Independent Japanese midwives: A qualitative study of their practise and beliefs

Aim: In the midwifery literature in English, little attention is paid to midwifery practise in Asian countries. To remedy this, we explore the knowledge and beliefs of independent Japanese midwives. Methods: We collected data in natural settings through the active participation of the authors in midwifery work after receiving informed consent. We visited midwives’ practise settings and observed ante‐partum, intra‐partum, and post‐partum midwifery practise. We also interviewed the midwives. Throughout the study, the authors discussed the findings with the participating midwives. Results: The concepts that summarize what midwives and women in our study described as the desired outcomes of care were: (i) feelings of happiness and joy; (ii) positive change; (iii) mother–child bonding; and (iv) lifelong health. The concepts that guided the midwifery process were: (i) positive communication; (ii) the woman’s commitment to her health; (iii) supporting the woman’s own way; (iv) the support of other pregnant women; (v) food as care; (vi) warmth; and (vii) respect for the natural process. The two encompassing features of midwifery practise were: (i) awareness, which includes the assurance of normalcy and the prevention of abnormalities; and (ii) networking and collaboration, which describes the relationships of midwives with their colleagues, doctors, and other health professionals. Conclusion: The traditional knowledge of Japanese midwives offers concepts that might be useful to international midwifery and should be studied more in depth.     

复方甲亢片对Graves病大鼠白细胞保护作用的实验研究

目的 研究复方甲亢片对Graves病大鼠白细胞保护作用.方法 小肠结肠炎耶尔森氏菌种尾静脉免疫注射建立Graves病大鼠模型.大鼠随机分为正常组、模型组、复方甲亢片组、中药组、他巴唑组.灌胃治疗30 d后,常规测定外周白细胞计数、骨髓有核细胞计数及粒系统比例,用酶联免疫吸附分析(ELISA)法测定血清粒-单系集落刺激因子(GM-CSF),比浊法测定血清溶菌酶.结果 与模型组比较,仅有中药组骨髓有核细胞计数显著增加(P＜0.05);与他巴唑组比较,复方甲亢片组和中药组白细胞计数和骨髓有核细胞计数增加(P＜0.05或P＜0.01);与正常组比较,模型组血清溶菌酶水平显著增加(P＜0.01);与模型组比较,仅有他巴唑组血清溶菌酶水平显著增加(P＜0.01);与他巴唑组比较,复方甲亢片组和中药组血清溶菌酶水平显著降低(P＜0.01);各组之间血清GM-CSF水平无差异.结论 复方甲亢片对GD大鼠的白细胞具有保护作用,其作用可能与增加骨髓有核细胞数、提高骨髓有核细胞粒系比例有关.     

4种代谢综合征诊断标准在河北任丘老年居民中应用的比较

目的：利用4种代谢综合征(MS)诊断标准对河北省任丘市60~70岁人群进行诊断,并分析比较4种诊断标准 MS 检出率及一致性情况。方法随机整群抽样法以任丘市年龄60~70岁的常住居民5010例为调查者,进行面对面健康问卷调查、人体测量、实验室检测,分别用中华医学会糖尿病学分会(CDS)标准、中国成人血脂异常防治指南制订联合会(JCDCG)标准、2005年美国国家胆固醇教育计划成人治疗方案第三次报告(ATPⅢ)标准、国际糖尿病联盟(IDF)标准对5010名研究对象进行 MS 诊断,分析比较4种诊断标准下 MS 及其组分检出率情况,并使用 k 值比较诊断结果的一致性。结果 ATPⅢ标准 MS 检出率最高,为53.37%(2674/5010),CDS 标准最低,为29.36%(1471/5010),JCDCG 标准 MS 检出率为32.99%(1653/5010),IDF 标准 MS 检出率为48.06%(2408/5010),4种诊断标准 MS 检出率差异有统计学意义(P <0.01);ATPⅢ标准与 IDF 标准一致性最高,一致率为94.69%,Kappa 值均为0.89。结论河北任丘老年人群 MS 患病率高,且不同诊断标准下存在较大差异,以 ATPⅢ标准筛检 MS 及其异常组分效果最佳。     

Effects of pentoxifylline on hemodynamic,hemorheological, and microcirculatory parameters in young SHRs during arterial hypertension development

