REM sleep deprivation increases preference for novelty in rats.

As a further test of the hypothesis that REM deprivation decreases fear, the behavior of 40 male rats was measured in a Y-maze adapted to test for preference for novelty. Prior to this test, the animals were exposed for 4 days to one of four treatments, i.e., either a dry environment control, a wet environment control, a 2-day REM deprivation period or a 4-day REM deprivation period. During the test both number of grid crossing in the novel and non-novel arms of the Y-maze and three indices of emotionality were recorded. The results were congruent with data we had reported earlier and offered convincing evidence in support of the hypothesis.     

部分手术类项目标准成本分析

对6个手术类医疗服务项目进行了标准成本测算,分析了其成本构成,并与全国的实际成本平均水平进行了比较。建议政府以标准成本作为调整医疗服务价格的依据,同时,建议医院在加强手术室成本管理时应着重加强医用材料的管理。     

Effect of novel environmental stimuli on rat behaviour and central noradrenaline function measured by in vivo microdialysis

Rationale: Although physically aversive stimuli induce functional changes in central noradrenergic neurones, little is known about the noradrenergic response to environmentally aversive stimuli. Objectives: The first aim was to characterise environmental features that are perceived as stressful by rats. The second was to investigate whether changes in the concentration of extracellular noradrenaline are induced by these environmental features. Methods: A light/dark shuttle-box was used to test rats’ behavioural response to a range of stimuli (novelty, bright light, and the presence of an unfamiliar rat), either before or after microdialysis probe implantation. Changes in the concentration of extracellular noradrenaline in the frontal cortex and hypothalamus in vivo were then evaluated on exposure to these same test conditions. Results: Naive rats spent less time in a brightly-lit test arena than a dark one. However, the behavioural response to the light arena was attenuated by the presence of an unfamiliar rat. Probe implantation intensified the response to the light arena but did not affect behaviour in the dark arena. In the microdialysis studies, there was no change in the concentration of extracellular noradrenaline on transfer of rats to the dark arena but there was an increase in both the frontal cortex (+45%) and hypothalamus (+75%) on exposure to the light arena. A similar increase was induced in both brain regions when the light arena contained an unfamiliar rat. Conclusions: Implantation of a microdialysis probe modifies the behavioural responses to certain environmental stimuli. Regardless of this, the extent to which rats perceive a novel environment as aversive is not the only determinant of the noradrenergic response to such stimuli. However, differences in stimulus controllability in the microdialysis and the behavioural experiments could influence the apparent intensity of the stress. Received: 29 October 1998 / Final version: 19 March 1999     

ABC分类法在医疗用品库存管理中的应用

结合医院库存用品的特点和特殊的经营性质,在阐述重点库存控制-ABC分类法的思想和操作步骤的基础上,提出了该方法在医院实际应用中应该注意的问题.     

2001-2005年度上海市卫生局科研基金项目申请与资助情况回顾分析

回顾分析了2001-2005年度上海市卫生局科研基金项目申请与资助的基本资料，结果表明，五年中项目申请数和中标数均逐年递增，中标率保持稳定，基金资助规模相对稳定；中青年高水平科研人员已担当了大部分科研工作，成为基金项目的研究主体，基金已覆盖了较多的学科领域。     

Peroperative scoring systems for predicting the outcome of cytoreductive surgery in advanced-stage ovarian cancer – A systematic review

The extent of peritoneal metastases (PM) largely determines the possibility of complete or optimal cytoreductive surgery in advanced ovarian cancer. An objective scoring system to quantify the extent of PM can help clinicians to decide whether or not to embark on CRS. Therefore several scoring systems have been developed by different research teams and this review summarizes their performance in predicting a complete or optimal cytoreduction in patients with advanced ovarian cancer. A systematic search in the MEDLINE database revealed 19 articles that described a total of five main scoring systems to predict the completeness of CRS in patients with FIGO stage III-IV ovarian cancer based on the surgical exploration of the abdominal cavity; PCI, PIV, Eisenkop, Espada, and Kasper. The Peritoneal Cancer Index (PCI) and the Predictive Index Value (PIV) were mentioned most frequently and showed AUCs of 0.69–0.92 and 0.66–0.98, respectively. Due to the use of different cut-offs sensitivities and specificities greatly varied. Therefore with the current data, no scoring system could be identified as best. An objective measure of the extent of disease can be of great clinical use for identifying ovarian cancer patients for which a complete (or optimal) CRS is achievable, however due to local differences in treatment strategies and surgical policy a widely adopted objective scoring system with a standard cut-off value is not feasible. Nevertheless, objective scoring systems can play an important role to guide treatment decisions.     

