提供这些动物的研究由英国食品、环境和农村事务部以及欧洲联盟（通过欧盟TSE参考实验室的资助）资助。我们感谢项目经理西蒙斯博士.M博士和杰弗里博士的支持.M。

1. 姿势评估
<ol><li>评估动物的姿势，同时不受干扰。</li>
	<li>受 TSEs 影响的动物可能站立在宽阔的四肢上，可能显得驼背，或者可能站立在低头车厢中。</li>
</ol>2. 行为评估
<ol><li>研究动物的行为，当被单独留下，当接近，当处理。</li>
	<li>受 TSE 影响的动物可能与其他绵羊分开站立或不立即跟随其他绵羊，从而显示其变异的引信。</li>
	<li>当动物接近时，它可能会逃跑和崩溃，或它崩溃到地板上时处理。强迫顺时针或逆时针盘旋可能会看到羊与非典型的刮刀。</li>
</ol>3. 威胁响应测试
<ol><li>握住动物的头，以测试威胁反应：将手或几根手指朝向动物的每只眼睛几次，以引起眨眼反应，但要小心，不要触摸任何面部毛发或产生任何可能导致动物眨眼的空气湍流。</li>
	<li>受刮伤影响的动物，尤其是非典型刮伤的绵羊，可能缺乏威胁反应。虽然威胁反应测试是作为协议一部分使用的唯一颅神经测试，但在此过程中对脸部的目视检查可能会显示其他神经缺陷的迹象，这些迹象通常不会在刮伤中看到， 例如 面部瘫痪。如果动物不眨眼以应对威胁，建议通过触摸眼睑来测试心绞痛反射，以确保动物不能眨眼不是由面部瘫痪引起的。</li>
</ol>4. 划痕响应测试
<ol><li>确保动物在这个过程是平静的，因为测试不能解释在挣扎的动物。</li>
	<li>胸腔、腰椎和囊性区域背部的划痕区域，在每个划痕发作之间暂停。</li>
	<li>如果动物用有节奏的头部或身体动作做出反应，或在划伤某一特定区域时移动或舔嘴唇，请重复划痕测试，以确认划痕响应的可重复性。</li>
	<li>在具有棱镜的动物中通常会产生可重复的反应，通常包括带有古典刮毛的绵羊或具有尖端刮伤形式的山羊，但通常没有反应的绵羊与非典型刮伤，除非存在其他棱镜皮肤条件或异位素。</li>
</ol>5. 检查羊毛损失和皮肤损伤
<ol><li>检查皮肤。</li>
	<li>由于刮伤通常会导致脱发，这可能是在投票，背部，臀部，胸部或腹部的一侧，由于过度摩擦或划伤，其基础皮肤看起来正常。</li>
	<li>如果动物有机会摩擦锋利的物体，以后可能会出现擦伤。由于四肢过度咬伤，可能会出现咬伤，尤其是在四肢上。</li>
</ol>6. 评分身体状况
<ol><li>通过苍白腰椎的躯干和横向过程来评估动物的身体状况。</li>
	<li>刮伤可能导致身体状况的逐渐丧失，其中腰椎的横向过程可以很容易地单独感觉到，并且过程的末端显得尖锐。</li>
</ol>7. 蒙住动物的双眼
<ol><li>用头罩遮住动物的眼睛，这可以通过使用任何不透视的袋子制成，其中一个角落被切断，允许动物呼吸。</li>
	<li>只有在没有安全问题的情况下才释放动物，并且没有因惊恐的动物而受伤的风险：否则保持羊和研究动物运动，同时仍然控制动物。</li>
	<li>蒙上眼睛可能会加剧前庭系统或小脑功能障碍的迹象，而动物通过视力进行补偿的能力可能会掩盖这些迹象。平衡、不协调或盘旋可能会引起损失，尤其是在临床上不起眼的羊群中，这些绵羊带有非典型刮伤。</li>
</ol>8. 动物运动的评估
<ol><li>研究动物的步态和肌肉运动时，它自由移动。</li>
	<li>不协调的特点可能是后肢的宽基运动，后肢跳跃，或在后肢过度摇摆，这可能导致绊倒或短暂坐下。</li>
	<li>当动物不受干扰时，头部震颤的存在往往是微妙的，但在临床检查完成期间或之后可能会变得更加明显。</li>
</ol>9. 解释
<ol><li>考虑这些发现对刮擦的重要性。</li>
	<li>虽然个别迹象的存在，如对划痕、震颤、异常行为、盘旋、崩溃发作、缺氧或缺乏威胁反应的可重复反应，可能有各种原因，但这些迹象中两个或两个以上共同发生的，极有暗示绵羊或山羊的刮伤。</li>
</ol>

