The mediating role of health professionals' recommendation in the uptake of colorectal cancer testing among older Chinese adults

The purpose of this study is to examine the mediating effect of health professionals' recommendations on the relationship between the characteristics of older Chinese adults and the use of colorectal cancer testing. This was a cross‐sectional population‐based telephone survey. A total of 2004 Chinese adults aged 50 or above were recruited between 2 and 28 May 2007 to complete an anonymous telephone survey. The survey covered demographics, perceived health status and susceptibility to cancer, utilization of complementary medicine, family history of cancer, and cancer screening behaviour. The uptake of flexible sigmoidoscopy/colonoscopy was 12%, of which only 3.4% had been recommended by health professionals. The effects of gender, a history of serious disease, perceptions related to health status and visiting doctor regularly on the flexible sigmoidoscopy/colonoscopy uptake were mediated by a health professional's recommendation. A health professional's recommendation can be a catalyst for the decision of undergoing a colorectal cancer screening test in older adult people, in particular for those who are more health‐conscious. As health professionals can play a crucial role in the development of successful population‐based colorectal cancer screening program, efforts should be made to facilitate them in making recommendations for colorectal cancer screening to targeted high‐risk group.     

Effects of hyperoxic ventilation on hemodilution-induced changes in anesthetized dogs

BACKGROUND: In subjects who have undergone acute preoperative normovolemic hemodilution (ANH), intraoperative hemorrhage is generally treated by immediate return of autologous blood collected during ANH. Simply increasing blood oxygen content by hyperoxic ventilation (HV, inspiratory fraction [FIO2] 1.0) might compensate for the acute anemia, allow further ANH, and delay onset of autologous blood return. STUDY DESIGN AND METHODS: This study 1) evaluated the effects of HV (FIO2 1.0) upon ANH to a hemoglobin (Hb) concentration of 7 g per dL in anesthetized dogs ventilated with room air and 2) compared the effects of subsequent profound ANH (Hb, 3 g/dL) with and without an intravenous perfluorocarbon emulsion (perflubron 60% wt/vol) versus those of autologous red cell transfusion. The results of the entire study are presented in two parts. Organ tissue oxygenation was assessed in skeletal muscle and liver, and systemic oxygenation status was evaluated. Myocardial contractility was deduced from left ventricular pressure-volume relationship. Seven of 22 dogs underwent further hemodilution while breathing 100-percent O2, for a determination of the Hb concentration at which HV-induced effects were abolished. RESULTS: HV completely reversed the ANH-induced increase in cardiac index (4.6 +/− 0.7 vs. 3.8 +/− 0.9 L/min/m2 before and during HV; p < 0.05) and partially reversed the decrease in systemic vascular resistance (1784 +/− 329 vs. 2087 +/− 524 dyn × cm-5 × sec × m-2; p < 0.05). Despite unchanged global O2 delivery, organ tissue oxygenation improved during HV (mixed venous partial pressure of O2: 40 +/− 3 vs. 59 +/− 7 torr; coronary venous pressure of O2: 30 +/− 4 vs. 43 +/− 6 torr; p < 0.05; liver surface: 31 +/− 11 vs. 39 +/− 13 torr; skeletal muscle surface: 30 +/− 14 vs. 41 +/− 22 torr; p < 0.05). This improvement was due to an increased contribution of physically dissolved O2 in plasma to O2 delivery (3.2 +/− 0.2% before HV vs. 14.6 +/− 1% during HV; p < 0.05) and O2 consumption (whole body: 6 +/− 1% vs. 47 +/− 8%, p < 0.05; myocardium: 4.3 +/− 0.9% vs. 31 +/− 6%, p < 0.05). The beneficial effects of HV were lost after an additional volume-compensated exchange of 19 percent of blood volume (Hb, 5.6 g/dL). CONCLUSION: In anesthetized dogs ventilated with room air and hemodiluted to a Hb of 7 g per dL, simple oxygen therapy by HV (FIO2 1.0) rapidly improves tissue oxygenation and permits extended hemodilution to Hb of 5.8 g per dL until the HV-induced effects are lost.     

