Effect of severity of asthma on quality of life

This study is aimed to evaluate the health related quality of life (HRQL) in asthmatics and the probable association between HRQL and disease severity and also other demographic factors by using a generic scale, SF-36 questionnaire. One-hundred and two asthmatics were enrolled. The scores of the 8 domains of SF-36 questionnaire were evaluated according to age, gender, status of education and compared with the severity of asthma. The mean age of 84 (83%) female and 18 (17%) male patients was 42.86 +/- 11.15. Fifty-two of them was well educated (51%) and 50 was poorly educated (49%). Atopy ratio was 81%. Mild intermittent, mild persistent and moderate-severe persistent groups were 27 (26%), 46 (45%) and 29 (29%) respectively. Female gender were worse in physical functioning (p= 0.000), physical role difficulties (p= 0.0049), vitality (p= 0.045) and social functioning (p= 0.025). Poorly educated group were worse in physical functioning (p= 0.001), physical role difficulties (p= 0.039), vitality (p= 0.045), emotional role difficulties (p= 0.046), general health (p= 0.030) and mental health (p= 0.044). Mental health was worse in the presence of atopy (p= .035). Physical functioning was better in mild intermittent group than moderate and severe persistent group (p= 0.024). General health was better in mild intermittent group than mild persistent group (p= 0.018), moderate and severe persistent group (p= 0.015). Vitality and emotional role difficulties was better in mild intermittent than mild persistent group (p= 0.042, p= 0.007). The HRQL scores and severity of asthma is well correlated like other objective parameters. So one of the primary goals in management of asthma should also improve QOL as well as functional parameters.     

Effects of vasoconstrictor agents on flow rate of isolated epicardial coronary artery of humans with various degrees of atherosclerosis and of young pigs

Constriction of epicardial coronary arteries induces severe flow reduction causing myocardial ischaemia in patients with vasospastic angina. Whether such constriction is inherent in coronary arteries in general was determined by perfusing isolated epicardial coronary segments of humans and pigs at a constant perfusion pressure. Mean flow reduction after perfusion with potassium chloride (60 mmol.litre-1), acetylcholine (10(-9)-10(-5) mol.litre-1), and histamine (10(-8)-10(-4) mol.litre-1) was not different between humans and pigs. Prostaglandin F2 alpha (PGF2 alpha; 3 X 10(-6) mol.litre-1) decreased the flow more substantially in humans (by 74(9)%) than in pigs (by 6(1)%) (p less than 0.01). A pronounced flow reduction to 0 ml.min-1 was observed in eight of 17 human coronary arteries after potassium chloride, histamine, or PGF2 alpha perfusion but in none of the pigs. Histological examination of the coronary arteries showed no atherosclerotic lesions in the pigs but various lesions in humans, ranging from intimal thickening to 96% luminal stenosis in cross sectional area. Flow reduction after PGF2 alpha was significantly greater in human coronary arteries with stenoses greater than 50% (94(4)%) than in those with stenoses less than 25% (55(14)%) (p less than 0.05). Complete cessation of flow was observed more often in the stenotic arteries (greater than 50% stenosis) than in others (p less than 0.05). A substantial reduction in flow, which may cause myocardial ischaemia in vivo, was not seen in normal pig coronary arteries even after strong vasoconstrictor stimuli but was present in human coronary arteries with atherosclerosis.     

The role of nebulised budesonide in the treatment of exacerbations of COPD.

