小干扰RNA抑制成纤维细胞激活蛋白3的表达对肺癌干细胞增殖和侵袭的影响

目的:探讨小干扰RNA(siRNA)抑制成纤维细胞激活蛋白3(fibroblast activation protein 3,FAP3)基因表达对肺癌干细胞增殖和侵袭的影响。方法:采用流式细胞术从肺癌细胞株A549中分选出CD44+/CD133+的肺癌的肿瘤干细胞(cancerstem cells,CSCs)。将肺癌CSCs分为3组:空白对照组(不转染任何质粒)、siRNA-FAP组(转染靶向沉默FAP3表达的siRNA质粒)、阴性对照组(转染包含随机序列的siRNA质粒)。采用MTT比色法检测靶向FAP3表达的siRNA(siRNA-FAP3)转染12、24、48和72h后对细胞增殖的影响;采用实时荧光定量逆转录-聚合酶链反应(RT-PCR)法和蛋白质印迹法(Western blot)分别检测转染72h后细胞株中FAP3、Ki67的mRNA和蛋白质的表达情况;采用软琼脂克隆集落形成实验检测siRNA-FAP3对肺癌CSCs侵袭能力的影响。结果:转染48h和72h后,siRNA-FAP3组的细胞增殖抑制率[(24.67±1.08)%,(53.98±3.75)%]大于阴性对照组[(3.76±0.88)%,(4.53±1.01)%]及空白对照组[(2.34±0.41)%,(3.28±0.65)%],差异均有统计学意义(P分别<0.05和0.01)。转染72h后,siRNA-FAP组细胞中FAP3和Ki67基因的mRNA表达水平(0.32±0.06,0.18±0.02)显著低于阴性对照组(1.03±0.12,0.99±0.17)和空白对照组(1.02±0.09,0.97±0.11),差异有统计学意义(P<0.01)。转染72h后,siRNA-FAP组细胞中FAP3和Ki67蛋白表达水平(0.16±0.05,0.25±0.09)显著低于阴性对照组(0.49±0.26,0.47±0.13)和空白对照组(0.59±0.27,0.63±0.22),差异有统计学意义(P<0.05)。siRNA-FAP组细胞克隆形成率[(13.09±5.21)%]显著低于阴性对照组[(77.59±8.29)%]和空白对照组[(83.86±10.11)%],差异有统计学意义(P<0.01)。结论:转染siRNA可有效抑制肺癌CSCs中FAP3蛋白的表达,并且还可抑制CSCs的体外增殖和侵袭能力。     

牛磺酸上调基因1对人绒毛膜癌JEG-3细胞增殖及迁移和凋亡的影响

目的探讨牛磺酸上调基因1(taurine-upregulated gene 1,TUG1)在人绒毛膜癌JEG-3细胞增殖、迁移和凋亡中的作用。方法采用小干扰RNA(small interfering RNA,siRNA)技术构建TUG1慢病毒载体。将对数生长期人绒毛膜癌JEG-3细胞随机分为空白对照组(不作任何处理)、阴性对照组(转染阴性对照靶序列慢病毒载体)和转染组(转染siRNA-TUG1慢病毒载体)。采用实时荧光定量PCR法检测3组TUG1mRNA、caspase-3mRNA、caspase-9mRNA相对表达量,采用Western blot法检测3组TUG1、caspase-3、caspase-9蛋白相对表达量,采用Transwell小室试验检测3组培养24h细胞侵袭能力,采用CCK-8法检测3组细胞培养72h吸光度值,采用流式细胞术检测3组培养72h细胞凋亡率。结果构建siRNA-TUG1载体的慢病毒滴度为3×108 TU/mL;转染72 h,转染组TUG1 mRNA、caspase-3mRNA、caspase-9mRNA相对表达量(0.42±0.02、0.31±0.01、0.21±0.01)低于阴性对照组(1.09±0.03、1.29±0.03、1.02±0.01)和空白对照组(1.01±0.01、1.02±0.02、1.00±0.01)(P0.05),TUG1、caspase-3、caspase-9蛋白相对表达量(0.24±0.07、0.49±0.23、0.11±0.02)低于阴性对照组(7.32±0.05、10.12±1.47、9.98±2.78)和空白对照组(6.08±0.19、9.88±0.93、9.91±1.44)(P0.05);培养24h,转染组迁移细胞数[(52.11±4.09)个]较阴性对照组[(142.11±14.02)个]和空白对照组[(131.32±18.39)个]少(P0.05);培养72h,转染组细胞吸光度值(24.27±3.11)较阴性对照组(51.12±2.47)和空白对照组(60.34±1.24)低(P0.05),细胞凋亡率[(35.21±13.31)%]较阴性对照组[(3.09±1.13)%]和空白对照组[(4.21±1.24)%]高(P0.05);阴性对照组各观察指标与空白对照组比较差异均无统计学意义(P0.05)。结论 TUG1沉默表达慢病毒载体可明显抑制人绒毛膜癌JEG-3细胞增殖和侵袭,促进细胞凋亡。     

