危重隐球菌性脑膜炎患者的护理

目的总结免疫功能正常患者的隐球菌脑膜脑炎护理经验。方法回顾性分析我单位近20a来收治的免疫功能正常的隐球菌性脑膜炎患者的临床资料,分析对应的护理策略与方法。结果收治的109例患者均有病原学依据,所有患者都存在头痛呕吐等症状,37例患者脑膜刺激征阳性,对这些危重患者需要进行特殊颅高压的护理;所有患者均有真菌学诊断指标。两性霉素B、氟康唑、5氟胞嘧啶和伏立康唑仍然是主要治疗药物,每种药物的副作用需要护理重视。腰穿后鞘内注射抗真菌药物,包括腰椎置管在内的各种脑脊液引流与分流治疗是提高治疗效果的有效手段,需要给予熟练的护理配合和术后观察。结论发生于免疫功能正常患者的隐球菌性脑膜炎均具有危重的中枢症状,药物治疗和各种操作治疗都具有不同的副作用和不良反应,需要采取对应的护理方案,以更好地提高疗效。     

浅谈癌症疼痛的临床护理

本文探讨了肿瘤患者疼痛的有效护理措施。对癌症疼痛患者加强非药物止痛、药物止痛护理,心理护理以及控制疼痛的用药指导做了论述。指出加强癌症患者的心理护理及药物指导能有效的控制癌症疼痛,更好的配合治疗。     

艾滋病合并马尔尼菲青霉菌败血症的护理

目的探讨艾滋病合并马尔尼菲青霉菌败血症的护理方法。方法回顾性分析65例艾滋病合并马尔尼菲青霉菌败血症患者的临床特点和护理措施。结果 65例患者表现为高热、贫血、咳嗽、皮疹、肝脾肿大、口腔黏膜白斑、全身性感染等;经给予及时有效的治疗和护理,如心理护理、及时处理高热、感染性休克,在对应用两性霉素B及高效抗逆转录病毒药物过程中及时发现及处理药物不良反应,加强基础护理及营养支持,做好服用药物依从性教育等,52例好转出院,5例中途放弃治疗自动出院,8例因严重败血症引发全身性感染治疗无效死亡。结论艾滋病合并马尔尼菲青霉菌败血症患者给予及时治疗和科学的护理,可促进患者病情康复,提高患者的生命质量,减少死亡。     

急诊静脉输注药物不良反应的影响因素及护理体会

目的分析急诊静脉输注药物不良反应的影响因素,并探讨其护理方法。方法选取2014年10月~2017年5月在我院行静脉输注药物治疗的患者172例为研究对象,按随机数字表法分为对照组和实验组各86例,对照组实施常规护理,实验组实施护理干预,观察比较两组患者的护理效果。结果药物与器具、患者自身条件、护理人员技术能力等是影响急诊静脉输注药物不良反应的主要因素。实施护理干预后的实验组患者不良反应发生率显著低于对照组,组间差异有统计学意义(P0.05)。结论分析和掌握静脉输注药物不良反应的影响因素,并采取科学有效的护理干预措施可有效预防药物不良反应,提高用药安全性。     

笼养猕猴瘫痪症防治的探讨

目的对长期笼养后肢瘫痪的猕猴，采用人工护理和药物治疗进行防治使之恢复正常。方法瘫痪猴采用科学合理的饲料配方，保证有充足的营养，笼舍保证宽大的活动空间和充足的日光，并有供其跳跃攀登活动的栖息架，按摩瘫痪肢体及功能锻炼等人工护理；同时使用维生素A、复合维生素B、维生素C和维生素D等维生素药物治疗，配合使用转移因子、干扰素、前列腺素、肾上腺皮质激素等炎症和免疫抑制药物辅助治疗。结果共实施治疗护理瘫痪猴18例，治愈率达60％，恢复良好，能正常行走活动。结论采用人工护理配合药物治疗，防治排尿粪障碍、后肢萎缩、淤血、水肿和坏死等，瘫痪猴能取得良好的治疗效果，对保护珍贵猕猴动物资源，减少因瘫痪引起猕猴的痛苦或死亡均有一定的参考价值。     

成人结核性脑膜炎的护理体会

作者介绍了成人结核性脑膜炎（简称结脑）的护理体会。认为：护士除了要精确地掌握结脑的临床分期与护理要点外,还要重视抗结脑药物治疗的护理,使患者都通过治疗和护理获得早日康复。     

脑血栓病人的心理护理

脑血栓病人的心理护理总参管理局医院车秀珍清栓酶是治疗脑血栓病的一种比较理想的药物。此药的特点是见效快,副作用小。近年来,在用该药治疗脑血栓病人过程中,我们体会到,做好患者的心理护理是治疗中不可缺少的重要环节。做好患者的心理护理,首先要了解、理解病人的...     

