铬对低硒状态所致心肌损伤保护机理研究

目的 研究铬对低硒状态所致心肌损伤保护作用，探讨其保护机理。方法 克山病病区粮喂养Wistar大鼠复制低硒动物模型，加铬加硒作为干预因素，观察其生长发育状况；描记心电图；玻璃微电极法测心肌细胞电生理；荧光偏振法测心肌细胞线粒体膜流动性；低温顺磁共振技术测心、肝自由基含量；生化法测血、心、肝GSH-Px及SOD活性；放射免疫法测心肌环磷酸腺苷和甲状腺激素；透射电镜观察心肌超微结构变化。结果 低硒饲料喂养动物生长延迟；心电图及心肌电生理QRS时限、Q-T间期及APD50、APD50延长；心肌细胞膜流动性降低；心肝自由基水平升高、抗氧化酶类GSH-Px及SOD活性降低；甲状腺激素T3、T4及心肌cAMP降低；心肌超微结构显示心肌损伤。铬则可改善低硒动物营养状况，恢复心肌组织生理病理学改变。结论 铬对低硒状态所致心肌损伤具有保护作用，逆转QRS时限、Q-T闻期和APD的改变；提高心肌细胞膜流动性；增强抗氧化酶活性，降低自由基水平及调整甲状腺激素和心肌cAMP代谢则是铬抗低硒心肌损伤的重要作用机制。     

Impact of COVID-19 pandemic on radiographers in the Republic of Cyprus. A questionnaire survey

IntroductionImaging is essential for the initial diagnosis and monitoring of the novel coronavirus, which emerged in Wuhan, China. This study aims to assess the insight of radiographers on how the COVID-19 pandemic has affected their work routine and if protective measures are applied.MethodA prospective observational study was conducted among radiographers registered in the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. A questionnaire composed of 28 multiple choice questions was utilised, and the data analysis was performed using SPSS software with the statistical significance assumed as p-value < 0.05.ResultsOut of 350 registered radiographers, 101 responses were received. The results showed that there are statistically significant differences regarding the working hours, the feeling of stress, the work effectiveness, the average examination time, the presence of a protocol used among the different workplaces of the participants; a private radiology centre, a private hospital or a public hospital, with a p-value 0.0022, 0.015, 0.027, 0.001, 0.0001 respectively. Also, statistically significant differences were observed in the decontamination methods used for equipment (p-value 0.007), for air (p-value 0.04) and when decontamination takes place (p-value 0.00032) among the different workplaces of the participants. Nonetheless, the majority of radiographers believe that their workplace is sufficiently provided with PPE, cleaning supplies, equipment, and with cleaning personnel and are optimistic regarding the adequacy of these provisions in the next three months.ConclusionThis study showed that in the Republic of Cyprus, there are protocols regarding protective measures against COVID-19, and the radiographers are adequately trained on how to face an infectious disease outbreak. However, work is needed in order to develop protocols that reassure the safety of patients and medical personnel while managing the excess workload effectively.Implications for practiceThis study indicates the importance of applying protective measures and protocols in the radiology departments in order to minimise the spread of the virus.     

Rapid review of virus risk communication interventions: Directions for COVID-19

ObjectiveIn response to COVID-19, we conducted a rapid review of risk communication interventions to mitigate risk from viruses to determine if such interventions are efficacious.MethodsWe searched for risk communication interventions in four databases: Medline, PsycInfo, the ProQuest Coronavirus Research Database, and CENTRAL. The search produced 1572 articles. Thirty-one articles were included in the final review.ResultsResults showed risk communication interventions can produce cognitive and behavior changes around viruses. Results were more consistently positive for interventions focused on HIV/AIDS as compared to influenza. There was no consistent best intervention approach when comparing peer health, audio/visual, and intensive multi-media interventions. Tailoring risk communication toward a target population, in comparison to not tailoring, was related to better outcomes.ConclusionThe results suggest that risk communication interventions can be efficacious at reducing risk from viruses. They also highlight the complexity of risk communication interventions. Additional research is needed to understand the mechanisms that lead risk communication to reduce risk from viruses.Practical valueResults support risk communication interventions to reduce risk from viruses.     

