笔者承认安妮·金特里与编制本手稿，兰迪Wesnitzer，初始纸静脉（IV）胰岛素协议和Devy A.李某，理学士（医药），CMPP的数据收集和分析的药学博士，药学博士，她协助她在编辑和手稿准备的援助。

<ol>
	<li>Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thaler, L. M., Ktabchi, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hyperglycemia:+an+independent+marker+of+in-hospital+mortality+in+patients+with+undiagnosed+diabetes.">Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes.</a> J. Clin. Endocrinol. Metab. 87, 978-982 (2002).</li><li>Bochicchio, G. V., Sung, J., Josh, M. I., Bochicchio, K., Johnson, S. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Persistent+hyperglycemia+is+predictive+of+outcome+in+critically+ill+trauma+patients.">Persistent hyperglycemia is predictive of outcome in critically ill trauma patients.</a> J. Trauma. 58, 921-924 (2005).</li><li>Finfer, S., Delaney, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tight+glycemic+control+in+critically+ill+adults.">Tight glycemic control in critically ill adults.</a> JAMA. 300, 963-965 (2008).</li><li>American Diabetes Association. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Standards+of+medical+care+in+diabetes-2008.">Standards of medical care in diabetes-2008.</a> Diabetes Care. 31, S12-S54 (2008).</li><li>Moghissi, E. S., Korytkowski, M. T., DiNardo, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+Association+of+Clinical+Endocrinologists+and+American+Diabetes+Association+Consensus+statement+on+inpatient+glycemic+control.">American Association of Clinical Endocrinologists and American Diabetes Association Consensus statement on inpatient glycemic control.</a> Endocr. Pract. 15, 1-17 (2009).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+NICE-SUGAR+Study+Investigators.+Intensive+versus+conventional+glucose+control+in+critically+ill+patients.">The NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients.</a> N. Engl. J. Med. 360, 1283-1297 (2009).</li><li>Brunkhorst, F. M., Engel, C., Bloos, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+insulin+therapy+and+pentastarch+resuscitation+in+severe+sepsis.">Intensive insulin therapy and pentastarch resuscitation in severe sepsis.</a> N. Engl. J. Med. 358, 125-139 (2008).</li><li>Griesdale, D. E., de Souza, R. J., van Dam, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+insulin+therapy+and+mortality+among+critically+ill+patients:+a+meta-analysis+including+NICE-SUGAR+study+data.">Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data.</a> CMAJ. 180, 821-827 (2009).</li><li>Van den Berghe, G., Wilmer, A., Hermans, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+insulin+therapy+in+the+medical+ICU.">Intensive insulin therapy in the medical ICU.</a> N. Engl. J. Med. 354, 449-461 (2006).</li><li>Trence, D. L., Kelly, J. L., Hirsch, I. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+rationale+and+management+of+hyperglycemia+for+in-patients+with+cardiovascular+disease:+time+for+change.">The rationale and management of hyperglycemia for in-patients with cardiovascular disease: time for change.</a> J. Clin. Endocrinol Metab. 88, 2430-2437 (2003).</li></ol>

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这EndoTool系统的选择，因为其复杂的算法和易用性。该计划是美国食品和药物管理局（FDA）批准，并协助该机构在健康保险可移植性和责任法案（HIPAA）符合。它可以装上了医院的服务器和内联网，而不需要额外的硬件。 该软件采用数学建模来计算病人特定的生理胰岛素剂量曲线的基础上，输入特定病人的血糖浓度。第四胰岛素剂量的基础是一个复杂的反馈机制，在控制的数学基础。该软件采用33算法分析和解释以前的病人的血糖读数，结合最近四个读数 - 在那个时间点来计算最合适的第四胰岛素剂量。随着每个后续的血糖读数的条目，曲线进行调整，以微量IZE极端的血糖浓度。初步匡算，因素影响血糖浓度，如糖尿病或糖皮质激素的使用存在/缺席，系统帐户。虽然协调小组提供准确和及时的在床边的剂量和速度信息，批判性思维仍然需要静脉胰岛素注射。制导计算机软件最终用户关于第四的胰岛素利率和碳水化合物的摄入量，新病人开始，在计算机中断（即服务器停机）做什么的信息提供指导。 的CGMS实施后，有一些医师的初步阻力，直到他们认为他们能够理解和信任的软件。然而，抵抗力减弱时，医务人员看到系统如何容易使用的，如何有效地控制血糖浓度，以及他们如何能够覆盖其建议，如果clinicallŸ必要的。总体而言，护理人员是渴望实现的CGMS由于他们的挫折与纸协议。然而，最初有一些护士在接受胰岛素输注率和丸剂量的CGMS建议犹豫。有时，系统会建议高得多的输液率和丸剂量保持在目标范围内的病人，比通常建议由纸协议。护士，早已成为舒适与协调小组的建议，并建议输注速率/丸剂量很少偏离。 住院患者良好的血糖控制的重要性已得到了很好的文献记载。这些研究表明当葡萄糖被有效地控制在住院期间的发病率和死亡率在下降。开关使用一个计算机化的葡萄糖在怀俄明州医学中心的管理体系文件的第四胰岛素协议。主要导致LLY改善目前的指导方针，按照高血糖患者的血糖控制，同时减少低血糖的风险。良好的血糖控制的好处，即使是医护专业人员之间，实施这样的策略了精心策划（ 见表2）。尽管纸协议的多个版本，在达到正常血糖水平，同时减少低血糖的结果是最理想的。总体而言，协调小组允许更迅速和更严格的血糖控制，实现了在所有读数大于75％的目标浓度。管理静脉注射胰岛素时，有一个天然的低血糖的恐惧。然而，使用CGMS低血糖的患病率为1％以下。

