舒降之对维持血透患者微炎症状态的影响

目的: 通过观察舒降之对维持性血液透析患者相关炎症和营养指标白介素-6(IL-6)、高敏C反应蛋白(hs-CRP)、白蛋白、前白蛋白、转铁蛋白的影响,了解其对维持性血液透析患者微炎症状态的作用,探讨他汀类药物在透析患者中应用指征.方法: 将34例稳定维持血液透析患者,随机分为实验组19例及对照组15例.实验期间实验组每位患者每日服用舒降之20 mg,对照组不服药,时间为2月,分别在实验开始、1月末、2月末检测患者血IL-6、CRP、前白蛋白、转铁蛋白及血脂浓度.实验结果采用t检验分析.结果:和实验前相比,实验结束时实验组IL-6明显升高、CRP明显降低、白蛋白与转铁蛋白升高 ,均具有统计学差异(P<0.01);而前白蛋白虽有一定幅度上升,但结果无统计学差异 .实验前后,总胆固醇、LDL浓度改变未显示出统计学差异.而实验结束时甘油三酯较1月末及实验开始时显著降低,结果具有统计学差异.对照组各项指标试验前后无明显改变.结论:舒降之可降低维持性血液透析患者血液CRP、IL-6浓度,升高转铁蛋白、白蛋白浓度,改善患者营养及微炎症状态,这种作用并不依赖于其调脂功能.     

Working patterns and the quality of training of medical house officers: evaluating the effect of the `new deal'

The `new deal' on junior doctors' hours of work has led to the widespread introduction of working patterns such as full shifts and partial shifts in the United Kingdom. The impact of these changes on the training of medical staff is unclear. The subjects of the current study were 36 pre-registration medical house officers working shift rotas and on-call rotas at a teaching hospital in the north of England. They were studied over a 12-month period using a self-report questionnaire seeking their views on the quality of their training experience and their satisfaction with the in-service training they received. Nursing staff, consultant and medical student opinion was also sought. Partial-shift and full-shift systems led to reduced hours of work when compared to on-call rotas (mean hours: partial shift 65·0; full shift 59·8; on-call 72·7), but they were associated with significantly lower training experience and training satisfaction scores for the house officers than were on-call systems (P < 0·01). Shift systems were unpopular among consultants and medical students but not nursing staff. Despite reducing excessive hours of work, shifts may be detrimental to the training of medical house officers. The further imposition of shift working should be suspended until such time as the impact of new working patterns on the training of medical staff has been determined.     

Benzo[b]thiophenesulphonamide 1,1-dioxide derivatives inhibit tNOX activity in a redox state-dependent manner

Benzo[b]thiophenesulphonamide 1,1-dioxide (BTS) derivatives are strong cytotoxic agents that induce reactive oxygen species (ROS) overproduction and apoptosis in tumour cells. Although the precise origin of BTS-induced ROS is not known, a clear correlation between their cytotoxic effect and ability to inhibit a tumour-associated NADH oxidase (tNOX) activity of the plasma membrane has been described. To analyse the putative implication of tNOX in BTS-induced ROS generation, in this work we have synthesised and tested a new BTS derivative, the 6-[N-(2-phenylethyl)]benzo[b]thiophenesulphonamide 1,1-dioxide. According to its high lipophilicity, this compound showed a strong cytotoxic activity against a panel of six human tumour cell lines, including two human leukaemia (K-562 and CCRF-CEM) and four human solid tumours (HT-29, HTB54, HeLa and MEL-AC). We also tested the ability of this compound to inhibit the tNOX activity and we found an absolute dependence of this inhibition on the redox state of the tNOX: while under reducing conditions, that is, 100 mM GSH, the drug inhibits strongly the NOX activity with an EC(50) of about 0.1 nM, under oxidising conditions, there is no effect of the drug or just a slight stimulation of activity.     