The most common form of hypertension in young adults is isolated diastolic hypertension. Diastolic arterial pressure is determined by the total peripheral resistance and depends on both vascular hindrance and blood viscosity. The aim of our work was to study the efficiency of pentoxifylline (PTX) in young spontaneously hypertensive rats (SHRs) during the development of arterial hypertension. The effects of a treatment course with PTX (100 mg/kg/day p.o. for 6 weeks, from 5 to 11 weeks old) on the mean, systolic, and diastolic blood pressure (BP); stroke volume; cardiac output; total peripheral resistance (TPR); whole blood viscosity (BV); plasma viscosity; hematocrit; RBC aggregation and deformability; local cerebral blood flow (lCBF); and microvascularization of the visual cortex were studied in SHRs in comparison with control SHRs and Wistar Kyoto rats. PTX-treated SHRs had significantly lower systolic, diastolic, and mean BP (by 24%, 26%, and 15%, respectively) and BV (by 5–9%) and a higher erythrocyte deformability index (by 1.5–2%), lCBF (by 42%), average diameter of capillaries (by 11%), density of the capillary network (by 23%), and percentage of capillaries with a diameter of 3–7 µm in comparison with control SHRs. In conclusion, PTX exerted positive effects on the hemodynamic, hemorheological, and microcirculatory parameters in SHRs during the development of arterial hypertension.     

生物酶纱布创面敷料换药对糖尿病足患者的疗效分析

目的评价生物酶纱布创面敷料用于糖尿病足创面换药的临床疗效和安全性。 方法选取2015年10月至2016年10月石家庄市中医院、石家庄市第一医院、石家庄市第二医院、石家庄长城医院、河北省沧州中西医结合医院及邯郸市中医院60例糖尿病足溃疡患者,按随机数字表法分为2组,分别应用生物酶纱布创面敷料（试验组30例）和0.9%氯化钠溶液敷料（对照组30例）换药,每天更换,持续42 d。患者年龄、体质量、空腹血糖、餐后血糖、创面面积、创面愈合时间以及治疗费用经统计学分析符合正态分布,以 ±s表示,采用成组t检验比较上述指标之间的差异。患者性别构成比、细菌清除率、创面渗出和创缘反应采用卡方检验或Fisher精确检验。 结果2组患者年龄、体质量、空腹血糖以及餐后血糖等指标经统计学检验差异均无统计学意义（P值均>0.05）,具有可比性。试验组7、14 d的细菌清除率分别为84%和96%,分别高于对照组的36%和44%,差异具有统计学意义（χ²=5.30,P=0.020;χ²=9.00,P=0.003）。治疗14、21、28 d后,试验组的创面渗出评分均优于对照组,差异具有统计学意义（P<0.05）。治疗7、14、21 d后,试验组的创缘反应评分均优于对照组,差异具有统计学意义（P<0.05）。治疗1、7、14、21、28 d后,试验组的创面面积变化情况均优于对照组,差异具有统计学意义（P<0.05）。治疗28 d后,试验组和对照组的创面愈合率分别为75.42%和16.67%。创面愈合时间试验组为（28.56±13.21）d,对照组为（38.38±15.40）d,差异具有统计学意义（t=-2.65,P=0.036）。试验组患者平均治疗费用（18 202.15±9189.92）元,对照组为（26 249.86±11 458.13）元,差异具有统计学意义（t=-3.00,P=0.020）。2组患者均未发生局部和全身不良反应。 结论生物酶纱布创面敷料具有良好的杀菌效果,能减少渗出和减轻创缘反应,促进创面早日愈合,减少治疗费用。     

Immune‐mediated pancytopenia induced by oxaliplatin: a case report

BACKGROUND: Drug‐induced immune pancytopenia is considered an uncommon disorder. CASE REPORT: A 76‐year‐old woman with metastatic gastric adenocarcinoma received 15 cycles of FOLFOX‐6 (oxaliplatin/folinic acid/fluorouracil) with a complete response. Upon disease progression, she was restarted on FOLFOX; during the seventh cycle of treatment, 1 hour after completing her oxaliplatin infusion, she presented oral bleeding, petechiae and generalized hematomas. Her platelet (PLT) count decreased from 164 × 10⁹/L to less than 5 × 10⁹/L within a 3‐hour period and her white blood cells (WBCs) decreased from 5 × 10⁹ to 1.5 × 10⁹/L. One day later she presented a decrease in hemoglobin level (from 11.4 to 10 g/dL, reaching 8.9 g/dL after 5 days). The patient's PLT and lymphocyte count started to recover after 3 days of immunosuppressive treatment. STUDY DESIGN AND METHODS: PLT, red blood cell (RBC), and WBC antibody detection tests were performed in the presence and absence of oxaliplatin. PLT‐associated antibodies were evaluated by monoclonal antibody immobilization of PLT antigen assay and flow cytometry; WBC antibodies were tested by flow cytometry; and RBC antibodies were evaluated by gel and indirect antiglobulin test tube testing drug‐treated RBCs and untreated RBCs in the presence of drug. RESULTS: Positive reactions were obtained only in the presence of the drug (1 mg/mL) for all tests performed (PLTs, RBCs, and WBCs). CONCLUSIONS: Our case convincingly demonstrates that oxaliplatin led to the production of drug‐dependent PLT, RBC, and WBC antibodies inducing pancytopenia in the patient. The oxaliplatin was discontinued and patient's hematologic values recovered to normal levels.     

