Practices of responsibility and nurses during the euthanasia programs of Nazi Germany: a discussion paper

In this paper, we focus on the contexts of moral decision-making by nurses in the euthanasia programs of Nazi Germany between 1939 and 1945 using Urban Walker's philosophical model. We use the second hypothesis of this model, that morality consists of practices of responsibility, to give an analysis of the understandings nurses had of their responsibilities in the euthanasia programs. The article starts with a brief introduction to the euthanasia programs of Nazi Germany from 1939 to 1945 and nurse participation, to illustrate how the responsibilities of nurses were manipulated. Secondly, nursing as moral practices are analysed in the context of the euthanasia programs that implement commonly shared understandings and practices of responsibility. Thirdly, the reasons that nurses gave for avoiding any responsibilities are examined. Fourthly, it is examined if nurses took any responsibility in the euthanasia programs. In conclusion, this paper discusses three points of relevance such a reflection on moral responsibility in the context of Nazi Germany has for nurses today who may be confronted with euthanasia.     

Vagus nerve stimulation-induced cognitive enhancement: Hippocampal neuroplasticity in healthy male rats

BackgroundVagus nerve stimulation (VNS) improves cognition in humans and rodents, but the effects of a single session of VNS on performance and plasticity are not well understood.ObjectiveBehavioral performance and hippocampal (HC) electrophysiology/neurotrophin expression were measured in healthy adult rats after VNS paired training to investigate changes in cognition and synaptic plasticity.MethodsPlatinum/iridium electrodes were surgically implanted around the left cervical branch of the VN of anesthetized male Sprague-Dawley rats (N = 47). VNS (100 μs biphasic pulses, 30 Hz, 0.8 mA) paired Novel Object Recognition (NOR)/Passive Avoidance Task (PAT) were assessed 24 h after training and post-mortem tissue was collected 48 h after VNS (N = 28). Electrophysiology recordings were collected using a microelectrode array system to assess functional effects on HC slices 90 min after VNS (N = 19). Sham received the same treatment without VNS and experimenters were blinded.ResultsStimulated rats exhibited improved performance in NOR (p < 0.05, n = 12) and PAT (p < 0.05, n = 14). VNS enhanced long-term potentiation (p < 0.05, n = 7–12), and spontaneous spike amplitude (p < 0.05, n = 7–12) and frequency (p < 0.05, n = 7–12) in the CA1. Immunohistochemical analysis found increased brain-derived neurotrophic factor expression in the CA1 (p < 0.05, n = 8–9) and CA2 (p < 0.01, n = 7–8).ConclusionThese findings suggest that our VNS parameters promote synaptic plasticity and target the CA1, which may mediate the positive cognitive effects of VNS. This study significantly contributes to a better understanding of VNS mediated HC synaptic plasticity, which may improve clinical utilization of VNS for cognitive enhancement.     

智能化兔膝关节持续被动活动康复仪的研制及其在兔胫骨平台骨折术后康复中的应用

目的 自行研制一套智能化兔膝关节持续被动活动(CPM)康复仪,并将其应用于兔胫骨平台骨折术后膝关节的早期康复中。 方法 根据仿生学原理设计,自制智能化兔膝关节CPM康复仪器,主要由核心机械、电控、控制程序三部分组成。选取6月龄雄性新西兰大白兔20只,行胫骨平台骨折术后,按随机数字表法分为CPM组和自由活动组。CPM组采用CPM康复仪器行早期关节活动康复,每日训练1次,每次30 min,共4周。2组大白兔均于造模前和造模成功后第3、7、14、21、28天进行体重监测以及术侧膝关节活动度和肿胀程度测量,并于造模成功28 d后于光镜下观察2组大白兔术侧关节软骨的病理结构。 结果 自制智能化兔膝关节CPM康复仪器运行过程安全可靠,可带动3只兔子同步运动,并可准确、方便地调节膝屈曲角度、运动速度和运动时间,其智能化满足实验要求。造模后第3天,2组大白兔的平均关节活动度与组内造模前比较,差异均有统计学意义(P<0.05);造模成功后第28天,CPM组的平均肿胀程度和平均关节活动度分别为（135.05±1.70）°和（0.175±0.002）cm,与自由活动组同时间点比较,差异均有统计学意义(P<0.05)。造模成功28 d后,CPM组的骨折处畸形程度以及骨折线处的光滑度均优于自由活动组。造模成功28 d后,CPM组缺损区优势组织以透明软骨为主,自由活动组缺损区优势组织以纤维软骨修复为主,且CPM组缺损区域与邻近关节软骨结合情况、软骨细胞新生情况、软骨细胞排列、细胞层次以及软骨下潮线恢复情况等均优于自由活动组。 结论 智能化兔膝关节CPM康复仪器是一种简便可靠、效果较好的胫骨平台骨折术后早期康复器械,其不仅可以促进兔子胫骨平台骨折处塑形和软骨的修复,还可改善膝关节活动度,消除肿胀。     

