Infertility, assisted reproduction technologies and imprinting disturbances: a Dutch study

BACKGROUND: Evaluation of relationships between assisted reproduction technologies (ART), fertility problems and disorders caused by disturbed genetic imprinting such as Angelman syndrome (AS) and Beckwith-Wiedemann syndrome (BWS). METHODS: A nation-wide questionnaire survey was performed regarding ART in families with a child with AS, BWS or Prader-Willi syndrome (PWS) including questions on fertility. Molecular data on the genetic disorder in affected children were gathered. RESULTS: Of the 220 affected children in this study, 14 (6.4%) were born following any form of ART compared with 83 818 (2.1%) in the Dutch population. Of AS, PWS or BWS children 15 (6.8%) were born after a fertility problem (Time To Pregnancy > 12 months, no forms of ART) compared to 141,340 (3.5%) in the Dutch population. Maternal age in the individual syndromes was higher than in the Dutch population. Families with affected children were three times more likely to experience fertility problems than the general population. All three syndromes were also individually associated with increased fertility problems in the families. CONCLUSIONS: After correction for the increased fertility problems of the parents, there is no increased incidence of ART related birth of AS, PWS or BWS children. ART does not seem to have a direct effect on the increase of imprinted diseases.     

CA-125 tumor-associated antigen in a patient with tuberculous peritonitis

A 64-year-old woman with a history of chronic hepatitis B had abdominal pain and ascites, a serum albumin ascitic gradient (SAAG) of 0.8, and an elevated serum CA-125 value. Exploratory laparotomy revealed ascites and obliteration of the abdominal cavity by advanced adhesive disease consistent with carcinomatosis. Surgical biopsy revealed noncaseating granulomas. She responded well to antituberculous therapy and is presently asymptomatic.     

桑叶黄酮对α-糖苷酶活性的影响

目的:观察桑叶提取物桑叶黄酮对α-糖苷酶活性的影响及其对小鼠餐后血糖的影响。方法:实验于2005-07/10在解放军总医院营养科实验室和动物中心实验室进行。在体外实验中,设立空白组、阿卡波糖不同含量组和桑叶黄酮不同含量组(终浓度为0,7.81,15.63,31.25,62.50,125.00,250.00mg/L)。以阿卡波糖为阳性对照、以无抑制剂时α-糖苷酶活性为100%,检测桑叶总黄酮、HP-20树脂吸附黄酮和非吸附黄酮对α-糖苷酶活性的影响。在体内实验中,将昆明小鼠40只,按血糖水平随机分为4组,即淀粉组、淀粉 HP-20吸附黄酮组、蔗糖组、蔗糖 HP-20吸附黄酮组,每组10只,分别给予淀粉(3g/kg)、淀粉(3g/kg) HP-20吸附黄酮(500mg/kg)、蔗糖(1.5g/kg)以及蔗糖(1.5g/kg) HP-20吸附黄酮(500mg/kg)。检测并比较1h、2h血糖水平。结果:①当阿卡波糖、桑叶总黄酮含量为0,7.81,15.63,31.25,62.50,125.00,250.00mg/L时,α-糖苷酶IC50=70.43,82.11mg/L。②在相同HP-20树脂吸附黄酮浓度条件下,α-糖苷酶活性分别为100.00%,94.61%,84.90%,63.04%,26.27%,11.37%和6.76%,其IC50=59.25mg/L;在相同HP-20树脂非吸附黄酮浓度条件下,α-糖苷酶活性分别为100.00%,90.55%,88.55%,85.91%,78.00%,69.91%和56.36%,其IC50=82.86mg/L。③在给予淀粉的糖耐量实验中,HP-20树脂吸附黄酮组1h后血糖水平明显低于其淀粉对照组[(9.06±1.10),(11.13±1.45)mmol/L,t=2.1009,P=0.00209];在给予蔗糖的糖耐量实验中,HP-20树脂吸附黄酮组1h后血糖水平也明显低于其蔗糖对照组[(9.88±1.01),(12.75±1.17)mmol/L,t=2.1009,P=0.000014]。结论:体外实验提示桑叶总黄酮、HP-20树脂吸附和非吸附黄酮均具有抑制α-糖苷酶活性的作用,其中HP-20吸附黄酮对糖苷酶的抑制作用强于阿卡波糖;体内实验也证实HP-20吸附黄酮能够抑制给予淀粉和蔗糖后1h血糖的升高。     

HLA class I and II antigen phenotypes of North American Indians from Minnesota: implications for marrow transplants using unrelated donors

As a result of an appeal for a bone marrow donor for a North American Indian (Native American) patient, 261 Native Americans from our community were typed for HLA-A,B,DR antigens, and 51 were typed for HLA-A,B antigens only. The HLA antigen frequencies of the Native Americans were compared with those of 12,881 white bone marrow donors and were found to differ markedly. To investigate the implications these differences in HLA antigen frequencies would have for the location of unrelated bone marrow donors, the HLA types of 12 Native American bone marrow transplant patients from our institution were used to search among 5389 HLA-A,B,DR-typed white donors in the National Marrow Donor Program file and the file of 261 HLA-A,B,DR-typed Native American donors. In the white donor file, at least two donors were found that matched at all HLA-A,B,DR antigen loci of one Native American patient (8%). Using the Native American donor file, which was less than one-twentieth the size of the white donor file, and HLA-A,B,DR-matched donor was also found for one (8%) of the patients. These results suggest that although donors for nonwhites can be identified in a file of HLA-typed white volunteers, the probability of finding a suitably matched donor for such individuals is enhanced if donors representing racial or ethnic minorities are included in unrelated donor registries.     

