An Integrative Review of American Nurses'' Perceived Cultural Self-Efficacy

PURPOSE: To review use of the Cultural Self-Efficacy Scale (CSES) and to summarize the cumulative findings. METHODS: A combination of literature searches and questionnaires to those who have requested the scale indicated 26 known uses. Fifteen reported sufficient data for statistical analysis. FINDINGS: Of the 26 known uses of the CSES, 8 were published in peer-reviewed journals, 5 in dissertations, 8 in theses, and 3 as data sets only. Two additional theses were not retrievable for the study. On a 5-point Likert-type scale, nurses reported the highest degree of self-efficacy with African American (3.1) and Hispanic (3.1) patients and the lowest with Asian American patients (2.4). Six of the reports include Cronbach's alpha coefficients, ranging from .86 to .98. In the final sample of 15 studies, nurses did not report feeling confident caring for patients from other cultures. CONCLUSIONS: Although the CSES has been used in many settings with over 3,000 nurses, inconsistencies in the data preclude specific conclusions. Further research is needed using consistent reporting practices and sufficient predictor variables to draw further conclusions regarding the scale's psychometric properties.     

认知矫正治疗对慢性精神分裂症患者临床症状和社会功能的影响

目的:观察认知矫正治疗对慢性精神分裂症患者临床症状和社会功能的改善作用。方法:选择2003-01/08在北京回龙观医院住院的慢性精神分裂症患者104例。均符合CCMD-Ⅲ及DSM-Ⅳ关于精神分裂症诊断标准;年龄25～55岁;病程≥2年;病情稳定,处于迁延、残留或部分缓解状态;药物治疗状况稳定,近期无换药打算;纳入对象或家属同意入组并签署知情同意书。应用随机数字表法将患者分认知矫正治疗组和对照组,每组52例。在相近药物治疗的基础上,认知矫正治疗组以Ann Delahunty和Rodney Morice等制定的神经认知矫正手册(汉化)为治疗工具,在治疗师的指导下进行认知作业练习,内容包括认知灵活性、工作记忆、计划执行功能3大功能模块。对照组予以相同时间的工娱治疗,主要包括有治疗师指导的操作性音乐治疗和舞蹈治疗。治疗前后两组患者分别进行PANSS、住院精神患者社会功能缺陷量表和护士观察量表的评定。结果:实验共纳入慢性精神分裂症患者104例,认知矫正治疗组44例,对照组46例进入结果分析,14例脱落。①治疗前后两组患者PANSS量表总分以及阴性症状量表、复合量表、一般精神病理量表、反应缺乏量表4个分量表的评分均有下降,组内比较差异有显著性意义(t=2.12～4.59,P<0.05);减分情况在两组间差异不明显(P>0.05)。②两组患者的社会功能缺陷量表总分在治疗后均有下降,与治疗前比较,差异有显著性意义(t=3.89,2.04,P<0.05);两组间比较,差异无显著性意义(P>0.05)。认知矫正治疗组治疗后护士观察量表的总病情以及总消极、迟滞2个分量表评分下降,与治疗前比较差异有显著性意义(t=1.49,1.19,2.81,P<0.05);其中迟滞项的减分在两组间比较,差异具有显著性意义(F=4.97,P<0.05)。③社会功能量表的改善与词语流畅性的改善呈正相关(R2=0.36,P<0.05),护士观察量表中总病情与积极两项评分的改善也与言语流畅性测验的改善正相关(R2=0.37,0.34,P<0.05)。结论:认知矫正治疗能在一定程度上改善精神分裂症患者的社会功能,并与部分认知功能的改善相关,但对临床症状无明显改善作用。     

在体微血管内测定肿瘤细胞黏附性的实验方法

目的:介绍一种用于研究在体微血管内肿瘤细胞黏附的实验原理和实现方法。方法:利用显微镜在体测量毛细管前小静脉里肿瘤细胞黏附率,每根微血管以1000μm/s的速度灌注(2～4)×109L-1的肿瘤细胞。结果:微针尖注射速度和压力差成正比,显微镜可观察肿瘤细胞在血管里黏附个数随时间的变化。结论:该方法可控制血管内压力和流速及灌注肿瘤细胞的浓度等,模拟微血管正常生理状态下不同条件下肿瘤细胞的黏附特性。     

Release of vascular endothelial growth factor from a human melanoma cell line, WM35, is induced by hypoxia but not ultraviolet radiation and is potentiated by activated Ras mutation

