LEVOMEPROMAZINE FOR NAUSEA AND VOMITING IN PALLIATIVE CARE

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online (http://www.thecochranelibrary.com). The April 2013 issue (2nd DVD for 2013) contains 5484 complete reviews, 2341 protocols for reviews in production, and 22,600 short summaries of systematic reviews published in the general medical literature. In addition, there are citations of 692,000 randomized controlled trials, and 15,700 cited papers in the Cochrane methodology register. The health technology assessment database contains some 12,000 citations. Ninety-four new reviews have been published in the previous 3 months, of which four have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 5.715. Readers are encouraged to access the full report for any articles of interest, as only a brief commentary is provided.     

吴崐著作版本考

吴崐是新安医学名家之一.1584年,吴崐撰成《医方考》6卷.1594年,撰成《素问吴注》24卷.1618年,撰成《针方六集》6卷,由程标捐资刊刻.吴崐尚撰有《脉语》2卷,成书年代不详.《医方考》有明刊本、日本及朝鲜刊本、旧抄本、现代版本4类版本.《吴注素问》有明清刊本、日本刊本、旧抄本、影印本、现代版本5类版本.《针方六集》有明刊本、抄本、影印本及现代版本4类版本.《脉语》多与《医方考》合刊,除部分现代版本未附《脉语》之外,《脉语》的版本大致同于《医方考》.     

经尿道输尿管镜术治疗输尿管结石的护理

目的:正确掌握经输尿管镜手术的护理.方法:总结36例经尿道输尿管镜手术病人的护理.结果:治疗成功30例,手术时间15～100 min,失败6例,其中因输尿管结石过大者4例,合并输尿管息肉者2例,于术中转开放手术.结论:对患者需求的调查分析,并采取有效措施,是提高护理效果,满足患者护理需求的有效措施.     

光盘镜像技术在大型医院病案信息化管理中的应用

病案是医学临床信息的重要载体。利用光盘镜像技术，将扫描后保存为光盘的病案，存人光盘镜像服务器中，实现了实时访问、智能检索、快速查询浏览和传输功能，改善了病案存储环境，提高了工作效率及病案的利用率。同时，可利用病案管理软件进行相应的统计和分析，实现了信息管理的科学化和标准化，为医疗信息资源得以进一步的开发和利用探索了一条有效途径。     

Mirror Movements of Hind Limbs of the Rat with Experimentally Induced Lumbosacral Agenesis

Abstract Neuropathological and electrophysiological studies were designed to clarify the pathomechanism of motor disturbance in the hind limbs of rats with sacral agenesis. The model animals were obtained from mother rats which had been treated with trypan blue on day 8 of gestation. Mirror movements in the hind limbs were observed in 7 out of 56 rats with lumbosacral agenesis. The conus medullaris in rats with lumbosacral agenesis ended at the level between Th13-L1 vertebra, whereas that in normal cases terminated between L3-4. The spinal cord of the lumbosacral region was hypoplastic and dysplastic particularly in the ventral half. Anterior horn cells were sporadic and there were no apparent median fissure in the spinal cord of the lumbosacral region. On the other hand, any abnormality was not found in the brain, the brain stem, and the spinal cord of the cervicothoracic region. Horseradish peroxidase (HRP) was injected into the unilateral hind limbs. In segments of the anomalous spinal cord, HRP-labeled neurons in the anterior horn were found not only on the injected side but also on the other side. In electrophysiological examination, F' wave was recorded on the non-stimulated side with longer latency and duration compared with that of the stimulated side. These morphological and physiological findings indicated that the mirror movements in the hind limbs of the model animals may arise from developmental errors of motor nervous pathway, with some deficient inhibitory mechanism in the upper neural system.     

Dissociable substrates for body motion and physical experience in the human action observation network

Observation of human actions recruits a well-defined network of brain regions, yet the purpose of this action observation network (AON) remains under debate. Some authors contend that this network has developed to respond specifically to observation of human actions. Conversely, others suggest that this network responds in a similar manner to actions prompted by human and non-human cues, and that one's familiarity with the action is the critical factor that drives this network. Previous studies investigating human and non-human action cues often confound novelty and stimulus form. Here, we used a dance-learning paradigm to assess AON activity during observation of trained and untrained dance cues where a human model was present or absent. Results show that individual components of the AON respond differently to the human form and to dance training. The bilateral superior temporal cortex responds preferentially to videos with a human present, regardless of training experience. Conversely, the right ventral premotor cortex responds more strongly when observing sequences that had been trained, regardless of the presence of a human. Our findings suggest that the AON comprises separate and dissociable components for motor planning and observing other people's actions.     

Procedural learning and striatofrontal dysfunction in Parkinson's disease.

The neural basis of procedural learning remains controversial. We further analyzed procedural learning in nondemented patients with Parkinson's disease (PD) according to the specific demands of the tasks and the severity of striatal and frontal lobe dysfunction. In the first experiment, the performance of 20 nondemented PD patients and matched normal control subjects was studied in two procedural learning tasks, rotor pursuit and mirror reading, that differ in terms of motor and cognitive involvement. A second experiment further assessed the relationship between learning in mirror reading and executive functions in a new group of 15 nondemented PD patients. In rotor pursuit, PD patients significantly progressed across the first sessions, although their asymptotic performance was inferior to that of controls. In mirror reading, both experiments showed substantial learning in PD patients considered as a group. However, subsequent analyses allowed us to distinguish PD patients without executive dysfunction, whose learning was normal, from PD patients with executive dysfunction, whose learning was severely impaired. These results confirm the involvement of striatofrontal circuits in procedural learning and indicate that the intervention of the frontal network may depend on the characteristics of the task.     

Conserved and novel structural characteristics of enantiomorphic Leu-enkephalin

The crystal of the Leu-enkephalin raceinate (L-Tyr-Gly-Gly-L-Phe-L-Leu and d -Tyr-Gly-Gly-D-Phe-D-Leu) was obtained as a centrosymmetric space group. Crystal data: C₂₈H₃₇N₅O₇· 1.5H₂O, M_w, = 582.6, triclinic, space group PI, a = 11.176(3), b = 16.115(3), c = 10.204(4) Å, α= 92.41(3), β= 104.86(2), γ= 85.35(2) °, V= 1770(1) ų, Z= 2; F(000) = 640, μ(CuKα) = 6.50 cm^?1, D_x= 1.081 g cm^?3. The structure was determined by X-ray diffraction. The conformation of the Leu-enkephalin racemate was classified into the extended form which has been often observed in natural enkephalin. The symmetry-related molecules were connected by hydrogen bonds and arranged in an antiparallel fashion. The molecular packing showed a sheet structure similar to that of natural enkephalin.