医护合作对类风湿性关节炎患者实施健康教育的效果评价

目的 探讨医护合作对类风湿性关节炎住院患者实施健康教育的新模式.方法 在风湿骨病科建立健康教育质量控制小组,了解患者的健康教育需求,加强护理人员的业务培训,提高护理人员的健康教育能力.医护合作应用多种健康教育方式,对患者实施有效的健康教育,并对2005年4月～2007年5月收治的103例类风湿性关节炎患者进行健康教育效果评价.结果 类风湿性关节炎患者对健康教育有着较强的需求,对病种相关知识及药物相关知识的健康教育需求最多,并渴望得到心理支持;最受欢迎的健康教育形式是医患座谈及病种咨询,其次是听专题讲座,患者间交流、阅读健康宣教资料也是患者愿意接受的方式.结论 医护合作对住院病人进行有效的健康教育,使患者治疗的依从性得到提高,患者对健康教育的效果有着较高的满意度,医护人员的业务水平、服务意识及沟通能力需要不断提高.     

LA795小鼠肺腺癌细胞系不同肺转移率克隆株流变特性的研究

本文对 ＬＡ７９５小鼠肺腺癌细胞系进行克隆分离，并以不同克隆株接种于 Ｔ７３９同基因小鼠，从而得到非转移、低转移及中转移三个瘤株，而后测定其细胞电泳时间、膜脂流动性、粘附性及剪切应力耐受性。结果表明：转移瘤株的细胞电泳率及粘附性均高于非转移瘤株，三个瘤株膜脂流动性与其肺转移率呈负相关关系，中转移瘤株剪切应力耐受性低于非转移及低转移瘤株。结合我们过去对不同转移率及途径瘤株接种于实验动物后引起其血液宏观流变性变化的研究，我们认为：肿瘤侵袭、转移过程与血液、血细胞及肿瘤自身细胞流变特性变化密切相关，在肿瘤发展早期提高血液及血细胞流变性，而在晚期降低其流变性，对抑制肿瘤转移有一定意义。     

Monitoring Therapeutic Response in a Case of Extrapulmonary Tuberculosis by Serial F-18 FDG PET/CT

Due to the low yield of AFB smear and culture in extrapulmonary tuberculosis, therapeutic responses of patients with extrapulmonary tuberculosis are usually monitored clinically and/or radiographically. Such monitoring techniques, however, are not enough to provide effective diagnosis if a remnant lesion exists after treatment. Tuberculosis presents hypermetabolic activity on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) scanning. Reported herein is a case of extrapulmonary tuberculosis where the therapeutic response was assessed via serial F-18 FDG PET/CT scanning, which was useful for detecting the extent of extrapulmonary tuberculosis and for estimating the patient’s therapeutic response.     

Ritonavir increases plasma amprenavir (APV) exposure to a similar extent when coadministered with either fosamprenavir or APV

To compare the effect of ritonavir on plasma amprenavir pharmacokinetics, healthy adults received either fosamprenavir (700 mg twice a day [BID]) or amprenavir (600 mg BID) alone and in combination with ritonavir (100 mg BID). Ritonavir increased plasma amprenavir pharmacokinetic parameters to a similar extent when coadministered with either fosamprenavir or amprenavir.     

Comparative susceptibilities of Pseudomonas aeruginosa to 1-oxacephalosporin (LY 127935) and eight other antipseudomonal antimicrobial agents (old and new)

In vitro susceptibilities of 53 clinical isolates of Pseudomonas aeruginosa to nine antipseudomonal antibiotics were determined. From 96 to 100% of the isolates were susceptible to piperacillin, ticarcillin, and 1-oxacephalosporin (LY 127935). Of the aminoglycosides, 89, 82, 79, and 29% were susceptible to amikacin, tobramycin, gentamicin, and netilmicin, respectively. A total of 96% and 78% of the isolates were susceptible to 1-oxacephalosporin (LY127935) and cefotaxime, respectively, at concentrations of 62.5 micrograms/l. Supplementation of testing media by calcium and magnesium not only markedly increased the minimal inhibitory concentrations of the aminoglycosides, but also raised those of cefotaxime and the penicillins; no significant effect was noted with 1-oxace-phalosporin. Synergy was not demonstrated consistently in vitro with 1-oxace-phalosporin combined with either carbenicillin, ticarcillin, gentamicin, or tobramycin.     