一次性气管切开集痰保湿防护罩在气管切开术后患者气道湿化中的应用效果

目的 评价一次性气管切开集痰保湿防护罩在气管切开术后非机械通气患者气道湿化中的应用效果。方法 选取气管切开术后非机械通气患者48例,随机将其分入传统组(n=16)、实验组(n=16)和对照组(n=16)。传统组采用2层湿纱布覆盖气管切开导管口进行湿化,实验组使用防护罩湿化,对照组使用人工鼻湿化。比较3组患者呼吸功能、气道温度和湿度、Ⅲ度黏痰以及湿化不足并发症的发生情况。结果 3组患者血氧饱和度、动脉血氧分压和动脉血二氧化碳分压在时间效应、组间效应及交互效应上比较,差异均无统计学意义(P＞0.05)。干预7 d后,实验组吸气温度高于对照组(P＜0.05),吸气湿度低于对照组(P＜0.05),且均高于传统组(P＜0.05);3组呼气温度比较,差异无统计学意义(P＞0.05),实验组与对照组呼气湿度差异无统计学意义(P＞0.05),但2组均高于传统组(P＜0.001);3组的痰液黏稠度比较,差异有统计学意义(χ²=6.400,P=0.041),3组气道出血及肺部感染发生率比较,差异无统计学意义(χ²=3.091,P=0.230;χ²=1.948,P=0.763)。结论 一次性气管切开集痰保湿防护罩能提升气管切开术后患者气道温度和湿度,有效湿化气道。     

新型冠状病毒感染疫情防控期间防护装备所致医护人员皮肤损伤的发生率及流行特征研究

背景　医疗器械相关性皮肤损伤主要发生于危重患者和矫形患者,一直是全球住院患者安全管理和专科护理的研究热点,但尚缺乏关于医护人员的报道。本次新型冠状病毒感染疫情防控期间,大量医护人员奋战在抗击疫情第一线,长时间穿戴防护装备容易引起皮肤损伤,严重危害了医护人员的健康,也增加了其被感染的风险,如何保护医护人员免受伤害成为亟待解决的问题。目的　探讨新型冠状病毒感染疫情防控期间防护装备所致医护人员皮肤损伤的发生率及流行特征,为制定有效的防护对策提供依据。方法　由本课题组研制调研问卷,主要内容包括医护人员的基本情况、防护装备佩戴情况、皮肤损伤情况、针对皮肤损伤的防护措施及损伤后处理情况。问卷通过“问卷星”网站发布,于2020-02-08至2020-02-15通过微信向抗击疫情一线的医护人员进行推送,采用自愿参与、手机“问卷星”在线填写的方法完成调研。1周内完成调研数据收集,建立数据库,并对医护人员的皮肤损伤发生率、损伤类型及流行特征进行统计分析。结果　共回收有效问卷2 901份,来源于我国19个省、3个自治区、4个直辖市的145家医院。其中,男214例（7.38%）、女2 687例（92.62%）,医生147例（5.07%）、护士2 754例（94.93%）。825例（28.44%）医护人员因佩戴防护装备发生皮肤损伤,合计皮肤损伤数量为2 794处。主要皮肤损伤类型为压力性损伤〔771例（26.58%）,人均2.53处〕、潮湿相关性皮肤损伤〔256例（8.83%）,人均2.77处〕、皮肤撕裂伤〔42例（1.45%）,人均3.12处〕。在发生皮肤损伤的825例医护人员中,存在≥2类皮肤损伤者221例（26.79%）。单因素分析显示：对于防护装备所致皮肤损伤发生率,男性高于女性（P<0.05）,31~45岁者高于≤30岁者（P<0.016 7）,工龄>10年者高于工龄<5年者（P<0.016 7）,医生高于护士（P<0.05）,武汉防疫定点医院高于其他医院（P<0.003 3）、其他医院中传染科高于其他科室（P<0.003 3）,三级防护高于二级防护、二级防护高于一级防护（P<0.016 7）,而不同连续佩戴时间医护人员皮肤损伤发生率间无统计学差异（P>0.05）。结论　抗疫防护装备所致医护人员皮肤损伤的发生率较高,并有多种类型、多个部位损伤并存现象,建议采取减压、减轻摩擦力、吸湿、护肤的综合预防措施减少医护人员皮肤损伤,同时关注性别、年龄、工作岗位等人力资源管理因素。     

