军队采供血机构血液储备应关注的问题

战备血液储备与常规的血液储备,在储备的形式、管理的方式、动用的权限等方面存在一定的差异,军队采供血机构在战备血液储备工作中应当关注：物资准备、人员培训、信息管理、动用权限、保密等问题。     

Post-traumatic stress in the medical setting

ABSTRACT

This article addresses the prevalence of posttraumatic stress arising from serious illness and injury. Its purpose is to underscore the importance of assessment and treatment of this population. The article reviews literature about patient stress responses to intensive care experiences and hospitalization. Above all, serious illness and injury hamper the individual’s ability to maintain their ongoing lifestyle and interpersonal relationships; the experience raises the specter of vulnerability and mortality and can obstruct the experience of a familiar “self”. Issues to be assessed and areas to be addressed therapeutically using hypnosis are suggested.     

Regulation of immune responses to Strongyloides venezuelensis challenge after primary infection with different larvae doses

Nematode infections are generally followed by high rates of reinfection, leading to elevated prevalence in endemic areas. Therefore, the effective control of nematode infections depends on understanding the induction and regulation of protective mechanisms. However, most experimental models for protective immune response against nematodes use high parasite exposure, not always reflecting what occurs naturally in human populations. In this study, we tested whether infecting mice with different Strongyloides venezuelensis larvae loads would affect protective responses against reinfection. Interestingly, we found that a previous infection with 10–500 larvae conferred high rate of protection against reinfection with S. venezuelensis in mice, by destroying large numbers of migrating larvae. However, low‐dose priming did not abolish adult worm maturation, as detected in high‐dose primed group. Results also indicated that a previous low‐dose infection delayed the development of cellular infiltrate, while a high inoculum rapidly induced these inflammatory features. Cytokine production by splenocyte cultures of challenge infected mice demonstrated that low‐dose priming had increased production of IL‐4 and IFN‐γ, while high‐dose induced IL‐4 production but not IFN‐γ. Our data support the hypothesis that low‐dose nematode infection does not induce a polarized type‐2 immune response, allowing adult worm survival.     

序列标签法寻找日本血吸虫新基因

目的　寻找日本血吸虫新的疫苗候选分子 ,通过构建基因的反义核酸表达载体进行基因性质功能研究。　方法　运用表达序列标签法寻找并获得日本血吸虫新基因 ,对未知基因进行功能分析 ,并构建反义真核表达载体。　结果　获得表达序列标签 JAYL0 2 30的全长 c DNA序列 ,其推导氨基酸序列与人类和猪等生物的抗凋亡因子 1具有同源性 ,将之反向克隆入真核表达载体 p EGFP- N3中。　结论　表达序列标签法与生物信息技术结合有利于寻找新基因 ,反义核酸载体的构建为进一步研究基因功能提供帮助     

Direct visualization of membrane clustering and endocytosis of thyrotropin into cultured thyroid cells

We prepared a highly fluorescent conjugate of thyrotropin (TSH) which retains approximately 25% of the binding affinity of native TSH towards TSH receptor and approximately 25% of the potency of the native hormone in stimulating the accumulation of cAMP in thyroid cells. Using an image-intensified microscopy system, we observed that our fluorescent TSH bound specifically to diffusely distributed membrane receptors on live rat or bovine embryo thyroid cells grown in culture. At 37 degrees C the fluorescent hormone formed visible patches which were internalized and subsequently degraded. Hence, TSH, like other polypeptide hormones, is internalized by a process of receptor-mediated endocytosis. The addition of bivalent antibodies against the fluorophore rhodamine, to thyroid cells that were previously exposed to sub-optimal concentrations of rhodamine TSH, elicited maximal stimulation of the thyroid adenyl cyclase. Monovalent Fab' fragments did not enhance the response of rhodamine TSH. Therefore we conclude that enhanced surface clustering of TSH molecules increases their capacity to stimulate the adenyl cyclase of thyroid cells.     

The role of cognitive biases and personality variables in subclinical delusional ideation

Introduction. A number of cognitive biases, most notably a data gathering bias characterised by “jumping to conclusions” (JTC), and the “bias against disconfirmatory evidence” (BADE), have been shown to be associated with delusions and subclinical delusional ideation. Certain personality variables, particularly “openness to experience”, are thought to be associated with schizotypy.

Methods. Using structural equation modelling, we examined the association between two higher order subfactors (“aspects”) of “openness to experience” (labelled “openness” and “intellect”), these cognitive biases, and their relationship to subclinical delusional ideation in 121 healthy, nonpsychiatric controls.

