影响腹膜透析患者社会回归因素的分析

目的：通过分析影响腹透患者社会回归的因素，探求促进腹透患者社会回归的途径。方法：分析16l例透析时间超过3个月的腹透患者的社会回归现状，分析患者的个人情况、临床治疗情况、社会心理及经济情况，探讨影响社会回归的可能因素。结果：社会回归为1级的患者占总患者数的13％，2级2912％，3级47．8％，4级12.4％。影响社会回归的因素为Charlson并发症指数、Hamilton抑郁积分、Engle系数。结论：加强慢性肾脏病的一体化治疗、改善患者的心理社会及经济因素可能是改善腹透患者社会回归的有效途径。     

Tideglusib reduces progression of brain atrophy in progressive supranuclear palsy in a randomized trial

It is believed that glycogen synthase kinase‐3 hyperphosphorylates tau protein in progressive supranuclear palsy (PSP). The Tau Restoration on PSP (TAUROS) trial assessed the glycogen synthase kinase‐3 inhibitor tideglusib as potential treatment. For the magnetic resonance imaging (MRI) substudy reported here, we assessed the progression of brain atrophy. TAUROS was a multinational, phase 2, double‐blind, placebo‐controlled trial in patients with mild‐to‐moderate PSP who were treated with oral tideglusib (600 mg or 800 mg daily) or with placebo for 1 year. A subset of patients underwent baseline and 52‐week MRI. Automated, observer‐independent, atlas‐based, and mask‐based volumetry was done on high‐resolution, T1‐weighted, three‐dimensional data. For primary outcomes, progression of atrophy was compared both globally (brain, cerebrum) and regionally (third ventricle, midbrain, pons) between the active and placebo groups (Bonferroni correction). For secondary outcomes, 15 additional brain structures were explored (Benjamini & Yekutieli correction). In total, MRIs from 37 patient were studied (placebo group, N = 9; tideglusib 600 mg group, N = 19; tideglusib 800 mg group, N = 9). The groups compared well in their demographic characteristics. Clinical results showed no effect of tideglusib over placebo. Progression of atrophy was significantly lower in the active group than in the placebo group for the brain (mean ± standard error of the mean: ?1.3% ± 1.4% vs. ?3.1% ± 2.3%, respectively), cerebrum (?1.3% ± 1.5% vs. ?3.2% ± 2.1%, respectively), parietal lobe (?1.6% ± 1.9% vs. ?4.1% ± 3.0%, respectively), and occipital lobe (?0.3% ± 1.8% vs. ?2.7% ± 3.2%, respectively). A trend toward reduced atrophy also was observed in the frontal lobe, hippocampus, caudate nucleus, midbrain, and brainstem. In patients with PSP, tideglusib reduced the progression of atrophy in the whole brain, particularly in the parietal and occipital lobes. © 2014 International Parkinson and Movement Disorder Society     

储能式下肢运动假肢的研究

本文叙述了储能式假肢的特点,在对人体跑步时生物力学分析的基础上,论述了储能式运动假肢的设计原理。文中介绍了由清华大学和中国康复研究中心联合研制的运动假肢。该假肢在试用中取得了突出的效果。此外还介绍了对假肢进行动态性能试验的装置,试验方法及试验结果,与国外同类产品相比,该假肢有良好的储能特性。     

Clinical efficacy and tolerability of an immune-stimulant<Superscript>*</Superscript> constituted by inactivated bacterial bodies in the prophylaxis of infectious episodes of airways: a double blind,placebo-controlled,randomized, multicentre study

Background

(Buccalin ®) is a Bacterial Lysates (BL) that belongs to a family of immune-stimulators, developed more than 30 years ago and it still has a role in the prophylaxis of Recurrent Respiratory Tract Infections (RRTI). However, original studies were conducted with an approach that does not seem to be aligned with the present methodologies. In addition, concomitant therapies substantially improved in the last decades. These two reasons strongly suggested to update our knowledge on the capacity of this bacterial lysate (Buccalin ®) to reduce the number of days with infectious episodes in patients with RRTI.

