Health-related quality of life measured by the Short Form 36 in immune thrombocytopenic purpura: a cross-sectional survey in China

OBJECTIVES: The aim of this study is to assess the quality of life (QoL) of Chinese adults with idiopathic thrombocytopenic purpura (ITP). METHODS: The Chinese (mainland) version of Medical Outcome Study SF-36 form (SF-36) Health Survey was used to measure health-related QoL of 236 adults with ITP in a cross-sectional study. RESULTS: Comparison of SF-36 subscores of patients with ITP with healthy individuals revealed the reduction of QoL in all of the eight SF-36 dimensions. The difference on statistical significance presented in six of eight dimensions of SF-36 including physical functioning (PF), role limitations due to physical problems, body pain, general health perception (GH), social functioning (SF), and role limitations due to emotional problems (RE) between the patients with ITP and the normal population (P < 0.01). The acute ITP group showed better scores in three dimensions including GH, energy/vitality, and RE than chronic ITP (P < 0.01). Meanwhile through classification with platelet count, three subgroups of patients also experienced significant differences in PF, GH, and SF from the eight dimensions. Age was a significant negative predictor of all eight dimensions other than the SF while current platelet count was a significant negative predictor of GH. Moreover, the treatment cost and family income also influenced the QoL scores. The subjective feeling of fear about bleeding had a detrimental impact on QoL. CONCLUSIONS: QoL was impaired in patients with ITP, especially in the acute patients. The platelet count and the feeling of fear about bleeding had a detrimental impact on QoL.     

Delay in initial treatment contact after first onset of mental disorders in metropolitan China

OBJECTIVE: There has been no community-based research on treatment delay among people with mental disorders in China. This study examines lifetime treatment and treatment delay in metropolitan China. METHOD: A multi-stage probability survey of 5201 respondents was administered in Beijing and Shanghai. Age of first treatment contact after onset of each of the three lifetime DSM-IV/CIDI disorder classes was compared with retrospective information on age of disorder onset. Length and predictors of treatment delay were examined using survival analysis. RESULTS: Survival curves estimate that 44.7%, 25.7%, and 7.9% of people with anxiety, substance, and mood disorders, respectively, will ever make treatment contact. Delays in first treatment contact of anxiety (21 years) and substance (17 years) disorders are longer than that of mood disorders (1 year). These delays are largely unrelated to sociodemographic variables. CONCLUSION: Failure to receive treatment is a pervasive phenomenon among people with mental disorders in metropolitan China.     

Haplotypes of 20 Y-chromosomal STRs in a population sample from southeast China (Chaoshan area)

In this study, 20 Y-specific short tandem repeat (STR) loci (DYS434, Y-GATA-A10, Y-GATA-H4, DYS438, DYS439, DYS443, DYS444, DYS446, DYS447, DYS448, DYS456, DYS458, DYS460, DYS520, DYS531, DYS557, DYS622, DYS630, DYS635(Y-GATA-C4), and DYS709) were analyzed in 158 unrelated healthy men from southeast China by three fluorescence-labeled multiplex polymerase chain reaction systems. The Y-STR multiplexes developed have followed the published nomenclature and International Society for Forensic Genetics (ISFG) guidelines for STR analysis. Gene diversity ranged from 0.2506 at DYS434 to 0.8034 at DYS447. A total of 157 different haplotypes were observed, and among these, 156 were unique, while 1 was found two times. The haplotype diversity value calculated from all 20 loci combined was 0.9997, which is informative. Furthermore, 80 father–son pairs, previously confirmed by autosomal STR analysis, were typed using the same 20 Y-STR loci, and four mutation events were identified at the Y-GATA-H4, DYS439, DYS456, and DYS458 loci, giving an average mutation rate of 0.25% per locus per generation (95% confidence interval 0.09–0.54). These results including the haplotype data at 20 Y-STR loci would enrich Chinese genetic informational resources and provide useful information in forensic practice. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Human papillomavirus DNA detected in peripheral blood samples from healthy Australian male blood donors