靶向p21基因saRNA抑制肝癌细胞生长实验研究

目的 探讨RNA激活p21对肝癌HepG2、Hep3b和SMMC-7721细胞生长和侵袭力的影响.方法 化学合成靶向p21的saRNA、阴性对照dsRNA,将其转染肝癌细胞系HepG2、Hep3b和SMMC-7721.每个细胞系分为3组,分别为p21-322组、阴性对照组和空白对照组,每组复3孔;p21-322组和阴性对照组分别采用p21-322 saRNA和阴性对照dsRNA进行转染,空白对照组不干预.转染后72 h,采用RT-PCR和Western blot检测各组细胞中的p21 mRNA和P21蛋白表达水平,采用MTT法检测细胞生长情况及划痕实验观察细胞侵袭能力的变化.结果 HepG2、Hep3b和SMMC-7721细胞p21-322组p21 mRNA相对表达水平分别为23.43±2.29、16.87±1.61、31.77±5.06,P21蛋白相对表达水平分别为55.93±12.66、32.91±5.17、24.96±6.81;空白对照组分别为3.53±0.07、2.39±0.02、5.70±0.89,3.21±0.03、2.91±0.14、4.15±0.12;阴性对照组分别为3.87±0.97、2.57±0.71、5.87±1.73,3.11±0.70、3.01±0.97、5.13±2.14;p21-322组p21 mRNA和蛋白相对表达水平明显高于空白对照组和阴性对照组(P＜0.01),空白对照组与阴性对照组比较差异无统计学意义(P＞0.05);细胞转染后第6天时HepG2、Hep3b、SMMC-7721细胞p21-322转染组细胞平均生长抑制率分别为41％、48％和52％;HepG2细胞p21-322组24 h后空白区域占原划痕区域面积的百分比((76±11)％)明显高于空白对照组((13±6)％)和阴性对照组((17±8)％)(P＜0.01),阴性对照组与空白对照组比较差异无统计学意义(P＞0.05).结论 靶向p21的RNAa能抑制肝癌细胞的生长和侵袭力,p21可作为一个具有肝癌治疗应用价值的靶基因.     

