海绵窦区肿瘤的显微外科手术治疗

目的探讨海绵窦区肿瘤的显微外科手术入路方式。方法采用显微外科手术治疗海绵窦区肿瘤31例,其中海绵窦本身的肿瘤11例,毗邻侵及海绵窦的肿瘤20例;侵袭性垂体腺瘤11例,脑膜瘤15例,神经纤维瘤5侧。结果31例海绵窦区肿瘤采用显微外科手术治疗,次全切10例,效果良好,无死亡;主要并发症是颅神经损伤,有6例症状加重,5例出现新的损伤。结论海绵窦区手术是神经外科的难题,合适的手术入路扣良好的显微手术技能是手术成功的关键。     

Brain recruitment of dendritic cells following Li-pilocarpine induced status epilepticus in adult rats

Activation of inflammatory and immune pathways may contribute to the development of epilepsy. Dendritic cells (DCs), a heterogeneous group of professional antigen presenting cells, can be detected in the brain under several inflammatory conditions. However, the spatiotemporal distribution and origin of seizure-induced DCs accumulation in the brain have not been explored yet. In the present study, we demonstrate the presence of CD11c-positive DCs in the hippocampus, thalamus and temporal cortex following Li-pilocarpine induced status epilepticus (SE) in rats. Recruitment of DCs occurs as early as 1 day following the induction of SE, reaching peak time at day 3, and still evident until day 5. The recruitment of DCs in the brain following lithium chloride administration was not detected. The observed DCs cannot be double-labeled with Iba-1 (an activated microglia marker) and whole-body radiation prevents seizure-induced DCs accumulation in brain parenchyma. Our data suggest that the recruitment of DCs in the epileptic brain may be derived from peripheral circulation and this population of immune cells may be involved in the immune processes after SE.     

四川省泸州市医务人员对《中华人民共和国精神卫生法》知识的知晓情况

目的了解医务人员对《中华人民共和国精神卫生法》的知晓情况,为卫生行政部门推进精神卫生法的实施提供理论依据。方法采用方便抽样方法,在泸州市分别选取一家综合医院和专科精神病院的656名医务人员进行精神卫生法相关知识问卷调查。结果及格率83.2%。专科精神病院、综合医院精神科和硕士以下学历的医务人员得分较高(P0.05)。结论泸州市医务人员对精神卫生法知识的知晓率总体较高;但综合医院医务人员特别是非精神科医务人员以及硕士及以上人员的精神卫生法知识知晓率还有待提高。     

Graduating nurses' self-efficacy in palliative care practice: An exploratory study

BackgroundEducational institutions and the health care industry agree that graduates from professional programs need to be “work ready” and capable of delivering competent and confident nursing care. One measure of program success is the student's self-efficacy in meeting expected graduate capabilities. In this study student's self-efficacy is related to palliative care graduate capabilities.AimTo explore graduating Bachelor of Nursing Science (BNSc) students' self-efficacy in caring for palliative care patients.DesignA qualitative design using semi-structured face-to-face interviews.SettingA regional Australian university.ParticipantsA purposive sample of 10 students in their final semester of study in a Bachelor of Nursing Science degree program.MethodSemi-structured face-to-face interviews were conducted. Interview questions were informed by published palliative care graduate capabilities. Interview data were transcribed verbatim and coded by capability. The coded data were then analysed to determine evidence of self-efficacy in caring for palliative care patients.ResultsAll participants had experiences in caring for palliative care patients. However, the responses did not consistently reflect high degrees of self-efficacy in four documented palliative care graduate capabilities required to care for persons with a life-limiting illness.ConclusionsThe findings support others that have identified gaps between curriculum and health care industry requirements in terms of students' beliefs about their empowerment to deliver nursing care as graduates. Education interventions and approaches to program evaluation require further development to better support students' growth of self-efficacy in undertaking their graduate roles.     

