The domain management model: a tool to help organize care of stroke survivors in skilled nursing facilities

More rehabilitative care takes place in nursing homes than in any other setting. Skilled nursing facilities (SNFs) face increasing challenges in delivering stroke rehabilitation care. The Domain Management Model (DMM) organizes care of stroke survivors by identifying four critical domains that include all problems patients and families may face. Problems identified through the Minimum Data Set and Resident Assessment Protocols can be organized by the domains as well. In the SNF setting, the DMM can help organize rehabilitation care by assisting in the identification of all relevant clinical problems and by serving as a structured format for team meetings, problem management, and discharge summaries.     

Perfusion-weighted imaging of interictal hypoperfusion in temporal lobe epilepsy using FAIR-HASTE: comparison with H(2)(15)O PET measurements.

To detect perfusion abnormalities in areas of high magnetic susceptibility in the brain, an arterial spin-labeling MRI technique utilizing flow-sensitive alternating inversion recovery (FAIR) and half-Fourier single shot turbo spin-echo (HASTE) for spin preparation and image acquisition, respectively, was developed. It was initially tested in a functional study involving visual stimulation, and was able to detect significant activation with an increase (approximately 70%) in relative cerebral blood flow. Subsequently, it was applied in a clinical situation in eight patients with temporal lobe epilepsy (TLE). The perfusion-weighted images obtained showed no susceptibility artifacts even in the region of the inferior temporal lobe and were able to detect interictal hypoperfusion in TLE. The results were compared with those derived from H(2)(15)O PET perfusion imaging in each patient. A statistically significant correlation (r = 0.75, P < 0.05) was found between results acquired from these two modalities. Magn Reson Med 45:431-435, 2001.     

免疫吸附亲和层析法分离纯化甲胎蛋白生产工艺研究

采用3～5个月胎龄的胚胎组织,通过盐析、凝胶层析和亲和层析法分离纯化甲胎蛋白(AFP).结果表明,通过盐析沉淀血红蛋白和Sephadex G-25柱层析脱盐,延长了亲和层析柱的使用寿命,亲和柱使用6次以上层析效果仍保持稳定.每个胚胎平均可分离得到AFP 0.7mg,回收率为45.71%.紫外吸收法测定抗体偶联率为95.38%.SDS-PAGE显示AFP在Mr 66000处一条带十分明显,纯度较高.该方法起始材料易得,适合规模化生产AFP.     

Syncope in adolescents. Diagnostic and therapeutic approach

Syncopal episodes are frequent in adolescence. Syncope is usually a benign, self-limiting condition but it may be a warning sign of serious disease that must be diagnosed and appropriately treated. The present article provides a review of the basic principles of the differential diagnosis of syncope in the adolescent patient and treatment recommendations.     

GJB2基因突变导致非综合征性耳聋的特点及JL055小家系

目的利用JL055小家系分析GJB2基因突变导致非综合征性耳聋（non-syndromic hearing impairment，NSHI）的特点，为遗传咨询和产前诊断提供理论基础。方法对来自吉林聋哑学校的先证者JL055及其部分家属的血样，进行GJB2基因聚合酶链反应（polymerase chain reaction，PCR）扩增产物测序，检测GJB2基因的序列改变，对测序结果进行临床分析。结果JL055的基因型为35delG／299-300delAT，两个等位基因分别来自父系和母系。结论JL055家系的测序结果为遗传咨询和产前诊断提供了理论基础。     

试剂盒配合琼脂糖EB染色法和PAGE银染法分析线粒体DNA A1555G突变的比较研究

目的 通过比较试剂盒配合琼脂糖EB染色法和PAGE银染法分析线粒体DNA A1555G突变的不同特点,探索应用标准试剂盒和PAGE银染方法检测线粒体DNA A1555G突变的快速筛查和诊断方法.方法 采用线粒体DNA A1555G突变诊断试剂盒配合PAGE胶电泳银染法检测线粒体DNA 1555位点正常者229例,A＞G突变阳性者17例,验证此试剂盒配合PAGE银染法检测的有效性和准确性.结果 线粒体DNA A1555G突变诊断试剂盒配合PAGE胶电泳银染法检测结果与酶切EB染色和测序结果完全吻合.结论 线粒体DNA A1555G突变诊断试剂盒配合PAGE胶电泳银染法和试剂盒配合EB检测法较前者更为灵敏和清晰,在分析线粒体DNA A1555G突变方面具有简单、价廉、结果直观的特点,适合在中国用于进行此突变的大规模筛查或预防性检查.     

High-density lipoproteins neutralize C-reactive protein proinflammatory activity

BACKGROUND: C-reactive protein (CRP), a well-recognized marker of atherosclerosis, has recently been suggested to have a direct proinflammatory effect. The constitutive expression of low levels of CRP in normal plasma suggests the likelihood that a natural factor exists to neutralize the effect of CRP. This factor(s) has not yet been identified. Method and Results- The proinflammatory effect of CRP was measured by the induction of inflammatory adhesion molecules in human umbilical vein endothelial cells (HUVECs). We show that CRP significantly induced upregulation of adhesion molecules in both protein and mRNA levels. The CRP-induced expression of these inflammatory adhesion molecules was completely suppressed when the cells were preincubated with a physiological concentration (1 mg/mL apolipoprotein A-I) of HDLs derived from human plasma (native HDL) or reconstituted HDL (rHDL) at a very low concentration (0.01 mg/mL apolipoprotein A-I). A novel mechanism of HDL inhibition is likely to operate, because (1) rHDL was 100 times more potent than native HDL, (2) preincubation with HDL and its sustained presence were obligatory, and (3) oxidized 1-palmitoyl-2-linoleoyl-sn-glycero-3-phosphocholine was the fundamental active component. CONCLUSIONS: The CRP-induced upregulation of inflammatory adhesion molecules in HUVECs was completely prevented by HDL via their oxidized phospholipid components.     

面神经麻痹中医证治体会

面神经麻痹是由于面神经炎引起的周围性面瘫,是临床常见病,多发病。认为治疗上以养血祛风法用于正气不足证,以驱邪祛风法用于风邪入络证,并提出内外合治,针药并用。