Equivalence of Chinese version of the Cohen-Mansfield Agitation Inventory

AIM: This paper is a report of a study undertaken to translate the Cohen-Mansfield Agitation Inventory from the original English into a Chinese language version and to establish the content, semantic and technical equivalence of the Chinese version. BACKGROUND: Ensuring the equivalence of a translated Chinese version of the Cohen-Mansfield Agitation Inventory for patients with dementia is an essential requirement for identifying culturally specific expressions of agitated behaviours. METHODS: In Phase I, five experts scrutinized the Inventory items to determine whether the behaviour described was relevant to the agitated behaviours present in the Taiwanese culture. In Phase II, experts did the initial translation into Chinese and then back-translated it into English. Four bilingual observers rated 31 residents with dementia to determine semantic equivalence across versions. In Phase III, the agitated behaviours of 32 residents were assessed by four observers using staff ratings and direct observation to determine the technical equivalence of the Chinese version. The study was carried out in Taiwan from August 2004 to April 2005. FINDINGS: In Phase I, the rating of behaviours described on the Cohen-Mansfield Agitation Inventory was relevant to the agitated behaviours based on Taiwanese culture with a content validity index (CVI) value of 0.993. In Phase II, intra-class coefficients for all items on the Chinese version and split-halves of Chinese and English versions ranged from 0.69 to 0.74. In Phase III, six possible results for estimation of reliability across methods and raters for the Chinese version ranged from 0.63 to 0.86. CONCLUSION: The Chinese Cohen-Mansfield Agitation Inventory had modest psychometric properties. Further studies are needed to assess criterion and conceptual equivalence.     

Transfusion of donor peripheral blood buffy coat cells as effective treatment for relapsed acute leukemia after transplantation of allogeneic bone marrow or peripheral blood stem cells from the same donor

BACKGROUND: The transfusion of same-donor peripheral blood buffy coat (PBBC) cells to chronic myelocytic leukemia patients in relapse after bone marrow transplantation has been increasingly used as an effective antileukemic therapy. A graft-versus-leukemia effect mediated by immunocompetent donor T cells underlies its success. In acute leukemia, however, the effect of this adoptive cellular immunotherapy has not been established, and the results are generally poor. STUDY DESIGN AND METHODS: Five patients, three with acute lymphoblastic leukemia and two with acute myelocytic leukemia, who relapsed within 6 months after allogeneic marrow transplantation were enrolled in a nonrandomized pilot study to receive donor PBBC cell transfusions either before or after undergoing cytoreductive chemotherapy. ABO genotyping and polymerase chain reaction amplification of human tetrameric short tandem repeats DNA typing were used to test for marrow chimerism. RESULTS: Two acute lymphoblastic leukemia patients-both of whom underwent chemotherapy before PBBC cell transfusions, experienced a complete remission, and developed acute and then chronic, extensive graft-versus-host disease-have been leukemia-free for 9 and 7 months, respectively. Repeated molecular studies of their marrow as early as 2 weeks to 8 months after treatment confirmed that the marrow was of donor origin. The other three patients, who chose not to undergo chemotherapy before PBBC cell transfusions, failed to achieve remission and died 14, 16, and 30 days, respectively, after leukemia relapse. CONCLUSION: Adoptive cellular immunotherapy may be effective for acute lymphoblastic leukemia patients in relapse after bone marrow transplantation if chemotherapy is administered before PBBC cell transfusions are initiated.     

A nursing experience in a patient with antipsychotics-induced overweight

The purpose of this article is to describe a nursing experience with a patient with schizophrenia who had antipsychotics-induced overweight. The authors assessed the patient's health condition and provided weight management to reduce her hallucinations as well as her body weight between May 1 and June 10, 2004. Three nursing problems had been identified as follows: disturbed sensory perception, imbalanced nutrition, and ineffective health maintenance. During the nursing process, the authors established a rapport relationship with the patient and her mother, educated them in skills for reducing hallucinations, and designed an individual body weight management program. After the interventions, the patient was able to positively face her illness, effectively use methods to reduce the impact of hallucinations, and successfully lose 5.5 kg. From this perspective, an individual body weight management program can be an effective intervention for nurses to care for this group of patients.     

