BDNF-TrkB signaling pathway is involved in pentylenetetrazoleevoked progression of epileptiform activity in hippocampal neurons in anesthetized rats

Pentylenetetrazole（PTZ）is a widely-used convulsant used in studies of epilepsy;its subcutaneous injection generates an animal model with stable seizures.Here,we compared the ability of PTZ via the intravenous and subcutaneous routes to evoke progressive epileptiform activity in the hippocampal CA1 neurons of anesthetized rats.The involvement of the BDNF-TrkB pathway was then investigated.When PTZ was given intravenously,it induced epileptiform bursting activity at a short latency in a dose-dependent manner.However,when PTZ was given subcutaneously,it induced a slowly-developing pattern of epileptogenesis;first,generating multiple population-spike peaks,then spontaneous interictal discharge-like spike,leading to the final ictal discharge-like,highly synchronized bursting firing in the CA1 pyramidal layer of the hippocampus.K252a,a TrkB receptor antagonist,when given by intracerebroventricular injection,significantly reduced the probability of multiple population spike peaks induced by subcutaneous injection of PTZ,delayed the latency of spontaneous spikes,and reduced the burst frequency.Our results indicate that PTZ induces a progressive change of neuronal epileptiform activity in the hippocampus,and the BDNF-TrkB signaling pathway is mainly involved in the early phases of epileptogenesis,but not the synchronized neuronal burst activity associated with epileptic seizure in the PTZ animal model.These results provide basic insights into the changing pattern of hippocampal neuronal activity during the development of the PTZ seizure model,and establish an in vivo seizure model useful for future electrophysiological studies of epilepsy.     

改良式痰标本采集器在ICU机械通气患者痰标本采集中的应用效果研究

目的：探讨改良式痰标本采集器在ICU机械通气患者痰标本采集中的应用效果。方法：将56例气管插管患者随机分为对照组和观察组各28例。对照组采用一次性痰标本采集器留取痰标本,观察组采用改良式痰标本采集器密闭式留取痰标本,比较两组患者痰标本采集所需时间、标本合格率及护士满意度等指标的差异。结果：观察组痰标本合格率及病原学检出阳性率与对照组相比差异无统计学意义（P>0.05）,观察组标本采集所需时间短于对照组,差异有统计学意义（P＜0.05）。结论：改良式痰标本采集器在不影响标本合格率的基础上,能够缩短痰标本采集所需的时间,且不中断呼吸机支持。     

Enhancing students’ preparedness to care for older people: A mixed methods analysis

BackgroundNursing students’ positive attitudes towards ageing and older people are central to developing person-centred care. Perceptions about older people are influenced by social and generational values and beliefs, including a general understanding that older people need to be cared for. Nursing students often undertake early clinical placements in aged care settings, where residents’ needs are complex, yet the nursing experience is often considered ‘basic’ care. Illustrating that older people have rich personal histories and are valuable contributors to society can balance students’ perceptions and expectations and outcomes of clinical placements. Educational interventions using photo-elicitation and in-depth dialogue may surface students’ assumptions and challenge their misperceptions of older people before the first clinical placement.AimTo examine the impact of the innovative Depth of Field: Exploring Ageing © (DOF) resource as preparation for nursing students’ clinical placement in residential aged care facilities.MethodsMixed methods, block randomised controlled study with first year students. Students attending clinical laboratory groups received either usual preparation (control, n = 108) or DOF plus usual preparation (intervention, n = 99). Pre/post surveys included: Geriatric Attitudes Scale (GAS) and demographics. Eight students from the intervention group participated in focus groups post-clinical.FindingsGroups were similar at baseline. There were statistically significant changes following the intervention (p ≤ .05) for 9/13 individual GAS items and difference in overall mean scores (intervention group: M = 0.26; SD = 0.27; control group: M = 0.01; SD = 0.27). Focus group themes included: preconceptions toward older people; feelings of being emotionally unprepared; and perceptions of the DOF intervention in preparing students to connect with the older person.DiscussionThe DOF vignette provided opportunity for students to preflect on ageing. Translation to practice was evidenced with students seeing beyond residents’ physical care requirements to the value of connecting with the older person’s story to facilitate person-centred care.ConclusionsThe DOF intervention assisted students to adopt positive attitudes and a broader perspective of older people, as preparation for placement in residential aged care facilities.     