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所有涉及动物的程序都是根据1986年《动物（科学程序）法》根据英国政府内政部的许可进行的。 作者宣称他们没有相互竞争的经济利益。

Scrapie 是世界卫生组织 （OIE） 列出的疾病，在没有快速可靠的 验尸 测试的情况下，它依赖于农民或兽医识别与这种疾病相关的临床症状的能力。然而，大多数刮伤病例，尤其是非典型刮伤病例，目前都是通过有针对性的 TSE 监控发现的， 即 通过对被屠宰或牲畜倒下的小反胃动物进行脑部检查。饲养绵羊以抵抗经典刮伤，这减少了经典刮伤病例的数量，很可能也降低了人们对这种疾病的认识，因此在绵羊神经紊乱的差别诊断中很少考虑它。非典型刮虫的流行率也很低，在欧洲4个测试中，屠宰场约有5例，每10，000个屠宰场有8个病例。此外，通常明显为脱发有或没有切除，通常被认为是刮13的特征迹象。因此，非典型刮刀12 或非普瑞克形式的卡普林刮11中观察到的没有伴随的普鲁里图斯的神经系统疾病可能不会引起 刮伤的怀疑。
此检查协议旨在通过评估与各种类型的刮刀相关的特定临床体征来识别羊身上的 TSE 临床体征（非典型和经典刮伤，后者以非典型 BSE 接种绵羊为代表，带有经典刮伤样标志）。在经典刮伤中，在研究的100多只绵羊中，表现出阳性刮伤反应（"咬反射"）的病例比例从50-77不等。根据各种研究18，在高达81%的经典刮伤病例中可以观察到运动障碍。不协调也是各种自然发生的非典型刮伤病例的主要标志，通常伴有行为变化1，但自然和实验感染的非典型刮羊报告的其他迹象是盘旋和视力障碍12，15，16，这就是为什么蒙上眼睛和威胁反应的测试被纳入检查协议。评分的身体状况，例如使用6分评分系统14，使评估消瘦，这可以在刮伤影响羊5观察。虽然以前曾提出过协助在羊身上检测刮刀的临床标准，但这些标准只与经典刮刀的检测有关，并考虑到临床历史，如果动物出现在屠宰场，可能无法获得。
目前的协议允许在短时间内对许多动物进行刮擦迹象的筛查。此外，检查协议可应用于绵羊和山羊绒被的实验研究，以监测临床发病、进展和终点。然而，它并没有用适当的临床病例史记录取代更详细的身体和神经检查，随后可能还会进行辅助诊断测试（血液和脑脊液检查;如果适当的话采用更先进的成像技术），这可能需要随后排除小反胃动物中出现类似症状的各种其他情况，如代谢或炎症性神经系统疾病，脑脓肿，或肿瘤。
虽然临床检查在检测受 TSE 影响的动物方面 通常不如基于 对普里昂蛋白2，11的验尸测试敏感，尤其是在潜伏期的早期阶段，但这是目前活体动物中唯一的检测方法，与那些没有针对性监测系统来识别受 TSE 影响的小反胃动物的国家最相关。

刮刀是绵羊和山羊的一种可传播海绵状脑病（TSE），属于蛋白质误折叠疾病，如牛的牛海绵状脑病（BSE），鹿的慢性浪费病，以及人类的克罗伊茨费尔特-雅科布病。诊断是在死后通过检测通常在大脑中具有抗蛋白酶的普里昂蛋白的异常形式而做出的。两种主要的自然产生的刮刮形式可以区分，它们在流行病学、病理学和生化学上是不同的：古典刮刮和非典型刮刀。此外，一种具有经典刮刀样临床症状的神经系统疾病可以通过实验感染BSSE剂6，10-11在绵羊和山羊中诱发。事实上，自然发生的BSSE已被诊断为山羊3，17。通过繁殖针对普里昂蛋白基因的遗传抗药性，对经典刮刀（和羊中的BSE）的控制已经实现，但是对于非典型刮虫来说，这更加困难，它被认为是一种零星疾病，在被认为没有经典刮刀的国家被诊断出来，例如新西兰7。
刮刀是一种成年绵羊和山羊的神经系统疾病，导致行为、感觉和运动的变化，但该病是缓慢渐进的，临床症状往往不被识别，因为动物饲养员或兽医可能不熟悉临床体征，或刮伤根本不考虑在小反胃动物的神经病的差异诊断。
拟议的检查方案旨在帮助对刮刀进行临床诊断，其目的有两个：应相当简短，以便在短时间内扫描许多动物，但具体到足以检测受刮伤影响的动物，这是通过评估受刮擦影响的动物中经常遇到的临床体征而实现的。该协议是一个轻微的修改，从一个用于监测山羊的经典刮11的迹象，包括蒙住动物，这可能加剧临床症状通常不与刮刀9。

