微量注射泵垂直移动后注出率改变最小的安全移动高度的实验室研究

目的 找出微量注射泵垂直移动后注出率改变最小的安全垂直移动高度,作为临床泵体垂直移动安全措施的理论依据.方法 使用Micorinfusion Pump WZ-50C、WZ-50C2、BRAUN Perfusor compact 3台微量注射泵在10 ml/min的运转速率下,分别用电子天平测定在平面未移动时以及分别垂直移动15,25,35,50 cm高度后1 min的注出量并进行比较. 结果 垂直移动注射泵各不同高度间的流量比较有显著差异;垂直移动15,25,35,50 cm与未移动时的1 min的平均注出流量的差值分别为0.004,0.017,0.033,0.046 ml,差值最小的是垂直移动15 cm高度;流出量剖面图显示水平面与垂直移动15 cm高度的流出量线条呈稍有抬高而接近水平线状态,而后此高度流出量的点成为了一个拐点,线条随着垂直移动高度的增大变得越来越陡直,显示注出量比较的改变随着移动高度的增加而急剧增加.结论 垂直移动15 cm高度注出量的变化最小,成为不同高度的增加使流出量急剧增加的拐点,此垂直移动高度是安全的移动高度.     

电脑输液泵控制鼻饲滴速的临床研究

目的 研究改进鼻饲的方法,减少腹泻、呕吐等并发症的发生.方法 选择重型颅脑外伤昏迷患者140例,按采用的鼻饲法分为对照组50例,实验组90例.对照组采用传统的鼻饲方法,实验组应用电脑输液泵控制鼻饲滴速,比较2组并发症的发生率.将实验组患者随机分为3组各30例,在营养液及总量相同的情况下,分别维持10,16,18 h,观察各时间段并发症发生率.结果 实验组腹泻、呕吐等并发症的发生率显著低于对照组;实验组在3个时间段中腹泻、呕吐等并发症的发生率比较无明显差异.结论 使用电脑输液泵控制鼻饲滴速,可明显降低腹泻、呕吐等并发症的发生率;鼻饲营养液在电脑输液泵控制下不必维持很长时间.     

Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation

We compared the pharmacokinetics of intraosseous (IO) drug delivery via tibia or sternum, with central venous (CV) drug delivery during cardiopulmonary resuscitation (CPR).

Methods

CPR of anesthetized KCl arrest swine was initiated 8 min post arrest. Evans blue and indocyanine green, each were simultaneously injected as a bolus with adrenaline through IO sternal and tibial needles, respectively, n = 7. In second group (n = 6) simultaneous IO sternal and IV central venous (CV) injections were made.

Results

Peak arterial blood concentrations were achieved faster for sternal IO vs. tibial IO administration (53 ± 11 s vs. 107 ± 27 s, p = 0.03). Tibial IO dose delivered was 65% of sternal administration (p = 0.003). Time to peak blood concentration was similar for sternal IO and CV administration (97 ± 17 s vs. 70 ± 12 s, respectively; p = 0.17) with total dose delivered of sternal being 86% of the dose delivered via CV (p = 0.22).

Conclusions

IO drug administrations via either the sternum or tibia were effective during CPR in anesthetized swine. However, IO drug administration via the sternum was significantly faster and delivered a larger dose.     

Infusion of imaging and therapeutic molecules into the plant virus-based carrier cowpea mosaic virus: Cargo-loading and delivery

This work is focused on the development of a plant virus-based carrier system for cargo delivery, specifically 30 nm-sized cowpea mosaic virus (CPMV). Whereas previous reports described the engineering of CPMV through genetic or chemical modification, we report a non-covalent infusion technique that facilitates efficient cargo loading. Infusion and retention of 130–155 fluorescent dye molecules per CPMV using DAPI (4′,6-diamidino-2-phenylindole dihydrochloride), propidium iodide (3,8-diamino-5-[3-(diethylmethylammonio)propyl]-6-phenylphenanthridinium diiodide), and acridine orange (3,6-bis(dimethylamino)acridinium chloride), as well as 140 copies of therapeutic payload proflavine (PF, acridine-3,6-diamine hydrochloride), is reported. Loading is achieved through interaction of the cargo with the CPMV's encapsidated RNA molecules. The loading mechanism is specific; empty RNA-free eCPMV nanoparticles could not be loaded. Cargo-infused CPMV nanoparticles remain chemically active, and surface lysine residues were covalent modified with dyes leading to the development of dual-functional CPMV carrier systems. We demonstrate cargo-delivery to a panel of cancer cells (cervical, breast, and colon): CPMV nanoparticles enter cells via the surface marker vimentin, the nanoparticles target the endolysosome, where the carrier is degraded and the cargo is released allowing imaging and/or cell killing. In conclusion, we demonstrate cargo-infusion and delivery to cells; the methods discussed provide a useful means for functionalization of CPMV toward its application as drug and/or contrast agent delivery vehicle.     

