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81.
Virginia K. Saba EdD RN FAAN FACMI LL Jean M. Arnold EdD RN BC 《International journal of nursing terminologies and classifications》2004,15(3):69-77
PURPOSE: To provide a means for calculating the cost of nursing care using the Clinical Care Classification System (CCCS). DATA SOURCES: Three CCCS indicators of care components, actions, and outcomes in conjunction with Clinical Care Pathways (CCPs). DATA SYNTHESIS: The cost of patient care is based on the type of action time multiplied by care components and nursing costs. CONCLUSIONS: The CCCM for the CCCS makes it possible to measure and cost out clinical practice. IMPLICATIONS FOR PRACTICE: The CCCM may be used with CCPs in the electronic patient medical record. The CCPs make it easy to track the clinical nursing care across time, settings, population groups, and geographical locations. Collected data may be used many times, allowing for improved documentation, analysis, and costing out of care. 相似文献
82.
Role of endogenous interleukin-10 in local and distant organ injury after visceral ischemia-reperfusion 总被引:4,自引:0,他引:4
The anti-inflammatory cytokine interleukin (IL)-10 has been detected in serum after visceral ischemia-reperfusion injury and exogenous IL-10 administration has been shown to attenuate the associated distant organ injury. This study was designed to examine the role that endogenous IL-10 production plays on both local and distant organ injury after visceral ischemia-reperfusion injury. Wild-type and IL-10(-/-)-null C57BL/6 mice were subjected to 20 min of supraceliac aortic occlusion or sham laparotomy. Serum and lung tissue cytokine levels (tumor necrosis factor alpha, IL-1beta, IL-6, KC/GRO, and IL-10) were measured after reperfusion (1, 2, and/or 4 h) using either enzyme-linked immunoassay or bioassay. Lung neutrophil infiltration and injury were quantified after reperfusion injury using myeloperoxidase concentration (2 h) and mean capillary permeability (4 h), respectively, whereas the direct liver injury was quantified with serum aspartate aminotransferase levels (1, 2, and 4 h). A subset of IL-10(-/-)-null animals was administered human recombinant IL-10 before the visceral ischemia and lung MPO was measured after reperfusion (2 h). Visceral ischemia-reperfusion in the wild-type and IL-10(-/-)-null mice was associated with in an increase in both serum (IL-1beta, KC/GRO, IL-6) and lung tissue (IL-1beta, KC/GRO) cytokine levels and resulted in lung neutrophil infiltration (myeloperoxidase), lung injury (mean capillary permeability) and liver injury (aspartate aminotransferase). The magnitude of the lung tissue cytokine response (IL-1beta, KC/GRO), neutrophil infiltration, and injury were greater in the IL-10(-/-)-null mice. Exogenous IL-10 resulted in a decrease in the lung neutrophil infiltration in the IL-10(-/-)-null mice. The endogenous IL-10 response to visceral ischemia-reperfusion attenuates the associated lung neutrophil infiltration and injury but has no effect upon either the hepatic injury or the magnitude of the systemic inflammatory response. The beneficial effects of IL-10 may be mediated by the inhibition of IL-1beta and KC/GRO through an endocrine rather than paracrine signal. 相似文献
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脑源性神经生长因子促进成年大鼠脑海马神经干细胞定向分化的浓度选择 总被引:1,自引:0,他引:1
目的:探讨培养基中表皮生长因子与血清两者浓度一定的条件下,不同浓度的脑源性神经生长因子对成年大鼠脑海马神经干细胞向神经元分化的影响。
方法:实验于2007—08在中国医科大学神经解剖研究室完成。①材料:清洁级雄性成年SD大鼠1只,由中国医科大学实验动物部提供,实验过程中对动物的处置符合动物伦理学标准。实验过程中应用的表皮生长因子、脑源性神经生长因子均由R&D公司提供:(多实验方法:无菌条件下分离大鼠脑海马组织,剪碎后胰蛋白酶消化,过滤、离心、弃上清,加入含2%B27、20μg/L表皮生长因子、20μg/L碱性成纤维生长因子的DMEM/F12无血清条件培养基体外培养神经干细胞,传至第4代时利用有限稀释法进行单克隆培养,100倍镜下克隆球直径约为200μm时制备单细胞悬液,稀释后滴加于96孔板内,设立两组,全量新鲜培养基组加入刚配置未使用过的DMEM/F12无血清培养基100μL,半量条件培养基组加入上述曾用于神经干细胞培养且含有其代谢产物的1/2DMEM/F12无血清培养基100斗L。(劲实验评估:观察神经干细胞的单克隆培养增殖情况。对克隆球行巢蛋白、神经元特异性烯醇化酶、胶质原纤维酸性蛋白免疫细胞化学染色。按培养基中脑源性神经生长因子终浓度的不同将所培养细胞设立0,50,100,150,200μg/L组,各组均加入20μg/L表皮生长因子和体积分数为0.1的胎牛血清,1周后行神经元特异性烯醇化酶免疫细胞化学染色,检测神经干细胞向神经元分化情况。
结果:①神经干细胞单克隆培养结果:单克隆培养开始时神经干细胞增殖缓慢,半量条件培养基组细胞增殖速度快于全量新鲜培养基组,随着细胞数的增多,两组细胞增殖速度也相应加快,分别在培养后第12天、第15天形成直径为200μm的克隆球。②神经干细胞免疫细胞化学染色结果:单克隆培养后克隆球表达巢蛋白,诱导分化后神经元特异性烯醇化酶、胶质原纤维酸性蛋白均呈阳性表达:③各组神经干细胞分化为神经元的比例:与0μg/L脑源性神经生长因子组比较,50,100μg/L脑源性神经生长因子组的神经干细胞分化为神经元比例均明显增高(t=2.502~5.025,P〈0.05);而浓度为150,200μg/L时均无明显变化(t=0.420~1.857,P〉0.05)。
结论:向含有B27、表皮生长因子、碱·性成纤维生长因子的DMEM/F12条件培养基中加入20μg/L表皮生长因子和体积分数为0.1胎牛血清的情况下,脑源性神经生长因子促使神经干细胞向神经元分化的较佳浓度为50μg/L。 相似文献
85.