护理干预对氯胺酮相关性膀胱炎的影响分析

目的 探讨护理干预对滥用氯胺酮(K粉)所致相关性膀胱炎患者的治疗效果.方法 将我科收治的15例K粉相关性膀胱炎患者在药物治疗基础上实行积极有效的护理干预,并通过治疗前后抑郁与焦虑的心理评分分析患者的生活质量有无改善.结果 15例患者在药物治疗基础上实行积极有效的护理干预后症状均有所改善,患者抑郁与焦虑的心理评分也明显改善,差异有显著性(P<0.001).结论 K粉所致相关性膀胱炎患者经过有效的治疗和护理干预,能明显改善患者负性心理状况,缓解膀胱炎症状,随访6个月均无复吸现象.     

老年人常见呼吸系统疾病临床护理研究

目的研究老年人常见呼吸系统疾病的临床护理。方法选取本院在2013年4月至2014年4月期间收治的102例老年常见呼吸系统疾病患者作为研究对象,通过实验室检测,所有患者均确诊为呼吸系统疾病。在药物治疗的基础上进行护理干预,同时对老年患者的临床护理进行分析。结果患者药物治疗和护理干预下,病情有了明显的改善,效果明显。结论老年人常见呼吸系统疾病与相关疾病有着紧密联系,因此要做好临床基础护理,提高患者的排痰、氧疗以及心理护理,同时引导患者养成良好的生活习惯,适当的锻炼身体,提高免疫力和抵抗力。     

抗糖尿病药的分类及其临床应用

抗糖尿病药是指用于降低血中的葡萄糖浓度来治疗糖尿病的一类药物.治疗的目的是使胰脏增加胰岛素的分泌量,或增加细胞对胰岛素的敏感性,或减少肠胃道吸收葡萄糖的速率.在临床实践中,要基于糖尿病的种类、患者的年龄和个人情况及其他原因选择抗糖尿病药.本研究系统地阐述抗糖尿病药物的分类和临床应用,为糖尿病患者对症下药和有效护理提供理论依据.     

Electrophysiological characterization of Tityus obscurus β toxin 1 (To1) on Na+-channel isoforms

To1, previously named Tc49b, is a peptide neurotoxin isolated from venom of the scorpion Tityus obscurus that is responsible for lethal human poisoning cases in the Brazilian Amazonian region. Previously, To1 was shown to be lethal to mice and to change Na⁺ permeation in cerebellum granular neurons from rat brain. In addition, To1 did not affect Shaker B K⁺ channels. Based on sequence similarities, To1 was described as a β-toxin. In the present work, To1 was purified from T. obscurus venom and submitted to an electrophysiological characterization in human and invertebrate Na_V channels. The analysis of the electrophysiological experiments reveal that To1 enhances the open probability at more negative potentials of human Na_V 1.3 and 1.6, of the insect channel BgNa_V1 and of arachnid VdNa_V1 channel. In addition, To1 reduces the peak of Na⁺ currents in some of the Na_Vs tested. These results support the classification of the To1 as a β-toxin. A structure and functional comparison to other β-toxins that share sequence similarity to To1 is also presented.     

The soybean F3′H protein is localized to the tonoplast in the seed coat hilum

We previously isolated a soybean (Glycine max (L.) Merr.) flavonoid 3'-hydroxylase (F3'H) gene (sf3'h1) corresponding to the T locus, which controls pubescence and seed coat color, from two near-isogenic lines (NILs), To7B (TT) and To7G (tt). The T allele is also associated with chilling tolerance. Here, Western-blot analysis shows that the sf3'h1 protein was predominantly detected in the hilum and funiculus of the immature seed coat in To7B, whereas sf3'h1 was not detected in To7G. A truncated sf3'h1 protein isolated from To7G was detected only upon enrichment by immunoprecipitation. An analysis using diphenylboric acid 2-aminoethyl ester (DBPA) staining revealed that flavonoids accumulated in the hilum and the funiculus in both To7B and To7G. Further, the scavenging activity of the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical in methanol extracts from the funiculus and hilum of To7B was higher than that of To7G. Moreover, the enzymatic activity of F3'H was detected using microsomal fractions from yeast transformed with sf3'h1 from To7B, but not from To7G. These results indicate that sf3'h1 is involved in flavonoid biosynthesis in the seed coat and affects the antioxidant properties of those tissues. As shown by immunofluorescence microscopy, the sf3'h1 protein was detected primarily around the vacuole in the parenchymatic cells of the hilum in To7B. Further immunoelectron microscopy detected sf3'h1 protein on the membranous structure of the vacuole. Based on these observations, we conclude that F3'H, which is a cytochrome P450 monooxygenase and has been found to be localized to the ER in other plant systems, is localized in the tonoplast in soybean.     

