萘酯酶影响的图象分析

用３．１Ｊ／ｃｍ＾２、９．４Ｊ／ｃｍ＾２、２５．０Ｊ／ｃｍ＾２和４９．９Ｊ／ｃｍ＾２剂量的Ｈｅ－Ｎｅ激光分别辐照人外周血。应用酶细胞化学方法显示淋巴细胞内酸性α－醋酸萘酯酶（ＡＮＡＥ）反应物，并用图像分析系统对ＡＮＡＥ反应物作定量分析。结果表明，３．１Ｊ／ｃｍ＾２辐照组的酶反应物颗粒数目、颗粒面积、颗粒面积与细胞面积比值和颗粒积分光密度４项参数值与对照组比较无明显变化；９．４Ｊ／ｃｍ＾２辐照组的四     

体外UVA照射正常人外周血对T细胞免疫的影响：Ⅰ.对淋巴细胞转化…

为探索长波紫外线对人Ｔ细胞免疫的激剂量，本实验以不同剂量的ＵＶＡ体外照射正常人外周血，以淋巴细胞转化率为指标，筛选出了ＵＶＡ对Ｔ淋巴细胞的激活剂量。结果表明：３４８．５－１３９４ｍＪ／ｃｍ＾２的ＵＶＡ对淋巴细胞具有明显的激活作，其中６９７ｍＪ／ｃｍ＾２为最佳激活剂量。一次最佳激活剂量照射对Ｔ淋巴细胞的激活作用至少持续６小时。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.