以QC小组活动助力服务质量提升——降低低分子肝素钙皮下注射瘀青率

目的 降低低分子肝素钙皮下注射瘀青率.方法 QC小组活动.结果 低分子肝素钙皮下注射瘀青率由活动前的33.1％降低到活动后的6.1％,达到了活动目标,提高了护理质量,提升了患者满意度.     

Serum 25-hydroxyvitamin D and biochemical markers of bone metabolism in patients with juvenile idiopathic arthritis

Our objective was to evaluate the concentrations of serum 25-hydroxyvitamin D [25(OH)D], serum calcium, serum phosphorus, alkaline phosphatase, and parathormone (PTH) in patients with polyarticular juvenile idiopathic arthritis (JIA) and to associate them with disease duration and activity, bone mineral density and use of medications. In a cross-sectional and controlled study, 30 patients with polyarticular JIA were evaluated and compared to 30 healthy individuals matched for age and gender. Clinical status, anthropometry, laboratory markers in both patients and controls, and bone mineral density, only in the patients, were measured. Of the 30 patients included in the study, 23 (76.7%) were female and 16 (53.3%) non-Caucasian; mean age was 14 years (range = 4 to 20 years). Mean disease duration was 5 years (range = 1 to 12 years). The mean concentrations of serum albumin-corrected calcium (9.04 ± 0.41 mg/dL) and alkaline phosphatase (153.3 ± 100.1 IU) were significantly lower in patients with JIA than in controls (P < 0.0001 and P = 0.001, respectively). No differences in 25(OH)D, PTH or serum phosphorus were observed between JIA and control subjects. Regarding 25(OH)D concentration, 8 patients (26.7%) and 5 controls (16.7%) had 25(OH)D concentrations compatible with deficiency (lower than 20 ng/mL) and 14 patients (46.7%) and 18 controls (60%) had concentrations compatible with insufficiency (20-32 ng/mL). These values were not associated with disease activity, use of medications or bone mineral density. We observed a high frequency of 25(OH)D insufficiency and deficiency in the study sample. The compromised bone metabolism emphasizes the importance of follow-up of JIA patients.     

Yaourts et autres laits fermentés

Fermented milks, the most renown one being yoghurt, are obtained through the action of lactic acid bacteria, including Streptococcus thermophilus and other bacteria belonging for most to the genera Lactobacillus and Bifidobacterium. The product should be maintained at cold temperatures as bacteria should remain numerous and alive until consumption. The variety of the bacterial strains and added ingredients (sugar, fruits) leads to a large number of products characterized by a moderate energy density and a significant calcium content. They should thus not be forgotten when one attempts to reach nutritional balance. Yoghurts and numerous fermented milks display functionalities relevant to health, which are linked to the bacterial strains they contain. Yoghurt favours lactose digestion and some fermented milks improve symptoms of irritable bowel syndrome. Other fermented milks can be active on the immune system.     

Effect of combined treatment with perindoprilat and low-power red light laser irradiation on human erythrocyte membrane fluidity,membrane potential and acetylcholinesterase activity

Erythrocyte membrane fluidity, membrane potential and acetylcholinesterase activity were estimated after in vitro combined treatment of human erythrocytes with perindoprilat and low-power red light irradiation. Membrane fluidity was determined using fluorescent labels spectroscopy; membrane potential was evaluated by means of potential-sensitive fluorescent dyes; and acetylcholinesterase activity was estimated using the Ellman method. Both perindoprilat and laser irradiation, when used separately, increase microviscosity in the polar region and hyperpolarize the membranes in comparison with control erythrocytes. The combined action of these agents does not cause any further change in these parameters. Perindoprilat has an additional inhibitory effect on the activity of acetylcholinesterase, whereas laser irradiation causes an increase in the activity of the enzyme. Their combined action restores the initial activity of the enzyme independently of the sequence of treatment with both agents.     