Symptom clusters and quality of life in Chinese patients with heart failure

BackgroundEffective symptom assessment and management can improve quality of life in patients with heart failure. However, how psychological symptom cluster, physical symptom cluster and heart failure symptom cluster influence the quality of life of patients with heart failure remains unknown.Aims(a) To describe the symptom clusters among Chinese patients with heart failure (HF), (b) explore the relationship between symptom clusters and quality of life (QOL), and (c) detect if physical and psychological symptoms are mediators of the association between heart failure symptom and QOL.MethodsThree hundred and one patients with heart failure completed measures of symptom (MSAS), QOL and demographic and clinical characteristics. Multiple regression analysis was used to analyse the data.FindingsThe mean age of participants was 72.19 years (range 31–96 years). Each patient was approximately accompanied by an average of 11.19 symptoms (range 0–31), and the top six most common symptoms of Chinese HF patients were shortness of breath, difficulty sleeping, difficulty breathing when lying flat, lack of energy, lack of appetite and cough. Both physical symptom cluster and psychological symptom cluster were the mediators of the relationship between heart failure symptom cluster and QOL.ConclusionsThere were mediating effects of physical symptom cluster and psychological symptom cluster between heart failure symptom cluster and QOL in Chinese patients with HF. Operative assessment, management and alleviation of physical symptoms and psychological symptoms should be prioritised in symptom management strategies for the clinical caregivers.     

Registered Nurses’ understanding,knowledge and perceptions of the association between sexually transmitted infections and domestic violence

BackgroundDomestic violence (DV) and sexually transmitted infections (STIs) are major healthcare issues, with known detrimental health outcomes. Though evidence confirms that individuals who experience DV are at a greater risk of acquiring STIs, there is paucity in the literature focused on nurses’ knowledge of the relationship between DV and STIs.AimThis study aimed to explore Registered Nurses’ (RNs’) knowledge of the association between DV and STIs.MethodsThe study was approved by the relevant Human Research Ethics Committee. Data were collected via face-to-face, telephone and computer-mediated interviews guided by a semi-structured interview schedule. The interviews were digitally recorded, transcribed verbatim, and thematically analysed using Braun and Clarke (2006).FindingsThree themes emerged from the data: Knowledge of DV/STIs: My knowledge is just general; Education: I feel I need a bit more education, and Knowledge of Association between DV/STIs: I really don’t know the answer.DiscussionThe study found that as a result of participants having a lack of education and knowledge associated with DV and STIs, they were unable to identify and articulate a relationship between DV and STIs. Because of these knowledge deficits participants did not consider transmission of STIs in an intimate relationship where DV could exist.ConclusionOur study suggests that nurses are unaware of the increased risk for STI acquisition within the context of DV. This lack of awareness would no doubt lead to missed opportunitites for screening and provision of appropriate care.     

百强固位纤维用于前牙外伤松动牙的效果及对牙龈指数和龈沟出血指数的影响

目的探讨百强固位纤维治疗前牙外伤松动牙的效果及对牙龈指数(GI)和龈沟出血指数(SBI)的影响。方法回顾性分析2012年6月至2014年6月上海市第五人民医院收治的108例患者(164颗患牙)的临床资料,将其按照治疗过程中使用的松动牙固定方法分为A组(38例,56颗牙),B组(34例,53颗牙)、C组(36例,55颗牙)。A组采用百强固位纤维联合流动树脂,B组采用钢丝联合树脂,C组采用牙弓夹板。观察三组患者的治疗效果,采用GI和SBI评价3种固定方式对牙龈和周围健康牙的影响。结果三组患者拆去固定装置6个月后疗效显示,A组治疗总有效率高于C组[92.1%(35/38)比61.1%(22/36)],差异有统计学意义(P<0.05),而与B组[85.4%(28/34)]比较差异无统计学意义(P>0.05)。三组患者口腔GI评分呈治疗后6周升高,治疗后6个月下降的趋势(P<0.05);A组和C组SBI评分呈治疗后6周升高,治疗后6个月下降的趋势(P<0.05),B组SBI评分呈下降趋势。三组患者GI、SBI评分组间、不同时间点、组间·不同时间点交互作用比较差异有统计学意义(P<0.05)。结论百强固位纤维联合流动树脂固定前牙外伤松动牙,疗效显著且稳定,对牙龈和周围健康牙影响小,值得临床推广。     