缺血再灌注后心肌细胞缝隙连接通讯改变与其凋亡及坏死的关系

目的:了解不同缺血再灌注时间心肌细胞缝隙连接通讯改变情况,分析心肌细胞缝隙连接通讯与心肌细胞坏死、凋亡的关系以及卡维地洛、庚醇的干预作用。方法:实验于2004-10/2005-03在中日友好医院临床研究所完成。取培育7d心肌细胞缺氧30min后换用正常含糖的DMEM培养基培养1,2,3,6h,造成再给氧损伤。给药方案:分为三组;未用药组,庚醇组,卡维地洛组。庚醇用DMEM(含5%的小牛血清)配成1,2mmol/L的浓度,卡维地洛配成0.001g/L的浓度,分别加入药物于受试细胞,培养细胞30min后再做相关实验。未用药组不加药。采用细胞划痕技术,在倒置荧光显微镜下直观地观察不同组别、缺氧再灌注不同时间罗氏黄经过缝隙连接流通情况。利用流式细胞仪观察缺氧再灌注不同时间细胞凋亡情况。结果:①在缺氧30min时心肌缝隙连接通讯明显下降,荧光仅传至划痕附近第二列细胞,正常细胞荧光则传至四列以外的细胞。再供氧1h时恢复到第三列,以后逐步恢复到正常。运用庚醇后传导明显减慢荧光仅传至第二列细胞,缺氧和再供氧时传导也无明显变化。运用卡维地洛后传导改变不明显。②正常和缺血30min时凋亡指数差异无显著性(P>0.05),再供氧1h凋亡指数为27.4%,与正常相比差异显著(P<0.01)。坏死的心肌细胞在再供氧2h后差异有显著性(P<0.01)。运用卡维地洛、庚醇后凋亡指数在再灌注1h时分别较未用药组减少了55.11%,21.53%。③培养7d的心肌细胞搏动频率为(120±18)次/min,缺氧30min时,搏动减弱,次数为(56±16)次/min,再供氧1h时,搏动次数为(118±22)次/min,两者差异显著(P<0.01)。加入浓度为2mmol/L的庚醇后,心肌细胞搏动明显减弱,约为(64±20)次/min,差异显著(P<0.001)。加入0.001g/L卡维地洛搏动次数也有不同程度的减低(P<0.05)。在缺氧再灌注过程中,两个干预组搏动次数变化不大。结论:心肌细胞在缺氧时缝隙连接通透性减低,庚醇、卡维地洛也有不同程度的降低缝隙连接通讯的作用。庚醇、卡维地洛通过改变缝隙连接通讯以及其他方面的作用来减少心肌细胞的死亡和凋亡。     

哮喘儿童的心理学特点

目的:总结哮喘儿童心理状态在哮喘发病及治疗中的作用。资料来源:应用计算机检索PubMed1992-01/2006-06关于儿童哮喘与心理学有关的文章,检索词"asthma,children,psychology",并限定文章语言种类为英文。同时计算机检索CNKI1992-01/2006-06关于儿童哮喘与心理学有关的文章,检索词"儿童哮喘,心理学"。资料选择:纳入标准:①儿童哮喘对儿童行为、性格、气质的影响的文章。②父母教养方式对儿童哮喘的影响的文章。③社会心理因素对儿童哮喘的影响的文章。排除标准:重复性研究。资料提炼:收集到儿童哮喘与心理学有关的英文文献72篇,中文文献59篇。对符合纳入标准37篇文章进行分析。资料综合:①心理因素对哮喘发作的影响:在10个涉及1939例哮喘患儿的调查中,发现焦虑、紧张对哮喘有诱导和加重作用。②哮喘对儿童心理的影响:主要体现在哮喘患儿容易出现抑郁症状。在5个涉及1086例哮喘儿童的调查中,4个调查均发现哮喘患儿偏于内向人格。③哮喘对儿童行为的影响:在6个涉及2645名哮喘患儿和非哮喘患儿的调查中,均发现哮喘患儿较非哮喘患儿更易出现行为问题。结论:哮喘对儿童行为、气质、性格产生影响,同样心理因素也有诱发和加重哮喘发作的作用。此外,父母的教养方式及社会心理学因素也对哮喘的发作有一定影响。心理干预方法和心理治疗正逐渐被应用到哮喘儿童中。     

