乳酸菌合生元对重型颅脑损伤患者营养状况及免疫水平影响的研究

目的:探讨乳酸菌合生元EN对重型颅脑损伤患者营养状态及免疫水平的影响。方法:将75例患者随机分为PN组、LEN组、FEN组,对比观察营养支持后3组患者的白蛋白、前白蛋白、TLC营养指标以及腹泻、腹胀等并发症的发生率。结果:LEN组和FEN组支持后前白蛋白、淋巴细胞计数无统计学差异,PN支持后明显降低;PN组的死亡率、二重感染、应激性溃疡发生率高于LEN组和FEN组。结论:乳酸菌合生元可促进患者蛋白质合成、免疫功能恢复、纠正负氮平衡及减少并发症。     

特殊体位对血压和心率的影响

目的 探讨体位改变与血压、心率之间的关系.方法 采用BIOLIGHTM69多功能监测仪测龟178名在校师生在平卧位、坐位、立位、半蹲佗4种体位时的血压和心率,并进行自身对比.同时,在立位时又分别加测右臂上举和负重时的血压和心率.结果 ①在半蹲位时收缩压、舒张压和心率测量值明显升高,与其他三种特定体位间有非常显著性差异(P<0.01).②立位、立位右臂上举及负重三者之间的心率与血压值有非常显著性差异(P<0.01).结论 体位变化会引起血压和心率的变化.     

The Effect of Scoliosis Angle on Center of Gravity Sway

[Purpose] The purpose of this study was to verify the effects of idiopathic scoliosis on the human body by comparing the postural balance of adolescents with and without idiopathic scoliosis, to provide basic data for the optimal desirable growth and development of adolescents. [Subjects] The subjects were 128 adolescents diagnosed with scoliosis on X-ray by orthopedists. The subjects were divided into a 10 to 19 degree group, 20 to 29 degree group, and 30 degree and over group according to the degree of scoliosis. For comparison, 15 normal adolescents without orthopedic injury within the last 6 months were selected as a control group. [Methods] As measurement tools, DK2 525R (Dongkang Medical: Korea) was used to measure the Cobb angle and a multifunktional traininggeraete device (MFT, Germany) was used to measure balance. One-way variance of analysis was conducted in order to examine differences among the four groups in left and right balance, forward and backward balance, and overall postural balance, and when there were differences, they were compared in detail using Duncan’s post-hoc test. [Results] The results of scoliosis angle and body mass index (BMI) showed significant differences between the normal group (NG) and the scoliosis groups (GI, G II, G III), but there were no significant differences among the scoliosis groups. The scoliosis groups showed a significantly lower BMI than that of the normal group. In addition, the results of the left/right and the front/rear balance abilities showed significant differences between the normal group and the scoliosis groups. Furthermore, the results of whole body balance ability were showed significant differences between the normal group and the scoliosis groups.Key words: Scoliosis, Gravity sway, Postural     

尿比重与急性脑梗死患者早期神经功能恶化的相关性

目的:探讨尿比重与急性脑梗死患者早期神经功能恶化(END)的相关性。方法:急性脑梗死患者158例,依据是否发生END分为非END组和END组,比较2组患者的临床资料和相关危险因素。结果:27例(17.1%)出现END(END组),131例(82.9%)症状稳定(非END组)。尿比重>1.010在2组比较差异有统计学意义(P=0.037),尤其尿比重>1.015在2组比较有显著差异(P=0.008),入院NIHSS评分≥12分患者比例在2组比较差异有统计学意义(P=0.036)。Logistic回归分析提示尿比重>1.010、尿比重>1.015与急性脑梗死患者发生END有良好的相关性(P=0.047,P=0.026)。结论:尿比重>1.010可能与急性脑梗死患者发生END有相关性。     

