流行性出血热并发急性呼吸衰竭(附5例临床观察)

本文报告流行性出血热并发的成人呼吸窘迫综合征5例,例1及时作气管切开,应用Bird牌呼吸机正压人工呼吸(IPPV)连续6天,改善了低氧血症而治愈,余4例死亡。提示对EHF合并ARDS病人,应早期作气管切开以呼吸机通气治疗,加强呼吸道管理,可以提高存活机会。     

Lower quality of life in young men after pediatric kidney transplantation when compared to healthy controls and survivors of childhood leukemia—a cross‐sectional study

Data about health‐related quality of life (HRQOL) in adult recipients after pediatric kidney transplantation (KTx) are scarce. In this nationwide questionnaire‐based study, HRQOL and social status in young adult men having undergone KTx during childhood (n = 29) were studied and compared to age‐ and gender‐matched healthy controls (n = 56) and survivors of childhood acute lymphoblastic leukemia (n = 52) comprising controls with another chronic disease of childhood. Altogether 41% of the KTx recipients, 50% of the leukemia survivors and 80% of the healthy controls lived in a permanent relationship. When compared with leukemia survivors, the KTx recipients reported significantly more bodily pain and worse general health (RAND‐36). Older age at time of study, longer duration of dialysis, multiple transplantations and diminished graft function correlated with lower scores. The KTx recipients had a significantly higher mean Beck Depression Inventory (BDI) score than the leukemia survivors (P = 0.000) or the healthy controls (P = 0.006). BDI scores were highest in patients who lived without a partner or children had lower educational level or were unemployed. KTx recipients had significantly lower HRQOL scores than their healthy and controls with childhood chronic disease. Early detection of psychosocial problems and poor physical functioning among these patients is warranted.     

癫痫病人生存质量及影响因素研究进展

介绍癫痫病人生存质量及影响因素研究进展,重点阐述癫痫病人生活质量测量工具、成年及儿童癫痫病人的生存质量、癫痫病人生存质量影响因素、改善病人生存质量的方法。     

A phenomenological study of early nursing experiences in Hong Kong

The experience of primary professional socialization is crucial for neophytes to learn to become a nurse. These early nursing encounters may also have long-term effects on professional development of individual nurses. However, research into the early experiences of nurses has been poorly documented. This study endeavours to reveal the early lived nursing experience amongst a group of nurses in Hong Kong. This study adopts a phenomenological approach which involves the thematic analysis of the critical incidents provided by 77 subjects. Findings revealed that incidents associated with death and dying, and clinical learning embracing interpersonal relations and professional development, were the most memorable events. Nurses were in general not equipped adequately to communicate with the dying and the grieving relatives. The subjects disclosed that positive clinical encounters confirmed their value of nursing work and motivated them to stay in the profession. Conversely, the negative experiences made them seriously consider leaving nursing. A number of implications for nursing education have been drawn from the research findings.     

Serum supplement, inoculum cell density, and accessory cell effects are dependent on the cytokine combination selected to expand human HPCs ex vivo

BACKGROUND: The prolonged periods of pancytopenia associated with cord blood transplants suggest that in some cases cell numbers may be limiting. The possibility that limiting cell numbers may be overcome and prolonged periods of pancytopenia abrogated by the transplantation of human umbilical cord blood cells expanded ex vivo has led to efforts to define optimal culture conditions for these cells. STUDY DESIGN AND METHODS: Cord blood CD34+ cells were cultured with three cytokine combinations: SCF+G-CSF+GM-CSF+MGDF (SGGM); IL-6+ SCF+MGDF+Flt3-ligand (6SMF); and IL-1+IL-3+IL-6+G-CSF+GM-CSF+SCF+Epo (GFmix). Serum effects, inoculum concentration (cells/mL) seeding density (cell/cm(2)) and accessory cell effects on the expansion of CD34+ cells were determined. RESULTS: Cellular outputs were significantly higher with fetal calf serum (FCS) than with cord blood serum (CBS) or adult group AB serum (ABS) in the presence of 6SMF, however, CBS was as effective as FCS. The best seeding concentrations varied for each of the cytokine combinations, and inoculum densities exceeding 1000 cells per cm(2) proved detrimental for cultures containing GFmix and SGGM. Accessory cell studies indicated that populations expressing the CD33 antigen inhibited the expansion of purified CD34+ cells in the presence of GFmix or SGGM, but not in the presence of 6SMF. CONCLUSION: Serum supplement, inoculum cell concentration, seeding densities, and accessory cell effects are dependent upon the cytokine combination selected to expand cord blood HPCs ex vivo. Thus, each of these measures should be assessed to establish reproducible and reliable conditions for the selection of different cytokine combinations to culture cord blood HPCs.     

Implicit Infantilizing Attitudes About Disability

This study serves as a preliminary investigation of implicit (unconscious) attitudes that associate disability with child-like features. A version of the Implicit Association Test was developed to assess the implicit association of disability-related words with words related to childhood. In order to assess its psychometric properties, this “infantilization IAT” was administered, along with a more evaluative IAT and measures of more explicit attitudes, two times over the course of three to five days to 30 staff persons of a facility that serves persons with multiple disabilities. The study's results: (1) Support the notion that individuals tend to implicitly associate disability-related words with words connoting childhood or child-like features; (2) Suggest that the infantilization IAT assesses attitudes that might not be captured through more traditional measurement strategies, and (3) Demonstrate divergent validity of the infantilization IAT when compared to results of the evaluative IAT, but (4) Also suggest relatively low test-retest reliability of the infantilization IAT.