Sonographic appearance of fallopian tube carcinoma

Fallopian tube carcinoma is the least common of gynecological malignancies. We report the case of a 56-year-old woman who presented with a 2 1/2-year history of intermittent vaginal bleeding and lower abdominal pain. Transvaginal sonography revealed a cystic lesion of the fallopian tube with papillary projections, distinct from the ovary and uterus. Doppler examination showed low vascular impedance (resistance index 0.50, pulsatility index 0.80). The suspicion of tubal malignancy was confirmed at surgery.     

带血供溃变神经游离移植后肌电图及组织学变化

目的:从神经血供和溃变两方面对自体神经的移植效果进行分析,观察神经游离移植后的电生理及组织学变化。方法:实验于2001-01/2002-06在白求恩国际和平医院动物实验室完成。①实验分组及方法:选用Wistar大鼠120只,按随机数字表法分为7组,正常对照组12只;其余108只根据移植神经的溃变时间分为3组,分别为健康(未溃变)、溃变1,4周组,每组再根据是否存在尺神经血供分为带和不带血供神经移植组。以双上肢为观察对象,以尺神经桥接正中神经缺损。②实验评估:各组分别于术后第4,8,12周在移植尺神经的中段和正中神经远端距吻合口3mm处,分别取材进行显微解剖观察和光镜观察,测量移植尺神经及正中神经远端横截面轴突的数目,并计算出有髓神经轴突的再生率;于术后第12周测定神经传导速度、诱发电位波幅及潜伏期;术后第12周切取正中神经行电镜观察。结果:120只大鼠全部进入结果分析。①神经外观各组间无明显差异,健康神经移植组移植术后神经与周围组织间粘连最轻。②移植术后第8,12周,相同溃变时间带血供组的神经轴突再生率高于不带血供组(P<0.05);健康神经组高于溃变神经组(P<0.05)。健康神经组与溃变1周组神经纤维生长情况差异无显著性意义(P>0.05)。③移植术后12周,相同溃变时间带血供组的尺神经及正中神经传导速度、诱发电位波幅均高于不带血供组(P<0.05),潜伏期短于不带血供组(P<0.05),而带血供组组间以及不带血供组差异均无显著性意义(P>0.05)。④带血供溃变1周神经轴突生长最好。结论:带血供溃变神经移植优于不带血供的溃变神经,带血供的短期溃变神经可以用来代替健康神经移植。     

Multicenter surveillance of antimicrobial resistance of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in Taiwan during the 1998-1999 respiratory season

A susceptibility surveillance study of 276 isolates of Streptococcus pneumoniae, 301 of Haemophilus influenzae, and 110 of Moraxella catarrhalis was carried out from November 1998 to May 1999 in Taiwan. High rates of nonsusceptibility to penicillin (76%), extended-spectrum cephalosporins (56%), azithromycin (94%), clarithromycin (95%), and trimethoprim-sulfamethoxazole (TMP-SMX) (65%) for S. pneumoniae isolates and high rates of nonsusceptibility to amoxicillin (58%) and TMP-SMX (52%) for H. influenzae isolates were found. Higher percentages of S. pneumoniae isolates nonsusceptible to aminopenicillins, extended-spectrum cephalosporins, macrolides, and TMP-SMX were observed among penicillin-intermediate and -resistant isolates. All quinolones tested were active in vitro against these three organisms.