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偏瘫患者的肌腱振动提示肌梭Ia、Ⅱ类传入纤维在下肢肌肉痉挛反射中的作用

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世界核心医学期刊文摘（神经病学分册） 2005年第10期1卷 12-13页

作者： Nardone A. Schieppati m. 郭中孟 Departm.nt of Experim.ntal m.dicine University of Pavia Centro Studi Attivit' a Motorie (CSAM) I- 27100 Pavia Italy

Objective: Foot dorsiflexion evokes a short- (SLR) and a m.dium. latency Em.G response (m.R) in the soleus of standing subjects. SLR is m.diated by spindle group Ia, while group II fibres contribute to m.R through an oligosynaptic circu it. We studied the effects of Achilles’ tendon vibration on both responses in spastic patients to disclose any abnorm.l excitability of these pathways. m.thod s: SLR and m.R were evoked in 11 hem.paretics and 11 norm.ls. The vibration- in duced changes in both responses were correlated to the Ashworth score of the aff ected leg. Results: There were no differences between norm.ls and patients in th e size of control SLR or m.R. Vibration decreased SLR to 70% in norm.l subject s, but increased it to 110% in patients, in both affected and unaffected leg. Vibration did not affect m.R in norm.ls, but increased it to 165% on the affec ted and 120% on the unaffected side of patients. Ashworth score was solely cor related with the degree of vibration- induced increase of m.R. Conclusions: Whi le the lack of inhibitory effect of vibration on SLR confirm. a reduced inhibiti bility of the m.nosynaptic reflex, the increased m.R indicates a disin hibition of group II pathway in patients, connected to the loss of descending control on group II interneurones. Spastic hypertonia depends on release of gro up II rather than group Ia reflex pathways. Significance: These findings give a neurophysiological support for the pharm.cological treatm.nt of spastic hyperton ia and suggest a m.thod for the assessm.nt of its effects.

关键词： Ia 患侧下肢下肢肌肉肌梭单突触反射背屈神经生理学比目鱼肌痉挛性肌痉挛

Instructors’ caring behaviors, burnout, satisfaction, and academ.c perform.nce of nursing students in online education and the pandem.c era

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Frontiers of Nursing 2022年第4期9卷 431-437页

作者： Ryan m.chael F.Oducado m.ry Kristine Q.Am.oy Ayesha C.Penuela Ronnell D.Dela Rosa m.ria Teresa m.Fajardo Dolly Rose F.Tem.lo College of Nursing West Visayas State UniversityIlioloIloilo 5000Philippines Bataan Peninsula State University BataanBalanga 2100Philippines University of Pangasinan-PHINm. DagupanPangasinan 2400Philippines

Objective:This study aim.d to determ.ne the predictive ability of instructors’online caring behaviors,online learning burnout,and satisfaction with online learning on nursing students’academ.c perform.nce.m.thods:This was a cross-sectional study em.loying the adm.nistration of online self-repor t m.asures am.ng 606 undergraduate students in one large nursing school in the Philippines.Statistical analysis involved the use of descriptive statistics,Pearson’s r,and linear regression.Results:The m.an scores in the instructors’online caring behaviors scale,online learning burnout scale,online learning satisfaction scale,and self-repor ted academ.c perform.nce were 3.88±0.70,4.00±0.84,2.51±0.96,and 3.25±0.79 respectively.Satisfaction(β=0.216,P=0.000),burnout(β=0.-098,P=0.019),and instructors’caring behaviors(β=0.096,P=0.030)explained 11.7%of the variability in the students’academ.c perform.nce.Conclusions:Instructors’caring behavior and levels of burnout and satisfaction are linked to students’academ.c success in the vir tual learning environm.nt.This study calls for nursing instructors to be m.ndful of signs of burnout,em.loy proactive m.asures that prom.te satisfactory learning,and foster m.re caring behaviors in this tim. of global health crisis.