一氧化氮、内皮素与血流剪切率在颈动脉粥样硬化斑块形成中的作用

目的 应用超声多普勒技术探讨一氧化氨、内皮素与血流剪切率在颈动脉粥样硬化斑块形成中的作用。方法将80例高血压患者按颈动脉是否存在粥样斑块分为斑块组和无斑块组。生化测定NO、ET及TC、TG、HDL、LDL水平，计算最大剪切率。结果 斑块组患者的年龄、颈动脉内径明显高于无斑块组，峰值流速及最大剪切率均低于无斑块组。斑块组颈动脉内中膜厚度与ET呈正相关(r=0．54)，与NO呈负相关(r=0．56)。结论 ET上升，NO下降促使颈动脉内中膜厚度增加，最大剪切率减低及年龄的升高是颈动脉粥样斑块形成的重要危险因素。     

Serum Hepatitis Specific Antigen (SH) in Commercial and Volunteer Sources of Blood

Blood from various commercial sources used for transfusion at two New York City hospitals, samples from a large commercial blood bank, and samples from the city's major volunteer blood source, Were tested for SH antigen by the Ouchterlony technic. The different commercial sources averaged an antigen positive incidence of 1.2 per 100 units, whereas the volunteer source had less than one positive per thousand. The relative risk of transfusion hepatitis between the two sources was approximately 12: 1. This is in accord with follow-up studies of patients. Improvements in the sensitivity of the antigen test and exclusion of positive units would reduce the absolute risk of posttransfusion hepatitis but would not be expected to alter the relative risk. Because of this, volunteer blood sources should be considered preferable to commercial sources, at least in large urban areas.     

Heart Rate Correlation, Response Time and Effect of Previous Exercise Using an Advanced Pacing Rate Algorithm for Temperature-Based Rate Modulation

A temperature-based algorithm to produce pacing rate that resembles chronotropic response to activity was developed. Measurement criteria for the algorithm included workload dependent rate increases with activity and response time within 60 seconds of exercise onset. To evaluate the aigorithm, right ventricular blood temperature was recorded during rest and treadmill exercise in 25 patients with implanted Kelvin 500 pacemakers (Cook Pacemaker). Patients included 16 maies and nine femaies, ages 44–81 (mean 72). Indications for pacing were sinus node disease, atrioventricular block and atrial fibrillation with siow ventricular response. Temperature changes reflected physical activity as well as emotional stress. The algorithm was based on the rate of change (dT/dt), the relative change (AT) and the baseline history (T) of temperature. At exercise onset, a rapid, brie/drop in temperature (dT/dt) typically occurred due to peripheral vasodilation, causing prompt increase in pacing rate. As exercise continued, the increase in metabolic rate caused dT/dt as well as AT to increase, further increasing pacing rate. After exercise, temperature returned to resting level which correspondingly decreased the pacing rate. Sensitivity of the algorithm to temperature variations, and the upper and lower pacing rate limits were programmable to adapt to individual patient needs. The rates produced by the algorithm mimicked intrinsic rate response for various activity levels and produced a mean response time of 16 seconds from exercise onset. Previous exercise had no significant effect on response time. Correlation between normal chronotropic response and simulated pacing rate from five exercise tests was 0.92. These results show good specificity and refute the statement that blood temperoture yields a slow response.     

Effect of Amiodarone on Electric Induction, Morphology, and Rate of Ventricular Tachycardia and its Relation to Clinical Efficacy

Using His bundle electrograms and programmed ventricular stimulation, the effects of chronic amiodarone treatment on induction, morphology, and the rate of ventricular tachycardia (VT) were studied in 17 consecutive patients treated with amiodarone for control of recurrent sustained VT or ventricular fibrilation. Studies were done before and after treatment with amiodarone for an average duration of 5.3 (range 2 to 18) months. During the control study, sustained VT could be induced in 16 patients. VT was initiated by single or double right ventricular (RV) extrastimuli in 14 patients, by double left ventricular (LV) extrastimuli in 1 patient, and by RV burst pacing in 1 patient. Only one pattern (morphology) of VT similar to that of spontaneous VT was induced in 12 patients and two patterns of VT in 4 patients. The average cycle length (CL) (mean ± SD) of induced VT was 325.8 ± 61.2 ms. After amiodarone, VT could be induced in 7 of 17 patients and was initiated by single RV extrastimuli in 5 patients, double RV extrastimuli in 1 patient, and RV burst pacing in 1 patient. In 3 of 5 patients in whom VT could be initiated by single RV extrastimuli, initiation of VT required double RV or double LV extrastimuli in the control study; in 1 of 5 patients VT could not be induced in the control study. Amiodarone induced nonclinical, polymorphic VT in 4 patients in whom only clinical VT could be induced during the control study. Compared to control, the CL of induced VT was significantly longer (322 ± 65.7 vs 416 ± 41.5 ms; P < 0.001). During a follow-up period ranging from 4 to 53 (mean ± SD; 18.6 ± 11.4) months, VT did not recur in 8 patients with no inducible VT and in 6 patients with persistence of inducible VT. One patient without inducible VT died suddenly; VT recurred in 2 patients, one without inducible VT and one with inducible VT. The results show that programmed stimulation studies late in the course of treatment do not accurately reflect the clinical efficacy of amiodarone in VT.     