The present study was designed to evaluate the hypothesis that nebulised budesonide (NB) might be an alternative to systemic corticosteroids (SC) in the treatment of patients with exacerbations of chronic obstructive pulmonary disease (ECOPD). Patients hospitalised with ECOPD (n = 159) were randomised into three groups. Group 1 received only standard bronchodilator treatment (SBDT), group 2 received SC (40 mg prednisolone) plus SBDT, and group 3 received NB (1,500 microg q.i.d.) plus SBDT. Improvement during 10-day hospitalisation was compared with exacerbation and rehospitalisation rates after discharge. While mean+/-sd age was 64.1+/-8.9 yrs (female/male = 0.1), mean forced expiratory volume in one second (FEV(1)) at admission was found to be 37.2+/-12.2% predicted. Arterial blood gases and spirograms recovered faster in groups 2 and 3. While improvements in arterial oxygen tension (P(a,O(2))) and forced vital capacity (FVC) in group 2, and improvements in P(a,O(2)), FVC and FEV(1) in group 3, became significant at 24-h control, the first significant improvement in group 1 appeared in arterial oxygen saturation at 72-h control. The mean improvement of P(a,O(2)) after 10 days was 1.20 and 1.06 kPa (9 and 8 mmHg) higher in group 2 and 3, respectively, than in group 1. Blood glucose exhibited an upward trend only in group 2. The study demonstrates that nebulised budesonide may be an effective and safe alternative to systemic corticosteroids in the treatment of exacerbations of chronic obstructive pulmonary disease.     

Evaluation of the cost of complications of automatic implantable defibrillators

The automatic implantable defibrillator (AID) has been shown to prevent sudden death but it frequently gives rise to complications. These complications seem to be costly but they do not figure in the economic assessments of AID. From 1989 to 2003, 202 patients (173 men, age 58 +/- 14 years) received consecutively 264 AID in the same centre of implantation. The authors studied the complications of these implantations. The medical indication was secondary (documented spontaneous ventricular tachycardia or fibrillation) in 145 patients (71.8%) and prophylactic in the remaining 57 patients (28.2%). During the 36 month (+/- 35) follow-up, 40.6% patients had an appropriate treatment: 50.3% in the secondary prevention group versus 15.8% in the prophylactic implantation group. The one year, 5 and 15 year survival rates were 99, 88 and 85% respectively. Eighty seven complications were observed resulting in a long term complication in 36.7% of patients. These complications were: inappropriate electric shock, n=24 (27.6%), fractured catheters, n=12 (13.6%), haematomas, n=12 (13.6%), loss of function of the AID, n=10 (11.4%), infection, n=6 (6.8%), pneumothorax, n=7 (8.0%), and others n=16 (18.4%). The cost of these complications was assessed in terms of hospital stay in intensive care (1010.40 euros per day) or in the general cardiology wards (546.70 euros per day). The complications resulted in 502 days of additional hospital stay (5.77 days per complication) with a total cost of 285 655.20 euros (3283.40 euros per complication). The most expensive complications in terms of hospital stay were: infections (24.5 days), fractured catheter (5.75 days), and postoperative haematoma (5.5 days). These results indicate a significant cost of complications which should be indicated in the economic evaluation of AID.     

肝纤维化大鼠肝窦内皮细胞整合素α6β1及粘着斑激酶表达的变化

目的研究正常及肝纤维化时大鼠肝窦内皮细胞(SEC)表面层粘连蛋白(LN)的整合素受体α 6 β 1及粘着斑激酶(FAK)的变化.方法用胶原酶原位灌注、Percoll不连续密度梯度离心法分离正常及四氯化碳(CCl4)实验性大鼠肝纤维化模型中的SEC,并进行体外培养.采用细胞-ELISA和免疫沉淀-蛋白质酪氨酸激酶活性测定的方法,分别观察SEC细胞表面整合素α 6 β 1表达及FAK活性的变化.结果正常大鼠SEC细胞表面几乎不表达整合素α6 β 1;在肝纤维化时SEC细胞表面α 6 β 1蛋白表达却明显增加(P＜0.05),且细胞中FAK活性明显增高(P＜0 05).结论在肝纤维化时SEC细胞表面整合素α 6 β 1的表达及FAK活性明显增高,可能在SEC的形态及功能改变中起重要作用.     

