Comparison of Infasurf (calf lung surfactant extract) to Survanta (Beractant) in the treatment and prevention of respiratory distress syndrome

OBJECTIVE: To compare the relative safety and efficacy of Infasurf (calf lung surfactant extract; ONY, Inc, Amherst, NY, IND #27169) versus Survanta (Beractant, Ross Laboratories, Columbus, OH) in reducing the acute severity of respiratory distress syndrome (RDS) when given at birth and to infants with established RDS. DESIGN: A prospective, randomized, double-blind, multicenter clinical trial. SETTING: Thirteen neonatal intensive care units participated in the treatment arm: seven of these concurrently participated in the prevention arm. PATIENTS: The treatment arm enrolled infants of 相似文献   

Is interleukin 2 necessary for the autocrine proliferation of Theileria -infected bovine cells?

Theileria-infected bovine lymphoblastoid cells are induced to proliferate permanently such that the division of the parasites and that of their host cells occur synchronously. The mechanism by which the parasites induce the transformation of their host cells is unknown. We investigated the growth-factor dependency of a number of Theileria-infected cell lines. Supernatants of the majority of the cell lines tested in our study showed no growth-enhancing activity. However, supernatants of a limited number of cell lines occasionally enhanced the growth of parasitized cells that were used as responder cells. Thus, they contained a growth factor whose biological effect was not eliminated by an anti-interleukin-2 (anti-IL-2) antibody. Moreover, neither the proliferation of T. parva-infected cells nor that of T. annulata-infected cells was impaired by this antibody. In contrast, the anti-IL-2 antibody substantially prevented bovine peripheral blood mononuclear cells from undergoing a proliferative response upon stimulation with concanavalin A (Con A). In line with these results we observed that unlike Con A-stimulated lymphocytes, the infected cell lines did not express IL-2 mRNA. Taken together, our results suggest that Theileria-infected cells do not secrete IL-2 and that IL-2 does not play an important role in the autocrine proliferation of the parasitized host cells. Received: 30 September 1998 / Accepted: 4 November 1998     

Medial joint line knee pain: a favourable response to perimeniscal steroid injection

This study was designed to evaluate the response of medial joint line pain in the knees of middle-aged subjects to perimeniscal corticosteroid and local anaesthetic injection. The response to local anaesthetic alone was assessed in a control group of patients. Patients with recurrent effusions or mechanical symptoms were excluded. Sixty-seven orthopaedic out-patients were recruited, of whom 50 completed the 6-month study. The patients were randomly allocated to the two groups. Initial symptoms, mean ages and sex distribution were similar in the two groups. Assessment by clinical review and completion of linear analogue scales indicating the severity of pain and tenderness was performed before—and 1, 3 and 6 months after — injection.

At 6 months, 19 (73%) of the 26 patients receiving steroid were asymptomatic compared with eight (33%) of the 24 receiving local anaesthetic alone (P < 0.01).     

比较基因组杂交研究鼻咽癌遗传变异

目的 了解鼻咽癌遗传学改变的特征。方法 应用比较基因组杂交检测20例鼻咽癌基因组的不平衡即DNA的丢失或扩增。结果 鼻咽癌常见的扩增的染色体是1q、2、3q、7q、8q、12;常见的缺失的染色体为3p、9p、11q、16q。结论 鼻咽癌细胞中存在多条染色体拷贝数的改变,由此引起相应瘤基因的扩增和抑癌基因的丢失可能参与了鼻咽癌的发生、发展。     

