HPM对大鼠大脑结构及其神经递质的影响

目的 探讨S波段高功率微波（HPM）辐射对大鼠皮层形态结构及其氨基酸类神经递质的影响。方法采用2～90mW／cm^2S波段高功率微波辐照Wistar大鼠，通过苏索索-伊红染色（HE）、甲苯胺蓝染色和电镜观察大脑皮层的形态结构改变；采用高效液相色谱仪检测10和50mW／cm^2照后6h和1d大脑皮层中4种氨基酸（谷氨酸、天门冬氨酸、γ-氨基丁酸和甘氨酸）含量的变化。结果平均功率密度10，50和90mW／cm^2S波段高功率微波可引起大脑皮层神经元固缩、深染，尼氏体减少；突触结构模糊，囊泡堆积；髓鞘融合、解离等。10和50mW／cm^2组照后6h大脑皮层上述4种氨基酸含量均显著增高（P〈0．01）；而照后1d仅见γ-氨基丁酸和甘氨酸含量仍较高（P〈0．01）。结论 S波段高功率微波辐射可引起大鼠大脑皮层神经元尼氏体、突触结构和髓鞘等损伤及氨基酸类神经递质代谢紊乱。     

高功率微波辐照后大鼠肺脏形态学改变

目的 观察HPM辐照后SD大鼠肺脏形态学的变化情况。方法辐照后不同时间点活杀SD大鼠取肺脏，分别用3％戊二醛以及10％福尔马林固定，用常规光镜以及扫描电镜观察大鼠肺脏形态学的变化。结果HPM辐照SD大鼠后6h，肺泡上皮细胞出现明显变性，可见肺泡上皮细胞脱落。肺泡隔断裂，形成肺大泡。辐照后24h，肺上皮细胞变性严重，肺泡隔断裂，变薄，出现广泛的肺大泡。间质水肿，炎细胞浸润。辐照后48h，肺内小静脉淤血。辐照后7d，肺泡隔局灶性恢复。结论HPM辐照可造成肺组织明显损伤，损伤具有时相性和可逆性。     

高功率微波对大鼠下丘脑和垂体中糖皮质激素受体影响

目的探讨高功率微波（high power microwave，HPM）辐照后下匠脑与垂体中糖皮质激素受体（glucocorticoid receptor，GR）的变化及其意义。方法采用2～90mW／cm^2的HPM辐照130只二级雄性Wistar大鼠，分别于照后6h、1、3、7、14d、28d与3月活杀动物，取下丘脑与垂体，采用免疫组化和图像分析技术研究GR在辐照后大鼠下丘脑与垂体中的表达。结果辐照后下丘脑神经元中GR表达减弱。10mW／cm^2组在6h与1d时较对照组有显著下降（P〈0．05），7d后呈恢复趋势；50mW／cm^2绀在1d时有显著下降（P〈0．05）。辐照后垂体远侧部内分泌细胞GR表达增强。10mW／cm^2组在6h时有显著升高（P〈0．01），7d后呈恢复趋势；50mW／cm^2组在1、3d时均有显著升高（P〈0．01）。结论一定功率密度的HPM辐照后，下丘脑GR表达下降；垂体GR表达增强；HPA轴负反馈调控紊乩；表明GR参与rHPM辐照后下丘脑．垂体．肾上腺轴病变的病理生理过程。     

HPM辐射后大鼠海马组织中细胞凋亡及Caspase 3的表达研究

目的探讨HPM辐射后大鼠海马组织中细胞凋亡及Caspase 3的表达及其意义.方法采用12 mW/cm2HPM模拟源辐照50只Wistar雄性大鼠,于照后6 h,1、3、7、14和28 d活杀取海马组织,经光镜、电镜、免疫组化和图像分析等技术,研究HPM辐射后大鼠海马组织中细胞凋亡的特点、Caspase 3的表达及其意义.结果12 mW/cm2HPM辐射后6 h～3 d,凋亡的细胞进行性增多,3 d达高峰,7 d后逐渐减少,14 d后恢复至正常水平.凋亡的细胞核染色质浓缩、边集.照射后1～3 d,Caspase-3于神经元胞浆中表达进行性增加,3 d达高峰,7 d后逐渐恢复,28 d基本恢复至正常水平.结论细胞凋亡是HPM辐射引起海马神经元死亡的主要方式,Caspase-3表达增加,参与HPM辐射后海马神经元凋亡的过程.     

