Hypohydrotic ectodermal dysplasia revisited

<正>INTRODUCTION Caroli's disease is the other name for congenital nonobstructive dilatation of large intrahepatic bile ducts[1].This rare entity was firstly described by Caroli et al[2].This disease may be multifocal and diffuse or may be localized to a lobe or segment of liver.Most cases are associated with congenital hepatic fibrosis.Medullary sponge kidney may be associated with this disease.We present a case of Caroli's disease diagnosed on ultrasound     

Comparison of Clinical Outcome after Transfer of Cryopreserved and Fresh Embryos Originating from Conventional IVF and ICSI

Embryo cryopreservation has been a routine component of clinical in-vitro fertilization(IVF) programmes. It offers the opportunity to reduce the number of embryos transferredper procedure, so as to avoid the occurrence of multiple pregnancies, while optimizing theclinical use of excessive embryos[1]. In case the patient is at risk of OHSS or when embryotransfer may be considered inadvisable for other reasons, it gives the option of freezing allthe available embryos for storage and transfer i…     

Hepatic angiomyolipoma demonstrating similar imaging characteristics as hepatocellular carcinoma: One case report

Angiomyolipoma (AML) is a benign mesenchymal tumor that has been frequently reported in the kidney but rarely in the liver[1]. AML is composed of fat, vascular, and smooth muscle elements. Because the proportion of the constituents composed of AML are varied, hepatic AML may be clinically, radiologically and morphologically difficult to distinguish from hepatocellular carcinoma (HCC) or other hepatic lesions. Here we report a case with pathologically confirmed hepatic AML who was previously diagnosed as HCC based on imaging examinations.     

Fos expression in the medullary visceral zone following transient decrease of blood pressure in rats under simulated weightlessness

Orthostatic intolerance is one of the main problemsafter spaceflight, which pose serious hazards tocrewmembers when re-entry and emergency egressionand affect the capacity to re-adapt to iG environment.The basic mechanism of postilight orthostatic intolerance has not been fully elucidated until nowll]. Besidesdecreased blood volume, other factors such as centralintegration, neurohumoral modulation and cardiovascular changes may also be involved[2]. Zhang et al havereported the reduced contract…     

Preparative Resolution of Gatifloxacin Enantiomers with Pre-Column Esterification Strategy and Comparing Their Enantioselectivity to Bacteria and Antibody

Gatifloxacin(GFX)is a kind of chiral fluoroquinolones compound due to the methyl group at the C-3 position of the piperazine ring[1].Although the enantiomers of GFX show similar levels of antimicrobial activity and pharmacokinetics[2],the other biological activities(i.e.,toxicity or enantioselective recognition to various receptors in vivo)of GFX enantiomers have not yet been studied.With this in mind,we developed a rapid and cost-effective high performance liquid     

Magnetic resonance imaging of Alzheimer’s disease: from diagnosis to therapeutic evaluation

Alzheimer＇s disease（AD）is a devastating late-life dementia that produces progressive loss of memory and mental faculties in elderly people.It is important to identify the earliest evidence of AD and to monitor the development of this disease for us to make positive response to its management.Magnetic resonance imaging（MRI）is powerful to image the tissue or organ without damnification.MRI can be employed to diagnose the early AD development and monitor the key biomarker development in AD.MRI may be helpful not only in diagnosing early AD,but also in evaluating its development.This article reviews the progress of MRI on the diagnosis and detection of AD,and makes comments on its therapeutic application.     

Determinants, Outcomes and Interventions of Teenage Pregnancy-an international perspective

Teenage pregnancy (defined as pregnancies occurring in women aged 19 or under[1]) is a big public health problem worldwide. According to the United Nation's report,among 132 million babies bom worldwide each year, about 14 million babies (10.6 %) are born to adolescent mothers[2]. In Britain, teenage pregnancy has been labeled alongside cardiovascular disease, cancer and mental health as major public health problem[3]. The Nordic Resolution on Adolescent Sexual Health and Rights counts as a measure of public health success the fact that the numbers of teenage pregnancies in the Nordic countries are among the lowest in the world[4]. Maybe the study designs and samples are different, and they may not represent adolescents as a whole, but they do give us some hint for the general trend of sexual behaviors of adolescents all around the world.     

