LONG‐TERM OUTCOME OF ENDOSCOPIC BALLOON DILATION IN OBSTRUCTIVE GASTROINTESTINAL CROHN's DISEASE

Background: Gastrointestinal strictures are the most often and serious complication in Crohn's disease. Because of the frequent postoperative recurrence in Crohn's disease, endoscopic therapy of gastrointestinal stricture is one of the best therapeutic options. Method: The present study sets out the results from a prospective study of endoscopic dilation therapy on 48 Crohn's disease patients with severe gastrointestinal stenoses. All patients who could not undergo endoscopic balloon dilation therapy (EBD) were operated on. Results: Long‐term success was attained in 32 of the 48 patients; cumulative avoidance of surgery after EBD was 86% at one year and 71% at three. Second, the most hazardous factor was recurrent inflammation causing restenosis. Patients who had strictures with oral luminal dilatation and patients with frequent recurrence had a tendency to be operated on. As a complication, perforation occurred in two cases (3.3%). Conclusions: EBD therapy for Crohn's stricture in the gastrointestinal tract is recommended before surgical intervention.     

Use of self-efficacy and dyspnea perceptions to predict functional performance in people with COPD.

This correlational and comparative study explored whether self-reports of self-efficacy and dyspnea perceptions predict the perceived level of functional performance in adults who have chronic obstructive pulmonary disease (COPD). The convenience sample included 97 Caucasian men (52) and women (45). Participants had to have a forced expiratory volume in 1 second (FEV1) of less than 70% predicted, and a FEV1/forced vital capacity (FVC) of less than 70%. Participants were recruited from pulmonary function laboratories and from better breather support groups in a Midwestern state. Three standardized, self-report instruments, COPD Self-Efficacy Scale (CSES), the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ), and Functional Performance Inventory (FPI) were used to measure the participants' self-report of their perceptions of self-efficacy, dyspnea, and functional performance. Dyspnea predicted 38.1% of the variance in functional performance, with self-efficacy contributing an additional 6.5% to the variance in the total sample. Self-efficacy predicted 36.5% of the variance in functional performance in men, with dyspnea contributing an additional 7.2% to the variance. However, in women, only dyspnea was a significant predictor of functional performance, at 48.5% when both dyspnea and self-efficacy were entered as independent variables. To improve patients' perceptions of functional performance, nurses can use methods such as breathing techniques and upper- and lower-body exercises that increase optimal management of dyspnea. Nurses may increase the self-efficacy of managing dyspnea by helping patients master breathing techniques and exercise through coaching and providing vicarious experiences through patient support groups or pulmonary rehabilitation programs.     

Excellent uricosuric efficacy of benzbromarone in cyclosporin-A-treated renal transplant patients: a prospective study

Patients on cyclosporin A (CsA) often develop hyperuricaemiaand gout. In transplant patients the use of uricosuric drugsfor treating hyperuricaemia may be preferable to allopurinolbecause of the known interaction of the latter with azathioprine.We therefore prospectively studied the uricosuric efficacy of100 mg benzbromarone (Bbr;Desuric®) daily in 25 CsA-treatedrenal transplant patients with stable graft function and hyperuricaemia(>359 µmol/l for females, >491 µmol/l formales). Benzbromarone decreased plasma uric acid from 579±18µmol/l to 313±24 µmol/l (mean±SEM;P<0.001) and thereby normalized plasma uric acid in 21 of25 patients. The remaining four patients had creatininc clearancesbetween 21 and 25 ml/min, the lowest of the entire study group.Mean fractional clearance of uric acid increased from 5.4±0.4%to 17.2±1.0% (P<0.001). The relative decrease of plasmauric acid closely correlated with baseline creatinine clearance(r=0.67; P<0.001). CsA trough values were not influenced.None of the patients experienced any significant side-effects.As an unexpected find-ing, urinary uric acid excretion increasedfrom 2082 ± 175 µmol7sol;24 h to 3233 ±232µmol/24 h after 4 weeks' treatment with benzbromarone. In conclusion, benzbromarone normalized plasma uric acid inall CsA-treated renal transplant recipients with a creatinineclearance >25 ml/min. Due to its excellent efficacy and lackof significant side-effects, benzbromarone appears to be preferableto allopurinol in CsA-treated renal transplant recipients witha creati nine clearance over 25 ml/min.     

Assessment of bone mineral content byin vivo measurement of flexural wave velocities

The determination of loss of bone mineral in an early stage of development is important. At the present time there exists no noninvasive or nonradiological methods which can be used for routine checks. An alternative method to obtain information about mineral content of bone is to measure the mechanical properties. A new method to measure the mechanical properties of long bones by means of the dispersion analysis of flexural waves is proposed. To be independent of the frequency spectrum of the impact pulse, the phase velocities were calculated from the signals of two accelerometers placed in vivo on the tibia. This method has the advantage that the velocities can be calculated for a frequency range. The results from this method were compared with the results from a well established measurement method for bone mineral content. Both methods were applied to 43 subjects selected in such a way that a broad range of bone mineral values was covered. The results imply that the proposed method can be used to test the mechanical properties of long bones.     

