情境模拟教学在康复专科护士临床实践教学中的应用探讨

目的分析和探讨康复专科护士学员在临床实践教学中应用情境模拟教学的效果。方法随机将2019年1—12月我院康复医学中心招收的80名康复专科护士学员随机分为观察组和实验组,观察组(40名)采用常规临床带教,实验组(40名)采用情境模拟教学方法。结果实验组学员理论知识平均得分、实践操作平均得分及康复专科护士学员对带教老师满意度均高于观察组(P<0.05)。结论在临床实践教学过程中应用情境模拟教学,能有效提升康复专科护士的理论知识水平及临床实践操作能力,提高教学质量和教学水平,提升教学效果。     

正常人开闭口位颞颌关节盘磁共振影像测量分析

目的:探讨正常人颞颌关节开、闭口位关节盘的形态变化特点及意义。方法:对9名健康男性大学生(21~23 岁),用超导磁共振仪,小视野线圈,分别采用左右侧卧位,拍摄双侧TMJ矫正矢状位质子加权开口位和闭口位不同层面的MRI影像,层厚3 mm,选取其中能清楚反映关节盘形态的166张图像用电子测量尺测量其关节盘的断面面积和周长。结果:正常人颞颌关节盘闭口位影像呈窄长形,开口位影像呈哑铃形;开口位影像断面面积明显大于闭口位面积(P<0101),断面周长二者间无明显差别(P>0105)。结论:正常人开口状态下颞颌关节盘形态较闭口时明显变粗,可能是该两种状态下关节内压变化的反映。     

Endogenous protein and enzyme fragments induce immunoglobulin E‐independent activation of mast cells via a G protein‐coupled receptor,MRGPRX2

Mast cells play a central role in inflammatory and allergic reactions by releasing inflammatory mediators through 2 main pathways, immunoglobulin E‐dependent and E‐independent activation. In the latter pathway, mast cells are activated by a diverse range of basic molecules (collectively known as basic secretagogues) through Mas‐related G protein‐coupled receptors (MRGPR s). In addition to the known basic secretagogues, here, we discovered several endogenous protein and enzyme fragments (such as chaperonin‐10 fragment) that act as bioactive peptides and induce immunoglobulin E‐independent mast cell activation via MRGPRX 2 (previously known as MrgX2), leading to the degranulation of mast cells. We discuss the possibility that MRGPRX 2 responds various as‐yet‐unidentified endogenous ligands that have specific characteristics, and propose that MRGPRX 2 plays an important role in regulating inflammatory responses to endogenous harmful stimuli, such as protein breakdown products released from damaged or dying cells.     

The accuracy of diagnostic tests for adenoid hypertrophy: A systematic review

BackgroundAdenoid hypertrophy may cause sleep-disordered breathing and altered craniofacial growth. The authors conducted a study to gauge the accuracy of alternative tests compared with nasoendoscopy (reference standard) for screening adenoid hypertrophy.MethodsThe authors conducted a systematic review that included searches of electronic databases, hand searches of bibliographies of relevant articles and gray literature searches. They included all articles in which an alternative test was compared with nasoendoscopy in children with suspected nasal or nasopharyngeal airway obstruction.ResultsThe authors identified seven articles that were of poor to good quality. They identified the following alternative tests: multirow detector computed tomography (sensitivity, 92 percent; specificity, 97 percent), videofluoroscopy (sensitivity, 100 percent; specificity, 90 percent), rhinomanometry with decongestant (sensitivity, 83 percent; specificity, 83 percent) and clinical examination (sensitivity, 22 percent; specificity, 88 percent). Lateral cephalograms tended to have good to fair sensitivity (typically 61-75 percent) and poor specificity (41-55 percent) when adenoid size was evaluated but excellent to good specificity when airway patency was evaluated (68-96 percent).ConclusionsNo ideal tool exists for dentists to screen adenoid hypertrophy, owing to access constraints, radiation concerns and suboptimal diagnostic accuracy. Research is needed to identify a low-risk, easily acceptable, highly valid diagnostic screening tool.Practical ImplicationsAlthough lateral cephalograms (which have good to fair sensitivity) and a thorough medical history (which has good specificity) are imperfect individually, when they are used together, they can compensate for each other's weaknesses. This combined approach is the best tool available to dentists for screening adenoid hypertrophy.     

Quantifying hemodynamic refractory bold effects in normal subjects at the single-subject level using an inverse logit fitting procedure

Purpose:

To evaluate whether hemodynamic refractory effects provoked by repeated visual stimulation can be detected and quantified at the single‐subject level using a recently described hemodynamic response function (HRF) fitting algorithm.

Materials and Methods:

Hemodynamic refractory effects were induced with an easily applicable functional MRI (fMRI) paradigm. A fitting method with inverse logit (IL) functions was applied to quantify net HRFs at the single‐subject level with three interstimulus intervals (ISI; 1, 2, and 6 s). The model yielded amplitude, latencies, and width for each HRF.

Results:

HRF fitting was possible in 44 of 51 healthy volunteers, with excellent goodness‐of‐fit (R² = 0.9745 ± 0.0241). Refractory effects were most pronounced for the 1‐s ISI (P < 0.001) and had nearly disappeared for the 6‐s ISI.

