健康教育及心理护理干预对肥胖型多囊卵巢综合征患者生活方式的影响研究

目的探讨健康教育及心理护理干预对肥胖型多囊卵巢综合征(PCOS)患者生活方式的影响。方法将100例肥胖型PCOS患者按照抽签方法随机均分为对照组与观察组各50例,对照组采用常规护理方法,观察组在此基础上采用健康教育及心理护理干预方法,比较2组护理干预前后生活方式的转变情况、生殖内分泌与脂肪代谢相关指标变化情况、心理状况变化情况以及护理干预后生活质量评分。结果 2组护理干预后生活方式(食用低脂食品、加强运动、禁烟/酒、自我疗养、合理用药、自测体重)较护理前均显著改善,且观察组改善程度大于对照组(P0.05);对照组护理干预前后生殖内分泌及脂肪代谢的相关指标(LH、T、LH/FSH、BMI、FINS及TG)水平差异均无统计学意义(P0.05),观察组护理干预前后上述指标差异均具有统计学意义(P0.05);2组护理干预前后SAS及SDS评分差异均具有统计学意义(P0.05),且护理干预后2组上述评分差异也均具有统计学意义(P0.05);根据SF-36生活质量评价标准,观察组生活质量评分显著高于对照组,差异具有统计学意义(P0.05)。结论与常规护理干预方式相比,健康教育及心理护理干预可改善肥胖型PCOS患者生活方式、心理状况及生活质量,应进行推广应用。     

不同方法检测肺炎支原体的比较

目的研究不同方法检测肺炎支原体的灵敏度和特异性。方法采集199例肺炎患者的血清和咽拭子,分别用酶联免疫吸附试验(ELISA)和荧光定量PCR技术检测肺炎支原体IgM抗体和DNA。结果 199例肺炎患者按照支原体肺炎诊断标准,61例确诊为支原体肺炎,ELISA法和PCR法检测的灵敏度分别为86.9%和96.7%,特异性分别为78.3%和97.1%。结论 PCR法检测的灵敏度和特异性均高于ELISA法。     

Enhancing public involvement in assistive technology design research

Purpose: To appraise the application of accepted good practice guidance on public involvement in assistive technology research and to identify its impact on the research team, the public, device and trial design. Methods: Critical reflection and within-project evaluation were undertaken in a case study of the development of a functional electrical stimulation device. Individual and group interviews were undertaken with lay members of a 10 strong study user advisory group and also research team members. Results: Public involvement was seen positively by research team members, who reported a positive impact on device and study designs. The public identified positive impact on confidence, skills, self-esteem, enjoyment, contribution to improving the care of others and opportunities for further involvement in research. A negative impact concerned the challenge of engaging the public in dissemination after the study end. Conclusions: The public were able to impact significantly on the design of an assistive technology device which was made more fit for purpose. Research team attitudes to public involvement were more positive after having witnessed its potential first hand. Within-project evaluation underpins this case study which presents a much needed detailed account of public involvement in assistive technology design research to add to the existing weak evidence base.

• Implications for Rehabilitation

• The evidence base for impact of public involvement in rehabilitation technology design is in need of development.

• Public involvement in co-design of rehabilitation devices can lead to technologies that are fit for purpose.

• Rehabilitation researchers need to consider the merits of active public involvement in research.

     

儿童遗尿的评估和治疗进展

遗尿(NE)俗称尿床,在5岁儿童人群中发病率高达8%~20%。虽然遗尿治疗方法很多,但仍有部分患儿治疗效果不佳或停药后复发。近年来,强调根据患儿的病史、体格检查、排尿日记、尿常规等资料,必要时行尿动力学检查,找出可能的病因和发病机制,并考虑患儿年龄、遗尿类型及治疗意愿等因素制定个体化的治疗方案。     

Biliary complications of arterial chemoembolization of hepatocellular carcinoma

Rationale and backgroundTransarterial chemoembolization (TACE) is the most frequently used palliative therapy for unresectable hepatocellular carcinoma (HCC). It is a safe and effective procedure with few major and minor complications. Rarely, biliary complications are also encountered following TACE. The goal of our study was to investigate the incidence and the presentation of biliary complications following TACE in patients with HCC.Material and methodsIn this retrospective study, data of patients with HCC who underwent TACE between June 2002 to December 2014 were obtained from the records. Their detailed information about the procedure of TACE, diagnosis of biliary complications and subsequent management details were reviewed.ResultOne hundred and sixty-eight patients with HCC underwent 305 procedures of TACE. Of these, biliary complications of various severities developed in 6 (3.6%) patients leading to an incidence of 1.9% (6/305). Minimal intrahepatic biliary dilatation (IHBD) occurred in three, biliary stricture in one and intrahepatic biloma in two patients. Supportive management was undertaken for IHBD patients while percutaneous aspiration and naso-biliary drainage was performed for the infected bilomas.ConclusionBiliary complications following TACE are infrequent. Diagnosis should be suspected clinically and confirmed with imaging. Treatment depends on the severity. Enforcing specific measures can minimize its frequency.     