clinical examination protocol to detect atypical and classical scrapie in sheep

肩伤是绵羊和山羊的一种可传播的海绵状脑病（TSEs），目前诊断基于通过 验尸 检测疾病相关普里昂蛋白。除非对绵羊或山羊种群的随机样本进行积极监测，否则刮伤病例的鉴定取决于临床疑犯的报告，而临床疑犯的发现取决于个人对疾病的熟悉程度和识别与刮伤相关的临床症状的能力。在小反胃动物的神经系统疾病的差别诊断中，可能不考虑刮伤，特别是在刮伤流行率较低的国家，或者不承认它是否表现为非典型刮伤等非典型形式。为了帮助识别临床疑犯，提出了一个简短的检查方案，以评估绵羊中与营养和非营养形式的 TSEs 相关的特定临床症状的显示，这些症状也适用于山羊。这包括行为评估、视力评估（通过测试威胁反应）、普鲁里图斯（通过测试刮伤反应）和运动（有或不蒙上眼睛）。这可能导致更详细的神经学检查报告动物作为刮刀嫌疑人。它也可以用于绵羊或山羊的实验性 TSE 研究，以评估疾病进展或确定临床终点。

临床健康的绵羊。投票多塞特是否来自一个无刮伤的羊群， 在接种后 49 个月， 用新西兰血统的牛脑接种， 并检查。这种羊的姿势正常，行为正常，表现出正常的威胁反应（图1），对划痕测试没有反应，羊毛完好无损，身体状况很好。它被蒙上眼睛，没有运动障碍的迹象，在临床上是无足轻重的。
非典型刮羊呈现在绵羊中不孕不躁的 TSEs 形式。切维奥特从无刮刀的羊群中，从同一普里昂蛋白基因型（AHQ/AHQ）的非典型刮伤场病例中接种大脑同源性，并在接种后36个月接受检查。这种羊也有一个正常的姿势，但行为不同于其他羊在笔和圆顺时针的方向。当威胁反应被测试时，它不会闪烁。划伤不会引起任何反应，羊毛变化也很明显，但身体状况是公平的。它被蒙上眼睛顺时针转（图2），失去平衡。步态是斧头的，可以看见一个细细的头部震颤。
非典型BSSE绵羊在绵羊中呈现了具有特性特塞的棱镜形式，临床上类似于经典刮伤绵羊的临床表现。因此，不包括经典刮刀案例。投票多塞特是否从无刮羊群内接种牛非典型 （L 型） Bse 大脑均质， 并在接种后 50 个月检查。这只羊稍微驼背，往往保持后肢宽基和落在地板上时，抓住。威胁反应很弱。背部不同部位的划痕引起头部或嘴唇运动（图3），在投票中出现羊毛损失，皮肤轻微外伤。身体状况良好。蒙上眼睛后，它不愿意移动，把后端放在障碍物上以保持平衡。绵羊是轴和显示前肢超米。
<img alt="Figure 1" fo:content-width="5in" fo:src="/files/ftp_upload/51101/51101fig1highres.jpg" src="/files/ftp_upload/51101/51101fig1.jpg"> 图1。威胁响应测试。 对动物眼睛的手势会引起眨眼反应。 <a href="https://www.jove.com/files/ftp_upload/51101/51101fig1highres.jpg" target="_blank">单击此处查看更大的图像。</a>
<img alt="Figure 2" fo:content-width="5in" fo:src="/files/ftp_upload/51101/51101fig2highres.jpg" src="/files/ftp_upload/51101/51101fig2.jpg"> 图2。蒙上眼睛。 顺时针盘旋，用头罩蒙住羊的双眼。 <a href="https://www.jove.com/files/ftp_upload/51101/51101fig2highres.jpg" target="_blank">单击此处查看更大的图像。</a>
<img alt="Figure 3" fo:content-width="5in" fo:src="/files/ftp_upload/51101/51101fig3highres.jpg" src="/files/ftp_upload/51101/51101fig3.jpg"> 图3。测试划痕响应。 背部划伤引起嘴唇舔与头部的侧向运动 <a href="https://www.jove.com/files/ftp_upload/51101/51101fig3highres.jpg" target="_blank">点击这里查看更大的图像。</a>

