Toxicological evaluation of lactose and chitosan delivered by inhalation

These days, inhalation constitutes a promising administration route for many drugs. However, this route exhibits unique limitations, and formulations aimed at pulmonary delivery should include as few as possible additives in order to maintain lung functionality. The purpose of this work was to investigate the safety of lactose and chitosan to the pulmonary tissue when delivered by inhalation. The study was carried out with 18 Wistar rats divided in three groups receiving distilled water, lactose or chitosan. A solution of each excipient was administered by inhalation at a dose of 20 mg. The lungs were excised and processed to determine several biochemical parameters used as toxicity biomarkers. Protein and carbonyl group content, lipid peroxidation, reduced and oxidized glutathione (GSSG), myeloperoxidase (MPO), cooper/zinc and manganese superoxide dismutase, catalase, glutathione S-transferase and glutathione peroxidase were determined. Results of myeloperoxidase activity and glutathione disulfide lung concentrations showed a relevant decrease for chitosan group compared to control: 4.67 ± 2.27 versus 15.10 ± 7.27 (P = 0.011) for MPO and 0.89 ± 0.68 versus 2.02 ± 0.22 (P = 0.014) for GSSG. The other parameters did not vary significantly among groups. Lactose and chitosan administered by inhalation failed to show toxic effects to the pulmonary tissue. A protective effect against oxidative stress might even be attributed to chitosan, since some biomarkers had values significantly lower than those observed in the control group when this product was inhaled. Nevertheless, caution must be taken regarding chemical composition and technological processes applied to incorporate these products during drug formulation, in particular for dry powder inhalators.     

Making the neurology clerkship more effective: can e-Textbook facilitate learning?

Abstract

Objective: In 1998, the 4-week neurology elective clerkship was converted into a 2-week required neurology rotation at the University of Illinois at Chicago. We hypothesized that the interactive e-Textbook, a computer-assisted learning tool, could successfully replace a paper-based syllabus and a traditional neurology textbook during a 2-week rotation, while incorporating department teaching conferences to replace the medical student lecture series.

Methods: We created an e-Textbook and made it available simultaneously in a CD-ROM format and on a password-protected website. The online quiz and course assessment were administered by the Blackboard Web Server.

Results: After implementation of the e-Textbook over 6 years, the feedback shows high student satisfaction, and student evaluations of the neurology clerkship have risen. Creation of an e-Textbook for the neurology clerkship made our faculty more productive while increasing student satisfaction and facilitating learning efficacy.

Discussion: The results show that the e-Textbook is an appropriate alternative to facilitate learning of basic and clinical neurology during a 2-week rotation. The students demonstrated successful learning in a computerized environment.     

自主探究式教学模式在护理研究课程教学中的应用

本研究基于有效培养学生科研思维和科研能力为目的，论述以揭示课题，明确目标；任务驱动，探索新知；协作讨论，深入质疑；成果展示，反思评价为操作流程的自主探究型教学模式的内涵及其应用效果。     

中医干预干扰素治疗慢性乙型肝炎副作用的研究近况

干扰素是国际上抗肝炎病毒治疗的首选药物之一,但因其副作用较多而影响临床疗效。该文通过回顾国内近年来中医干预干扰素治疗慢性乙型肝炎副作用的研究,以期从中得到启发,为进一步的研究提供思路。     

中医治疗乙型肝炎相关性肝衰竭的经验与进展

肝衰竭(liver failure)是临床常见的严重肝病症候群,病死率极高.各国学者对肝衰竭的定义、分类、诊断和治疗等问题进行多年研究,但仍无一致意见.2006年中华医学会感染病学分会和中华医学会肝病学分会制订的《肝衰竭诊疗指南》根据肝衰竭的病理组织学特征和病情发展的速度,将其分为急性肝衰竭(acute liver failure,ALF)、亚急性肝衰竭(subacute liver failure,SALF)、慢加急性(亚急性)肝衰竭(acute-on-chronic liver failure,ACLF)和慢性肝衰竭(chronic liver failure,CLF)[1].     