Comparative Investigation by Two Analytical Approaches of Enthalpy Relaxation for Glassy Glucose,Sucrose, Maltose,and Trehalose

No HeadingPurpose. In an effort to understand the stability of glassy sugars such as glucose, sucrose, maltose, and trehalose, the molecular mobility below the glass transition temperature (T_g) was investigated by an enthalpy relaxation measurement with differential scanning calorimetry (DSC).Methods. The glassy sample was aged over several days at (T_g – 10) K to (T_g – 30) K, before a DSC heating scan was taken. The relaxed enthalpy (H_relax) was estimated from the endothermic peak area. The enthalpy relaxation time was analyzed from the time course of H_relax using two different approaches; Kohlrausch-Williams-Watts (KWW) and extended Adam-Gibbs (exAG).Results. ^KWW, which is defined as the mean average enthalpy relaxation time in a distribution, and ^eff₀ and ^eff, which correspond to the enthalpy relaxation time of the initial minimum and final maximum cooperative rearrangement region, were estimated by KWW and exAG, respectively. And three activation energies for enthalpy relaxation were calculated from the Arrhenius plot.Conclusions. Although these Es originated from different theoretical backgrounds, almost the same trend was observed for a comparison of the values of the four sugars. The finding that the Es of glassy trehalose were the largest among the four sugars may support the reason that glassy trehalose is an effective stabilizer.     

Up-regulation of telomere-binding TRF1, TRF2 related to reactive oxygen species induced by As(2)O(3) in MGC-803 cells

In this work, our study focused on As(2)O(3) action in view point of telomere. Results showed that treatment of human gastric cancer MGC-803 cells with arsenic trioxide could cause up-regulation of telomeric repeat binding factor TRF1 and TRF2 mRNA and protein levels, and induced G2/M phase arrest and cell apoptosis. At the same time, telomere length shortening and telomerase inhibitory were not obvious. Flow cytometry measurements indicated that the increase of TRF1 and TRF2 proteins is related to oxidative stress by arsenic trioxide. Results also indicate that after arsenic trioxide treatment, p53 protein levels increased significantly and also could bind directly at the telomere t-loop junction. These findings demonstrate arsenic trioxide-induced cell cycle arrest and apoptosis might involve a novel pathway related to TRF1, TRF2 protein.     

某地区受艾滋病影响儿童心理状况调查

目的调查山西某艾滋病比较集中的地区受艾滋病影响儿童的情绪状况、社会支持、应对方式和心理韧性等方面的现状。方法采用中文版儿童焦虑性情绪障碍筛查表(SCARED)、中文版儿童抑郁自评量表(DSRS)、社会支持评定量表(SSS)、简易应对方式问卷(SCSQ)及青少年心理韧性量表(RSCA)进行调查。结果①在焦虑、抑郁情绪得分上,受艾滋病影响儿童组即研究组(分别为23.45±11.32、11.37±4.37)与普通儿童组即对照组(分别为22.53±11.08、11.40±4.38)之间的差异不具有统计学意义(P>0.05);②在积极应对得分上,研究组(19.61±6.40)与对照组(22.70±5.28)之间的差异具有统计学意义(P<0.05);③在客观支持、主观支持以及社会支持总分上,研究组(分别为9.30±2.92、24.11±3.97、41.83±7.01)与对照组(分别为10.81±2.71、25.75±3.75、45.34±6.44)之间的差异具有统计学意义(P<0.05);④在目标专注、积极认知以及心理韧性总分得分上,研究组(分别为3.58±0.80、3.55±0.92、93.97±14.06)与对照组(分别为3.84±0.66、3.79±0.74、97.69±11.64)之间的差异具有统计学意义(P<0.05)。结论与普通儿童相比,受艾滋病影响儿童在社会支持的获得上存在明显的不足,同时,其积极应对的能力和心理韧性也需要进一步加强,有必要在这些方面对他们实施有针对性的心理辅导和干预。     

慢性心功能不全患者生活质量及其相关因素的临床研究

目的探讨慢性心功能不全患者的生活质量及其相关因素。方法用症状自评量表(SCL-90)和心功能不全生活质量量表(LHFQ)对80例住院慢性心功能不全患者进行测评。结果慢性心功能不全患者的生活质量总分为(64.2±14.4)分;SCL-90量表中躯体化(2.47±0.68)分,恐怖(1.79±0.43)分,焦虑(1.97±0.39)分,抑郁(1.86±0.55)分;生活质量与焦虑、抑郁情绪呈正相关(r=0.277～0.389,P<0.05,0.01),与文化程度、经济收入呈显著负相关(r=-0.288～0.415,P<0.05或0.01);与家庭负担、总病程以及既往住院次数呈显著正相关(r=0.279～0.398,P<0.05,0.01)。结论慢性心功能不全患者存在不良心理状态和相对较低的生活质量,生活质量受多方因素影响,有必要对其进行心理、社会支持,以提高其生活质量。     