Cardiorenal syndrome: pathophysiological mechanism, preclinical models, novel contributors and potential therapies

Objective To review the current knowledge about the pathophysiological mechanisms,preclinical models,novel contributors and potential therapies of cardiorenal syndrome.Data sources The literature concerning cardioranal syndrome in this review was collected from PubMed published in English up to January 2014.Study selection Original articles and critical reviews related to cardiorenal syndrome were selected and carefully analyzed.Results Cardiorenal syndrome is a condition characterized by kidney and heart failure where failure of one organ worsens the function of the other thus further accelerating the progressive failure of both organs.The pathophysiology of cardiorenal syndrome is not fully understood,but may be caused by a complex combination of neurohormonal system activation,endothelial dysfunction,proteinuria,oxidative stress,uremic toxins and other factors.Managing cardiorenal syndrome is still a major therapeutic challenge in clinical practice because many of the drugs used to control heart failure can worsen renal function,and vice versa.Non-dialyzable uremic toxins,such as indoxyl sulfate,causing detrimental effects on the heart and kidney as well as stimulation of inflammatory responses,may be an effective therapeutic target for cardiorenal syndrome.Conclusions Suitable disease models of cardiorenal syndrome are urgently needed to investigate the pathophysiology and effective therapeutic approaches to the condition.Non-dialyzable protein-bound uremic toxins that may have cardiac and renal effects may provide therapeutic benefit to cardiorenal syndrome patients.     

照顾者护理技巧对阿尔茨海默病患者康复效果的影响

目的探讨照顾者护理技巧对阿尔茨海默病（Alzheimer＇s disease,AD）患者康复效果的相互关系,为实施优质家庭护理提供依据。方法将120例AD患者和他们的照顾者随机分为观察组和对照组。对观察组照顾者进行AD疾病知识、日常生活护理、安全护理等知识的培训和康复训练指导,以提高照顾者的护理技巧。干预前后采用简易精神状态检查量表（MMSE）、日常生活能力量表（ADL）和健康状况调查问卷（SF-36）对两组患者进行评定。结果干预后观察组患者的ADL得分为（15.86±3.81）,SF-36综合评分得分为（578.3±142.4）,均高于对照组,差异有统计学意义（P〈0.05）。MMSE得分（16.12±2.84）,与对照组相比差异有统计学意义（P〈0.01）。结论提高照顾者护理AD患者的技巧,可延缓AD患者病程进展,提高患者的生活质量。     

基于结构方程模型的社区失能老人主要照顾者焦虑影响因素研究

目的 探讨社区失能老人主要照顾者焦虑的影响因素,分析应对方式、照顾负担、自我效能和社会支持对照顾者焦虑的直接与间接作用,并建立其作用关系模型。 方法 采用自行设计的患者和照顾者一般资料问卷、医学应对方式量表、Zarit照顾者负担量表、一般自我效能感量表、社会支持评定量表和焦虑自评量表于2016年6月-12月对上海市浦东新区金杨社区5个社区440名失能老人及主要照顾者进行调查。建立失能老人照顾者焦虑影响因素模型用AMOS 17.0软件进行分析。 结果 模型数据拟合度良好,结构方程模型分析显示:照顾负担对焦虑有间接正向效应(β=0.384,P<0.01);社会支持对焦虑有直接负向效应(β=-0.053,P<0.01)和间接负向效应(β=-0.590,P<0.01);自我效能对焦虑有直接负向效应(β=-0.070,P<0.01)和间接负向效应(β=-0.374,P<0.01);应对方式对焦虑有直接负向效应(β=-0.706,P<0.01)。 结论 应对方式、自我效能和社会支持均可直接影响照顾者焦虑,照顾负担通过应对方式间接影响照顾者焦虑,自我效能通过照顾负担和应对方式间接影响照顾者焦虑,社会支持通过照顾负担、自我效能和应对方式间接影响照顾者焦虑,因此,社区护士未来应鼓励照顾者应用积极的应对方式,给予针对性的医疗知识和提高照顾技能来增强照顾者的自我效能感,应多角度多方位地给予增强照顾者社会支持系统来最终减轻照顾者焦虑。      

Efficacy of rivastigmine on activities of daily living in Sri Lankan patients with Alzheimer disease and on improving caregiver burden: a prospective study