Recent studies have shown that human papillomavirus (HPV) DNA can be found in circulating blood, including peripheral blood mononuclear cells (PBMCs), sera, plasma, and arterial cord blood. In light of these findings, DNA extracted from PBMCs from healthy blood donors were examined in order to determine how common HPV DNA is in blood of healthy individuals. Blood samples were collected from 180 healthy male blood donors (18–76 years old) through the Australian Red Cross Blood Services. Genomic DNA was extracted and specimens were tested for HPV DNA by PCR using a broad range primer pair. Positive samples were HPV‐type determined by cloning and sequencing. HPV DNA was found in 8.3% (15/180) of the blood donors. A wide variety of different HPV types were isolated from the PBMCs; belonging to the cutaneous beta and gamma papillomavirus genera and mucosal alpha papillomaviruses. High‐risk HPV types that are linked to cancer development were detected in 1.7% (3/180) of the PBMCs. Blood was also collected from a healthy HPV‐positive 44‐year‐old male on four different occasions in order to determine which blood cell fractions harbor HPV. PBMCs treated with trypsin were negative for HPV, while non‐trypsinized PBMCs were HPV‐positive. This suggests that the HPV in blood is attached to the outside of blood cells via a protein‐containing moiety. HPV was also isolated in the B cells, dendritic cells, NK cells, and neutrophils. To conclude, HPV present in PBMCs could represent a reservoir of virus and a potential new route of transmission. J. Med. Virol. 81:1792–1796, 2009. © 2009 Wiley‐Liss, Inc.     

Pain Sensitivity in Sleepy Pain-Free Normals

Study Objective:

Past studies have shown that acute experimental reduction of time in bed in otherwise healthy, non-sleepy people leads to hyperalgesia. We hypothesized that otherwise healthy, sleepy people may also exhibit hyperalgesia relative to their non-sleepy counterparts.

Design:

Between-groups sleep laboratory study.

Setting:

Hospital-based sleep disorders center.

Participants:

Twenty-seven, healthy, normal participants (age 18–35 years) were recruited and categorized into sleepy and non-sleepy groups based on their average sleep latencies on a screening multiple sleep latency test (MSLT).

Interventions:

Both groups were then allowed 8 hours time in bed, following which they underwent pain sensitivity testing (10:30 and 14:30) and sleepiness assessments by the MSLT (10:00, 12:00, 14:00, and 16:00). Pain sensitivity assessments were made by measuring finger withdrawal latencies to a radiant heat source delivering 5 different heat intensities.

Measurements and Results:

This study showed that after only one night of 8 hours time in bed, the sleepy participants continued to be sleepy and exhibited a more rapid finger withdrawal response (i.e., increased pain sensitivity) to radiant heat than non-sleepy participants.

Conclusion:

This suggests that sleepy individuals experience hyperalgesia in response to a painful stimulus when compared with non-sleepy individuals.

Citation:

Chhangani BS; Roehrs TA; Harris EJ; Hyde M; Drake C; Hudgel DW; Roth T. Pain sensitivity in sleepy pain-free normals. SLEEP 2009;32(8):1011-1017.     

Shared and persistent asymptomatic cutaneous human papillomavirus infections in healthy skin

Cutaneous human papillomavirus (HPV) types are commonly found in normal skin, and some of them have been suspected to play a role in the development of non‐melanoma skin cancer. This present study is divided into three sections, the aims of this study were to examine if certain HPV‐types persist over time and if HPV‐types are shared within families. From the first part of the study, swab samples from foreheads were collected for three longitudinal studies from one family with a newborn baby. Five specific HPV‐types were isolated from the family with a newborn, with HPV‐5 and FA67 being found at various time points and prevalence rates in all four members of the family. Part 2 consisted of a followed up study from two families with a 6 years interval. Six of the family members were found to have at least one of the HPV‐types identified in the family 6 years earlier. Many of the HPV‐types identified were shared within the families studied. Part 3 of this study involved weekly samples from four healthy females for 4 months. Among the four healthy individuals, 11%, 65%, and 56% of the weekly samples were HPV‐DNA positive with one individual HPV‐negative. All specimens were tested for HPV‐DNA by PCR using the broad range HPV‐type primer pair FAP59/64. The positive samples were HPV‐type determined by cloning and sequencing. Specific cutaneous HPV‐types persist over long periods of time in healthy skin in most individuals investigated and certain HPVs are shared between family members. J. Med. Virol. 81:1444–1449, 2009. © 2009 Wiley‐Liss, Inc.     