慢性乙型肝炎患者病毒复制与肝纤维化五项联合检测的临床应用

目的探讨慢性乙型肝炎患者乙型肝炎病毒(HBV)DNA复制与肝纤维化五项指标:透明质酸(HA)、Ⅲ型前胶原N端肽(PⅢPN)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、甘胆酸(CG)联合检测的临床意义。方法选取2018年7月至2019年9月在汉川市人民医院确诊的慢性乙型肝炎患者109例为研究对象,选取40例健康体检者为对照组,按HBV DNA的载量,将研究对象分为低载量组(104copy/mL)39例,中载量组[(104～106)copy/mL]33例,高载量组(106copy/mL)37例,对照组(500 copy/mL)40例。分别检测HBV DNA和肝纤维化五项,采用SPSS 19.0统计学软件对数据进行统计分析。结果低载量组和中载量组肝纤五项检测结果与对照组比较,差异无统计学意义(P0.05);高载量组肝纤五项检测结果与对照组比较,差异有统计学意义(P0.05)。随着HBV DNA载量的增加,肝纤五项各检测指标的数值也在增加。肝纤五项(HA、PⅢPN、CⅣ、LN、CG)的ROC曲线下面积(AUC)分别为0.556、0.763、0.742、0.420、0.695,其中PⅢPN的AUC最大,表明PⅢPN比其他指标对肝脏疾病的诊断准确率最高;LN的AUC最小,0.5,表明其单独诊断的准确率低。结论 HBV DNA载量与血清肝纤维化五项指标联合检测是慢性乙型肝炎患者病情监测的一个良好指标,临床应及时关注慢性乙型肝炎患者病毒复制与肝纤维化水平,延缓肝硬化的发生。     

Novelty,conditioning and attentional bias to sexual rewards

The Internet provides a large source of novel and rewarding stimuli, particularly with respect to sexually explicit materials. Novelty-seeking and cue-conditioning are fundamental processes underlying preference and approach behaviors implicated in disorders of addiction. Here we examine these processes in individuals with compulsive sexual behaviors (CSB), hypothesizing a greater preference for sexual novelty and stimuli conditioned to sexual rewards relative to healthy volunteers. Twenty-two CSB males and forty age-matched male volunteers were tested in two separate behavioral tasks focusing on preferences for novelty and conditioned stimuli. Twenty subjects from each group were also assessed in a third conditioning and extinction task using functional magnetic resonance imaging. CSB was associated with enhanced novelty preference for sexual, as compared to control images, and a generalized preference for cues conditioned to sexual and monetary versus neutral outcomes compared to healthy volunteers. CSB individuals also had greater dorsal cingulate habituation to repeated sexual versus monetary images with the degree of habituation correlating with enhanced preference for sexual novelty. Approach behaviors to sexually conditioned cues dissociable from novelty preference were associated with an early attentional bias to sexual images. This study shows that CSB individuals have a dysfunctional enhanced preference for sexual novelty possibly mediated by greater cingulate habituation along with a generalized enhancement of conditioning to rewards. We further emphasize a dissociable role for cue-conditioning and novelty preference on the early attentional bias for sexual cues. These findings have wider relevance as the Internet provides a broad range of novel and potentially rewarding stimuli.     

Males show stronger contextual fear conditioning than females after context pre-exposure

Estradiol affects the structure and function of the hippocampus. We have found that repeated estradiol affects neurogenesis and cell death in the hippocampus of adult female, but not male rats. In the present study we sought to determine whether using the same regimen of estradiol would influence hippocampus-dependent behaviour. Adult male and female rats were given estradiol or sesame oil for 15 days, and then tested using a contextual pre-exposure paradigm in which performance depends on the hippocampus. The time spent freezing displayed by rats was scored on subsequent days in (1) the training context, (2) a novel context in which rats had never been shocked, and (3) the training context a second time. Irrespective of treatment, males showed stronger memory for the context by exhibiting greater freezing in both the training context exposures and the novel context. Previous estradiol treatment, in either sex, did not affect the ability to learn and retain information about the training context. However, female rats treated with estradiol and exposed to a novel context after fear conditioning exhibited less freezing behaviour than controls. Taken together, our results demonstrate that gonadectomized male rats outperform females, regardless of previous treatment with estradiol, on a hippocampus-contextual fear conditioning test, and that previous estradiol treatment has a subtle effect on performance in female but not male rats.     

Which are the most important discriminatory items for subclassifying non‐specific low back pain? A Delphi study among Greek health professionals

Rationale, aims and objectives Developing homogenous low back pain (LBP) classification groups is recommended for enhancing clinical outcomes. However, an important step towards the development of specific subgroups is the selection and consensus agreement among health professionals on the discriminatory clinical items (sings and symptoms) that should be included in the classification process. Thus, this study's objective was to develop a list of clinical features for the assessment of LBP by health care providers within Greece, which are believed to be discriminatory in identifying LBP subgroups. Methods A random sample stratified by geographical region and work status of 150 Greek physiotherapists (PTs) participated in a two‐round Delphi study. PTs were asked to obtain consensus and hierarchy, the most important items out of a list of evaluating/diagnostic features believed to be discriminatory for LBP patients. These items included 80 clinical features and were generated in by PTs and doctors previous work. Results Second‐round questionnaires were returned by 112 PTs (74.6% response rate). A total of 66 clinical features were rated as important discriminatory items in LBP assessment. Clinical items included characteristics of present symptoms and the history's condition, general medical history, information regarding patient function, patients' attitudes regarding movement, diagnosis, expectations, fear‐avoidance beliefs as well as aspects of a physical examination including observation, active and passive movements, neurological and muscular examination. Conclusions This is the first study identifying important clinical items for LBP patients in Greece. It may be that these features are ‘discriminatory’ for different LBP subsets; however, further research is needed.