An algorithm based on one or two nasal samples is accurate to identify persistent nasal carriers of Staphylococcus aureus

Persistent Staphylococcus aureus nasal carriers are at high risk of S. aureus infection. The present study delineates a simple strategy aimed at identifying rapidly and accurately this subset of subjects for clinical or epidemiological purposes. Ninety healthy volunteers were each identified as persistent, intermittent or non-nasal carriers of S. aureus by using seven specimens sampled over a 5-week period. By reference to this so-called reference standard, six other strategies aimed at simplifying and speeding the identification of persistent carriers and based on the qualitative or quantitative detection of S. aureus in one to three nasal samples were evaluated by the measure of the area under the curve of receiver operating characteristic diagrams. Among strategies using qualitative results, there was no statistical difference between protocols using seven and three samples. A threshold of 10³ CFU of S. aureus per swab was found capable of defining persistent nasal carriage with a sensitivity of 83.1% and a specificity of 95.6%. These figures reached 95.5% and 94.9%, respectively, by using an algorithm including one or two nasal specimens according to the threshold of 10³ CFU of S. aureus in the first swab. The latter two strategies were shown to be costly equivalents. The proposed algorithm-based strategy proved to be relevant to identify properly and consistently persistent nasal carriers of S. aureus. However, as it was built from data of healthy volunteers, it needs to be confirmed prospectively on patients potentially at risk for S. aureus infection.     

中西医结合治疗维持性血透患者贫血和微炎症状态的临床研究

目的：观察中西医结合治疗对尿毒症维持性血液透析患者贫血及微炎症状态的疗效,探讨其作用机制和临床适应证。方法：采用随机对照试验设计方案,以单纯西医治疗为对照,将78例患者随机分为单纯西医治疗组（39例）和中西医结合治疗组（39例）,治疗12周,观察超敏C-反应蛋白（hs-CRP）、瘦素（Leptin）、白蛋白（Alb）、红细胞计数（RBC）、血红蛋白（Hb）及红细胞压积（Hct）等疗效指标及肝功能、不良事件等安全性指标。结果：两组的人口学特征及hs-CRP、Leptin、Alb、RBC计数、Hb及Hct差异无统计学意义。治疗12周后：1）单纯西医治疗组和中西医结合治疗组的RBC计数、Hb及Hct,hs-CRP、Leptin、Alb分别较治疗前均有改善,且中西医结合治疗组的疗效更显著（P〈0.05）。2）相关分析表明血清hs-CRP浓度与Hb、Hct、Alb呈负相关（P〈0.05或P〈0.01）。3）观察过程中两组不良事件发生率差异无统计学意义,且均未发生严重不良事件。结论：中西医结合治疗可明显改善维持性血透患者的贫血状态和微炎症状态,无严重不良反应。     

原发性高血压患者血栓前状态的研究

目的:检测原发性高血压患者血栓前状态相关指标,探讨血栓前状态(prothrombotic state,PTS)与原发性高血压的关系.方法:定量检测80例原发性高血压患者及30例正常对照组的血液流变学指标、纤维蛋白原( fibrinogen,FIB).结果:①高血压1和2级组FIB、血黏度高于正常对照组(P＜0.05).高血压1和2级组血小板聚集率显著高于正常对照组(P＜0.01).高血压3级组FIB高于正常对照组(P＜0.05).高血压3级组血黏度、血小板聚集率显著高于正常对照组(P＜0.01).高血压1和2级组与高血压3级组FIB、血黏度、血小板聚集率没有统计学意义(P＞0.05).②血浆黏度与FIB呈正相关(r =0.297,P＜0.01).结论:原发性高血压患者存在血栓前状态.