血清瘦素对慢性阻塞性肺疾病患者营养状态影响的初步研究

目的 探讨血清瘦素及肿瘤坏死因子α（ＴＮＦ－α）的慢性阻塞性肺疾病（ＣＯＰＤ）患者营养不良发生中的意义。方法 测定３１例ＣＯＰＤ患者（分为营养不良组１２例,非营养不良组１９例）及１１名正常人的血清瘦素、ＴＮＦ－α浓度、体重指数（ＢＭＩ）、理想体重百分比（ＮＷ％）、三头肌皮皱厚度（ＴＳＦ）、肩胛下皮皱厚度（ＳＳＦ）、上臂中部臂围（ＭＡＣ）,血清白蛋白（ＡＬＢ）、总淋巴细胞计数（ＬＹＭ）等指标。瘦素与     

Investigation of relaxant effects of propofol on sheep sphincter of Oddi.

BACKGROUND/AIMS: Intravenous anesthetics are often used for conscious sedation in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincter of Oddi (SO) manometry. This study was designed to investigate the effects of propofol on sheep SO. METHODS: SO rings were mounted in a tissue bath and tested for changes in isometric tension in response to propofol (10(-8)-10(-4)M) in the presence or absence of L-NAME (3 x 10(-5)M), a non-specific inhibitor of nitric oxide (NO) synthase; indomethacin (10(-5)M), an inhibitor of cyclooxygenase; glibenclamide (10(-5)M), an inhibitor of ATP-sensitive potassium channels; tetraethylammonium (3 x 10(-4)M), inhibitors of calcium-activated potassium channels; 4-aminopyridine (10(-3)M), a voltage-dependent potassium channel blocker. Furthermore, we investigated the Ca(2+) antagonist feature of propofol in precontracted SO rings by CaCl(2). RESULTS: Carbachol (10(-9)-10(-5)M) induced concentration-dependent contraction responses in the SO rings. Propofol (10(-8)-10(-4)M) produced concentration-dependent relaxation on isolated SO rings precontracted by carbachol (10(-6)M). Preincubation of SO rings by L-NAME (3 x 10(-5)M), indomethacin (10(-5)M), glibenclamide (10(-5)M), and 4-aminopyridine (10(-3)M) did not produce a significant alteration on propofol-induced relaxation responses (p > 0.05), while preincubation by tetraethylammonium (3 x 10(-4)M) significantly decreased the propofol-induced relaxation responses (p < 0.05). Propofol (10(-8)-10(-4)M) induced concentration-dependently relaxations in precontracted isolated SO rings by CaCl(2). CONCLUSION: The results suggest that propofol induced concentration-dependent relaxations in precontracted isolated SO rings. These relaxations are independent from NO, cyclooxygenase metabolites, and opened ATP-sensitive and voltage-dependent potassium channels. Opened Ca(2+)-sensitive K(+) channels and inhibited L-type Ca(2+) channels existing in smooth muscle by propofol can contribute to these relaxations. Propofol can be beneficial as alternative drugs for obtaining selective relaxation during SO manometry after controlled clinical studies.     

Complications of endoscopic surgery of the pituitary adenomas: analysis of 570 patients and review of the literature

Endoscopic transsphenoidal surgery is emerging as a minimally invasive and maximally effective procedure for pituitary adenomas. In this report we analyzed the complications in 624 procedures of endonasal transsphenoidal endoscopic surgery in the treatment of 570 patients with pituitary adenomas. The leading author (MB) operated pituitary adenomas via pure endoscopic endonasal transsphenoidal surgery between January 2006 and August 2011 at the Hacettepe University, Department of Neurosurgery in Ankara. Complications were assessed in 624 surgical procedures under five groups; rhinological, CSF leaks, infection, vascular and endocrinologic complications. We observed a total of 76 complications (12.1%). Rhinological complications occurred in 8 patients (1.3%): 4 epistaxis (0.6%) and 4 hyposmia (0.6%). Postoperative CSF leaks occurred in 8 patients (1.3%), and infectious complications occurred in 8 patients: 3 cases of sphenoidal sinusitis (0.4%), 5 cases of meningitis (0.8%). Only 1 case of internal carotid aneurysm rupture during the opening of sellar floor (0.16%) was observed. Endocrinologic complications occurred in 51 (8.1%) patients: Anterior pituitary deficiency in 12 (1.9%), transient diabetes insipidus (DI) in 29 (4.6%), permanent DI in 3 (0.4%) and inappropriate antidiuretic hormone secretion syndrome occurred in 7 (1.1%). There was no mortality directly related to the surgical procedure. The complication rates observed in our study suggests that the endoscopic pituitary surgery is at least as safe as microscopic transphenoidal surgery. These rates were obtained with due experience and well-coordinated teamwork. To further improve these rates, new technological developments will be helpful.     