Evidence for the functional compartmentalization of spike generating regions of rat mdbrain dopamine neurons recorded in vitro

The regulation of spike generation in rat midbrain dopamine (DA) neurons was investigated using in vitro intracellular recordings. DA neurons fired long (greater than 1.8 ms) action potentials that exhibited comparatively depolarized spike thresholds (approx. −35 to −45 mV). Depolarization of the DA neuron increased the duration and the threshold of subsequent action potentials. The action potential was composed of two distinct components, a fast (0.8–1.5 ms duration) initial segment (IS) spike which triggered a slow (1.5–3 ms duration) somatodendritic (SD) component. Cobalt application (2 mM) blocked the SD spike component and revealed fast TTX-sensitive spikes. These fast spikes were also observed in untreated neurons following large hyperpolarizing pulses, and showed consistent changes in threshold and amplitude during membrane depolarization. Administration of 4-aminopyridine decreased the threshold of this TTX-sensitive spike, whereas tetraethylammonium (TEA) had no effect. When the fast spike was blocked by TTX, depolarization was ineffective in triggering further spike activity. However, after the administration of TEA (but not 4-AP), high threshold cobalt-sensitive spike activity could be triggered by relatively small depolarizations. TEA increased the duration of the SD portion of the action potential without altering the action potential threshold. The effect of 4-AP on spike threshold and the increase in SD spike duration caused by TEA were similar in nature to the changes in action-potential waveforms produced by polarizing the DA neuron membrane. Drawing from evidence gathered here and in previous in vivo studies, the properties of the TTX-sensitive fast spike are consistent with those of the IS spike component of the action potential, whereas the SD component is similar in nature to the high threshold calcium spike. One hypothesis that can be drawn from these studies is that dendritic and axonal spiking regions may exist in different functional subcompartments of the DA neuron, and may be independently modulated by pharmacologically distinct conductances. Under these conditions, synaptic influences could exist to modulate dendritic excitability and thus regulate putative dendritic spike-dependent functions, such as neuronal activity state, electrical coupling, and dendritic DA synthesis and release.     

Treatment of Paget's disease of bone with a combination of intranasal salmon calcitonin and oral calcium and thiazide

Summary The purpose of this study was to establish the smallest dose of nasally administered salmon calcitonin (SCT) which, if given in conjunction with a previously published calcium/thiazide treatment, would be as effective as parenteral SCT in the treatment of Paget's disease of bone. Forty patients suffering from symptomatic Paget's disease were treated with 0.5 g calcium three times daily, 10 mg/day clopamide, and 400 IU nasally administered salmon calcitonin given once or twice weekly. This regimen was given for 5 months, after which all treatment was ceased for 4 months. Parenteral SCT (100 IU) was then given three times weekly for 5 months to 25 of the patients. With the oral/nasal treatment, the plasma alkaline phosphatase level (AP) decreased by 30±15 (SD) % when the SCT was given once weekly and by 39±11% (P<0.05) when the SCT was given twice weekly. There were similar decreases in the fasting urinary hydroxyproline: creatinine ratios. The parenteral SCT reduced the AP by 33±23%. Though reduction in bone pain was similar with both treatments, most patients preferred the oral/nasal treatment. It is concluded that the oral/nasal treatment, when the SCT is given twice weekly, has similar efficacy to parenteral SCT, and is a well tolerated, effective initial treatment for Paget's disease of bone.     

Pharmacological characterization of mitogen-activated protein kinase activation by recombinant human 5-HT<Subscript>2C</Subscript>, 5-HT<Subscript>2A</Subscript>, and 5-HT<Subscript>2B</Subscript> receptors

