NO,iNOS与胃癌关系的研究进展

幽门螺杆菌(H.pylori)感染造成的炎症反应,可刺激诱导型NO合酶(inducible NO synthase,iNOS)产生大量的NO,对胃癌的启动和发展起重要作用.进入20世纪90年代以来,一氧化氮(NO)研究跨入了迅猛发展的阶段,许多调节功能及其在病理生理过程中所起的重要作用被逐渐认识,特别是NO在致癌和致突变过程中表现的双重性,更是近年的研究热点之一[1,2].本文就NO、iNOS与胃癌关系的研究进展作一综述.     

Human marrow erythropoiesis in culture. I. Characterization of methylcellulose colony assay

We examined the morphological and functional characteristics of human marrow erythrocytes cultured with a recently developed methylcellulose colony assay technique. Erythrocytic cells in various stages of development were observed, and a significant degree of maturational synchrony within individual colonies was noted. By light microscopy, colonies consisting of late normoblasts appeared compact, had an orange hue attributable to their hemoglobin, and demonstrated pseudoperoxidase activity, whereas colonies composed of early erythroblasts grew less compact or in clusters of smaller cell aggregates and showed no reddish tinge. Colonies possessing intermediate features were also observed. Maturational synchrony of individual colonies was confirmed using ransmission and scanning electron microscopy. The ultrastructure and cytochemistry of most immature cells were normal. The mature erythrocytes, however, were severely microcytic and hypochromic and contained one to several Heinz bodies. These defects in the cytoplasmic maturation of erythrocytes corresponded with impaired granulocytic maturation in culture, which we observed previously, and suggest environmental or nutritional defects in culture. Linearity of the method was confirmed using five normal bone marrows. Erythropoietin dose-responses observed in ten normal marrows were comparable to the previously reported results and revealed significant variation in individual plating efficiencies.     

Getting a grip on Safewards: The cross impact of clinical supervision and Safewards model on clinical practice

The Safewards model is used across various mental health settings to reduce incidents of conflict and containment and its efficacy in reducing the use of seclusion and restraint, improving patients' experiences of care, and enhancing safety within clinical settings is well documented (Bowers, Journal of Psychiatric & Mental Health Nursing, 21, 2014, 499). However, there are barriers to successful implementation, including level of staff buy-in (Baumgardt et al., Frontiers in Psychiatry, 10, 2019, 340; Price et al., Mental Health Practice, 19, 2016, 14). This mixed-method study assessed the impact of adopting a Safewards model within a clinical supervision framework in an approach, named Group Reflective integrated Practice with Safewards (GRiP-S), which integrates Safewards theory within the clinical supervision framework. Both quantitative and qualitative data were collected using the questions derived from the Manchester Clinical Supervision Scale −26© (Winstanley & White, The Wiley International Handbook of Clinical Supervision. John Wiley & Sons Ltd, 2014). A total of 67 surveys and eight interviews were completed by nursing staff. Overall, the results showed that the GRiP-S approach improves the implementation of Safewards and nurses' clinical practice. Nursing staff satisfaction with clinical supervision and Safewards improved post GRiP-S pre-GRIP-S- 69.54 (SD 16.059); post-GRIP-S 71.47 (SD 13.978). The survey also identified nursing staff's perception of GRiP-S in the restorative and formative domains of clinical supervision improved. The restorative mean score pre-GRiP-S was 28.43 (SD 5.988) and post-GRiP-S 29.29 (SD 3.951). The formative mean score pre-GRiP-S was 20.10 (SD 5.617) and post-GRiP-S 20.63 (SD 13.978). The qualitative results further explained the satisfaction levels and the changes seen in perception domains. The GRiP-S approach reported (i) improved therapeutic relationships and patient centred care, (ii) improved staff communication and teamwork, (iii) barriers to GRiP-S engagement, and (iv) assistance with the change process. The results indicate that the GRiP-S approach had a positive impact on Safewards delivery and supports ongoing change of practice.     

A technique to access difficult to find upper extremity veins for right heart catheterization: The levogram technique

Upper extremity venous access provides a safer alternative for performance of right heart catheterization compared to femoral venous access. We describe a technique to access deep veins of the upper extremity, in patients undergoing transradial catheterization, using levophase contrast venography. This technique allows the operator to access deep veins of the upper extremity without the need for additional equipment, staff or training, using traditional basic catheterization laboratory skills and equipment. © 2011 Wiley‐Liss, Inc.     

A method for maintaining vascular access when Impella exchange is required

A 45‐year old male with no prior cardiac history, presented with cardiogenic shock in the setting of an anterolateral ST elevation myocardial infarction. We first placed a 2.5 Impella for hemodynamic support, and proceeded with emergent percutaneous coronary intervention to the proximal LAD. Several hours following percutaneous coronary intervention (PCI), the patient became acutely hypotensive and an echocardiogram revealed the Impella catheter was kinked within the left ventricle. The patient was taken back to the cath lab for Impella adjustment; however, damage to the distal catheter required the Impella be exchanged. As the patient was therapeutically anticoagulated and on dual antiplatelet therapy, we modified the Impella catheter in order to maintain existing vascular access during Impella exchange. This case demonstrates our method for maintaining vascular access during Impella exchange, thereby eliminating the need for a second arterial puncture. © 2017 Wiley Periodicals, Inc.     

ACR guidance document on MR safe practices: 2013

Because there are many potential risks in the MR environment and reports of adverse incidents involving patients, equipment and personnel, the need for a guidance document on MR safe practices emerged. Initially published in 2002, the ACR MR Safe Practices Guidelines established de facto industry standards for safe and responsible practices in clinical and research MR environments. As the MR industry changes the document is reviewed, modified and updated. The most recent version will reflect these changes. J. Magn. Reson. Imaging 2013;37:501–530. © 2013 Wiley Periodicals, Inc.