犬Marshall韧带心肌细胞电生理特性的研究

目的　研究Marshall韧带(ligamentofMarshall, LOM)内心肌细胞的电生理特性。方法　组织块酶解法分离犬LOM内单个心肌细胞,在倒置显微镜下直接比较细胞形态;采用全细胞膜片钳技术记录心肌细胞动作电位的时程 (APD90,APD50 )和振幅 (APA),测量ICa,L、Ito、IK1、IK、INa等离子电流密度。结果　LOM内有两种不同形态的心肌细胞:一种为短矩形,另一种为长杆形,两者的长宽比分别为 2 .99±0. 95和 12. 05±2 .41,P<0. 01。两种形态细胞均表现为快反应动作电位,短矩形细胞的APA(mV)、APD50 (ms)和APD90 (ms)均小于长杆形细胞,分别为 80. 02±3 .68比 91 .72±7. 56、69 .62±6 .33比 83. 14±3 .66和 107. 55±4 .25比 144. 00±5 .15,P<0 .05。两种细胞的INa、ICa,L、Ito、IK1等离子的电流密度差异有统计学意义。结论　Marshall韧带中肌细胞呈现两种形态,并且在动作电位及许多离子电流密度上存在差异,两者的细胞电生理呈不均一性。     

Causes of death in systemic vasculitis of polyarteritis nodosa. Analysis of a series of 165 patients

The case histories of the 49 patients who died in a series of 165 patients admitted to the Medical Unit between 1958 and 1984 with polyarteritis nodosa (PAN) were reviewed. The causes of death of the 29 men and 20 women, mean age 51.44 +/- 7.4 years, were classified into 6 groups. Infection accounted for 26.5% (13/49) of deaths, the initial site of infection being pulmonary, complicated by septicaemia in 6 cases. Cardiovascular events were responsible for death in 24.4% (11/49): terminal cardiac failure (4 cases), myocardial infarction (1 case), ventricular tachycardia (1 case), stroke (1 case), pulmonary embolism (2 cases), fulminant hemoptysis (1 case). Gastrointestinal complications were the cause of death in 16.3% (8/49): ischemic necrosis (5 cases), acute pancreatitis (2 cases), oesophageal ulceration (1 case). Renal failure was observed in 10.2% (5/49), all occurring before 1972: acute renal failure (3 cases), chronic renal failure (2 cases). Cancer was the cause of death in 10.2% (5/49): primary bronchial carcinoma (2 cases), laryngeal carcinoma (1 case), carcinoma of the vulva (1 case), bone metastases (1 case). Finally, 14.2% (7/49) could not be classified in the preceding groups. Sudden death occurred in 3 patients, shock in 1 patient, multivisceral PAN in 2 patients and anaphylactic shock in 1 patient. Three of the 12 patients who had post-mortem studies had signs of progressive vasculitis. The results are compared with other reports in the literature and the pathogenic mechanisms are discussed. The infections and cardiovascular deaths occurred early or late and were not related to the state of the activity of the vasculitis. Immunosuppressive treatment seems to play an important role in their pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Utility of airway endoscopy in the diagnosis of respiratory complications of cardiac transplantation