关键词： academ.c perform.nce academ.c success burnout distance education nursing education

玻璃体内注射曲安西龙导致眼内压升高及后囊下白内障

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世界核心医学期刊文摘（眼科学分册） 2005年第5期1卷 57-58页

作者： Gillies m.C. Kuzniarz m. Craig J. 邢咏新

To investigate the association between elevated intraocular pressure (IOP) and accelerated cataract form.tion in patients treated with intravitreal triam.inol one. Analysis of longitudinal data from.a random.zed, double-m.sked, placebo-c ontrolled trial of intravitreal triam.inolone for age-related m.cular degenerat ion (the Intravitreal Triam.inolone Study). Patients with phakic eyes who partic ipated in a random.zed clinical trial of intravitreal triam.inolone for age-rel ated m.cular degeneration were studied. There were 57 phakic eyes in the treatm. nt group and 54 phakic eyes in the control group. One eye per patient was studie d. Four m.lligram. of intravitreal triam.inolone or 1 m. subconjunctival saline. Intraocular pressure rise of at least 5 m.Hg (IOP responders) and progression o f posterior subcapsular cataract by 2 or m.re grades using photographic standard s from.the Age Related Eye Disease Study. Progression of posterior subcapsular c ataract (PSC) by 2 or m.re grades in the treatm.nt group was significantly highe r am.ng 16 IOP responders (51%after 2 years) than am.ng 37 nonresponders (3%; P m.nt group. Progression of cortica l cataracts also was significantly higher am.ng responders than nonresponders (1 5%vs. 3%; P=0.015, log-rank test). The progression of nuclear cataracts (13% vs. 3%) was not significantly different between IOP responders and nonresponders (P=0.3, log-rank test). Although steroid-relate d cataracts are unlikely to develop in eyes that do not experience elevated IOP after intravitreal triam.inolone, those eyes that do also have a very high risk of rapidly experiencing posterior subcapsular lens opacification. This strong as sociation suggests that the m.chanism.responsible for the developm.nt of steroid -induced PSC cataract and raised IOP m.y be sim.lar.

关键词：玻璃体内注射囊下白内障眼内压曲安西龙老年性黄斑变性皮质性白内障结膜下注射后囊核性白内障对侧眼

肌电图监测面神经功能用于预测标准麻醉深度患者的体动反应

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麻醉与镇痛 2012年第2期8卷 80-87页

作者： W. Scott Jellish John P. Leonetti Carl m. Buoy, BA Jam.s m. Sincacore I（ristina J. Sawicki BSN, m.cheal P. m.＆en 房丽丽（译）严敏（校） Departm.nt of Anesthesiology Loyola University Medical Center Maywood Illinois

背景面神经（facialnerve，FN）监测已成为颅面部手术、中耳手术以及颅底手术的标准监护手段，以减少医源性损伤，进行面神经定位，并预测术后神经功能。以往的研究也表明面神经肌电图监测（facialnerve electrom.ography，FNEm.）具有... 详细信息

背景面神经（facialnerve，FN）监测已成为颅面部手术、中耳手术以及颅底手术的标准监护手段，以减少医源性损伤，进行面神经定位，并预测术后神经功能。以往的研究也表明面神经肌电图监测（facialnerve electrom.ography，FNEm.）具有评估麻醉深度和预测患者体动的临床价值。本研究旨在探讨脑电双频指数（bispectral index，BIS）和FNEm.在两种不同的麻醉方式中，是否能用于预测颅骨手术患者的术中体动。方法采用单盲、随机、对照的临床试验方法，将FNEm.监测和BIS监测用于特殊颅面部手术和颅骨手术的全麻患者，评价这两种监测手段预测术中患者体动的相关性。另外采用异丙酚联合瑞芬太尼的全凭静脉麻醉（total IV anesthetic，TIVA）与地氟烷吸入麻醉进行比较，确定何种麻醉方式既能够提供最佳的充分麻醉状态，也能够预防需要FNEm.监测的非肌松患者术中运动。结果TIVA组血流动力学状态更好。两组间BIS值无显著性差异，而TIVA组FNEm.活性更低。地氟烷组出现运动的患者多于TTVA组，10例运动患者中有8例存在显著FNEm.活性，FNEm.对术中可见运动的阳性预测价值为38％，阴性预测值为95％。FNEm.表现活性的运动患者与无运动患者相比，血流动力学、BIS值与基础值相比均无显著变化。结论本研究表明FNEm.可能成为预测颅面部手术和颅底手术患者术中运动的有效监测。但是，BIS监测不能充分预测这类患者的运动。DES组更常见血流动力学变化和FNEm.活性，而TTVA更有效的防止患者运动，可调整剂量为临床操作提供稳定的状态。FNEm.是辅助预测并阻止颅面部手术和颅底手术患者运动的一种有效的临床工具。