还原型谷胱甘肽对高功率微波致大鼠脑能量代谢改变的影响

目的观察GSH对HPM致大鼠脑能量代谢改变的影响,在HPM致脑损伤的药物治疗方面进行初步探索。方法将30只W istar大鼠随机分为假辐射组、50 mW/cm2的HPM辐射组、50mW/cm2的HPM辐射+GSH组(于辐射后即刻起腹腔注射GSH 600 mg/kg,每天1次,共7天),于辐射后7天活杀取脑,制作恒温低冷切片,进行ATP酶和SDH染色,光镜下观察并采用图像分析方法进行定量分析。结果50 mW/cm2的HPM辐射后7天,大鼠脑内ATP酶活性升高、SDH活性下降,使用GSH治疗未见ATP酶和SDH活性改变,辐射后14天辐射组ATP酶和SDH活性恢复。结论HPM可引起大鼠脑能量代谢障碍,GSH具有一定的保护作用。     

高功率微波辐照对原代培养心肌细胞超微结构及肌动蛋白表达的影响

[目的 ]研究高功率微波 (HPM)对原代培养心肌细胞超微结构和肌动蛋白表达的影响 ,以探讨其对心肌细胞的损伤和修复规律及损伤机制。 [方法 ]HPM辐照细胞后 ,采用扫描电镜、透射电镜、原子力显微镜和免疫组织化学技术 ,观测心肌细胞超微结构和肌动蛋白表达的变化。 [结果 ]HPM辐照后 ,心肌细胞膜凹陷、穿孔和破裂 ,孔洞直径 ( 840± 5 7.5 9)nm ,深度 ( 2 0 8± 17.2 1)nm。线粒体肿胀 ,高尔基体和内质网扩张肿胀 ,多量髓鞘样结构出现。肌动蛋白的表达明显降低并与辐照剂量密切相关 ,r =-0 .945 (P <0 .0 1)。 [结论 ]HPM对心肌细胞超微结构特别是细胞膜结构造成明显损伤 ,损伤可能存在剂量 效应关系 ,并且有一定的发展和修复规律。     

健康促进模式教育对消化性溃疡生活方式的影响

目的：探讨健康促进模式(health promoting model,HPM)对消化性溃疡生活方式的影响。方法：选取2012年1月至2014年12月我院收治的106例消化性溃疡患者,其中52例行HPM教育(实验组),54例行传统健康教育(对照组)。采用健康促进生活方式问卷(HPLP-Ⅱ)和自制的消化性溃疡特异性生活方式依从性问卷在出院6个月进行调查。结果：实验组49例完成出院6个月的随访和调查问卷,随访率为94.23%;对照组53例,随访率为98.15%。实验组的健康行为总分及健康责任、营养及压力应对3个维度得分明显高于对照组,差异有统计学意义(均P<0.05),而两组的运动、人际关系及自我实现3个维度得分比较,差异并无统计学意义(均P>0.05)。实验组的特异性生活方式依从性总分及“不吃或少吃甜食”、“少用调味品”、“避免过度精神紧张及焦虑”、“保持充足睡眠及休息”4个条目得分明显高于对照组,差异有统计学意义(均P<0.05),而两组的“三餐规律饮食”、“营养均衡”、“勿食刺激性及难消化食物”和“戒烟酒”4个条目得分比较,差异并无统计学意义(均P>0.05)。结论：HPM教育可提高消化性溃疡患者健康行为水平,增加其特异性生活方式的依从性。     

Influenza-related health care utilization and productivity losses during seasons with and without a match between the seasonal and vaccine virus B lineage

Objective

To assess and compare direct medical costs (incurred by payers) and indirect productivity losses (incurred by employers) associated with influenza seasons with matched or mismatched circulating and vaccine containing influenza B lineages.

