Timebanking and the co-production of preventive social care with adults; what can we learn from the challenges of implementing person-to-person timebanks in England?

This paper explores the potential contribution of timebanking, an innovative volunteering scheme, to the co-production of preventive social care with adults in England. Interest in volunteering in social care has increased as one proposed solution to the international crisis of a rising demand for services in juxtaposition with decreased resources. Volunteering has been particularly promoted in preventive services that prevent or delay care needs arising. Despite sustained interest in volunteering and co-production in social care, little is known about how theory translates into practice. Reporting implementation data from a Realistic Evaluation of six case studies in England, this paper explores one volunteering scheme, timebanking. The research explores how timebanks were working, what contribution they can make to adult social care, and whether they are an example of co-production. Data collected included interviews, focus groups or open question responses on surveys from 84 timebank members, and semi-structured interviews with 13 timebank staff. Each timebank was visited at least twice, and all timebank activity was analysed for a period of 12 months. Data were triangulated to improve reliability. The research found that in practice, timebanks were not working as described in theory, there were small numbers of person-to-person exchanges and some timebanks had abandoned this exchange model. Timebanks faced significant implementation challenges including managing risk and safeguarding and the associated bureaucracy, a paternalistic professional culture and the complexity of the timebank mechanism which required adequate resources. Lessons for timebanks are identified, as well as transferable lessons about co-production and volunteering in social care if such schemes are to be successful in the future.     

骨髓基质细胞和内皮细胞联合种植构建组织工程化骨的初步研究

为阐明骨髓基质细胞和内皮细胞联合种植在生物复合材料上构建组织工程化骨 ,在促进成骨过程、加速局部血管生成中的作用 ,将大鼠骨髓基质细胞和人脐静脉内皮细胞联合种植在左旋聚乳酸 /β-磷酸三钙 (PL L A/β- TCP)多孔复合支架材料上作为实验组 ,仅种植骨髓基质细胞在该材料上作为对照组。将此种有活细胞的复合材料种植于裸鼠大腿后侧肌袋内 ,分别于种植后 1、4、8、12、16周处死动物 ,取出复合材料 ,行组织学检测 ,并用图像处理技术计算实验组和对照组的成骨面积百分比和材料面积百分比 ,观察其变化规律。结果显示 :实验组成骨面积百分比增加比对照组明显加快 ,而材料面积百分比减少比对照组迅速 ;其内毛细血管网形成情况也要明显优于对照组。表明骨髓基质细胞和内皮细胞联合种植于支架材料构建组织工程化骨不仅有利于成骨作用 ,促进新生骨区内部血管网形成 ,还有利于复合材料的降解吸收 ,这在构造组织工程化骨过程中具有重要意义。     

前路病灶清除植骨Ventrofix固定治疗胸腰椎结核

目的 评估AO圆捧内固定系统(VentroFix)在胸腰椎结核前路病灶彻底切除植骨内固定术中的临床应用价值。方法 对16例胸腰椎结核患者行病灶切除，植骨及应用VentroFix进行内固定。结果 16例经9～18个月随访，无术中，术后并发症，植骨全部融合，无植骨块移位或塌陷及高度丢失。亦无螺钉断裂无松动等现象，脊髓神经功能均有不同程度的恢复。结论 该固定系统具有固定牢固，稳定性高，操作简单安全，合并症少，生物相容性好，无磁性等优点，是胸腰椎结核良好的前路内固定器械。     

