Professional Commitment, Patient Safety, and Patient-Perceived Care Quality

Purpose: To examine how professional commitment influences patient safety and patient-perceived care quality.
Design: Investigators for this study used a cross-sectional design with questionnaires. A total of 348 pairs of nurses and inpatients were contacted at two medical centers in Taiwan during the period from August 2007 to January 2008, yielding 284 pairs of completed questionnaires.
Methods: Frequencies of six adverse patient events were used to measure patient safety; and the Service Quality Scale was used to measure patient-perceived care quality. Four items of the Professional Commitment Questionnaire were used to measure professional commitment. Regressions were used for the analyses.
Findings: Professional commitment positively influenced overall patient safety (ß=.19, p =.00) and overall patient-perceived care quality (ß=.13, p =.03). Furthermore, professional commitment positively influenced all patient safety indicators (ß≥.12, p ≤.04), except frequency of nosocomial infections, the coefficient of which reached borderline significance (ß=.11, p =.07). Professional commitment also positively influenced care quality in terms of responsiveness (ß=.16, p =.01) and empathy (ß=.14, p =.03).
Conclusions: Professional commitment may enhance patient safety and patient-perceived care quality.
Clinical Relevance: This study indicates that nurse professional commitment can enhance patient safety and patient-perceived care quality.     

亮氨酸对必特螺旋霉素发酵组分的影响

本文针对必特螺旋霉素发酵主要组分异戊酰基螺旋霉素以及异戊酰基螺旋霉素Ⅲ的提高，在摇瓶培养基试验中，通过一次性添加与分批添加终浓度为15．4mmol／L的亮氨酸，发现分批添加亮氨酸可以维持效价基本不变，而总异戊酰基螺旋霉素与异戊酰基螺旋霉素Ⅲ分别由对照的31．1％和12．0％提高至46．9％和19．5％。通过分析发酵过程的有机酸以及氨基酸的变化规律，讨论了亮氨酸提高必特螺旋霉素主要组分的作用机理，同时在15L发酵罐中对分批添加亮氨酸添加效果进行了验证试验，结果表明，发酵液必特螺旋霉素组分中总异戊酰基螺旋霉素和异戊酰基螺旋霉素Ⅲ在96h分别提高至59．91％和21．45％。     

Functional role of beta-adrenergic receptors in the mitogenic action of nicotine on gastric cancer cells.

We previously reported that nicotine promoted gastric cancer cell growth via upregulation of cyclooxygenase 2 (COX-2). In the present study, we further investigated whether beta-adrenoceptors, protein kinase C (PKC), and extracellular signal-regulated kinase-1/2 (ERK1/2) were involved in the modulation of COX-2 expression and cell proliferation by nicotine in AGS, a human gastric adenocarcinoma cell line. Results showed that nicotine dose dependently increased the phosphorylation of EKR1/2 and the expression of AP-1 subunits c-fos and c-jun. In this connection, the ERK1/2 inhibitor U0126 abrogated the upregulation of AP-1 and COX-2 as well as cell proliferation induced by nicotine. Moreover, nicotine induced the translocation of PKC-betaI from cytosol to membrane and increased the total levels of PKC expression. Inhibition of PKC by staurosporine attenuated nicotine-induced ERK1/2 phosphorylation and COX-2 expression. Furthermore, atenolol and ICI 118,551, a beta1- and beta2-adrenoceptor antagonist, respectively, reversed the stimulatory action of nicotine on the expression of PKC, ERK1/2 phosphorylation, and COX-2 together with cell proliferation. Collectively, these results suggest that nicotine stimulates gastric cancer cell growth through the activation of beta-adrenoceptors and the downstream PKC-betaI/ERK1/2/COX-2 pathway.     

Effects of three biodiesels and a low sulfur diesel in male rats--a pilot 4-week oral study.