We evaluated 39 episodes (in 32 patients) of pulmonary parenchymal infiltrates following cardiac transplantation with fiberoptic bronchoscopy (FOB) in a prospective study of 94 consecutive recipients. Initial FOB established the diagnosis in 24/39 (62 percent) instances. Subsequent examinations included repeat FOB (five), open lung biopsy (five), needle aspiration (two), and autopsy (nine), establishing 49 diagnoses. Specific pathogens were identified in 45 instances, neoplasm in two, and idiopathic interstitial pneumonitis in two. Bronchoalveolar lavage alone yielded diagnoses in 63 percent and transbronchial biopsy and bronchial washings/brushings in 46 and 43 percent, respectively. Transbronchial biopsy suggested idiopathic interstitial pneumonitis in 17 instances, but four had spontaneous clearing, and open lung biopsy or autopsy showed alternative diagnoses (particularly CMV and Aspergillus) in 11. The main complication of FOB was moderate (25 to 100 ml) hemorrhage after transbronchial biopsy (10 percent); no severe episodes occurred despite elevated pulmonary vascular pressures. In this population of immunocompromised hosts: (1) bronchoalveolar lavage is the most sensitive bronchoscopic technique for detecting infection; (2) transbronchial biopsy is not useful in detecting CMV or Aspergillus infection; (3) pulmonary hypertension is associated with some risk of moderate but not severe hemorrhage after transbronchial biopsy.     

NMR Studies on the Conformation of Derivatives of the Side Chain of Oxytocin: Examples of cis-trans Isomerism

The 220 MHz spectra reported in this paper show the existence of cis-trans isomerism about the Cys-Pro bond in (S-benzyl)-L-Cys-L-Pro-L-Leu-Gly(NH(2)) and about the Z-Pro bond in (N-benzyloxycarbonyl)-L-Pro-L-Leu-Gly(NH(2)). These peptides are derivatives of the side chain of oxytocin, which has the structure L-Pro-L-Leu-Gly(NH(2)). Taken in water-free (CD(3))(2)SO, the spectra also show differences between the two isomers in the amide chemical shifts, which indicate interaction of the terminal end of the peptides with the rest of the residues. The ratio of the isomeric forms is about 2:3 for the S-benzylcysteinyl peptide, while it is 1:1 for the N-benzyloxycarbonyl-protected peptide. The probable assignment of peaks in isomers is discussed, in addition to routine spectral assignments based on extensive decoupling experiments.     

Modulation of energy-dependent quenching of excitons in antennae of higher plants

Energy-dependent exciton quenching, or q(E), protects the higher plant photosynthetic apparatus from photodamage. Initiation of q(E) involves protonation of violaxanthin deepoxidase and PsbS, a component of the photosystem II antenna complex, as a result of lumen acidification driven by photosynthetic electron transfer. It has become clear that the response of q(E) to linear electron flow, termed "q(E) sensitivity," must be modulated in response to fluctuating environmental conditions. Previously, three mechanisms have been proposed to account for q(E) modulation: (i) the sensitivity of q(E) to the lumen pH is altered; (ii) elevated cyclic electron flow around photosystem I increases proton translocation into the lumen; and (iii) lowering the conductivity of the thylakoid ATP synthase to protons (g(H+)) allows formation of a larger steady-state proton motive force (pmf). Kinetic analysis of the electrochromic shift of intrinsic thylakoid pigments, a linear indicator of transthylakoid electric field component, suggests that, when CO(2) alone was lowered from 350 ppm to 50 ppm CO(2), modulation of q(E) sensitivity could be explained solely by changes in conductivity. Lowering both CO(2) (to 50 ppm) and O(2) (to 1%) resulted in an additional increase in q(E) sensitivity that could not be explained by changes in conductivity or cyclic electron flow associated with photosystem I. Evidence is presented for a fourth mechanism, in which changes in q(E) sensitivity result from variable partitioning of proton motive force into the electric field and pH gradient components. The implications of this mechanism for the storage of proton motive force and the regulation of the light reactions are discussed.     

