脑外伤后认知障碍社区康复的可行性研究

目的：了解认知康复服务的需求，有关专业人士的认知康复知识水平以及他们对创新性认知康复的态度和接受程度，以便帮助制定认知障碍社区康复计划。方法：采用自行设计的结构式问卷调查表，155名神经外科医生、康复科医生、康复治疗师、护士等接受了问卷调查。结果：95．4％的调查对象认为在中国有必要开展脑外伤后的认知障碍康复。按康复的重要性需要优先考虑的前4个问题为：语言能力、记亿力、定向力、注意力；脑外伤后康复场所的重要性依次为：家庭、医院、社区；三种康复训练方法的重要性依次为：面对面方式、电脑辅助方式、网上远程指导方式。家庭是首选的康复场所、“面对面”是主要康复方式。康复训练方式与康复场所之间存在良好的相关关系，即相对于其他训练方式，在家庭或医院人们更愿意选择“面对面”训练；对于远程指导而言，在家中则比医院能更好地发挥作用。结论：①认知康复服务正在快速发展并获得有关专业人士的大力支持；②“面对面”训练仍是认知康复主要跟务方式；③在家中开展认知康复远程指导也是一项合适的服务选择，以家庭为基础的康复是社区康复的重要内容，网上和／或远程指导的认知康复服务值得大力提倡；④需进一步探讨创新性认知康复服务方式的有效性和实用性。     

聚丙烯材料假发移植物的组织相容性及可移植假发的外观效果

目的:以聚丙烯为基础材料制作假发移植物,通过动物实验观察其组织相容性及可移植假发的外观仿真效果。方法:实验于2005-08/2006-08在南方医科大学动物实验中心完成。运用聚丙烯材料设计并加工成侧面呈锯齿状锚刺,顶端固定假发的移植物。移植物主干和锚刺均使用医用聚丙烯单丝线(购自上海浦东金环医疗用品有限公司)制作;发束由单根或多根真人毛发或其他动物毛发组成,根部插在主干端头的埋入孔内,加压融合。取10只新西兰白兔(南方医科大学动物实验中心提供),每只白兔头皮采用毛囊单位移植技术,植入20根假发移植物,10只白兔头皮共移植200根。将10只白兔按随机数字表法分为两组,即大体观察组和组织学观察组,每组5只。大体观察组主要观察1年内移植物脱落情况并计数;组织学观察组分别于移植后第1周、第2周及其后1年内每个月在无菌条件下,每只兔分次采集包含有1根移植物的头皮组织条,进行组织学观察。结果:10只白兔全部进入结果分析,无脱失。①移植物的组织形态学观察结果:移植后1周移植物周围组织炎症反应轻微;移植后2周移植物周围有大量胶原纤维形成,炎症细胞局部稍有增多,移植物的主干和锚刺间已有胶原纤维长入;移植1个月后,成熟的纤维组织形成包膜于移植物及锚刺周围,无明显炎症反应。移植2个月后至1年,移植物周围组织无明显不良反应。②移植物脱落情况:5只白兔头皮共移植100根移植物。移植后第1周共脱落4根,第2周脱落2根,第3周￣第12个月无脱落,总结1年内脱落率为6%,并集中于最初2周。结论:以聚丙烯为基础材料的假发移植物可以较稳固地锚定于头皮,具有良好的组织相容性,可获得较佳仿真效果,是运用毛发修复外科技术治疗秃发的一种新的探索。但移植术后早期要注意保护创面,防止牵拉移植物。     

Characteristics of red cells irradiated and subsequently frozen for long-term storage

Irradiation of blood components eliminates the risk of transfusion- associated graft-versus-host disease. Freezing directed or rare red cell units that are irradiated but not transfused would facilitate inventory management and would increase the transfusion options for the involved patients. However, no studies have been performed to evaluate whether prestorage irradiation damages subsequently frozen red cells. Ten normal volunteers donated a unit of whole blood on two separate occasions. One unit was irradiated with 15 Gy (1500 rad), stored at 4 degrees C for 6 days, and then frozen and stored at -75 degrees C for 56 days. The other unit (control) was similarly stored but was not irradiated. Aliquots of the units were tested on Day 0 and Day 6 and, after deglycerolization, on Day 62. Comparison of means and changes in means showed no significant differences in red cell ATP, 2,3 DPG, or supernatant hemoglobin and glucose in control and irradiated units. The difference in the change in supernatant potassium from Day 0 to Day 6 in control and irradiated units was significant (1.5 to 28.6 mmol/L vs. 1.5 to 48.5 mmol/L: p < 0.0001). Irradiation did not cause significant differences in postdeglycerolization red cell recovery (control, 84.5% vs. irradiated, 81.2%) or in 24-hour posttransfusion autologous red cell survival (control, 91.1% vs. irradiated, 90.9%). Red cells can be irradiated, stored at 4 degrees C for 6 days, and subsequently frozen with no increase in detectable damage as compared to controls that were not irradiated.     