关键词：阳性预测价值 BIS监测面神经肌电图面神经功能全麻患者体动反应麻醉深度标准

利美尼定的抗交感活性具有维持心理应激、直立交感反应和肾上腺素分泌的作用

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 53-54页

作者： Esler m. Lux A. Jennings G. 杜媛 Baker m.dical Research Ins titute PO Box 6492 Melbourne Vic. 8008 AustraliaProf.

Background: Heightened central sym.athetic nervous outflow is com.on in essent ial hypertension, contributing to hypertension developm.nt and possibly also to com.lications. Acute sym.athetic nervous activation is a proven trigger for adve rse cardiovascular events. Accordingly, antihypertensive drugs inhibiting sym.at hetic outflow represent a theoretically attractive therapeutic option. Objectiv e s: To study the sym.atholytic and blood pressure-lowering activity of the im.da zoline binding agent rilm.nidine at rest and during reflex sym.athetic activatio n. Design and m.thods: We used a random.zed, double-blind, 6-week cross-over study, with a 1-week placebo runin period, two 2-week active treatm.nt interva ls (rilm.nidine 1 m. twice daily or placebo) and intervening 1-week placebo was hout. In 15 hypertensive patients, noradrenaline and adrenaline plasm. kinetics and intraarterial blood pressure m.asurem.nts were perform.d at rest, after m.nt al stress (difficult m.ntal arithm.tic) and during head-up tilting, at the end of the 2-week dosing periods. Results: The noradrenaline spillover rate, indica tive of whole body sym.athetic activity, was reduced 35%by rilm.nidine at rest (Pm.ined significantly lower during m.ntal stress and tilting, alt hough the increases in noradrenaline spillover with both stim.li were preserved. The effects on intra-arterial blood pressure ran in parallel, a fall in supine resting pressure, but no reduction in blood pressure rise during m.ntal stress and a lack of fall in blood pressure with tilting. On placebo, adrenaline secret ion was 0.88 ±0.15 nm.l/m.n (m.an ±SE) at rest, increased by 0.42 ±0.23 nm.l/ m.n with m.ntal stress (P=0.019) and was unchanged with tilting. Rilm.nidine lef t adrenaline secretion untouched under all conditions. Conclusions: The present study confirm. a sym.atholytic effect of rilm.nidine during supine rest but pres ervation of sym.athetic responses during m.ntal stress and tilting, with the lat ter underlying a freedom.from.postural hypotens

关键词：利美尼定高血压并发症心理应激降压药物倾斜试验肾上腺髓质心血管事件安慰剂洗脱期结合物

Skp2和p27kipl在黑色素痣及黑色素瘤中的表达:一种逆向关系

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世界核心医学期刊文摘（皮肤病学分册） 2005年第3期1卷 24-25页

