Tamm-Horsfall protein: unusual, large perinephric deposits

A case in which unusually large deposits of Tamm-Horsfall protein were identified in perinephric adipose tissue is presented. The deposition around the kidney in this case was most likely due to calyceal rupture, secondary to distal ureteric obstruction. The peculiar gross and microscopic appearance of these deposits, their intense staining with the periodic acid--Schiff technique, and their association microscopically with epithelial fragments raised the possibility of infiltration by mucin-producing adenocarcinoma. The localization of Tamm-Horsfall protein in the deposits by the immunoperoxidase technique helped to confirm their true nature.     

Inactivation by alveolar macrophages of slow-reacting substance of anaphylexis released from pig lung cells

The influence of alveolar macrophages on the release of slow-reacting substance of anaphylaxis (SRS-A) and histamine from dispersed pig lung cells was studied. The addition of alveolar macrophages to lung cells (1:3) decreased SRS-A release by 62% ± 7% without a significant decrease in histamine release. Increased numbers of alveolar macrophages (1:1) decreased both SRS-A release (by 90% ± 5%) and to a lesser extent histamine release (by 59% ± 18%). The decrease in released SRS-A was not caused by prostaglandin release from macrophages, and kinetic data indicated that in contrast to histamine the decrease was predominantly the result of SRS-A inactivation rather than inhibition of its release. When alveolar macrophages were incubated with SRS-A, inactivation (191 units /10⁷ cells/30 min) was confirmed. SRS inactivation was not reproduced by glutaraldehyde-treated macrophages or by granulocyte and mononuclear populations obtained from peripheral blood. Alveolar macrophages may limit the consequences of SRS-A release in the peripheral air spaces.     

Beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma

In a double-blind, randomized study, 93 corticosteriod-independent patients with chronic bronchial asthma were treated with either beclomethasone dipropionate aerosol at 400 μg per day or its vehicle for 4 wk to determine and compare the effectiveness and safety of the preparations. Evaluations made before, at weekly intervals during, and 1 wk after treatment indicated that beclomethasone dipropionate aerosol was superior to its vehicle in improving FVC, FEV₁, FEF_25%–75%, and clinical signs and symptoms, and in the overall evaluations by both the investigators and the patients. Plasma cortisol levels measured at the end of the second and fourth weeks were not substantially different from those before treatment in either group. No significant side effects or abnormalities in laboratory results were noted.     

The effect of sleep duration and sleep quality on hypertension in middle-aged and older Chinese: the Dongfeng-Tongji Cohort Study

ObjectiveTo examine the independent and combined associations of sleep duration and sleep quality with hypertension in a middle-aged and older Chinese population.MethodsWe included 21,912 individuals aged 62.2 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Sleep duration was self-reported and sleep quality was evaluated with questions designed according to the Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure ≥140/90 mmHg, or self-reported physician diagnosis of hypertension, or self-reported current use of antihypertensive medication.ResultsIn the cross-sectional analyses, the odds ratio of hypertension prevalence was significantly elevated (OR = 1.13, 95% CI = 1.03–1.24) in those who slept less than 7 h after adjusting for sex, age, body mass index, midday napping, cigarette smoking and sleep quality. It was particularly evident among males (OR = 1.19, 95% CI = 1.01–1.40) and individuals who were thin (OR = 2.00, 95% CI = 1.01–3.93) with full adjustment. The association was also found for sleep duration of 9∼<10 h after adjusting various covariates (OR = 1.14, 95% CI = 1.04–1.27). In addition, impaired sleep quality was only associated with hypertension in obese individuals (OR = 1.25, 95% CI = 1.02–1.50), not in other subgroups. However, no significant association was detected in any category of sleep duration or sleep quality in all models in the prospective analyses, and the results remained unchanged in the subgroup analyses of sex, age and body mass index.ConclusionsThe results of this study provide limited support for association of sleep duration and sleep quality with hypertension in middle-aged and older Chinese. Further studies are needed to confirm the results.     

Living Kidney Donation From a Donor With Pulmonary Sarcoidosis: A Case Report and Review of the Literature

Background

Sarcoidosis is a chronic systemic disease that is characterized by the formation of noncaseating granuloma and whose etiology is unclear. It is unclear whether patients with sarcoidosis are suitable organ donors.

Gua Sha therapy for chronic low back pain: A randomized controlled trial

ObjectiveTo test the efficacy of Gua Sha therapy in patients with chronic low back pain.Methods50 patients with chronic low back pain (78% female, 49.7 ± 10.0 years) were randomized to two Gua Sha treatments (n = 25) or waitlist control (n = 25). Primary outcome was current pain intensity (100-mm visual analog scale); secondary outcome measures included function (Oswestry Disability Index), pain on movement (Pain on Movement Questionnaire), perceived change in health status, pressure pain threshold, mechanical detection threshold, and vibration detection threshold.ResultsAfter treatment, patients in the Gua Sha group reported lower pain intensity (p < 0.001) and better overall health status (p = 0.002) compared to the waitlist group. No further group differences were found. No serious adverse events occurred.ConclusionsGua Sha appears to be an acceptable, safe, and effective treatment for patients with chronic low back pain. Further rigorous studies are needed to confirm and extend these results.     

兰德公司的资金来源、支出结构与智库服务质量

美国民间智库在美国军事领域扮演着重要角色,其运行机制和发展经验对我国军方智库建设具有借鉴和启示意义。采用案例研究法,以美国国家战略咨询机构兰德公司为例,从资金来源和支出结构角度进行分析,通过网站和文献进行调研,研究兰德公司的资金来源、使用结构和使用成效,并总结其特征和优势。美国民间智库强调智库建设资金来源的多样化,注重对人才招募和建设的资金投入,重视对自主性课题研究的资金支持,为智库的发展壮大提供了良好的经济支撑。     

Patient Willingness to Pay for Reductions in Chronic Low Back Pain and Chronic Neck Pain

Many recommended nonpharmacologic therapies for patients with chronic spinal pain require visits to providers such as acupuncturists and chiropractors. Little information is available to inform third-party payers’ coverage policies regarding ongoing use of these therapies. This study offers contingent valuation-based estimates of patient willingness to pay (WTP) for pain reductions from a large (n = 1,583) sample of patients using ongoing chiropractic care to manage their chronic low back and neck pain. Average WTP estimates were $45.98 (45.8) per month per 1-point reduction in current pain for chronic low back pain and $37.32 (38.0) for chronic neck pain. These estimates met a variety of validity checks including that individuals’ values define a downward-sloping demand curve for these services. Comparing these WTP estimates with patients’ actual use of chiropractic care over the next 3 months indicates that these patients are likely “buying” perceived pain reductions from what they believe their pain would have been if they didn't see their chiropractor—that is, they value maintenance of their current mild pain levels. These results provide some evidence for copay levels and their relationship to patient demand, but call into question ongoing coverage policies that require the documentation of continued improvement or of experienced clinical deterioration with treatment withdrawal.PerspectiveThis study provides estimates of reported WTP for pain reduction from a large sample of patients using chiropractic care to manage their chronic spinal pain and compares these estimates to what these patients do for care over the next 3 months, to inform coverage policies for ongoing care.