Application of a pigment measuring device – Mexameter®– for the differential diagnosis of vitiligo and nevus depigmentosus

Background/purpose: Vitiligo and nevus depigmentosus (ND) present similar hypopigmented macules with significantly different prognoses. Although the distinction between the two diseases is important, differential diagnosis relies on medical history and physical examination, which is far from decisive in some cases. The Mexameter^® is an objective skin color-measuring device, and has been reported to provide a reproducible and sensitive means of quantifying small skin color differences. In this study, we investigated the usefulness of a Mexameter^® for discriminating these diseases.
Methods: A selection of 202 hypopigmented skin lesions (182 from vitiligo and 20 from ND) were the objects of this study. Using a Mexameter, MIs were obtained from lesions and symmetrically located control skin. RMIs, ratios of the MIs of lesional skins to control skins, were calculated.
Results: The mean MIs and RMIs were significantly different for vitiligo and ND. The mean RMI of ND lesions was 74±13, which was significantly higher than that of vitiligo lesions (50±24). No ND lesion had an RMI of <50%.
Conclusion: This study shows that the Mexameter^®, an objective pigment-measuring device, can be used to achieve a more accurate diagnosis of hypopigmentary disorders, and that the relative melanin index (RMI), which represents the relative pigment levels, might be a more effective parameter than the melanin index (MI) itself for comparing pigmentation differences.     

Efficacy and safety of herbal medicines for idiopathic Parkinson's disease: a systematic review.

The objective of this study is to assess the efficacy and safety of herbal medicines (HMs), as a monotherapy or adjunct therapy, compared to placebo or conventional approaches in the treatment of idiopathic Parkinson's disease (PD). We conducted a systematic review of randomized controlled trials from both conventional and alternative medicine sources. Outcome measures were overall improvement, quality of life, reduction of levodopa dose, and adverse events. Nine studies were included, each testing a different HM. Six of the trials had limited internal validity due to major flaws in design, including the lack of proper randomization; insufficient blinding; unclear inclusive criteria in terms of diagnostic criteria, baseline staging, and duration of disease; lack of proper sample size calculation; and insufficient data analysis. Imbalances in gender and ethnicity among the patients in the included trials were observed. No major adverse events emerged, and no specific pattern was detected from the trials describing such data. In addition to major methodological defects, heterogeneity in (1) HM tested, (2) control treatment, and (3) outcome measure hindered in-depth data analysis and synthesis. Current evidence is insufficient to evaluate the efficacy and safety of various HMs. Further studies with improved trial design and reporting, with assessment on cost-effectiveness, quality of life, and qualitative data are warranted.     

胸膜腔造影和注射粘连剂对难治性气胸的诊治

目的：为更清晰地显示顽固性气胸的漏气部位和性质，为不能耐受手术者摸索一种新的治疗手段。方法：选择１８例患者，先用７６％泛影葡胺行胸膜腔造影，而后在局部注入少量粘连剂。结果：造影后发现多发性肺大泡８例，单发性肺大泡６例，肺大泡伴粘连带４例。病变分别位于左上肺，右上肺，中下肺野及叶间裂。注射粘连剂后，１５例一次成功，３例第二次成功。随防６～１８个月，未见复发。结论：该方法易掌握，无明显副作用。病变显示明显，易被患者接受，具有明显的临床效果和推广价值     

Adrenergic signalling between rat taste receptor cells

In taste buds, synaptic transmission is traditionally thought to occur from taste receptor cells to the afferent nerve. This communication reports the novel observation that taste receptor cells respond to adrenergic stimulation. Noradrenaline application inhibited outward potassium currents in a dose-dependent manner. This inhibition was mimicked by the β agonist isoproterenol and blocked by the β antagonist propranolol. The α agonists clonidine and phenylephrine both inhibited the potassium currents and elevated intracellular calcium levels. Inwardly rectifying potassium currents were unaffected by adrenergic stimulation. Experiments using the RT-PCR technique demonstrate that lingual epithelium expresses multiple α (α1a, α1b, α1c, α1d, α2a, α2b, α2c) and β (β1, β2) subtypes of adrenergic receptors, and immunocytochemistry localized noradrenaline to a subset of taste receptor cells. Collectively, these data imply strongly that adrenergic transmission within the taste bud may play a paracrine role in taste physiology.     

多媒体辅助于中药学教学存在的问题及对策

中药学理论源远流长,知识要点繁杂,涉及学科面广。中药学教学对植物药、动物药、矿物药的形象展示、真伪鉴别,地道药材确定以及加工、炮制、煎煮方法的情景呈现有特殊要求,而多媒体课件丰富的色彩、直观的形象,尤其是妙趣横生的音频、视频及动画效果可弥补传统教学的缺憾,为中药学教学提供了新的手段和方法。回顾中药学教学历程,辩证地分析多媒体辅助中药学教学存在的问题,探索解决问题的方法和措施,以期寻求更好的教学策略。     

Parental education and children's online health information seeking: Beyond the digital divide debate

Research has shown that increasing numbers of teenagers are going online to find health information, but it is unclear whether there are disparities in the prevalence of online health seeking among young Internet users associated with social and economic conditions. Existing literature on Internet uses by adults indicates that low income, less educated, and minority individuals are less likely to be online health seekers. Based on the analysis of data from the Pew Internet and American Life Project for the US, this study finds that teens of low education parents are either as likely as or even more likely than teens of high education parents to seek online health information. Multiple regression analysis shows that the higher engagement in health seeking by teens of low education parents is related to a lower prevalence of parental Internet use, suggesting that some of these teens may be seeking online health information on behalf of their low education parents. Implications of these findings are discussed in relation to the issues of the digital divide and digital empowerment.     

Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.     

不同针刺深度对前列腺增生症大鼠重量指数的影响及形态学观察

目的与方法 采用深刺和浅刺对丙酸睾酮所致前列增生症（BPH）大鼠模型进行干预，研究其作用殊同。结果 针刺组前列腺，膀胱指数明显小于模型组；形态学观察，针刺组较模型组增生明显减轻，腺上皮呈单层柱状，腺体数目明显减少，间质充血，钙化明显减轻，结缔组织无增生，腺腔内分泌物减少。深刺组好于浅刺组。结论 深刺对实验性BPH大鼠的干预作用好于浅刺方法。     

AMPK在妊娠期糖尿病发病机制中的作用

腺苷酸活化蛋白激酶是一种重要的蛋白激酶,主要作用是协调代谢和能量平衡.腺苷酸活化蛋白激酶被激活后,在增加骨骼肌对葡萄糖摄取、增强胰岛素敏感性、增加脂肪酸氧化以及调节基因转录等方面发挥重要作用.已经证实脂联素有调节糖脂代谢的作用,但其作用机制尚不十分清楚,很可能是通过腺苷酸活化蛋白激酶介导,对脂联素信号转导通路的研究将成为进一步理解脂联素作用的关键所在.而脂联素又是妊娠期糖尿病的预测因子,所以腺苷酸活化蛋白激酶逐渐成为对妊娠期糖尿病研究中的焦点.