improving iv insulin administration in a community hospital

糖尿病是一个重要的独立危险因素，增加发病率和死亡率在住院和血糖浓度升高，即使在非糖尿病患者，预测不良后果。1-4美国临床内分泌学家协会（2008年共识声明AACE的）和美国糖尿病协会（ADA）指出，“在高血糖住院的病人，不论其原因，是明确不良后果。”重要的是要认识到，高血糖以及已知或确诊的糖尿病患者发生在那些以前糖耐量正常的急性疾病。 在重症监护评价生存的正常血糖葡萄糖算法规例（纳爱斯糖）超过600万成人重症监护病房（ICU）患者强化血糖控制或常规血糖，随机参与研究控制6令人惊讶的是，这项试验发现，强化血糖控制的死亡风险增加了14％（胜算比为1.14; P = 0.02）。此外，有严重的低血糖，在密集的对照组的患病率增加，比常规对照组（分别为6.8％和0.5％，P &lt;0.001）。从这一关键试验和另外两个人，7,8怀俄明州医学中心（WMC）实现了控制在住院的病人的高血糖，同时也避免了由此产生的低血糖的负面影响的重要性。 尽管静脉注射胰岛素纸协议，从纸协议在WMC的节目，在达到正常血糖水平，同时减少低血糖，结果不理想的使用数据分析的多个版本。因此，通过系统的实施计划，监测患者的血糖水平，使用纸张第四胰岛素协议切换到电脑葡萄糖managemenT系统。通过比较血糖水平的电脑系统使用纸协议，它被确定，总体来说，电脑的血糖管理系统，比传统的纸协议更迅速和更严格的血糖控制。具体来说，在大幅增加的时间花费在目标血糖浓度范围内，以及减少在严重的低血糖（血糖&lt;40毫克/升），临床低血糖（BG &lt;70毫克/升），高血糖的患病率（BG&gt; 180毫克/升），被目击在首五个月后葡萄糖计算机化管理系统的实施。电脑化系统，实现了在所有读数大于75％的目标浓度，同时减少低血糖的风险。低血糖的患病率（BG &lt;70毫克/升）与计算机的血糖管理系统的使用是在1％以下。

Watch this Scientific Journal Video about Improving IV Insulin Administration in a Community Hospital at JoVE.com

Improving IV Insulin Administration in a Community Hospital

相比上一纸协议，一个计算机化的血糖管理系统在目标范围内的大幅增加在血糖浓度测量结果的执行情况。使用一个计算机化的血糖管理系统，以监测血糖水平，减少严重低血糖（&lt;40毫克/升），临床低血糖（&lt;70毫克/升），也可以观察到的高血糖（&gt; 180毫克/升）。

提高在社区医院静脉注射胰岛素政府

Diabetes mellitus is a major independent risk factor for increased morbidity and mortality in the hospitalized patient, and elevated blood glucose ...

improving-iv-insulin-administration-in-a-community-hospital

Research

Education

JoVE Core

JoVE Journal

Nursing

Medicine

Unit 1

The Nursing Process II

SCIENTISTS IN ACTION

18.4K 次观看.  Wyoming Medical Center. 相比上一纸协议，一个计算机化的血糖管理系统在目标范围内的大幅增加在血糖浓度测量结果的执行情况。使用一个计算机化的血糖管理系统，以监测血糖水平，减少严重低血糖（