老年男性1 304名人体形态学指标变化规律与血压的关系

目的:了解男性老年人各项人体形态学指标变化规律,探讨这些指标与高血压之间的关系。方法:选择2004-05/09在本院门诊进行全面体检的老年男性共1304名。年龄60～89岁。纳入标准:健康查体的60岁以上老年汉族男性。排除标准:慢性心、肾功能不全、痴呆、恶性肿瘤、水肿和腹水患者。按年龄分为2组:年龄<80岁为老年人组;年龄≥80岁为高龄老年人组。按体质量指数分为3组:体质量指数=18.5～23.9kg/m2为正常体质量组,体质量指数=24～27.9kg/m2为超重组,体质量指数>28kg/m2为肥胖组。按腰围分2组:腰围≤85cm为正常组;腰围>85cm为腹部肥胖组。分析人体形态学指标与血压间的关系,高血压定义为收缩压≥140mmHg和/或舒张压≥90mmHg。人体形态学指标与血压的关系用线性回归分析(逐步引入-剔除法);以受试者工作特性曲线下面积评价各人体测量指数预测高血压准确性。结果:纳入老年男性体检者共1304名均进入结果分析。男性老年人三头肌皮褶厚度和C-指数及腰围身高比值随年龄的增高而增加,而身高、体质量、上臂围、上臂肌围、体质量指数则随年龄增加而呈下降趋势。超重率和肥胖率随年龄增加有下降趋势。Logistic逐步回归分析表明体质量指数(OR=1.078;95%可信区间1.036～1.121)是老年男性高血压的危险因素。结论:三头肌皮褶厚度、体质量指数和年龄是老年男性收缩压的危险因素,而年龄、体质量和上臂围是老年男性舒张压的危险因素。三头肌皮褶厚度、体质量指数和年龄与老年男性收缩压呈显著正相关;舒张压与年龄呈显著负相关关系,而与体质量和上臂围呈正相关关系。     

Written and computerized care plans. Organizational processes and effect on patient outcomes

The purpose of this study was to determine how use of a standardized nomenclature for nursing diagnosis and intervention statements on the computerized nursing care plan in a long-term care (LTC) facility would affect patient outcomes, as well as organizational processes and outcomes. An experimental design was used to compare the effects of two methods of documentation: Computer care plan and paper care plan. Twenty participants (10 in each group) were randomly assigned to either group. No statistically significant differences were found by group for demographic data. Repeated measures ANOVA was computed for each of the study variables with type of care plan, written or computerized, as the independent variable. There were no statistically significant differences between participants, group (care plan), within subjects (across time), or interaction (group and time) effects for the dependent variables: Level of care, activities of daily living, perception of pain, cognitive abilities, number of medications, number of bowel medications, number of constipation episodes, weight, percent of meals eaten, and incidence of alteration in skin integrity. There were significantly more nursing interventions and activities on the computerized care plan, although this care plan took longer to develop at each of the three time periods. Results from this study suggest that use of a computerized plan of care increases the number of documented nursing activities and interventions, but further research is warranted to determine if this potential advantage can be translated into improved patient and organizational outcomes in the long-term care setting.     

Nursing administration model for administrative practice

The winds of change have swept in a new era for nursing. Complex decisions can be aided by a conceptual model for nursing administration practice. The authors discuss how the Iowa Model of Nursing Administration can be used by nurse administrators to solve administrative problems. Two practical examples are described.     

Assessing the reliability, validity, and sensitivity of nursing outcomes classification in home care settings

The purpose of this study is to provide evidence of the validity, inter-rater reliability, and sensitivity of 36 clinically useful of Nursing Outcomes Classification (NOC) results for Home Care (HC) settings. The results of inter-rater reliability, criterion-related validity, and sensitivity evaluations of 36 NOC outcomes were compiled from a 10-site regional evaluation of the NOC. Findings of HC and all sites data were contrasted. More than 90% of the inter-rater reliability scores on the 36 NOC outcome label ratings were within one point, with a substantial number of absolute agreements. All but six of the criterion measures were significantly associated with the corresponding NOC outcomes, and most mean change scores were zero or positive. This was impressive evidence of the adequacy of these measures for reliable and valid use in practice.