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1.

Context

Family caregivers constitute a critical component of the end-of-life care system with considerable cost to themselves. However, the joint association of terminally ill cancer patients' symptom distress and functional impairment with caregivers' subjective caregiving burden, quality of life (QOL), and depressive symptoms remains unknown.

Objectives/Methods

We used multivariate hierarchical linear modeling to simultaneously evaluate associations between five distinct patterns of conjoint symptom distress and functional impairment (symptom-functional states) and subjective caregiving burden, QOL, and depressive symptoms in a convenience sample of 215 family caregiver–patient dyads. Data were collected every 2 to 4 weeks over patients' last 6 months.

Results

Caregivers of patients in the worst symptom-functional states (States 3–5) reported worse subjective caregiving burden and depressive symptoms than those in the best two states, but the three outcomes did not differ between caregivers of patients in State 3 and States 4–5. Caregivers of patients in State 5 endured worse subjective caregiving burden and QOL than those in State 4. Caregivers of patients in State 4 suffered worse subjective caregiving burden and depressive symptoms but comparable QOL to those in State 2.

Conclusion

Patients' five distinct, conjoint symptom-functional states were significantly and differentially associated with their caregivers' worse subjective caregiving burden, QOL, and depressive symptoms while caring for patients over their last 6 months.  相似文献   
2.
Adrenergic signalling between rat taste receptor cells   总被引:2,自引:0,他引:2  
In taste buds, synaptic transmission is traditionally thought to occur from taste receptor cells to the afferent nerve. This communication reports the novel observation that taste receptor cells respond to adrenergic stimulation. Noradrenaline application inhibited outward potassium currents in a dose-dependent manner. This inhibition was mimicked by the β agonist isoproterenol and blocked by the β antagonist propranolol. The α agonists clonidine and phenylephrine both inhibited the potassium currents and elevated intracellular calcium levels. Inwardly rectifying potassium currents were unaffected by adrenergic stimulation. Experiments using the RT-PCR technique demonstrate that lingual epithelium expresses multiple α (α1a, α1b, α1c, α1d, α2a, α2b, α2c) and β (β1, β2) subtypes of adrenergic receptors, and immunocytochemistry localized noradrenaline to a subset of taste receptor cells. Collectively, these data imply strongly that adrenergic transmission within the taste bud may play a paracrine role in taste physiology.  相似文献   
3.
背景:与小肠黏膜下层等材料相比,脱细胞血管具有天然管状结构,与输尿管形态结构相近,替代输尿管时仅需端端吻合即可,手术操作简单,血管外壁光滑,获取及制备方法简便等优点。 目的:拟应用同种颈动脉血管无细胞基质体外构建输尿管。 设计、时间及地点:观察性实验,于2006-09/2008-06在上海交通大学医学院附属新华医院动物实验中心完成。 材料:长风杂交白猪由上海松联实验动物公司提供。上海交通大学医学院实验动物中心提供的健康成年大鼠8只,用于血管无细胞基质的动物毒性实验。 方法:剥去猪颈动脉血管外膜,PBS冲洗若干遍,然后将血管置于pH 7.1 的PBS中4 ℃下振荡清洗,0.5%十二烷基硫酸钠振荡24 h,后使用双蒸水4 ℃下反复振荡洗涤1周,每日换双蒸水2次。对于解剖过程中肌肉残留相对稍多的血管,在双蒸水洗涤前以混合消化液37 ℃下振荡消化约2 h,再行双蒸水洗涤。制备的无细胞基质置于青、链霉素溶液中,4 ℃保存,完成脱细胞支架制备。 主要观察指标:光镜及电镜观察脱细胞后管壁无细胞基质片的主要成分。将同种异体来源内皮祖细胞培养增殖后植入血管无细胞基质,观察细胞生长情况,并进行血管无细胞基质动物毒性实验。拉力实验了解血管无细胞基质材料的收缩性能。 结果:颈动脉血管无细胞基质中已无细胞成分,无细胞基质主要由胶原成分组成。扫描电镜未见该材料表面存在细胞及细胞碎片,同时发现该无细胞基质存在孔隙样结构。体外同种异体来源的内皮祖细胞培养增殖后植入血管无细胞基质,细胞黏附于无细胞基质。血管无细胞基质按毒性分级属于无毒级。拉力实验说明该无细胞基质具有一定的韧性和牵张性。 结论:采用胰酶和十二烷基硫酸钠制备的颈动脉血管无细胞基质材料无细胞残留,具有一定的韧性和牵张性,种植于其中的种子细胞具备一定的生长能力。  相似文献   
4.
5.
Four Chinese patients (2 boys, 2 girls), ages 4–9 years, who had episodes of perception error of body schema and objects are reported. The metamorphopsia, which had been named Alice in Wonderland syndrome, is the major presentation. All of them were proved to have acute Epstein-Barr virus infection, as documented by positive heterophil antibody test and/or positive IgM antibody to Epstein-Barr virus capsid antigen. The duration of the perception disorder ranged from 1 week to 3 months. We believe that any young child presenting with Alice in Wonderland syndrome should undergo examination for Epstein-Barr virus infection; complete recovery from the disorder can be expected.  相似文献   
6.
小切口股骨近端解剖钢板治疗股骨转子间骨折   总被引:5,自引:4,他引:1  
目的 探讨股骨转子间骨折的治疗方法和疗效。方法小切口微创股骨近端解剖钢板内固定治疗股骨转子间骨折17例。结果 随访时间8个月~3年,平均1.6年,优良16例,占94%(16/17)。结论 小切口微创股骨近端解剖钢板内固定治疗股骨转子间骨折具有切口小、出血少等优点,是一种微创手术。  相似文献   
