Depressive symptoms associated with psychological correlates of physical activity and perceived helpfulness of intervention features

The anti-depressive benefits of physical activity are well-evidenced; however little is known about whether people with more frequent depressive symptoms have different psychological correlates of physical activity than people with less frequent symptoms, or whether special consideration is needed in targeting web-based physical activity interventions toward people with frequent depressive symptoms. An online cross-sectional survey was used to collect data from 511 adults (age = 45.99 ± 14.73 years). Two multiple regression analyses were conducted to test the relationship between frequency of depressive symptoms and (1) psychological correlates of physical activity (i.e., intentions, perceived behavioral control, affective attitudes, instrumental attitudes, and perceived physical activity effectiveness), and (2) perceived helpfulness of a variety of web-based physical activity intervention features. People with more frequent depressive symptoms had lower perceived behavioral control of physical activity (β = −0.19), were more likely to report that goal-setting intervention tools (β = 0.10) and personally-relevant information (β = 0.09) would be helpful, and were less likely to report intervention features portraying information about how similar people are being regularly active as helpful (β = −0.10) than those with less frequent symptoms. These findings highlight key components for designing web-based physical activity intervention content for people with depressive symptoms.     

综合ICU医院感染的目标监测与分析

目的对医院综合ICU医院感染的情况进行目标监测,为预防和控制医院感染提供依据。方法对2012年1月-2013年9月医院综合ICU患者的侵入性操作与相关感染情况开展感染目标监测,并对监测的结果进行统计和分析。结果调查的ICU患者例数1 152例,发生医院感染200例,医院感染率17.36%,日感染率为16.59‰,根据病情的严重程度调整后感染的发生率为4.42%;呼吸机相关性肺炎发生率为23.32‰,导尿管相关性尿路感染率为7.18‰,静脉置管相关性血流感染率为5.18‰;感染部位以下呼吸道为主,占48.50%;检测病原菌以革兰阴性杆菌为主,其中铜绿假单胞菌最常见,占19.03%。结论综合性ICU患者的医院感染率较高,与留置各类导管及应用医疗器械而破坏患者正常的生理屏障相关,针对ICU侵入性操作应加强无菌管理和护理干预。     

朗格汉斯细胞组织细胞增生症神经变性病研究进展北大核心CSCD

朗格汉斯细胞组织细胞增生症(LCH)是一种罕见的以CD1a+CD207+树突状细胞浸润为特征的髓源性肿瘤疾病, 由于受累器官的部位和多少的不同临床表现差异很大。神经变性病(ND)是LCH中枢神经系统受累的表现之一。LCH-ND发病机制不清, 临床上主要以神经功能学障碍和进行性发展的影像学改变为特征。目前LCH-ND主要的治疗包括静脉注射免疫球蛋白、化疗及靶向治疗等。早期治疗和积极干预可能是延迟LCH-ND进展、稳定中枢神经系统功能和提高生活质量的关键。现就LCH-ND的发病机制、临床表现、诊断、治疗及临床评估作简要综述。     

177Lu-FA-DOTA-PEG-PLGA靶向可降解纳米粒子腹腔灌注治疗小鼠卵巢癌伴腹膜转移的实验研究

目的 观察放射性核素¹⁷⁷Lu标记的叶酸-二乙烯三胺五乙酸-聚乙二醇-聚乳酸共聚物(¹⁷⁷Lu-FA-DOTA-PEG-PLGA)纳米粒子的体内靶向分布,评价腹腔灌注纳米粒子治疗小鼠卵巢癌腹膜转移瘤及腹水疗效。方法 制备¹⁷⁷Lu-FA-DOTA-PEG-PLGA纳米粒子,向人卵巢癌移植瘤荷瘤小鼠尾静脉注射纳米粒子后4、24、72 h和7 d,行微型单光子发射计算机断层显像仪(micro-SPECT/CT)显像,观察纳米粒子体内分布情况。将12只人卵巢癌腹腔转移瘤裸鼠模型按随机抽签法分为阴性对照组(生理盐水)、化疗组(顺铂3 mg/kg,2次/周)和粒子组(¹⁷⁷Lu-FA-DOTA-PEG-PLGA粒子18.5 MBq),每组4只,腹腔灌注给药。7 d后行活体荧光成像评价腹腔肿瘤生长情况,计算相对抑瘤率,TUNEL法检测肿瘤细胞凋亡率,免疫组织化学法检测肿瘤Ki67增殖活性,比较治疗后各组腹水体积。结果 micro-SPECT/CT显像显示,移植瘤放射性浓聚,24 h肿瘤肌肉摄取比值(T/M)最高,为2.81±0.49。活体荧光成像显示,腹腔给药治疗后,粒子组、化疗组和阴性对照组的腹腔肿瘤荧光强度分别为(1.45±0.19)×10¹⁰、(2.21±0.36)×10¹⁰和(2.63±0.79)×10¹⁰,差异有统计学意义(F=6.09,P=0.029);粒子组和化疗组的相对肿瘤抑制率(TGI)分别为35.6%和18.6%。粒子组和化疗组的肿瘤细胞凋亡率(AI)均高于阴性对照组(F=9.96,P=0.009),粒子组和化疗组的Ki67指数均低于阴性对照组(F=9.93,P=0.013),粒子组和化疗组腹水体积均小于阴性对照组(F=13.43,P=0.006)。结论 ¹⁷⁷Lu-FA-DOTA-PEG-PLGA纳米粒子可行小鼠卵巢癌靶向显像,腹腔灌注后局部滞留和降解吸收,抑制卵巢癌腹膜转移瘤和腹水生长,为晚期卵巢癌伴腹膜转移患者诊疗提供新思路。     