Impaired activation of Stat1 and c‐Jun as a possible defect in macrophages of patients with active tuberculosis

Studies of patients with active tuberculosis (TB) and infected healthy individuals have shown that interferon (IFN)‐γ is present in sites of Mycobacterium tuberculosis infection in comparable levels. This suggests that there is a deficiency in the macrophage response to IFN‐γ in TB patients. We used recombinant human IFN‐γ to stimulate adherent monocyte‐derived macrophages from three groups of people: patients with active tuberculosis (TBP), their healthy household contacts (HHC) and healthy uninfected controls from the community (CC). We then evaluated the ability of the macrophages to inhibit the growth of M. tuberculosis H37Rv as well as their cytokine profile at early in infection (48 h). After IFN‐γ treatment, macrophages of healthy individuals (HHC and CC) controlled M. tuberculosis growth and produced mainly nitric oxide (NO) and interleukin (IL)‐12p70, whereas TBP macrophages did not kill M. tuberculosis. Additionally, TBP macrophages produced low levels of NO and IL‐12p70 and high levels of tumour necrosis factor (TNF)‐α and IL‐10. Transforming growth factor (TGF)‐β levels were similar among all three groups. M. tuberculosis infection had little effect on the cytokine response after IFN‐γ stimulus, but infection alone induced more IL‐10 and TGF‐β in TBP macrophages. There were no differences in Stat1 nuclear translocation and DNA binding between the groups. However, the phosphorylated Stat1 and c‐Jun (AP‐1) in nuclear protein extracts was diminished in TBP macrophages compared to macrophages of healthy individuals. These results indicate an impairment of Stat1‐dependent and Stat1‐independent IFN‐γ signalling in macrophages of people with active tuberculosis, suggesting a different molecular regulation that could impact macrophage functionality and disease outcome.     

美国VIPPS网上药房认证对我国的启示

目的:为我国网上药房认证标准完善提供建议。方法:通过研究美国网上药房审批和"网上药房开业认证网站"(VIPPS)认证管理,从机构、程序和标准等方面比较分析我国网上药房审批监管方面的不足。结果与结论:我国应在再认证周期、处方监管、消费者资料和沟通咨询等方面,完善网上药房的许可标准,提高网上药房的准入门槛。     

中国西部健康人群口服替诺福韦富马酸酯片的药动学研究

目的:研究口服替诺福韦富马酸酯片在中国西部健康人群的药动学特征。方法:24名健康志愿者随机分为3组,每组8人,分别给予替诺福韦富马酸酯片300mg、恩曲他滨胶囊200mg+替诺福韦富马酸酯片300mg、脂肪食物(食物中脂肪比例50%)+替诺福韦富马酸酯片300mg,分别在服药前0h及服药后0.5、0.75、1、1.5、2、3、4、6、8、12、24、36、48、72h时取静脉血2mL,分离血浆,采用固相萃取,以高效液相色谱-紫外(HPLC-UV)法测定替诺福韦血药浓度,以DAS(Ver2.1.1)软件计算药动学参数。结果:3组药动学参数分别为:t1/(218.78±3.28)、(12.72±2.83)、(13.08±1.47)h,tma(x1.05±0.16)、(1.28±0.30)、(1.55±0.37)h,cma(x290.71±63.21)、(420.84±96.71)、(429.06±174.81)ng·mL-1,AUC0～7(21871.60±377.00)、(3869.42±962.85)、(3569.47±633.47)μg·h·L-1,AUC0～∞(2284.16±373.54)、(4107.09±974.82)、(3856.00±618.39)μg·h·L-1,CL/F(2.25±0.39)、(1.28±0.28)、(1.33±0.20)L·h-1·kg-1。与替诺福韦富马酸酯组比较,恩曲他滨+替诺福韦富马酸酯组、脂肪食物+替诺福韦富马酸酯组的t1/2降低,cmax、AUC0～72、AUC0～∞、tmax均明显增加。结论:中国西部人群单独给予替诺福韦富马酸酯的药动学特征与国外人群相似,高脂肪饮食以及合用恩曲他滨可改变替诺福韦的药动学特征。