无陪护老年病人住院期间护理需求的质性研究

目的:了解无陪护老年病人在住院期间的护理需求。方法:采用质性研究中现象学研究的半结构化、面对面、深度访谈方法采访11位内科无陪护老年病人,之后依据Claizzit的现象学资料7步分析法分析、整理资料。结果:无陪护老年病人住院期间的需求涉及病室、护理人员、陪护人员三方面。结论:无陪护老年病人住院期间有着其特殊需求,无陪护的原因主要有经济因素及陪护人员综合素质较低、无统一管理等,所以除了医院在护理工作中针对这类病人给予一些特殊照护外,呼吁政府建立规范的陪护人员培训及管理机构,为广大患者提供正规、专业化的陪护。     

Psychiatric and cardiovascular comorbidities in patients with diabetes mellitus starting antiobesity drugs

The aim of the study was to assess whether the baseline risk of psychiatric and cardiovascular disease in patients with diabetes mellitus differs between those starting to use antiobesity drugs and those not starting to use these drugs. A retrospective nested case-control study within the General Practice Research Database (1987-2002) was done. The cohort included all patients with diabetes mellitus (n = 141,164). Information on patient characteristics (general, cardiovascular, and psychiatric characteristics) was extracted from the medical records. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A total of 511 patients starting to use antiobesity drugs (cases) and 3,065 controls were included in the study cohort. Starters were younger and more frequently female. Of the starters, 91.8% did not receive any dietary advice before starting treatment. Depression (in the year before index date) was associated with the use of antiobesity drugs (OR 2.2; 95% CI 1.7-2.8), as was anxiety (OR 1.6; 95% CI 1.1-2.4). Of the cases, 25.2% had multiple cardiovascular risk factors (>4) compared to 19.0% of the controls. The baseline risk for psychiatric disorders and cardiovascular disease was found to be higher in patients with diabetes mellitus starting to use antiobesity drugs compared to patients with diabetes mellitus not starting such treatment.     

蒜香藤叶挥发油的化学成分

蒜香藤（Pseudocalymma alliaceum Sandw．）又名紫铃藤,为紫葳科（Bignoniaceae）常绿藤状灌木,原产于南美洲的圭亚那和巴西。蒜香藤花、叶在搓揉之后,有浓浓的大蒜香味,其叶深绿富有光泽,花形大而优美,中国许多地方已引种栽培,一般作为篱笆、围墙美化或凉亭、棚架装饰之用。蒜香藤具有浓郁的蒜香,甚至可作为蒜的替代物用于烹饪。但有关其叶挥发性成分研究尚未见报道。本文利用气相色谱-质谱联用技术（GC—MS）分析了西双版纳植物园引种栽培的蒜香藤叶挥发油的化学成分,以期为合理开发和利用蒜香藤植物资源提供科学依据。     

Superantigen-induced T cell:B cell conjugation is mediated by LFA-1 and requires signaling through Lck, but not ZAP-70.

The formation of a conjugate between a T cell and an APC requires the activation of integrins on the T cell surface and remodeling of cytoskeletal elements at the cell-cell contact site via inside-out signaling. The early events in this signaling pathway are not well understood, and may differ from the events involved in adhesion to immobilized ligands. We find that conjugate formation between Jurkat T cells and EBV-B cells presenting superantigen is mediated by LFA-1 and absolutely requires Lck. Mutations in the Lck kinase, Src homology 2 or 3 domains, or the myristoylation site all inhibit conjugation to background levels, and adhesion cannot be restored by the expression of Fyn. However, ZAP-70-deficient cells conjugate normally, indicating that Lck is required for LFA-1-dependent adhesion via other downstream pathways. Several drugs that inhibit T cell adhesion to ICAM-1 immobilized on plastic, including inhibitors of mitogen-activated protein/extracellular signal-related kinase kinase, phosphatidylinositol-3 kinase, and calpain, do not inhibit conjugation. Inhibitors of phospholipase C and protein kinase C block conjugation of both wild-type and ZAP-70-deficient cells, suggesting that a phospholipase C that does not depend on ZAP-70 for its activation is involved. These results are not restricted to Jurkat T cells; Ag-specific primary T cell blasts behave similarly. Although the way in which Lck signals to enhance LFA-1-dependent adhesion is not clear, we find that cells lacking functional Lck fail to recruit F-actin and LFA-1 to the T cell:APC contact site, whereas ZAP-70-deficient cells show a milder phenotype characterized by disorganized actin and LFA-1 at the contact site.     