7.
当归对衰老小鼠脑组织细胞凋亡及胸腺指数的影响   总被引:2,自引:0,他引:2  
目的:研究当归的抗衰老作用及作用机制。方法:用D—半乳糖诱导小鼠制成衰老模型,同时给予不同剂量的当归水煎剂,观察当归对脑组织细胞凋亡及胸腺指数的影响。结果:当归能明显抑制小鼠脑组织细胞凋亡,提高胸腺指数。结论:当归具有抗衰老作用。  相似文献   
8.
湿润烧伤膏治疗褥疮26例的临床体会   总被引:7,自引:0,他引:7  
目的:进一步观察湿润烧伤膏对治疗褥疮的疗效,寻找最理想的治疗方法。方法:通过对26 例不同原因所致褥疮的治疗,探索湿润烧伤膏对治疗褥疮病人最合理的用药方法,创面的变化及其愈合时间。结果:25例病人创面愈合,死亡1例。结论:湿润烧伤膏治疗褥疮方法简便,实用性强,疗效显著,值得各级医院推广。  相似文献   
9.
Summary— To investigate if the functional alterations observed in resistance arteries of spontaneously hypertensive rats (SHRs) were also present at the coronary level, in vitro experiments were performed in mesenteric resistance arteries (MRA) and in right (RIC) and left interventricular coronary (LIC) arteries taken from 15–25-week-old SHR and age-matched Wistar Kyoto rats WKYs. Using a passive extension protocol, internal diameters corresponding to 100 mmHg intraluminal pressure (D100) were determined and vessels were set up to a normalized internal diameter (0.9 D100). SHR mesenteric resistance arteries had a significantly smaller diameter compared to WKY arteries, whereas both types of SHR coronary arteries had a greater diameter compared to those of WKY rats. In arteries in the absence of contracting agonist, nitro-L-arginine (NOLA, 100 μM) induced a progressive rise in basal tone, which could be reversed by subsequent addition of L-arginine (100 μM) but not D-arginine (100 μM). When expressed as percent of maximal contractions induced by agonists (noradrenaline, NA [10 μM] in MRA; serotonin, 5-HT [10 μM], in RIC and LIC), these contractions were significantly stronger in WKY compared to SHR coronary and mesenteric resistance arteries. In NA-precontracted MRA and 5HT-precontracted coronary arteries in the presence of indomethacin (10 μM), the magnitude of acetylcholine-induced maximal relaxations (expressed as percent of maximal contractions induced by agonists) was greater in WKY compared to SHR arteries. After a 30-min incubation period, NOLA (100 μM) completely inhibited relaxations induced by acetylcholine (0.01–10 μM) in all types of precontracted arteries. Subsequent additions of sodium nitroprusside, (SNP, 10 μM) induced complete relaxations in all preparations. These results show that a basal release of NO or NO-like compound by endothelial cells is present in isolated mesenteric resistance and coronary arteries of WKY rats and SHRs. The contribution of endothelium-derived relaxing factor-nitric oxide (EDRF-NO) to arterial tone was lower in MRA compared to coronary arteries in both strains and in SHR compared to WKY arteries. In the SHR preparations, the impaired relaxation induced by acetylcholine appeared to be due to a functional alteration of the endothelium in the presence of normal reactivity of the smooth muscle cells.  相似文献   
10.
Objective: To examine the relationship between ambient lead levels and blood lead levels and to explore the modifiers of the relationship between ambient lead and blood lead. Method: A cross-sectional study was conducted in two lead battery factories. Blood lead level and ambient lead concentration were measured for each participant concurrently. A structured questionnaire was administered to collect sociodemographic characteristics and occupational history. Design: Biological and personal environmental measurements of 219 lead-exposed workers were analyzed by both simple and multiple linear regression. A regression model was selected for interpretation. Results: A high correlation (r=0.62) between ambient lead (PbA) and blood lead (PbB) was observed. In addition, numerous factors, including age, sex, alcohol consumption, personal hygiene practice and type of lead exposure, were also found to influence blood lead levels. Although PbB was highly correlated with PbA, blood lead level may not be effectively lowered by reducing ambient lead level. Based on the regression coefficients, improvement of hygienic practice was more effective at lowering PbB than reducing ambient lead level. Good hygienic practice may be the preferential way to reduce lead exposure in current conditions. Conclusion: Education of correct work practice may be more important than engineering control in the developing countries to lower blood lead levels in lead battery factories. Received: 28 May 1996/Accepted: 30 August 1996  相似文献   
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