Conclusion:

Quantifying refractory effects in individuals was possible in 86.3% of normal subjects using the IL fitting algorithm. This setup may be suitable to explore such effects in individual patients. J. Magn. Reson. Imaging 2012;35:723‐730. © 2011 Wiley Periodicals, Inc.     

Single- and multiple-dose pharmacokinetics of genistein capsules in healthy chinese subjects: A phase I, randomized, open-label study

Background: Genistein capsules are currently being developed to treat osteoporosis in China. Genistein is extracted from the fruit of Sophora japonica Leguminosae.Objective: The objective of this study was to assess the pharmacokinetics of genistein capsules after single and multiple oral doses in healthy Chinese subjects.Methods: This was a Phase I, randomized, open-label, single- and multiple- dose study in healthy Chinese adults (aged 19-40 years). In the single-dose study, subjects were randomly assigned in a 1:1:1 ratio to receive genistein 50, 100, or 300 mg (in 50-mg capsules). To assess the effect of food on the pharmacokinetics, subjects in the 50-mg group were equally randomized again into fasting and postprandial (genistein was administered after a high-fat breakfast) groups according to a 2-way cross-over design. A separate equal-sized group of subjects were administered genistein 50 mg on day 1 (single dose), received no treatment on days 2 and 3, and were administered genistein 50 mg QD for 6 days (days 4-9) to obtain a multiple-dose pharmacokinetic profile. Because genistein is converted so rapidly and completely to glucuronidated genistein after administration, plasma concentrations of glucuronidated genistein were determined using a validated high-performance liquid chromatography/ tandem mass spectrometry method. Drug tolerability was assessed by monitoring adverse events (AEs) and laboratory parameters.Results: The study enrolled 40 healthy subjects (24 men, 16 women; 10 each in the 50-, 100-, and 300-mg single-dose groups and 10 in the multiple-dose group). Three subjects voluntarily withdrew (2 in the 100-mg group and 1 in the 300-mg group) before study drug administration. Thirty-seven subjects (24 men, 13 women) completed the study and were included in the analysis. The mean (SD) values of the single-dose genistein 50-, 100-, and 300-mg groups were as follows: T_max, 6.0 (2.4), 7.4 (2.4), and 5.6 (1.2) hours, respectively; t_l/2, 13.0 (4.0), 12.6 (5.8), and 9.4 (1.1) hours; AUC_0−t, 3344 (1635), 8389 (5164), and 9361 (2428) ng/mL · h⁻¹; and C_max , 218.7 (68.6), 435.7 (202.1), and 553.4 (152.8) ng/mL. The plasma glucuronidated genistein concentrations were directly proportional to the administered dose over the range of 50 to 100 mg and increased nonproportionately with the 300-mg dose. No statistically significant differences in pharmacokinetic parameters were found in the fasting group compared with the postprandial group. In the multiple-dose group, the mean (SD) steady-state pharmacokinetic parameters on day 9 were similar to those following a single dose of genistein on day 1 (T_max, 6.0 [1.0] vs 5.9 [1.5] hours, respectively; t_l/2, 9.5 [1.5] vs 9.1 [1.5] hours; AUC_0−t, 2830 [1541] vs 2078 [1308] ng/mL · h⁻¹; C_max, 203.1 [130.9] vs 168.4 [105.7] ng/mL). All AEs were assessed as mild or moderate and resolved without treatment, with the exception of elevated alanine aminotransferase and aspartate aminotransferase activities in one subject that resolved with treatment.Conclusions: The pharmacokinetics of glucuronidated genistein appeared to fit the linear-dose range of genistein 50 to 100 mg, but not the 300-mg dose in these healthy Chinese volunteers. Food consumption did not significantly affect the pharmacokinetic properties. No significant differences were observed in the pharmacokinetic parameters after multiple doses of genistein compared with a single dose, suggesting that the drug did not accumulate after multiple doses.     

Vaccinia virus strain LC16m8 defective in the B5R gene keeps strong protection comparable to its parental strain Lister in immunodeficient mice

BackgroundAttenuated vaccinia virus strain, LC16m8, defective in the B5R envelope protein gene, is used as a stockpile smallpox vaccine strain in Japan against bioterrorism: the defect in the B5R gene mainly contributes to its highly attenuated properties.MethodsThe protective activity of LC16m8 vaccine against challenge with a lethal dose of vaccinia Western Reserve strain was assessed in wild-type and immunodeficient mice lacking CD4, MHC class I, MHC class II or MHC class I and II antigens.ResultsThe immunization with LC16m8 induced strong protective activity comparable to that of its parent strain, Lister (Elstree) strain, in wild-type mice from 2 days to 1 year after vaccination, as well as in immunodeficient mice at 2 or 3 weeks after vaccination. These results implicated that the defect in the B5R gene hardly affected the potential activity of LC16m8 to induce innate, cell-mediated and humoral immunity, and that LC16m8 could be effective in immunodeficient patients.ConclusionLC16m8 with truncated B5 protein has an activity to induce immunity, such as innate immunity and subsequent cell-mediated and humoral immunity almost completely comparable to the activity of its parental strain Lister.