Clinical analysis of surgical treatment of portal hypertension

AIM: To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS: The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization (PAD), 167 with portasystemic shunt (PSS), 62 with selective shunt (SS), 11 with combined portasystemic shunt and portaazygous devascularization (PSS+PAD), 9 with liver transplantation (LT), 3 with union operation for hepatic carcinoma and portal hypertension (HCC+PH). RESULTS: In the 167 patents treated with PSS, free portal pressure (FPP) was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation (P<0.01). After the operation, FPP in the former patients markedly decreased compared to the latter ones (P<0.01). The incidence rate of hemorrhage in patients treated with PAD, PSS, SS, PSS+PAD, and HCC+PH was 21.09% (54/256), 13.77 (23/167), 11.29 (7/62), 36.36% (4/11), and 100% (3/3), respectively. The incidence rate of hepatic encephalopathy was 3.91% (10/256), 9.58% (16/167), 4.84% (3/62), 9.09% (1/11), and 100% (3/3), respectively while the operative mortality was 5.49% (15/256), 4.22% (7/167), 4.84% (3/62), 9.09% (1/11), and 66.67% (2/3) respectively. The operative mortality of liver transplantation was 22.22% (2/9). CONCLUSION: Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.     

热量限制对人二倍体成纤维细胞衰老相关基因表达的影响

目的观察热量限制对人二倍体成纤维细胞IMR-90衰老相关基因表达的影响。方法应用RT-PCR和Western blot的方法，对含低浓度（3．0mmol／L）、高浓度（22．5mmol／L）葡萄糖和正常对照组（含5．0mmol／L葡萄糖）培养条件下的IMR-90细胞衰老相关基因p16、p21和p53的mRNA和蛋白表达水平进行分析。结果与对照组和高糖培养条件下的早期和晚期细胞相比较，低浓度葡萄糖培养条件下的早期和晚期细胞p16和p21在mRNA水平均显著下降（P〈0．05）；低浓度葡萄糖组、对照组和高浓度葡萄糖培养组晚期细胞p16蛋白水平分别为4．2、7．4、9．7，比各自早期细胞表达（0．6、1．0、1．8）增加5～7倍；低浓度葡萄糖组，对照组和高浓度葡萄糖培养早期细胞和低糖培养晚期细胞p21蛋白水平差异无统计学意义，分别为1．1、1．0、1．3、0．9，但与对照组和高糖培养晚期细胞p21蛋白水平（3．1、4．2）相比较则降低3～4倍；各组培养条件下的早期和晚期细胞中p53表达差异均无统计学意义（P〉0．05）。结论各组晚期细胞比各自早期细胞p16基因表达增高；对照组和高糖培养条件下的晚期细胞比各自早期细胞p21基因表达增高；低浓度葡萄糖培养延缓IMR-90细胞衰老并伴有p16和p21基因表达下调；p53基因可能不是IMR-90细胞复制衰老主要调节因子。     

Histaminergic neuromodulation of the release of vasopressin

In an attempt to clarify the nature of histaminergic neuromodulation of the vasopressinergic system, several studies under different experimental paradigms were carried out. L-Histidine loads (8 mmol/kg, i.p.) induced a marked increase in histamine (HA) in the anterior (AHR) and posterior (PHR) hypothalamic regions, the median eminence (ME) and adenohypophysis (Ah) with no apparent effect on the concentration of HA in the neurohypophysis (Nh), as measured by high-performance liquid chromatography. These findings correlated with decreases in vasopressin (VP) levels in the AHR and ME, accompanied by increases of the neuropeptide in the PHR and Ah. Intraperitoneal injections of HA (6 mumol/kg), resulted in a significant (p less than 0.005) rise in VP levels in the PHR, ME and Ah. HA induced an elevation of VP in the prefrontal cortex (PFC) from 6.23 +/- 2.02 to 43 +/- 4.05 microU/mg, as well as a 60% reduction in neurohypophyseal VP. These HA-induced VP responses were abolished by both mepyramine (3 mumol/kg) and famotidine (4 mumol/kg) in the PHR and PFC. Mepyramine suppressed the HA-induced VP response in the Ah and enhanced it in the Nh, while famotidine did the opposite. When alpha-fluoromethylhistidine (FMH), an irreversible inhibitor of histidine decarboxylase, was administered at doses of 100 mg/kg/day (i.p.), hypothalamic HA levels fell by 40-45% after 1 h, by 50% after 3 h, and by 65-80% after 24 h in adrenalectomized rats. In the same conditions, but after a week of treatment with FMH, the VP response to adrenalectomy was clearly impaired.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of efficacy of powder and tablet of mebendazole in the treatment of strongyloidiasis

