维拉帕米对MDR1基因转染的Swiss－3T3细胞的化疗增敏作用

为进一步了解维拉帕米对抗药性逆转作用的待征，在人ＭＤＲ１基因转染的Ｓｗｉｓｓ－３Ｔ３多药抗药性细胞，观察了维拉帕米逆转幅度与阿霉素抗性水平的关系。各个转染细胞与母细胞相比，阿霉素毒性明显降低。非毒性浓度（３Ｕｍｏｌ·Ｌ－１）的维拉帕米对阿霉素毒性的增强作用，在转染细胞均高于母细胞，但逆转幅度与抗性水平成反比。Ｓｏｕｔｈｅｒｎ杂交显示，转染细胞基因组中有ＭＤＲ１ｃＤＮＡ整合。转染细胞的阿霉素蓄积障碍可被维拉帕米纠正。讨论了药物主动转运的饱和现象在维拉帕米增强效应中的作用，以及Ｐ－糖蛋白与药物相互作用的方式。     

维拉帕米对MDR1基因转染的Swiss-3T3细胞的化疗增敏作用

为进一步了解维拉帕米对抗药性逆转作用的特征,在人MDR1基因转染的Swiss-3T3多药抗药性细胞,观察了维拉帕米逆转幅度与阿霉素抗性水平的关系。各个转染细胞与母细胞相比,阿霉素毒性明显降低。非毒性浓度(3μmol·L^-1)的维拉帕米对阿霉素毒性的增强作用,在转染细胞均高于母细胞,但逆转幅度与抗性水平成反比。Southern杂交显示,转染细胞基因组中有MDR1 cDNA整合。转染细胞的阿霉素蓄积障碍可被维拉帕米纠正。讨论了药物主动转运的饱和现象在维拉帕米增强效应中的作用,以及P-糖蛋白与药物相互作用的方式。     

Memory training interventions for older adults: a meta-analysis

A systematic review and meta-analysis of memory training research was conducted to characterize the effect of memory strategies on memory performance among cognitively intact, community-dwelling older adults, and to identify characteristics of individuals and of programs associated with improved memory. The review identified 402 publications, of which 35 studies met criteria for inclusion. The overall effect size estimate, representing the mean standardized difference in pre-post change between memory-trained and control groups, was 0.31 standard deviations (SD; 95% confidence interval (CI): 0.22, 0.39). The pre-post training effect for memory-trained interventions was 0.43 SD (95% CI: 0.29, 0.57) and the practice effect for control groups was 0.06 SD (95% CI: 0.05, 0.16). Among 10 distinct memory strategies identified in studies, meta-analytic methods revealed that training multiple strategies was associated with larger training gains (p=0.04), although this association did not reach statistical significance after adjusting for multiple comparisons. Treatment gains among memory-trained individuals were not better after training in any particular strategy, or by the average age of participants, session length, or type of control condition. These findings can inform the design of future memory training programs for older adults.     

The association between activity participation and time to discharge in the assisted living setting

OBJECTIVES: Given recent evidence that activity participation may reduce functional decline, the effect of activity on resident ability to remain in assisted living (AL) is of interest. This study examines the relationship between participation in activities and the length of time residents remain in AL. METHODS: The data reported here were gathered in the initial phase of the Maryland Assisted Living Study (MDAL), an epidemiologic study of psychiatric disorders in AL. A stratified, random sample of 198 residents of 22 AL facilities in central Maryland was evaluated using a number of cognitive, behavioral, general health, and functional assessments. The total amount of time each resident spent in group and solitary activity in the prior month was quantified. The dependent variable, time to discharge (TTD), was the number of days between the date of initial assessment by the study team and the date of death in AL, discharge, or administrative censoring. RESULTS: Greater levels of activity participation at baseline are associated with longer TTD in an univariate Cox proportional hazards model. After adjustment for global cognitive functioning, general medical health, and mobility, greater activity participation remained associated with longer TTD in AL (p=0.017). CONCLUSIONS: Higher levels of activity are associated with longer retention in the AL setting. This effect appeared to be independent of other potentially confounding factors such as general health, cognitive impairment, and mobility. This finding is consistent with the hypothesis that engagement in activities delays functional decline, but further longitudinal research is needed to understand this finding.     

Effect of dementia and treatment of dementia on time to discharge from assisted living facilities: the Maryland assisted living study

OBJECTIVES: To estimate the association between dementia and time to discharge from individual assisted living (AL) facilities and examine, in residents with dementia, factors associated with shorter duration of residence in individual AL facilities. DESIGN: Prospective cohort study. SETTING: Twenty-two AL facilities in central Maryland. PARTICIPANTS: Stratified random sample of 198 AL residents followed for a median of 18 months. MEASUREMENTS: Detailed assessments to diagnose dementia; assess treatment of dementia; and rate clinical; cognitive, functional, and quality-of-life measures. RESULTS: Residents with dementia remained in a facility 209 fewer days at the median (P=.001) than residents without dementia. After adjustment for other variables, lack of treatment for dementia (P=.01) and more-serious medical comorbidity (P=.02) were associated with earlier discharge in participants with dementia. Impaired mobility and limited activity participation had weaker associations with earlier time to discharge. CONCLUSION: Dementia may accelerate time to discharge, and its treatment may attenuate this effect. The hypothesis that the detection and treatment of dementia might delay discharge from AL should be tested in randomized trials.     

“At least we finally found out what it was”: Dementia diagnosis in minoritized populations

Background

Disparities in diagnosis persist among persons living with dementia (PLWD); most research on delayed diagnosis relies on medical records or administrative claims. This study aimed to identify factors that delay or facilitate dementia diagnoses in racial or ethnic minoritized PLWD and elicit care partner perspectives on timing and effects of diagnosis.

Methods

Maryland-based participants cared for a PLWD age 60 or older, self-identified as Black/African/African-American, Asian, or Hispanic/Latino, and spoke English. Nineteen care partner in-depth, semi-structured interviews were conducted and analyzed using conventional qualitative content analysis methods.

Results

Biological, sociocultural, and environmental factors delayed dementia diagnosis. Memory loss was the most common early symptom, but the onset was often subtle or perceived as normal aging. Stigma and secrecy surrounding dementia influenced recognition and discussion of dementia among families and communities. Diagnoses were family-initiated and started in primary care. Care partners were divided in their perceptions of diagnosis timeliness and whether earlier diagnosis would have changed outcomes. Family reactions to dementia diagnoses varied; most participants expressed a strong sentiment of service and duty to care for older family members. Participants overwhelmingly felt the benefits of obtaining a dementia diagnosis outweighed harms.

Conclusions

Numerous factors affect dementia diagnosis in racial and ethnic minoritized PLWD. Normalization of brain health discussions and systematic, proactive discussion and detection of dementia in primary care may address multilevel barriers and facilitators to diagnosis. Systems-level and community-led public health interventions may also help address disparities in brain health education and dementia diagnosis.     

咳停片祛痰作用及析方研究

目的：观察咳停片的祛痰作用，通过初步析方评价该处方的配伍合理性。方法：分复方组（咳停片）、无氯组（不含氯化铵的咳停片）和氯化铵组3组，比较3组对小鼠气管酚红排泌和青蛙食道纤毛运动的影响。结果：复方组、无氯组、氯化铵组均能增强小鼠气管酚红排泌量，加快青蛙食道纤毛运动的速度，但复方组的作用强度明显优于无氯组或氯化铵组。结论：氯化铵与中药成分的协同作用证明咳停片是一个合理的处方。