Self Chest Clapping: Patients'' Views and the Effects on Oxygen Saturation

The literature suggests that self chest clapping (SCC) does not enhance rate of sputum clearance if combined with the active cycle of breathing techniques (ACBT), but many patients find SCC beneficial and continue to use it. Previous studies have examined the effects of assisted chest clapping on oxygen saturation (SaO₂), but what would be the effects of SCC on SaO₂? It was important to establish any possible detrimental effects from its use and to explore the views of patients using it as part of their treatment.

The SaO₂ was measured in 20 clinically stable patients with cystic fibrosis during their physiotherapy (the ACBT with SCC in a gravity assisted position) and all patients completed a short anonymous questionnaire to obtain their views on SCC. Patient characteristics of lung function, arterial blood gases, response to bronchodilator therapy, 24-hour sputum weight and exercise ability were recorded, within 48 hours of participation within the study, to identify a possible relationship between these and a change in SaO₂.

In the group as a whole there was a statistically significant mean fall in SaO₂ with SCC (p = 0.026). However, this fall was never greater than 4.4%. In some patients a fall in SaO₂ was recorded with SCC, but in others there was an increase. There was no correlation between the variables measured and a fall in SaO₂ with SCC. The patients using SCC had strong views and beliefs about why they did so.     

Bilateral synchronous tonsillar carcinoma.

Synchronous cancers occur in four per cent of patients with head and neck malignancies but no bilateral synchronous tonsillar carcinomas have been described in the English literature. We describe the first such case and discuss the prognostic aspect of this carcinoma. In the presence of contralateral neck nodes in patients with head and neck malignancies, a careful search should be made for a second head and neck primary.     

Stress and family functioning among caregivers of persons with Parkinson's disease

This study investigated components of caregiving that cause distress among Parkinson's caregivers and explored relationships between stress and family functioning. Fifty caregivers completed two self-report measures designed to assess caregiver stress and characteristics of the family environment. Differences in terms of family environment were found between caregivers who reported high and low stress. Certain aspects of caregiving were reported to be more distressing than others, and demographic characteristics were related to family functioning. Duration of the caregiving was not related to stress and there were no differences in family environment based on duration. These results have implications for clinical practice and the development of interventions for Parkinson's caregivers.     

肺不藏魄型失眠模型大鼠相关脏器多巴胺D1、D2受体表达差异研究

目的:探讨肺不藏魄型失眠模型大鼠相关脏器中多巴胺D1、D2受体的表达差异。方法:将16只大鼠用随机数字表法分为对照组和失眠模型组,每组8只。失眠模型组采用小平台水环境法进行造模,造模9 d。造模成功后,取两组大鼠的肺、大肠、脑、心、肝、脾和肾组织,采用HE染色观察肺和脑的病理变化,免疫组化法观察各组织中多巴胺D1、D2受体的表达。结果:失眠模型组肺组织HE染色可见肺泡壁毛细血管轻微扩张充血、纤维结缔组织增生致使肺泡壁增厚、肺泡腔可见巨噬细胞;脑组织未见明显病理改变。与对照组比较,在肺、大肠、脑、心中,失眠模型组D1受体表达明显升高(P<0.05),D2受体表达明显降低(P<0.05)。结论:肺不藏魄型失眠模型大鼠肺、大肠、脑、心中多巴胺D1受体表达明显增加,D2受体表达明显降低,说明D1受体表达增加,D2受体表达降低与肺不藏魄型失眠机制密切相关,是该型失眠模型的失眠机制之一。     

Percutaneous ultrasound-guided biopsy in the definitive diagnosis of osteosarcoma

Thirty-three patients with 35 bone lesions suspicious for osteosarcoma underwent image-guided biopsy. Of those 35 biopsies, 12 were performed with use of fluoroscopy or computed tomography (CT) guidance to target the osseous abnormality. Diagnostic magnetic resonance imaging revealed a soft tissue component in 23 cases; in these cases, biopsies were performed with use of ultrasonography (US) to target the soft tissue component of the tumor. Of the 35 tumors in which biopsy was performed, 33 (94%) were definitively diagnosed as osteosarcoma by image-guided biopsy. All 23 US-guided biopsies resulted in definitive diagnosis. Two of the 12 fluoroscopy- or CT-guided biopsies (17%) were inconclusive.     

Reliability of tunnel angle in ACL reconstruction: two-dimensional versus three-dimensional guide technique

Purpose  

To compare the reliability of tibial tunnel position and angle produced with a standard ACL guide (two-dimensional guide) or Howell 65° Guide (three-dimensional guide) in the coronal and sagittal planes. In the sagittal plane, the dependent variables were the angle of the tibial tunnel relative to the tibial plateau and the position of the tibial tunnel with respect to the most posterior aspect of the tibia. In the coronal plane, the dependent variables were the angle of the tunnel with respect to the medial joint line of the tibia and the medial and lateral placement of the tibial tunnel relative to the most medial aspect of the tibia.     

急性百草枯中毒大鼠肺组织MMP-2和TIMP-1的基因表达

目的 利用实时荧光定量PCR法测定急性百草枯中毒大鼠肺组织中基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶组织因子抑制剂-1(TIMP-1)基因的表达,探讨其在急性百草枯中毒所致的大鼠急性肺损伤及纤维化中的作用.方法 80只SD大鼠,随机分为对照组(n:8)、染毒组(n:72);对照组一次性腹腔注射与染毒组等体积的生理盐水,染毒组一次性腹腔注射百草枯溶液(18mg/kg)染毒;分别于1、3、5、7、14、28 d光镜下观察两组大鼠的肺组织病理变化,同时利用实时荧光定量PCR法动态测定MMP-2、TIMP-1的mRNA表达量.结果 与对照组相比,染毒组大鼠早期主要表现为肺脏的急性炎症反应,肺水肿和出血明显,染毒5 d后观察到肺纤维化变化,第28天纤维化最明显;染毒组肺组织中的MMP-2的mRNA表达较对照组从第1天开始即明显增强,第7天达到高峰,为对照组的2.83倍,以后逐渐下降,但28 d时仍高于对照组,差异无统计学意义(P<0.01);TIMP-1的mRNA表达第1天也明显高于对照组,逐渐增强至14 d达到峰值,为对照组的7.28倍,后开始缓慢下降,28 d时仍明显高于对照组(P<0.01).结论 MMP-2、TIMP-1在急性百草枯中毒所致的急性肺损伤中起了重要的作用,同时大鼠的肺纤维化进程与MMPs/TIMPs的基因表达比例失调有很大的关系.