Methods

A double blind, placebo-controlled, randomized, multicentre study was programmed (EudraCT code: 2011-005187-25). The reduction of the number of days with infectious episodes (IE) was the primary endpoint. Secondary endpoints were the number of IE, the use of concomitant drugs, the efficacy on signs and symptoms of RRTI and the safety of the drug. Patients were treated according to the registered schedule and were followed up for a period of 6 months.

Results

From a cohort of 188 patients eligible for the study, 90 were included in the active group and 88 in the placebo group. The study was completed in 170 patients. A significant reduction of the number of days with IE was observed (6.57 days in the active group and 7.47 in the placebo group). Secondary endpoints were only partially achieved. No virtual adverse events related to the treatment were recorded.

Conclusion

The administration of bacterial lysate (Buccalin ®) in patients with RRTI had the capacity to significantly reduce the number of days with IE in a multicentre, randomized, placebo controlled, clinical study. The treatment was safe. Of note, all patients were free to be treated with the best concomitant therapies. In these conditions, the positive results observed demonstrated that this bacterial lysate has maintained its capacity of reducing the days with infections in patients with RRTI, also in association to the concomitant therapies available nowadays.

     

Effectiveness and Feasibility of the Early Start Denver Model Implemented in a Group-Based Community Childcare Setting

A recent study documented the efficacy of the Early Start Denver Model (ESDM) delivered in a 1:1 fashion. In the current study we investigated the effectiveness and feasibility of the ESDM in the context of a long-day care community service, with a child-staff ratio of 1:3. Outcomes of 27 preschoolers with ASD undergoing 15–25 h per week of ESDM over 12 months were compared to those of 30 peers with ASD undergoing a different intervention program delivered in a similar community long-day care service. Children in both groups made gains in cognitive, adaptive and social skills. Participants in the ESDM group showed significantly higher gains in developmental rate and receptive language.     

多普勒超声测定左心室Max（dp／dt）的新方法

心室内压力变化率峰值Ｍａｘ（ｄｐ／ｄｔ）是一项评价心肌收缩功能的重要指标。但其测定常需借助于心导管术，临床应用受到限制。依据流体力学基本定律，本文提出：等容收缩期内表现为压力的势能将在射血期部分地转化为以１／２ｐＶ２为形式的动能，因而势能的最大变化率Ｍａｘ（ｄｐ／ｄｔ）将在动能的最大变化率Ｍａｘ（ｄｋ／ｄｔ）上得到反映。应用特制计算机软件将主动脉血流速度曲线转化为４Ｖ２曲线，该曲线的一级导数峰值即为Ｍａｘ（ｄｋ／ｄｔ）。应用脉冲多普勒超声测定２３例先天性心脏病患儿的主动脉血流频谱参数并与心导管测定的左心室Ｍａｘ（ｄｐ／ｄｔ）进行对比分析。结果显示：主动脉血流频谱参数Ｍａｘ（ｄｋ／ｄｔ）与左心室Ｍａｘ（ｄｐ／ｄｔ）呈良好相关（ｒ＝０．８１７，Ｐ＜０．００１），直线回归方程为：Ｍａｘ（ｄｐ／ｄｔ）＝０．４７Ｍａｘ（ｄｋ／ｄｔ）＋６７．９（Ｋｐａ／ｓ），平均加速度ｍＡ及Ｖｐ２／ＡＴ与Ｍａｘ（ｄｐ／ｄｔ）亦有较好的相关性。表明由多普勒超声获得的主动脉血流频谱参数Ｍａｘ（ｄｋ／ｄｔ）能较准确地估侧左室Ｍａｘ（ｄｐ／ｄｔ），因而可作为评价心脏收缩功能的可靠指标     

鼻咽癌患者淋巴细胞近端着丝粒染色体随体联合频率的分析

本文对60例鼻咽癌患者用银染及非银染方法比较分析了近端着丝粒染色体随体联合的频率(SAs及Ag-AA),发现每细胞平均出现的SAs及Ag-AA分别为0.55和1.29(P<0.01)。D、G组染色体在随体联合中的比例分别为DSAf0.620及0.597,GSAf为0.380及0.403,具有随机性。G显带证实13、14、21号染色体更多地参与随体联合。