Watch this Scientific Journal Video about Clinical Examination Protocol to Detect Atypical and Classical Scrapie in Sheep at JoVE.com

Clinical Examination Protocol to Detect Atypical and Classical Scrapie in Sheep

提供一份简短的临床检查协议，以帮助检测绵羊和山羊的经典和非典型刮刀。

临床检查协议检测非典型和经典刮在绵羊

The diagnosis of scrapie, a transmissible spongiform encephalopathy (TSEs) of sheep and goats, is currently based on the detection of disease-associated ...

clinical-examination-protocol-to-detect-atypical-classical-scrapie

Research

JoVE Journal

Medicine

12.7K 次观看.  Animal Health and Veterinary Laboratories Agency Weybridge. 提供一份简短的临床检查协议，以帮助检测绵羊和山羊的经典和非典型刮刀。

视频: Clinical Examination Protocol to Detect Atypical and Classical Scrapie in Sheep

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

The Institute of Medicine has targeted patient-centeredness as an important area of quality improvement. A major dimension of patient-centeredness is respect for patient's values, preferences, and expressed needs. Yet specific approaches to gaining this understanding and translating it to quality care in the clinical setting are lacking. From a patient perspective quality is not a simple concept but is best understood in terms of five dimensions: technical outcomes; decision-making efficiency; amenities and convenience; information and emotional support; and overall patient satisfaction. Failure to consider quality from this five-pronged perspective results in a focus on medical outcomes, without considering the processes central to quality from the patient's perspective and vital to achieving good outcomes. In this paper, we argue for applying the concept of fair process in clinical settings. Fair process involves using a collaborative approach to exploring diagnostic issues and treatments with patients, explaining the rationale for decisions, setting expectations about roles and responsibilities, and implementing a core plan and ongoing evaluation. Fair process opens the door to bringing patient expertise into the clinical setting and the work of developing health care goals and strategies. This paper provides a step by step illustration of an innovative visual approach, called photovoice or photo-elicitation, to achieve fair process in clinical work with acquired brain injury survivors and others living with chronic health conditions. Applying this visual tool and methodology in the clinical setting will enhance patient-provider communication; engage patients as partners in identifying challenges, strengths, goals, and strategies; and support evaluation of progress over time. Asking patients to bring visuals of their lives into the clinical interaction can help to illuminate gaps in clinical knowledge, forge better therapeutic relationships with patients living with chronic conditions such as brain injury, and identify patient-centered goals and possibilities for healing. The process illustrated here can be used by clinicians, (primary care physicians, rehabilitation therapists, neurologists, neuropsychologists, psychologists, and others) working with people living with chronic conditions such as acquired brain injury, mental illness, physical disabilities, HIV/AIDS, substance abuse, or post-traumatic stress, and by leaders of support groups for the types of patients described above and their family members or caregivers.

This paper illustrates an innovative visual approach (photovoice or photo-elicitation) to achieve fair process in clinical care for patients living with chronic health conditions, illuminate gaps in clinical knowledge, forge better therapeutic relationships, and identify patient-centered goals and possibilities for healing.

利用视觉和叙事方法，以实现公平的进程中，在临床护理

The Institute of Medicine has targeted patient-centeredness as an important area of quality improvement. A major dimension of patient-centeredness is ...

