脑囊虫病人血清、脑脊液中抗体在MRI各期的变化

目的 检测脑囊虫病人血清和脑脊液中抗体在MRI各期的变化。方法 用抑制性ELISA法检测血清及脑脊液中的抗体。同时根据MRI表现将病例分为活动期、退变期、非活动期。结果 在69个病例中，脑脊液中抗体阳性率分别是：活动期75．00％，退变期62．50％，非活动期17.24％；血清中是81．25％、16．67％、22．22％。在相应各期中，脑脊液和血清抗体阳性率无显著性差别。结论 在影像学的不同时期抗体阳性率存在明显的变化。     

肺癌组织中血管内皮生长因子受体Flt1及KDR的表达及其与肿瘤转移和预后的关系

①目的　探讨肺癌中血管内皮生长因子受体Flt1、KDR的表达与其转移及预后的关系。②方法　应用免疫组织化学PowerVisionTM PV90 0 0法 ,测定 75例肺癌标本中Flt1、KDR的表达。③结果　肺癌组织中Flt1、KDR的表达较为广泛 ,主要位于肿瘤细胞胞浆及胞膜上 ,纤维母细胞和血管内皮细胞胞浆中亦有表达。Flt1、KDR在肿瘤细胞中的阳性率均显著高于在间质纤维母细胞中的表达 (χ2 =6 .0 7、5 .88,P <0 .0 5 )。肿瘤细胞及纤维母细胞中该两种受体的阳性率在不同年龄、不同性别及不同病理类型、不同病理分级之间差异均无显著性 (χ2 =0 .0 1～4 .84 ,P >0 .0 5 ;P =0 .2 9～ 0 .79)。肿瘤细胞中Flt1、KDR的阳性表达率在 3组不同大小的肿瘤间差异均有显著性(χ2 =1 0 .35、7.2 9,P <0 .0 5 ) ,而纤维母细胞中差异均无显著性 (χ2 =2 .86、2 .5 6 ,P >0 .0 5 ) ;肿瘤细胞及纤维母细胞中Flt1、KDR的阳性率在淋巴结有、无转移两组间的差异均有显著性 (χ2 =4 .72～ 9.32 ,P <0 .0 5 ) ,在 3组不同术后生存时间病人间亦均有显著性差异 (χ2 =8.81～ 1 9.1 9,P <0 .0 5 )。肿瘤细胞中Flt1、KDR的表达呈极显著性正相关 (r =0 .4 4 ,P <0 .0 1 )。④结论　肺癌的生长主要依赖自分泌机制 ,联合检测Flt1、KDR可能对肺癌转移     

'Not everything that can be counted counts and not everything that counts can be counted'– towards a critical exploration of modes of satisfaction measurement in sheltered housing

This paper reflects on a research project funded by a consortium of leading sheltered housing (SH) providers and their regulatory body, the Housing Corporation. The project aimed to ascertain which aspects of SH older people perceived to be central to their satisfaction and the methods they judged most appropriate to measuring this. We outline key policy developments of importance to SH (specifically the development of performance measurement regimes), and changes in the nature of SH, which are driving providers to re‐evaluate how they measure user satisfaction. We discuss the aims of the project, our methodology and findings, and conclude by raising critical questions about the process of measuring satisfaction within an increasingly managerialised housing system. We argue that this favours standardised methods of information gathering (such as questionnaires) rather than engage with clients in order to develop methods and systems capable of eliciting qualitative issues of concern to them. Our conclusions are, we believe, applicable to health and social care provision, where similar tensions exist around performance measurement and user satisfaction.     

护士社会支持与焦虑状况相关因素调查分析

目的了解护士的社会支持与焦虑状况的相关因素,为心理干预提供理论依据.方法采用社会支持评定量表、状态焦虑量表(S-AT)对100名女护士进行调查,并分析其相关因素.结果护士社会支持评分为(37.22±6.94)分,S-AT评分(42.70±7.20)分;护士社会支持与焦虑状态呈负相关,即社会支持越高,焦虑状态越低;年龄<25岁、工龄<5年、未婚、合同护士社会支持明显偏低.结论良好的社会支持有助于减轻护士心理压力,是维护护士身心健康的重要因素.     

