我国山丘疫区和平原疫区利什曼原虫分离株基因组DNA基因型分析

目的：分析我国山丘和平原疫区利什曼原虫分离株基因组DNA（nDNA）的多态性。方法：对基因组DNA进行内切酶酶切、Southern杂交、染色体定位。探针采用地高辛标记。结果：采用gp63探针，显示杜氏利什曼原虫（Leishmaniadonovani，L．d．）江苏人株和L．d．Jeddah nDNA之间有相似的染色体杂交带，L．d．四川人株和L．infantum nDNA之间有相似的染色体杂交带；采用β－tubulin探针，显示L．d．江苏人株与L．d．Jeddah nDNA之间有两条相似的染色体杂交带，L．d．四川犬株与L．d．甘肃犬株nDNA之间有三条相似的染色体杂交带、与L．d．汶川人株nDNA之间有两条相似的染色体杂交带。结论：提示平原疫区的江苏人株与L. d. J eddah 之间存在同源性, 山丘疫区的L. d. 四川人株与L. infantum 之间存在同源性, L. d. 四川犬株与L. d. 甘肃犬株之间存在同源性、与L. d. 汶川人株之间既存在同源性又存在差异, 山丘疫区与平原疫区分离株之间存在异源性。     

细胞因子体外扩增脐血CD^＋34细胞移植SCID鼠人类免疫功能的 …

ObjectiveTo explore the hematopoietic function of cytokine-expanding CD⁺₃₄ cells from umbilical cord blood in vitro.MethodCord blood cells expanded with FLT3(FMS-like tyrosine kinase 3)-ligand and thrombopoietin were transplanted in SCID(severe combined immune-deficient)mice. Human mature cell surface markers were detected with flow cytometry and used as indicator of succeeding transplantation.ResultAfter 2 and 3 weeks culture,the number of CD⁺₃₄ cells increased approximately 10 and 37 folds. After transplantation with 6.6×10⁴ to 6.9×10⁵ CD⁺₃₄ cells,respectively the percentage of human CD⁺₄₅ cells in the bone marrow of all 10 SCID mice is 0.2%～4.0%. The percentage of human CD⁺₃ cells in the peripheral blood and spleen of 6 SCID mice is 0.1%～2.3%. The percentage of human CD⁺₁₉ cells in the peripheral blood and spleen of 3 SCID mice are 0.3%～1.3%.ConclusionCD⁺₃₄ cells expanded with FLT3-ligand and thrombopoietin are potential engraft used for reconstitution of both hematopoietic and immunologic function of SCID mice.     

Catheter ablation of atrial fibrillation in elderly population

Background Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed. A total population of 3197 patients was dichotomized by the age of 70 years (394 elderly vs. 2803 younger subjects). Patients were followed in terms of arrhythmia status and sur?vival for a median period of 18 vs. 21 and 35 vs. 57 months, respectively. Results Elderly patients were more frequently females (49% vs. 29%, P < 0.0001), had a history of hypertension (79% vs. 57%, P < 0.0001), diabetes (16% vs. 11%, P < 0.01), stroke (9% vs. 6%, P < 0.01), coronary/peripheral artery disease (14% vs. 8%, P < 0.0001), and CHA2DS2-VASc score (3.1 ± 1.3 vs. 1.5 ± 1.2 s, P < 0.0001). Major complications were more frequent in elderly (5.3% vs. 3.2%, P = 0.03); however, this difference was driven by vascular complications (3.6% vs. 1.9%, P = 0.04). There were comparable rates of cerebrovascular (0.3 vs. 0.3%) or nonvascular complications (1.8 vs. 1.2%). Good arrhythmia control was inferior in elderly patients as compared with the rest of the cohort, both without and with antiarrhythmic drugs: 44.2% vs. 58.2% (P < 0.0001) and 78.2 vs. 83.2% (P < 0.01), respectively. Poor arrhythmia control was associated with relative risk of all-cause mortality of 2.7 (95% CI: 1.1–6.4) in elderly patients and 1.4 (95% CI: 0.9–2.0) in younger subjects. Conclusions Catheter abla?tion for AF in elderly patients is safe although somewhat less effective. Good arrhythmia control is associated with better survival, especially in elderly patients.     