视频: Improving IV Insulin Administration in a Community Hospital

Intranasal Administration of CNS Therapeutics to Awake Mice

Intranasal administration is a method of delivering therapeutic agents to the central nervous system (CNS). It is non-invasive and allows large molecules that do not cross the blood-brain barrier access to the CNS. Drugs are directly targeted to the CNS with intranasal delivery, reducing systemic exposure and thus unwanted systemic side effects1. Delivery from the nose to the CNS occurs within minutes along both the olfactory and trigeminal neural pathways via an extracellular route and does not require drug to bind to any receptor or axonal transport2. Intranasal delivery is a widely publicized method and is currently being used in human clinical trials3.
Intranasal delivery of drugs in animal models allows for initial evaluation of pharmacokinetic distribution and efficacy. With mice, it is possible to administer drugs to awake (non-anesthetized) animals on a regular basis using a specialized intranasal grip. Awake delivery is beneficial because it allows for long-term chronic dosing without anesthesia, it takes less time than with anesthesia, and can be learned and done by many people so that teams of technicians can dose large numbers of mice in short periods. Efficacy of therapeutics administered intranasally in this way to mice has been demonstrated in a number of studies including insulin in diabetic mouse models 4-6 and deferoxamine in Alzheimer's mouse models. 7,8
The intranasal grip for mice can be learned, but is not easy and requires practice, skill, and a precise grip to effectively deliver drug to the brain and avoid drainage to the lung and stomach. Mice are restrained by hand using a modified scruff in the non-dominant hand with the neck held parallel to the floor, while drug is delivered with a pipettor using the dominant hand. It usually takes 3-4 weeks of acclimating to handling before mice can be held with this grip without a stress response. We have prepared this JoVE video to make this intranasal delivery technique more accessible.

A method to intranasally administer drugs to awake mice for the purpose of targeting the brain is described. This method allows for repeat dosing over long periods using intranasal administration of drug without anesthesia, and nose-to-brain delivery with minimal systemic exposure.

清醒小鼠滴鼻的CNS药物治疗管理

Intranasal administration is a method of delivering  therapeutic agents to the central nervous system (CNS). It is  non-invasive and allows large ...

科研

医学

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples

Despite the public health importance of mucosal pathogens (including HIV), relatively little is known about mucosal immunity, particularly at the female genital tract (FGT). Because heterosexual transmission now represents the dominant mechanism of HIV transmission, and given the continual spread of sexually transmitted infections (STIs), it is critical to understand the interplay between host and pathogen at the genital mucosa. The substantial gaps in knowledge around FGT immunity are partially due to the difficulty in successfully collecting and processing mucosal samples. In order to facilitate studies with sufficient sample size, collection techniques must be minimally invasive and efficient. To this end, a protocol for the collection of cervical cytobrush samples and subsequent isolation of cervical mononuclear cells (CMC) has been optimized. Using ex vivo flow cytometry-based immunophenotyping, it is possible to accurately and reliably quantify CMC lymphocyte/monocyte population frequencies and phenotypes. This technique can be coupled with the collection of cervical-vaginal lavage (CVL), which contains soluble immune mediators including cytokines, chemokines and anti-proteases, all of which can be used to determine the anti- or pro-inflammatory environment in the vagina.

The use of cytobrush sampling to collect lymphocytes and monocytes from the endocervix is a minimally invasive technique that provides samples for analysis of female genital tract immunity. In this protocol, we describe the collection of cytobrush samples and immune cell isolation for flow cytometry assays.

收集，分离，和人类宫颈样品的流式细胞仪分析

Despite the public health importance of mucosal pathogens (including HIV), relatively little is known about mucosal immunity, particularly at the female ...

A Radio-telemetric System to Monitor Cardiovascular Function in Rats with Spinal Cord Transection and Embryonic Neural Stem Cell Grafts

High thoracic or cervical spinal cord injury (SCI) can lead to cardiovascular dysfunction. To monitor cardiovascular parameters, we implanted a catheter connected to a radio transmitter into the femoral artery of rats that underwent a T4 spinal cord transection with or without grafting of embryonic brainstem-derived neural stem cells expressing green fluorescent protein. Compared to other methods such as cannula insertion or tail-cuff, telemetry is advantageous to continuously monitor blood pressure and heart rate in freely moving animals. It is also capable of long term multiple data acquisitions. In spinal cord injured rats, basal cardiovascular data under unrestrained condition and autonomic dysreflexia in response to colorectal distension were successfully recorded. In addition, cardiovascular parameters before and after SCI can be compared in the same rat if a transmitter is implanted before a spinal cord transection. One limitation of the described telemetry procedure is that implantation in the femoral artery may influence the blood supply to the ipsilateral hindlimb.

