hTERT反义基因对舌鳞癌Tca8113细胞端粒酶活性的影响

目的研究hTERT反义基因对舌鳞癌Tca8113细胞株的影响.方法应用RT-PCR法获得反义hTERT基因并转染舌鳞癌细胞,采用TRAP-DNA测序法检测转染前后细胞的端粒酶活性,并对细胞生长速度和倍增时间进行比较.结果转染后细胞的端粒酶活性及生长速度较转染前明显下降.结论 hTERT反义基因的表达可显著抑制舌鳞癌细胞的端粒酶活性和生长速度.     

Effect of nondipper hypertension on coronary artery disease progression in patients with chronic coronary syndrome

Background/aimIt has been suggested that there is a significant progress in coronary artery disease (CAD) by many pathophysiological mechanisms. Nondipper hypertension (NDH) has been shown to have higher target organ damage and have a higher rate of cardiovascular mortality and morbidity. In this study, we investigated the effect of nondipper hypertension on the progression of coronary atherosclerosis.Materials and methodsA total of 186 patients who underwent coronary angiography twice between 6 months and 3 years were included in the study. Coronary angiography was repeated on the admission day due to angina or positive exercise test and the patients were divided into groups.ResultsProgression of coronary artery disease was detected in 58 of 186 patients. Seventy-one of the total patients were found to be nondipper hypertensive. Nondipper hypertension, hypertension, diabetes mellitus, low-density lipoprotein, and total cholesterol were found to be effective in the progression of CAD. Among these parameters, it was seen that nondipper hypertension and hyperlipidemia were the most important independent risk factors.Conclusion Coronary artery disease is a progressive disease, and this progression depends on many reasons. In our study, we showed that nondipper hypertension is a new parameter that is effective in CAD progression.     

Ventilator-associated tracheobronchitis (VAT): questions,answers, and a new paradigm?

Nosocomial lower respiratory tract infections are a common cause of morbidity and mortality in intensive care unit (ICU) patients. Although many studies have investigated the management and prevention of ventilator-associated pneumonia (VAP), few have focused on ventilator-associated tracheobronchitis (VAT). In this issue of Critical Care, Nseir and coworkers present interesting data from a randomized controlled study of antimicrobial therapy for VAT. Patients randomly assigned to antibiotic therapy had more mechanical ventilation-free days (P < 0.001), fewer episodes of VAP (13% versus 47%; P < 0.001), and a lower ICU mortality rate (18% versus 47%; P = 0.05) than those without antibiotic therapy. Although this study has limitations, the data suggest that VAT may be an important risk factor for VAP or overlap with early VAP. More importantly, targeted antibiotic therapy for VAT may improve patient outcomes and become a new paradigm for prevention or early therapy for VAP.     

Diagnostic delay in lung cancer: a qualitative study

Title. Diagnostic delay in lung cancer: a qualitative study Aim. This paper is a report of a study to identify factors influencing delay in reporting symptoms of lung cancer. Background. Lung cancer accounts for approximately 5% of deaths in the Western world. For up to 80% of patients, their disease is inoperable because it has been diagnosed too late. This suggests that reducing diagnostic delay could reduce mortality. Methods. This qualitative study was conducted from July 2005 to May 2006 in community and hospital settings in the United Kingdom. A purposive sample of people diagnosed with lung cancer in the previous 6 months (n = 18), and two 18‐month survivors took part in individual interviews. Findings. Participants reported a range of interrelating factors that influenced delay in reporting symptoms of lung cancer. Barriers to symptom reporting included symptom experience, lack of knowledge and fear. Blame and stigma because of smoking were also prevalent influences, as well as cultural factors, non‐standard patterns of healthcare utilization and underlying stoical attitudes. The only factor to emerge as helpful in overcoming delay was the role families played. Conclusion. Lack of knowledge and awareness about lung cancer could be addressed by better education of the public. Social marketing is a way of developing education messages which tackle cultural influences on treatment‐seeking delay. Nurses have a potential role in developing and disseminating those messages.     

Human health exposure factor estimates based upon a creel/angler survey of the lower Passaic River (part 3)

The results of an analysis of site-specific creel and angler information collected for the lower 6 miles of the Passaic River in Newark, NJ (Study Area), demonstrate that performing a site-specific creel/angler survey was essential to capture the unique characteristics of the anglers using the Study Area. The results presented were developed using a unique methodology for calculating site-specific, human exposure estimates from data collected in this unique urban/industrial setting. The site-specific human exposure factors calculated and presented include (1) size of angler population and fish-consuming population, (2) annual fish consumption rate, (3) duration of anglers' fishing careers, (4) cooking methods for the fish consumed, and (5) demographic information. Sensitivity and validation analyses were performed, and results were found to be useful for performing a site-specific, human health risk assessment. It was also concluded that site-specific exposure factor values are preferable to less representative "default values." The results of the analysis showed that the size of the angling population at the Study Area is estimated to range from 154 to 385 anglers, based on different methods of matching intercepts with anglers. Thirty-four anglers were estimated to have consumed fish; 37 people consumed fish from the river. The fish consumption rate for anglers using this area was best represented as 0.42 g/day for the central tendency and 1.8 g/day for the 95th percentile estimates. Anglers fishing at the river have relatively short fishing careers with a median of 0.9 yr, an average of 1.5 yr, and a 95th percentile of 4.8 yr. Consuming anglers tend to fry the fish they caught. The demographics of anglers who consume fish do not appear to differ substantially from those who do not, with no indication of a subsistence angling population.     