科研

医学

EEG Mu Rhythm in Typical and Atypical Development

Electroencephalography (EEG) is an effective, efficient, and noninvasive method of assessing and recording brain activity. Given the excellent temporal resolution, EEG can be used to examine the neural response related to specific behaviors, states, or external stimuli. An example of this utility is the assessment of the mirror neuron system (MNS) in humans through the examination of the EEG mu rhythm. The EEG mu rhythm, oscillatory activity in the 8-12 Hz frequency range recorded from centrally located electrodes, is suppressed when an individual executes, or simply observes, goal directed actions. As such, it has been proposed to reflect activity of the MNS. It has been theorized that dysfunction in the mirror neuron system (MNS) plays a contributing role in the social deficits of autism spectrum disorder (ASD). The MNS can then be noninvasively examined in clinical populations by using EEG mu rhythm attenuation as an index for its activity. The described protocol provides an avenue to examine social cognitive functions theoretically linked to the MNS in individuals with typical and atypical development, such as ASD.&#160;

Assessment of the EEG mu rhythm provides a unique methodology for examining brain activity and when combined with behaviorally based assays, can be a powerful tool for elucidating aspects of social cognition, such as imitation, in clinical populations.

脑电图沐节奏典型和非典型发展

Electroencephalography (EEG) is an effective, efficient, and noninvasive method of assessing and recording brain activity. Given the excellent temporal ...

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 million concussions occur in sports and recreational activities annually. Concussion as defined by the 2013 Concussion Consensus Statement &#8220;may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an &#8216;impulsive&#8217; force transmitted to the head.&#8221; Concussions leave the individual with both short- and long-term effects. The short-term effects of sport related concussions may include changes in playing ability, confusion, memory disturbance, the loss of consciousness, slowing of reaction time, loss of coordination, headaches, dizziness, vomiting, changes in sleep patterns and mood changes. These symptoms typically resolve in a matter of days. However, while some individuals recover from a single concussion rather quickly, many experience lingering effects that can last for weeks or months. The factors related to concussion susceptibility and the subsequent recovery times are not well known or understood at this time. Several factors have been suggested and they include the individual&#8217;s concussion history, the severity of the initial injury, history of migraines, history of learning disabilities, history of psychiatric comorbidities, and possibly, genetic factors. Many studies have individually investigated certain factors both the short-term and long-term effects of concussions, recovery time course, susceptibility and recovery. What has not been clearly established is an effective multifaceted approach to concussion evaluation that would yield valuable information related to the etiology, functional changes, and recovery. The purpose of this manuscript is to show one such multifaceted approached which examines concussions using computerized neurocognitive testing, event related potentials, somatosensory perceptual responses, balance assessment, gait assessment and genetic testing.

There is great variability in an individual&#8217;s risk for concussion and their corresponding recovery. A multifaceted approach to concussion evaluation is warranted; including baseline testing of athletes before participation in sport and timely evaluation post injury. The goal of this protocol is to provide an appropriate multifaceted approach to examine concussions.

一个神经科学方法脑震荡的学生运动员的考试

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 ...

Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination

Common foot and ankle pathologies have been linked to isolated Musculus gastrocnemius tightness (MGT). Various examination techniques have been described to assess MGT. Still, a standardized examination procedure is missing. Literature argues for weightbearing examination but the degree of knee flexion needed to eliminate the restraining effect of the M. gastrocnemius on ankle dorsiflexion (ADF) is unknown. This manuscript investigates the effect of knee flexion on ankle dorsiflexion and provides a detailed description of a standardized examination protocol. Examination on 20 healthy individuals revealed, that 20&#176; of knee flexion is sufficient to fully eliminate the influence of the M. gastrocnemius on ADF. This builds the prerequisite for a standardized examination for MGT. Non-weightbearing and weightbearing examination of ADF has to be conducted with the knee fully extended and at least 20&#176; flexed. Two investigators should conduct non-weightbearing testing with the subject in supine position. In order to obtain reliable results, the axis of the fibula should be marked. One examiner can conduct weightbearing examination with the subject in lunge stance. Isolated MGT is present if ADF is impaired with the knee fully extended and knee flexion results in a significant ADF increase. The herein presented standardized examination is the prerequisite for future studies aiming at establishing norm values.

Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination

Isolated Musculus gastrocnemius tightness is a common cause for foot and ankle pathologies. Currently no standardized examination procedure exists. This manuscript demonstrates that 20 degree of knee flexion eliminates the restraining effect of the M. gastrocnemius on ankle dorsiflexion and presents a video description of a standardized examination protocol.

诊断<em&gt;家鼠腓肠肌</em&gt;密封性 - 关键因素临床考试

Common foot and ankle pathologies have been linked to isolated Musculus gastrocnemius tightness (MGT). Various examination techniques have been described ...