Convalescent plasma treatment for COVID-19: Tempering expectations with the influenza experience

The COVID-19 pandemic caused by the zoonotic coronavirus, SARS-CoV-2 has swept the world in 5 months. A proportion of cases develop severe respiratory tract infections progressing to acute respiratory distress syndrome and a diverse set of complications involving different organ systems. Faced with a lack of coronavirus-specific antiviral drugs and vaccines, hundreds of clinical trials have been undertaken to evaluate repurposed drugs. Convalescent plasma from recovered patients is an attractive option because antibodies can have direct or indirect antiviral activity and immunotherapy works well in principle, in animal models, and in anecdotal reports. However, the benefits of convalescent plasma treatment can only be clearly established through carefully designed randomized clinical trials. The experience from investigations of convalescent plasma products for severe influenza offers a cautionary tale. Despite promising pilot studies, large multicenter randomized controlled trials failed to show a benefit of convalescent plasma or hyperimmune intravenous globulin for the treatment of severe influenza A virus infection. These studies provide important lessons that should inform the planning of adequately powered randomized controlled trials to evaluate the promise of convalescent plasma therapy in COVID-19 patients.     

踝关节持续被动运动治疗脑瘫足外翻的临床疗效

目的 观察踝关节持续被动运动(CPM)治疗脑瘫患儿足外翻的临床意义。 方法 共纳入36例脑瘫患儿,按随机数字表法分为对照组、无持续被动运动(NCPM)组和CPM组,每组12例(24只足)。NCPM组给予常规康复治疗及家庭康复治疗,CPM组在NCPM组的基础上增加CPM治疗,对照组暂只进行家庭康复治疗。1个月为1个疗程,CPM组及NCPM组前20日行院内综合康复治疗,所有的项目均为每日1次,后10日行家庭康复治疗,每日1次。分别于入组前、治疗2个月和4个月后,分别对3组患儿进行足底压力测量、GMFM-88项站立及走跑跳两项评估。 结果 ①组内比较：对照组治疗前后的各数值变化差异均无统计学意义(P>0.05);治疗4个月后,NCPM组和CPM组的MMF压力百分比与治疗前比较,差异均有统计学意义(P<0.05);2组患者的(ICP+FFCP)百分比、FFP百分比差异均有统计学意义(P<0.05);2组患儿的站立评分及走跑跳评分差异均有统计学意义(P<0.05)。②组间比较：治疗4个月后, NCPM组与CPM组MMF压力百分比与对照组比较,差异有统计学意义(P<0.05);2组(ICP+FFCP)百分比及FFP百分比组间差异均有统计学意义(P<0.05);2组患儿的站立评分及走跑跳评分组间差异均有统计学意义(P<0.05);与NCPM组相比,CPM组MMF压力百分比差异无统计学意义(P>0.05),FFP百分比差异有统计学意义(P<0.05),站立评分差异有统计学意义(P<0.05),走跑跳评分差异无统计学意义(P>0.05)。 结论 常规康复治疗结合踝关节CPM治疗脑瘫患儿足外翻疗效较单纯常规康复治疗疗效显著,踝关节CPM治疗可改善脑瘫患儿步行能力。     

Transfer of serum and cells from Yersinia ruckeri vaccinated doubled-haploid hot creek rainbow trout into outcross F1 progeny elucidates mechanisms of vaccine-induced protection

Yersinia ruckeri is a well-established bacterial pathogen for many salmonid species, against which a formalin-killed bacterin vaccine has been effective in reducing disease outbreaks. Previous studies have reported conflicting results about the protective value of the systemic humoral response to Y. ruckeri vaccination. Here we directly demonstrate that plasma contains the long-term protective component elicited by both immersion and intraperitoneal injection vaccination of rainbow trout. A total of 0.5 μL of plasma from vaccinated fish provided almost complete protection against experimental challenge. Conversely, the cells obtained from peripheral blood conferred little or no protection in naïve recipients. The protective component of immune sera was IgM based on size exclusion chromatography and recognition by monoclonal antibody Warr 1–14. Immune plasma generated against a Y. ruckeri biotype 1 strain protected equally against challenges with Y. ruckeri biotype 1 and 2 strains. These results illustrate the importance of the humoral IgM response against Y. ruckeri and the use of doubled haploid rainbow trout (Oncorhynchus mykiss) and transfer of plasma/serum and cells into F1 outcross progeny as a model system for dissection of the mechanism(s) of vaccine-induced protection.     