环丙沙星治疗急性细菌性痢疾29例临床疗效观察

食源性急性菌例２９例中２８例大便培养为弗氏２ａ志贺氏菌。经２天吡哌酸加ＴＭＰ短程快速治疗，２９例无一例治愈。依据药敏试验改用环丙沙星治疗，其中１１例感染严重者先予静脉点滴，每１２小时２００ｍｇ，１￣２天，症状好转即改口服，每１２小时２５０ｍｇ。另１８例口服，疗程均为４天。用药后，平均退热时间１．３２天，大便次数恢复正常时间平均２．１０天，大便常规正常时间平均２．８６天，２８例大便培养阳性者，平均阴     

曲肘式机构的优化设计

以功效系数为目标函数,相应地确定了设计变量和约束函数,对塑料注塑机合模机构的参数进行优化计算,提高了机构的综合性能。     

复配杀虫母液灭蚊效果评价

目的 :评价复配杀虫母液灭蚊虫效果。方法 :设试验区和对照区 ,试验区用有效成分含量 2 0 %的复配杀虫母液按 5 m l/ m3超低容量喷雾 ;对照区用 2 0 % DDVP同浓度超低容量喷雾。结果 :复配杀虫母液超低容量喷雾 2 h后 ,蚊密度下降率为 93.3% ,RPI为 2 6 .7;4h后下降率为 98.3% ,RPI为 12 .4。结论 :复配杀虫母液用超低容量喷雾能迅速杀灭成蚊 ,是特殊情况下短时间内降低室内成蚊密度较为理想的杀虫药剂。     

Comparison of the reinforcing efficacy of cocaine and procaine in rhesus monkeys responding under a progressive-ratio schedule

Rhesus monkeys (n=5) were prepared with chronic IV catheters and trained to lever press under a PR schedule of drug injection. The schedule consisted of five components, each made up of four trials (i.e., 20 trials total). Each trial within a component had the same response requirement. The response requirement in the first component was 120/trial and doubled in successive components to a maximum of 1920 in the fifth. A trial ended with an injection or the expiration of a 12-min limited hold (LH). The inter-trial interval (ITI) was 15 or 30 min. Following an injection or expiration of the LH, all stimulus lights were extinguished and responding had no consequence for the remainder of the trial. A session ended when either all 20 injections were self-administered or the response requirement was not met within the LH for two consecutive trials. The number of injections/session and responses/session increased with dose for cocaine (0.012–0.1 mg/kg per injection) and procaine (0.12–2.0 mg/kg per injection) at both ITI values. At the 15-min ITI, responding decreased again at higher doses in some monkeys with cocaine and in all monkeys with procaine. At maximum, cocaine maintained significantly more injections and responses/session when the ITI was 30 min than when it was 15 min. In contrast, the increase in ITI did not increase the maximum maintained by procaine. Cocaine was approximately 10-fold more potent than procaine and maintained at maximum significantly more injections and responses than procaine when the ITI was 30 min but not when the ITI was 15 min. These results are consistent with previous studies demonstrating that cocaine is a more efficacious positive reinforcer than procaine. Moreover, they extend recent findings suggesting that number of injections/session provides a measure of PR performance that is amenable to statistical analysis and may, therefore, be useful in establishing reliable differences among drugs in terms of relative reinforcing efficacy. Reliable quantification of between-drug differences in reinforcing efficacy can enhance not only estimates of relative abuse liability but also pharmacological analysis of central mechanisms mediating reinforcing effects.     

管状骨增宽牵引成骨组织形态学变化的实验研究

目的 探讨管状骨增宽牵引后新骨形成的变化。方法 在成年山羊的后肢放置2只增宽牵引器。实验组9只术后第8天牵引，对照组3只不牵引。牵引完毕后不同时期，各宰杀3只，评价管状骨增宽牵引后新骨形成的质和量。结果 实验组胫骨平均增宽7．83mm，X射线见牵引间隙逐渐变模糊，暴露侧有骨不连，非暴露侧成骨良好，牵引完毕3个月，未暴露侧新形成板层骨与原来胫骨融为一体，而暴露侧骨不连区为致密纤维组织。结论 管状骨增宽牵引成骨后，两侧牵引间隙成骨不一致，良好的血供，对新骨形成至关重要。     

示范区创建活动与社区卫生服务长效机制的建立和可持续发展对策的思考

通过第三方评估全国社区卫生服务示范区是我国社区卫生服务发展史上的一大创举。此项活动的开展,极大的提高了各地政府对发展社区卫生服务的思想认识、政策理解和经费投入力度。通过创建和评估活动,系统总结了各申报地区社区卫生服务的经验和特色,分析了存在的问题和不足,提出了发展社区卫生服务的对策和建议,制定了社区卫生服务可持续发展的长效机制,取得了预期效果,达到了预期目的。随着《国务院关于发展城市社区卫生服务的指导意见》的出台,示范区的典型示范效应会日益凸显出来,对我国社区卫生服务的发展将起到不可估量的作用。