Effect of Oral Sebacic Acid on Postprandial Glycemia, Insulinemia, and Glucose Rate of Appearance in Type 2 Diabetes

OBJECTIVE

Dicarboxylic acids are natural products with the potential of being an alternate dietary source of energy. We aimed to evaluate the effect of sebacic acid (a 10-carbon dicarboxylic acid; C10) ingestion on postprandial glycemia and glucose rate of appearance (R_a) in healthy and type 2 diabetic subjects. Furthermore, the effect of C10 on insulin-mediated glucose uptake and on GLUT4 expression was assessed in L6 muscle cells in vitro.

RESEARCH DESIGN AND METHODS

Subjects ingested a mixed meal (50% carbohydrates, 15% proteins, and 35% lipids) containing 0 g (control) or 10 g C10 in addition to the meal or 23 g C10 as a substitute of fats.

RESULTS

In type 2 diabetic subjects, the incremental glucose area under the curve (AUC) decreased by 42% (P < 0.05) and 70% (P < 0.05) in the 10 g C10 and 23 g C10 groups, respectively. At the largest amounts used, C10 reduced the glucose AUC in healthy volunteers also. When fats were substituted with 23 g C10, AUC of R_a was significantly reduced on the order of 18% (P < 0.05) in both healthy and diabetic subjects. The insulin-dependent glucose uptake by L6 cells was increased in the presence of C10 (38.7 ± 10.3 vs. 11.4 ± 5.4%; P = 0.026). This increase was associated with a 1.7-fold raise of GLUT4.

CONCLUSIONS

Sebacic acid significantly reduced hyperglycemia after a meal in type 2 diabetic subjects. This beneficial effect was associated with a reduction in glucose R_a, probably due to lowered hepatic glucose output and increased peripheral glucose disposal.The World Health Report launched in 2002 by the World Health Organization advised that more than 1 billion adults worldwide are overweight and at least 300 million are clinically obese. Type 2 diabetes can be considered a threatening obesity-related disease because hyperglycemia causes relevant complications such as micro- and macroangiopathy. Patients with type 2 diabetes exhibit increased hepatic glucose output, which is identified as the main cause of fasting hyperglycemia and is associated with impaired plasma glucose clearance (1) and reduced hepatic synthesis of glycogen of ∼25–45% compared with that in nondiabetic subjects (2). Increased hepatic gluconeogenesis has been considered to be responsible for elevated hepatic glucose output in type 2 diabetes (3). When glycogen is available in adequate amounts, there is an autolimitation of hepatic glucose production. In diabetes, a breakdown of this autoregulation may occur if glycogenolysis is limited by glycogen depletion (4).Jenkins et al. (5) have shown that spreading the nutrient load over a longer period of time by increased meal frequency, the so-called nibbling diet, is beneficial in terms of reduction of circulating levels of glucose, insulin, and free fatty acids in type 2 diabetes. Thus, the availability of snacks poor in fat and that do not induce hyperglycemia and/or overstimulate insulin secretion would be a good tool in the diet of insulin-resistant, type 2 diabetic subjects.Dicarboxylic acids are naturally occurring substances produced by both higher plants and animals via ω-oxidation of fatty acids (6,7). In plants, long-chain dicarboxylic acids are components of natural protective polymers, cutin and suberin, which support biopolyesters involved in waterproofing the leaves and fruits, regulating the flow of nutrients among various plant cells and organs, and minimizing the deleterious impact of pathogens (7). In animals and humans, medium chain dicarboxylic acids, which include prevalently sebacic (C10) and dodecanedioic (C12) acids, derive from the β-oxidation of longer chain dicarboxylic acids (8). Long-chain dicarboxylic acids, in turn, are formed from the correspondent fatty acids by ω-oxidation in the microsomal membranes (9) or are taken in with a diet rich in vegetables (7).We have shown previously that medium-chain dicarboxylic acids represent a suitable alternate energy substrate to glucose in clinical conditions with marked insulin resistance and/or impaired aerobic glycolysis (10). Interestingly, in type 2 diabetes, medium-chain dicarboxylic acids are rapidly oxidized, do not stimulate insulin secretion, and reduce muscle fatigue (11). Nevertheless, the effect of C10 or C12, not as a substitute but in addition to available carbohydrates, on glucose homeostasis has never been studied.On this basis, our aim was to investigate the effect of oral administration of C10 on postprandial glycemia, insulinemia, and glucose rate of appearance (R_a) in type 2 diabetic subjects compared with that in healthy volunteers. To further elucidate the mechanism of action of sebacic acid in diabetes, insulin-mediated glucose uptake and GLUT4 protein expression were assessed in L6 cells in vitro.     