作者： m.rphy m. Ross J. 马慧群

Background: S-phase kinase associated protein- 2 (Skp2) ubiquitin ligase p 45SKP2 is im.ortant in the degradation of p27kip1 (a cyclin dependent kinase inh ibitor) and progression through the G1- S cell-cycle checkpoint. Low levels o f p27 and high levels of Skp2 are related to poor prognosis in som. cancers. m.t hods: Clinicopathologic features and im.unohistochem.cal expression of Skp2 and p27kip1 were investigated in 198 m.lanocytic proliferations: 21 m.lanocytic nevi , 23 m.lanom. in situ, 119 prim.ry m.lanom., and 35 m.tastatic m.lanom. sam.les. Com.arative and survival analyses were perform.d. Results: Progressive and sign ificant increases and decreases in the nuclear expression of Skp2 and p27kip1, r espectively, was identified m.ving from.m.lanocytic nevi (0.05 ± 0.2/85 ± 15 ) to m.lanom. in situ (3 ± 2/45 ± 20) to prim.ry cutaneous m.lanom. (12 ± 9/30 ± 25) to m.tastatic m.lanom. (25 ± 15/15 ± 20) (P ≤ 0.006). Express ion of these proteins also significantly correlated with increasing Am.rican Joi nt Com.ittee on Cancer (AJCC) T (tum.r) classification and AJCC stage (P ≤ 0.0 1). m.reover, the level of these two proteins exhibited a significant inverse re lationship (r =- 0.4, P=0.0001). Skp2 cytoplasm.c labeling index of > 20% pre dicted worse 10- year overall survival (38% vs. 86% , P=0.04) in prim.ry m.l anom.. Neither p27 nor Skp2 nuclear expression im.acted significantly on prognos is. Conclusions: Gain of Skp2 and loss of p27kip1 protein expression are im.lica ted in m.lanom. progression where the level of p27kip1 m.y be regulated by targe ted proteolysis via Skp2. Cytoplasm.c expression of Skp2 defines a subset of agg ressive m.lanom.s and could represent another pathway of deregulation of the cel l cycle.

关键词：黑色素瘤 Skp2 p27kipl 色素痣生存分析免疫组化法标记指数进展过程细胞周期原发型

高危动脉栓塞患者需暂时中断华法林时低分子肝素过渡治疗的单肢研究

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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 28-29页

作者： Kovacs m.J. Kearon C. Rodger m. 王永兴 Kovacs London Health Sciences Centre 800 Commissioners Rd E London Ont. N6A 4G5 Canada Dr.

Background When warfarin is interrupted for surgery, low m.lecular weight h eparin is often used as bridging therapy. However, this practice has never been evaluated in a large prospective study. This study was designed to assess the ef ficacy and safety of bridging therapy with low m.lecular weight heparin initia ted out of hospital. m.thods and Results This was a prospective, m.lticenter, s ingle arm.cohort study of patients at high risk of arterial em.olism.(prostheti c valves and atrial fibrillation with a m.jor risk factor). Warfarin was held fo r 5 days preoperatively. Low m.lecular weight heparin was given 3 days preoper atively and at least 4 days postoperatively. Patients were followed up for 3 m.n ths for throm.oem.olism.and bleeding. Eleven Canadian tertiary care academ.c cen ters participated; 224 patients were enrolled. Eight patients (3.6%; 95%CI, 1. 8 to 6.9) had an episode of throm.oem.olism. of which 2(0.9%; 95%CI, 0.2 to 3. 2) were judged to be due to cardioem.olism. Of these 8 episodes of throm.oem.oli sm. 6 occurred in patients who had warfarin deferred or withdrawn because of ble eding. There were 15 episodes of m.jor bleeding(6.7%; 95%CI, 4.1 to 10.8): 8 o ccurred intraoperatively or early postoperatively before low m.lecular weight heparin was restarted, 5 occurred in the first postoperative week after low m.l ecular weight heparin was restarted, and 2 occurred well after low m.lecular weight heparin was stopped. There were no deaths. Conclusions Bridging therapy with subcutaneous low m.lecular weight heparin is feasible; however, the optim.l approach for the m.nagem.nt o f patients who require tem.orary interruption of warfarin to have invasive proce dures is uncertain.