BACKGROUND: The potential use of solvent/detergent-treated plasma (S/D plasma) in transfusion practice raises concerns about the cytolytic effects that any residual solvent and detergent in the virally inactivated blood component might have on units of red cells in vitro, if the two components are mixed during preparation. STUDY DESIGN AND METHODS: S/D plasma was mixed with variously processed units of stored red cells, in vitro, to evaluate the effect the residual solvent and detergent would have on cell membrane integrity. A paired protocol design was used in which half-units of red cells were exposed to S/D plasma (test), and the matched half-units were exposed to either the supernatant additive solution from the original red cell unit or standard fresh-frozen plasma (FFP) (control). After incubation for up to 5 days, the units were evaluated for evidence of hemolysis or changes in other red cell storage assays. RESULTS: This study showed that, for fresh additive solution red cells (AS-1), the 5-day storage plasma hemoglobin levels were comparable in the red cells exposed to S/D plasma (21 mg/dL) and in the paired half-units stored in the original AS-1 supernatant (31 mg/dL) (p > 0.05). Similar findings were recorded for stored AS-1 red cells (S/D plasma; 111 mg/dL vs. AS-1 supernatant, 147 mg/dL; p > 0.05); stored CPDA-1 red cells (S/D plasma, 133 mg/dL vs. FFP, 103 mg/dL; p > 0.05); frozen red cells (S/D plasma, 28 mg/dL vs. FFP, 18 mg/dL; p > 0.017); and stored irradiated AS-1 red cells (S/D plasma, 608 mg/dL vs. AS-1 supernatant, 726 mg/dL; p > 0.05). Comparable results were found for other assays, including levels of plasma potassium, osmotic fragility, and red cell antigen titer. CONCLUSION: These data show that S/D plasma does not induce red cell lysis even after 5 days of in vitro storage. These results are consistent with previous findings by this laboratory that platelets are not harmed by storage in S/D plasma. Red cells resuspended in S/D plasma and stored for up to 5 days maintain in vitro storage characteristics that are acceptable for the use of the cells in clinical transfusion practice. 相似文献
86.
87.
瑞芬太尼是一种新型的超短效阿片药物,它的出现使得麻醉可控性和预见性得到了优化。最近有更多的研究将它用于产科的麻醉与镇痛,为产科麻醉用药带来了新的选择。本文将就瑞芬太尼近年来在产科麻醉与镇痛方面的临床研究进展进行探讨。 相似文献
88.
89.
SIGRID SVALHEIM ERIK TAUB
LL TONE BJ
RNENAK LINE SVEBERG R
STE TORE M
RLAND ERIK R. STRE LEIF GJERSTAD 《Seizure》2003,12(8):529-533
PROBLEM: Menstrual disorders, reduced fertility and sexual problems seem to be more frequent in women with epilepsy than in the general population. Most investigations concerning menstrual disturbances in epilepsy patients, however, are small and based on selected materials. We therefore wanted to investigate the frequency of menstrual disturbances in a large, unselected population of epilepsy patients. METHODS: A retrospective, questionnaire study of a cohort of female outpatients, aged 18-45 was conducted. Each patient chose a close female friend who served as control, to optimise matching regarding age and lifestyle. RESULTS: Answers were received from 265 patients and 142 controls. Menstrual disturbances were more frequent in patients with epilepsy (48.0%) than in controls (30.7%) (P=0.004). Menstrual disturbances were more frequent in patients on polytherapy versus monotherapy (P=0.049) and more frequent in patients with high seizure frequency (>5seizures/year) compared to patients with a lower seizure frequency or those seizure free (P=0.006). The frequency of menstrual disturbances was higher in patients on valproate compared to carbamazepine monotherapy (P=0.045). CONCLUSION: This investigation confirms that women with epilepsy have an increased frequency of menstrual disturbances compared to women without epilepsy. In women with high seizure frequency and in those on polytherapy, the frequency of menstrual disturbances are further increased. The highest frequency of menstrual disturbances occurred in women using valproate. 相似文献
90.