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011 PCI应用药物洗脱支架与CABG术后生活质量改善的比较[Cohen DJ,van Hout B,Serruys PW,et al.N Engl J Med,2011,364(11):1016-1026(英文)]经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)都可选择用于治疗多支血管冠状动脉病变;以往研究显示:多支血管冠状动脉病变实施CABG或PCI实施气囊血管成形术或金属裸支架后,心绞痛发作频率和生活质量均明显改     

Role of NADPH-cytochrome P450 reductase and cytochrome-b5/NADH-b5 reductase in variability of CYP3A activity in human liver microsomes

NADPH-cytochrome P450 reductase (CPR) and cytochrome-b(5) (b(5)) together with NADH-b(5) reductase (b(5)R) play important roles in cytochrome P450 3A-mediated drug metabolism via electron transfer. However, it is not clear whether variability in expression of these accessory proteins contributes to the known interindividual variability in CYP3A activity. CPR and b(5) were measured in human liver microsomes (HLMs) by spectrophotometry and immunoblotting. HLMs from elderly (>or=46 years) male donors (n=11) averaged 27% (P=0.034) and 41% (P=0.011) lower CPR levels than young (相似文献   

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雷公藤红素是雷公藤主妻活性成分之一,本支报道它在试管内及整体均明显抑制小鼠脾细胞溶血空斑细胞的形成,此作用与浓度呈依赖关系。对手大鼠实验性棉球肉芽肿的形成,小鼠二硝基氧苯。(DNCB)所致迟发型超敏反应均有明显抑制作用,回时还观察到它能延长戊巴比妥钠致小鼠睡眠时间。     

Time to solve persistent,pernicious and widespread nursing workforce shortages

Aim

This paper discusses four main strategies for addressing nursing shortages that have been persistent, widespread and growing. Fallout from the COVID-19 pandemic might offer valuable impetus to address this tenacious challenge.

Background

Nursing shortages are common, widespread and have been persistent for most of a century. Many of the reasons behind these shortages are well known and are themselves enduring, as are the types of strategies put forward for addressing them. These strategies can generally be classified into four main categories: enhancing retention, improving recruitment, encouraging return to practice and drawing on international human resources. The COVID-19 pandemic is the latest major threat to ensuring a sufficiently sized and skilled nursing workforce. Many nurses have succumbed to burnout as well the plethora of factors that predated the pandemic and have a negative impact on nurse wellbeing, turnover and intention to leave.

Sources of evidence

This discussion paper draws on international sources of evidence.

Discussion/conclusion

This paper highlights how many of the factors behind and strategies for addressing nursing shortages at the local, national and global levels are widely studied and known. A sustained combination of strategies that focus both within and beyond health and nursing, including on the broader social context, is necessary. While COVID-19 has been extremely damaging, it might present an opportunity to make sustainable, effective reforms to address nursing shortages.

Implications for policy

Knowledge users must recognise that a combination of approaches across the gamut of policies that influence nursing workforces is necessary to address nursing shortages. Attention must also focus on factors beyond nursing and healthcare if shortages are to be remedied.