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61.
目的:观察肌萎缩侧索硬化(ALS)患者重复神经电刺激(RNS)时复合肌肉动作电位(CMAP)波幅衰减和递增的特点及意义。方法:对确诊的42例ALS患者与42例重症肌无力(MG)患者的尺神经3Hz(低频)与15Hz(高频)RNs的结果进行比较。结果:42例ALS患者中,低频RNS有明确衰减者30例,无明确衰减或递增者12例;高频RNS有明确衰减者4例,明确递增者22例,无明确衰减或递增者16例。以上结果均与以作对照的MG组比较,差异均有统计学意义(P〈0.05)。结论:ALS患者存在神经肌肉传递障碍,RNS衰减或递增可能与突触前机制有关,或许与突触前、后均受损害有关,RNS结果异常是病情活跃的标志,确切意义有待进一步探讨。  相似文献   
62.
Previously, we demonstrated that macrophages from thrombospondin 1 (TSP1)-deficient mice have a reduced inflammatory phenotype, suggesting that TSP1 plays a role in macrophage activation. In this study, we determined how TSP1 regulates macrophage function. We found that recombinant or purified piatelet human TSP1 treatment stimulated tumor-necrosis factor (TNF)-α expression in bone marrow-derived macrophages in a time- and dose-dependent manner. Toll-like receptor 4 (TLR4) expression (at the mRNA and protein levels) and nuclear factor-kappaB (NF-KB) activity were also stimulated by TSP1 treatment. The TSPl-mediated increase in TNF-a production was abolished in TLR4-deficient macrophages, suggesting that TSP1 activates macrophages through a TLR4-dependent pathway. TSP1 also stimulated TLR4 activation in macrophages in vivo. Furthermore, TSPl-mediated macrophage activation was attenuated by using a peptide or an antibody to block the association between TSP1 and CD36. Taken together, these data suggest that the stimulation of the macrophage TLR4 pathway by TSP1 is partially mediated by the interaction of TSP1 with its receptor, CD36.  相似文献   
63.

Objective

To evaluate a web-based self-management training for health professionals. Patients spend 99% of their time outside the healthcare system. Thus self-management support from health professionals is central to optimal care. Our objective was to teach health professionals the skills to provide this support.

Methods

Primary care residents and practicing providers enrolled in six groups. Each group received four web-based interactive training sessions derived from self-efficacy theory. Retrospective-pre/post assessed changes in self-management beliefs and confidence. Wilcoxon signed-rank tests with Bonferroni correction compared responses. Focus groups solicited qualitative feedback.

Results

Fifty-seven residents and providers across the United States enrolled. Residents demonstrated positive changes on all belief questions (P 0.001–0.012). Practicing providers had a non-significant positive change on one and significant changes on the remainder (P 0.001–0.018). Both types of participants demonstrated significant increases on confidence questions regarding their ability to support self-management (P < 0.01 for all). Participants described learned techniques as being useful, reducing burnout, and increasing acceptance of patient involvement in care planning.

Conclusion

The web-based self-management support training for health professionals was feasible and changed beliefs and confidence.

