Discontinuation of tube feeding in young children by hunger provocation - a randomized controlled trial

Tijdschrift voor Kindergeneeskunde -     

Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm

Objectives: This in vitro study investigated the effects of silver diamine fluoride (SDF) on dentine carious lesion with cariogenic biofilm. Study Design: Thirty human dentine blocks were inoculated with Streptococcus mutans and Lactobacillus acidophilus dual-species biofilm to create carious lesion. They were equally divided into test and control group to receive topical application of SDF and water. After incubation anaerobically using micro-well plate at 37oC for 7 days, the biofilms were evaluated for kinetics, morphology and viability by colony forming units (CFU), scanning electron microscopy (SEM), and confocal microscopy (CLSM), respectively. The carious lesion underwent crystal characteristics analysis, evaluation of the changes in chemical structure and density of collagen fibrils using x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and immune-labeling. Results: The log CFU of S. mutans and L. acidophilus in the test group was significantly lower than control group. SEM and CLSM showed confluent biofilm in control group, but not in test group. XRD showed the loss of crystallinity of dentine due to the dissolution of hydroxyapatite crystal structure in test group was less than control group. FTIR showed that log [Amide I: HPO42-] for test vs. control group was 0.31±0.10 vs. 0.57±0.13 (p<0.05). The gold-labeling density in test vs. control group was 8.54±2.44/µm2 vs. 12.91±4.24/µm2 (p=0.04). Conclusions: SDF had antimicrobial activity against the cariogenic biofilms and reduced demineralization of dentine. Key words:Caries, caries arrest, dentine, silver, silver diamine fluoride, fluoride, biofilm,cariogenic.     

白藜芦醇对动物离体心房收缩力和心率作用的种属差异性比较

目的:观察白藜芦醇对豚鼠、小鼠和家兔离体心肌收缩力和心率的影响。方法:实验于2005-08/2006-12在河北医科大学西校区实验中心完成。①实验分组:离体豚鼠、小鼠和家兔心肌各分为9组:空白对照组、溶剂对照组、递增累积浓度白藜芦醇组(浓度为10-6,3×10-6,10-5,3×10-5,10-4,3×10-4mol/L),白藜芦醇对照组(5×10-5mol/L),ATP敏感性钾通道阻断剂格列苯脲(5×10-5mol/L)预孵育 白藜芦醇组,钙激活钾通道阻断剂四乙胺(10-3mol/L)预孵育 白藜芦醇组,电压依赖性钾通道阻断剂4-氨基吡啶(10-3mol/L)预孵育 白藜芦醇组,内向整流钾通道阻断剂氯化钡(10-4mol/L)预孵育 白藜芦醇组,乙酰胆碱调节钾通道阻断剂阿托品(10-5mol/L)预孵育 白藜芦醇组。②实验方法:不同类型的钾通道阻断剂均预孵育15min后,分别加入白藜芦醇(终浓度为5×10-5mol/L),连续记录30min,与相应动物白藜芦醇对照组相比较。③评估指标:分析不同阻断剂与白藜芦醇联用对心房收缩力下降率及心率抑制率的影响。结果:①白藜芦醇可降低豚鼠和小鼠离体心肌收缩力和心率(P<0.05),并被ATP敏感性钾通道阻断剂格列苯脲和钙激活钾通道阻断剂四乙胺部分阻断。②白藜芦醇可降低家兔离体心肌心率,格列苯脲可阻断白藜芦醇的负性变时作用。③电压依赖性钾通道阻断剂4-氨基吡啶、内向整流钾通道阻断剂氯化钡、乙酰胆碱调节钾通道阻断剂阿托品均不能阻断白藜芦醇对3种不同动物离体心房收缩力和心率的作用(P>0.05)。结论:白藜芦醇可呈剂量依赖性减慢豚鼠、小鼠和家兔的心率,白藜芦醇可减弱豚鼠心肌收缩力,其作用是与开放ATP敏感性钾通道有关,而与电压依赖性钾通道、内向整流钾通道和乙酰胆碱调节钾通道无关。同时,钙激活钾通道也参与了白藜芦醇对豚鼠和小鼠离体心房收缩力和/或心率的抑制作用。白藜芦醇对离体心肌收缩力和心率的作用有种属差异性。     

