The isolated spinal cord-skin preparation of the newborn rat and effects of some algogenic and analgesic substances

We have developed an isolated spinal cord-skin preparation of the newborn rat. The spinal cord together with a piece of skin connected to the cord by the saphenous nerve was isolated from 1- to 4-day-old rats and separately superfused with artificial cerebrospinal fluid in two neighbouring chambers. Potentials were recorded extracellularly from the third lumbar ventral root. Application of capsaicin (0.5-2 μM) or KCl (60–350 mM) with brief pressure pulses to the perfusion bath of the skin evoked a depolarizing response of 20- to 40-s duration in the ventral root. The response was depressed by [Met⁵]enkcphalin (0.03–3 μM). morphine (0.1–2 μM) and a tachykinin antagonist, [D-Arg¹,D-Trp^7,9,Leu¹¹] substance P (spantide), 1–10 μM), applied to the spinal cord by superfusion, whereas the response was augmented by centrally administered calcitonin gene-related peptide (0.1–0.2 μM) or bicuculline (0.5–1 μM).     

复合膳食纤维对大鼠体内脂质过氧化作用的影响

制备复合膳食纤维 (dietaryfiber,DF) ,并分别探讨复合、混合及三种单一的DF对高脂血症大鼠体内脂质过氧化作用的影响。选健康、断乳Wistar大鼠 6 4只 ,按体重随机分为 8组 ,用高脂饲料诱发高脂血症的同时 ,分别添加 10 %的DF :纤维素 (B组 )、果胶 (C组 )、海藻酸钠 (D组 )、纤维素 -果胶复合物 (E组 )、纤维素 -海藻酸钠复合物 (F组 )、纤维素 -果胶混合物 (G组 )、纤维素 -海藻酸钠混合物 (H组 ) ,以单纯的高脂饲料组为对照组 (A组 ) ,观察各种DF对大鼠的生长发育及脂质过氧化作用的影响。结果显示 :1、添加 10 %的各种DF不影响大鼠的生长发育。 2、各种DF皆可显著升高血清超氧化物歧化酶 (SOD) (P <0 0 1)、谷胱甘肽过氧化物酶 (GSH Px)活性 (P <0 0 1) ,降低丙二醛 (MDA)水平 (P <0 0 5 ,B、D组除外 ) ,提高红细胞膜的流动性 (P <0 0 5 ) ,以复合物、混合物效果为明显。 3、各种DF可不同程度地增加粪重和粪脂排出量 (P <0 0 5 ,D组除外 ) ,以复合物、混合物为明显。提示各种DF皆可不同程度地降低大鼠体内脂质过氧化作用 ,提高红细胞膜的流动性 ,其中可溶性DF效果优于不可溶性DF ,而复合、混合DF的效果又优于单一的DF ,且以复合物效果为佳     

The potential of an anaesthesiologist–manned ambulance service in a rural/urban district

The use of anaesthesiologists in prehospital emergency care is controversial. We wanted to assess the impact of an anaesthesiologist and a short time interval from acceptance of a mission to take–off at survival rates in a rural/urban emergency medical service. Prospectively registered data for 991 consecutive patients through a 12–month period were retrospectively evaluated by an independent foreign expert. Of all primary missions, 3.3% were considered probably lifesaving from site of injury to receiving hospital. Of these, the lifesaving result in 50% were dependent on both the qualifications of the anaesthesiologist and a short response time. Survival from hospital admission to discharge was 44%. All patients were discharged to their own homes, able to live a fully functional life. The consistent use of anaesthesiologists compared to less qualified personnel and the maintaining of response times below presently required minima doubles the potential for lives saved in services comparable to the one studied.     

Development and evaluation of a presurgical preparation program

Three presurgical preparation programs were developed and evaluated in an Australian hospital utilizing an additive component design. The component basic to all three preparation programs was modeling. This technique was compared with the additional components of teaching child coping skills and parent coping skills via videotape. Subjects were 28 children between the ages of 4 and 13 years who were scheduled for elective surgery. Anxiety of both the children and parents was assessed by self-report and behavior observation. Results indicated that there was no further anxiety reduction by the addition of child and parent coping skills. Results are discussed in terms of the viability of teaching coping skills via videotape particularly to parents. Methodological difficulties associated with research in this area are examined.     

Development of quality of care indicators for Parkinson's disease.

