Diagnosis of tachycardia syndromes associated with orthostatic symptoms

The postural tachycardia syndrome (POTS) is characterized by excessive tachycardia only in upright position without evidence of a cardiac or metabolic disease in combination with orthostatic symptoms like dizziness, lightheadedness or syncope but without relevant falls in blood pressure. The cause is unknown. A specific diagnostic marker has not been found so far. Eighteen patients with typical symptoms of POTS were examined. They underwent standard autonomic function tests with continuous measurement of heart rate (HR) and blood pressure. All fulfilled the inclusion criteria of pathologically increased HR activation during passive tiltor standing over 90 seconds. The upper limits of normal were based on data from 137 healthy volunteers between 18 and 85 years of age. Actively standing up induced more POTS-typical HR increases and lead to more consistent results than passive tilt. HR responses during Valsalva manoeuvre and deep breathing were normal in all except one patient each, indicating that assessment of HR during these tests does not contribute to the diagnosis of POTS. Frequency of symptoms reducing overall well-being and the degree of impairment of life quality by symptoms typical of POTS were measured with a self-assessment scale. The majority of patients reported a permanent reduction of overall wellbeing and a relevant impairment of life quality due to dizziness, tachycardia, and syncopes. This underlines the importance of considering POTS as a differential diagnosis of orthostatic syndromes and the necessity of treating it adequately.     

压疮预防治疗的新进展

压疮的防治一直是医护人员探讨的问题,该文从压疮形成自身、压力、理化等因素进行分析,并对临床预防措施,中、西药治疗,营养支持,及湿性愈合理论等方面进行综述,积极采取有效的预防手段对压疮加以控制,并且在应用与实践中不断总结,力争得到更好的方法,减轻病人的痛苦,提高护理质量。     

'Mind and Body': a lifestyle programme for people on antipsychotic medication

Rationale  Psychiatric illnesses such as schizophrenia and their treatments have consequences in terms of lifestyle, diet and weight.
Aims and objectives  'Mind and Body' is a 10-week programme of weekly sessions aimed to improve the health status of people treated with second generation antipsychotic medications.
Methods  The programme focuses on a range of lifestyle strategies including diet and exercise and was conducted at a Community Health Centre by professionally qualified staff. Between 2002 and 2006, 50 participants enrolled in, and 30 completed the programme. Measures of body weight, health status (Short Form-36) and blood markets (plasma glucose, haemoglobin A1c and lipid profile) were collected at commencement and completion of the programme.
Results  A modest improvement was demonstrated in mean values for the majority of measures collected.
Conclusions  A lifestyle program for people treated with antipsychotic medications is achievable and may be worthwhile although gains may be modest.     

凝胶法测定脐带间充质干细胞培养上清中细菌内毒素

目的 探讨凝胶法测定人脐带间充质干细胞培养上清中细菌内毒素的可行性。方法 收集人脐带间充质干细胞培养72 h的上清为供试品。参照《中国药典》2020年版第三部通则1143细菌内毒素检查法中凝胶法的具体要求和步骤对鲎试剂进行灵敏度复核,对供试品进行干扰初筛试验、干扰试验和供试品细菌内毒素的测定。结果 鲎试剂灵敏度测定值为0.125EU/mL,在0.5λ～2.0λ符合规定,可用于后续试验。供试品1、2、4倍稀释对鲎试剂均无干扰;干扰试验验证2倍稀释供试品对细菌内毒素凝胶法检测无干扰作用;采用凝胶法测定2倍稀释供试品的细菌内毒素含量均≤0.5 EU/mL,判定供试品中细菌内毒素含量合格。结论 凝胶法可用于人脐带间充质干细胞培养上清中细菌内毒素的检测。     

白血病细胞源外泌体的作用研究进展

<正>白血病(leukemia)是一类造血干/祖细胞恶性克隆性疾病。外泌体是活细胞分泌到胞外的一种纳米级的微囊泡,是细胞间对话的信息和物质载体~([1])。外泌体携带亲本细胞来源的蛋白质、核酸(mRNA、microRNA和DNA等)及脂质等生物信息分子,可近距离和/或经体液流动远距离、特异性调控靶细胞的生理和病理活动~([2-3])。靶细胞摄取外泌体的途径主要有网格蛋白介导的内吞途径、小窝蛋白依赖型内     

游离犬舌黏膜重建尿道的研究

目的探讨舌黏膜游离移植替代尿道的可行性和有效性。方法将随机选定的10条杂种雌犬剥离尿道黏膜4cm×1cm后用等面积的舌黏膜替代尿道。术后留置硅胶导尿管1周，拔除尿管后观察排尿情况。3个月后对10条实验犬行逆行尿道造影检测尿道通畅情况，并用10Fr尿管证实有无狭窄。随后处死实验犬测定移植物长度并行病理组织学检查，以观察舌黏膜移植至尿道后组织学上改变。结果实验犬全部存活。10条中9条排尿通畅；1条发生尿道狭窄；无尿瘘发生。移植的舌黏膜存活良好；在舌黏膜与尿道黏膜交界处，舌黏膜的鳞状上皮有渐被尿道的移行上皮替代趋势。结论犬的尿道黏膜可用舌黏膜替代。     

球部尿道悬吊治疗前列腺切除术后尿失禁

目的　探讨球部尿道悬吊术治疗前列腺切除术后尿失禁的疗效。　方法　前列腺切除术后尿失禁患者 5例 ,病史 2～ 10年。 1例完全性尿失禁 ,4例每天需尿垫 2～ 5块。在尿动力学检查仪监测下采用球部尿道悬吊术治疗。　结果　 4例术后能完全控制尿 ,无排尿困难 ;1例术后出现排尿困难 ,经膀胱颈部电切后排尿通畅。　结论　球部尿道悬吊术是治疗前列腺切除术后尿失禁的有效方法。