Results. Our results suggest that cognitive biases (specifically the data gathering bias and BADE) and the “openness” aspect are independently associated with subclinical delusional ideation, and the data gathering bias is weakly associated with “positive schizotypy”. “Intellect” is negatively associated with delusional ideation and might play a potential protective role.

Conclusions. Cognitive biases and personality are likely to be independent risk factors for the development of delusions.     

B cell elimination in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a worldwide distribution, potentially life-threatening with considerable morbidity. The elimination of pathogenic B cells has emerged as a rational therapeutic option. Many open label studies have reported encouraging results in which clinical and serological remission have invariably been described, often enabling the reduction of steroid and immunosuppressive treatment. However, the results from randomized controlled studies have been disappointing and several questions remain to be answered. In this review we will focus on results of B cell direct depletion in the treatment of patients with systemic lupus erythematosus.     

The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study

BackgroundWe recently showed headache to be common in children (aged 7–11 years) and adolescents (aged 12–17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden.MethodsFollowing the generic protocol for Lifting The Burden’s global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration < 1 h). Burden enquiry was conducted in multiple domains.ResultsQuestionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (±SD) of 3.7 ± 4.5 days/4 weeks and mean duration of 1.6 ± 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1–3 was 1.6 ± 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 ± 2.8 days/4 weeks. Lost school time was 0.5 ± 1.5 days/4 weeks (migraine 0.7 ± 1.5, pMOH 5.0 ± 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 ± 2.4, migraine 1.5 ± 2.2, pMOH 8.4 ± 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types.ConclusionsHeadache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania.     

Assessment of the level of vaccine-induced anti-HBs antibodies in children with inflammatory systemic connective tissue diseases treated with immunosuppression

Objectives

Protective vaccinations are the most effective method of prevention of type B virus hepatitis. The aim of the study was to determine whether in children receiving immunosuppressive therapy due to inflammatory systemic connective tissue diseases the protective concentration of the anti-HBs antibodies produced after vaccination against type B virus hepatitis in infancy is maintained.

Material and methods

The concentration of anti-HBs antibodies was assessed in the sera of 50 children with inflammatory connective tissue diseases – 37 girls (74%) and 13 boys (26%), aged 1.5–17.5 years – during the immunosuppressive treatment, which lasted at least 6 months. The control group consisted of 50 healthy children – 28 girls (56%) and 22 boys (44%) aged 2–17 years. All children were vaccinated in infancy with Engerix B vaccine according to the 0–1–6 months schedule. The antibody concentration of ≥ 10 mIU/ml in patients is regarded as protective.

Results

No protective antibody concentrations were found in 25 cases (50%) in the group of diseased children and only in 2 children in the control group (4%).

Conclusions

The concentration of vaccine-induced antibodies should be assessed in children with inflammatory systemic connective tissue diseases and, in case of the absence of a protective concentration, revaccination should be started. The use of glucocorticosteroids, synthetic and biological disease-modifying antirheumatic drugs is no contraindication to vaccination against hepatitis B.     

Valor diagnóstico de anticuerpos antipéptido citrulinado del fibrinógeno en la artritis reumatoide

ObjectiveTo determinate the diagnostic value of an antibody against a citrullinated fibrinogen peptide in Cuban patients with rheumatoid arthritis, using an enzyme immunasay.Materials and methodsA citrullinated peptide of fibrinogen designed by informatics prediction was synthesized and used in an enzyme immunoassay. The participants were 81 patients with early disease, 81 patients with established disease, 58 patients with other rheumatic and inflammatory diseases, and 43 healthy individuals. Anti- citrullinated fibrinogen peptide, anti-mutated citrullinated vimentin, anti second generation citrullinated peptides and rheumatoid factor antibodies were determined by enzyme-linked immunosorbent assay.ResultsDetermination of anti-citrullinated peptide of fibrinogen antibodies by the designed enzyme immunoassay showed the best diagnostic value in early rheumatoid arthritis patients, with the highest value sensitivity (84%), negative predictive value (85%), Youden index (0.73%) and area under the receiver operating curve (0.9192). Specificity (89%) and positive predictive value (88%) were higher than rheumatoid factor, similar to anti- mutated citrullinated vimentin, but lower than second generation anti-citrullinated peptides assay. The positivity of C-reactive protein was associated with the presence of anti- citrullinated fibrinogen peptide antibodies and the titres of these antibodies correlated with clinical activity in early disease.ConclusionsThe immunoassay designed with a citrullinated fibrinogen peptide has a high diagnostic value and can identify patients with greater clinical activity in early rheumatoid arthritis.