Secondary acute myeloblastic leukemia with t(16;21)(q24;q22) involving the AML1 gene

A t(16;21)(q24;q22) translocation was detected by fluorescence in situ hybridization in a patient with acute myeloblastic leukemia previously treated for malignant lymphoma. While the breakpoint on chromosome 21 was within the AML1 gene as determined by FISH, the gene partner on chromosome 16 could not be identified. Band 16q24 appears to be rearranged in several types of myeloid proliferation and a review of the literature shows that these rearrangements most often occur in secondary leukemia and myelodysplastic syndrome or are part of complex chromosomal rearrangements.     

Evaluation of volumetric changes of teeth in a Brazilian population by using cone beam computed tomography

The purpose of this study was to test the usefulness of some morphometric parameters of the teeth in 5 different age groups through images of Cone Beam CT. 118 upper central incisors clinically acquired of 60 women and 58 men aged between 22 and 70 years were selected. The hard tissue volume and the pulp cavity volume of each tooth was obtained and computed by the software DentalSlice^® and the measures were assessed (pulp cavity volume, hard tissue volume, tooth volume and pulp cavity/tooth volume ratio). The pulp cavity volume and the pulp cavity/tooth volume ratio showed significant differences between age groups (p < 0.001). Linear regression analysis showed a coefficient of determination of 0.21 which suggests that there is a weak correlation between the pulp cavity/tooth volume ratio and age.     

Low academic achievement as a predictor of test anxiety in secondary school students

ObjectivesThe present study had two objectives: 1) to examine the differences between students with different levels of academic achievement (low, average and high) in Anxiety/Depression and Test Anxiety; and 2) to test the predictive effect of academic achievement on test anxiety.MethodData were collected in two moments. In time 1, the sample was comprised of 305 students. The students were aged between 15 to 18 years, attending secondary school. The assessment protocol consisted of a Socio-demographic Data Sheet, the Youth Self-Report and the Cognitive Test Anxiety Scale.ResultsStudents with low academic achievement presented higher test anxiety than students with average and high academic achievement. Low academic achievement on time 1 predicted higher levels of test anxiety on time 2 when186 participants remained in the study.ConclusionResults suggest the importance of early psychological intervention with students with low academic achievement, and the relevance of promoting the development of skills that enable students to manage their test anxiety.     

CASR基因新发变异致新生儿重症甲状旁腺功能亢进症1例报告

新生儿重症甲状旁腺功能亢进症是一种罕见的危及生命的疾病,在新生儿期表现为严重的高钙血症、甲状旁腺功能亢进和骨质减少。患儿,女,14日龄,生后4天起病,表现为高胆红素血症、纳差、反应差、肌张力低下,严重的高钙血症和甲状旁腺功能亢进。基因检测显示,CASR基因存在未报道过的c.888C > A (p.Ser296Arg)(来源于父亲)、c.1576G > T (p.Glu526Ter)(来源于母亲)复合杂合变异。患儿经多次唑来膦酸静脉滴注,吸吮力、反应及肌张力有好转,血钙开始明显下降但一周后又升高。生后54天患儿行一侧甲状旁腺切除术,血钙有所下降,于生后64天出院。生后17月随访,患儿体格和神经发育迟缓。NSHPT由CASR基因失活变异引起,表现为严重的高钙血症和甲状旁腺功能亢进,伴生长发育迟缓。甲状旁腺全切除术是首选治疗手段,双膦酸盐可能具有一定的疗效。     

The repetitive portion of the Xenopus IgH Mu switch region mediates orientation-dependent class switch recombination