甘薯愈伤组织中的淀粉酶

从甘薯愈伤组织和块根可溶性提取物中淀粉酶的非变性凝胶电泳和活性染色发现 ,愈伤组织和块根的淀粉酶完全不同。前者有 4种不同大小的淀粉酶 (2种α 淀粉酶和 2种 β 淀粉酶 ) ,而后者只有一种 (β 淀粉酶 ) ;其次 ,块根 β 淀粉酶对EDTA和 β 巯基乙醇都不敏感 ,而愈伤组织的淀粉酶对EDTA和 β 巯基乙醇都敏感。这些结果表明甘薯愈伤组织中不仅淀粉酶同工酶的数量多 ,而且包括α和 β两种类型。     

Validation of improved recording site to measure phrenic conduction from surface electrodes in humans.

Phrenic nerve stimulation, electrical (ES) or from cervical magnetic stimulation (CMS), allows one to assess the diaphragm contractile properties and the conduction time of the phrenic nerve (PNCT) through recording of an electromyographic response, traditionally by using surface electrodes. Because of the coactivation of extradiaphragmatic muscles, signal contamination can jeopardize the determination of surface PNCTs. To address this, we compared PNCTs with ES and CMS from surface and needle diaphragm electrodes in five subjects (10 phrenic nerves). At a modified recording site, lower and more anterior than usual (lowest accessible intercostal space, costochondral junction) with electrodes 2 cm apart, surface and needle PNCTs were similar (CMS: 6.0 +/- 0.25 ms surface vs. 6.2 +/- 0.13 ms needle, not significant). Electrodes recording the activity of the most likely sources of signal contamination, i.e., the serratus anterior and pectoralis major, showed distinct responses from that of the diaphragm, their earlier occurrence strongly arguing against contamination. With ES and CMS, apparently uncontaminated signals could be consistently recorded from surface electrodes.     

牛尾草中一新的对映-贝壳杉烷型二萜

从牛尾草[Isodon ternifolius(D.Don)Kudo]的地上部分分离得到一个新的对映－贝壳杉烷型二萜,命名为牛尾草素H（1）,通过波谱方法鉴定了它的结构。此外,还分离得到5个已知的对映－贝壳杉烷型二萜化合物：香茶菜醛（2）,长管香茶菜素A,E和G（3－5）,开展香茶菜素E（6）,以及木樨草素（7）,芹菜素（8）,α－香树脂醇（9）,乌索酸（10）和2α－羟基乌索酸（11）。     

鸡脚参中一个新木脂素

从鸡脚参[Orthosiphon wulfenioides (Diels)Hand.-Marzz.]根中提取分离了一个新的木脂素,命名为鸡脚参木脂素。其结构由NMR、MS等波谱分析确定。初步活性实验显示该化合物不具备抗真菌和抗肿瘤活性。     

细叶香茶菜中两个新的对映—贝壳杉烷二萜化合物

从云南中甸产细叶香茶菜 (Isodontenuifolia (W .W .Smith)Kudo)的地上部分分离得到 6个化合物 ,它们的结构通过波谱方法得到鉴定。其中化合物 1和 2为新的对映_贝壳杉烷二萜化合物 ,即细叶香茶菜甲素 (3β ,6α ,15 β_trihydroxy_1α ,7β_diacetoxy_11β ,16 β_epoxy_ent_kaurane) (1)和细叶香茶菜乙素 (1α,6α ,11β_trihydroxy_3β,7β_diacetoxy_ent_kaur_16_en_15_one) (2 )。