Sequentially releasing dual-drug-loaded PLGA–casein core/shell nanomedicine: Design,synthesis, biocompatibility and pharmacokinetics

The present study reports an engineered poly-l-lactide-co-glycolic acid (PLGA)–casein polymer–protein hybrid nanocarrier 190 ± 12 nm in size entrapping a combination of chemically distinct (hydrophobic/hydrophilic) model drugs. A simple emulsion–precipitation route was adopted to prepare nearly monodispersed nanoparticles with distinct core/shell morphology entrapping paclitaxel (Ptx) in the core and epigallocatechin gallate (EGCG) in the shell, with the intention of providing a sequential and sustained release of these drugs. The idea was that an early release of EGCG would substantially increase the sensitivity of Ptx to cancer, thereby providing improved therapeutics at lower concentrations, with less toxicity. The hemo- and immunocompatibility of the core/shell nanomedicine was established in this study. The core/shell nanoparticles injected via the tail vein in Sprague–Dawley rats did not reveal any organ toxicity as was evident from histopathological evaluations of the major organs. In vivo pharmacokinetic studies in rats by high-performance liquid chromatography confirmed a sustained and sequential release of both the drugs in plasma, indicating prolonged circulation of the nanomedicine and enhanced availability of the drugs when compared to the bare drugs. Overall, the polymer–protein multilayered nanoparticles proved to be a promising platform for nanopolypharmaceutics.     

Working with Problems of Perversion

Psychoanalytic psychotherapists increasingly find themselves treating patients who present with problems of compulsive sexual behaviour or sexual perversions. Drawing from clinical examples and theoretical perspectives, the author delineates six key themes which encapsulate her own learning when commencing work with perverse patients. The first is the heterogeneity of this group of patients, both in terms of symptoms and presentation, but also in terms of the depth and developmental implications of the pathology. Further themes are the patient's fear of the object and the inability to bear separation. The author explores the significance of negative countertransference which may be experienced in relation to perverse patients, as well as the risks of being drawn into exhibitionistic or voyeuristic dynamics. Finally, the nature of the superego in perverse patients and the impact of this on the transference are discussed drawing on O'Shaughnessy's notion of the abnormal superego.     

Risk prediction of cerebrovascular events with carotid plaque magnetic resonance analysis: A meta-analysis

Background and purpose

It is not conclusive that magnetic resonance (MR)-based carotid atherosclerotic plaque assessment identifies high-risk features associated with cerebrovascular events. We aimed to systematically summarize the association of MR imaging (MRI)-determined intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), and thinning/rupture of the fibrous cap (TRFC) with subsequent ischemic events.

U.S. initiatives to strengthen forensic science & international standards in forensic DNA

A number of initiatives are underway in the United States in response to the 2009 critique of forensic science by a National Academy of Sciences committee. This article provides a broad review of activities including efforts of the White House National Science and Technology Council Subcommittee on Forensic Science and a partnership between the Department of Justice (DOJ) and the National Institute of Standards and Technology (NIST) to create the National Commission on Forensic Science and the Organization of Scientific Area Committees. These initiatives are seeking to improve policies and practices of forensic science. Efforts to fund research activities and aid technology transition and training in forensic science are also covered.The second portion of the article reviews standards in place or in development around the world for forensic DNA. Documentary standards are used to help define written procedures to perform testing. Physical standards serve as reference materials for calibration and traceability purposes when testing is performed. Both documentary and physical standards enable reliable data comparison, and standard data formats and common markers or testing regions are crucial for effective data sharing. Core DNA markers provide a common framework and currency for constructing DNA databases with compatible data. Recent developments in expanding core DNA markers in Europe and the United States are discussed.     

Implication of core beliefs about negative-self in neuroticism

Abstract

Objective: Core beliefs about negative-self are beliefs about self-deficiencies in basic aspects of human adaptation. Meanwhile, neuroticism is a personality trait characterised by negative emotionality, i.e., a tendency to react to stress with negative emotions. The present study tested the hypothesis that core beliefs about negative-self are implicated in neuroticism.

Methods: The subjects were 309 Japanese healthy volunteers. Core beliefs about negative-self were evaluated by the Brief Core Schema Scales, and neuroticism was evaluated by the NEO Personality Inventory-Revised.

Results: In both multiple regression analysis and structural equation modelling, higher neuroticism was strongly predicted by higher levels of core beliefs about negative-self.

Limitations: The present study cannot determine the causal relationship between core beliefs about negative-self and neuroticism, because of its cross sectional design.