Viability of platelets following storage in the irradiated state. A pair-controlled study

Gamma irradiation of blood products is a standard practice recommended for the prevention of posttransfusion graft-versus-host disease in susceptible hosts. We studied the effects of irradiation on stored platelet concentrates and evaluated whether platelets could be stored for 5 days in the irradiated state without adverse effects on their viability. Using a pair-controlled design in which each of six normal subjects acted as his or her own control, we compared in vitro storage characteristics and in vivo kinetics of platelet concentrates exposed to 30 Gy and stored for 5 days with those of platelet concentrates simply stored for 5 days without irradiation. Irradiation had no significant effects on in vitro storage characteristics (platelet count, mean platelet volume, pH, and white cell count) or on in vivo kinetics, including initial recovery and mean platelet survival. Using the multiple-hit model, initial recovery was 49.6 +/- 10.8 percent, and mean platelet survival was 5.6 +/- 1.05 days for irradiated concentrates, compared with 51.3 +/- 13.0 percent and 5.9 +/- 0.50 days, respectively, for the unirradiated control concentrates. We conclude that irradiation of platelet concentrates with up to 30 Gy has no effect on their in vivo recovery or survival, and that irradiation administered before storage of platelet concentrates does not interfere with their clinical efficacy.     

Dispatches from Biotech beginning BeginNGS: Rapid newborn genome sequencing to end the diagnostic and therapeutic odyssey

In this Dispatch from Biotech, we briefly review the urgent need for extensive expansion of newborn screening (NBS) by genomic sequencing, and the reasons why early attempts had limited success. During the next decade transformative developments will continue in society and in the pharmaceutical, biotechnology, informatics, and medical sectors that enable prompt addition of genetic disorders to NBS by rapid whole genome sequencing (rWGS) upon introduction of new therapies that qualify them according to the Wilson and Jungner criteria (Wilson, J. M. G., & Jungner, G., World Health Organization. (1968). Principles and Practice of Screening for Disease. World Health Organization. Retrieved from https://apps.who.int/iris/handle/10665/37650 ). Herein we describe plans, progress, and clinical trial designs for BeginNGS (Newborn Genome Sequencing to end the diagnostic and therapeutic odyssey), a new international, pre-competitive, public–private consortium that proposes to implement a self-learning healthcare delivery system for screening all newborns for over 400 hundred genetic diseases, diagnostic confirmation, implementation of effective treatment, and acceleration of orphan drug development. We invite investigators and stakeholders worldwide to join the consortium in a prospective, multi-center, international trial of the clinical utility and cost effectiveness of BeginNGS.     

克拉玛依市区15岁以上常住居民高血压患病情况调查

目的:调查克拉玛依市区15岁以上常住居民高血压患病情况及危险因素。方法:调查于2002-05/2003-07进行,采用整群随机抽样抽取了克拉玛依市克拉玛依区15岁以上居住3年以上常住人群4500余人。对所有入选者进行统一问卷调查,询问病史、家族史、职业、文化程度、经济收入、饮食习惯、卫生知识水平等,体格检查包括身高、体质量、血压、脉率、腰围、血脂、血糖、尿酸、肾功能、心电图等。结果:4402人进入结果分析,资料的缺失率为2%。①高血压患病率21.51%,男性27.08%,女性15.67%,主要分布在25～45岁。血压正常人群占33.51%、高血压人群占21.51%,高危人群占44.98%。②年收入2万元以上和1万元以下高血压患者偏多。③汉族高血压比例最大,为22.58%,其次为哈萨克族18.66%。④高血压患者中1级高血压占47.63%,2级高血压占13.83%,随着高血压分级越高,靶器官损害越重,脉压差越大,心脑血管事件亦越多。⑤新检出高血压占整个高血压患者的41.39%。⑥高血压知晓率37.95%、治疗率27.93%、控制率22.52%。⑦高血压患者中高三酰甘油血症者占40.1%,高胆固醇血症者占30.7%,空腹血糖≥6.0mmol/L者9.6%,肥胖者60.0%。结论:①克拉玛依市高血压患病率较高,男性大于女性,且呈现年轻化趋势。②高血压与种族、经济收入和不良生活习惯有关。③克拉玛依市高血压知晓率、治疗率和控制率有待进一步提高。