The surfaces of the parasitic nematodes Trichinella spiralis and Toxocara canis differ in the binding of post-C3 components of human complement by the alternative pathway

The binding of human complement components C3, C5 and C9 to the surface of the infective larvae of the nematode parasites Toxocara canis and Trichinella spiralis, by the alternative pathway, was examined by direct and indirect immunofluorescence on the intact parasites. This showed that although C3 bound to both nematodes, they differed markedly in the binding of C5 and C9; C5 bound only minimally to T. spiralis, and C9 binding to this parasite was barely detectable. In contrast, both early and late components bound to T. canis to a high density, comparable to, or in excess of, the binding of these components to the infective larvae of the trematode Schistosoma mansoni. The lack of binding of the post-C3 components to T. spiralis did not correlate with enhanced binding of the control protein, Factor H.     

Effects of Diesel Vehicle Emissions of Polycyclic Aromatic Hydrocarbons on the Surrounding Environment and Residents

Ten stations alongside major thoroughfares were selected as exposure sites, while a small village located about 3 kilometers away from a main traffic route was selected as the control site. The concentrations of particulate matters with aerodynamic less than 2.5 μm (PM_2.5) and elemental carbon (EC) at exposure sites were both higher than those at the control site. Daytime mean concentrations of total polycyclic aromatic hydrocarbons (t-PAHs), carcinogenic PAHs (car-PAHs), and Benzo(a)pyrene-equivalent dose (BaP_eq) at exposure sites were all about twice as high as those at the control site. A significant relationship between t-PAHs and EC was found, suggesting that most of the t-PAHs at exposure sites were contributed by diesel exhaust. Furthermore, the diagnostic ratios also show that diesel emissions were the dominant sources of PAHs at exposure sites. A multiple linear regression was applied to urinary 1-hydroxyprene (1-OHP) using four variables (exposure status, sex, smoker status, and incense burning) as independent variables. The results showed that the concentrations of 1-OHP in exposure groups were significantly (p < 0.001) higher than those in the control group. The explainable percentage for exposure status was 91.1%, indicating that the exposure factor, in comparison with other factors, has a dominant contribution to the concentration of 1-OHP. After subtracting the background levels of 1-OHP, the levels of urinary 1-OHP for residents exposed to the exhaust of 100 vehicles were about 0.062 μg/g creatinine.     

A longitudinal study of immunological status in Chinese haemophiliacs: importance of the heat viral inactivation of factor concentrates. I. Immunological associations with the consumption of factor concentrates

Summary . Twenty-four of 117 cases of haemophilia A (20.5%) and none of 18 cases of haemophilia B reported in this study had an antibody to the human immuno-deficiency virus (HIV). Both groups of patients showed similar immunological alterations. HIV-seropositive haemophilia A patients had an increased CD8 cell count and a similarly decreased CD4/CD8 ratio as compared to HIV-seronegative haemophilia A patients. Multiple regression analysis for the association of CD4/CD8 ratio with HIV infection status and dosage of plasma products in haemophilia A and B patients, respectively, revealed that there was a significant negative association of ln(CD4/CD8) with dosage of factor VlII concentrates (P = 0.0435) and factor IX concentrates (P = O.O028), respectively. N o association occurred between CD4/CD8 ratio and HIV infection as well as dosage of other plasma products. These data indicate that the immunological abnormalities of our haemophilia A and B patients in their early years were primarily caused by various viral infections and/or a suppressive effect of allogeneic protein through infusion of factor concentrates and not caused simply by HIV infection.     

儿童感觉统合及感觉统合失调

感觉统合指大脑对前庭觉、触觉、本体觉、视听觉以及嗅觉等多种感觉信息进行识别、分类、解释和整合,并依据既往经验,对环境做出适应性反应。感觉统合失调(sensory integration dysfunction, SID)主要指前庭平衡、触觉防御、本体感觉以及视听觉语言等多个方面出现障碍。感觉统合训练通常都是基于经典的感觉统合理论,临床可用于注意缺陷多动障碍(ADHD)、孤独症谱系障碍(ASD)以及脑性瘫痪(CP)等多种疾病治疗。本文就感觉统合理论及感觉统合训练的适用范围及治疗效果进行综述。     

Reliability and Validity of the King's Health Questionnaire for Male Lower Urinary Tract Symptoms in Taiwan