Echocardiographic and Histological Examination of Cardiac Morphology in the Mouse

An increasing number of genetically modified mouse models has become available in recent years. Moreover, the number of pharmacological studies performed in mice is high. Phenotypic characterization of these mouse models also requires the examination of cardiac function and morphology. Echocardiography and magnetic resonance imaging (MRI) are commonly used approaches to characterize cardiac function and morphology in mice. Echocardiographic and MRI equipment specialized for use in small rodents is&#160;expensive and requires a dedicated space. This protocol describes cardiac measurements in mice using a clinical echocardiographic system with a 15 MHz human vascular probe. Measurements are performed on anesthetized adult mice. At least three image sequences are recorded and analyzed for each animal in M-mode in the parasternal short-axis view. Afterwards, cardiac histological examination is performed, and cardiomyocyte diameters are determined on hematoxylin-eosin- or wheat germ agglutinin (WGA)-stained paraffin sections. Vessel density is determined morphometrically after Pecam-1 immunostaining. The protocol has been applied successfully to pharmacological studies and different genetic animal models under baseline conditions, as well as after experimental myocardial infarction by the permanent ligation of the left anterior descending coronary artery (LAD). In our experience, echocardiographic investigation is limited to anesthetized animals and is feasible in adult mice weighing at least 25 g.

Echocardiographic examination is frequently used in mice. Expensive high-resolution ultrasound devices have been developed for this purpose. This protocol describes an affordable echocardiographic procedure combined with histological morphometric analyses to determine cardiac morphology.

超声心动图与小鼠心脏形态学的组织学检查

An increasing number of genetically modified mouse models has become available in recent years. Moreover, the number of pharmacological studies performed ...

Protocol to Create Chronic Wounds in Diabetic Mice

Chronic wounds develop as a result of defective regulation in one or more complex cellular and molecular processes involved in proper healing. They impact ~6.5M people and cost ~$40B/year in the US alone. Although a significant effort has been invested in understanding how chronic wounds develop in humans, fundamental questions remain unanswered. Recently, we developed a novel mouse model for diabetic chronic wounds that have many characteristics of human chronic wounds. Using db/db-/- mice, we can generate chronic wounds by inducing high levels of oxidative stress (OS) in the wound tissue immediately after wounding, using a one-time treatment with inhibitors specific to the antioxidant enzymes catalase and glutathione peroxidase. These wounds have high levels of OS, develop biofilm naturally, become fully chronic within 20 days after treatment and can remain open more for more than 60 days. This novel model has many features of diabetic chronic wounds in humans and therefore can contribute significantly to advancing fundamental understanding of how wounds become chronic. This is a major breakthrough because chronic wounds in humans cause significant pain and distress to patients and result in amputation if unresolved. Moreover, these wounds are very expensive and time-consuming to treat, and lead to significant loss of personal income to patients. Advancements in this field of study through the use of our chronic wound model can significantly improve health care for millions who suffer under this debilitating condition. In this protocol, we describe in great detail the procedure to cause acute wounds to become chronic, which has not been done before.

Chronic wounds are developed from acute wounds on a diabetic mouse model by inducing high levels of oxidative stress after a full-thickness cutaneous wound. The wound is treated with inhibitors for catalase and glutathione peroxidase, resulting in impaired healing and biofilm development by bacteria present in the skin microbiome.

在糖尿病小鼠中创建慢性伤口的协议

Chronic wounds develop as a result of defective regulation in one or more complex cellular and molecular processes involved in proper healing. They impact ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

Here, we present a protocol for a study comparing the efficacy, safety, and delivery of olive-oil-based 3CB and soybean-oil-based CoB formulations in adults requiring parenteral nutrition. The results revealed that olive-oil-based 3CBs is non-inferior and well tolerated compared to soybean formulations.