Comparison of in-hospital outcomes between octogenarians and nonagenarians undergoing transcatheter aortic valve replacement: a propensity matched analysis

Background Aortic valve stenosis (AS) is very common in the elderly patients above 80 years. Transcatheter aortic valve replacement (TAVR) in such patients is being increasingly performed. This study sought to assess in-hospital outcome differences between octogenarians and nonagenarians and predictors of mortality in nonagenarians undergoing TAVR with severe AS. Method The study population was derived from the National Inpatient Sample (NIS) for the years 2012–2014 using ICD-9 CM procedure codes 35.05 and 35.06 for TAVR. Hospitalizations below 80 years of age were excluded. After performing propensity score matching (1: 2), in-hospital outcomes were compared in matched cohorts. Then, multivariate model was developed to analyze predictors of in-hospital mortality in nonagenarians. Results There were 11,630 hospitalizations in the octogenarian and 5815 hospitalizations in the nonagenarian group. Primary outcome of in-hospital mortality (6% vs. 4.1%, P ≤ 0.001) was higher in nonagenarians compared to octogenarians. Secondary outcomes including stroke (3.4% vs. 2.8%, P ≤ 0.001), renal failure (18.9% vs. 17.3%, P ≤ 0.001), blood transfusion (35% vs. 32.6%, P ≤ 0.001), vascular complications (4.5% vs. 3.5%, P ≤ 0.001), and pacemaker implantation (27.8% vs. 24.8%, P ≤ 0.001) were higher in nonagenarians. There was no difference in their length of stay. Median cost (70,374$ vs. 65,381$, P ≤ 0.001) was slightly higher with nonagenarian. Conclusions Although in-hospital mortality is slightly higher in nonagenarians, it is acceptable. This difference in mortality is at least partly explained by higher complications in nonagenarians. Efforts should be made to decrease the complications which can further narrow the difference in in-hospital mortality between the groups.     

The comparative efficacy of ezetimibe added to atorvastatin 10 mg versus uptitration to atorvastatin 40 mg in subgroups of patients aged 65 to 74 years or greater than or equal to 75 years

Background Coronary heart disease (CHD) risk increases with age; yet lipid-lowering therapies are significantly under-utilized in patients > 65 years. The objective was to evaluate the safety and efficacy of lipid-lowering therapies in older patients treated with atorvastatin 10 mg + ezetimibe 10 mg (EZ/Atorva) vs. increasing the atorvastatin dose to 40 mg. Methods Patients ≥ 65 years with atherosclerotic vascular disease (LDL-C ≥ 1.81 mmol/L) or at high risk for coronary heart disease (LDL-C ≥ 2.59 mmol/L) were randomized to EZ/Atorva for 12 wk vs. uptitration to atorvastatin 20 mg for 6 wk followed by atorvastatin 40 mg for 6 wk. The percent change in LDL-C and other lipid parameters and percent patients achieving prespecified LDL-C levels were assessed after 12 wk. Results EZ/Atorva produced greater reductions in most lipid parameters vs. uptitration of atorvastatin in patients ≥ 75 years (n = 228), generally consistent with patients 65–74 years (n = 812). More patients achieved LDL-C targets with combination therapy vs. monotherapy in both age groups at 6 wk and in patients ≥ 75 years at 12 wk. At 12 wk, more patients ≥ 75 years achieved LDL-C targets with monotherapy vs. combination therapy. EZ/Atorva produced more favorable improvements in most lipids vs. doubling or quadrupling the atorvastatin dose in patients ≥ 75 years, generally consistent with the findings in patients 65–74 years. Conclusions Our results extended previous findings demonstrating that ezetimibe added to a statin provided a generally well-tolerated therapeutic option for improving the lipid profile in patients 65 to 74 years and ≥ 75 years of age.     

Growth hormone-releasing hormone and gonadotropin-releasing hormone stimulate nitric oxide production in 17beta-estradiol-primed rat anterior pituitary cells

It was reported that neuronal nitric oxide synthase (nNOS) was expressed only in gonadotrophs and folliculo-stellate cells in the anterior lobe of the pituitary gland. However, recent studies have demonstrated the occurrence of nNOS in the somatotrophs and lactotrophs. In the present study, we investigated effects of growth hormone-releasing hormone (GHRH), gonadotropin-releasing hormone (GnRH), and 17β-estradiol on nitric oxide (NO) release in cultured rat anterior pituitary cells in vitro. The NO ₂ ⁻ level in the incubation medium of the rat anterior pituitary cells was dependent on the cell density. Pretreatment with 10 μM 17β-estradiol resulted in an increase in medium NO ₂ ⁻ level. GHRH and GnRH failed to change medium NO ₂ ⁻ levels, but they elicited increases in medium NO ₂ ⁻ levels in estrogen-treated cells. The GHRH-induced increase in NO ₂ ⁻ level was inhibited by Nχ-nitro-l-arginine methyl ester, a NOS inhibitor. These findings suggest that GnRH and GHRH could activate nNOS in the gonadotrophs and the somatotrophs, respectively.     

