Infectious disease complications of simultaneous pancreas kidney transplantation

BACKGROUND: Although technical success rate of simultaneous pancreas kidney (SPK) transplantation in insulin-dependent diabetes mellitus (IDDM) patients with diabetic nephropathy has improved, morbidity remains high due to infection and rejection. The purpose of this study was to analyse infections encountered in our series of SPK transplants, using a restrictive antibiotic prophylaxis policy. METHODS: We reviewed all infectious diseases after 66 consecutive bladder-drained SPK transplantations in 64 IDDM patients with end-stage renal disease due to diabetic nephropathy. During follow-up, the perioperative antibiotic regimen was altered (from 5 days preemptive therapy with multiple drugs to 1 day prophylaxis with cefamandole), and long-term viral prophylaxis (high-dose aciclovir) was introduced. For post-operative urinary tract or opportunistic infection, no prophylaxis was given. RESULTS: Overall mean infection rate was 2.9 infections/ patient/year after a mean follow-up of 2.3 years. Surgical site infections (SSI) were seen in 30% of the patients, with Enterococci present in 47%. Logistic regression showed one day cefamandole prophylaxis to be associated with SSI, but there was no significant influence of SSI on either graft or patient survival. Forty-eight percent of all infections were lower urinary tract infections (UTI). There were 59 first UTIs (89%), probably related to long-term Foley catheter use, and 47 second UTIs (71%). Subsequent UTIs were not microbiologically related to first UTIs. Cytomegalovirus (10 patients) and other opportunistic agents did not cause mortality or graft loss. Five grafts were lost due to infection (SSI three times, post-transplant lymphoproliferative disease twice). Only one patient died because of infection (2%). CONCLUSIONS: Infectious diseases after SPK transplantation caused significant morbidity but did not influence either patient or graft survival. A change in prophylactic policy for both SSI as well as recurrent UTI, combined with earlier Foley removal, may lower incidences of these infections.      

Identification, chromosomal mapping and tissue-specific expression of hREV3 encoding a putative human DNA polymerase zeta

The Saccharomyces cerevisiae REV3 gene encodes the catalytic subunit of a non-essential DNA polymerase zeta, which is required for mutagenesis. The rev3 mutants significantly reduce both spontaneous and DNA damage- induced mutation rates. We have identified human cDNA clones from two different libraries whose deduced amino acid sequences bear remarkable homology to the yeast Rev3, and named this gene hREV3. The hREV3 gene was mapped to chromosome 1p32-33 by fluorescence in situ hybridization. The hREV3 encodes an mRNA of >10 kb, and its expression varies in different tissues and appears to be elevated in some but not all of the tumor cell lines we have examined. In light of recent reports of a putative mouse REV3, these results indicate that mammalian cells may also contain a mutagenic pathway which aids in cell survival at the cost of increased mutation.      

热诱导培养角朊细胞表达HSP70

0　引言　热休克蛋白 (HSP)是一类当细胞受到各种有害因素刺激时合成增多的蛋白质 ,在细胞内蛋白的加工过程中具有重要作用 .我们对体外培养的角朊细胞进行热处理 ,然后观察细胞中 HSP70的表达情况 ,并对其意义进行初步探讨 .1　材料和方法1 .1　材料　角朊细胞无血清培养基 (KC- SFM) (GibcoBRL) ,鼠抗人 HSP70单克隆抗体 (Santa Cruz公司 ) ,生物素化羊抗鼠 Ig G及 SABC试剂盒 (武汉博士德生物工程有限公司 ) ,HSP70寡核苷酸探针 (上海生命技术公司合成 ) .1 .2　方法　取手术包皮 (本校西京医院门诊手术室提供 ) ,用2 .5 g·…     

过锝酸钠过敏性皮炎1例

１　病例报告　男,３５岁,汉族,内蒙古籍,１９９８０６中旬无明显诱因出现左侧颈部肿痛,在当地医院诊断为“甲状腺炎”,经静滴“青霉素”好转．但随后又多次复发,１９９８０７１４来我院内分泌科就诊,当日上午１０∶００ｉｖ过锝（９９Ｔｃｍ）酸钠行甲状腺检查,４ｈ后双手背随即出现密集的红色斑丘疹、瘙痒剧烈,随后皮疹逐渐扩展至全身,来我院皮肤科门诊,以过敏性皮炎收治．作者简介：王文清,男,２６岁,第四军医大学９７级硕士研究生．电话：（０２９）３３７５４０６收稿日期：１９９９０６１８;　修回日期：１…     

护理专业学生通过艺术理解慢性疾病的学习体会研究

[目的]了解护理专业本科生对于将艺术作为一种工具了解慢性疾病病人疾病感受的学习体会。[方法]选取护理本科生10名,进行为期3周的培训,然后通过访谈,收集所分管慢性疾病病人的资料,对收集的资料采用诠释学和类别学方法进行分析。[结果]共收到15例慢性病病人有关疾病体验性知识的艺术作品19件,作品内容可分为3种类型:直接抒发患病感受,间接表达患病感受,看似阳光却反衬出病人的消极心境。[结论]慢性疾病对病人的影响是多方面的、深层次的,有很强的个体差异;通过艺术让病人表达疾病感受是可行的。     

Emotional intelligence and patient-centred care

The principles of patient-centred care are increasingly stressed as part of health care policy and practice. Explanations for why some practitioners seem more successful in achieving patient-centred care vary, but a possible role for individual differences in personality has been postulated. One of these, emotional intelligence (EI), is increasingly referred to in health care literature. This paper reviews the literature on EI in health care and poses a series of questions about the links between EI and patient-centred outcomes. Papers concerning empirical examinations of EI in a variety of settings were identified to determine the evidence base for its increasing popularity. The review suggests that a substantial amount of further research is required before the value of EI as a useful concept can be substantiated.     

纺织工作环境及其噪声对女工心理健康的影响

目的：评价纺织工作环境及其噪声对纺织女工心理健康的影响,为有关部门制定卫生标准和防护措施提供科学依据。 方法：调查于2006-02/04进行,选取成都市某织布厂接触噪声高于85dB（A）的女工341名作观察组,另选取同厂接触噪声强度低于85dB（A）的女工154名作对照组,检测两组作业环境的噪声强度、风速、气温、气湿,并了解两组受试者的一般情况,采用SCL-90症状自评量表评价调查对象的心理健康状况,包括躯体不适、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执和精神病性9项因子,得分越高症状越重。 结果：495名受试者的资料进入结果分析。①两组作业环境检测,除观察组接触的噪声强度超过国家噪声卫生限值[85dB（A）]外,两组的其余各项指标均符合国家卫生标准,并且其一般情况的构成相似。②观察组SCL-90量表的9项因子分、总均分、阳性项目数以及阳性症状均分均高于对照组（P〈0.05）,躯体不适和强迫症状两项因子分≥3分的阳性检出率明显高于对照组（P〈0.05）。③观察组各个工龄组SCL-90的9项因子分、总均分和阳性项目数中,除躯体不适和敌对因子以外,其余指标均以1-年工龄组为最高（P〈0.05）。 结论：高强度的纺织噪声对女工心理健康有一定的影响,其中对1-年工龄组的影响最明显。建议采取积极有效的措施,以保护纺织女工的心理健康。