护理干预对小儿静脉输液顺从性及穿刺成功率的影响

目的：探讨护理干预对提高小儿静脉输液的顺从性、穿刺成功率、满意度的影响。方法收集2012年6-7月于接受静脉输液治疗的患儿1800例,采用随机数字表法分为对照组与观察组,两组各900例,对照组患儿给予常规护理,观察组患儿通过改进小儿静脉输液相关护理工作,提高护理干预技术。比较两组患儿的顺从性、穿刺成功率及满意度。结果观察组患儿静脉输液的顺从性为90．00％,明显高于对照组的62．22％,两组比较差异有统计学意义（χ2＝190．99;P＜0．05）;观察组患儿穿刺成功率为93．33％,明显高于对照组的67．78％,两组比较差异有统计学意义（χ2＝187．54;P＜0．05）。观察组患儿家属满意度为98．89％,明显高于对照组的77．78％,两组比较差异有统计学意义（χ2＝194．61;P＜0．05）。结论积极的护理干预措施可有效提高患儿静脉输液的顺从性、穿刺成功率及家属满意度。     

综合护理干预对2型糖尿病病人服药依从性的影响

目的探讨综合护理干预对糖尿病病人服药治疗依从性的影响。方法将116例住院2型糖尿病病人随机分为对照组和观察组各58例。对照组给予常规护理措施和一般健康教育,观察组在此基础上实施综合护理干预。比较两组病人糖尿病相关知识水平、服药依从性和并发症发生率的差异。结果综合护理干预后,与对照组比较,观察组病人糖尿病相关知识水平较高,服药依从性较好,相关并发症发生率较低,差异均有统计学意义。结论综合护理干预可提高2型糖尿病病人的知识水平,提高服药的依从性,有利于控制疾病进展。     

Impact of albumin on drug delivery — New applications on the horizon

Over the past decades, albumin has emerged as a versatile carrier for therapeutic and diagnostic agents, primarily for diagnosing and treating diabetes, cancer, rheumatoid arthritis and infectious diseases. Market approved products include fatty acid derivatives of human insulin or the glucagon-like-1 peptide (Levemir^® and Victoza^®) for treating diabetes, the taxol albumin nanoparticle Abraxane^® for treating metastatic breast cancer which is also under clinical investigation in further tumor indications, and ^99mTc-aggregated albumin (Nanocoll^® and Albures^®) for diagnosing cancer and rheumatoid arthritis as well as for lymphoscintigraphy. In addition, an increasing number of albumin-based or albumin-binding drugs are in clinical trials such as antibody fusion proteins (MM-111) for treating HER2/neu positive breast cancer (phase I), a camelid albumin-binding nanobody anti-HSA-anti-TNF-α (ATN-103) in phase II studies for treating rheumatoid arthritis, an antidiabetic Exendin-4 analog bound to recombinant human albumin (phase I/II), a fluorescein-labeled albumin conjugate (AFL)-human serum albumin for visualizing the malignant borders of brain tumors for improved surgical resection, and finally an albumin-binding prodrug of doxorubicin (INNO-206) entering phase II studies against sarcoma and gastric cancer. In the preclinical setting, novel approaches include attaching peptides with high-affinity for albumin to antibody fragments, the exploitation of albumin-binding gadolinium contrast agents for magnetic resonance imaging, and physical or covalent attachment of antiviral, antibacterial, and anticancer drugs to albumin that are permanently or transiently attached to human serum albumin (HSA) or act as albumin-binding prodrugs. This review gives an overview of the expanding field of preclinical and clinical drug applications and developments that use albumin as a protein carrier to improve the pharmacokinetic profile of the drug or to target the drug to the pathogenic site addressing diseases with unmet medical needs.     