Objectives: To investigate the reliability and validity of the King's Health Questionnaire (KHQ), and understand the impacts of lower urinary tract symptom (LUTS) on health‐related quality of life (HR‐QoL). Methods: A cross‐sectional design was used and a convenience of 393 men participated in the study. The reliability was measured by testing the Cronbach's α coefficients. Factor analysis was used to explore the underlying factor structure of the KHQ. The discriminant validity was assessed using the one‐way analysis of variance (ANOVA) tests with post hoc analysis (Games‐Howell method) by comparing the differences scores in KHQ domains between men with three LUTS severity groups (mild, moderate, and severe). Results: Men with severe, moderate, mild LUTS accounted for 7.9, 25.4, and 66.7%, respectively. Internal consistency of KHQ was excellent with Cronbach's α coefficients of 0.750–0.943. Factor analysis showed three underlying components to explain constructive validity. The KHQ subscores in both the severe and moderate LUTS groups were significantly higher than those in mild LUTS group (all P < 0.05), implying that the discriminant validity was adequate. Excepting for two single‐item questions, the first three greater disparities in KHQ domains between the severe and mild LUTS groups were “Emotion”, “Sleeping/Energy”, and “Physical limitation”, while the least disparities was found in “Personal relationships” domain. Conclusion: LUTS could produce a substantial impact on different domains of HR‐QoL. The traditional Chinese KHQ has suitable reliability and validity for men with general LUTS, and might be a useful tool for HR‐QoL measure in future.     

电子处方警示系统减少门诊重复用药:以台湾289家医院为例

目的:探讨台湾医院门诊应用电子处方警示系统的效果。方法:采集1998-2009年的医保数据库,纳入各年均有数据库数据的259家医院进行分析。根据台湾医院应用门诊电子处方警示系统的发展,12年分为4个阶段:1998—2000年(T1)、2001-2003年(T2)、2004—2006年(T3)、2007—2009年(T4)。重复用药率是计算每个时间段医院门诊重复用药处方数占全部处方数的比例。应用广义估计方程(Generalized Estimating Equation,GEE)分析4个阶段的重复用药率改变。结果 :T1总体门诊重复用药率11.7%,T2减少到10.4%,但T2-T4维持在10. 5%上下。GEE分析发现重复用药率如期呈现下降,但降幅逐渐减小(T2:b=-2.44; T3:b-3.20;T4:b=-3.30;P0.001)。结论:医院门诊重复用药率随电子处方警示系统应用趋势呈现递减后维持平稳,表示系统虽然有效,但仍有需要持续改善之处。     

临床路径对医疗资源使用的效益——以腹腔镜胆囊切除手术患者为例

目的:应用医院病例数据评价临床路径对腹腔镜胆囊切除手术患者医疗资源使用的管理效果。方法:采集深圳市7家公立医院2015年12月—2016年9月的病案首页,研究对象为第一诊断是胆囊结石伴慢性胆囊炎(ICD10:K80. 1)且行腹腔镜胆囊切除手术(ICD-9-CM:51. 23)。统计分析方法采用独立t检验、卡方检验以及广义线性回归分析。结果:共有932例符合研究对象的定义,其中路径组696例,平均住院天日7. 15天,住院费用15 181. 5元;非路径组236例,平均住院天日9. 42天,住院费用19 774. 8元。校正其他影响因素后,路径组的住院天日比非路径组少1. 51天(P 0. 001),住院费用少3 818元(P 0. 001)。结论:患者的疾病状况虽然是影响住院天日与住院费用的重要因素,但本研究发现临床路径实施对腹腔镜胆囊切除患者的医疗质量与医疗资源管理具有影响,建议未来有更多实证研究检验临床路径效果,以供相关政策参考。     

Relationship between age and clinical characteristics of patients with gastric cancer

The relationship between the prognosis and age of patients with gastric cancer is controversial. To evaluate whether there is a biological characteristic specific to the age of patients, we examined the clinical characteristics of patients with gastric cancer with special reference to their age. Based on a prospective database, a retrospective study of 419 patients who underwent radical gastrectomy for cure in the past 6 years was conducted. Clinical characteristics including gender, gross appearance of the tumour (Borrmann's classification, tumour location), histopathology (depth of tumour invasion, lymph node status, Lauren's classification and degree of tumour cell differentiation) and TNM tumour stage were analysed in six different age groups (< 39, 40–49, 50–59, 60–69, 70–79, > 80 years). The mean age of the 419 patients was 64.6 years (range from 26–91) and the peak age incidence of gastric cancer (46.3%) was in the 60–69 year old age group. The male: female ratio was 4.6: 1 on the whole and male gender predominated at ages > 60. The proportion of diffuse type tumours (68.4%) by Lauren's criteria in the young age group (< 39 yrs) decreased with age (25% in the > 80 years group; P<0.001). Similarly, the proportion of poorly-differentiated tumours (89.5%) in the young age group (< 39 yrs) decreased with advancing age (P<0.001). These findings suggest that both diffuse type and poorly-differentiated tumours predominate in younger patients and, without considering the factor of delay in diagnosis, may explain the poorer prognosis demonstrated in younger patients.     

Superoxide dismutase gene expression and activity in the brain of spontaneously hypertensive rats and normotensive rats

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