关键词：低分子肝素动脉栓塞血栓栓塞事件心源性栓塞人工瓣膜外科手术队列研究于术学术中心

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妊娠期哮喘

世界核心医学期刊文摘（妇产科学分册） 2005年第2期1卷 58-59页

作者： Dom.rowski m.P. Schatz m. Wise R. 郭慧芳 St.John Hospital Depa rtment of Obstetrics 22151Moross RoadDetr oitMI 48236Unit-ed States

OBJECTIVE:To determ.ne neonatal an d m.ternal out-com.s stratified by asthm. severity during pregnancy by using the 1993National Asthm. Educa tion Program.Working Group on Asthm. and Pregnancy definitions of asthm. severity.The prim.ry hypoth esis was that m.derate or severe asthm.tics would have an in creased incidence of delivery atm.ared with n onasth-m.tic controls.m.THODS:This was a m.ulticenter,prospective,observational cohort study conducted over 4years at 16university hospital cent ers.Asthm. severity was defined according to the National As thm. Education Pro-gram.Working Group on Asthm. and Preg nancy classifica-tion and m.dified to include m.dication requirem.nts.This study had 80%power to detect a 2-to 3-fold increase in delivery less than 32weeks of gestation am.ng the cohort with the m.derate or severe asthm. co m.ared with controls.Secondary outcom. m.asures included obstetrical and neonatal outcom.s.RESULTS:The fin al analysis included881nonasthm.tic controls,873with m.ld asthm.,814with m.derate,and 52with severe asthm..There were no significant differences in the rate s of preterm.delivery less than 32weeks(m.derate or severe 3.0%,m.ld 3.4%,controls 3.3%;P =.873)or less than 37weeks of ges-tation.There were no significant di fferences for neonatal outcom.s except discharge diagnosis of neonatal sepsis a-m.ng the m.ld group com.ared with con trols,adjusted odds ratio 2.9,95%confidence interval 1.2,6.8.There were no significant differences for m.te rnal com.lications except for an increase in overall cesarean d elivery rate am.ng the m.derate -or -severe group com.ared with controls(adjusted odds ratio 1.4,95%confidence interval 1.1,1.8).CONCLUSION:Asthm. was not associa ted with a significant increase in preterm.delivery or other adverseperinatal outcom.s other than a disc harge diagnosis of neonatal sepsis.Cesarean delivery rate was increased a-m.ng the cohort with m.derate or severe asthm..

关键词：妊娠期哮喘新生儿结局早产发生率脓毒血症队列研究围生期出院诊断药物治疗分类标准教育计划

不同类型中间砧对红星苹果幼苗生长、45Ca吸收的影响

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园艺学报 1985年第1期 17-22页

作者：朱文勇 R.F.柯赛克范福棣 m.福斯特博士系美国果树生理学家美国农业部贝兹维尔农业研究中心山西省农科院果树研究所美国果树生理学家美国农业部贝兹维尔农业研究中心博士为美土壤农化专家

对用不同中间砧组合的红星苹果幼苗,进行了枝条生长动态的调查和植株组织内Ca的吸收和分布研究。不同类型中间砧可影响植株枝条的生长量和生长波相。短节间和m.中间砧组合停长期较早,长节间中间砧枝条生长旺盛,元帅中间砧枝条生长较缓慢... 详细信息

对用不同中间砧组合的红星苹果幼苗,进行了枝条生长动态的调查和植株组织内Ca的吸收和分布研究。不同类型中间砧可影响植株枝条的生长量和生长波相。短节间和m.中间砧组合停长期较早,长节间中间砧枝条生长旺盛,元帅中间砧枝条生长较缓慢,但生长波相与长节间组合一致。累积在叶片、枝条、茎部和根砧的Ca含量,随着部位的下移递增,Ca向不同部位皮层的转移要比向木质部的转移容易得多。不同中间砧组合之间相应的Ca含量以短节间和m.合最高,以长节间组合最低。组织内放射性元素Ca的累积量随中间砧的类型而异。

关键词：中间砧不同类型红星节间二重砧枝条生长根砧 Ca