WHAT BECOMES OF PEOPLE WITH DEMENTIA REFERRED TO COMMUNITY PSYCHOGERIATRIC TEAMS?

Objective: To monitor key processes and outcomes in joint health and social services community psychogeriatric teams. Design: Six month follow-up of new referrals to 4 teams in Cambridge. Data collected from structured clinical assessment forms at baseline and interviews with keyworkers at follow-up. Data for groups with and without dementia were compared. Setting: Two rural and two urban teams in area with relatively large long stay inpatient facility but low independent sector provision. All were routine service teams, rather than run for research purposes. Main outcome measures: The main outcome measures were survival, institutionalisation, key worker assessments of avoidable admissions, appropriateness of placement, unmet needs, carer stress and global outcome for patient and carers. Results: Rates of referral to urban teams were double rural rates. Around forty percent of the dementia group had a social worker as assessor and keyworker. The dementia group was significantly more dependent and received more informal and formal care. After six months, only 54% of the dementia group were alive and living outside institutional care, compared to 79% in the functionally ill group. Unplanned admissions to hospitals or homes were rarely judged avoidable by keyworkers. Outcomes for carers were judged poor in 15% of both groups, and 13% and 11% of carers respectively were judged to be under severe stress. Unmet needs were more common in the dementia group, and related principally to residential care and carer respite. A number of measures, including evidence of geographical inequity and identification of unmet needs, provided an important contribution to local policy development. Further work is needed on the validity of keyworker assessments of carer stress, given the findings of the carer interview sub-study.     

静脉血栓栓塞症护理管理干预实践与探讨

目的:规范院内静脉血栓栓塞症(VTE)的防治护理工作,为住院患者提供规范、同质的VTE护理.方法:建立院内VTE防治护理专项小组,完善VTE防治护理程序,构建VTE管理信息化平台,采用多种形式的VTE知识培训,进行VTE防治质量监控.结果:组建VTE防治护理专项小组后,VTE高危患者健康教育知晓率为84.2％,高于组建...     

Inter‐subject alignment of MEG datasets in a common representational space

Pooling neural imaging data across subjects requires aligning recordings from different subjects. In magnetoencephalography (MEG) recordings, sensors across subjects are poorly correlated both because of differences in the exact location of the sensors, and structural and functional differences in the brains. It is possible to achieve alignment by assuming that the same regions of different brains correspond across subjects. However, this relies on both the assumption that brain anatomy and function are well correlated, and the strong assumptions that go into solving the under‐determined inverse problem given the high‐dimensional source space. In this article, we investigated an alternative method that bypasses source‐localization. Instead, it analyzes the sensor recordings themselves and aligns their temporal signatures across subjects. We used a multivariate approach, multiset canonical correlation analysis (M‐CCA), to transform individual subject data to a low‐dimensional common representational space. We evaluated the robustness of this approach over a synthetic dataset, by examining the effect of different factors that add to the noise and individual differences in the data. On an MEG dataset, we demonstrated that M‐CCA performs better than a method that assumes perfect sensor correspondence and a method that applies source localization. Last, we described how the standard M‐CCA algorithm could be further improved with a regularization term that incorporates spatial sensor information. Hum Brain Mapp 38:4287–4301, 2017. © 2017 Wiley Periodicals, Inc.     

全能麻醉机演示教学模型的设计

麻醉机是麻醉的最重要器械,是麻醉设备学的主要研究内容.通过该模型的演示学习可使麻醉医师全面掌握麻醉机的结构、性能、操作要点及其可能的故障和危险.     