We previously treated 47 patients with 100 mg of mebendazole (MBZ) twice a day by oral use for 5 days and this treatment was repeated 1, 3 and 4 weeks later. Although the cure rate was 100%, liver injury was observed in 48.9% of the patients. On this study, we reduced the periods of administration of MBZ (powder; 100 mg twice a day) to 4 days, and repeated it once after 3 days interval, and this initial treatment was performed one more time after 10 days interval (group 1). As Strongyloides stercoralis is mainly located in upper digestive systems, we used the drug reduced to powder for the purpose of better contact with the parasites. We considered that the powder should be absorbed well and liver injury occurred in high incidence. As group 2, we used the tablet itself in the same schedules of group 1. The results obtained were as follows; 1) The eradication rates at 10 days after the initial treatment were 97.8% (44 of 45 patients) in group 1 (powder) and 93.0% (40/43) in group 2 (tablet). 2) At 3 days after the whole treatment, the eradication rates were 100.0% in group 1, and 97.7% (42/43) in group 2. 3) Slight side effects such as constipation (6.7% in the group 1), dizziness or vertigo (6.7% in the group 1) and itching (6.7% in the group 2) were observed. 4) Liver injury was observed at 11.1% (5/45) 10 days after the initial treatment in the group 1 and 13.3% (6/45) in the group 2.(ABSTRACT TRUNCATED AT 250 WORDS)     

全球哮喘防治创议推荐糖皮质激素的半量吸入分级治疗支气管哮喘患者的疗效分析

目的为减轻支气管哮喘(简称哮喘)患者的经济负担,探讨中国控制哮喘最小吸入糖皮质激素(ICS)剂量。方法86例患者随机分为:(1)G组42例:应用全球哮喘防治创议(GINA)推荐高限剂量,中度患者每次250μg,每天2次;重度患者每次375μg,每天2次;(2)H组44例:应用G组剂量半量,中度患者每次125μg,每天2次;重度患者早晨125μg、晚上250μg,每天各1次。采用随机、对照、平行分组、多中心临床研究,筛选期1周仅按需吸入沙丁胺醇。治疗期共24周。结果治疗后G和H组日间症状评分:重度哮喘G组为(0.7±0.8)分,H组为(0.4±0.6)分,中度G组为(0.4±0.5)分,H组为(0.3±0.5)分;第一秒用力呼气容积(FEV1):重度G组为(1.5±0.5)L,H组为(1.8±0.6)L,中度G组为(2.3±0.6)L,H组为(2.3±0.8)L;第一秒用力呼气容积占预计值百分比(FEV1占预计值%):重度G组为(54±17)%,H组为(59±19)%,中度G组为(79±14)%,H组为(79±15)%;晨间最大呼气流量(PEF)增加值:中、重度G组分别为45、67L/min,中、重度H组分别为56、65L/min;夜间憋醒天数:重度G、H组分别为81、69d;无症状天数:重度G、H组分别为88、98d;合并用沙丁胺醇剂量(重度G、H组分别为5.0、3.4喷/d)等32项(次)比较差异均无统计学意义(P均>0.05)。G组中度哮喘患者首次加重3例,H组为11例,两组比较差异有统计学意义(χ2=4.74,P<0.05);G组中度哮喘控制例数为18例,H组为12例,两组比较差异有统计学意义(χ2=4.97,P<0.05);而G组中度哮喘患者夜间症状评分为(0.30±0.22)分,H组为(0.13±0.33)分,两组比较差异有统计学意义(t=-2.06,P<0.05)、重度哮喘加重天数G组为11d,H组为6d,两组比较差异有统计学意义(U=31.00,P<0.05)。结论大多数中国哮喘患者应用GINA推荐的ICS高限剂量与其半量分级治疗,可取得相似的疗效。     