An equine chromosome 3 inversion is associated with the tobiano spotting pattern in German horse breeds

The tobiano white-spotting pattern is one of several known depigmentation phenotypes in horses and is desired by many horse breeders and owners. The tobiano spotting phenotype is inherited as an autosomal dominant trait. Horses that are heterozygous or homozygous for the tobiano allele ( To ) are phenotypically indistinguishable. A SNP associated with To had previously been identified in intron 13 of the equine KIT gene and was used for an indirect gene test. The test was useful in several horse breeds. However, genotyping this sequence variant in the Lewitzer horse breed revealed that 14% of horses with the tobiano pattern did not show the polymorphism in intron 13 and consequently the test was not useful to identify putative homozygotes for To within this breed. Speculations were raised that an independent mutation might cause the tobiano spotting pattern in this breed. Recently, the putative causative mutation for To was described as a large chromosomal inversion on equine chromosome 3. One of the inversion breakpoints is approximately 70 kb downstream of the KIT gene and probably disrupts a regulatory element of the KIT gene. We obtained genotypes for the intron 13 SNP and the chromosomal inversion for 204 tobiano spotted horses and 24 control animals of several breeds. The genotyping data confirmed that the chromosomal inversion was perfectly associated with the To allele in all investigated horses. Therefore, the new test is suitable to discriminate heterozygous To/+ and homozygous To/To horses in the investigated breeds.     

Rpp25 is a major target of autoantibodies to the Th/To complex as measured by a novel chemiluminescent assay

Introduction

Autoantibodies to the Th/To antigen have been described in systemic sclerosis (SSc) and several proteins of the macromolecular Th/To complex have been reported to react with anti-Th/To antibodies. However, anti-Th/To has not been clinically utilized due to unavailability of commercial tests. The objective of the present study is to evaluate the newly developed ELISA and chemiluminescent immunoassay (CLIA) to measure autoantibodies to Rpp25 (a component of the Th/To complex) using immunoprecipitation (IP) as the reference method.

Methods

The first cohort consisted of 123 SSc patients including 7 anti-Th/To positive samples confirmed by IP. Additional seven anti-Th/To positive samples from non-SSc patients were also tested. For evaluation of the QUANTA Flash Rpp25 CLIA (research use only), 8 anti-Th/To IP positives, a cohort of 70 unselected SSc patients and sera from various disease controls (n = 357) and random healthy individuals (n = 10) were studied.

Results

Anti-Rpp25 antibodies determined by ELISA were found in 11/14 anti-Th/To IP positive but only in 1/156 (0.6%) negative samples resulting in a positive percent agreement of 78.6% (95% confidence interval [CI] 49.2, 95.3%) and a negative percent agreement of 99.4% (95% CI 96.4, 100.0%). To verify the results using a second method, 53 samples were tested by ELISA and CLIA for anti-Rpp25 reactivity and the results were highly correlated (rho = 0.71, 95% CI 0.56, 0.81; P < 0.0001). To define the cutoff of the CLIA, anti-Th/To IP positive and negative sera were tested using the anti-Rpp25 CLIA. At the cutoff selected by receiver operating characteristic (ROC) analysis 8/8 (100.0%) of the anti-Th/To positive sera but only 2/367 (0.5%) of the controls were positive for anti-Rpp25 antibodies. The positive and negative percent agreements were 100.0% (95% CI 63.1, 100.0%) and 99.5% (95% CI 98.0, 99.9%), respectively. In the disease cohorts 2/70 (2.9%) of the SSc patients were positive for anti-Rpp25 antibodies compared to 2/367 (0.5%) of the controls (P = 0.032). ROC analysis showed discrimination between SSc patients and controls with an area under the curve value of 0.732 (95% CI 0.655, 0.809).

Conclusion

Rpp25 is a major target of autoantibodies to the Th/To autoantigen complex. Further studies are needed to evaluate the clinical utility of the new assays.     

Definition of the Th/ To ribonucleoprotein by RNase P and RNase MRP

We show that the Th/ To ribonucleoprotein is defined by (i) the co-immunoprecipitation of two RNAs, (ii) the co-immunoprecipitation of four major polypeptides and (iii) the quantitative immune recognition of both RNase P and RNase MRP. No serum was found that recognizes either one of these two enzymes exelusively. The specific co-immunoprecipitation of RNase MRP and RNase P by all Th/ To ribonucleoprotein autoantibodies indicates that the anti-Th/ To autoimmune response is directed against both enzymes in a quantitatively indistinguishable manner. Thus the Th/ To ribonucleoprotein is defined by RNase P and RNase MRP.     