We present a protocol for using a radio-telemetric system to record cardiovascular parameters in T4 spinal cord transected rats eight weeks after embryonic brainstem neural stem cell grafting into the lesion site. Telemetry is an advanced technique to accurately evaluate cardiovascular function in conscious freely moving spinal cord injured rats.

无线电遥测系统，以监测大鼠脊髓横断和胚胎神经干细胞移植在心血管功能

High thoracic or cervical spinal cord injury (SCI) can lead to cardiovascular dysfunction. To monitor cardiovascular parameters, we implanted a catheter ...

Rapid Fractionation and Isolation of Whole Blood Components in Samples Obtained from a Community-based Setting

Collection and processing of whole blood samples in a non-clinical setting offers a unique opportunity to evaluate community-dwelling individuals both with and without preexisting conditions. Rapid processing of these samples is essential to avoid degradation of key cellular components. Included here are methods for simultaneous peripheral blood mononuclear cell (PBMC), DNA, RNA and serum isolation from a single blood draw performed in the homes of consenting participants across a metropolitan area, with processing initiated within 2 hr of collection. We have used these techniques to process over 1,600 blood specimens yielding consistent, high quality material, which has subsequently been used in successful DNA methylation, genotyping, gene expression and flow cytometry analyses. Some of the methods employed are standard; however, when combined in the described manner, they enable efficient processing of samples from participants of population- and/or community-based studies who would not normally be evaluated in a clinical setting. Therefore, this protocol has the potential to obtain samples (and subsequently data) that are more representative of the general population.

We outline a methodology for the processing of whole blood to obtain a variety of components for further analysis. We have optimized a streamlined protocol that enables rapid, high-throughput simultaneous processing of whole blood samples in a non-clinical setting.

快速分馏和全血的成分的分离样品中从社区为基础的设置获得

Collection and processing of whole blood samples in a non-clinical setting offers a unique opportunity to evaluate community-dwelling individuals both ...

A Reproducible Computerized Method for Quantitation of Capillary Density using Nailfold Capillaroscopy

Capillaroscopy is a non-invasive, efficient, relatively inexpensive and easy to learn methodology for directly visualizing the microcirculation. The capillaroscopy technique can provide insight into a patient&#8217;s microvascular health, leading to a variety of potentially valuable dermatologic, ophthalmologic, rheumatologic and cardiovascular clinical applications. In addition, tumor growth may be dependent on angiogenesis, which can be quantitated by measuring microvessel density within the tumor. However, there is currently little to no standardization of techniques, and only one publication to date reports the reliability of a currently available, complex computer based algorithms for quantitating capillaroscopy data.1 This paper describes a new, simpler, reliable, standardized capillary counting algorithm for quantitating nailfold capillaroscopy data. A simple, reproducible computerized capillaroscopy algorithm such as this would facilitate more widespread use of the technique among researchers and clinicians. Many researchers currently analyze capillaroscopy images by hand, promoting user fatigue and subjectivity of the results. This paper describes a novel, easy-to-use automated image processing algorithm in addition to a reproducible, semi-automated counting algorithm. This algorithm enables analysis of images in minutes while reducing subjectivity; only a minimal amount of training time (in our experience, less than 1 hr) is needed to learn the technique.

Capillaroscopy is a non-invasive, efficient, relatively inexpensive and easy-to-learn methodology for directly visualizing capillaries in the microcirculation. However, only one publication to date describes the reliability of a complex software program available for quantitating capillaroscopy data. Here, we present a simple, reliable protocol for quantitating capillaries using a standardized algorithm.

对于毛细血管密度的定量使用甲襞Capillaroscopy可再生的计算机化方法

Capillaroscopy is a non-invasive, efficient, relatively inexpensive and easy to learn methodology for directly visualizing the microcirculation. The ...

Transarterial Administration of Oncolytic Viruses for Locoregional Therapy of Orthotopic HCC in Rats

Hepatocellular carcinoma (HCC) is a disease with limited treatment options and poor prognosis. In recent years, oncolytic virotherapies have proven themselves to be potentially powerful tools to fight malignancy. Due to the unique dual blood supply in the liver, it is possible to apply therapies locally to orthotopic liver tumors, which are predominantly fed by arterial blood flow. We have previously demonstrated that hepatic arterial delivery of oncolytic viruses results in safe and efficient transduction efficiency of multifocal HCC lesions, resulting in significant prolongation of survival in immune competent rats. This procedure closely mimics the application of transarterial embolization in patients, which is the standard palliative care provided to many HCC patients. The ability to administer tumor therapies through the hepatic artery in rats allows for a highly sophisticated preclinical model for evaluating novel viral vectors under development. Here we describe the detailed protocol for microdissection of the hepatic artery for infusion of oncolytic virus vectors to treat orthotopic HCC.