抗抑郁药对脱毒依从性和成功率的影响

目的观察抗抑郁药对脱毒依从性和成功率的影响。方法对91例戒毒患者,采用随机双盲的方法分为3组,在使用美沙酮治疗过程中,分别给予盐酸安非他酮、盐酸曲唑酮和安慰剂,比较患者住院天数和脱毒成功率。结果盐酸安非他酮和盐酸曲唑酮组的住院天数和脱毒成功率均高于安慰剂组。但盐酸安非他酮和盐酸曲唑酮组间差异无统计学意义。结论抗抑郁药可明显提高自愿戒毒患者的脱毒依从性和脱毒成功率。     

Novel geometry type of nanocarriers mitigated the phagocytosis for drug delivery

Target geometry for mitigating phagocytosis has garnered considerable attention recently in the drug delivery field. This study examined nanoparticles (NPs) with same volume but different shapes, namely, spherical NPs (SNPs) and hexagonal nanoprisms (HNPs), and analyzed their behaviors in vitro and in vivo. These NPs were constructed with a multifunctional block copolymer component, mPEG-b-P(HEMA-co-histidine-PLA). Geometry of SNPs and HNPs was controlled by adjusting copolymer properties and particle size was controlled by adjusting formulation parameters. Nanoparticle morphology had no effect in mitigating phagocytosis when NP size was 70 nm; however, morphology had a significant effect when NP size was 120 nm. The radioactivity-time curves for ^99mTc-labeled NPs, fitted by the two-compartment pharmacokinetic model, show that the prolonged plasma distribution half-life of HNPs is indicative in the bloodstream. The in vitro and in vivo studies reveal that dual stealth characteristics, pegylation and hexagonal prism structure, of nanocarriers can be adopted in clinical application for safe and efficient delivery of cancer therapy.     

不同接生方式对阴道分娩产妇分娩结局的影响

目的探讨无保护会阴接生与传统会阴保护接生对阴道分娩产妇分娩结局的影响。方法将在本院分娩的160例初产妇随机分为2组各80例,对照组采取传统的会阴保护接生方法,研究组采取无保护会阴接生方式,对比2组产妇的分娩并发症发生情况、新生儿Apgar评分等。结果研究组的会阴侧切率为30.00%,低于对照组的65.00%;研究组第二产生时间、住院时间均显著短于对照组,会阴完整率高于对照组,产后第1天疼痛评分显著低于对照组,产后出血量显著少于对照组,差异有统计学意义(P0.05);2组的新生儿Apgar评分比较无显著差异(P0.05);研究组的新生儿窒息发生率、产后并发症发生率均显著低于对照组(P0.05)。结论与传统的会阴保护接生方式相比,无保护会阴接生更有利于保护会阴的完整性,降低新生儿窒息风险,促进自然分娩,改善分娩结局。     

健康教育对糖尿病患者遵医行为的影响

目的探讨健康教育对糖尿病患者遵医行为的影响。方法选择278例建档的糖尿病患者进行针对性的健康教育,对患者健康教育前后的遵医行为进行比较。结果健康教育后患者的遵医率较健康教育前显著提高。结论实施健康教育可提高糖尿病患者自我保健意识,改变不良生活方式,提高患者的遵医率,增强其对糖尿病相关知识的认识,使血糖控制在理想状态。     

健康教育对糖尿病患者遵医行为的影响

目的 探讨健康教育对糖尿病患者遵医行为的影响.方法 选择278例建档的糖尿病患者进行针对性的健康教育,对患者健康教育前后的遵医行为进行比较.结果 健康教育后患者的遵医率较健康教育前显著提高.结论 实施健康教育可提高糖尿病患者自我保健意识.改变不良生活方式,提高患者的遵医率,增强其对糖尿病相关知识的认识,使血糖控制在理想状态.     

载药超声微泡的制备及其在肿瘤治疗中的应用进展

载药超声微泡是近年来国内外研究的热点之一,本文就载药超声微泡的制备、在肿瘤治疗中的应用、存在的问题及发展前景做一简要综述。     

第一胎药物流产致输卵管性不孕的分析

目的探讨第一胎药物流产后继发不孕的主要原因。方法对第一胎药物流产后继发不孕者 5 4例 ,同期原发不孕患者 117例均行子宫输卵管造影术 ,比较两组输卵管梗阻发生率。结果继发不孕组有 19例 (35 .19% ) ,原发不孕组有 2 0例 (17.0 9% ) ,均出现不同程度的输卵管梗阻。两组比较因输卵管梗阻引起的不孕有显著性差异 (P <0 .0 5 )。结论第一胎产妇行药物流产存在一定的不安全性 ,输卵管梗阻是继发不孕的主要原因。     