The type 2 serotonin (5-HT₂) receptor subfamily is known to couple to phosphoinositide hydrolysis (PI) and the subsequent mobilization of intracellular Ca²⁺, as well as the release of arachidonic acid (AA). Less is known of 5-HT₂-mediated activation of the mitogen-activated protein kinase (MAPK) or extracellular signal-regulated kinase (ERK1/2) signaling. The present study measured the relative efficacies and potencies of 5-HT agonists to activate ERK2 in non-neuronal cells expressing recombinant human 5-HT_2A, 5-HT_2B, and 5-HT_2C(ISV) receptors. 5-HT agonists stimulated ERK2 activity via all three 5-HT₂ subtypes. There were no meaningful differences in the potencies or relative efficacies of these agonists to affect ERK2 activity vs. PI accumulation or Ca²⁺ mobilization, suggesting that these pathways may be sequentially linked. Indeed, ERK2 activity was very sensitive to PKC inhibition and calcium chelation and insensitive to tyrosine kinase and PI-3-kinase inhibition. 5-HT₂ receptors efficiently couple to MAPK activation via sequential PI hydrolysis, and Ca²⁺ mobilization. This profile differs from reports of “agonist-directed trafficking of receptor stimulus” between PI/Ca²⁺ and AA pathways activated by 5-HT₂ receptors.     

常规剂量三氧化二砷对心脏功能影响的临床和实验研究

目的　研究常规剂量的三氧化二砷 (As2 O3)对急性早幼粒细胞白血病 (APL)患者心脏功能的影响。方法　通过对患者基础心率和心电图的动态观察 ,膜片钳技术对豚鼠心肌细胞用药前后动作电位和电流的监测 ,激光共聚焦技术对用药前后豚鼠心肌细胞内钙的测定 ,分析As2 O3对APL患者心脏功能影响的可能机制。结果　常规剂量的As2 O3静脉给药第 1～ 2周 ,5 2 .5 %～ 35 .0 %的APL患者产生不同程度的心脏不良反应 ,心电图上QT间期延长等。膜片钳监测显示 1,2 ,5 μmol LAs2 O3使豚鼠心肌细胞动作电位时程从 (5 6 3.0± 5 5 .8)ms分别延长到 (737.7± 131.7)ms、(84 2 .4± 115 .6 )ms和 (110 3.2± 96 .3)ms (P值分别 <0 .0 5 ,0 .0 1,0 .0 1) ,使L 型钙电流增加。激光共聚焦检测结果显示 ,1,2 ,5 μmol LAs2 O3使心肌细胞内钙增加 ,并可以被钙通道阻滞剂阻断。结论　常规剂量的As2 O3可使部分APL患者出现一过性心动过速、QT间期延长等不良反应。As2 O3对心脏功能的影响可能是通过影响心肌离子通道和细胞内钙来实现的。     

钙离子选择性电极测定奶粉中钙的方法探讨

[目的 ]　探索用钙离子选择性电极测定奶粉中钙含量方法的可行性。　 [方法 ]　摸索钙离子选择性电极测定奶粉中钙的实验条件和干扰物对测定结果的影响。　 [结果 ]　经准确度和精密度测试 ,相对误差为 -3 .2 8%～4.10 %,相对标准差为 2 .6%。　 [结论 ]　该法用于奶粉中钙测定是可行的 ,不仅简化了操作程序而且也缩短了检测时间     

豚鼠心脏氧反常损伤机制及药物保护

本文在离体灌流豚鼠心脏模型上研究了氧反常损伤的机制。结果表明：缺氧４０ｍｉｎ时，心肌钠，钾－三磷酸腺苷酶（Ｎａ~＋，Ｋ~－ＡＴＰａｓｅ）活性下降２４％（Ｐ＜０．０５），钙（Ｃａ~（２＋））含量升高２８％（Ｐ＜０．０５），丙二醛（ＭＤＡ）含量无明显变化。复氧２ｍｉｎ时，Ｎａ＋，Ｋ＋－ＡＴＰａｓｅ活性下降４８％，与缺氧４０ｍｉｎ相比有显著差异，Ｃａ~（２＋）和ＭＤＡ含量分别增加９０％和４３％；复氧２０ｍｉｎ时，Ｎａ~＋，Ｋ~＋－ＡＴＰａｓｅ活性下降７２％，Ｃａ~（２＋）和ＭＤＡ含量分别增加７．２倍和３．７倍。复氧２０～３０ｓ即有·ＯＨ和Ｏ－２产生，在复氧３ｍｉｎ时达高峰。结果提示，氧自由基可能是氧反常损伤的初始原因；小壁胺（３μＭ）和地尔硫（３μＭ）能不同程度地减轻氧反常损伤。