Household illness is the strongest predictor of upper respiratory tract symptom risk in elite rugby union players

ObjectivesTo identify periods of increased risk for upper respiratory tract symptom (URTS) episodes, and examine whether biomarkers and/or self-reported lifestyle and wellness data can predict URTS risk in elite rugby union players.DesignProspective, longitudinal and repeated-measures study.MethodsSalivary secretory immunoglobulin A (SIgA), salivary cortisol, URTS, internal training load and self-reported lifestyle and wellness data including household illness, stress, mood, fatigue, muscle soreness and sleep quality were repeatedly measured in elite Southern hemisphere rugby union players (n = 28) throughout a season. Univariate frailty model analysis, which included 495 observations, was used to determine predictors of URTS risk.ResultsSurprisingly, the highest incidence of URTS occurred after rest weeks, namely the Christmas break and bye weeks (i.e., no scheduled trainings or matches); whereas URTS risk was reduced during weeks involving international travel (Hazard ratio (HR): 0.43, p < 0.001)). Household illness was the strongest predictor of URTS risk; players were almost three-fold more at risk for an URTS episode when illness in the household was present (HR: 2.90, p = 0.002). A non-significant, but potentially important trend for an inverse association between SIgA concentration and URTS incidence was also observed (HR: 0.99, p = 0.070).ConclusionsRest weeks were identified as periods of increased risk for URTS; while international travel did not appear to increase players risk for URTS. Incidence of household illness and SIgA concentration independently predicted URTS risk, with household illness being the strongest predictor. These findings can assist practitioners monitoring and management of athletes to potentially reduce URTS risk.     

2011年全国寄生虫病防治技术竞赛成绩分析报告:蠕虫检测能力分析

目的通过竞赛了解当前我国各级疾控机构寄生虫病防治专业人员的蠕虫检测能力,从而推动各级疾控机构的能力建设。方法2011年9月以省(区、市)为单位,每省选送各级疾控机构的在职专业技术人员4名(年龄<45周岁,县级不少于2名)。竞赛内容包括粪便标本改良加藤厚涂片制作(每参赛选手30 min内制作完成5张涂片;计满分为15分,9分为及格)和11种常见蠕虫卵镜检鉴别(每张标本片含1种或1种以上蠕虫卵;镜检10张,每张5 min;计满分为60分,36分为及格)。结果来自30个省(市、区)的119名参赛选手中,改良加藤厚涂片制片成绩,平均为11.4分,及格者111人,占93.3%;11种常见蠕虫卵镜检读片成绩,平均为22.0分,及格者20人,占16.8%。不同性别、年龄(≤30岁、31~40岁和>40岁)、专业技术职称(初级、中级和高级)、来源单位的级别(省级、市级和县级)的参赛人员制片和镜检成绩的差异无统计学意义(P>0.05)。来自有血吸虫病防治任务省份的参赛选手的制片(12.1±1.7)、镜检读片(32.1±11.5)成绩均好于没有血吸虫病防治任务的省份(11.1±1.8和18.1±10.5);西部地区参赛选手的镜检读片成绩(18.4±11.4)均低于东部(25.2±12.4)和中部(24.1±13.1)。结论我国寄生虫病防治机构的病原检测能力总体水平发展不均衡,仅部分地区检测能力较强,有待进一步的加强和提高。     

甘胆酸化学发光定量免疫分析方法的建立

目的 建立甘胆酸（CG）化学发光免疫检测方法.方法 采用竞争法,固相微孔L板包被技术,通过与参比试剂盒临床结果相关性的比较,保证其具有同等的临床诊断价值.结果 本试剂盒的线性范围为0.25～ 40 μg/mL,灵敏度为0.05μg/mL,批内精密度分别为7.1％和7.4％;批间精密度为11.3％和15.74％;样品的回收率在85％～115％之间.与透明质酸、Ⅳ型胶原、Ⅲ型前胶原氨端肽、层粘连蛋白、胆酸以及鹅脱氧胆酸的交叉反应率在0.010％～1.480％之间,均不会对CG的正常测定构成干扰.通过临床样品正常值的测定确定了正常值范围,与有关文献报道基本一致.同时,与北京北方生物技术研究所的放免药盒临床结果进行科学比较,两组结果的相关系数r为0.947.结论 该试剂盒与参比试剂盒的测定结果具有较高的符合率,应用于临床,可为慢性肝炎复发、轻度肝硬变、肝癌、肝胆胃肠消化系统疾病的研究诊断提供可靠的指标.同时,肝胆酸与血清Ⅳ型胶原、透明质酸和前白蛋白（PA）动态联检对于肝硬化的诊断、疗效及预后判断具有重要的临床意义.     