A study of HLA (Bg) on red cells and platelets by immunoblotting with monoclonal antibodies

HLA class I antigens (Bg) on red cells (RBCs) are expressed by some normal donors and by many patients with systemic lupus erythematosus (SLE). To identify the membrane components previously detected by hemagglutination with HLA class I-specific monoclonal antibodies (MoAbs), RBC membrane preparations were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotted with the HLA class I MoAbs. Two components were obtained that reacted with the MoAbs: a heavy chain of 45 kDa and a light chain termed beta2-microglobulin (beta2-M) of 11 kDa. The effect of chloroquine and acid elution in stripping HLA antigens is shown to be due to the removal of beta2-M, as only that component was detected in eluates from reactive RBCs. Neither antibody elution method affected the heavy chain expression assessed by immunoblotting. It is concluded that HLA class I antigens on RBCs are integral membrane components of the type normally found and wisely distributed on many nucleated cells. Platelets, which have stronger HLA class I antigen expression, were also studied, and their membrane preparations yielded heavy chain and beta2-M molecules; the effect of chloroquine treatment was harder to assess than that of acid elution, owing to the sensitivity with which both components are detected in immunoblotting. In eluates obtained from acid treatment only beta2-M is detected.     

Palliative care at home: Stress for nurses in urban and rural New South Wales, Australia

Nurses often experience positive and negative dimensions of caring for dying clients and their families. This project aimed to compare stress experienced by urban and rural community nurses working with palliative-care clients in the home. Participants included five nurses working in rural Australia and seven nurses working in an urban area. Transcribed data from unstructured audio-taped interviews were coded for common and contrasting themes, and a comparison was made of the stress experienced by the two groups of nurses. The major themes were role conflict and definition, family dynamics, time and workload. For both groups of nurses, the impact of family relationships and role conflict within the community impacted significantly to the stress they experienced. Debriefing opportunities for nurses to discuss stress, including educational and support sessions, is an essential component of best practice. Rural nurses had the additional stress of trying to provide a 24 h service over vast distances with a lack of financial resources.     

Psychopathology in individuals with post-traumatic headaches and other pain types

In this study, the psychological functioning of patients with chronic post-traumatic headache (PTH), chronic combination headache and chronic low back pain without headache, whose time of onset was similar, and a matched group of controls was investigated. The Symptom Checklist 90-Revised (SCL-90-R), State-Trait Anger Expression Inventory (STAXI), State-Trait Anxiety Inventory, Form Y (STAI-Y), and Beck Depression Inventory (BDI) were used to assess the degree of psychopathology. A MANOVA test indicated highly significant differences between groups. In general, the pain groups fell along a continuum with PTH subjects demonstrating the highest elevations, back pain subjects demonstrating the next highest elevations, and combination subjects demonstrating fewer elevations. A cluster analysis indicated that findings were best classified into four clusters, but no one pain diagnosis predominated in any cluster. Eighty-nine percent of controls were assigned to clusters 1 or 2, which revealed essentially normal scores on all tests. It is suggested that while chronic pain patients demonstrate more psychopathology than non-pain controls, a variety of coping styles exists within each pain group independent of diagnostic categorization.     