Molecular mechanism of a thumb domain hepatitis C virus nonnucleoside RNA-dependent RNA polymerase inhibitor

A new pyranoindole class of small-molecule inhibitors was studied to understand viral resistance and elucidate the mechanism of inhibition in hepatitis C virus (HCV) replication. HCV replicon variants less susceptible to inhibition by the pyranoindoles were selected in Huh-7 hepatoma cells. Variant replicons contained clusters of mutations in the NS5B polymerase gene corresponding to the drug-binding pocket on the surface of the thumb domain identified by X-ray crystallography. An additional cluster of mutations present in part of a unique beta-hairpin loop was also identified. The mutations were characterized by using recombinant replicon variants engineered with the corresponding amino acid substitutions. A single mutation (L419M or M423V), located at the pyranoindole-binding site, resulted in an 8- to 10-fold more resistant replicon, while a combination mutant (T19P, M71V, A338V, M423V, A442T) showed a 17-fold increase in drug resistance. The results of a competition experiment with purified NS5B enzyme with GTP showed that the inhibitory activity of the pyranoindole inhibitor was not affected by GTP at concentrations up to 250 microM. Following de novo initiation, the presence of a pyranoindole inhibitor resulted in the accumulation of a five-nucleotide oligomer, with a concomitant decrease in higher-molecular-weight products. The results of these studies have confirmed that pyranoindoles target the NS5B polymerase through interactions at the thumb domain. This inhibition is independent of GTP concentrations and is likely mediated by an allosteric blockade introduced by the inhibitor during the transition to RNA elongation after the formation of an initiation complex.     

Consistent and precise localization of brain activity in human primary visual cortex by MEG and fMRI

The tomographic localization of activity within human primary visual cortex (striate cortex or V1) was examined using whole-head magnetoencephalography (MEG) and 4-T functional magnetic resonance imaging (fMRI) in four subjects. Circular checkerboard pattern stimuli with radii from 1.8 to 5.2 degrees were presented at eccentricity of 8 degrees and angular position of 45 degrees in the lower quadrant of the visual field to excite the dorsal part of V1 which is distant from the V1/V2 border and from the fundus of the calcarine sulcus. Both fMRI and MEG identified spatially well-overlapped activity within the targeted area in each subject. For MEG, in three subjects a very precise activation in V1 was identified at 42 ms for at least one of the two larger stimulus sizes (radii 4.5 and 5.2 degrees ). When this V1 activity was present, it marked the beginning of a weak wave of excitations in striate and extrastriate areas which ended at 50 ms (M50). The beginning of the next wave of activations (M70) was also marked by a brief V1 activation, mainly between 50 and 60 ms. The mean separation between V1 activation centers identified by fMRI and the earliest MEG activation was 3-5 mm.     

Comparison between successful and failed sit-to-stand trials of a patient after traumatic brain injury

OBJECTIVE: To compare the peak whole-body center of mass (COM) velocities and joint angular contributions in successful and unsuccessful sit-to-stand (STS) trials in a subject with traumatic brain injury (TBI). DESIGN: Single-case study. SETTING: Motion research laboratory. PARTICIPANT: A 24-year-old man who was 3.5 years post-TBI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak horizontal and vertical velocities of the whole-body COM and peak angular velocities of the ankle, knee, hip, and shoulder joints. RESULTS: The peak whole-body COM vertical velocity was significantly lower in the unsuccessful STS trials. Angular velocities at the hip, knee, ankle, and shoulder joints in successful trials exceeded those in unsuccessful trials (P<.001). The subject's peak knee extension velocity was the single major predictor of the peak whole-body COM vertical velocity (r(2)=.90). Knee extension angular velocities greater than 3.25 radian/s were associated with successful STS trials. Knee extension angular velocities between 2.75 and 3.25 radian/s were associated with successful rising 50% of the time; the subject had no success in rising when velocities were less than 2.75 radian/s. CONCLUSIONS: For this subject, sit-back failures occurred in STS attempts characterized by peak whole-body COM vertical velocities that were lower than those generated in successful rising trials. These unsuccessful rising attempts were primarily the result of the subject's inability to generate sufficient knee extension angular velocity.     

高压氧综合救治颅脑损伤的治疗策略及转化研究

目的探讨高压氧综合救治颅脑损伤患者的治疗策略。方法对进行高压氧治疗的875例颅脑损伤患者的疗效及并发症进行回顾性分析。患者入院后由治疗小组制定药物治疗、高压氧治疗、康复计划,确定护理重点并判断预后。分别以＂首次高压氧治疗时的昏迷程度,高压氧治疗时是否已行气管切开手术,开始高压氧治疗的时间＂为分组条件,比较不同组患者之间的有效率。结果格拉斯哥昏迷评分〈9分患者的有效率为60.68%,与其他组比较最低（P〈0.05）;气管切开术后患者的有效率为48.02%,与对照组比较差异有统计学意义（P〈0.001）;首次高压氧治疗距离外伤时间〈1个月的患者有效率为88.40%,与其他组比较最高（P〈0.01）。出现并发症后及时处置。结论以高压氧治疗为主的综合治疗改善了颅脑损伤患者的预后。