心内科临床药师参与冠心病慢病管理的实践和体会

目的通过系统研究,探讨心内科临床药师在冠心病合理与规范用药中的作用。方法通过对比研究的方法,比较接受临床药师用药教育组与未接受临床药师用药教育组在合理用药各项对比指标中的差异,对冠心病认知情况、对药物适应症了解情况、对用法用量掌握情况、对注意事项了解程度、用药依从性、生活方式改变程度、ADR发生后的应对程度进行统计学分析,以考察是否有显著性差异。结果以上各组对比数据接受心病科临床药师教育组明显优于未接受心病科临床药师用药教育组,2组差异具有统计学意义(P<0.05)。结论说明临床药师在慢病管理工作中意义显著。     

Spectrophotometric plasma iron determination from fingerpuncture specimens

A simple, sensitive, precise and reproducible micromethod for the determination of plasma iron in a 50-μl sample has been devised by modification of the ICSH reference procedure, which requires a 2-ml sample. The micromethod uses microcuvettes and substitutes ferrozine for the bathophenanthroline chromogen of the ICSH. Comparison of plasma iron values on 47 paired specimens obtained by fingerpuncture and venipuncture determined by the micro- and ICSH-methods respectively gave identical means of 15.8 μmol/l (88 μg/dl); the correlation of the two methods was r = 0.92 (p < 0.0001). The micro-method has been successfully used to measure plasma iron levels in fingerpuncture specimens collected in a field study of 429 children.     

手法联合核心稳定训练治疗老年非特异性腰痛临床研究

目的:观察手法联合核心稳定训练治疗老年非特异性腰痛的临床疗效。方法:124例随机分为研究组和对照组各62例。两组均行手法治疗,观察组加用核心稳定训练治疗。结果:治疗后两组VAS、ODI评分均较治疗前改善(P<0.01),观察组改善程度优于对照组(P<0.01)。治疗后两组闭眼单脚站立时间、闭目原地踏步时间均较治疗前延长(P<0.01),观察组延长程度大于对照组(P<0.05)。结论:手法可以瞬间纠正腰椎“骨错缝、筋出槽”,恢复力学平衡。配合核心稳定性训练,使筋强骨健,维持腰椎稳定,疗效较好且安全。     

大剂量中西药物硬膜外腔灌注治疗椎动脉型颈椎病的临床研究

目的观察大剂量中西药物硬膜外腔灌注治疗椎动脉型颈椎病的临床效果。方法以2005-01—2006-10中西药物硬膜外腔灌注治疗椎动脉型颈椎病119例为研究对象，随机分为大剂量中西药物硬膜外腔灌注治疗组（89例）和单纯静脉注射用药治疗对照组（30例），分别观察和记录治疗前后临床主要自觉症状的模拟评分，评定治疗效果。结果大剂量硬膜外腔灌注结束时即刻开始观察，治疗后所有临床主要自觉症状的模拟评分较治疗前均显著降低（P〈0．01）；与对照组比较，各观察阶段均有显著疗效。结论大剂量中西药物硬膜外腔灌注治疗颈椎病有令人满意的的疗效。     

Sensitization of primary afferents to mechanical and heat stimuli after incision in a novel in vitro mouse glabrous skin-nerve preparation

In this study, we recorded activity from afferent fibers innervating the mouse plantar skin, the same region evaluated in pain behavior experiments. We compared responses of afferents from incised and unincised hind paw skin. The plantar skin together with attached medial and lateral plantar nerves was dissected until they could be completely removed intact and placed in an organ bath chamber continuously perfused with oxygenated Kreb’s solution with the temperature maintained at 32 °C. Afferent nerve activities to feedback-controlled mechanical and heat stimuli and cooling were recorded. Eighty-five single Aδ- and C-fiber afferents were recorded, 42 from control and the remainder from incised animals. A greater proportion of C-fibers (11/34) from incised skin had spontaneous activity than in the unincised preparation (2/32). The mechanical thresholds of both Aδ- and C-fiber units were not different between control and incised groups but the responses to suprathreshold mechanical stimulation were increased in low threshold Aδ- and C-fibers. The greatest change in heat sensitivity was apparent when multi-fiber total activity was measured; threshold was reduced, total spikes were greater and the peak discharge frequency was increased. In summary, feedback-controlled stimulation identified mechanical sensitization after incision in an in vitro preparation. Few fibers were excited by cooling. Heat sensitization of primary afferents was more prominent when activities of unclassified afferents are included. The preparation allows us to study afferent function of the same tissue that is examined for in vivo pain behavior assays in mice.     