系列高频成分节段在正常人中的分布

将１３４例正常人按年龄分为幼儿组、学龄组、青年组和中老年组，分别观察分析了系列高频成分节段的分布特点。其分布无年龄、性别差异（Ｐ＞０．０５），系列高频成分节段对急性病毒性心肌炎的诊断特异性为８２．４１％。各年龄组的特异性分别是幼儿组９０％、学龄组８３．３％、青年组７２．４１％。中老年组８２．０５％。     

Conditioned Medium from Chondrocyte/Scaffold Constructs Induced Chondrogenic Differentiation of Bone Marrow Stromal Cells

For the application of bone marrow stromal cells (BMSCs) in cartilage tissue engineering, it is imperative to develop efficient strategies for their chondrogenic differentiation. In this study, the conditioned media derived from chondrocyte/scaffold constructs were used to direct chondrogenic differentiation of BMSCs. The porcine articular chondrocytes were seeded on the PGA/PLA scaffolds to form chondrocyte/scaffold constructs and were cultured to form engineered cartilage in vitro. The culture media were collected as conditioned media and used for chondrogenic induction of BMSC pellets (experimental group, Exp.). The chondrocyte pellets and BMSC pellets were cultured routinely as positive control (PC) and negative control (NC), respectively. After 4 weeks, the wet weight and GAG content in Exp. group and PC group were significantly higher than that in NC group. Histological and immunohistochemical analysis showed that cartilaginous tissue was formed with typical cartilage lacuna structure and positive staining of collagen Type II (Col II) in the peripheral area of the BMSC pellets in Exp. group. Gene expression of Sox9, Col II, and COMP in Exp. group and PC group were significantly higher than that in NC group. The growth factors in the conditioned media derived from human costal chondrocytes‐scaffold constructs were tested by protein microassay. The conditioned media contained low levels of TGF‐β1,2,3, IGF‐1 and high levels of IGF‐2, FGF‐4, and IGFBP4,6, and so forth. The soluble factors derived from the engineered cartilage can induce chondrogenic differentiation of BMSCs independently. Many cytokines may function in chondrogenesis in a coordinated way. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.     

术前磁共振弥散加权成像及血清CA125测定构建预测子宫内膜癌淋巴结转移模型研究

目的探讨术前磁共振弥散加权成像(magnetic resonance diffusion-weighted magnetic resonance imaging,MRDWI)、血清CA125测定及子宫内膜活检等检查方法构建预测子宫内膜癌淋巴结转移模型的价值。方法 2006年1月至2010年12月在中山大学附属中山市人民医院对196例子宫内膜癌患者的住院记录进行分析。196例患者均经术前MR-DWI评估、血清CA125测定及诊断性刮宫,术中作充分的手术病理分期和系统性盆腔或盆腔及腹主动脉旁淋巴清扫。结果 196例中164例(83.7%)经术后病理检查无淋巴结转移,32例(16.3%)有淋巴结转移。MRI弥散加权成像对子宫内膜癌侵犯宫颈的准确率达96.9%。对MR-DWI提示的肌层侵犯深度、淋巴结转移、肿瘤大小、CA125值、组织学分类、分级进行单变量及多变量logistic回归分析,得出盆腹腔MRI提示盆腔或腹主动脉旁淋巴结转移及低分化具有独立的统计学意义,P<0.05。用上述6项指标构建术前预测淋巴结转移的模型,模型全局性检验有统计学意义,P<0.01。并给各项指标附值评分1分,构建ROC曲线,获得低危组(5...     

Endogenous protein and enzyme fragments induce immunoglobulin E‐independent activation of mast cells via a G protein‐coupled receptor,MRGPRX2

Mast cells play a central role in inflammatory and allergic reactions by releasing inflammatory mediators through 2 main pathways, immunoglobulin E‐dependent and E‐independent activation. In the latter pathway, mast cells are activated by a diverse range of basic molecules (collectively known as basic secretagogues) through Mas‐related G protein‐coupled receptors (MRGPR s). In addition to the known basic secretagogues, here, we discovered several endogenous protein and enzyme fragments (such as chaperonin‐10 fragment) that act as bioactive peptides and induce immunoglobulin E‐independent mast cell activation via MRGPRX 2 (previously known as MrgX2), leading to the degranulation of mast cells. We discuss the possibility that MRGPRX 2 responds various as‐yet‐unidentified endogenous ligands that have specific characteristics, and propose that MRGPRX 2 plays an important role in regulating inflammatory responses to endogenous harmful stimuli, such as protein breakdown products released from damaged or dying cells.