Angiogenesis, the formation of blood vessels, is a major factor influencing tumor growth and metastatic capacity, and VEGF is the prototype angiogenic factor. VEGF expression is also found in the dermis and tumor stroma during the course of melanoma progression. Various oncogenes such as c-Src, v-Raf, and Ras, and multiple environmental stimuli, including hypoxia and ultraviolet radiation (UVR), can regulate VEGF expression under certain conditions. We have constructed several cell lines from a radial growth phase, primary human melanoma cell line, WM35. We have stably transfected WM35 cells with mutant activated H-ras, N-ras, dominant negative p53, or empty vector. In this report, we determined how VEGF expression and release from these melanoma cell lines were affected by the following important factors associated with melanoma initiation and progression: hypoxia, UVR, activated Ras, dominant negative p53, and culture conditions mimicking radial growth phase melanoma (monolayer culture) and vertical growth phase melanoma (spheroid culture). We found that hypoxia, but not UVR, up-regulates VEGF mRNA expression and protein release in these melanoma cells. In addition, activated Ras and dominant negative p53 enhances the hypoxia-induced VEGF protein release. We propose that hypoxia-induced VEGF release promotes tumor progression, especially in melanomas with Ras or p53 mutations.     

NURR1基因修饰C17.2神经干细胞移植治疗脑梗死

目的:比较C17.2神经干细胞和NURR1基因修饰的C17.2神经干细胞移植治疗对脑梗死模型鼠神经功能缺损的改善效果,观察细胞移植后与宿主脑组织的整合、存活、移行及分化情况。方法:实验于2005-06/12在中山大学附属第二医院林百欣实验中心完成。①实验材料:选取清洁级健康SD雄性大鼠78只,随机数字表法分为模型对照组、神经干细胞组、转基因神经干细胞组,26只/组。条件永生化神经干细胞系C17.2由哈佛大学儿童医院Even Synder教授惠赠。pAdeasy-NURR1重组复制缺陷性腺病毒由本实验室成功构建。Dil18荧光染料(Chemicon公司产品)。②实验方法:收集C17.2神经干细胞和pAdeasy-NURR1 C17.2神经干细胞,各分为两管,一管加入Dil18荧光示踪剂。各组大鼠均采用线栓法建立局灶性脑缺血/再灌注损伤模型,3d后进行细胞移植,以江湾Ⅱ型脑立体定向仪进行立体定位,选择缺血半暗区3个位点为移植区:前囟头侧1mm,旁开2mm,深度1.2mm;前囟尾侧3mm,旁开1.5mm,深度1.2mm;前囟尾侧6mm,旁开2mm,深度1.2mm。模型对照组每位点注射单纯培养液2μL;神经干细胞组取6只每位点移植Dil18标记的C17.2神经干细胞悬液2μL,剩余20只每位点移植C17.2神经干细胞悬液2μL;转基因神经干细胞组取6只每位点移植Dil18标记的pAdeasy-NURR1 C17.2神经干细胞悬液2μL,余20只每位点移植pAdeasy-NURR1 C17.2神经干细胞悬液2μL。③实验评估:各组大鼠分别在移植前1d及移植后1周、2周、1个月进行神经功能缺损评分。移植后1周、2周、1个月进行荧光示踪检查及神经元特异烯醇化酶免疫组化检测。移植后6个月行组织学检查。结果:移植后1周,模型对照组死亡1只,神经干细胞组死亡2组,转基因神经干细胞组死亡2只,均淘汰并予以补充。①神经功能缺损评分:移植前1d各组大鼠神经功能缺损评分基本相似(P>0.05)。移植后1周、2周、1个月神经干细胞组、转基因神经干细胞组神经功能缺损评分均明显低于模型对照组(P<0.05);转基因神经干细胞组下降趋势较神经干细胞组更为显著(P<0.05)。②Dil18荧光细胞示踪结果:移植后1周荧光示踪细胞主要在针道内,少数细胞开始移行至周围神经组织。移植后2周,细胞移行至更远距离,并明显向梗死灶方向移行,细胞有突触样结构与周围细胞形成联系。移植后1个月细胞向周围扩散,甚至在远隔部位也可见荧光细胞。③神经元特异烯醇化酶免疫组化检测结果:移植后2周、1个月,转基因神经干细胞组神经元特异烯醇化酶阳性细胞数均明显高于神经干细胞组(P均<0.05)。④细胞组织学检查:移植后6个月,各组大鼠注射针道周围脑组织仍呈正常的层次和结构,未见有明显异型细胞增生。结论:①NURR1基因修饰的C17.2神经干细胞移植治疗局灶性脑梗死能显著改善神经功能缺损,效果优于C17.2神经干细胞。②移植后供体细胞存活并向注射针道周围神经组织移行,促进神经干细胞向神经元方向的分化。     

输液中注射用头孢米诺钠的稳定性

1材料和方法 1.1材料日本岛津10-Arp高效液相色谱仪,C18柱(5 μm,4.6 mm×150 mm),PHS-3C型pH计(上海雷磁仪器厂);注射用头孢米诺钠(南昌立健药业有限公司,批号:20040701),50 g/L葡萄糖注射液(四川科伦大制药有限公司,批号:040912-091),100 g/L葡萄糖注射液(湖南科伦大制药有限公司,批号:040710-07),9 g/L氯化钠注射液(湖南科伦大制药有限公司,批号:040926-06),葡萄糖氯化钠注射液(湖南科伦大制药有限公司,批号:040929-06),甲硝唑注射液(安徽双鹤药业有限公司,批号:040926-2E);甲醇、冰醋酸、四氢呋喃均为分析纯.     