A systematic literature review of nurse shortage and the intention to leave

chan z.c.y., tam w.s., lung m.k.y., wong w.y. & chau c.w. (2013) Journal of Nursing Management  21 , 605–613 A systematic literature review of nurse shortage and the intention to leave Aim To present the findings of a literature review regarding nurses’ intention to leave their employment or the profession. Background The nursing shortage is a problem that is being experienced worldwide. It is a problem that, left unresolved, could have a serious impact on the provision of quality health care. Understanding the reasons why nurses leave their employment or the profession is imperative if efforts to increase retention are to be successful. Evaluation Electronic databases were systematically searched to identify English research reports about nurses’ intention to leave their employment or the profession. Key results concerning the issue were extracted and synthesized. Key issues The diversified measurement instruments, samples and levels of intention to leave caused difficulties in the attempt to compare or synthesize findings. The factors influencing nurses’ intention to leave were identified and categorized into organizational and individual factors. Conclusions The reasons that trigger nurses’ intention to leave are complex and are influenced by organizational and individual factors. Further studies should be conducted to investigate how external factors such as job opportunities correlate with nurses’ intention to leave. Implications for nursing management The review provides insight that can be useful in designing and implementing strategies to maintain a sustainable workforce in nursing.     

静脉药物配置中心在防范用药失误中的作用

目的 探讨静脉药物配置中心（PIVAS）在防范用药失误中的作用。方法 医院成立质控小组，对PIVAS记录在案的用药失误进行记录、总结和分类。结果 PIVAS自成立以来，接受科室所提交的处方983876份，涉及用药失误的处方2096份，其中医师处方错误1617份；处方信息传递错误9份；PIVAS内部调配错误470份。提出用药安全问题反映医院管理水平，用药失误的防范，需要医生、护士、药师三方面共同配合。需对各阶段的错误进行分析，对错误频率高发过程加以管理和控制。结论 建立规范的操作规程．加强医护人员岗位培训，制定严格的考核、报告、奖惩制度是确保用药安全的关键。     

Sigmoid resection for diverticulitis is more difficult than for malignancies

Purpose

Sigmoid resection for diverticulitis is usually the first procedure performed when starting the learning process for laparoscopic colorectal surgery. The aim of this study is to evaluate the difficulty of laparoscopic sigmoid resection for diverticulitis in comparison to sigmoid malignancy in order to assess its role in the residents training program.

Methods

A cohort of patients was selected who suffered either from malignancy or recurrent diverticulitis in the sigmoid colon. Laparoscopic sigmoid resection was performed. The degree of difficulty was assessed by intraoperative complications and intraoperative technical challenges. Furthermore, take-overs from assistant to surgeon, surgeon to surgeon, and conversion were reported.

Results

A total of 224 patients were included, 119 (53.1%) men and 105 (46.9%) women.Patients suffering from diverticulitis had significantly less co-morbidities than those with malignancies. In the diverticulitis group, there were significantly more technical challenges. There was a higher rate in take-overs from residents (p = 0.02) as well as surgeon to surgeon (p = 0.04). The rate of conversions was also significantly higher in the diverticulitis group (p = 0.03) when compared to the malignancy group.

Conclusions

The outcomes of our study show that diverticulitis may not be the ideal condition to start the learning process for laparoscopic colorectal surgery.

     

中耳胆脂瘤和慢性化脓性中耳炎手术临床分析

目的　探讨中耳胆脂瘤和慢性化脓性中耳炎术式选择及临床效果。方法　对110例中耳乳突病变,包括中耳胆脂瘤和慢性化脓性中耳炎,根据范围显微镜下实施完壁式或开放式乳突根治,部分同时鼓室成形术,随访术后干耳状况、并发症、复发情况以及术后听力改善程度等。结果　110例患者中66例中耳胆脂瘤、44例慢性化脓性中耳炎,出现颅内外并发症者7例。手术方式：51例（46.36%）行完壁式乳突根治术,46例（41.81%）同时行鼓室成形术,59例（53.64%）行开放式乳突根治术。完壁式乳突根治术后听 力提高＞25 dB 37例（33.64%）,＞15 dB 14例（12.72%）;开放式乳突根治术后听力提高＞15 dB 5例（4.55%）,听力减退4例（3.64%）,比较手术前后言语频率区平均听阈,差异有统计学意义（P＜0.05）。术后随访1年发现开放式和完壁式两组胆脂瘤复发共4例。结论　中耳胆脂瘤与慢性化脓性中耳炎通过选择恰当手术方式可获得较好的临床疗效。