Practice implications

The program may maximize patient self-management by increasing provider self-efficacy and skill for self-management support.  相似文献   
64.
目的 构建人源抗破伤风毒素重链C端单链二硫键稳定抗体原核表达载体,并进行原核表达和生物学特性鉴定.方法 采用PCR定点突变的方法,获得二硫键稳定的抗破伤风毒素重链C端(TeNT-Hc)单链抗体基因(27G-scdsFv).连接pET22b(+)载体,转化大肠杆菌BL21 (DE3)工程菌,IPTG诱导表达,SDS-PAGE、Western blot法鉴定表达产物.ELISA检测27G-scdsFv体外抗原特异结合活性和抗体相对稳定性;非竞争酶免法检测抗体亲和力.采用免疫荧光法检测27G-scdsFv体外中和活性.结果 测序结果显示获得正确的27G-scdsFv基因.原核表达scdsFv以包涵体形式存在,表达量约占菌体总蛋白的50%.复性后的27G-scdsFv保持了与TeNT-Hc的特异结合活性,亲和力较其scFv形式略有提升,KD =0.93×10-7 mol/L,1L培养物可获得5 mg scdsFv蛋白.27G-scdsFv的稳定性较scFv形式明显增强.27G-scdsFv在体外可以明显抑制TeNT-Hc与神经元细胞的结合.结论 成功构建人源抗破伤风毒素重链C端单链二硫键稳定抗体原核表达载体,并获得有活性的目的蛋白,为27G-scdsFv的进一步生物学功能研究奠定基础.  相似文献   
65.
Journal of Molecular Medicine - Inflammation is the phenotypic form of various diseases. Recent development in molecular imaging provides new insights into the diagnostic and therapeutic evaluation...  相似文献   
66.
Distal metaphyseal tibial fractures (3-5 cm from the joint with zones of comminution or <3 cm from the joint) are challenging to fix and are associated with many complications. The study objective was to evaluate the functional outcomes and complications after treating distal metaphyseal tibial fractures using anatomical anterolateral tibia locking plates or anterolateral-medial plates. This retrospective study included 57 patients with distal metaphyseal tibial fractures. Thirty patients were treated by open reduction internal fixation with anterolateral plates; 27 patients were treated with anterolateral-medial plates. Patients were followed at regular intervals. The time to fracture union and complications were recorded. We evaluated the stage of fracture healing using the Radiographic Union Score for Tibial fractures. The patients treated with anterolateral plates had significantly higher rates of loss of reduction and malunion than those treated with anterolateral-medial plates (p = .02 and p = .002, respectively). There were no significant differences in the radiographic union scores (p = .22), non-union (p = .17), incision necrosis (p = .91), or infection (p = .94) between the 2 groups. The functional outcomes were assessed using the American Orthopedic Foot and Ankle Society hindfoot-ankle score at the 12-month follow-up. The mean hindfoot-ankle scores were 90.9 ± 5.0 (range 79 to 100, median 90) and 92.3 ± 5.1 (range 82 to 100, median 92) for the anterolateral plates and anterolateral-medial plates, respectively (p = .29). For distal metaphyseal tibial fractures, anterolateral-medial plates may be worthwhile for reducing loss of reduction and malunion.  相似文献   
67.
抗癫痫药物对戊四氮点燃大鼠认知功能影响的研究   总被引:6,自引:0,他引:6  
目的研究抗癫痫药物(AEDs)对大鼠认知功能的影响。方法10周龄健康雄性SD大鼠70只,随机分为7组,每组10只。随机选取1组作为正常对照组(NS组);其余6组用戊四氮(PTZ)点燃,致痫后随机选取1组作为癫痫对照组(PTZ组),其余5组分别给予卡马西平(CBZ组)、苯妥英钠(PHT组)、丙戊酸钠(VPA组)、妥泰(TPM组)及拉莫三嗪(LTG组)控制癫痫发作。治疗2周后用Morris水迷宫进行测试。结果TPM组较其他6组在每次测试中所用时间长(P〈0.05)。在第1天测试中,TPM组LTG组所用时间长(P〈0.05);在第2天测试中,TPM组比VPA组、LTG(P〈005);在第3天测试中,TPM组比PTZ组、LTG组所用时间长(P〈0.05);在第4天测试中,TPM组比CBZ组、VPA组、LTG组所用时间长(P〈0.05)。6次测试所用总时间TPM组最长,PHT组次之,LTG组最短(P〈0.05,P〈0、01)。4天总测试时间TPM组比CBZ组、VPA组、PTZ、LTG组长(P〈0.05)。TPM组定向寻找平台象限时间较其他6组长(P〈0.01)。TPM组逗留时间明显短于CBZ组(P〈0.05)、LTG组(P〈0.01)。结论TPM、PHT可损害大鼠认知功能,而VPA、CBZ、LTG对大鼠认知功能有改善作用。  相似文献   
68.
随着CT技术的发展和体检的普及,肺部小结节的检出率不断提高。其中部分肺小结节不能排除恶性肿瘤的可能,治疗首选手术切除。因此,如何在术中对肺小结节精确定位、并在最大限度保护肺功能的前提下精准切除结节,是胸外科医师面临的重要课题。目前,肺部小结节术前辅助定位的核心是置入标志物,临床常用的定位方法主要有带钩金属丝定位法、微弹簧圈定位法、亚甲蓝穿刺注射定位法以及生物胶定位法等。本文简要综述现有定位方法的发展现状、适用范围及优缺点等,为临床应用及后续研究提供参考。  相似文献   
69.
正一、前列腺癌多参数磁共振成像的现状近年来国际、国内掀起了精准医学、无创诊断的多参数磁共振成像(multiparametric MRI,mpMRI)浪潮,利用影像图像,提取影片中的病灶影像特征,结合患者的临床数据,分析影像学潜在的基因组学、蛋白组学及其他病理生理学特征。在大数据的潮流当中,从大量影像检查的数据中  相似文献   
70.
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time‐zero biopsy specimens. The incidence of DGF was 16.7 and 37.5% in the HMP and CCP groups, respectively; the difference between the two groups was statistically significant (P < 0.05). The incidence of acute rejection was 4.1 (1/24) and 8.3% (2/24) in the HMP and CCP groups, respectively; this difference was not statistically significant (P > 0.05). Forty‐eight kidney patients were followed up for 6 months, and the two groups of recipients all survived, yielding a survival rate of 100%. The mean 6‐month serum creatinine levels were 98.7 ± 23.6 µmol/L in the HMP group and 105.3 ± 35.1 µmol/L in the CCP group; there was no significant difference between the two groups. HMP can reduce the incidence of DGF in DCD kidneys, and this effect is greater for expanded criteria donors kidneys. HMP can also improve early renal function.  相似文献   
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