shRNA-FAM-38A基因对宫颈癌CS1213细胞增殖和迁移的影响

目的探讨shRNA-FAM-38A基因在宫颈癌CS1213细胞增殖和迁移中的作用。方法宫颈癌CS1213细胞分为空白对照组、阴性对照组和实验组。空白对照组细胞不转染慢病毒载体,阴性对照组细胞转染无序序列慢病毒载体,实验组细胞转染沉默shRNA FAM-38A慢病毒载体。采用实时荧光定量PCR法检测3组细胞FAM-38A、caspase-3和caspase-9 mRNA相对表达量,采用Transwell小室实验检测3组CS1213细胞迁移细胞数,采用CCK-8实验检测3组细胞增殖率。结果实验组细胞FAM-38A mRNA相对表达量(0.32±0.07)、迁移细胞数[(44.38±5.32)个]、细胞增殖率[(47.54±7.63)%]低于空白对照组[0.95±0.13、(99.72±19.63)个、(144.63±21.75)%]和阴性对照组[1.14±0.23、(119.63±21.87)个、(145.62±11.97)%](P0.05),caspase-3、caspase-9 mRNA相对表达量(5.11±1.21、12.64±2.87)高于空白对照组(0.84±0.09、0.22±0.03)和阴性对照组(0.89±0.12、0.21±0.04)(P0.05),空白对照组FAM-38A、caspase-3、caspase-9 mRNA相对表达量及迁移细胞数、细胞增殖率与阴性对照组比较差异均无统计学意义(P0.05)。结论 shRNA-FAM-38A基因可抑制宫颈癌细胞的增殖和迁移能力,可作为宫颈癌的潜在治疗靶点。     

siRNA干扰β-catenin基因表达情况与喉癌Hep-2细胞增殖、凋亡和侵袭的关系

目的探讨小干扰RNA(siRNA)干扰β-链蛋白(β-catenin)基因表达对喉癌Hep-2细胞增殖、凋亡和侵袭的影响。方法前瞻性选取喉癌Hep-2细胞,随机分为空白对照组、阴性对照组和干扰组,其中干扰组转染靶向β-catenin的siRNA,阴性对照组转染空白siRNA。采用荧光定量PCR和Western-blot检测β-catenin mRNA和蛋白表达,MTT检测细胞增殖,流式细胞仪检测细胞凋亡,Transell法观察细胞侵袭能力。结果干扰组β-catenin mRNA和蛋白相对表达量分别为(0.304±0.015)和(0.234±0.065),明显低于空白对照组和阴性对照组(P0.05);干扰组培养48 h和72 h吸光值分别为(0.721±0.250)和(0.942±0.321),明显低于空白对照组和阴性对照组(P0.05);干扰组细胞凋亡率为(19.10±1.24)%,明显高于空白对照组和阴性对照组(P0.05);干扰组穿膜细胞数为(22.41±3.25)个,明显低于空白对照组和阴性对照组(P0.05)。结论干扰β-catenin基因,可抑制喉癌Hep-2细胞增殖和侵袭,促进细胞凋亡。     

过表达DACT1通过调节凋亡相关蛋白对人白血病细胞增殖的抑制作用研究

目的研究过表达DACT1通过调节凋亡相关蛋白对人白血病细胞增殖的抑制作用。方法在人白血病K562细胞中,通过基因转染试剂对空载质粒vector与DACT1质粒分别进行转染,分别作为阴性对照组与观察组,并使DACT1呈现过表达。另设置一组未经任何处理的细胞为空白对照组。通过流式细胞术、CCK-8法对DACT1过表达后K562细胞周期、增殖、凋亡的影响进行检测。并采用Western blot法对DACT1过表达后调节凋亡相关蛋白的表达进行检测。结果观察组克隆形成率为(6. 33±0. 98)%,较空白对照组(20. 74±3. 12)%、阴性对照组(20. 43±3. 32)%均明显降低(P 0. 05)。细胞增殖实验结果发现,观察组细胞增殖活性较空白对照组、阴性对照组均显著降低。观察组细胞凋亡率为(28. 97±3. 04)%,较空白对照组(0. 85±0. 12)%、阴性对照组(0. 83±0. 09)%均显著升高(P 0. 05)。观察组细胞G0/G1期比例较空白对照组、阴性对照组显著增加(P 0. 05)。观察组半胱氨酸天冬氨酸蛋白酶-3(caspase-3)、半胱氨酸天冬氨酸蛋白酶-9(caspase-9)、Bcl-2相关X蛋白(Bax)等促凋亡蛋白表达较空白对照组和阴性对照组均显著上调,而B淋巴细胞癌-2(Bcl-2)等抗凋亡蛋白的表达较空白对照组和阴性对照组均显著降低。结论在人白血病K562细胞中,DACT1过表达可阻滞细胞增殖,促使细胞凋亡,亦会影响细胞周期,使得细胞出现G0/G1期阻滞。分析其原因,可能与DACT1过表达具有潜在的抗肿瘤作用,其作用机制可能与上调促凋亡蛋白(caspase-3、caspase-9、Bcl-2)表达和抑制抗凋亡蛋白(Bcl-2)表达密切相关。     