Parkinson's disease (PD) is a major cause of disability. To date, there have been no large-scale efforts to measure the quality of PD care because of a lack of quality indicators for conducting an explicit review of PD care processes. We present a set of quality indicators for PD care. Based on a structured review of the medical literature, 79 potential indicators were drafted. Through a two-round modified Delphi process, an expert panel of seven movement disorders specialists rated each indicator on criteria of validity, feasibility, impact on outcomes, room for improvement, and overall utility. Seventy-one quality indicators met validity and feasibility thresholds. Applying thresholds for impact on outcomes, room for improvement, and overall utility, a subset of 29 indicators was identified, spanning dopaminergic therapy, assessment of functional status, assessment and treatment of depression, coordination of care, and medication use. Multivariable analysis showed that overall utility ratings were driven by validity and impact on outcomes (P < 0.01). An expert panel can reach consensus on a set of highly rated quality indicators for PD care, which can be used to assess quality of PD care and guide the design of quality improvement projects.     

超细纤维乳管镜引导下乳管内肿瘤切除术

目的探讨超细纤维乳管镜引导下乳管内肿瘤切除术的应用价值。方法对312例乳头溢液进行乳管镜检查，其中乳管内发现肿瘤者行手术治疗。利用乳管镜冷光源的皮肤透照点定象限，乳管扩张器探针定乳管走行方向，亚甲蓝染色定乳管末梢的分布。结果78例导管内发现肿瘤：单发性乳头状瘤68例，乳头状瘤病5例，导管内癌5例。28．2％（22／78）的病灶位于总导管，48．7％（38／78）位于导管Ⅰ级分支，17．9％（14／78）位于Ⅱ级分支，位于Ⅲ级和Ⅳ级分支病灶仅占3．8％（3／78）和1．3％（1／78）。病灶距乳头开口的平均距离为2．5cm（1～5cm）。78例均行手术治疗。术后病理诊断证实：65例乳头状瘤，8例乳头状瘤病，5例为导管内癌。乳管镜诊断符合率：乳头状瘤96％（65／68），乳头状瘤病100％（5／5），导管内癌100％（5／5）。单纯导管切除术65例，区段切除术8例，保乳根治术3例，改良根治术2例。结论通过光、针、色三位一体的方法定位以最小的切除范围达到最准确的切除目的，实现乳管内肿瘤的微创治疗。     

Community-based situation analysis of maternal and neonatal care in South Africa to explore factors that impact utilization of maternal health services

This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies of women with no antenatal care and/or home birth, and verbal/social autopsies of maternal and infant deaths, conducted in three diverse sites across the country. Data analysis used quantitative statistics for the semistructured interviews and a qualitative thematic content approach for the case studies and verbal/social autopsies. Each component was analyzed separately and then triangulated. The following themes emerged: 1) transport and distance to care were the biggest problems, particularly in rural areas; 2) providers' communication with families was very poor; 3) health-seeking behavior was better than anticipated; 4) treatment by health providers and quality of care showed mixed results; 5) HIV/AIDS is a major issue; however, basic maternity and neonatal service quality cannot be overlooked; and 6) families and communities are an untapped resource for improving maternal and neonatal health. Implications for maternal and infant health care in developing countries are discussed, with a particular focus on barriers to utilization and involvement of communities and families in maternity care.     

Early childhood teachers' preparation and the quality of program outcomes

The issue of the preparation of effective teachers becomes more critical for teachers of early childhood programs. It has been hypothesized that better program quality depends on better-educated teachers. The purpose of this investigation was to explore the importance of a high level of education for all early childhood education teachers. This issue has intrigued early childhood researchers and has prompted a large amount of research studies over the past decades. In order to assess the status of this line of inquiry and to provide guidance for future research, a critical analysis of 40 studies on the preparation of early childhood education teachers and the quality of their educational programs that were published within a 15-year (1989-2004) period is presented here. The analysis consisted of literal and allegorical critical analysis and interpretative critical analyses, which generated results in three main areas that focused on the professional development of the teachers, including teachers' professional development, the importance of a Bachelor's Degree and educational standards for early childhood education teachers.     

定君生胶囊用于妊娠期细菌性阴道病的临床观察

目的调查妊娠期细菌性阴道病(BV)的发病情况,观察定君生胶囊治疗细菌性阴道病的有效性。方法采用珠海市银科生物技术应用研究所生产的细菌性阴道病快速检测卡,对不同孕周的1500名孕妇进行BV筛查,确定妊娠期细菌性阴道病的发病率。对确诊为BV的孕妇266例,随机分为两组。定君生组:136例,给予定君生胶囊(乳杆菌活菌胶囊)阴道给药治疗;孚舒达组:130例,给予孚舒达栓(复方甲硝唑栓)阴道给药治疗。两组均连续用药10d,停药7d后复查。结果妊娠期BV的检出率为17.73%。定君生胶囊治疗BV的总有效率为92.65%,孚舒达栓治疗BV的总有效率为91.53%,二者差异无显著性(P>0.5)。结论妊娠期BV的发病率较高。定君生胶囊能有效改善阴道内生态环境,治疗妊娠期细菌性阴道病安全、有效,易为孕妇所接受。