Family Caregivers' Subjective Caregiving Burden,Quality of Life,and Depressive Symptoms Are Associated With Terminally Ill Cancer Patients' Distinct Patterns of Conjoint Symptom Distress and Functional Impairment in Their Last Six Months of Life

Context

Family caregivers constitute a critical component of the end-of-life care system with considerable cost to themselves. However, the joint association of terminally ill cancer patients' symptom distress and functional impairment with caregivers' subjective caregiving burden, quality of life (QOL), and depressive symptoms remains unknown.

Hippocampal damage and cytoskeletal disruption resulting from impaired energy metabolism

To determine if impaired energy metabolism might contribute to some aspects of Alzheimer disease (AD), including the vulnerability of the CA1 region of the hippocampal formation and the altered cytoskeleton evident in neurofibrillary tangles, we examined the effects of metabolic poisons on neuronal damage and cytoskeletal disruption in the hippocampal formation. Intrahippocampal injection of 3-nitropropionic acid (3-NP) and malonic acid resulted in neuronal death, particularly in CA1. Cytoskeletal disruption included loss of dendritic MAP2, but sparing of axonal τ. MK-801 (a noncompetitive NMDA receptor antagonist) did not atenuate the lesions produced by intrahippocampal injection of malonate. MK-801, however, was effective against intrastriatal malonate. Acute systemic 3-NP resulted in neuronal damage and cytoskeletal disruption in the CA1 region of the hippocampal formation, including an extensive loss of MAP2 immuno-reactivity, but sparing of τ. The neuronal loss in CA1 was delayed as compared to striatum. Chronic intraventricular infusion of 3-NP produced a different pattern of neuronal damage. Loss of τ-1 immuno-reactivity was observed in CA3 and CA1 s. oriens, whereas MAP2 immunostaining was preserved. These results demonstrate that chronic and acute administration of metabolic inhibitors produce distinct patterns of neuronal damage and cytoskeletal disruption. The results further suggest a differential involvement of the NMDA receptor in malonate-induced neuronal damage in striatum as compared to the hippocampus. The pattern of neuronal damage and cytoskeletal disruption observed following acute metabolic impairment resembled some aspects of neurofibrillary pathology in AD, but did not result in τ hyperphosphorylation.     

胸大肌肌皮瓣在口腔颌面部缺损修复中的应用

报道２１９例口腔颌面部肿瘤，其中良性肿瘤１８例，恶性肿瘤２０１例，在肿瘤切除后，均采用胸大肌肌皮瓣修复缺损。采用单皮岛肌皮瓣２０１例，双皮岛肌皮瓣１６例，肌皮骨瓣２例。成功２０１例，失败１８例。讨论了胸大肌皮瓣的优点及适用范围。介绍了手术设计、操作方法。分析了成功与失败的影响因素，认为正确，精细的手术技巧是成功的关键因素。     

Hypoxia effects on vascular endothelial growth factor derived epithelial cells of nasal polyps]

OBJECTIVE: To understand the role of nasal mucous epithelial cells to hypoxia in early stage of nasal polyps(NP) formation. METHODS: Epithelial cells of NP and inferior turbinate (IT) were cultured without serum under normal oxygen and hypoxia, and stimulus of inflammatory cytokines. Erythropoietin (EPO) was regarded as hypoxia mark, and expression of vascular endothelial growth factor(VEGF) mRNA and protein derived from epithelial cells were detected respectively by in situ hybridization and ELISA. RESULTS: 1. Under hypoxia, EPO mRNA was expressed intensely in epithelial cells from NP and IT, and there was no significant difference between both of them. This result suggested that EPO might be regarded as a hypoxic mark. 2. The ability of producing VEGF mRNA increased with cytokines stimulation, especially under hypoxia. Protein level of VEGF from epithelial cells of NP and IT increased with cytokines stimulation, especially in hypoxia and was time-dependent. CONCLUSION: Epithelial cells actively produce vast VEGF under hypoxia. The VEGF induced by hypoxia of the mucosa in middle meatus is of importance in the formation of nasal polyps(NP) in early stage, which may be the major cause of NP formation in middle meatus.     

“亚地克病”诊断标准探讨及修正建议

在新疆石河子市远郊缺碘地甲病区7～17岁儿童中取样,检测智力、精神运动功能、身高、体重和骨龄,发现精神运动发育障碍和骨龄落后的程度及发生频度明显高于非病区;而智力落后和体格发育落后两区无显著差异。根据这一发现认为在“亚地克病”诊断中,“精神运动发育测验”较“比内测验”更具有特异性和敏感性;建议在“出生、居住于缺碘地甲病区”前提下,将精神运动发育障碍和智力落后并列为主要条件。另根据地克病的分型原则,提出“亚地克病”的分型标准。     

Subtotal resection of clavicle for chronic, recurrent, multifocal osteomyelitis in children

Chronic, recurrent, multifocal osteomyelitis (CRMO) is an obscure disease of bone, occurring in children. It appears to be an inflammatory condition with no obvious microbiological cause. Current treatments of antibiotics and anti-inflammatory medication appear to have limited success. This case report looks at two separate cases of CRMO where partial resection of the affected bone—the clavicle—leads to complete resolution of symptoms and regrowth of the excised bone.     

早期糖尿病视网膜病变的视网膜电图分析

目的 分析早期糖尿病视网膜病变(DR)的闪光视网膜电图(F—ERG)和视网膜电图震荡电位(OPs)各参数的变化特点，寻找反映早期DR的敏感指标。方法 对16例(32只眼)正常人进行OPs和F-ERG检测。对27例(53只眼)糖尿病病人进行眼底荧光血管造影(FFA)、OPs和F—ERG检测。结果 OPs中Os波幅、O4波幅、OPs总波幅及F-ERG中b波峰潜时较其他指标敏感，其中O4波幅和b波峰潜时为最敏感指标，但均不能反映早期DR的严重程度。结论 OPs的O4波幅和F—ERG的b波峰潜时可作为早期糖尿病视网膜病变诊断的敏感指标。     

Carotid sinus nerve blockade to reduce blood pressure instability following carotid endarterectomy: a systematic review and meta-analysis.

OBJECTIVES: Local anaesthetic infiltration into the carotid sinus during carotid endarterectomy (CEA) has been recommended to minimise blood pressure fluctuations but its use remains controversial. The aim of this meta-analysis was to determine whether intra-operative administration of local anaesthetic reduces the incidence of haemodynamic instability following CEA. MATERIALS AND METHODS: A search of the Medline, Pubmed and Embase databases and the Current Controlled Trials register identified four trials, which met the pre-defined inclusion criteria for data extraction. Pooled odds ratios with 95 per cent confidence intervals (c.i.) for the development of post-operative hypotension and hypertension were calculated using a random-effects model. RESULTS: Outcomes of 432 patients were studied. Local anaesthetic blockade of the carotid sinus was associated with a pooled odds ratio of 1.25 (95 per cent c.i. 0.496 to 3.15); p=0.216) and 1.28 (95 per cent c.i. 0.699 to 2.33; p=0.428) for the development of post-operative hypotension and hypertension respectively. Although none reach significance there was a trend towards increased risk of developing a complication in those patients who received local anaesthetic. CONCLUSIONS: There are insufficient data to determine the role of intra-operative local anaesthetic administration in reducing post-operative blood pressure lability following CEA. Conversely, the possibility of harm cannot be excluded on the basis of the currently available data.