Widespread Differential Maternal and Paternal Genome Effects on Fetal Bone Phenotype at Mid‐Gestation

Parent‐of‐origin–dependent (epi)genetic factors are important determinants of prenatal development that program adult phenotype. However, data on magnitude and specificity of maternal and paternal genome effects on fetal bone are lacking. We used an outbred bovine model to dissect and quantify effects of parental genomes, fetal sex, and nongenetic maternal effects on the fetal skeleton and analyzed phenotypic and molecular relationships between fetal muscle and bone. Analysis of 51 bone morphometric and weight parameters from 72 fetuses recovered at day 153 gestation (54% term) identified six principal components (PC1–6) that explained 80% of the variation in skeletal parameters. Parental genomes accounted for most of the variation in bone wet weight (PC1, 72.1%), limb ossification (PC2, 99.8%), flat bone size (PC4, 99.7%), and axial skeletal growth (PC5, 96.9%). Limb length showed lesser effects of parental genomes (PC3, 40.8%) and a significant nongenetic maternal effect (gestational weight gain, 29%). Fetal sex affected bone wet weight (PC1, p < 0.0001) and limb length (PC3, p < 0.05). Partitioning of variation explained by parental genomes revealed strong maternal genome effects on bone wet weight (74.1%, p < 0.0001) and axial skeletal growth (93.5%, p < 0.001), whereas paternal genome controlled limb ossification (95.1%, p < 0.0001). Histomorphometric data revealed strong maternal genome effects on growth plate height (98.6%, p < 0.0001) and trabecular thickness (85.5%, p < 0.0001) in distal femur. Parental genome effects on fetal bone were mirrored by maternal genome effects on fetal serum 25‐hydroxyvitamin D (96.9%, p < 0.001) and paternal genome effects on alkaline phosphatase (90.0%, p < 0.001) and their correlations with maternally controlled bone wet weight and paternally controlled limb ossification, respectively. Bone wet weight and flat bone size correlated positively with muscle weight (r = 0.84 and 0.77, p < 0.0001) and negatively with muscle H19 expression (r = –0.34 and –0.31, p < 0.01). Because imprinted maternally expressed H19 regulates growth factors by miRNA interference, this suggests muscle‐bone interaction via epigenetic factors. © 2014 American Society for Bone and Mineral Research.     

慢性乙型肝炎中医诊疗专家共识(2012年1月)

前言中医药治疗各种慢性肝病,具有悠久的历史和确切的疗效,在长期的临床实践和科学研究中积累了丰富的资料和经验,引起国内外专业工作者的关注。中医(含中西医结合)治疗慢性肝炎的标准化工作虽然取得某些进展,但尚未形成规范的诊疗常规或指南,因此,在临床研究工作中遇到了某些工作难题。纵观国外肝病领域,自上世纪九十年代已形成慢性乙型肝     

护理学基础实验课中反思性教学的应用体会

总结了16名护理学基础实验课教师在2005—2008学年进行反思性教学的体会，探讨反思性教学在护理学基础实验课中的应用。组织教师学习反思性教学理论，讨论进行反思性教学的实际方法并融入实践。在2005-2008年3届学生的教学过程中，有计划地采取了写反思日记、教学日记，组织教师间的交流与讨论，录像、录音回放，邀请专家点评听课等反思方式。通过反思性教学的应用，教师提高了职业成就感与教学经验，学生护理学基础实验课的成绩与满意度得到了提高，教学水平明显提高，取得较好的效果。     

对护理教育质量工程建设工作的几点思考

“质量工程”是教育部全面推进高等教育质量的重要举措，在护理教育中实施质量工程所要求的深化教育教学改革、强化实验教学建设、高水平专业教师队伍建设和精品课程建设，对提高护理教育教学质量，实现护理教育可持续发展有着十分重要的意义。