OBJECTIVE: This open label, parallel group, prospective cohort study investigated the efficacy of rivastigmine treatment on activities of daily living (ADL) in patients with mild to moderate Alzheimer's disease (AD) and the possible benefits of this therapy on caregiver stress levels. METHODS: Thirty eight consecutive patients with mild to moderate AD were recruited; 22 received rivastigmine 3-6 mg twice daily (treatment group) for 20 weeks. Sixteen patients who did not receive rivastigmine served as the control group. The 17-item ADL Index was used to assess ADL and to determine the presence of functional deterioration. Caregivers were evaluated with the Caregiver Stress Scale (CSS). Each patient was required to have a committed caregiver and all caregivers were interviewed and administered the ADL Index and the Caregiver Stress Scale (CSS) at the start of treatment (week 0) and at the end of 20 weeks of treatment (week 20). RESULTS: Patients in the control group showed a significant decline in ADL Index score at 20 weeks compared to rivastigmine-treated patients (difference in mean ADL Index score = 8.5; p < 0.001). At week 20, mean change from baseline scores for CSS total and individual domain scores were better for caregivers in the treatment group than those in the control group (CSS total mean difference = 19.2). CONCLUSION: We conclude that treatment of AD patients with rivastigmine for 20 weeks produces a significant improvement in patient ADL functioning, and lower levels of caregiver stress.     

阿尔茨海默病主要家庭照顾者管理负担来源及其管理策略的质性研究

背景　我国65岁以上阿尔茨海默病的患病率为5.14%，是老年人的常见疾病，给其主要家庭照顾者带来巨大的管理负担，受到了国内外的广泛关注。目的　了解阿尔茨海默病主要家庭照顾者管理负担来源及其家庭管理策略的主要方法，为进一步制定阿尔茨海默病家庭管理体系提供依据。方法　采用目的性抽样法，选取2018年9-12月在杭州市第七人民医院和浙江省中医院门诊复查的12例阿尔茨海默病的主要家庭照顾者为研究对象。运用质性研究中现象学的研究方法，对阿尔茨海默病主要家庭照顾者进行深度访谈，采用Colaizzi的现象学资料7步分析法进行资料分析。结果　经过比对分析，阿尔茨海默病主要家庭照顾者管理负担来源共析出5个亚主题：患者病情复杂，缺乏照顾知识；社交性负担；情感性负担；身体性负担；照顾努力不被肯定与欣赏。家庭管理策略共析出照顾者自我管理策略、患者家庭管理策略2个主题，以及理性接受、主动迁就等6个亚主题。结论　社会及医务人员需为主要家庭照顾者提供有效的情感性支持，普及照护知识，以形成有效的家庭管理策略，同时，完善多元长期照护体系，减轻照顾负担。     

Integrating caregiver health into patient care

As the population of older adults continues to grow, there will be a simultaneous increase in the number of informal spousal and family caregivers. Given the demands of caregiving, informal caregivers are at risk for significant mental and physical health problems. Since many patients are dependent upon the caregiver to assist them with health-care needs, identifying caregiver needs and making appropriate referrals during patient visits is vital to ensuring quality care for your primary patient. The three main objectives for this review article are to 1) Provide an overview of negative mental and physical health consequences of caregiver stress, 2) Discuss the benefits to both patient and caregiver of addressing caregiver stress, and 3) Suggest ways in which caregiver stress can be identified and resources provided in health clinics with minimal staff time. A bibliography of resources for health care staff, patients, and families is included at the conclusion of the article.     

神经精神症状问卷中文版的信度和效度

目的 评估神经精神症状问卷中文版(Chinese version of the neuropsychiatric inventory,CNPI)的信度和效度.方法 对2004年至2008年间到上海交通大学医学院附属精神卫生中心就诊的219例阿尔茨海默病(AD)患者的照料者进行CNPI的测试,每例被测试者在4周后均进行重测.应用SPSS11.0统计软件进行信效度分析.结果 CNPI症状分问卷Cronbach α系数为0.69,CNPI苦恼分问卷Cronbach α系数为0.72.重测相关系数在0.66～0.98之间(P<0.001),其中症状分问卷总分相关系数为0.96(P<0.001),苦恼分问卷总分相关系数为0.94(P<0.001);对症状分问卷12个条目进行主轴因子分析产生5个公因子,累积解释变异量为67.0%;对苦恼分问卷12个条目进行主轴因子分析也产生5个公因子,累积解释变异量为70.2%.结论 CNPI的同质性信度和重测信度较高,内容效度和结构效度较好.     