儿童慢性鼻窦炎的综合治疗

目的探讨儿童慢性鼻窦炎的有效治疗方法。方法回顾分析2001年1月～2004年10月在大连大学附属中山医院治疗的113例儿童慢性鼻窦炎的临床资料,分析5种治疗方法的疗效。结果根据患儿的病情,分别采取5种治疗方法,按1997年海口会议标准评定疗效,总有效率为88．5％。结论儿童慢性鼻窦炎的治疗要根据病情及伴随的相关疾病采取相应的治疗方法,才能提高疗效。     

Investigations of Takeout proteins’ ligand binding and release mechanism using molecular dynamics simulation

Takeout (To) proteins exist in a diverse range of insect species. They are involved in many important processes of insect physiology and behaviors. As the ligand carriers, To proteins can transport the small molecule to the target tissues. However, ligand release mechanism of To proteins is unclear so far. In this contribution, the process and pathway of the ligand binding and release are revealed by conventional molecular dynamics simulation, steered molecular dynamics simulation and umbrella sampling methods. Our results show that the α4-side of the protein is the unique gate for the ligand binding and release. The structural analysis confirms that the internal cavity of the protein has high rigidity, which is in accordance with the recent experimental results. By using the potential of mean force calculations in combination with residue cross correlation calculation, we concluded that the binding between the ligand and To proteins is a process of conformational selection. Furthermore, the conformational changes of To proteins and the hydrophobic interactions both are the key factors for ligand binding and release.     

Identification and phylogenetic analysis of Tityus pachyurus and Tityus obscurus novel putative Na+-channel scorpion toxins

Background

Colombia and Brazil are affected by severe cases of scorpionism. In Colombia the most dangerous accidents are caused by Tityus pachyurus that is widely distributed around this country. In the Brazilian Amazonian region scorpion stings are a common event caused by Tityus obscurus. The main objective of this work was to perform the molecular cloning of the putative Na⁺-channel scorpion toxins (NaScTxs) from T. pachyurus and T. obscurus venom glands and to analyze their phylogenetic relationship with other known NaScTxs from Tityus species.

Methodology/Principal Findings

cDNA libraries from venom glands of these two species were constructed and five nucleotide sequences from T. pachyurus were identified as putative modulators of Na⁺-channels, and were named Tpa4, Tpa5, Tpa6, Tpa7 and Tpa8; the latter being the first anti-insect excitatory β-class NaScTx in Tityus scorpion venom to be described. Fifteen sequences from T. obscurus were identified as putative NaScTxs, among which three had been previously described, and the others were named To4 to To15. The peptides Tpa4, Tpa5, Tpa6, To6, To7, To9, To10 and To14 are closely related to the α-class NaScTxs, whereas Tpa7, Tpa8, To4, To8, To12 and To15 sequences are more related to the β-class NaScTxs. To5 is possibly an arthropod specific toxin. To11 and To13 share sequence similarities with both α and β NaScTxs. By means of phylogenetic analysis using the Maximum Parsimony method and the known NaScTxs from Tityus species, these toxins were clustered into 14 distinct groups.

Conclusions/Significance

This communication describes new putative NaScTxs from T. pachyurus and T. obscurus and their phylogenetic analysis. The results indicate clear geographic separation between scorpions of Tityus genus inhabiting the Amazonian and Mountain Andes regions and those distributed over the Southern of the Amazonian rainforest. Based on the consensus sequences for the different clusters, a new nomenclature for the NaScTxs is proposed.     

Oxygen transfer, gill resistance and structural changes in rainbow trout (Salmo gairdneri, Richardson) gills perfused with vasoactive agents

1. Gill resistance (Rg) and oxygen transfer (To2) were measured in perfused rainbow trout gills. After perfusion the gills were analysed morphometrically. 2. Rg increased with 40% and To2 decreased with 91% during 60 min perfusion without vasoactive substances in the perfusion Ringer. 3. In presence of 10 micro M adrenaline both Rg and To2 remained stable at their starting levels throughout the experimental period (60 min). 4. With 0.2 micro M acetylcholine and 10 micro M adrenaline in Ringer Rg increased nearby to the same extent as in perfusions without vasoactive agents, while To2 was not significantly affected. 1 micro M acetylcholine increased Rg with 76% and decreased To2 with 51%. 5. The changes in Rg and To2 could be explained by structural changes in the secondary lamellae.