Psychological,muscular and kinematic factors mediate performance under pressure

It is well established that performance is influenced by pressure, but the underlying mechanisms of the pressure‐performance relationship are poorly understood. To address this important issue, the current experiment evaluated psychological, physiological, and kinematic factors as mediators of the pressure‐performance relationship. Psychological, physiological, and kinematic responses to three levels of competitive pressure were measured in 23 males and 35 females during a golf putting task. Pressure manipulations impaired putting performance. Self‐reported anxiety, effort, and perceived pressure were increased. Heart rate, heart rate variability, muscle activity, and lateral clubhead acceleration were also elevated. Mediation analyses revealed that effort, muscle activity, and lateral acceleration partially mediated the decline in performance. Results confirmed that pressure elicits effects on performance through multiple pathways.     

Exogenously cued attention triggers competitive selection of surfaces

It has been reported that when an endogenous cue directs attention to a brief translation of one of two superimposed surfaces, observers reliably report the direction of that translation as well as the direction of a second translation of the cued surface. In contrast, if the uncued surface translates second, direction judgments are severely impaired for several hundred milliseconds. We replicated this result, but found that the impairment survived the removal of the endogenous cue. The impairment is therefore not due to endogenously cued attention. Instead, a brief translation of one surface acts as an exogenous cue that triggers an automatic selection mechanism, which suppresses processing of the other surface. This study provides a clear case of exogenous cueing of surface-based attention. We relate these results to identified competitive selection mechanisms in visual cortex.     

Competition of tamoxifen with thyroxine for TBG binding: ligand binding assay and computational data

Objective: Tamoxifen, a nonesteroidal antiesterogen, is widely used in the treatment of breast cancer. Recently, the effect of tamoxifen on thyroid function has caused considerable concern, yet the results of different studies are controversial and the precise mechanism of such influence is obscure. In view of the fact that some drugs such as furosemide, diclofenac and mefenamic acid, based on the structural similarities to thyroxine could compete for binding to thyroxine binding globulin (TBG) and appears that there are some structural similarities between tamoxifen and thyroxine, one can hypothesize that tamoxifen is also able to compete for TBG binding and thereby affecting thyroid function tests.

Design and methods: In this study, we designed an in vitro binding assay as well as computational methods using MOPAC 7 package for evaluation of competitive potency of tamoxifen for TBG binding in comparison with well-known TBG competitors (including furosemide, mefenamic acid and diclofenac).

Results: The result of competition assay and Scatchard analysis revealed that tamoxifen does not bind to TBG at the T4 binding site, thus it is not a thyroxine competitor. Computational results also indicated that structural characteristics of tamoxifen are significantly different from those of T4 and its well-known competitors.

Conclusion: In conclusion, the probability of competition between tamoxifen and T4 is ruled out by these results.     

生理学教学中PBL教学法的运用

将PBL运用于临床医学本科生理学课堂教学，阐述了作为指导教师在PBL的整个教学过程中，在提出问题、分组、引导学生进行讨论以及竞赛中所起的作用，并且对PBL模式的灵活运用提出意见。     

从现代市场的一般规律看医德医风建设

随着改革的深入,现代市场已变成以消费者为中心的买方市场,高尚的医德、良好的医风已成为医疗市场的无形资产,而加强医德建设、千方百计的满足患者的需求,已成为医疗单位提高竞争力的关键,作者从多方面为此作了阐述。