简易实验性细菌性心内膜炎模型的制作方法

目的用α_甲型溶血链球菌建立兔细菌性心内膜炎模型。方法自麻醉兔颈总动脉插一导管至左心室 ,24h后随机分为空白对照组和感染组。对照组耳缘静脉注射1ml生理盐水 ,感染组注射108CFU甲型溶血链球菌 ,7d后抽血进行血液培养 ,处死后观察主动脉瓣赘生物和左心室腔内壁性赘生物的情况。结果感染组的每个动物在主动脉瓣和左心室中底部均有大小不等的赘生物生长 ,血液中均有细菌。对照组则没有。结论用这种方法制作的兔实验性细菌性心内膜炎成功率高且简单易行。     

Brush Border Enzymes in Evaluation of Acute Small Bowel Rejection

The change in activity of three disaccharidase enzymes (maltase, sucrase and lactase) was determined according to the method of Dahlqvist during acute rejection in non-immunosuppressed piglet small bowel grafts. In addition, two brush border enzymes, lactase and aminopeptidase, were stained with monoclonal antibodies. Diminishing disaccharidase activity was an early event during rejection. Diminution began 2 days before distinct morphological changes were seen in the mucosal biopsies. Evaluation of disaccharidase activity can thus be used as a confirmatory method in detecting rejection. Reduction in immunohistological staining of lactase and aminopeptidase with monoclonal antibodies and changes in mucosal morphology were observed to progress simultaneously.     

Confidential conversations between supervisor and employee as a means for improving leadership: a quasi-experimental study in hospital wards

Although yearly confidential conversations between a supervisor and an employee have been recommended as a means for improving leadership, evidence on the actual effects of these conversations has been lacking. The present study therefore investigated whether confidential conversations improve perceptions of goal clarity, sufficiency of feedback and innovativeness, and elicit satisfaction with the supervisor's leadership style within the hospital setting. Nine wards were divided into one experimental group (3 wards) and two control groups (3+3 wards). A questionnaire on goal clarity, feedback, innovativeness and satisfaction was administered twice to every group (1st measurement: n=186, 2nd measurement: n=163). The experimental group began confidential conversations after the first measurement, control group 1 entered into conversations during both measurements, and control group 2 did not enter into conversations at the time of either measurement. Confidential conversations improved perceived feedback. In both measurements, the sufficiency of feedback was reported to be significantly better in the groups having conversations than in the other groups. In addition, there was a significant positive change in the perceived sufficiency of feedback in the experimental group but not in the other groups. Confidential conversations did not affect the perceptions of goal clarity and innovativeness or elicit satisfaction with the supervisor's management style.     

Determining optimal sleep position in patients with positional sleep-disordered breathing using response surface analysis

A lateral position (LP) during sleep is effective in reducing sleep disorder symptoms in mild or moderate sleep apnea patients. However, the effect of head and shoulder posture in LP on reducing sleep disorders has not been reported. In this study, effective sleeping positions and a combination of sleep position determinants were evaluated with respect to their ability to reduce snoring and apnea. The positions evaluated included the following: cervical vertebrae support with head tilting (CVS-HT), scapula support (SS), and LP. A central composite design was applied for response surface analysis (RSA). Sixteen patients with mild or moderate positional sleep apnea and snoring who underwent polysomnography for two nights were evaluated. Based on an estimated RSA equation, LP (with a rotation of at least 30°) had the most dominant effect [ P  = 0.0057 for snoring rate, P  = 0.0319 for apnea–hypopnea index (AHI)]. In addition, the LP was found to interact with CVS-HT ( P  = 0.0423) for snoring rate and CVS-HT ( P  = 0.0310) and SS ( P  = 0.0265) for AHI. The optimal sleep position reduced mild snoring by more than 80% (i.e. snoring rate in the supine position was <20%) and the snoring rate was approximately zero with a 40° rotation. To achieve at least 80% reduction of AHI, LP and SS should be >30° and/or 20 mm respectively. To determine an effective sleep position, CVS-HT and SS, as well as the degree of the LP, should be concurrently considered in patients with positional sleep apnea or snoring.     

腺嘌呤致不同性别大鼠骨质疏松的差异

肌酸尿时多见而又为主要病因的腺嘌呤广泛地应用于临床，但是腺嘌呤过多对人体是有害的。到目前为止，只有应用雄性动物研究腺嘌呤影响的报告。在雄鼠发现喂饲富含腺嘌呤的饲料会引起肾衰竭。由于腺嘌呤对雌性动物的影响的报告还甚少，本实验研究了腺嘌呤处理对不同性别大鼠的影响，并进行了讨论。年轻雄性和雌性大鼠分别给与一种预定浓度的腺嘌呤(6、60及100mg／mL)共8周(3次／周)。结果100mg／mL腺嘌呤处理能引起雄鼠肾衰，50mg／mL能引起肾功能失调。但是，只有100mg／mL才能引起雌鼠肾功能失调，其影响与雄性大鼠有些不同。雄鼠血清睾酮水平及BMD可因腺嘌呤处理而降低，但肾功能失调可有可无。相反，雌鼠尽管有肾功能失调，血清17-β雌二醇水平及BMD可完全不受腺嘌呤处理的影响。如上所述，本研究能说明腺嘌呤对骨代谢的影响是通过性激素合成实现的。腺嘌呤常含于临床药物及日常食物中，过多摄入包括腺嘌呤在内的核酸会影响内分泌功能。     

Intrapericardial drug delivery: pharmacologic properties and long-term safety in swine

BACKGROUND: Intrapericardial drug delivery is a promising new technique, but the pharmacologic properties of various agents delivered via this route are not known. Furthermore, the long-term safety of intrapericardial catheters has not been previously examined. METHODS: Using a pericardial access device, a catheter connected to a drug-delivery system was implanted in five pigs. Plasma levels and electrocardiographic measurements were obtained after intravenous and intrapericardial administration of digoxin and procainamide. Histological examination was performed after the device had been implanted for a total of 6 months. RESULTS: The QTc interval did not change significantly after digoxin or procainamide intravenous administration. QTc decreased by 47+/-23 ms (p=0.046) 8 h after digoxin intrapericardial administration and increased by 128+/-60 ms (p=0.002) 1 h after procainamide intrapericardial administration. The QRS duration did not change significantly after intravenous administration of either agent, but it increased by 17+/-9 ms (p=0.004) 1 h and by 15+/-4 ms (p=0.01) 8 h after procainamide intrapericardial administration. After intravenous procainamide the RR interval decreased, but it did not change significantly after intrapericardial administration of either agent. Histology showed moderate inflammatory infiltration and fibrosis adjacent to the catheter. CONCLUSIONS: Intrapericardial delivery of digitalis and procainamide produces unique electrophysiological properties. In contrast to satisfactory success of the implantation technique, long-term dwell of the catheter in the pericardium induces moderate, albeit probably clinically significant, fibrosis.