Conclusions: The present study suggests that core beliefs about negative-self are deeply implicated in neuroticism.

• Key Points

• Implication of core beliefs about negative-self in neuroticism was examined.

• Neuroticism was predicted by higher levels of these core beliefs.

• These core beliefs may be involved in negative emotionality of neuroticism.

     

基于核心能力的临床医学专业研究生课程体系建设研究

临床医学专业研究生课程体系是培养研究生过程中极为重要的环节，课程是实现教育教学目标的关键载体和平台。目前，我国对于临床医学教育提出了创新改革课程体系的具体要求。2019年我国教育部发布了《教育部卫生部关于加强医学教育工作提高医学教育质量的若干意见》，表示各大医学高校要“积极全面开展课程体系革新，使得医学知识与自然科学和人文科学知识的融合”。突出学生的教学主体性，创建学生为中心的专业教学模式，大力促进教学方法的创新和实践，强化学生综合知识能力、创新意识以及批判性思维的培养和锻炼。本文对基于核心能力的临床医学专业研究生课程体系建设进行研究，并提出具体的建设策略，以期为我国临床医学专业研究生培养提供有价值的参考建议。     

Training Clinical Psychology Students in Aging

Many conference reports have urged various strategies to increase the numbers of mental health service providers to the aged. The effectiveness of two strategies-specialized training and the infusion of gerontological content into regular professional curricula-were addressed in a program evaluation. Two groups of clinical psychology doctoral trainees were assessed on knowledge, attitudes, and akills. One group was in a special clinical-aging track; the other had different primary interests but-by virtue of being in the same graduate program-encountered gerontological content. The results support the suggestion that exposure to aging indirectly can contribute to increased knowledge and sophistication.     

Expression of core?binding factor alpha 1 and collagen Ⅱ in patients with chronic kidney disease stage 5

Objective To study the relationship between the medial artery calcification and expression of core?binding factor alpha 1 (Cbfα?1) and collagen Ⅱ (ColⅡ) in chronic kidney disease(CKD) stage 5 patients. Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation. Ten patients with subtotal gastrectomy and normal renal function were chosen as control. The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα?1 and ColⅡ by immunohistochemistry. According to von Kossa stain, CKD stage 5 patients were divided into no calcification group, mild?moderate calcification group and severe calcification group. Other related factors including serum calcium，phosphate, intact parathyroid hormone (iPTH), C?reactive protein (CRP), triglyceride(TG), cholesterol(TC) and low?density lipoproteins(LDL) were also detected. Results Seventeen (42.5%) of CKD Stage 5 patients showed vascular calcification, while calcification was not found in controls. Most calcification occurred in medial layer．Positive immunohistochemical staining of core?binding factor and ColⅡ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification. However, above positive staining was also observed in 78.3% of no calcification group. But there was little staining in control group. Positive staining score of Cbfα?1 and ColⅡ in severe calcification group was significantly higher than that in no calcification group. Same findings were obtained in mild?moderate calcification group, but the difference between them was not statistically significant. CRP and Ca×P were positively correlated with staining score of Cbfα?1 and ColⅡ. Serum phosphate was positively correlated with Cbfα?1 (r=0.786, P<0.01) and ColⅡ (r=0.785, P<0.01) respectively． Conclusions 42.5% of CKD stage 5 patients in our group shows vascular calcification, which occurrs mainly in medial layer. High expression of Cbfα?1 and ColⅡ can be observed in vascular calcification of radial arteries, which is earlier than vascular histological changes. Cbfα?1 and ColⅡ may be involved in the development of vascular calcification.     

基于团队文化建设的急诊护士核心能力培训模式的建立

目的探讨基于团队文化建设的急诊护士核心能力培训模式的建立与实施效果。方法选取2014年01-12月参加常规急诊护士核心能力培训方案进行培训的24名就职于江苏大学附属医院急诊科护士作为对照组,对培训结果进行分析,找出培训中存在的不足并进行分析。选取2015年1-12月参加团队文化建设融入在急诊护士核心能力培训方案培训的24名就职于江苏大学附属医院急诊科护士作为观察组;对两组护士的一般自我效能感量表、中国注册护士核心能力量表、护理工作满意度量表测量结果进行对比分析。结果经培训后,观察组在护士核心能力、一般自我效能感、工作满意度三方面得分高于对照组,差异均有统计学意义(P0.05)。结论基于团队文化建设的急诊护士核心能力培训模式更有利于护士核心能力的提高,有利于增强护士自身效能感与工作满意度的提高,值得推广。