Elección informada en el cribado del cáncer de mama: el papel del nivel educativo

ObjectiveTo evaluate the effect of receiving information about the benefits and harms of breast cancer screening in informed choice, according to educational level.MethodSecondary analysis of a randomized, controlled study, in four screening programs, in Catalonia and the Canary Islands (Spain). We analyzed 400 women who were going to be invited to participate for the first time. The intervention group received a decision aid that showed the benefits and harms of screening. The control group received a standard brochure that recommended participating in the screening program. Educational level was grouped into two categories, low and high. The primary outcome was informed choice defined as adequate knowledge and consistency between attitudes and intentions.ResultsThe intervention produced a greater increase in knowledge in women with a high educational level compared to those with a lower educational level. Among women who received the intervention, informed choice was almost three times higher in those with a high educational level (27% versus 11%). No differences were observed between educational levels in decisional conflict, confidence in the decision, anxiety and worry about breast cancer, in the intervention and control groups.ConclusionsA decision aid for breast cancer screening had much more impact on informed choice among women with a high educational level. In women with low educational level, the attitude towards screening improved and there was an increase in the intention to be screened.     

基于UPLC-Q-TOF-MS技术的刺五加叶血清药物化学初步研究

目的对刺五加Acanthopanax senticosus叶进行血清药物化学初步研究。方法大鼠ig给予刺五加叶提取液,采集含药血清。采用超高效液相色谱-四级杆-飞行时间串联质谱(UPLC-Q-TOF-MS/MS)技术,通过比较相同色谱、质谱条件下刺五加叶提取物、空白血清及给药血清图谱,并利用Peakview和MetabolitePilot数据处理软件,根据质谱所提供的保留时间、精确相对分子质量及二级质谱裂解碎片来鉴定和推测其血中移行成分。结果刺五加叶提取液ig给药后从血清中检测出19个入血成分,其中9个为原型成分,10个为代谢产物。结论初步确定了刺五加叶的入血成分,为阐明其药效物质基础提供依据。     

刺五加提取液对慢性疲劳模型大鼠下丘脑-垂体-肾上腺轴的调节作用

目的：观察刺五加提取液对慢性疲劳（chronic fatigue,CF）大鼠的行为和下丘脑-垂体-肾上腺（HPA）轴的影响,探讨其抗疲劳机制。方法：30只大鼠随机分为5组：对照组,CF组,刺五加提取液50、100、200 mg/kg组。除对照组6只大鼠外,其余24只大鼠用跑台训练法建立CF模型。各组大鼠分别灌胃给予生理盐水,生理盐水,刺五加提取液50、100、200 mg/kg,每天给药1次,共21 d。测定各组大鼠给药后力竭时间;放射免疫分析法（RIA）检测促肾上腺皮质激素释放素（CRH）、促肾上腺皮质激素（ACTH）和皮质酮的血浓度,实时（real-time）PCR法检测下丘脑促皮质素释放激素受体1（CRHR1）mRNA表达。结果：刺五加提取液100、200 mg/kg大鼠跑台致力竭时间比CF组明显延长（P＜0.01）。CF模型大鼠CRH、ACTH和皮质酮的血浓度显著升高（P＜0.01）,下丘脑CRHR1 mRNA表达上调（P＜0.01）。刺五加提取液50、100、200 mg/kg可部分逆转由CF引起的CRH、ACTH及皮质酮血清浓度升高（P＜0.05,P＜0.01）和CRHR1 mRNA表达的上调（P＜0.05,P＜0.01）。结论：刺五加提取液的抗疲劳作用可能与抑制HPA轴功能亢进,改善CRHR1偶联的信号通路有关。     

红毛五加叶中常春藤皂苷元的高效液相色谱法测定

目的 建立红毛五加叶中常春藤皂苷元的测定方法.方法 采用高效液相色谱法.色谱柱为Welchrom C_(18)色谱柱(4.6 mm×250 mm,5 μm);流动相为甲醇-水-冰醋酸-三乙胺(85:15:0.04:0.02);流速:1.0 ml·min~(-1);柱温:35 ℃;检测波长为210 nm.结果 常春藤皂苷元的线性范围为0.68 ～10.94 μg,平均加样回收率为100.42%,RSD小于2%.结论 该方法准确、专属性强,可为红毛五加叶的综合开发利用提供参考.     

体外培养刺五加生产刺五加苷B、E的研究

目的 探讨2,4-D和培养基对刺五加愈伤组织和体细胞胚胎生产刺五加苷B、E的影响,建立有利于刺五加苷B、E积累的刺五加体外培养体系.方法 将来自同一外植体的刺五加愈伤组织和体细胞胚胎分别诱导增殖或产生次级体胚,HPLC法测定培养物中刺五加苷B、E含量和培养物质量,考察培养物类型、培养基种类和激素对刺五加苷B、E生产的影响.结果 体细胞胚胎的质量虽略低于愈伤组织的质量,但体细胞胚胎生产刺五加苷B、E的能力优于愈伤组织.2,4-D对刺五加苷B、E含量影响较小,仅改变了培养物的质量.MS培养基处理中培养物的刺五加苷B、E产量优于1/2MS培养基.结论 刺五加体外培养物可以生产刺五加苷B、E,其产量取决于培养物类型、培养基种类和2,4-D浓度.     

Treatment of pediatric atlantoaxial instability with traditional and modified Goel–Harms fusion constructs

There are several treatment options for rigid fixation at C1–C2 including Brooks and Gallie type wired fusions and C1–2 transarticular screws. The use of a Goel–Harms type fusion, a construct with C1 lateral mass screws and C2 pedicle screws, has not been extensively described in pediatric patients. Here, we describe its relatively safe and effective use for treating pediatric patients by retrospective chart review of patients treated by the senior author for atlantoaxial instability with a Goel–Harms-type constructs during a 3-year period (2005–2007). Six patients were treated using Goel–Harms-type constructs. Five patients were treated utilizing a construct containing C1 lateral mass screws and C2 pedicle screws; one patient was treated using construct containing C1 lateral mass screws and C2 trans-laminar screws. The patients ranged in age from 7 to 17 years old (mean 12.7). All patients had findings of an os odontoideum on CT scans and three of the six patients had T2 hyperintensity on MRI. Three of the six patients presented with transient neurologic deficits: quadraplegia in two patients and paresthesias in two patients. In each patient C1 lateral mass and C2 screws were placed and the subluxation was reduced to attain an anatomical alignment. No bone grafts were harvested from the iliac crest or rib. Local morsalized bone and sub-occipital skull graft was used. All patients tolerated the procedure well and were discharged home on post-operative day 3–4. The patients wore a hard cervical collar and no halo-vests were needed. All patients had solid fusion constructs and normal alignment on post-operative imaging studies performed on average 14 months post-operatively (range: 7–29). The results demonstrated that Goel–Harms fusions are a relatively safe and effective method of treating pediatric patients with atlantoaxial instability and are not dependent on vertebral anatomy or an intact ring of C1. Follow-up visits and studies in this limited series of patients demonstrated solid fusion constructs and anatomical alignment in all patients treated.