Because of the accessible and renewable nature of feedstock and the potential for the reduction of harmful combustion emissions and greenhouse gases, biodiesels have received increasing interest as an alternate fuel. Oral exposure to biodiesels is a concern because of contact during refuelling, accidental ingestion and exposure through ground water contamination. Although biodiesels from various feedstock are in use commercially and experimentally, very little is known about their potential adverse effects and no data is available on their potential for ground water contamination. A study was performed on male rats following oral treatment with experimental biodiesels (dissolved in corn oil) derived from canola oil (Bio-C), soy oil (Bio-S) and fish oil (Bio-F), at 500 mg/kg body weight/day, 5 days per week, for 4 weeks. Separate groups of animals were treated with low sulfur diesel (LSD) for comparison purpose, and with corn oil alone to serve as control. The potential for ground water contamination by biodiesels was investigated by the preparation of water-accommodated fractions (WAF) followed by gas chromatographic analysis. WAF from Bio-F and Bio-S was found to have the highest level of dichloromethane extractable materials. Gas chromatographic analysis indicated that the extractable materials from biodiesels contained much higher proportion of C15-C30 materials than LSD. Increased liver weight was observed in animal treated with Bio-C, Bio-S and LSD and decreased thymus weight was found in those treated with Bio-S. Histopathological changes typical of male-rat specific hyaline-droplet nephropathy were detected in kidney tubules of animals treated with LSD, Bio-S and Bio-C. Mild adaptive changes were observed in thyroids of animals treated with LSD, Bio-S and Bio-F. Clinical chemical and biochemical changes were confined to Bio-S and LSD treated rats and included elevation in some hepatic phase-I and phase-II drug metabolizing enzymes and hepatic palmitoyl Co-A oxidase, and elevated urinary concentrations of ascorbic acid and albumin. At the given dose level of 500 mg/kg bw/day, the overall treatment-related effects of biodiesels and LSD are mild, and the severity of the treatment effects may be ranked as: LSD>Bio-S>Bio-C>Bio-F. Considered together with the presence of a higher level of water extractable materials, Bio-S may be more of a concern for potential human health than Bio-C and Bio-F in an oral exposure scenario. Further studies are needed to identify and characterize the constituents contributing to the treatment-related effects specific to these experimental biodiesels.     

One-week once-daily triple therapy for Helicobacter pylori--a pilot study

BACKGROUND/AIMS: Proton-pump inhibitor-based triple therapy given over one to two weeks is currently one of the recommended regimens for eradication of Helicobacter pylori. Most of these regimens require twice daily intake of medication. The present study explored the possibility of using a one-week once-daily triple therapy in the eradication of H. pylori. METHODOLOGY: Thirty-two consecutive patients with acid-peptic disease associated with H. pylori infection (duodenal ulcer 18 patients; gastric ulcer 8 patients; duodenitis 1 patient; gastritis 5 patients) were prospectively recruited. They were given a 1-week course of lansoprazole 30 mg, clarithromycin modified-release 500 mg, and metronidazole 800 mg, all taken once daily. RESULTS: The age of these 32 patients ranged from 17-89 years with a mean of 57.5 years. Side effects occurred in 5 patients (15.6%; 95% CI: 5.3-32.8%). All patients finished the treatment and underwent a second endoscopy. Positive endoscopic finding was found in one patient (3.1%; 95% CI: 0.07-16.2%). On intent-to-treat and per protocol analysis, the eradication rate was 87.5% (95% CI: 71.0-96.5%). CONCLUSIONS: A one-week once-daily course of lansoprazole, clarithromycin modified release and metronidazole is a safe, well-tolerated, easy to comply with, and efficacious treatment for H. pylori infection. In view of the small sample size, further studies should be performed to validate its effectiveness.     

Diabetic retinopathy: a review

Diabetic retinopathy is a progressive disease elicited by chronic exposure to high blood glucose, e.g., hyperglycemia and is generally recognized as a vascular disease like other diabetes‐related diseases. Although the pathogenesis of diabetic retinopathy has not been clearly elucidated, numerous drugs have been developed based on the current understanding of the complicated and intricate biochemical and pathophysiological aspects of the disease. Current therapy for diabetic retinopathy includes laser photocoagulation, surgery, and metabolic control. Future therapies for diabetic retinopathy are based on the pathophysiology of the disease, such as anti‐VEGF, anti‐angiogenesis, and anti‐inflammatory and anti‐extracellular matrix pathways. Several clinical trials are ongoing for diabetic macular edema using drug delivery routes including intravitreal injections, subtenon injections and intravenous injection, topical drops, and intravitreal implants. Drug Dev Res 69:1–14, 2008. © 2008 Wiley‐Liss, Inc.     

L‐type Ca2+ channel opener BayK 8644‐induced Ca2+ influx and Ca2+ release in human oral cancer cells (OC2)