La psychiatrie de la personne âgée : enjeux et perspectives

Psychiatry in the elderly is a recent branch of psychiatry, born with the increased elderly population, and which tries to be an autonomous discipline in France. European and international Psychiatry in the elderly developed a corpus of knowledge, practices and institutional organizations of its own since 1950s. In France, its current organization is very recent and unequal between regions, so it needs to be clarified and developed. Its teaching has also to be delimited in order to give a better training for different levels of professionals, especially psychiatrists. We will discuss the current situation in France in the light of national and international data and will make hypothesis for development perspectives of its teaching.     

Cloning,phylogeny, and regional expression of a Y5 receptor mRNA in the brain of the sea lamprey (Petromyzon marinus)

The NPY receptors known as Y receptors are classified into three subfamilies, Y1, Y2, and Y5, and are involved in different physiological functions. The Y5 receptor is the only member of the Y5 subfamily, and it is present in all vertebrate groups, except for teleosts. Both molecular and pharmacological studies show that Y5 receptor is highly conserved during vertebrate evolution. Furthermore, this receptor is widely expressed in the mammalian brain, including the hypothalamus, where it is thought to take part in feeding and homeostasis regulation. Lampreys belong to the agnathan lineage, and they are thought to have branched out between the two whole‐genome duplications that occurred in vertebrates. Therefore, they are in a key position for studies on the evolution of gene families in vertebrates. Here we report the cloning, phylogeny, and brain expression pattern of the sea lamprey Y5 receptor. In phylogenetic studies, the lamprey Y5 receptor clusters in a basal position, together with Y5 receptors of other vertebrates. The mRNA of this receptor is broadly expressed in the lamprey brain, being especially abundant in hypothalamic areas. Its expression pattern is roughly similar to that reported for other vertebrates and parallels the expression pattern of the Y1 receptor subtype previously described by our group, as it occurs in mammals. Altogether, these results confirm that a Y5 receptor is present in lampreys, thus being highly conserved during the evolution of vertebrates, and suggest that it is involved in many brain functions, the only known exception being teleosts. J. Comp. Neurol. 522:1132–1154, 2014. © 2013 Wiley Periodicals, Inc.     

Postprandial coagulation activation in overweight individuals after weight loss: Acute and long-term effects of a high-monounsaturated fat diet and a low-fat diet

Diet is important in the prevention of cardiovascular disease, and it has been suggested that a high-MUFA diet is more cardioprotective than a low-fat diet. We hypothesised that the postprandial thrombotic risk profile is improved most favourably by a high-MUFA diet compared with a low-fat diet. This was tested in a parallel intervention trial on overweight individuals (aged 28.4 (SD 4.7) years) randomly assigned to a MUFA-diet (35-45% of energy as fat; > 20% as MUFA, n = 21) or a low-fat (LF) diet (20-30% of energy as fat, n = 22) for 6 months after a weight loss of ~ 10%. All foods were provided free of charge from a purpose-built supermarket. Meal tests designed after the same principles were performed before and after the dietary intervention, and blood samples were collected at 8.00 h (fasting), 12.00 h, and 18.00 h and analysed for factor VII coagulant activity (FVII:C), activated FVII, fibrinogen, prothrombin fragment 1 + 2 (F1 + 2), D-dimer, plasminogen activator inhibitor (PAI:Ag), and thrombin activatable fibrinolysis inhibitor. There were significant postprandial increases in F1 + 2 and D-dimer before and after dietary intervention, with significantly lower values after 6 months. No significant differences were observed between the postprandial changes induced by the two diets. The postprandial decrease in FVII:C and PAI:Ag did not differ before and after intervention, irrespective of the diets. Our findings suggest postprandial coagulation activation in overweight subjects with more pronounced acute than long-term effects. We observed similar effects of the MUFA diet and the LF diet on the postprandial prothrombotic risk profile.