犬骨髓间质干细胞体外诱导及非诱导培养后向心肌细胞的分化

目的：骨髓间质干细胞体外诱导和非诱导培养向心肌细胞分化的结果的对比。方法：实验于2003-03／2004-12在阜外心血管病医院中心实验室完成。①分离犬骨髓间质干细胞。②于体外培养，应用不同浓度（0，6，8，10，12，14，20μmol／L）的5-氮胞苷定向诱导并连续传代培养4周，未诱导的细胞培养8周。③进行细胞形态学、细胞免疫组织化学、透射电镜鉴定。结果：（D骨髓间质于细胞于5-氮胞苷诱导培养2周时，α-肌动蛋白、TroponinI染色阴性；4周时，α-肌动蛋白染色阳性，Troponin I阴性；电镜下可见肌丝结构，其中8mmol／L 5-氮胞苷诱导的间质干细胞肌丝结构排列较规则。②骨髓间质干细胞非诱导培养8周时，α-肌动蛋白染色阳性，Troponin I阴性，电镜下亦可见肌丝结构形成；而培养4周时全部为阴性。结论：骨髓间质干细胞经5-氮胞苷诱导培养4周及未诱导连续培养8周均可定向转化为具有肌丝结构的肌样细胞，而非心肌样细胞。     

应用循证护理预防常规留置胃管鼻饲液反流及误吸

留置胃管给予鼻饲饮食,对于一些不能经口进食的病人,不但能补充必要的营养物质,同时对维持组织及器官的结构和功能、保持病人营养平衡、减少继发性损伤、促进机体康复有极为重要的作用.     

Research and Application of Adlay in Medicinal Field

The traditional Chinese medicine(TCM) adlay has been used as a dietary supplement to promote health and treat various ailments for thousands of years.The effective and safe ingredients of TCM could be used as sources for developing new drugs.This paper reviews the main research and application of adlay seed in medicinal field in the following aspects:botanical resource,ethnopharmacological function,chemical constituents,pharmacology and pharmacokinetics,safety evaluation and toxicity,and clinical application.We hope that the review could help researchers mine the scientific values of adlay seed,innovative drug design,provide the guidance for the application in clinical therapy,and enhance the academic level and clinical efficacy of adlay seed.     

清肺解毒饮治疗肺胃蕴热型痤疮临床研究

目的 评价清肺解毒饮治疗肺胃蕴热型痤疮的疗效.方法 将符合入选标准的93例女性痤疮患者按随机数字表法随机分为3组,每组31例.观察组口服清肺解毒饮,中药对照组口服丹参酮胶囊,西药对照组口服醋酸环丙氯地孕酮,3组均治疗4周.采用ELISA法检测血清双氢睾酮(dihydrotestosterone,DHT)、IL-6、IL-8水平,观察治疗前后的皮损变化,记录治疗期间的不良反应,评价临床疗效.结果 治疗后,观察组血清DHT[(56.94±15.74)pg/ml比(74.48±18.53)pg/ml,t=2.089]、IL-6[(22.84±11.77)pg/ml比(30.37±14.50)pg/ml,t=2.135]、IL-8[(22.64±7.38)pg/ml比(29.54±9.65)pg/ml,t=2.057]水平均低于中药对照组(P<0.05).治疗后,观察组皮损消退率[(65.4±15.0)%比(44.7±12.9)%、(42.7±13.6)%,F=6.862]与综合证候有效率[(57.2±12.6)%比(46.3±12.8)%、(44.8±11.7)%,F=5.322]均高于中药对照组与西药对照组(P<0.05).观察组与中药对照组均未见明显不良反应,西药对照组有1例恶心.结论 清肺解毒饮可降低女性肺胃蕴热型痤疮患者血清DHT、IL-6、IL-8水平,提高皮损消退率与综合证候有效率,疗效优于口服丹参酮胶囊或醋酸环丙氯地孕酮治疗.     

Incorporation of the fluoroless C-Arm Trainer at the American Urological Association hands on training percutaneous renal access

Objectives

To assess for usefulness and validity evidence for incorporating the C-Arm Trainer (CAT) simulator into the annual AUA hands on course for training percutaneous nephrolithotomy (PCNL).

Materials and methods

The course started with a didactic session followed by four stations for training the “bull’s eye” technique using the CAT simulator. Each station included a pre-test, 30-min practice on the simulator, and post-test. All participants were assessed using a 4-item checklist. All participants were asked to fill in a qualitative self-assessment questionnaire after the pre- and the post-test, and respond to a course evaluation questionnaire and post-course survey.

Results

A total of 38 physicians, who attended the hands on course, voluntarily participated in the study. Only 21.1% had previous practice on PCNL simulators. Compared with the results of the checklist total score and the qualitative self-assessment questionnaire scores after the pre-test, there was significant improvement in the checklist total score (p < 0.001), temporal demands (p = 0.003), situational stress (p = 0.003, and performance (0.003) after the post-test. A total of 14 (36%) participants responded to the course evaluation questionnaire, 50% evaluated the course as excellent, 28.6% as very good, and 21.4% as good. Unfortunately, only five (13%) participants responded to the post-course survey, 4/5 implemented the new competencies and knowledge into their practice, and 3/5 have attempted to obtain fluoroscopic guided PCA without assistance.

Conclusion

The CAT simulator was considered useful for training the percutaneous renal access procedure. There was significant improvement in the qualitative and quantitative assessment parameters after the post-test compared with the pre-test.