The effect of BayK 8644, a chemical widely used to activate L‐type Ca²⁺ channels, on cytosolic free Ca²⁺ concentrations ([Ca²⁺]_i) in human oral cancer cells (OC2) has not been explored to date. The present study examined whether BayK 8644 altered basal [Ca²⁺]_i levels in suspended OC2 cells by using fura‐2. BayK 8644 (10 pM–10 µM) increased [Ca²⁺]_i in a concentration‐dependent manner. The Ca²⁺ signal was reduced partly by removing extracellular Ca²⁺. BayK 8644‐induced Ca²⁺ influx was blocked by nifedipine, but was not altered by the store‐operated Ca²⁺ entry inhibitors, econazole and SKF96365; protein kinase C modulators phorbol 12‐myristate 13‐acetate (PMA) and GF109203X; the protein kinase A inhibitor H89; and the phospholipase A₂ inhibitor, aristolochic acid. In Ca²⁺‐free medium, after pretreatment with 1 µM BayK 8644, 1 µM thapsigargin (an endoplasmic reticulum Ca²⁺ pump inhibitor)‐induced [Ca²⁺]_i rises were abolished; and conversely, thapsigargin pretreatment abolished BayK 8644‐induced [Ca²⁺]_i rises. Inhibition of phospholipase C with U73122 did not change BayK 8644‐induced [Ca²⁺]_i rises. Collectively, in OC2 cells, BayK 8644 induced [Ca²⁺]_i rises by causing phospholipase C‐independent Ca²⁺ release from the endoplasmic reticulum; and Ca²⁺ influx via L‐type Ca²⁺ channels. Drug Dev Res 69: 2008. © 2008 Wiley‐Liss, Inc.     

ELISA法检测HBsAg影响结果因素的分析

目的分析ELISA法检测HBsAg影响结果的原因。方法用ELISA法检测HBsAg。结论试剂的选择、标本的处理、溶血、加样时间、洗板不当、显色、操作不当等因素都影响HBsAg的检测结果。     

艾可合剂抗实验性急性前列腺炎及急性毒性实验

目的 观察艾可合剂(AKHJ)抗实验性急性前列腺炎的作用及急性毒性反应,考察其有效性和安全性.方法 用1%角叉菜胶生理盐水溶液致大鼠急性前列腺炎模型,观察AKHJ抗实验性急性前列腺炎作用.设AKHJ高、中、低3个剂量组,每日分别给予AKHJ(含生药26.0,13.0,6.5 g/kg).连续灌胃7 d.模型对照组和假手术组按同法每日灌胃等量蒸馏水.另设最大给药量组和生理盐水对照组,采用灌胃给药.结果 服用AKHJ后,模型大鼠前列腺质量不同程度减轻;光学显微镜显示腺腔内炎症细胞浸润程度及纤维母细胞增生程度有所减轻,高、中剂量组较模型对照组差别有统计学意义(P＜0.01).按生药量计算小鼠对AKHJ最大耐受量＞156.4 g/kg(生药/体质量),相当于临床给药剂量的20倍.实验期间小鼠活动略减少,未出现中毒症状,AKHJ最大给药量组和生理盐水组小鼠均无死亡,体质量增加相近.结论 AKHJ具有良好的抗急性前列腺炎作用,且毒性小,安全性高.     

Biomechanical change of lumbar unilateral graded facetectomy and strategies of its microsurgical reconstruction report of 23 cases

Objective： To evaluate the lumbar stability and the primary clinical results of unilateral facetectomy, transforaminal lumbar interbody fusion （TLIF） and unilateral pedicle screw fixation by X-Tube system. Methods： Five human lumbar cadaveric functional spine units（FSU） were obtained and graded facetectomy by 0, 1/4, 1/2, 3/4 and 4/4 were performed respectively on the left articular process of them. The stability of these 5 models was evaluated at flexion, extension, lateral bending and axial rotation. After a serial of biomechanical researches, 23 patients from June 2004 to March 2006 in our department underwent unilateral facetectomy, transforaminal lumbar interbody fusion （posterior lumbar interbody fusion） and unilateral pedicle screw instrumentation by X-Tube system. After general anaesthesia, with the guide of fluoroscopy and using X-Tube system, procedures of unilateral endoscopic facetectomy, spinal nerve root decompression, autologus spongy bone transplantation, one cage oblique insertion and unilateral pedicle screw instrumentation were performed. Results： There was no significant difference in flexion, extension, lateral bending and axial rotation of lumbar motion range after unilateral graded facetectomy. The stability of left/right axial direction was greatly affected when the range of graded facetectomy exceed 1/2. According to the Nakai criteria, for the 23 patients, the clinical result was excellent in 15 （65.2%）, good in 6 （26.1%） and fair in 2 （8.7%）. The fusion rate was 95.6% in excellent and good cases. Although partial absorption of bone grafts was observed in 1 case which might indicate a unsuccessful fusion, there was no loosing and replacement of instrument and no clinical symptoms occurred. Conclusion： The lumbar stability will be affected significantly when the range of graded facetectomy exceeds 1/2. Procedures of unilateral facetectomy, transforaminal lumbar interbody fusion and unilateral pedicle screw fixation is an optional strategy for microsurgi