Methods

A retrospective analysis, using two MarketScan databases, for the years 2000–2009. Each influenza season was categorized as matched or mismatched after comparing that season's circulating influenza B lineage and the vaccine influenza B lineage. Patients selected had at least one diagnosis claim for influenza (ICD-9-CM code 487.xx [influenza] or 488.1 [H1N1]) during an influenza season. We assessed the incidence of influenza (overall and influenza B), influenza-related medical utilization and associated costs, and productivity losses for each season.

Results

The four matched seasons had lower average influenza incidence (overall incidence per 100,000 plan members: 509; 95% confidence interval [CI]: 505–512) than the five mismatched seasons (748; 95% CI: 745–751). The mismatched seasons had lower influenza B incidence (average incidence per 100,000 plan members: 126; 95% CI: 125–128) than the matched seasons (165; 95% CI: 163–167). The average, per-patient, total influenza-related medical costs in the mismatched seasons ($300.83; range: $245.38–$371.58) were approximately $61.00 higher than in the matched seasons ($239.43; range: $201.49–$264.01). The mismatched seasons had greater average per-patient, influenza-related productivity-loss costs than the matched seasons (mean: $237.31 vs. $175.10).

Conclusion

CDC data showed that influenza A was the predominant circulating strain during seasons in which the circulating influenza B lineage did not match the vaccine influenza B lineage. This resulted in lower influenza B incidence during the mismatched seasons. However, the average, per-patient, influenza-related direct medical costs and indirect productivity losses were higher during the mismatched seasons. Additional research is required to determine if these higher costs can be attributed to influenza B infections and if the influenza severity varies during mismatched seasons     

高功率微波辐射对大鼠脑HIF-1α表达影响

目的探讨高功率微波（high power microwave,HPM）辐射后大鼠不同脑区低氧诱导因子1α（hypoxia in-ducible factor-1 alpha,HIF-1α）的改变及其意义。方法60只Wistar雄性大鼠于0,30和100mW/cm2HPM辐射后6h,1,3和7d时活杀取大脑皮层和海马,采用苏木素-伊红染色观察形态改变,采用免疫组织化学、原位杂交和图像分析等技术检测大鼠不同脑区HIF-1α蛋白和mRNA表达改变。结果对照组大鼠皮层和海马毛细血管形态规则,未见毛细血管间隙增宽;30和100m Wcm2组大鼠皮层和海马脑辐射后6h～1d毛细血管周隙增宽,3d达高峰,7d后恢复;对照组HIF-1α蛋白于皮层和海马神经细胞呈弱阳性,30和100m Wcm^2组皮层和海马神经元和胶质细胞核HIF-1α于辐射后6h～1d呈阳性,其后呈弱阳性;HIF-1α mRNA改变规律与其蛋白变化相同。结论脑内神经元的损伤和修复过程中HIF-1α表达增加,参与了毛细血管通透性升高的过程。     

Understanding Palliative Care and Hospice: A Review for Primary Care Providers

Palliative care provides invaluable clinical management and support for patients and their families. For most people, palliative care is not provided by hospice and palliative medicine specialists, but rather by their primary care providers. The recognition of hospice and palliative medicine as its own medical subspecialty in 2006 highlighted the importance of palliative care to the practice of medicine, yet many health care professionals harbor misconceptions about palliative care, which may be a barrier to ensuring that the palliative care needs of their patients are identified and met in a timely fashion. When physicians discuss end-of-life concerns proactively, many patients choose more comfort-focused care and receive care more aligned with their values and goals. This article defines palliative care, describes how it differs from hospice, debunks some common myths associated with hospice and palliative care, and offers suggestions on how primary care providers can integrate palliative care into their practice.