A survey of the incidence of Miltenberger antibodies among Hong Kong Chinese blood donors

BACKGROUND: The ready availability of red cells of the Miltenberger (Mi) class III phenotype (6.28%) prompted the study of Mi antibodies among Chinese blood donors in Hong Kong, 98 percent of whom are descended from inhabitants of Guangdong Province in southern China. STUDY DESIGN AND METHODS: Red cells of the Mi class III phenotype were used to conduct a survey of the frequency of Miltenberger antibodies in 56,161 random Chinese blood donors, over a period of 12 months, using a microplate technique. RESULTS: Sera from 32 donors (0.057%) were found to contain Mi antibodies: sera from 22 contained anti-Mur + Hut; sera from 4 contained anti-Vw + Mur + Hut; sera from 4 had monospecific anti- Mur; and sera from 2 had monospecific anti-Hil. The immunoglobulin isotypes of 24 sera were mixtures of IgM and IgG, 4 were pure IgM, and 4 were pure IgG. CONCLUSION: The majority of Mi antibodies detected were naturally occurring. This survey proved useful for mass screening of random donors for the procurement of valuable Mi antisera.     

Lupus Nephritis and Pregnancy

Sixty-four pregnancies in 41 women with biopsy proven lupusnephritis between 1965 and 1991 were analysed to record fetaland maternal outcome and identify risk factors for poor outcome.Of 65 fetuses, 22 (34 per cent) were lost (including therapeuticabortions), 19 (30 per cent) were live born but premature (     

转基因小鼠胰岛β细胞株胰岛素样生长因子1受体和胰岛素受体表达与小檗碱的干预效应

目的:观察小檗碱对转基因小鼠胰岛β细胞株胰岛素受体和胰岛素样生长因子1受体mRNA表达的影响。方法:实验于2005-09/2006-10在华中科技大学同济医学院附属同济医院中西医结合研究所完成。①实验材料:培养NIT-1细胞,在低糖(5.5mmol/L)和高糖(11.1mmol/L)环境下,分别加入0,1,3,10,30μmol/L的小檗碱和1μmol/L的格列苯脲,0μmol/L小檗碱组为空白对照组。②实验评估:培养24h后,采用四甲基偶氮唑盐法检测小檗碱NIT-1细胞增殖抑制作用;逆转录-聚合酶链反应测定NIT-1细胞胰岛素受体和胰岛素样生长因子1受体mRNA表达。结果:①四甲基偶氮唑盐法检测发现,不同浓度小檗碱(1～30μmol/L)与NIT-1细胞作用24h后,小檗碱组吸光度值比空白对照组低,随着小檗碱浓度的增加,吸光度值逐渐从0.356±0.061降低至0.162±0.014,而且在各组之间有显著性差异。②在低糖及高糖环境下,与空白对照组相比,小檗碱能促进NIT-1细胞胰岛素受体mRNA的表达(低糖环境:0.27±0.04,0.49±0.02;高糖环境:0.22±0.04,0.42±0.03;P<0.01),但仍低于格列苯脲组(低糖环境:0.75±0.22;高糖环境:0.78±0.01;P<0.01);而且随着小檗碱浓度的升高,NIT-1细胞胰岛素受体mRNA表达的增加更为明显,分别从0.49±0.02增高至0.68±0.44及从0.42±0.03增高至0.71±0.01。与空白对照组相比,小檗碱组胰岛素样生长因子1受体mRNA的表达无明显改变。结论:小檗碱促进胰岛素分泌,其作用机制可能与促进胰岛β细胞胰岛素受体mRNA表达有关。     

A flow cytometric method for phenotyping recipient red cells following transfusion

BACKGROUND: Reticulocyte phenotyping is used for transfused patients, who have red cell antibodies, to match blood for subsequent transfusion. Current methods are labor-intensive and require a significant amount of sample. STUDY DESIGN AND METHODS: A simple dual- color flow cytometry method developed for antigen typing of reticulocytes in mixed red cell populations is reported. Antigens were labeled by an indirect immunofluorescence technique using undiluted reagent sera as the primary label, biotinylated goat anti-human IgG as the secondary label, and avidin-phycoerythrin as the fluorescent stain. Reticulocytes were labeled with a thiazole orange fluorescent stain. Reticulocyte identification and antigen typing were performed on 319 samples to establish the validity of the procedure. Mixed red cells were prepared in all possible c antigen combinations to simulate transfusion concentrations of 25, 50, and 75 percent. RESULTS: The anti- c flow cytometry profiles readily distinguished between antigen- positive and antigen-negative populations and allowed the detection of reticulocytes at all simulated transfusion concentrations. Similar results were obtained in experiments using C, K, s, Fya, Fyb, Jka, or Jkb sera against equal volumes of antigen-positive and -negative cells. Anti-S gave inconsistent results. The in vitro results were confirmed in 19 transfused patients who had received red cells antigenically different from their own as well as cells from 1 chimera blood donor. CONCLUSION: This method provides a simpler, safer, less labor- intensive, and less subjective technique requiring far less sample volume than current methods for antigen typing of reticulocytes in mixed red cell samples from recently transfused patients.