Seroepidemiological study of toxoplasmosis in different sections of population of Union Territory of Chandigarh

Infections with Toxoplasma gondii in humans are usually asymptomatic or in the form of mild febrile illness. Primary infection in pregnant women may result in congenital toxoplasmosis while infection in immunocompromised subjects like AIDS patients may cause potentially fatal toxoplasma encephalitis. In India, only a few studies in hospital based patients have shown prevalence of toxoplasmosis to be between 1.5 and 21%. No field study involving general population is available. The present study investigates the prevalence of toxoplasmosis in subjects from rural, urban and urban slum populations of Union Territory, Chandigarh. Serum samples from 500 subjects from each group were collected and antitoxoplasma IgM and IgG was detected by conventional micro ELISA technique using soluble Toxoplasma gondii tachyzoite antigen. Overall 5.4% subjects were positive for IgM while 4.66% showed IgG antitoxoplasma antibodies. Amongst the three groups, significantly higher number of subjects in slum area (7.8%) showed IgM antibodies as compared to urban and rural areas (4.2% each). There was no significant difference in IgG positivity between three study areas. Prevalence of T. gondii specific IgG antibodies was significantly higher amongst females of both slum (7.31%) and rural area (8.44%) as compared to the males (2.85% and 3.27% respectively) in the same areas (p<0.05) and also to females of the urban area (2.98%, p<0.05). Prevalence of IgM antibodies was significantly higher (p<0.05) in females in the slum area (10.5%) as compared to females in the urban area (2.55%). In both urban and slum areas, highest IgM seropositivity was observed in age group 6-12 years (10% and 13.3% respectively), while in the rural area the highest IgM seropositivity was seen in the age group > or = 5 years (17.7%). These data indicate that majority of children are exposed to toxoplasma before 12 years of age and particularly in rural areas higher number of subjects acquire Toxoplasma gondii infection early in childhood probably as a result of higher exposure due to farming, poor hygiene and handling of animals.     

Evaluation of the Importance of Maternal History of Diabetes and of Mitochondrial Variation in the Development of NIDDM

In 79 South Indian nuclear pedigrees ascertained via probands with NIDDM and both parents living, parental diabetic status was established through previously diagnosed NIDDM (n = 97) or oral glucose tolerance testing (n = 61). There was no significant difference between diabetes prevalence in mothers and fathers (60 vs 53 (76 % vs 67 %), respectively, p = 0.22). ‘Age at diabetes diagnosis’ survival curves did differ according to parental gender (p = 0.02) but this may reflect gender differences in health provision rather than pathophysiology. No maternal excess effects of the magnitude evident in previous studies were detected, suggesting either ethnic differences or overestimation of the maternal effect when reported histories of parental diabetes have been used. The tRNA^Leu(UUR) gene region was studied for diabetes-associated variation given the role of mutations in this gene in some pedigrees displaying maternal transmission of NIDDM. None of 142 unrelated South Indian NIDDM subjects displayed the MELAS mutation at nt3243. However, sequencing identified two variants of potential importance: (a) at nt3290 in the tRNA^Leu(UUR) gene, seen in 7/142 diabetic and 1/85 control subjects (p = 0.11), (b) at nt3316 in the ND1 gene (4/142 vs 1/85 subjects, respectively (p = 0.51)). Further studies are needed to determine the relevance of these variants to the development of NIDDM.