N-甲基-D-天冬氨酸受体在缺氧缺血性脑损伤新生大鼠脑海马中的远期表达

目的:观察新生大鼠缺氧缺血性脑损伤后,海马发育过程中N-甲基-D-天冬氨酸受体的远期表达变化。方法:实验于2006-03/06在解放军第三军医大学新桥医院中心实验室完成。选用新生7日龄SD大鼠72只,按随机数字表法分为缺氧缺血性脑损伤组和假手术组,每组36只。各组又分为生后15d(n=6)、22d(n=6)、29d(n=6)、36d(n=12)及43d(n=6)5个时相点。①参照Rice法通过结扎7日龄大鼠左侧颈总动脉,吸入氧气体积分数为0.08的氮氧混合气,制成缺氧缺血性脑损伤模型,出现自发或夹尾左旋则证明模型制作成功。假手术组仅切开颈部皮肤,暴露左侧颈总动脉。②应用免疫组织化学法检测缺氧缺血后不同时点两组大鼠脑海马CA1区N-甲基-D-天冬氨酸受体NR1亚单位的表达(n=6),测量平均灰度值,灰度值越低,蛋白表达越强;生后36d时相点大鼠(n=6)利用Morris水迷宫测定学习记忆能力;最后应用电镜观察生后36d大鼠海马突触结构。结果:72只大鼠,全部进入结果分析,无脱失。①生后22-43d缺氧缺血性脑损伤组大鼠(缺氧缺血后15-36d)脑海马CA1区NR1平均灰度值分别为167.69±6.48,174.57±4.81,179.30±5.92,176.50±5.93,均显著高于同日龄假手术组148.96±4.91,151.17±6.37,152.06±9.86,156.32±6.86(P均<0.01)。②Morris水迷宫实验中,缺氧缺血性脑损伤组大鼠逃避潜伏期显著长于假手术组(48.87±9.47)s,(11.97±2.20)s,(P<0.01);原平台象限游泳距离/总游泳距离的百分比显著低于假手术组(14.45±3.85)%,(62.20±8.74)%(P<0.01)。③生后36d(缺氧缺血后29d),透射电镜下缺氧缺血性脑损伤组大鼠患侧海马突触后膜致密物较假手术组明显减少。结论:新生大鼠缺氧缺血性脑损伤后期存在海马N-甲基-D-天冬氨酸受体的表达下调,可能对大鼠远期空间学习记忆产生一定影响。     

Respiratory insufficiency in neuronopathic and neuropathic disorders

Twenty-nine patients with a neuronopathic or neuropathic disorder were referred for assessment of respiratory insufficiency between 1978 and 1994. Diagnoses included spinal muscular atrophy (6), chronic idiopathic demyelinating neuropathy (4), Vialetto-van Laere syndrome (3), hereditary motor and sensory neuropathy (3) and a miscellaneous group (5). We also describe seven patients with Guillain-Barre syndrome (GBS) who required long-term ventilatory support for over 6 months to 7 years after the initial illness. Respiratory insufficiency occurred as a consequence of respiratory muscle weakness, impaired bulbar function and restrictive lung defects. In some groups presentation was with progressive nocturnal hypoventilation culminating in acute respiratory failure. Five patients with GBS or chronic idiopathic demyelinating neuropathy were weaned from ventilatory support up to 18 months after the initial illness. The remaining 24 patients required continuous or nocturnal ventilatory support using intermittent positive-pressure ventilation (13), negative pressure ventilation (4), nasal-mask-delivered intermittent positive-pressure ventilation (4), nasal-mask-delivered continuous positive-pressure ventilation (3), mouthpiece-assisted ventilation by day (2) and rocking bed (1). None have been weaned from support after a period of ventilation ranging from one month to 10 years. Eight patients have subsequently died.      

Clinical measurement of swallowing in health and in neurogenic dysphagia

We studied clinical features potentially related to dysphagia and three indices from a timed test of swallowing--average volume per swallow (ml), average time (s) per swallow and swallowing capacity (ml/s)--in 181 screened healthy adults and 30 patients with motor neurone disease (MND). In healthy adults, age, sex and height accounted for 44.3% and 55.6% of the variance of log average volume per swallow and log swallowing capacity, respectively. Symptoms and signs were more prevalent in the MND group and were associated with reduced swallowing capacity and reduced average volume per swallow; repeatability studies on these two indices in both groups showed that the median difference between the mean of two recordings on successive days and the mean of all recordings (6-15 over 3 days) was < 5% (maximum third quartile 12.8%, indices expressed as percent predicted according to age and sex). Using this simple bedside test, swallowing function can be quantified on a ratio scale and expressed as percent of that predicted by age and sex; such information may improve the predictive value of clinical assessment and provides a practical way of monitoring change in patients with dysphagia.