血管内皮生长因子、p53蛋白与微血管密度在非小细胞肺癌中的表达及其相关性

目的:研究血管内皮生长因子(VEGF)、p53蛋白、微血管密度(MVD)在非小细胞肺癌中的表达及其相关性,探讨其在非小细胞肺癌发生、发展中的作用.方法:采用免疫组织化学S-P法检测80例非小细胞肺癌组织、20例肺良性病变组织中VEGF、p53蛋白的表达,并对肺癌组织中CD34单抗标记的血管计数MVD.结果:肺癌组织VEGF、p53蛋白阳性表达率明显高于肺良性病变组织(P＜0.05).VEGF、p53蛋白表达与肺癌患者的年龄、性别、组织学类型均无关(P＞0.05),与肺癌组织的分化程度、TNM分期及淋巴结转移均有关(P＜0.05).VEGF与p53蛋白表达呈正相关(P＜0.05).在肺癌组织中,VEGF、p53蛋白表达阳性组MVD分别明显高于VEGF、p53蛋白表达阴性组(P＜0.05);p53蛋白与VEGF表达均阳性组MVD明显高于p53蛋白与VEGF表达均阴性组(P＜0.05).结论:VEGF、p53可能与肺癌的发生、发展有关.VEGF与p53蛋白在肺癌组织中的表达呈正相关,提示突变型p53基因可能上调VEGF的表达.肺癌组织中MVD与VEGF、p53蛋白表达密切相关,突变型p53基因和VEGF在肺癌血管形成中具有协同作用.     

沉默p21活化激酶1表达对人黑素瘤A375细胞凋亡及侵袭能力的影响

目的探讨shRNA沉默p21活化激酶1(p21-activated kinase 1, PAK1)基因表达对人黑素瘤A375细胞凋亡、迁移及侵袭能力的影响。方法对数生长期人黑素瘤A375细胞随机分为转染组(转染PAK1特异性shRNA)、阴性对照组(转染NC-shRNA)、空白对照组(不进行转染)。转染后培养72 h,采用实时荧光定量PCR法检测A375细胞PAK1 mRNA相对表达量,采用Western blot法检测A375细胞PAK1及p-PAK1蛋白相对表达量,采用流式细胞术检测细胞凋亡率,采用Transwell小室实验检测细胞迁移、侵袭能力。结果转染后培养72 h,转染组PAK1 mRNA相对表达量(0.45±0.07)、PAK1蛋白相对表达量(0.53±0.01)、p-PAK1蛋白相对表达量(0.21±0.03)均低于阴性对照组(0.98±0.04、0.65±0.02、0.38±0.04)、空白对照组(1.00±0.08、0.67±0.51、0.36±0.02)(P0.05),细胞凋亡率[(11.20±0.21)%]高于阴性对照组[(5.86±0.51)%]、空白对照组[(5.43±0.03)%](P0.05),迁移细胞数[(47.00±2.23)个]、侵袭细胞数[(30.00±4.44)个]较阴性对照组[(76.00±4.85)、(54.00±3.67)个]、空白对照组[(77.90±4.97)、(56.00±4.12)个]少(P0.05),阴性对照组上述各指标与空白对照组比较差异均无统计学意义(P0.05)。结论沉默PAK1基因表达可促进人黑素瘤A375细胞凋亡,降低其迁移及侵袭能力。     