18 F-FDG PET/CT显像在评价不同病理亚型淋巴瘤疗效方面的价值

目的：探讨18 F-脱氧葡萄糖(18 F-FDG) PET/CT在不同病理亚型淋巴瘤疗效的评估价值。方法收集我科近4年来治疗前后均行PET/CT检查的淋巴瘤患者资料,同时根据自愿原则随机选取治疗前已行PET/CT检查的淋巴瘤患者,于治疗2~4个疗程后再次行PET/CT检查。回顾性分析并比较43例不同病理亚型淋巴瘤病灶(包括淋巴结病灶和结外灶)治疗前最大标准摄取值( SUVmax )、滞留指数( RI)和治疗后的SUVmax并进行统计学分析。所有病例随访至少3个月。结果治疗前霍奇金淋巴瘤( HL)与非霍奇金淋巴瘤( NHL)的病灶间平均SUVmax比较及RI比较差异无统计学意义。治疗前不同病理亚型的NHL淋巴瘤病灶平均SUVmax及RI与NHL的侵袭性呈正相关性,与淋巴瘤的分期无明显相关;治疗后43例患者达到完全缓解23例,部分缓解16例,疾病稳定状态1例,复发或进展3例。治疗前后淋巴瘤病灶的SUVmax差异有统计学意义(P<0．01)。结论18 F-FDG PET/CT显像对淋巴瘤患者治疗前后病灶平均SUVmax及RI的比较分析能有效评价疗效、判断预后,并为进一步治疗方案制定提供帮助和指导。     

MRI Evaluation of Lateral Geniculate Body in Normal Aging Brain Using Quantitative Susceptibility Mapping

Objective To investigate the changes of lateral geniculate body(LGB) in the normal aging brain using quantitative susceptibility mapping(QSM) technique. Methods Magnetic resonance(MR) phase and magnitude images were acquired from enhanced gradient echo T2 star weighted angiography sequence with 16 echoes on 3.0T MR system using the head coil with 32 channels. Morphology Enabled Dipole Inversion(MEDI) method was applied for QSM, and the susceptibility value of LGB was measured by region of interest(ROI) drawn manually on three orthogonal planes. Results LGB of the middle-aged group had a higher susceptibility value(0.16±0.05 ppm) than that of the youth group(0.12±0.05 ppm) and elderly group(0.13±0.03 ppm)(all P<0.05). Partial correlation analysis demonstrated that there was significantly positive correlation between susceptibility value and age in the youth group(r=0.71, P<0.05). Conclusion LGB could clearly be identified on QSM in the brain in vivo.     

Quantitative trait loci for obesity and insulin resistance (Nob1, Nob2) and their interaction with the leptin receptor allele (LeprA720T/T1044I) in New Zealand obese mice

Abstract Aims/hypothesis. To locate genes responsible for obesity and insulin resistance, a backcross model of New Zealand obese (NZO) mice with the lean Swiss/Jackson Laboratory (SJL) strain was stablished. Results. In female NZO x F1 backcross mice, two major quantitative trait loci for variables of obesity (body weight, body mass index, total body fat) and insulin resistance (hyperinsulinaemia) were identified on chromosomes 5 (Nob1) and 19 (Nob2) close to the markers D5Mit392 and D19Mit91. The aberrant alleles have presumably contributed by the NZO genome. Whereas Nob1 contributed mainly to higher body weight, Nob2 seemed to mainly aggravate insulin resistance independent of obesity. The leptin receptor variant of NZO (Lepr ^A720T/T1044I) failed to alter any of the variables of obesity. It seemed, however, to enhance the effect of Nob1 on body weight and that of Nob2 on serum insulin concentration. When expressed in COS-7 cells, Lepr ^A720T/T1044I produced a normal basal and maximum activation with a minor increase in the EC₅₀ of leptin. Conclusions/interpretation. The data identify two new quantitative trait loci that are responsible for a major part of obesity and hyperinsulinaemia as produced by recessive genes in NZO mice. Lepr ^A720T/T1044I alone cannot produce obesity, but may enhance the effects of other obesity/insulin resistance genes in this mouse model. [Diabetologia (2000) 43: 1565–1572] Received: 20 March 2000 and in final revised form: 11 August 2000     

Study for determination of the optimal cessation period of therapy with anti-platelet agents prior to invasive endoscopic procedures

Background Anti-platelet agents are widely used for the treatment and prevention of thrombotic diseases. On the other hand, continuation of anti-platelet agents increases the risk of hemorrhagic complications in gastrointestinal endoscopy, and cessation of anti-platelet agents exposes the patient to the risk of thromboembolism. Only a few studies have actually studied the whether a cessation period is required prior to endoscopic procedures and if so, the optional duration of the period. The present study assessed the time course of primary hemostasis after the cessation of anti-platelet agents.Methods Eleven healthy men (age range, 19–29 years) were assigned to each of the following regimens: aspirin (ASA; 100 mg/day), ticlopidine (TP; 300 mg/day), and a combination of ASA (100 mg/day) and TP (300 mg/day) for 7 days. There was a washout period of more than 3 weeks between each regimen. A quantitative bleeding time test (QBT test) and platelet aggregation test were performed before the beginning of administration, on the last day of administration, and at 1, 3, and 5 days after cessation, and also at 7 days after cessation for the combination regimen.Results The average bleeding time (BT) and total bleeding loss volume (Tv) of the 11 subjects after administration of the three regimens were significantly increased compared with those before administration. With the administration of ASA, increases of BT and Tv at 3 days after cessation were not significant. The Tv at 5 days after cessation of TP was not significantly increased. With the combination regimen, the BT and Tv at 7 days after cessation were not significantly increased.Conclusions A 3-day cessation period for ASA, a 5-day cessation period for TP, and a 7-day cessation period for ASA + TP administration seem to be sufficient.