Improvisation of Pressmud by Organic Amendment and Its Effect on Soil Quality and Growth of Chilli,Capsicum annum

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Pressmud is a byproduct of sugar industry. Currently it is used both as a soil reclamation agent and soil...     

插管、按压、除颤时机选择对心肺复苏成功率的影响

目的:研究气管插管、胸外按压及心脏电击除颤的时机选择对心肺复苏(CPR)成功率的影响.方法:将178例心脏骤停(CA)病人随机分为时机选择复苏组90例(A组)和常规复苏组88例(B组),比较两组复苏成功率.结果:A组CPR成功率48.9%明显高于B组成功率的19.3%,P<0.05.结论:气管插管、胸外按压及心脏电击除颤需根据CA的不同病因及现场情形进行选择.     

Bullying: Effects on School-Aged Children,Screening Tools,and Referral Sources

Bullying is not a new concept or behavior, and is now gaining national attention as a growing public health concern. Bullying leads to short- and long-term physical and psychological damage to both the victims and the bullies. The serious implications of bullying drive a clinical mandate for teachers and school nurses to be educated and adequately trained to identify and address bullying within schools. This review of the literature describes screening tools that can be utilized to identify both victims and bullies. In addition, referral services utilizing collaborative intervention measures are discussed. This literature review will help school nurses and teachers to identify and expand their role in school-wide bullying prevention and intervention measures.     

Secondary Data on Health-Related Subjects: Major Sources, Uses, and Limitations

Although secondary data are generally neglected by nurses, they are useful for nurse researchers, practitioners, educators, administrators, and policy makers. Major sources of data on health-related subjects are medical records, administrative records, the census, vital statistics, surveys of the National Center for Health Statistics, social science archives, and nursing archives, each with its specific uses and limitations.     

出院后护理干预对患者戒烟率的影响

目的探讨出院后护理干预对患者戒烟率的影响。方法164例呼吸系统疾病患者在住院期间戒烟后,出院时随机分为护理干预组和非干预组,干预组在出院后继续实施心理、生活、饮食、运动等护理干预,非干预组不进行出院后护理干预,统计1年后两组戒烟率。结果1年后干预组82例中失访3例,戒烟63例,戒烟率80%;非干预组失访5例,戒烟29例,戒烟率38%,干预组戒烟率明显高于非干预组(2χ=26.83,P<0.001)。结论对出院后的患者继续进行护理干预,能有效降低其出院后香烟的复吸率。     