Clofarabine induces hypomethylation of DNA and expression of Cancer-Testis antigens

In this study, treatment of lymphoid tumor cells with low dose clofarabine upregulated the expression of Sp17 and SPAN-Xb. This was associated with an increase in hypomethylated CpG dinucleotides and a decrease in global DNA methylation, as demonstrated by decreases in the percent of methylated Alu repeats. The most optimal concentration of clofarabine to induce DNA hypomethylation and CT antigen expression was between 1 × 10⁻⁹ and 1 × 10⁻⁸ M. Above this, clofarabine resulted in tumor cell growth inhibition and apoptosis. Our results provide the first evidence for the CT antigen-inducing and DNA hypomethylating property of low concentration clofarabine.     

Axial myopia induced by hyperopic defocus in guinea pigs: A detailed assessment on susceptibility and recovery

This study investigated whether adolescent guinea pigs can develop myopia induced by negative lenses, and whether they can recover from the induced myopia. Forty-nine pigmented guinea pigs (age of 3 weeks) were randomly assigned to 4 groups: 2-week defocus (n = 16), 4-week defocus (n = 9), 2-week control (n = 15) and 4-week control (n = 9). A −4.00 D lens was worn in the defocus groups and a plano lens worn in the control groups monocularly. The lenses were worn from 3 weeks to 5 weeks of age in the 2-week treatment groups with the biometry measured at 2, 4, 6, 10 and 14 days of lens wear. The lenses were worn from 3 weeks to 7 weeks of age in the 4-week treatment groups with the biometry measured immediately and at 2, 4, 6, 10 and 14 days after lens removal. Refractions in the defocused eyes developed towards myopia rapidly within 2 days of lens wear, followed by a slower development. The defocused eyes were at least 3.00 D more myopic with a greater increase in vitreous length by 0.08 mm compared to the fellow eyes at 14 days (p < 0.05). The estimated choroidal thickness of the defocused eyes decreased rapidly within 2 days of lens wear, followed by a slower decrease over the next 4 days. Relative myopia induced by 4 weeks of negative-lens treatment declined rapidly following lens removal. A complete recovery occurred 14 days after lens removal when compared to the fellow controls. The refractive changes during the recovery corresponded to a slower vitreous lengthening and a rapid thickening of the choroid. The plano-lens wearing eyes showed a slight but significant myopic shift (<−0.80 D) with no associated biometrical changes. Guinea pigs aged 3 weeks can still develop negative lens induced myopia and this myopia is reversible after removal of the lens. The myopia and recovery are mainly due to changes in vitreous length and choroidal thickness.     

调制中频电刺激联合常规康复治疗对脑卒中偏瘫患者躯干屈曲功能恢复的影响

探讨调制中频电刺激联合常规康复治疗对脑卒中偏瘫患者躯干屈曲双侧主动肌及躯干屈曲双侧协同肌功能恢复的影响。方法将40例脑卒中偏瘫患者按不同的治疗方法分为2组:对照组和治疗组,每组20例。2组患者均采用常规康复治疗。在此基础上,治疗组加用调制中频电刺激治疗。2组疗程均为40d。观察2组患者治疗前后表面肌电信号(sEMG)特征值[最大值(MAX)和均方根值(RMS)]和躯干屈曲双侧主动肌、躯干屈曲双侧协同肌MAX、RMS及躯干屈曲双侧主动肌MAX/躯干屈曲双侧协同肌MAX比值、日常生活活动能力(采用Fulg-Meyer平衡功能评定量表评定)、Barthel指数(采用Barthel指数量表评定)的情况。结果 2组患者治疗后表面肌电MAX、RMS值与治疗前比较差异均有统计学意义(均P<0.05),治疗组患者治疗后表面肌电MAX、RMS值与对照组比较差异均有统计学意义(均P<0.05),治疗组患者治疗后躯干屈曲双侧主动肌、躯干屈曲双侧协同肌MAX、RMS值及躯干屈曲双侧主动肌MAX/躯干屈曲双侧协同肌MAX比值与对照组比较差异均有统计学意义(均P<0.05)。对照组患者治疗后Barthel ADL指数评分值与治疗前比较差异无统计学意义(P>0.05),治疗组患者治疗后日常生活活动能力、Barthel ADL指数评分值与对照组比较差异均有统计学意义(均P<0.05)。结论调制中频电刺激联合常规康复治疗对脑卒中偏瘫患者躯干屈曲双侧主动肌及躯干屈曲双侧协同肌的运动功能、平衡能力及日常生活活动能力均具有良好的改善作用。