Adipose-derived stem cells seeded on polyglycolic acid for the treatment of stress urinary incontinence

Purpose

To evaluate the effect and possible mechanism of suburethral tissue-engineered sling in an animal model of stress urinary incontinence (SUI).

Methods

Adipose-derived stem cells (ADSCs) were obtained from the adipose tissues of rats. The differentiation potential, proliferation, and viability of rat ADSCs were evaluated after infecting these cells with a lentiviral vector-encoding green fluorescent protein (GFP). Next, GFP transfected ADSCs were seeded on polyglycolic acid (PGA) fibers to construct the tissue-engineered sling with the induction of 5-azacytidine (5-Aza). Afterward, the tissue-engineered slings were transplanted into a rat model of SUI that was established by vaginal balloon dilatation method and bilateral ovariectomy. Histology and the leak point pressure measurements were performed at 2 months after tissue-engineered sling implantation.

Results

The ADSCs were found to be efficiently transfected with GFP, without any effects on proliferation, cell cycle and multi-differentiation potential. After been seeded on PGA fibers, ADSCs formed tissue-engineered slings in 4 weeks of induction culture. Two months after implantation, the mean leak point pressure (LPP) was significantly increased in sling-treated rats compared with the balloon-injured ovariectomized rats. Immunofluorescence assay showed that some of the GFP expressing cells stained positive for muscle-specific markers.

Conclusions

The newly suburethral tissue-engineered sling restores LPP in the rat model of SUI, which could be an effective treatment in future SUI therapy.

     

区域低值医用耗材信息化管理探讨

本文试图以区域低值医用耗材物流配送服务外包为契机,探讨运用先进的信息化手段建立科学完整的区域低值医用耗材管理系统,加强医疗耗材采购、使用、监管等环节管理,起到采购公开、透明,使用准确无误,从而降低采购成本,减少运营成本,优化管理流程,提高服务和质量,确保医用耗材的使用安全。     

Interaction between synchronous bilateral prophylactic oophorectomy and adjuvant chemotherapy in female patients with locally advanced colorectal cancer

Aim In this study we explored the prognostic impact of synchronous bilateral prophylactic oophorectomy in female patients with primary colorectal cancer undergoing radical surgery. Method From 1991 to 2000, 267 female patients with stage II or stage III colorectal cancer, who had undergone curative resection, were retrospectively reviewed. In 224 patients, the ovaries were preserved. The other 43 patients underwent synchronous bilateral prophylactic oophorectomy. Univariate and multivariate analyses (Kaplan–Meier and Cox regression, respectively) were used to evaluate the effect of prophylactic oophorectomy and other clinical factors on the prognosis of patients. Results Both univariate and multivariate analyses showed that tumor stage and adjuvant chemotherapy were the only two significant clinical factors that affected the 5‐year overall survival of patients (P < 0.01). There was no significant difference in the 5‐year overall survival between patients who had, or had not, undergone prophylactic oophorectomy (75%vs 73%, P > 0.05). In the subgroup analysis by adjuvant chemotherapy, the 5‐year overall survival in patients receiving adjuvant chemotherapy was similar between nonoophorectomy and oophorectomy groups. However, in patients without adjuvant chemotherapy, the oophorectomy group was shown to have a significantly better 5‐year overall survival than the nonoophorectomy group (76%vs 51%, P = 0.047). Conclusion Prophylactic oophorectomy may improve the overall survival of female patients with locally advanced colorectal cancer without adjuvant chemotherapy, but its survival benefit vanished in patients receiving adjuvant chemotherapy. The role of prophylactic oophorectomy may be substituted by adjuvant chemotherapy, which makes prophylactic oophorectomy unnecessary during surgery for locally advanced colorectal cancer.