血液透析患者家庭护理提供者焦虑状态的调查

目的探讨MHD患者家庭护理提供者焦虑状态及其影响因素。方法选取在我院血液净化中心行规律血液透析患者家庭护理提供者54例及同期在我院肾脏内科病房住院非透析患者家庭护理提供者40例作为调查对象。采用SAS量表评估调查对象的焦虑状态,分析焦虑情绪与年龄、性别、文化程度、职业、与患者关系、照料时间、患者透析龄、透析费用、生活规律改变程度的关系。结果 66.7%的MHD患者家庭护理提供者处于不同程度的焦虑状态,显著高于同期肾脏内科病房住院非透析患者家庭护理提供者17.5%焦虑发生率（P（0.01）;照料时间、透析费用、生活规律改变程度对焦虑情绪有显著影响（P（0.05）,MHD患者透析龄对家庭护理提供者焦虑情绪有显著影响（P（0.01）。结论 MHD患者家庭护理提供者焦虑情绪发生率较高,并且受照料时间、透析费用、生活规律改变程度及患者透析龄影响。MHD患者家庭护理提供者精神心理问题应引起医务人员的重视,并积极给予心理支持和关怀,以减少其焦虑情绪的发生率。     

老年慢性病患者家庭照顾者虐待倾向及影响因素研究

目的 探讨老年慢性病患者家庭照顾者虐待倾向现状及影响因素.方法 选取老年慢性病患者家庭照顾者402人,采用中文版照顾者虐待老年人评估量表进行调查,并对结果进行统计分析.结果 63.70％的老年慢性病患者家庭照顾者存在虐待倾向,影响因素涉及照顾者和被照顾者两方面,包括老年慢性病患者性别、文化程度、生活自理能力和照顾者年龄、受教育程度、照顾时长、是否与老人同住等方面.结论 应重视老年慢性病患者受虐问题,需要多学科团队协作,采取各种有效途径,减轻家庭照顾者压力,降低虐待危险的发生.     

脑卒中病人家庭照顾者照顾能力的现况研究

目的探讨脑卒中家庭照顾者的照顾能力现状及其影响因素。方法选取186例脑卒中病人家庭照顾者为研究对象,采用一般资料调查表、家属照顾者照顾能力量表（FCTI）、一般自我效能感量表（GSES）进行现况调查。结果脑卒中家庭照顾者的FCTI总均分为（17.26±2.07）分,一般自我效能处于中等水平,为（25.13±4.76）分,其照顾能力各维度得分与自我效能呈负相关关系（r=-0.546~-0.395,P < 0.01）,即自我效能越高其照顾能力越强,照顾能力受照顾者年龄、照护时长、身体状况、自我效能感及被照护者的依赖程度的影响（回归系数B分别为-0.36、-0.51、-0.71、-2.62、1.05,P < 0.05~P < 0.01）,表现为年龄越大、照护时长越长、无慢性疾病、自我效能高以及所照顾的脑卒中病人依赖程度低的照顾者,其照顾能力越强。结论护理人员应加强对高依赖程度病人家庭照顾者的帮助,护理病人的同时,关注照顾者的身心健康,采取提高照顾者自我效能感的措施以保证照护质量。     

Validation of the Thai QOL-AD version in Alzheimer’s patients and caregivers

Background

Quality of life (QOL) plays an important role in determining the improvement of patient care in Alzheimer’s disease (AD). The simple and easily used Thai instrument for measuring QOL is still limited.

Aims

This study aimed to translate the Quality of Life–Alzheimer’s Disease (QOL-AD) scale original version into a Thai version and test its psychometric properties.

Method

A Thai version of QOL-AD was translated following the sequential method. The validation was tested in 136 pairs of patients and their caregivers. Mild to moderate Alzheimer’s patients were recruited from outpatient clinics at Chiang Mai Neurological Hospital and Chiang Mai Psychiatry Hospital from April to September 2012. Internal consistency, factor analysis, and construct validity were evaluated.

Results

Internal consistency of Thai QOL-AD version was good for both patients (0.82) and caregivers (0.82). The results of factor analysis indicated three factors (physical and psychological well-being, social well-being, and close interpersonal relationships) in the patient group, while four factors were found (social well-being, functional ability, psychological well-being, and physical well-being) in the caregiver group. The scaling success in the patient group was around 80–83 per cent for convergent validity, and 70–83 per cent for discriminant validity. The caregiver group showed higher scaling success in convergent validity except for the psychological well-being domain. The scaling success of discriminant validity was around 44–83 per cent for caregivers.

Conclusion

The findings of the study demonstrate a good reliability of a Thai QOL-AD version for both patient and caregiver groups. Validity, especially in the caregiver group, might need to be re-examined.