一项临床试验，评估基于橄榄油的三腔袋的亲子营养的安全性、有效性和交付

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Longitudinal evaluations of critically ill patients by combinations of clinical examination, biochemical analysis and critical care ultrasonography (CCUS) may detect adverse events of interventions such as fluid overload at an early stage. The Simple Intensive Care Studies (SICS) is a research line that focuses on the prognostic and diagnostic value of combinations of clinical variables.
The SICS-I specifically focused on the use of clinical variables obtained within 24 h of acute admission for prediction of cardiac output (CO) and mortality. Its sequel, SICS-II, focuses on repeated evaluations during ICU admission. The first clinical examination by trained researchers is performed within 3 h after admission consisting of physical examination and educated guessing. The second clinical examination is performed within 24 h after admission and includes physical examination and educated guessing, biochemical analysis and CCUS assessments of heart, lungs, inferior vena cava (IVC) and kidney. This evaluation is repeated at days 3 and 5 after admission. CCUS images are validated by an independent expert, and all data is registered in an online secured database. Follow-up at 90 days includes registration of complications and survival status according to patient&#39;s medical charts and the municipal person registry. The primary focus of SICS-II is the association between venous congestion and organ dysfunction.
The purpose of publishing this protocol is to provide details on the structure and methods of this on-going prospective observational cohort study allowing answering multiple research questions. The design of the data collection of combined clinical examination and CCUS assessments in critically ill patients are explicated. The SICS-II is open for other centers to participate and is open for other research questions that can be answered with our data.

Structured protocols are necessary to provide answers on research questions in critically ill patients. The Simple Intensive Care Studies (SICS) provides an infrastructure for repeated measurements in critically ill patients including clinical examination, biochemical analysis and ultrasonography. SICS projects have specific focus but the structure is flexible to other investigations.

简单重症监护室内反复临床检查和重症监护室超声观察性研究方案

Longitudinal evaluations of critically ill patients by combinations of clinical examination, biochemical analysis and critical care ultrasonography (CCUS) ...

Transthoracic Echocardiographic Examination in the Rabbit Model

Large animal models such as the rabbit are valuable for translational preclinical research. Rabbits have a similar cardiac electrophysiology compared to that of humans and that of other large animal models such as dogs and pigs. However, the rabbit model has the additional advantage of lower maintenance costs compared to other large animal models. The longitudinal evaluation of cardiac function using echocardiography, when appropriately implemented, is a useful methodology for preclinical assessment of novel therapies for heart failure with reduced ejection fraction (e.g. cardiac regeneration). The correct use of this non-invasive tool requires the implementation of a standardized examination protocol following international guidelines. Here we describe, step by step, a detailed protocol supervised by veterinary cardiologists for performing echocardiography in the rabbit model, and demonstrate how to correctly obtain the different echocardiographic views and imaging planes, as well as the different imaging modes available in a clinical echocardiography system routinely used in human and veterinary patients.

Here we describe, step by step, a detailed protocol for performing echocardiography in the rabbit model. We show how to correctly obtain the different echocardiographic views and imaging planes, as well as the different imaging modes available in a clinical echocardiography system routinely used in human and veterinary patients.

兔子模型中的跨胸超声心动图检查

Large animal models such as the rabbit are valuable for translational preclinical research. Rabbits have a similar cardiac electrophysiology compared to ...

Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit

Creative music therapy for preterm infants and their parents (CMT) has emerged as a promising family-integrated early intervention involving communicative musicality to improve infant development, parental well-being, and bonding. It aims at relaxing and nurturing the infant as well as promoting safety and social interaction for the parent-infant dyad. A music therapist specially trained in CMT hums or sings in an infant-directed, improvised, lullaby style continually adjusting to the individual needs, expressions, and breathing pattern of the preterm infant. Based on the principles of family-integrated care, the family is incorporated individually in the therapeutic process, namely by delivering CMT during kangaroo care (KC) and by motivating and facilitating parental vocal interaction with their infant to strengthen the parent-infant bonding. CMT aims at relaxing, stimulating, and coregulating premature infants at a time when many other interventions are still risky and can overwhelm the vulnerable patient group. CMT may be advantageous not by educating and teaching parents, but rather by uncovering the intuitive capacities of parenting that are often overshadowed by the traumatic experience of preterm birth. However, CMT can only be provided when the infants are clinically stable. CMT with parental integration is feasible when parents are available and receptive to participate. This paper presents a detailed protocol on how to use CMT to empower preterm infants and their families.

Creative music therapy for preterm infants and their parents has emerged as a promising family-integrated early intervention. We present a detailed protocol on how to use vocal interaction, humming, or singing to empower preterm infants and their families.

新生儿重症监护病房早产儿及其家长创造性音乐治疗的临床实践规程

Creative music therapy for preterm infants and their parents (CMT) has emerged as a promising family-integrated early intervention involving communicative ...