同源盒A13在胃癌组织中表达对SGC-7901细胞增殖和侵袭的影响

目的探讨胃癌组织及癌旁组织中同源盒A13(homeobox gene A13,HOXA13)表达差异,及下调胃癌SGC-7901细胞HOXA13基因表达对细胞增殖和侵袭能力的影响。方法取109例胃癌患者手术切除的胃癌组织和癌旁正常组织,采用免疫组织化学法检测HOXA13蛋白表达;取对数生长期SGC-7901细胞分为转染组(转染siRNA-HOXA13)、阴性对照组(转染siRNA-NC)和空白对照组(不作任何处理),采用MTT法检测转染12、24、48、72、96h时细胞增殖能力,Transwell法检测转染后培养48h时细胞侵袭能力,Western blot法检测转染后培养48h时细胞HOXA13、Twist、E-cadherin和Vimentin蛋白表达。结果胃癌组织HOXA13蛋白阳性表达率(75.23%)高于癌旁正常组织(33.94%)(P0.05);HOXA13蛋白阳性表达率在进展期胃癌(82.98%)、低分化程度(84.93%)、TNM分期Ⅲ～Ⅳ期(86.27%)、有淋巴结转移者(84.38%)均高于早期胃癌(26.67%)、中高分化程度(55.56%)、TNM分期Ⅰ～Ⅱ期(65.52%)、无淋巴结转移者(62.22%)(P0.05),在性别、年龄、肿瘤直径上差异均无统计学意义(P0.05);转染组转染后培养24、48、72、96h时吸光度值低于阴性对照组和空白对照组(P0.05),阴性对照组与空白对照组比较差异无统计学意义(P0.05);转染组转染后培养48h时侵袭细胞数[(97.14±10.03)个]均较阴性对照组[(115.39±5.77)个]和空白对照组[(125.11±12.45)个]少(P0.05),阴性对照组与空白对照组比较差异无统计学意义(P0.05);转染组转染后培养48h时细胞HOXA13、Twist和Vimentin蛋白表达(0.24±0.05、0.34±0.07、0.36±0.04)均低于阴性对照组(0.87±0.11、0.75±0.02、0.75±0.07)和空白对照组(0.88±0.05、0.76±0.05、0.72±0.06)(P0.05),E-cadherin蛋白表达(0.67±0.08)高于阴性对照组(0.33±0.06)和空白对照组(0.35±0.04)(P0.05),阴性对照组与空白对照组比较差异无统计学意义(P0.05)。结论胃癌组织中HOXA13蛋白呈高表达,其表达程度与肿瘤恶性程度有关;下调SGC-7901细胞HOXA13基因表达可抑制细胞增殖和侵袭能力。     

载基因壳聚糖纳米超声微泡转染miRNA诱导Hela细胞凋亡的研究

目的:探讨载Survivin-miRNA的壳聚糖纳米超声微泡对癌细胞凋亡、增殖的影响.方法:实验分为5组,空白对照组、壳聚糖纳米超声微泡组和低、中、高浓度载Survivin-miRNA的壳聚糖纳米超声微泡转染组(分别给予50、100和200 nmol/L miRNA转染).流式细胞术检测各组Hela细胞凋亡指数(AI)和增殖指数(PI),RT-PCR检测靶向Survivin和caspase-3的mRNA表达,荧光分光光度法分析caspase-3活性变化.结果:各浓度转染组细胞AI明显高于对照组(P＜0.05),高浓度转染率最明显(P＜0.05);各浓度miRNA转染组PI明显低于对照组(P＜0.05),高浓度转染组最明显(P＜0.05);各浓度miRNA转染组Survivin mRNA转录水平有不同程度减弱.Caspase-3 mRNA的表达在各组细胞间差异无显著性(P＞ 0.05);各转染组细胞caspase-3活化水平较对照组明显提高(P＜0.01).结论:不同浓度靶向Survivin基因的miRNA能下调Survivin的mRNA表达水平,对caspase-3 mRNA的表达无明显作用,能激活caspase-3无活性前体,从而诱导Hela细胞凋亡,抑制细胞增殖.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。