山茱萸对大鼠佐剂性关节炎特异性细胞免疫功能的调节作用

目的:探讨山茱萸对大鼠佐剂性关节炎(AA)特异性细胞免疫功能的调节作用。方法:利用流式细胞仪检测AA大鼠模型外周血中TLC亚群CD4+TLC,CD8+TLC的改变,放免法检测外周血中TLC转化率,酶联免疫法(ELISA)检测血清IL-2的水平。结果:山茱萸能降低AA大鼠模型的CD4+及CD4+/CD8+,IL-2以及TLC转化率。结论:山茱萸能治疗大鼠佐剂性关节炎(AA),其作用主要是通过抑制大鼠的细胞免疫功能而产生效果。     

实验性脑梗死对大鼠心率变异性的影响

目的 探讨急性脑梗死对心脏自主神经活性的影响.方法 Wistar大鼠32只随机分为正常组、假手术组和脑梗死组,脑梗死组用线栓法行右侧大脑中动脉阻塞.脑梗死组和假手术组于术前及术后24 h作心率变异性(HRV)检测,同时检测正常组HRV,将3组的HRV指标进行比较.实验终点取各组心肌组织检测儿茶酚胺和神经肽Y(NPY)...     

山东省临朐县1987～2005年恶性肿瘤发病死亡及生存时间分析

目的探讨临朐县近20年恶性肿瘤发病及死亡规律，为肿瘤防治提供依据。方法对1987～2005年临朐县恶性肿瘤登记资料进行统计分析，计算发病率、标化发病率、死亡率和标化死亡率，利用1993～2000年肿瘤登记资料计算发病年龄中位数和平均生存时间。结果临朐县恶性肿瘤年平均发病率145．23／10万（国标率158．07／10万、世标率174．68／10万），年平均死亡率133．35／10万（国标率138．32／10万、世标率155．14／10万）；男性发病率和死亡率与女性相比分别为1．9：1、1．8：1，80％以上的肿瘤发病和死亡发生在45～79岁人群；胃癌居临朐县恶性肿瘤发病和死亡首位，其次为肺癌和肝癌，三大肿瘤占恶性肿瘤总发病和死亡数的近70％（男性74．2％、女性61．1％）；1987～2005年肿瘤发病率和死亡率分别上升57．11％和31．78％，其中肺癌发病率和死亡率分别上升了52．7％和22．4％，胃癌发病率和死亡率分别下降了16．18％和38．97％；恶性肿瘤发病年龄中位数65岁，平均生存时间2．06年。结论临胸县恶性肿瘤的发病率和死亡率总的呈上升趋势，平均生存时间较短。胃癌、肺癌、肝癌是危害当地人民群众生命健康的主要恶性肿瘤，属全国高发地区。中老年，尤其是男性中老年，是恶性肿瘤的高危人群。     

Variable Effects of Physical Training of Heart Rate Variability, Heart Rate Recovery, and Heart Rate Turbulence in Chronic Heart Failure

Background: Heart rate variability (HRV), heart rate turbulence (HRT), and heart rate recovery (HRR), indices that reflect autonomic nervous system (ANS) activity, are outcome predictors in patients with chronic heart failure (CHF). It is not clear, however, whether they reflect the same components of ANS activity. No study has examined the effects of physical training (PT) training on HRV, HRT, and HRR in CHF.
Study Objective: To examine the responses of HRV, HRT, and HRR to a PT program in patients presenting with CHF.
Methods: In 41 patients (mean age = 58.7 ± 10.2 years) in New York Heart Association CHF functional classes II or III, and with a left ventricular ejection fraction <40%, HRV, HRT, and HRR were measured before and after 8 weeks of PT.
Results: The training was clinically effective in all patients. Before versus after PT, standard deviation of all normal RR intervals increased from 107 ± 30 to 114 ± 32 ms (P = 0.047), high frequency increased from 210 ± 227 to 414 ± 586 ms²/Hz (P = 0.02), and the low/high frequency ratio decreased from 1.8 ± 1.55 to 1.1 ± 1.2 (P = 0.002). HRT and HRR did not change significantly after PT.
Conclusions: In patients with CHF, the positive effects of PT were limited to HRV indices, which reflect parasympathetic activity, without significantly changing HRR and HRT. These observations indicate that different mechanisms modulate HRV, HRR, and HRT, which provide complementary information regarding ANS activity. The 8-week PT program failed to completely normalize ANS function.