心理干预对肝硬化患者依从性的影响

目的 探讨心理干预对提高肝硬化患者的依从性的影响.方法 将100例肝硬化患者随机分为实验组和对照组各50例,对照组按传统方法进行常规护理;实验组由责任护士对患者及家属进行系统的心理干预.比较2组护理、干预后的效果.结果 实验组患者的依从性明显高于对照组,P＜0.05,差异有统计学意义.结论 实施心理干预对提高肝硬化患者依从性有比较明显的帮助.     

自知力教育对门诊精神分裂症患者自知力及服药依从性的影响

目的探讨自知力教育对门诊精神分裂症患者自知力恢复及服药依从性的影响.方法将60例首次门诊治疗精神分裂症患者随机分为对照组及观察组各30例,对照组常规药物治疗,观察组在常规药物治疗基础上进行自知力教育.分别于首次就诊时、2周、4周、8周复诊时进行简明精神病评定量表（BPRS）,自知力与治疗态度问卷表（ITAQ）测定以及服药依从性评定.结果首次就诊和2周、4周复诊时2组BPRS量表,ITAQ及服药依从性差异无显著性（P〉0.05）,门诊治疗8周后观察组ITAQ评分显著高于对照组,BPRS评分显著低于对照组,服药依从性明显提高,差异有显著性意义（P〈0.05）;ITAQ与服药依从性,BPRS评分呈显著负相关.结论对门诊精神分裂症患者进行自知力教育可以有效恢复患者自知力,提高服药依从性,促进疾病恢复.     

心理干预对肝硬化患者依从性的影响

目的探讨心理干预对提高肝硬化患者的依从性的影响。方法将100例肝硬化患者随机分为实验组和对照组各50例，对照组按传统方法进行常规护理；实验组由责任护士对患者及家属进行系统的心理干预。比较2组护理、干预后的效果。结果实验组患者的依从性明显高于对照组，P〈0．05，差异有统计学意义。结论实施心理干预对提高肝硬化患者依从性有比较明显的帮助。     

Investigation of microbubble response to long pulses used in ultrasound-enhanced drug delivery

In current drug delivery approaches, microbubbles and drugs can be co-administered while ultrasound is applied. The mechanism of microbubble interaction with ultrasound, the drug and the cells is not fully understood. The aim of this study was to investigate microbubble response to long ultrasonic pulses used in drug delivery approaches. Two different in vitro set-ups were considered: with the microbubbles diluted in an enclosure and with the microbubbles flowing in a capillary tube. Acoustic streaming, which influences the observed bubble response, was observed in “typical” drug delivery conditions in the first set-up. With the capillary set-up, streaming effects were avoided and accurate bubble responses were recorded. The diffraction pattern of the source greatly influences the bubble response and in different locations of the field different bubble responses are observed. At low nondestructive pressures, microbubbles can oscillate for thousands of cycles repeatedly. At high acoustic pressures (at 1 MHz), most bubble activity disappeared within about 100 μs despite the length of the pulse, mainly due to violent bubble destruction and subsequent accelerated diffusion.     

综合护理干预对溃疡性结肠炎患者依从性的影响

目的 探讨护理干预对溃疡性结肠炎患者依从性及疾病康复的影响.方法 将75例溃疡性结肠炎患者随机分为A组(干预组)和B组(对照组),分别给予综合性护理干预和常规性治疗护理,比较两组的依从性和治疗效果、复发率.结果 A组患者依从性高于B组,且A组患者有效率高、复发率低.结论 综合性护理干预可提高患者的依从性,从而促进溃疡性结肠炎患者的康复,减少复发.     

导乐陪伴分娩产时服务模式对分娩的影响

目的探讨实施导乐陪伴分娩产时服务模式对分娩的影响。方法将400例产妇分为两组,观察组200例实施导乐陪产服务模式,对照组200例采用常规产时服务模式。结果观察组产妇满意度、自然分娩率明显高于对照组(P<0.05),而产时干预、产程时间、剖宫率、产后出血率、新生儿窒息发生率明显低于对照组(P<0.05)。结论导乐陪产服务模式能有效地改善分娩结局,促进自然分娩,有利于提高产科质量,保证母婴安全,值得推广。