A case of cerebral toxoplasmosis

A histopathologically proven case of cerebral toxoplasmosis in a young HIV positive patient has been presented. The clinical problems in management are highlighted.     

Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators

Background

Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain.

磁性护理工作环境与职业倦怠的关系研究

目的:调查某院磁性护理工作环境和护士职业倦怠的现状并分析两者关系.方法:运用中文版医院磁性要素量表和马氏人际工作倦怠量表对某院380名注册护士进行调查.结果:磁性护理工作环境得分为(137.06±24.98)分和职业倦怠检出率为38.95％.磁性护理工作环境与职业倦怠呈负相关(P<0.01);工龄、科室、护理人力资源的合理配置、护理管理者的支持、教育支持和文化价值观是职业倦怠的影响因素.结论:管理者应改善护理工作条件,构建健康工作环境,以期降低职业倦怠水平.     

GW654652, the pan-inhibitor of VEGF receptors, blocks the growth and migration of multiple myeloma cells in the bone marrow microenvironment

Previous studies have shown that the multiple myeloma (MM) cell line and MM patient cells express high-affinity vascular endothelial growth factor (VEGF) receptor-1 or Fms-like tyrosine kinase-1 (Flt-1) but not VEGF receptor-2 or Flk-1/kinase insert domain-containing receptor (Flk-1/KDR) and that VEGF triggers MM cell proliferation through a mitogen-activated protein kinase (MAPK)-dependent pathway and migration through a protein kinase C (PKC)-dependent pathway. The present study evaluates the efficacy of the small molecule tyrosine-kinase inhibitor GW654652, which inhibits all 3 VEGF receptors with similar potency. We show that GW654652 acts directly on MM cells and in the bone marrow microenvironment. Specifically, GW654652 (1-10 microg/mL) inhibits, in a dose-dependent fashion, VEGF-triggered migrational activity and cell proliferation of MM cell lines that are sensitive and resistant to conventional therapy. As expected from our previous studies of VEGF-induced signaling and sequelae in MM cells, GW654652 blocked VEGF-induced Flt-1 phosphorylation and downstream activation of AKT-1 and MAPK-signaling cascades. Importantly, GW654652 also inhibits interleukin-6 and VEGF secretion and proliferation of MM cells induced by tumor cell binding to bone marrow (BM) stromal cells. The activity of a pan-VEGF receptor inhibitor against MM cells in the BM milieu, coupled with its lack of major toxicity in preclinical mouse models, provides the framework for clinical trials of this drug class to improve patient outcome in MM.     

Delayed extradural hematoma: a case report

Three patients of delayed extradural hematoma (EDH) were seen in the last one year among forty eight consecutively treated cases of EDH. All the three hematomas were evacuated. Awareness of this entity and a high degree of vigilance are strongly recommended to detect such cases. Repeat CT should always be done, especially after decompression by either surgical or medical means, recovery from shock or whenever there is evidence of even minimal bleeding under a skull fracture on initial CT scan.     

大鼠创伤性脑损伤后Claudin-5表达水平变化的研究

目的：探讨大鼠创伤性脑损伤后不同时间点血脑屏障通透性及Claudin-5表达水平的变化,为进一步研究创伤后脑水肿的机制及治疗时机提供理论依据。方法：大鼠随机分为对照组和脑损伤组,参照Feeney＇s的自由落体致伤法,制作大鼠顶叶局灶皮质挫裂伤模型。应用伊文兰（evansblue）法测定伤后不同时间点损伤灶皮层脑组织中EB含量;应用Westernblot法检测损伤灶脑微血管内皮细胞紧密连接相关蛋白Claudin-5的表达水平。结果：损伤灶皮层中EB含量在伤后1～6h明显增多,高峰期在3h。Westernblot结果显示损伤后1～6h,Claudin-5表达水平较对照组显著降低（P〈0.05）,3h最明显,24h与对照组差异无统计学意义。结论：大鼠顶叶局部脑挫裂伤可能通过下调紧密连接相关蛋白Claudin-5的表达水平,开放紧密连接,增加血脑屏障的通透性。     

痰热清注射液治疗上呼吸道感染的临床分析

目的观察、比较痰热清注射液、利巴韦林治疗上呼吸道感染患者的治疗效果和症状缓解方面的差异。方法将297例上呼吸道感染患者分为两组,痰热清组（152例）患者使用痰热清注射液,0.6 ml/（kg.d）,加入到5%葡萄糖注射液中,进行静脉滴注,每日1次。利巴韦林组（145例）患者使用利巴韦林注射液,每日2次,1次0.5 g,加入到5%葡萄糖注射液中,进行静脉滴注。结果痰热清组的有效率为98.03%,利巴韦林组的有效率为71.03%,两组比较差异有统计学意义（P〈0.05）;痰热清组87例（57.2%）给药后48 h内退热,全身情况大有改善,食欲增加,而利巴韦林组仅56例（38.6%）痊愈。结论痰热清注射液在治疗上呼吸道感染方面有较好的退热、止咳、祛痰等作用,起效快,疗程短,安全可靠,值得在临床应用中推广。