自我清洁间歇导尿在脊髓损伤神经源性膀胱患者中的应用

目的探讨自我清洁间歇导尿的应用对脊髓损伤神经源性膀胱患者的影响。方法将符合入选标准的80例患者按随机数字表法分为清洁间歇导尿组(自我清洁间歇导尿)和留置导尿组(长期留置尿管)各40例,比较两组患者4周后尿路感染发生率、出院3个月后残余尿量及日常生活活动能力。结果两组患者尿路感染发生率比较,差异有统计学意义(P0.01);出院3个月两组日常生活活动能力比较,差异有统计学意义(P0.01)。结论自我清洁间歇导尿优于长期留置尿管,有利于提高患者生活质量。     

Cyclooxygenase inhibitors in urinary bladder cancer: in vitro and in vivo effects

More than 14,000 people die from invasive transitional cell carcinoma (TCC) of the urinary bladder yearly in the United States. Cyclooxygenase (COX)-inhibiting drugs are emerging as potential antitumor agents in TCC. The optimal in vitro or in vivo systems to investigate COX inhibitor antitumor effects have not been defined. The purpose of this study was to determine COX-1 and COX-2 expression and antitumor effects of COX inhibitors in human TCC cell lines (HT1376, RT4, and UMUC3 cells) and xenografts derived from those cell lines. COX-2 expression (Western blot, immunocytochemistry) was high in HT1376, modest in RT4, and absent in UMUC3 cells in vitro. Similarly, COX-2 expression was noted in RT4 but not UMUC3 xenografts. COX-2 expression in HT1376 xenografts was slightly lower than that observed in vitro. None of four COX inhibitors evaluated (celecoxib, piroxicam, valeryl salicylate, and NS398) reduced TCC growth in standard in vitro proliferation assays at concentrations that could be safely achieved in vivo (< or =5 micromol/L). Higher celecoxib concentrations (> or =50 micromol/L) inhibited proliferation and induced apoptosis in all three cell lines. Celecoxib or piroxicam treatment in athymic mice significantly delayed progression of HT1376 xenografts, which express COX-2, but not UMUC3 xenografts that lack COX-2 expression. In conclusion, standard in vitro assays were not useful in predicting COX inhibitor antitumor effects observed in vivo. Athymic mice bearing TCC xenografts provide a useful in vivo system for COX inhibitor studies. Results of this study provide justification for further evaluation of COX inhibitors as antitumor agents against TCC.     

精神病房实施开放式管理的护理对策

通过分析精神病房实施开放式管理过程中可能遇到的影响因素,介绍相应的护理对策,以杜绝安全隐患和医疗纠纷,确保精神病房开放式管理的安全实施,使治疗护理工作顺利进行.     

河南农村中医药文化的发展阶段与特征初探

河南是中医药文化的发祥地之一,在华夏文明、黄河文明和中原文化的滋养中产生了中医药文化,中医药文化作为传统文化的代表又进一步丰富发展了中原文化、黄河文明,成为中华中医药文化的主要贡献者、创造者、发展者。中医药文化是农业文化的典型代表,与农村农民农业有着天然的联系,特别是在以农业生产为主的河南大地生根发芽,经历萌芽期、形成期、固化成熟期、没落期、复兴期、严峻考验期六个时期,并具有原创性、完整性、包容性等特色。随着时代的发展,农村单一化发展模式被打破,要促进农村中医药文化的复兴,就要与时俱进,继承创新。     

Less patient discomfort by one-man colonoscopy examination

A randomised prospective trial compared safety and patient tolerance for one-man method with two-man method undergoing colonoscopy. Eighty patients were randomized to 1 of 2 groups: the two-man method group (n = 40); or the one-man method group (n = 40). All colonoscopic examinations were performed by the same endoscopist to reduce skill-based variation. Patient tolerance for colonoscopy was evaluated with a numerical rating scale ranging from 0 for painless to 5 for maximal pain. Cardiopulmonary parameters were recorded during the procedure. Patients receiving one-man method had lower pain score than two-man method. The length of the scope reach to the cecum was shorter in the one-man group than the two-man group. The patients underwent two-man colonoscopy had higher maximum increase in heart rate during the procedure compared with one-man group. One-man colonoscopy can improve patient tolerance and reduces patient pain by decreasing the redundancy of colonoscope during the procedure.     

抑郁症患者脑源性神经营养因子基因位点多态性与负性生活事件的相关性研究——附85例报告

目的:探讨脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)基因G196A住点多态性与抑郁症患者负性生活事件的相关性.方法:对85例抑郁症患者(抑郁症组)和158名健康人(对照组)进行BDNF基因G196A基因型检测和生活事件量表(life events scale,LES)评分,比较2组的结果,分析G196A位点多态性与负性生活事件的相关性.结果:抑郁症组的LES中总生活事件、负性生活事件、正性生活事件评分均高于对照组.抑郁症组G等位基因频率为70%(119/170)、A等位基因频率为30%(51/170);对照组相应为51.3%(162/316)、48.7%(154/316),2组比较差异有统计学意义(P<0.05).抑郁症组G等位基因频率与负性生活事件呈正相关(P<0.05,优势比为3.102,95%可信区间为1.118～8.609);A等位基因频率与负性生活事件呈负相关(P<0.05,优势比2.962,95%可信区间为1.038～8.451).结论:BDNF基因G196A位点G等位基因可能是抑郁症患者对负性生活事件敏感的遗传基础.     

Effect of Jianpi-yangwei decoction on gut fungi in the patients with gastric cancer undergoing chemotherapy

Background:Our previous study shows that the empirical formula of Chinese medicine Jianpi-yangwei decoction(JYD)can improve the quality of life in patients with gastric cancer undergoing chemotherapy by increasing beneficial gut bacteria and decreasing harmful bacteria.The present study aims to investigate the effect of JYD on gut fungi in patients with gastric cancer undergoing chemotherapy.Methods:A total of 73 patients with gastric cancer undergoing chemotherapy were recruited.Twenty-nine patients in the chemotherapy group were given standard chemotherapy and 44 patients in the observation group were given JYD plus standard chemotherapy.A control group(55 cases)was recruited from the healthy medical examiners.After 3 months of treatment,life-quality score was evaluated and fecal microbiota was tested by high-throughput sequencing based on the 18S rRNA gene.Results:After treatment,life-quality score in the observation group was significantly lower than that in the chemotherapy group(P<0.05).There was no significant difference between the observation and control groups’diversity and richness indices of intestinal fungi.The Chao index for intestinal fungi in the chemotherapy group was significantly lower than that in the observation group(P<0.05).There was a significant difference between the control and chemotherapy groups in the intestinal fungi according to Shannon and Simpson indices(P<0.05).Linear discriminant analysis effect size analysis showed no significant differences among the three groups,but significant difference in intestinal fungi was observed between the observation group and the chemotherapy group.At the genus level,the relative abundance of the Aspergillus genus in the observation and control groups was significantly lower(P<0.05),the relative abundance of the Cutaneotrichosporon,Galactomyces,and Ganoderma genus taxa was significantly higher compared with those in the chemotherapy group(P<0.05),and there was no significant difference between the observation group and control group.Conclusion:JYD can ameliorate chemotherapy-induced fungal dysbacteriosis in patients with gastric cancer undergoing chemotherapy and improve the quality of life of patients.