男性乳房异常发育症的中医治疗近况

男性乳房异常发育症是指男性一侧或两侧乳腺胀痛、压痛、乳腺增大、乳晕中央有扁圆形肿块为主要症状的一种疾病,中医称“乳疬”。现代医学认为本病为内分泌失调、激素水平失衡所致。肝脏疾病、内分泌疾病患者,长期服用某些药物及精神病患者均易出现本病,中医中药治疗本病疗效显著。现将近年来中医治疗本病的文献报道综述如下。1辨证分型治疗辨证分型治疗是中医治疗本病的常用方法。成忠琴[1]将本病分为3型:肝郁化火型,拟清火疏肝、散结止痛法,方用丹栀逍遥散加减。药物:柴胡10 g、丹皮10 g、山栀10 g、青皮10g、夏枯草20 g、郁金10 g、生牡…     

Calorie restriction increases serum parathyroid hormone and decreases serum calcitonin levels in patients with maturity onset diabetes mellitus

Calorie restriction is important in managing patients with maturity onset diabetes mellitus (NIDDM). The effect of such restriction on calcium metabolism is not known. The objective of this study was to determine whether patients on calorie restricted diets would show any modification of parathyroid hormone (PTH) and calcitonin (CTN). The serum levels of PTH and CTN were measured by radioimmunoassays in 269 patients with NIDDM. The patients were divided into two groups depending on the intake of calorie, and PTH and CTN were monitored for 2 years. Plasma levels of vitamin D were measured by competitive protein binding assays before and after each program. The level of PTH (520.8±266.0 pg/ml) (mean±S.D.) was significantly (P<0.01) higher in 109 diabetic patients whose calorie intake was restricted for 2 years (diet (D) group) as compared with that (256.6±103.8 pg/ml) of 160 diabetic patients whose calorie intake was not restricted (non-diet (ND) group). The daily oral calcium intake of the two groups did not differ significantly. We found no significant difference in the serum PTH level in the ND groupVS. normal control subjects (248.8±98.4, N=78). The serum calcium concentration and the amount of calcium excreted in urine were slightly but significantly (P<0.01) lower in the D than in the ND group. The rate of tubular reabsorption of phosphate (% TRP) was significantly lower in the D group than that in the ND group (P<0.01). The serum CTN level was significantly (P<0.01) lower in the D group (33.9±11.3 pg/ml) than in the ND group (64.9±21.2 pg/ml) 2 years after each treatment. The plasma 1,25-(OH)₂-vitamin D level was significantly (P<0.01) lower in the D group (22.2±6.6 pg/ml) than in the ND group (50.6±4.2 pg/ml). When the restriction of calorie intake in the D group was canceled, their PTH levels decreased, which was accompanied by increase in the 1,25-(OH)₂-vitamin D levels, whereas their CTN levels were unchanged. These observations suggested that a restricted calorie intake is a risk factor for secondary hyperparathyroidism as well as for a low serum level of CTN in patients with NIDDM.     

An exploration of the role of the nurses'' uniform through a period of non-uniform wear on an acute medical ward

The nursing staff on an acute medical hospital ward elected to wear their own clothes to work for a period of 2 months. The trial was evaluated using a variety of research methods and it raised a number of issues about the role of uniform, about patients' perceptions of nurses and nurses' perceptions of their role. The study has led to questions being raised about the assumptions that are made if uniform is worn and the appropriateness of a uniform dress.     

A Comparison of Depressive Symptoms in Stroke and Primary Care: Applying Rasch Models to Evaluate the Center for Epidemiologic Studies-Depression Scale

OBJECTIVES: Clinical trials and community-based studies often include the Center for Epidemiologic Studies-Depression scale (CES-D) as a measure of depression outcome. We compared responses to symptom-related items on the CES-D by depressed stroke and primary-care patients for several purposes: 1) to illustrate the use of Item Response Theory (IRT)-based (Rasch) models for comparing scale functioning across different patient subgroups; and 2) to inform clinicians and outcome researchers about scale functioning and depressive symptomatology in stroke- compared with primary care-based depression. METHODS: Two data sources were analyzed, including 32 depressed patients who were 3 months poststroke, and 366 depressed primary-care patients. Presence of depression was based on a CES-D score 16 or higher. Rasch models were used to assess item fit and compare item hierarchies between depressed primary-care and stroke patients. RESULTS: Item hierarchies were similar for poststroke depression and primary care-based depression. Interpersonal disruption items were the most difficult to endorse for both groups. No items misfit the scale in primary-care depression. Items relating to restless sleep, unfriendliness, and crying slightly misfit the scale in stroke patients, that is, may measure a different trait. Differential item functioning (DIF) between the groups was identified for items relating to appetite, restless sleep, crying, and feeling disliked. CONCLUSIONS: Results generally supported the use of the CES-D as measure of depression outcome, particularly in primary care-based depression. DIF may imply that slightly different clusters of depressive symptoms are reported by depressed stroke patients compared with primary care, but this is conjectural given the small stroke sample size and the same items have been previously associated with bias in studies of large nonstroke samples. This study found Rasch models to be useful tools to investigate scale performance for different clinical applications.