复方强化戊二醛消毒液对细菌芽孢的杀菌效果观察

[目的]了解复方强化戊二醛消毒液对细菌芽孢杀灭效果。[方法]采用载体定量和定性杀菌试验进行了实验室观察和现场试验。[结果]以含23．0g／L戊二醛的复方强化戊二醛消毒液对载体上枯草杆菌黑色变种芽孢作用Ih，杀灭率〉99．9％；作用3h达到完全杀灭。能量试验对大肠杆菌最低有效浓度为1000mg／L。经模拟现场试验用含23．0g／L戊二醛消毒液对污染在止血钳上的枯草杆菌黑色变种芽孢作用3h达到完全杀灭。连续使用稳定性杀菌试验，14d后达到完全杀灭细菌芽孢的效果需要作用5h。[结论]复方强化戊二醛消毒液对细菌芽孢杀灭效果较好，性能稳定。     

Passive electrical properties of atrial fibers of the rabbit heart

Summary In order to polarize simultaneously a group of fibers of the isolated right atrium of the rabbit, a relatively large extracellular suction electrode was used and the electrotonic spread of the applied current was measured by means of microelectrodes impaled at various distances from this polarizing electrode.This method (described in detail) seemed to be reliable since in sheep Purkinje fibers the current spread with approximately the same space and time constants as when current was injected intracellularly by means of a microelectrode (Weidmann, 1952; Fozzard, 1966). In the crista terminalis and the atrial trabecula space constants of about 1 mm and 0.65 mm respectively were found. In both preparations the membrane time constant, as measured by the time-course of electrotonic potentials, was about the same, namely 3.0 msec and 2.7 msec respectively.From the conduction velocity and the time constant of the early exponential change of the foot of the propagated action potential, the specific membrane capacity of atrial fibers could be calculated to be about 1 F/cm² when assumptions were made for the specific internal resistance and the diameter of these fibers. From the values given above the specific membrane resistance of rabbit atrial fibers is of the order of 3000 ohmcm².     

Temporal profile of forced expiratory lung function in allergen-challenged Brown-Norway rats

The Brown–Norway rat is often used to study the allergic pulmonary response. However, relatively little is known about the delayed phase reactions after allergen challenge in this species. To evaluate the temporal changes in lung function and elucidate the mechanisms involved in the delayed phase response, Brown–Norway rats were sensitized and challenged to aerosolized ovalbumin and lung functions were measured by forced expiratory maneuvers and forced oscillation for up to 10 days after a single antigen challenge. Statistically significant (P < 0.05) reductions in inspiratory capacity, forced vital capacity, functional residual capacity, peak expiratory flow and maximum mid-expiratory flow and increases in respiratory system resistance and elastance were seen by 1 to 3 days after ovalbumin challenge that returned to baseline by 10 days. The reductions in lung function after ovalbumin challenge were blocked by the corticosteroid, betamethasone (1 mg/kg, p.o.). Histological evaluation of lung tissue of sensitized rats demonstrated evidence of interstitial pulmonary edema, an increase in tissue eosinophils and an increase in Periodic Acid Schiff-positive cells in the airway epithelium. Bronchoalveolar lavage fluid samples showed large numbers of eosinophils and increased mucin content up to 6 days after antigen challenge. There was also an increase in wet-to-dry lung weight ratio in the lungs of sensitized rats after antigen. These results demonstrate that prolonged reductions in lung function occur after a single antigen challenge in Brown–Norway rats that is probably due to inflammatory processes producing interstitial pulmonary edema, mucus secretion and cellular influx into the lungs.     

Recent thinking about end of life issues

Frequently, ethical dilemmas for clinicians in ICU focus on the conflict between the sanctity of life principle and other important ethical principles, such as patient autonomy or quality of life. Therefore, this chapter seeks to reveal the ethical tension between the sanctity of life and other competing ethical obligations, clearly outlining how the law in reality is making decisions and what a clinician's duties are in end of life issues.     

县级血吸虫病防治机构诊断实验室现状

目的 了解我国县级血吸虫病防治机构血吸虫病诊断实验室建设及诊断能力现状,为国家和省级有关部门制订卫生(血防)政策、优化卫生资源配置提供依据.方法 随机抽取40个国家级血吸虫病监测点所在的县级血防专业机构实验室,通过问卷调查等方式调查实验室人员、用房面积、仪器设备配置情况及常用血吸虫病诊断方法等信息;抽取各监测点10%的...     

Advance end-of-life healthcare planning in an acute NHS hospital setting; development and evaluation of the Expression of Healthcare Preferences (EHP) document

Objective: design and evaluate a document to enable older inpatientsin an NHS hospital to discuss and record end-of-life healthcarepreferences. Design: user and professional collaboration to design the Expressionof Healthcare Preferences (EHP). Prospective questionnaire surveyand outcome evaluation. Setting and Participants: inpatients on wards for older adultsin a London NHS Hospital Trust. Results: the EHP consists of a form and explanatory booklet.95 patients (mean age 81, median MMSE 28) received the EHP.61 (64% (54–74%)) read the EHP and 29 (48% (35–61%))of these recorded their healthcare preferences in the EHP form.The form prompted end-of-life care discussions between 43% (30–57%)of these patients and medical staff and between 52 (38–65)of these patients and "those close to them". The EHP was highlyrated: on a score of 1 to 10 it was thought to be helpful (medianscore 8), interesting (8), informative (8) and reassuring (7)but not upsetting (1). Conclusion: the EHP is an end-of-life advance healthcare planningtool that we have shown can be used to prompt older inpatientsto discuss and record their end-of-life healthcare preferences.     