Oncolytic virotherapies are under development as novel therapeutics for the treatment of hepatocellular carcinoma (HCC). Here we describe a method for locoregional therapy of HCC via hepatic arterial administration of oncolytic virus.

溶瘤病毒的Transarterial管理局大鼠原位肝癌的局部治疗

Hepatocellular carcinoma (HCC) is a disease with limited treatment options and poor prognosis.  In recent years, oncolytic virotherapies have proven ...

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Murine infection models are critical for understanding disease pathogenesis and testing the efficacy of novel therapeutics designed to combat causative pathogens. Infectious pneumonia is among the most common infections presented by patients in the clinic and thus warrants an appropriate in vivo model. Typical pneumonia models use intranasal inoculation, which deposits excessive organisms outside the lung, causing off-target complications and symptoms, such as sinusitis, gastritis, enteritis, physical trauma, or microparticle misting to mimic aerosol spread more typical of viral, tuberculous, or fungal pneumonia. These models do not accurately reflect the pathogenesis of typical community- or healthcare-acquired bacterial pneumonia. In contrast, this murine model of oropharyngeal aspiration pneumonia mimics the droplet route in healthcare-acquired pneumonia. Inoculating 50 &#181;L of the bacteria suspension into the oropharynx of anesthetized mice causes reflexive aspiration, which results in pneumonia. With this model, one can examine the pathogenesis of pneumonia-causing pathogens and new treatments to combat these diseases.

Infectious pneumonia is among the most common infections in human. An appropriate in vivo model is critical for understanding disease pathogenesis and testing the efficacy of novel therapeutics. With this murine oropharyngeal aspiration pneumonia model, one can examine the pathogenesis and new treatments against these deadly infections.

呼吸机相关和医院获得性肺炎的小鼠口咽吸入模型

Murine infection models are critical for understanding disease pathogenesis and testing the efficacy of novel therapeutics designed to combat causative ...

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. The purpose of this study is to report the physical fitness benefits of a training program for independent community-dwelling older adults using an agility ladder. Each training session lasted approximately 30 minutes, and the benefits were achieved with two sessions per week for 14 weeks. Training was timed and involved four different drills and varying levels of difficulty through time. The exercises were performed at the School of Physical Education of the University of Campinas, S&#227;o Paulo state, Brazil. The study participants (n = 16; mean age of 66.9 &#177; 5.0 years) were instructed to perform the exercises as quickly as possible without making mistakes and were assisted by a physical trainer when they made mistakes. Assessments were performed both before and after training using five functional tests (i.e., Illinois agility, five times sit-to-stand, timed up-and-go, walking usual speed, and one-leg stand). Although the study sample was not compared with a control group, the results indicate that training protocols using an agility ladder are easy and practical and improve physical function performance in older adults.

The aim of this study is to present an agility training program for older people. The feasibility of this program is described, and the training protocol demonstrated by video imaging.

一个用于社区居住老年人敏捷阶梯的培训计划

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. ...

Using a Chemical Biopsy for Graft Quality Assessment

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated with an increased survival rate and greater quality of patient&#8217;s life when compared to conventional dialysis. Regrettably, transplantology suffers from a lack of reliable methods for organ quality assessment. Standard diagnostic techniques are limited to macroscopic appearance inspection or invasive tissue biopsy, which do not provide comprehensive information about the graft. The proposed protocol aims to introduce solid phase microextraction (SPME) as an ideal analytical method for comprehensive metabolomics and lipidomic analysis of all low molecular compounds present in kidneys allocated for transplantation. The small size of the SPME probe enables performance of a chemical biopsy, which enables extraction of metabolites directly from the organ without any tissue collection. The minimum invasiveness of the method permits execution of multiple analyses over time: directly after organ harvesting, during its preservation, and immediately after revascularization at the recipient&#8217;s body. It is hypothesized that the combination of this novel sampling method with a high-resolution mass spectrometer will allow for discrimination of a set of characteristic compounds that could serve as biological markers of graft quality and indicators of possible development of organ dysfunction.

The protocol presents utilization of the chemical biopsy approach followed by comprehensive metabolomic and lipidomic analysis for quality assessment of kidney grafts allocated for transplantation.

使用化学活检进行移植质量评估

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated ...