产气胶囊与产气粉在胃双重造影应用中的比较

目的:比较产气胶囊与产气粉在胃双重造影中的应用。方法:将产气粉装入胃溶胶囊,拟检患者被随机分成两组,研究组148例口服胶囊剂,对照组178例口服粉剂。结果:研究组,胶囊溶解部位为胃,产气优良率100％。无不良反应,溶解时间小于等于1min者无;对照组,产气粉溶解部位为口腔和食管,产气优良率67.41％,不良反应75.28％,溶解时间小于等于1min,96.63％(P≤0.01)。结论:产气胶囊是产气粉改型的最佳剂型。     

They Aren't for Everyone

The purpose of this research was to examine the role that caregiver support groups play for caregivers to a relative with dementia. First, we compared current caregivers who attended support groups (i.e, attendees; n = 27) with those who did not attend (i.e., nonattendees; n = 52) with respect to hassles appraisals, coping effort, and global indices of well-being (i.e., depression, negative and positive affect, life satisfaction). Next, we compared nonattendees who were unable to attend support groups due to logistical barriers (e.g., lack of transportation) with those who chose not to attend support groups. Attendees and nonattendees did not differ with respect to caregiving hassles or self-help, negative focus or escape coping strategies, although caregivers who attended support groups did engage in more help-seeking behaviors. Similarly, attendees and nonattendees did not differ with respect to any of the well-being outcomes. However, caregivers who were unable to attend support groups due to logistical barriers reponed significantly more caregiving hassles and lower positive affect than did caregivers who chose not to attend groups. Results highlight the importance of motivational and situational aspects of caregivers' support group participation.     

绿梅花中4种成分双标多测法的建立

目的 建立双标多测法同时测定绿梅花中绿原酸、芦丁、金丝桃苷、异槲皮苷4种成分含量,更经济高效地控制和评价绿梅花质量。方法 采用高效液相色谱法,流动相以含0.1%甲酸的乙腈溶液为A相,0.1%甲酸溶液为B相,流速1.0 mL·min^–1,检测波长355 nm,柱温25℃。以DRSOrigin软件筛选出绿原酸和金丝桃苷为参照物,采用双标线性校正法预测色谱峰的保留时间,以相对校正因子法测定各成分含量。结果 双标线性校正法预测不同成分保留时间的预测结果准确且优于相对保留时间法;相对校正因子法计算的含量与外标法的结果相对误差均<1%,无明显差异。10批绿梅花中绿原酸、芦丁、金丝桃苷、异槲皮苷的含量分别为46.18～69.68,3.91～8.00,1.76～3.11,3.21～5.56 mg·g^–1。结论 建立的双标多测法预测待测成分保留时间的结果准确,色谱柱的适用范围广,节省对照品,经济高效;同时也可准确测定各成分含量,为绿梅花多成分质量控制和评价提供新的思路和方法。     

吞咽障碍研究协会第15届年会热点聚焦

吞咽障碍研究协会(Dysphagia Research Society,DRS)举办的第15届年会于2007年3月7～10日在加拿大温哥华的君悦摄政酒店(Hyatt Regency Hotel)举行。来自美国、加     

放射性碘治疗在儿童分化型甲状腺癌中应用

儿童分化型甲状腺癌(cDTC)的临床病理特征及远期预后与成人分化型甲状腺癌(aDTC)存在较大差异,针对成人的诊疗策略并不能完全适用于儿童。目前cDTC的¹³¹I治疗推荐主要基于复发风险分层,相对于aDTC,现有指南中c DTC的复发风险分层体系证据有限且更多侧重淋巴结转移。新近的研究证据揭示了基因特征与c DTC的侵袭性及分化程度的关系,这将为cDTC的复发风险分层体系增加新的证据,并将有助于指导¹³¹I治疗前评估、治疗决策及预测疗效;针对融合基因的靶向治疗诱导分化联合¹³¹I治疗为儿童碘难治性(RAIR)晚期DTC的治疗提供了新的思路;动态风险度评估(DRS)体系及刺激性甲状腺球蛋白(sTg)水平或可用于cDTC的疗效评价及实时预测最终疾病状态。上述进展将有望为cDTC¹³¹I个体化精准诊疗决策提供依据。     

老年期谵妄临床特征及预后状况对照研究

目的 探讨老年期谵妄的临床特征及预后状况,为临床干预提供依据.方法将61例老年期谵妄患者按年龄不同分为两组,年龄<75岁共33例,设为A组;≥75岁共28例,设为B组;对两组的一般资料、躯体疾病状况、诱发谵妄危险因素、谵妄评分量表评分、临床疗效等资料以及出院后6月-1 a的随访结果进行对比分析.结果 两组90.20%为急性起病,一般资料差异无显著性;A组脑梗塞及老年期痴呆发病率显著低于B组(X2=5.60、17.87,P<0.05或0.01);有精神刺激、白细胞增高、低氧血症、胆红素增高等诱发谵妄危险因素均显著高于B组(P<0.05);谵妄评分量表总分及急性起病、意识水平的改变、知觉障碍、精神运动性兴奋因子分均显著高于B组(P<0.01);精神运动性抑制因子分显著低于B组(P<0.01);两组总有效率,住院死亡率差异均无显著性(P>0.05);A组出院1 a内死亡率为6.25%,B组为29.63%,A组显著低于B组(P<0.01).结论 老年期谵妄发病急,有波动病程,发病以意识障碍为主,及时诊断与治疗预后相对较好;高龄老年期谵妄抑制症状较多,出院后易罹患痴呆或加重原痴呆症状、1 a内死亡率较高,因此,对出院的老年期谵妄患者要密切随访,及时治疗躯体疾病,以改善老年期谵妄的预后.     

Quality and Feasibility of Automated Digital Retinal Imaging in the Emergency Department

BackgroundEmergency physicians (EPs) frequently evaluate patients at risk for sight-threatening conditions but may have difficulty performing direct ophthalmoscopy effectively. Digital fundus photography offers a potential alternative.ObjectiveWe sought to assess the performance of an automated digital retinal imaging platform in a real-world emergency department.MethodsWe performed a prospective, observational study of emergency department patients who were at risk for acute, nontraumatic, posterior segment pathology. Photographs were obtained using an automated digital retinal camera and were subsequently reviewed by an ophthalmologist. We recorded the number of attempts required, total time required, patient comfort, and findings on EP-performed direct ophthalmoscopy, if performed.ResultsOf 123 participants completing the study, 93 (75.6%) had ≥1 eye with a diagnostically useful image, while 29 (23.6%) had no photographs of diagnostic value. The mean number of attempts required to obtain images was 1.45 (range 1–3) and the mean elapsed time required to complete photography was 109.6 s. The mean patient comfort score was 4.6 on a 5-point scale, where 5 was the most comfortable. Direct ophthalmoscopy was performed by an emergency department provider for 19 (15.4%) patients. Acute findings were noted in 14 patients during expert review of fundus photographs, though in only 2 of these cases was direct ophthalmoscopy performed by an EP with only 1 finding ultimately identified correctly.ConclusionsAutomated digital imaging of the ocular fundus is rapidly performed, is well tolerated by patients, and can be used to obtain diagnostic quality images without the use of pharmacologic pupillary dilation in most emergency department patients who are at risk for acute posterior segment pathology.