A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation

BACKGROUND: A third version of the Spinal Cord Independence Measure (SCIM III), made up of three subscales, was formulated following comments by experts from several countries and Rasch analysis performed on the previous version. OBJECTIVE: To examine the validity, reliability, and usefulness of SCIM III using Rasch analysis. DESIGN: Multicenter cohort study. SETTING: Thirteen spinal cord units in six countries from North America, Europe, and the Middle-East. SUBJECTS: 425 patients with spinal cord lesions (SCL). INTERVENTIONS: SCIM III assessments by professional staff members. Rasch analysis of admission scores. MAIN OUTCOME MEASURES: SCIM III subscale match between the distribution of item difficulty grades and the patient ability measurements; reliability of patient ability measures; fit of data to Rasch model requirements; unidimensionality of each subscale; hierarchical ordering of categories within items; differential item functioning across classes of patients and across countries. RESULTS: Results supported the compatibility of the SCIM subscales with the stringent Rasch requirements. Average infit mean-square indices were 0.79-1.06; statistically distinct strata of abilities were 3 to 4; most thresholds between adjacent categories were properly ordered; item hierarchy was stable across most of the clinical subgroups and across countries. In a few items, however, misfit or category threshold disordering were found. CONCLUSIONS: The scores of each SCIM III subscale appear as a reliable and useful quantitative representation of a specific construct of independence after SCL. This justifies the use of SCIM in clinical research, including cross-cultural trials. The results also suggest that there is merit in further refining the scale.     

探讨认知—行为干预对行胸腔镜辅助胸骨抬举术患儿的影响

目的:探讨认知—行为干预对胸腔镜辅助胸骨抬举术后患儿的影响。方法:选择40例胸腔镜辅助胸骨抬举术后患儿,随机分为对照组和观察组,对照组给予术后常规护理,观察组给予常规护理的同时实施认知—行为干预,比较两组患儿焦虑及疼痛评分以及对术后康复知识的掌握、住院天数、住院费用情况。结果:两组患儿在焦虑及疼痛评分、住院天数、住院费用及健康知识掌握情况等方面比较均有统计学意义。结论:认知一行为干预能减轻患儿焦虑及疼痛,减少住院天数,降低住院费用,促进患儿快速康复。     

利用“军字一号”医嘱摆药系统管理毒麻药品

目的改进HIS信息化条件下毒麻药品调配及统计方法,使医嘱药品摆药更加具有科学性、先进性。方法在HIS医嘱摆药系统增加毒麻药品专用调配及处方统计程序。结果通过对HIS医嘱摆药系统进行优化升级,利于毒麻药品的使用及管理。结论在HIS中增加毒麻药品专用操作程序,提高医疗单位的信息化管理水平,使用操作简单,统计准确率高,提高工作效率。     

症状性颈动脉狭窄不良事件发生的影响因素

  目的  研究影响症状性颈动脉狭窄不良事件的相关因素，探讨支架血管成形术对症状性颈动脉狭窄不良事件的影响及事件相关诱发电位对不良事件的诊断价值。  方法  回顾性收集昆明医科大学附属延安医院神经内科及外科302例症状性颈动脉狭窄患者，根据不良事件分为正常组及不良事件组，收集2组患者年龄、性别、血红蛋白、血小板计数、血糖、总胆固醇、甘油三酯、治疗方式、事件相关诱发电位、颈动脉狭窄程度，进行统计学分析。  结果  颈动脉球囊扩张和支架血管成形术（carotid artery stent，CAS）是症状性颈动脉狭窄不良事件的保护因素（P < 0.001），事件相关诱发电位（event-related evoked potential，ERP）（P = 0.007）、颈动脉狭窄程度（P < 0.001）、总胆固醇（P = 0.001）是症状性颈动脉狭窄不良事件的危险因素，事件相关诱发电位对不良事件诊断试验:灵敏度 = 0.70，特异度 = 0.78，颈动脉球囊扩张和支架血管成形术减少不良事件的发生优于内科治疗（P < 0.001）。  结论  颈动脉球囊扩张和支架血管成形术能减少症状性颈动脉狭窄不良事件的发生，事件相关诱发电位对评判症状性颈动脉狭窄预后有一定的指导意义。