Formoterol,a new long-acting selectiveβ 2-agonist,decreases airway responsiveness in children with asthma

We compared the protective effect and duration of action of inhaled formoterol with salbutamol and placebo in 16 asthmatic children in a double-blind, cross-over study. All had an FEV₁ ≥ 70% predicted normal and a provocative concentration of methacholine (MCh) required to decrease their FEV₁ by 20% (PC₂₀) ≤ 4 mg/ml. On each study day, FEV₁ was within 10% and PC₂₀ within one doubling-dose of the initial visit. Patients received either placebo, salbutamol 200μg, formoterol 12μg, or formoterol 24μg by metered-dose inhaler. FEV₁ and PC₂₀ were measured repeatedly over 12 h. After salbutamol, peak FEV₁ was 120% of baseline at 30 min and returned to baseline in 3 h. After formoterol (12 or 24μg) peak FEV₁ was 118% at 3 h and remained above baseline for at least 12 h. Protection from MCh by both doses of formoterol was significantly better than by salbutamol. Protection from formoterol 12 and 24μg at 12 h was equivalent to that from salbutamol at 3 h. The PC₂₀ of four children 48 h after formoterol 24μg was more than twice their baseline PC₂₀. Formoterol by inhalation is potent and long-acting and provides significantly better antiasthma protection than salbutamol.     

Real-world comparison of non-vitamin K antagonist oral anticoagulants and warfarin in Asian octogenarian patients with atrial fibrillation

Background The efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asian octogenarian atrial fibrillation (AF) patients have not been established in a real-world setting. We aimed to evaluate the efficacy and safety of NOACs and warfarin in Korean octogenarian patients. Methods A total of 293 consecutive patients aged ≥ 80 years with non-valvular AF who had taken either NOACs (148 cases, 50.5%) or warfarin (145 cases, 49.5%) were retrospectively reviewed. The efficacy outcome was the composite of stroke or systemic embolism. The safety outcome was major bleeding. Results The follow-up duration was 375 patient-years (172 patient-years with NOACs and 203 patient-years with warfarin). Patients on NOACs were slightly older (P = 0.006) and had slightly higher HAS-BLED scores (P = 0.034). The efficacy of both anticoagulants was high (1.16% for NOACs vs. 2.98% for warfarin per 100 patient-years, P = 0.46). The safety outcome was relatively high in both NOACs and warfarin groups (8.96% vs. 12.46%, P = 0.29). The efficacy and safety outcomes tended to decrease non-significantly in low dose NOACs than in common dose NOACs or warfarin (0.85% vs. 1.84% vs. 2.98% in efficacy outcome, P = 0.69; and 6.97% vs. 13.29% vs. 12.46% in safety outcome, P = 0.34). Conclusions NOACs were highly effective for prevention of stroke or systemic embolism in Asian octogenarian AF patients. However, major bleeding occurred excessively high in both anticoagulant groups. Further study is required on the optimal anticoagulant regimen in octogenarian population.     

我国伊蚊族蚊类记录的校订及新分类系统的建议（双翅目∶蚊科）

本文根据国外蚊虫分类经验,对我国伊蚊族蚊类以往记录171种的分类地位作了校订,其中160种可归入我国伊蚊族新分类系统的29个属中,另外11种地位未定,暂按旧分类地位列名表供查考。我国伊蚊族新分类系统包括伊蚊属Aedes、阿蚊属Armigeres、艾蚊属Ayurakitia、博蚊属Bothaella*、布蚊属Bruceharrisonius*、环喙蚊属Christophersiomyia*、科蚊属Collessius*、丹蚊属Danielsia*、唐蚊属Downsiomyia*、箭阳蚊属Edwardsaedes*、纷蚊属Finlaya*、弗蚊属Fredwardsius*、贾蚊属Gilesius*、领蚊属Heizmannia、喜蚊属Himalaius*、霍金蚊属Hopkinsius*、呼蚊属Hulecoeteomyia*、连蚊属Jihlienius*、奈蚊属Kenknightia*、陆蚊属Luius*、霉蚊属Mucidus*、新黑蚊属Neomelaniconion*、骚扰蚊属Ochlerotatus、花蚊属Phagomyia*、盾蚊属Scutomyia*、覆蚊属Stegomyia*、田中蚊属Tanakaius*、尤蚊属Udaya和奇阳蚊属Verrallina等29属,其中22属（*）为我国新记录。此外,还对《中国动物志,昆虫纲第8卷,双翅目：蚊科上卷》记载的4种伊蚊作了重要订正。安图伊蚊Ae. （Edw.） antuensis应是平坝箭阳蚊Ed. pingpaensis的同物异名。滇西伊蚊Ae. （Sin.） occidentayunnanus、黄背伊蚊Ae. （Och.） flavidorsalis和亚同伊蚊Ae. （Fin.） subsimilis分别订正为滇西领蚊Hz. （Mat.） occidentayunnana、白色骚扰蚊Oc. albineus和亚同尤蚊Ud. subsimilis。     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

高血压降压治疗目标的再认识

根据传统的高血压水平的定义,1993年WHO高血压治疗指南提出血压控制目标为<140/90mm Hg(1mm Hg=0.133kPa),但是并非所有患者都必须将血压降至同一水平,而应根据患者情况进行个体化治疗。Framingham进行的一项长达10～12年的心血管事件研究发现,第5年后,正常上限血压[收缩压(SBP     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.