听觉刺激器的研制

作者介绍一种用微机听觉诱发电位刺激器。该刺激器可以产生“喀呖”声，具有十二档刺激频率，四档刺激脉冲宽度，刺激强度最大１３２分贝，并具白噪声屏蔽。     

Mannose prevents lipopolysaccharide-induced acute lung injury in rats

Objective: To investigate the effect of mannose on lipopolysaccharide (LPS) induced acute lung injury (ALI) in rats. Methods: Ten groups of Sprague–Dawley rats were used: 1) the control group received an intratracheal instillation of saline, 2) the LPS group received an intratracheal instillation of LPS (3 mg/kg), 3–6) the mannose groups were injected i.v. with 15, 45, 135, and 405 mg/kg mannose, 7–9) the glucose, galactose, and fructose groups were injected with different hexoses (135 mg/kg), and 10) the dexamethasone (DXM) group was injected with DXM (2 mg/kg). In groups 2–8, LPS was administered after injection of drugs. Lung wet/dry weight ratio, permeability index (PPI), total leukocytes and polymorphonuclear neutrophils (PMNs) counts in bronchoalveolar lavage fluid (BALF), myeloperoxidase (MPO) and superoxide dismutase (SOD) activity, tumor necrosis factor (TNF)-α and interleukin (IL)-10 in lung and BALF were determined. Results: Pre-treatment with mannose attenuated pulmonary edema and protein exudation in a dose-dependent manner, the maximal effect was similar to or greater than that of DXM. Mannose also prevented the inflammatory cell accumulation, although the maximal effect was weaker than that of DXM. Mannose was more effective than DXM in inhibiting MPO activity and restoring SOD activity. Moreover, it inhibited production of TNF-α and IL-10. Histological changes of the lungs were also ameliorated by mannose. There were no significant improvements observed in rats pre-treated with glucose, galactose or fructose. Conclusions: Mannose is effective in reducing LPS-induced ALI. Project supported by the National Natural Science Foundation of China, No. 30670930 and the Science and Technology Department of Zhejiang Province (No.2004C23011) Received 4 March 2007; returned for revision 13 May 2007; returned for final revision 17 July 2007; accepted by M. Katori 12 September 2007     

HLA-DPB1 allelic frequency of the Lisu ethnic group in the Southwest China and evolutionary relationship of Lisu with other populations

A sequencing-based typing of human leukocyte antigen-DPB1 (HLA-DPB1) gene was carried out in 37 unrelated healthy individuals from the Yunnan Lisu ethnic minority. A total of 12 DPB1 alleles, in which DPB1*1301 (33.3%), DPB1*0402 (16.6%), DPB1*040101 (13.8%), and DPB1*0501 (11.1%) were highly predominant, were found, and allele DPB1*200102 was found for the first time in a Chinese population. A dendrogram constructed by neighbor-joining method showed that the Lisu ethnic group belongs to East Asian cluster.     

卡维地洛对高血压大鼠主动脉的保护作用

目的 :研究卡维地洛对核因子 κB(NF κB)、单核细胞趋化蛋白 1(MCP 1)在自发性高血压大鼠 (SHR)大血管中表达的影响 ,探讨其对血管保护的机制。方法 :18只雄性 12周龄SHR随机分为阳性组 ,卡维地洛组 ( 30mg/kg·d) ,美托洛尔组 ( 50mg/kg·d) ,灌喂 8周 ;另选同龄雄性WistarKyoto大鼠为阴性组 (n =6 )。用免疫组化法测各组主动脉NF κB、MCP 1的表达 ,ELISA法测血清MCP 1含量。结果 :与阴性组比较 ,阳性组主动脉组织中NF κB、MCP 1表达增加 (P<0 .0 1) ,且两者正相关 (r=0 .72 8,P <0 .0 1) ;血清MCP 1含量升高 1.6 4(P <0 .0 1)。 8周后 ,治疗组之间血压无明显差异 (P >0 .0 5) ,但卡维地洛更显著抑制NF -κB、MCP 1表达 (P <0 .0 5)。结论 :卡维地洛可能独立于降压外抑制NF κB的活化来调控MCP 1表达。     

围术期高血糖的流行病学研究进展

目的：围术期高血糖的研究逐渐成为临床研究的热点。在围术期高血糖的流行病学研究中发现，围术期各种因素的影响致使高血糖的发生率较高，其结果导致了围术期并发症发生率的升高和生存率的下降，与围术期高血糖在血液流变学中呈现出高粘滞状态和微循环灌流障碍相关。