经听觉统合训练改善听觉传导功能的孤独症谱系障碍患儿核心症状的变化分析

目的探究接受听觉统合训练(auditory integration training,AIT)后听觉传导功能障碍得到缓解的孤独症谱系障碍患儿核心症状的改善情况。方法将存在听觉诱发电位异常的ASD患儿分入AIT组(接受训练后恢复正常的组成试验组)、对照组A组(空白对照组)、对照B组(应用行为分析训练组),分别在各组入组时、入组1个月后、入组3个月后进行波特奇发育检核表、儿童孤独症评定量表(CARS)、孤独症治疗评定量表(ATEC)评估,以各因子分数的变化值评价核心症状改善水平。结果入组时试验组、对照A组及对照B组CARS[分别为(36.31±4.08)分,(36.33±3.76)分,(36.33±5.14)分]及ATEC语言[分别为(19.08±6.43)分,(16.40±6.42)分,(18.48±5.96)分]、社交[分别为(15.63±7.13)分,(16.05±7.57)分,(16.19±7.19)分]、感知[分别为(16.78±5.39)分,(16.92±6.75)分,(17.12±6.73)分]、自理[分别为(15.98±8.71)分、(17.93±8.22)分、(17.26±8.93)]评分均差异无统计学意义(均P>0.05)。入组1月、3月后,重复测量方差分析显示,试验组、对照B组、对照组A组CARS分值[1月:(33.96±3.79)分,(35.09±4.38)分,(34.30±3.98)分;3月:(32.95±3.15)分,(36.86±3.86)分,(33.95±3.90)分]的影响:时间主效应显著(F=22.308,P<0.01),组别主效应不显著(F=2.647,P>0.05),时间与组别存在交互作用(F=8.626,P<0.01);对ATEC语言[1月:(16.18±7.10)分,(18.62±6.63)分,(13.40±5.44)分;3月:(14.13±6.13)分,(18.40±6.35)分,(10.75±5.17)分]、社交[1月:(12.31±6.68)分,(17.76±6.82)分,(15.08±6.75)分;3月:(10.71±5.42)分,(16.31±6.30)分,(12.15±7.30)分]、感知觉[1月:(14.37±5.86)分,(17.43±7.22)分,(18.58±6.92)分;3月:(10.35±5.43)分,(16.44±7.05)分,(16.68±7.37)分]分量表分值的影响,时间主效应显著(F=35.534,40.729,40.401,均P<0.01),组别主效应亦显著(F=7.600,6.193,7.675,均P<0.01),时间与组别存在交互作用(F=7.602,3.355,7.649,均P<0.05),事后多重比较示:试验组与对照B组、对照A组与对照B组在干预后ATEC语言量表分值差异有统计学意义(I1-J1=-1.69,P1<0.05;I2-J2=-4.98,P2<0.01);试验组与对照A组在干预后ATEC社交量表分值差异有统计学意义(I-J=-4.54,P<0.01);试验组与对照A组、试验组与对照B组在干预后ATEC感知觉量表分值差异有统计学意义(I1-J1=-3.16,P1<0.05;I2-J2=-4.89,P2<0.01);对ATEC自理能力分量表分值影响的时间主效应显著(F=22.876,P<0.01),组别主效应亦显著(F=3.427,P<0.05),时间与组别无交互作用(F=1.885,P>0.05),事后多重比较示:试验组与对照A组在干预后ATEC自理能力量表分值差异有统计学意义(I-J=-4.46,P<0.05)。结论AIT训练后听觉传导功能恢复正常的ASD患儿的核心症状也能得到明显改善。     

Varenicline potentiates alcohol-induced negative subjective responses and offsets impaired eye movements

Background: Varenicline (VAR) is a partial nicotinic receptor agonist that is an effective smoking cessation medication. Preliminary evidence indicates that it may also reduce alcohol consumption, but the underlying mechanism is not clear. For example, VAR may reduce alcohol consumption by attenuating its subjectively rewarding properties or by enhancing its aversive effects. In this study, we examined the effects of an acute dose of VAR upon subjective, physiological, and objective responses to low and moderate doses of alcohol in healthy social drinkers. Methods: Healthy men and women (N = 15) participated in 6 randomized sessions; 3 sessions each with 2 mg VAR and placebo (PL) followed 3 hours later by a beverage containing PL, low‐dose alcohol (0.4 g/kg), or high‐dose alcohol (0.8 g/kg). Subjective mood and drug effects (i.e., stimulation, drug liking), physiological measures (heart rate, blood pressure), and eye tracking tasks were administered at various intervals before and after drug and alcohol administration. Results: VAR acutely increased blood pressure, heart rate, ratings of dysphoria and nausea, and also improved eye tracking performance. After alcohol drinking (vs. PL), VAR increased dysphoria and tended to reduce alcohol liking ratings. It also attenuated alcohol‐induced eye‐tracking impairments. These effects were independent of the drug’s effects on nausea before drinking. Conclusions: Our data support the theory that VAR may reduce drinking by potentiating aversive effects of alcohol. VAR also offsets alcohol‐induced eye movement impairment. The evidence suggests that VAR may decrease alcohol consumption by producing effects, which oppose the rewarding efficacy of alcohol.