腹腔镜Anderson-Hynes小儿肾盂输尿管成形的手术配合

目的总结腹腔镜辅助下小儿肾盂输尿管成形的手术配合经验。方法回顾分析32例肾积水患儿于腹腔镜下经结肠系膜入路行Anderson-Hynes肾盂输尿管成形术的手术配合资料。结果 32例患儿手术中医护配合默契,顺利完成手术。结论充分的术前准备,熟练的手术配合,仪器设备、器械的正确维护保养是手术顺利进行的保障。     

Analysis of Chlamydomonas thiamin metabolism in vivo reveals riboswitch plasticity

Thiamin (vitamin B₁) is an essential micronutrient needed as a cofactor for many central metabolic enzymes. Animals must have thiamin in their diet, whereas bacteria, fungi, and plants can biosynthesize it de novo from the condensation of a thiazole and a pyrimidine moiety. Although the routes to biosynthesize these two heterocycles are not conserved in different organisms, in all cases exogenous thiamin represses expression of one or more of the biosynthetic pathway genes. One important mechanism for this control is via thiamin-pyrophosphate (TPP) riboswitches, regions of the mRNA to which TPP can bind directly, thus facilitating fine-tuning to maintain homeostasis. However, there is little information on how modulation of riboswitches affects thiamin metabolism in vivo. Here we use the green alga, Chlamydomonas reinhardtii, which regulates both thiazole and pyrimidine biosynthesis with riboswitches in the THI4 (Thiamin 4) and THIC (Thiamin C) genes, respectively, to investigate this question. Our study reveals that regulation of thiamin metabolism is not the simple dogma of negative feedback control. Specifically, balancing the provision of both of the heterocycles of TPP appears to be an important requirement. Furthermore, we show that the Chlamydomonas THIC riboswitch is controlled by hydroxymethylpyrimidine pyrophosphate, as well as TPP, but with an identical alternative splicing mechanism. Similarly, the THI4 gene is responsive to thiazole. The study not only provides insight into the plasticity of the TPP riboswitches but also shows that their maintenance is likely to be a consequence of evolutionary need as a function of the organisms’ environment and the particular pathway used.     

Working Without a Net: Leukemia and Lymphoma Survivors’ Perspectives on Care Delivery at End-of-Treatment and Beyond

This study explored survivors’ perspectives on care delivery and supportive care needs during reentry. Fifty-one individual interviews were conducted with adult leukemia and lymphoma survivors, 3 to 48 months from treatment cessation. Survivors reported poor continuity of care across the patient–survivor transition, difficulty finding appropriate information/services, lack of preparation, lack of support for survivorship issues, and inadequate or poorly timed follow-up as factors contributing to adjustment difficulties at end of treatment and beyond. Improved care coordination is needed after active treatment, including use of an exit interview and delivery of services that are more congruent and better timed to meet ongoing and emergent survivorship needs.     

医教协同培养儿童药物临床研究人才的探索与实践

目的 在药学专业型研究生培养中探索儿童药物临床研究人才的培养模式。方法 分析儿童药物临床研究者应具备的素质，构建系统化、多层次的医教协同培养机制，以应用为导向优化课程体系，以儿科药物治疗需求为驱动引导学位论文选题，加强培养过程监管。通过促进研究生角色和观念转换，进行儿童药物临床研究技术培训，促进成果转化，强化研究生儿童药物临床研究能力培养。结果 初步建成了基于医教协同理念的儿童药物临床研究人才培养模式，培养的研究生符合社会与行业需求。结论 构建医教协同培养机制是培养儿童药物临床研究人才的重要路径。     

Recognition of lysozyme using surface imprinted bacterial cellulose nanofibers

Here, we developed the lysozyme imprinted bacterial cellulose (Lyz-MIP/BC) nanofibers via the surface imprinting strategy that was designed to recognize lysozyme. This study includes the molecular imprinting method onto the surface of bacterial cellulose nanofibers in the presence of lysozyme by metal ion coordination, as well as further characterizations methods FTIR, SEM and contact angle measurements. The maximum lysozyme adsorption capacity of Lyz-MIP/BC nanofibers was found to be 71 mg/g. The Lyz-MIP/BC nanofibers showed high selectivity for lysozyme towards bovine serum albumin and cytochrome c. Overall, the Lyz-MIP/BC nanofibers hold great potential for lysozyme recognition due to the high binding capacity, significant selectivity and excellent reusability.     

The role of social workers in addressing nonmedical needs in primary health care

Nonmedical needs are intricately linked to health. Unaddressed nonmedical needs often result in poorer health and increased healthcare costs. Although social workers are well positioned to address nonmedical needs, their role in healthcare environments to address nonmedical needs is limited. The limited role relates to a lack of reimbursement streams, which stems from poor articulation about their unique contributions. An analysis of a case study in which a social worker using AIMS, a protocolized care coordination model, was undertaken to highlight specific activities performed by social workers. Implications for patient health outcomes and healthcare costs are discussed.     

Automatic classification of gait in children with early-onset ataxia or developmental coordination disorder and controls using inertial sensors

Early-Onset Ataxia (EOA) and Developmental Coordination Disorder (DCD) are two conditions that affect coordination in children. Phenotypic identification of impaired coordination plays an important role in their diagnosis. Gait is one of the tests included in rating scales that can be used to assess motor coordination.A practical problem is that the resemblance between EOA and DCD symptoms can hamper their diagnosis. In this study we employed inertial sensors and a supervised classifier to obtain an automatic classification of the condition of participants. Data from shank and waist mounted inertial measurement units were used to extract features during gait in children diagnosed with EOA or DCD and age-matched controls. We defined a set of features from the recorded signals and we obtained the optimal features for classification using a backward sequential approach. We correctly classified 80.0%, 85.7%, and 70.0% of the control, DCD and EOA children, respectively. Overall, the automatic classifier correctly classified 78.4% of the participants, which is slightly better than the phenotypic assessment of gait by two pediatric neurologists (73.0%). These results demonstrate that automatic classification employing signals from inertial sensors obtained during gait maybe used as a support tool in the differential diagnosis of EOA and DCD. Furthermore, future extension of the classifier’s test domains may help to further improve the diagnostic accuracy of pediatric coordination impairment. In this sense, this study may provide a first step towards incorporating a clinically objective and viable biomarker for identification of EOA and DCD.