Vertebrates developed immunoglobulin heavy chain (IgH) class switch recombination (CSR) to express different IgH constant regions. Most double-strand breaks for Ig CSR occur within the repetitive portion of the switch regions located upstream of each set of constant domain exons for the Igγ, Igα or Igϵ heavy chain. Unlike mammalian switch regions, Xenopus switch regions do not have a high G-density on the non-template DNA strand. In previous studies, when Xenopus Sμ DNA was moved to the genome of mice, it is able to support substantial CSR when it is used to replace the murine Sγ1 region. Here, we tested both the 2 kb repetitive portion and the 4.6 kb full-length portions of the Xenopus Sμ in both their natural (forward) orientation relative to the constant domain exons, as well as the opposite (reverse) orientation. Consistent with previous work, we find that the 4.6 kb full-length Sμ mediates similar levels of CSR in both the forward and reverse orientations. Whereas, the forward orientation of the 2 kb portion can restore the majority of the CSR level of the 4.6 kb full-length Sμ, the reverse orientation poorly supports R-looping and no CSR. The forward orientation of the 2 kb repetitive portion has more GG dinucleotides on the non-template strand than the reverse orientation. The correlation of R-loop formation with CSR efficiency, as demonstrated in the 2 kb repetitive fragment of the Xenopus switch region, confirms a role played by R-looping in CSR that appears to be conserved through evolution.     

复方胃蛋白酶散联合枯草杆菌二联活菌颗粒防治婴幼儿支气管肺炎继发性腹泻临床观察

目的探讨复方胃蛋白酶散联合枯草杆菌二联活菌颗粒防治婴幼儿支气管肺炎继发性腹泻的临床效果。方法将260例支气管肺炎患儿随机分为两组,各130例。两组均给予头孢哌酮钠静脉滴注+氨溴索雾化吸入治疗。对照组给予复方胃蛋白酶散口服,观察组加用枯草杆菌二联活菌颗粒口服。观察两组继发性腹泻发生率、腹泻消失时间及住院时间。结果观察组<1岁、1~2岁、>2岁患儿继发性腹泻发生率均低于对照组(P<0.05),总继发性腹泻发生率低于对照组(P<0.01);观察组继发性腹泻患儿腹泻消失时间和住院时间均短于对照组(P<0.01或P<0.05)。结论复方胃蛋白酶散联合枯草杆菌二联活菌颗粒防治婴幼儿支气管肺炎继发性腹泻效果显著,可降低腹泻发生率,缩短患儿治疗时间,值得在临床推广应用。     

醒脾养儿颗粒治疗小儿肺炎继发性腹泻的临床疗效

目的：探究并分析醒脾养儿颗粒治疗小儿肺炎继发性腹泻的临床疗效。方法随机选取该院自2013年12月—2014年12月收治的60例肺炎继发性腹泻患儿,采用随机数字表法分成试验组和对照组,每组30例患儿。对照组患儿采用常规的治疗方案,试验组患儿采用在常规治疗的基础上加用醒脾养儿颗粒的治疗方案,分别观察两组患儿经不同方式治疗后总有效率及呕吐、腹泻、发热及治愈时间的对比情况。结果试验组总有效率为93.33%,对照组总有效率为60.00%,试验组总有效率明显高于对照组,差异有统计学意义（P＜0.05）。试验组患者呕吐改善时间、腹泻改善时间及治愈时间明显短于对照组患者,差异有统计学意义（P＜0.05）。结论采用醒脾养儿颗粒治疗小儿肺炎继发性腹泻可提高总有效率,减轻患儿的痛苦,值得临床推广。     

北京市二级医院护理人员专业自主性现状及影响因素调查

目的：了解北京市二级医院护理人员专业自主性现状,并分析其影响因素。方法于2014年1—3月以中文版护理实践量表（ NAS）为调查工具,对北京市平谷区3家二级医院364名临床科室护理人员的专业自主性进行调查。结果3家二级医院的364名护理人员专业自主性得分为（177．96±18．52）分,处于中高等水平。不同年龄、护龄、职称、职务的护理人员的专业自主性得分比较差异有统计学意义（t值分别为6．284,9．700,5．410,6．435;P＜0．05）。结论管理者应关注自主性较低人群,有针对性的采取措施,提高护理人员整体的专业自主性水平,以提升护理质量。     

Competition,gatekeeping, and health care access

We study gatekeeping physicians’ referrals of patients to specialty care. We derive theoretical results when competition in the physician market intensifies. First, due to competitive pressure, physicians refer patients to specialty care more often. Second, physicians earn more by treating patients themselves, so refer patients to specialty care less often. We assess empirically the overall effect of competition with data from a 2008–2009 Norwegian survey, National Health Insurance Administration, and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the Herfindahl–Hirschman index. The empirical results suggest that competition has negligible or small positive effects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care.