甘冰漱口液防治放射性口腔炎的临床观察

目的: 观察漱口液对放射性口腔炎的影响。 方法: 选取鼻咽癌放疗患者45例,治疗组25例,对照组20例。在放疗开始1周后,治疗组使用甘冰漱口液进行含漱,对照组用配置的西药含漱,采用RTOG指标观察口腔反应,比较两组效果。 结果: 统计学结果均显示:放射治疗低剂量时,两组无显著性差异( P ＞0.05)。放射治疗中高等剂量时,两组有显著性差异( P ＜0.05)。 结论: 甘冰液治疗口腔炎的疗效确切,适用于鼻咽部肿瘤患者的放射治疗,降低口腔炎的发生。     

长期住院精神分裂症患者的孤独感与共情缺陷

目的探讨长期住院精神分裂症患者的孤独感和共情缺陷特征。方法采用病例对照研究,67例住院时间超过2年的精神分裂症患者为研究组,66例病史大于2年的门诊精神分裂症患者为对照组。所有受试完成一般情况调查表、感情-社会孤独量表(ESLS)和人际反应指针量表(IRI-C)。结果①两组性别、年龄、文化程度差异均无统计学意义(P均0.05);②研究组感情-社会孤独量表总评分高于对照组[(29.78±5.58)分vs.(27.16±3.79)分],差异有统计学意义(t=-3.17,P=0.002),情感孤独与社会孤独因子分也均高于对照组,差异有统计学意义(P均0.05);③研究组IRI-C总评分低于对照组[(31.39±11.02)分vs.(39.69±9.61)分],差异有统计学意义(t=4.61,P0.001),反映共情缺陷的"同情关心"因子评分研究组低于对照组[(9.21±3.46)分vs.(11.18±2.93)分],差异有统计学意义(t=3.55,P=0.001)。结论长期住院精神分裂症患者共情缺陷和孤独感明显,需鼓励患者回归社区以缓解孤独感,降低共情缺陷。     

“双心医学”模式下社区老年心脏病患者的抑郁症状

目的：探讨双心医学模式下社区老年常见心脏疾病与抑郁症状共患情况。方法采用横断面调查法,共调查771名社区老年患者,采用流调研究用抑郁量表（CES-D）调查抑郁症状,追踪老年患者的门诊或住院病历记录调查其心血管疾病：包括心绞痛、冠心病和高血压。结果心血管疾病（不包括高血压）总患病率为22.7%,其中冠心病为20.5%,心绞痛为10.9%;高血压患病率为49.3%。抑郁症状在所有心血管疾病患者中的发生率是20.9%。伴心血管疾病老年人的抑郁症状发生率（33.1%）高于无心血管疾病者（18.3%）,差异有统计学意义（χ^2=17.59,P〈0.001）;有冠心病者的抑郁症状发生率（34.8%）高于无冠心病者（18.3%）,差异有统计学意义（χ^2=20.25,P〈0.001）;有心绞痛疾病患者的抑郁症状发生率（34.5%）高于无心绞痛疾病者（20.1%）,差异有统计学意义（χ^2=9.19,P=0.002）;有高血压患者的抑郁症状发生率（25.0%）高于无高血压者（18.4%）,差异有统计学意义（χ^2=4.93,P=0.026）。结论社区老年人心血管疾病的罹患率高,在心血管疾病患者中抑郁症状的检出率比无心血管疾病患者高。需加强双心医学模式下对伴心血管疾患老年人的心理干预。     

131I标记多肽K237的最佳条件及标记肽的体外生物活性

目的探索131I标记多肽K237,获得放射化学纯度高于95%的131I-K237的最佳条件,研究标记产物的体外稳定性及生物学活性。方法应用Iodogen法对K237进行131I标记,采用正交实验筛选最佳标记条件。用高效液相色谱仪(HPLC)联合薄层层析法(TLC)测定标记率及放射化学纯度,SephadexG25层析柱分离纯化131I-K237。将分离纯化的131I-K237(放射化学纯度大于95%)分别放置于室温及37℃水浴箱,于不同时间测定其放射化学纯度以观察其稳定性。应用cck-8法进行人脐静脉内皮细胞(HUVEC)增殖抑制实验,分别计算K237及131I-K237对HUVEC的抑制率,判定131I-K237的生物活性。结果最佳标记条件中,K237100μg与Iodogen 50μg,在37℃条件下反应时间40 min,标记率可达70%以上。稳定性实验结果表明,131I-K237在体外放置24 h后,其放射化学纯度>90%。131I-K237和K237对HUVEC细胞增殖的抑制率差异无统计学意义(P>0.05),说明K237被131I标记后,其生物学活性未改变。结论 Iodogen法131I标记多肽K237简单高效,标记产物的生物活性得到保留,未受明显破坏。