富含胶原蛋白肽的肠内营养支持联合被动训练对重型颅脑损伤患者胃肠道功能的影响

目的探讨富含胶原蛋白肽的肠内营养支持联合被动训练对重型颅脑损伤患者胃肠道功能的影响。方法随机选取我院2015年6月至2019年9月收治的79例重型颅脑损伤住院患者为研究对象,随机分为研究组39例和对照组40例,对照组实施常规肠内营养,研究组实施富含胶原蛋白肽的肠内营养联合被动训练,对比两组呕吐、腹泻、胃潴留、便秘发生率及首次排便时间和达到肠内营养目标量时间。结果研究组呕吐、腹泻、胃潴留、便秘不良反应发生率显著低于对照组(P<0.05);研究组首次排便时间和达到肠内营养目标量时间较对照组提前(P<0.05)。结论重型颅脑损伤应用富含胶原蛋白肽肠内营养支持联合被动训练,可有效缩短首次排便时间和肠内营养目标量时间,降低呕吐、胃潴留、腹泻、便秘等胃肠道不良反应,具有临床应用价值。     

控烟是预防肺癌的主要措施——记太原市肺癌病例对照流行病学调查

背景 与目的:山西省太原市空气污染常较为严重.了解各种类型肺癌的危险因素,以采取有效的预防措施.方法:2005年3月—2007年9月,山西省太原市396例肺癌新发病例和465名健康对照者纳入本研究.利用太原市肿瘤医院病理学检查确诊的肺癌病例,配以人群为基础、随机选择的对照,进行病例对照询问调查和环境监测.分析时注意排除...     

载阿霉素聚合物纳米粒的制备、表征与体内外性能研究

目的 以两亲性三嵌段共聚物聚己内酯-聚乙二醇-聚己内酯(PCL-b-PEG-b-PCL)为载体材料,制备包载抗肿瘤药物阿霉素(DOX)的聚合物纳米粒,并对其进行体内外性能研究.方法 以PCL-b-PEG-b-PCL作为载体材料,通过薄膜水化超声分散法制备出载DOX的聚合物纳米粒,并对其形态、粒径及其分布、载药量及包封率等理化性能进行表征.采用MTS法研究载DOX聚合物纳米粒对EMT6乳腺癌细胞的细胞毒性,激光扫描共聚焦显微镜(CLSM)观察EMT6细胞对纳米粒的细胞吞噬,离体脏器荧光成像研究纳米粒在荷EMT6乳腺癌小鼠的组织分布.结果 通过薄膜水化超声分散法成功制备出载DOX聚合物纳米粒,透射电镜和扫描电镜结果表明,该纳米粒呈球形,大小均匀,具有明显的核壳结构.粒度分析表明,载DOX聚合物纳米粒的平均粒径为130.8 nm,且粒径分布较窄(多分散系数为0.200).DOX在聚合物纳米粒中的包封率和载药量分别为(86.71±2.05)％和(8.71±0.57)％.细胞毒性研究发现,空白纳米粒对EMT6细胞无毒性,而载入DOX后,DOX-NPs的细胞毒性具有时间和剂量依赖性;在DOX质量浓度较高(20 μg/ml和40μg/ml)和孵育时间较长(72 h)时,载DOX聚合物纳米粒与游离DOX的细胞毒性相当,差异无统计学意义(P＞0.05).CLSM观察发现,EMT6乳腺癌细胞与载DOX聚合物纳米粒共同孵育后,DOX的荧光在细胞质和细胞核中均有分布,但与游离DOX共同孵育后,DOX的红色荧光主要出现在细胞核中.离体脏器荧光成像研究表明,分别对荷EMT6乳腺癌小鼠尾静脉注射载DOX聚合物纳米粒及游离DOX后,载DOX聚合物纳米粒可通过增强渗透和滞留效应(EPR)在肿瘤部位有效聚集.结论 载DOX聚合物纳米粒具有适合静脉注射的粒径、高载药量和包封率及良好的被动靶向特性,是一种在肿瘤治疗中具有潜在应用前景的纳米药物递送系统.     

Mast cell corticotropin-releasing factor subtype 2 suppresses mast cell degranulation and limits the severity of anaphylaxis and stress-induced intestinal permeability

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