早产儿早期干预与潜能开发项目的探讨

目的探讨社区早产儿的管理模式。方法将越秀区20个社区中心辖内206名早产儿随机分为两组,观察组100人,对照组106人,观察组接受三年的专案系统管理,定期返我院进行随访,随访内容包括Gesell测验、Peabody、运动发育量表、气质评估,生长发育监测。并参照程淮、程跃主编的《同步成长全书》制定出干预方案进行指导训练。对智力运动发育落后或疑似脑瘫的患儿及时收治进行康复综合治疗。对照组于纠正年龄后1周岁时进行随访。结果观察组体格发育、智能发育指数和运动发育指数均明显高于对照组,差异有非常显著性（P〈0．01）。结论加强对早产儿的专案管理,重视潜能开发,发现异常情况早期干预,有益于早产儿身心健康和谐发展。     

Nursing and midwifery research in Scotland: from partnership to collaboration

Nurses and midwives form the workforce that provides the greatest proportion of direct care to service users. They have the ability to make a significant impact not only on the quality and outcomes of patient care, but also on service users' and carers' perceptions of the care experience. It is therefore vital that nursing and midwifery practice has a robust knowledge and evidence base. The Scottish Executive Health Department, in partnership with other key stakeholders, launched in 2004 an 8 million pounds funding package for research and development capacity and capability initiatives for nursing, midwifery and the allied health professions. This article seeks to describe the process of engagement and partnership building that enabled this scheme to be developed. It will attempt to illustrate how the convergence of political, policy and professional agendas has provided the opportunity for nurses and midwives to set a direction of travel for research and development that will enable them to become key players within multidisciplinary research at United Kingdom and international levels.     

Functional assessment of human alcohol dehydrogenase family in ethanol metabolism: significance of first-pass metabolism

BACKGROUND: Alcohol dehydrogenase (ADH) is the principal enzyme responsible for ethanol metabolism in mammals. Human ADH constitutes a unique complex enzyme family with no equivalent counterpart in experimental rodents. This study was undertaken to quantitatively assess relative contributions of human ADH isozymes and allozymes to hepatic versus gastric metabolism of ethanol in the context of the entire family. METHODS: Kinetic parameters for ethanol oxidation for recombinant human class I ADH1A, ADH1B1, ADH1B2, ADH1B3, ADH1C1, and ADH1C2; class II ADH2; class III ADH3; and class IV ADH4 were determined in 0.1 M sodium phosphate at pH 7.5 over a wide range of substrate concentrations in the presence of 0.5 mM NAD+. The composite numerical formulations for organ steady-state ethanol clearance were established by summing up the kinetic equations of constituent isozymes/allozymes with the assessed contents in livers and gastric mucosae with different genotypes. RESULTS: In ADH1B*1 individuals, ADH1B1 and ADH1C allozymes were found to be the major contributors to hepatic-alcohol clearance; ADH2 made a significant contribution only at high ethanol levels (> 20 mM). ADH1B2 was the major hepatic contributor in ADH1B*2 individuals. ADH1C allozymes were the major contributor at low ethanol (< 2 mM), whereas ADH1B3 the major form at higher levels (> 10 mM) in ADH1B*3 individuals. For gastric mucosal-alcohol clearance, the relative contributions of ADH1C allozymes and ADH4 were converse as ethanol concentration increased. It was assessed that livers with ADH1B*1 may eliminate approximately 95% or more of single-passed ethanol as inflow sinusoidal alcohol reaches approximately 1 mM and that stomachs with different ADH1C genotypes may remove 20% to 30% of single-passed alcohol at the similar level in mucosal cells. CONCLUSIONS: This work provides just a model, but a strong one, for quantitative assessments of ethanol metabolism in the human liver and stomach. The results indicate that the hepatic-alcohol clearance of ADH1B*2 individuals is higher than that of the ADH1B*1 and those of the ADH1B*3 versus the ADH1B*1 vary depending on sinusoidal ethanol levels. The maximal capacity for potential alcohol first-pass metabolism in the liver is greater than in the stomach.     

Persisting asymmetries of vision after right side lesions

Visual neglect and extinction are well-known effects of lesions in the right hemisphere. This study shows that even with minor or no clinical signs of these deficits, and in the stable phase of recovery, asymmetric visual perception is common after right side lesions. Whole, partial and colour report experiments were used to estimate psychophysical parameters related to visual capacity and attentional weighting in 26 patients with stroke in the right side of the brain. The results were analyzed using Bundesen's Theory of Visual Attention (TVA [Bundesen, C. (1990). A theory of visual attention. Psychological Review, 97, 523-547]) including bootstrap estimation of the measurement error related to each test result [Habekost, T., & Bundesen, C. (2003). Patient assessment based on a theory of visual attention (TVA): Subtle deficits after a right frontal-subcortical lesion. Neuropsychologia, 41, 1171-1188]. Lesions were examined by MR scanning and analyzed statistically. Two main types of deficit were found. The first type was related to perception of unilateral displays, where most patients showed left side reductions of visual processing speed. This visual asymmetry correlated with injury to the putamen and surrounding white matter. The second deficit type occurred with bilateral displays, which increased the visual asymmetry (extinction effect) for most patients with large cortico-subcortical lesions, but rarely for patients with focal lesions. However, in a single case with pulvinar damage, visual asymmetry occurred selectively with bilateral stimulation. Overall, the study provided an overview of the cognitive structure and lesion anatomy of subtle visual asymmetries after right side stroke.