反义寡核苷酸抗肝炎病毒研究进展

反义核酸是指能够与基因组DNA有意义链(sense sequence),或有意义链的转录体互补结合的核苷酸序列,包括反义RNA、反义NDA、反义寡核苷酸具有核酸特异切割活性的核酶等.反义寡核苷酸(antisense oligodeoxynucleotide,ASODN)是指合成的20个碱基左右的一小段核苷酸,按照Watson-Crick碱基配对原则与特定的靶序列杂交,从而抑制基因表达.其作用方式有2种:①与mRNA杂交,单纯阻断核糖体对mRNA的翻译;②激活一种降解mRNA的选择性内切酶RNaseH.ASODN治疗具有高特异性,是一种改变肿瘤、AIDS等病毒感染性疾病中操纵基因表达的治疗方法.本文就ASODN的化学修饰、药理学研究,以及其抗肝炎病毒作用作一综述.     

Bromodeoxyuridine incorporation and Ki 67 expression in oral hairy leukoplakia

OBJECTIVES: Oral hairy leukoplakia (HL) is an acan-thotic, hyperparakeratotic lesion characterised by the presence of a replicative Epstein-Barr virus (EBV) infection in the superficial and adjoining layers of the epithelium. EBV or its gene products are capable of modifying epithelial differentiation. The aim of this study was to establish whether the presence of EBV was associated with an alteration in cell turnover by assessing bromodeoxyuridine (BrdU) incorporation and Ki 67 expression in lesional tissue and control mucosa.
METHODS: Biopsies of HL together with age, site and sex matched controls ( n = 7 and 8 respectively) were incubated in 200 μM BrdU in vitro , fixed in methacarn and processed to paraffin wax. Following acid hydrolysis, incorporated BrdU and Ki 67 were identified in serial 5 fim sections using a three-stage immunoperoxidase technique and cell density expressed as the number of positive cells per mm basement membrane length.
RESULTS: Overall, there was no difference in the number of BrdU positive cells per mm basement membrane length between control and HL tissue. However, within HL alone, the presence'of focal EBV replication was associated with a significant reduction in the number of basal cells incorporating BrdU compared to adjacent EBV free areas (P < 0.05). There was no significant difference between Ki 67 positive cells in control and HL tissue and no evidence of a reduction of Ki 67 positive cells in areas associated with EBV replication.
CONCLUSIONS: These results suggest that there is no evidence of a generalised alteration of the proliferative capacity of basal cells in HL, although the focal reduction in BrdU incorporation may reflect subtle changes on cell turnover by EBV infection.     

BH3 mimetic ABT-737 and a proteasome inhibitor synergistically kill melanomas through Noxa-dependent apoptosis

The Bcl-2 family is important in modulating sensitivity to anticancer drugs in many cancers, including melanomas. The BH3 mimetic ABT-737 is a potent small molecule inhibitor of the anti-apoptotic proteins Bcl-2/Bcl-X(L)/Bcl-w. In this report, we examined whether ABT-737 is effective in killing melanoma cells in combination with the proteasome inhibitor MG-132, and further evaluated the mechanisms of action. Viability, morphological, and Annexin V apoptosis assays showed that ABT-737 alone exhibited little cytotoxicity, yet it displayed strong synergistic lethality when combined with MG-132. In addition, the detection of Bax/Bak activation indicated that the combination treatment synergistically induced mitochondria-mediated apoptosis. Furthermore, mechanistic analysis revealed that this combination treatment induced expression of the pro-apoptotic protein Noxa- and caspase-dependent degradation of the anti-apoptotic protein, Mcl-1. Finally, siRNA-mediated inhibition of Mcl-1 expression significantly increased sensitivity to ABT-737 in these cells, and knocking down Noxa expression protected the cells from cytotoxicity induced by the combination treatment. These findings demonstrate that ABT-737 combined with MG-132 synergistically induced Noxa-dependent mitochondrial-mediated apoptosis. In summary, this study indicates promising therapeutic potential of targeting anti-apoptotic Bcl-2 family members in treating melanoma, and it validates rational molecular approaches that target anti-apoptotic defenses when developing cancer treatments.