Cinética de la enolasa neuroespecífica: una herramienta adicional para el pronóstico neurológico después de una parada cardiaca

Introduction and objectivesTo analyze neuron-specific enolase (NSE) kinetics as a prognostic biomarker of neurological outcome in cardiac arrest survivors treated with targeted temperature management.MethodsWe performed a retrospective analysis of patients resuscitated from in- or out-of-hospital cardiac arrest admitted from September 2006 to May 2018 in a single tertiary care center and cooled to 32 °C to 34 °C for 24 hours. Blood samples for measurement of NSE values were drawn at hospital admission and at 24, 48, and 72 hours after return of spontaneous circulation (ROSC). Neurological outcome was evaluated by means of the Cerebral Performance Category (CPC) score at 3 months and was characterized as good (CPC 1-2) or poor (CPC 3-5).ResultsOf 451 patients, 320 fulfilled the inclusion criteria and were analyzed (80.3% male, mean age 61 ± 14.1 years). Among these, 174 patients (54.4%) survived with good neurological status. Poor outcome patients had higher median NSE values at hospital admission and at 24, 48 and 72 hours after ROSC. At 48 and 72 hours after ROSC, NSE predicted poor neurological outcome with areas under the receiver-operating characteristic curves of 0.85 (95%CI, 0.81-0.90) and 0.88 (95%CI, 0.83-0.93), respectively. In addition, delta NSE values between 72 hours after ROSC and hospital admission predicted poor neurological outcome with an area under the receiver-operating characteristic curve of 0.90 (95%CI, 0.85-0.95) and was an independent predictor of unfavorable outcome on multivariate analysis (P < .001).ConclusionsIn cardiac arrest survivors treated with targeted temperature management, delta NSE values between 72 hours after ROSC and hospital admission strongly predicted poor neurological outcome.     

Ebstein畸形合并右侧旁道的射频消融及靶点图特征探讨

报道６例Ｅｂｓｔｅｉｎ畸形合并右侧房室旁道患者（１例为外科手术切断未成功），其中顺向型房室折返性心动过速（ＡＶＲＴ）５例、逆向型１例。６例中有心房颤动和电击复律史者３例。经导管射频消融均成功地阻断了旁道。与心内结构正常的１５例右后侧壁显性旁道消融结果比较，平均消融时程（１３９±７４ｍｉｎｖｓ１１３±４６ｍｉｎ）、Ｘ线曝光时间（２８±１７ｍｉｎｖｓ２３±１２ｍｉｎ）均无显著性差异（Ｐ＞０．０５）。平均随访８±５月，１例术后６个月复发，经再次消融成功。其余病例未服用任何抗心律失常药物无心动过速复发。无并发症发生。提出掌握Ｅｂｓｔｅｉｎ畸形旁道消融的有效靶点图特征及其消融的特殊性，此种病人的消融疗效可与心内结构正常的旁道者相当     

生长抑素受体介导的靶向放疗在消化系统肿瘤治疗中的研究进展

生长抑素受体介导靶向放疗是建立在对生长抑素、生长抑素类似物及其受体的研究基础之上.目前已经证实生长抑素类似物有良好的抗肿瘤效应,应用放射性核素标记生长抑素类似物与消化系统肿瘤高表达的生长抑素受体特异性和选择性结合以达到两者共同抗肿瘤作用的方法,具有重要的应用前景.本文就生长抑素受体介导的靶向放疗在消化系统肿瘤治疗方面的研究进展作一综述.