Ursodeoxycholic acid in the treatment of primary biliary cirrhosis: A short-term, randomized, double-blind controlled, cross-over study with long-term follow up

Abstract In order to evaluate the efficacy of ursodeoxycholic acid (UDCA) in the treatment of Chinese patients with primary biliary cirrhosis, a short-term, randomized, double-blind controlled, cross-over study was done with long-term follow up. In the first part of the study, 12 patients were randomly chosen to receive either UDCA 600 mg/day for 3 months followed by a placebo for 3 months or a placebo for 3 months followed by UDCA for 3 months. The clinical symptoms of pruritus improved when the patients were receiving UDCA but became worse when receiving a placebo. Mean serum levels of alkaline phosphatase (ALPase), γ-glutamyl transferase (γ-GT), total bilirubin, cholesterol, alanine aminotransferase (ALT) and aspartate aminotransferase all decreased below the baseline values when receiving UDCA treatment and all increased above the baseline values when receiving the placebo. The difference was statistically significant. In the second part of the study, 19 patients received long-term UDCA treatment (mean 20 months). The clinical symptoms of pruritus improved in 90% of the pruritic patients. Serum levels of ALPase, γ-GT and ALT fell significantly from the pretreatment values 6, 12 and from the mean 20 months after UDCA treatment. Serum levels of total bilirubin fell significantly 6 and 12 months after UDCA treatment but did not reach statistical significance at the last follow up. No patient lost antimitochondrial antibody and elevated immunoglobulin levels did not improve significantly, but the Mayo clinical risk score improved significantly after long-term UDCA treatment. Treatment failure was noted in three patients: two patients in the histologic stage IV with clinical overt jaundice died of complications 4 and 5 months after UDCA treatment, respectively; another patient underwent a liver transplantation 1 year after the UDCA treatment due to progressive jaundice. No severe adverse reaction was noted during UDCA treatment, only one patient suffered from a mild allergic reaction. In conclusion, UDCA is safe and effective in the treatment of Chinese PBC patients in stages I—III.     

麝香保心丸治疗冠心病心绞痛临床疗效观察

目的 :观测麝香保心丸治疗冠心病心绞痛的疗效。方法 :将 2 0 0例冠心病心绞痛的患者随机分析治疗组 12 0例 ,对照组 80例 ,治疗组口服麝香保心丸 ,每次 2片 ,每日 3次 ,对照组口服单硝酸异酯脂 ,每次 2 0mg ,每日 2次。 结果 :麝香保心丸可显著改善冠心病心绞痛临床症状 ,显著改善心电图 ,缺血总面积。总的症状疗效 :治疗组为 83% ,对照组为6 1% ,(P <0 .0 5 ) ,心电图疗效 :治疗组为 74 % ,对照组为 4 6 % (P <0 .0 5 )。结论 :麝香保心丸治疗冠心病心绞痛优于单硝酸异山梨酯。     

Predictors of nurse absenteeism in hospitals: a systematic review

Aim  This study aimed to identify and examine predictors of short-term absences of staff nurses working in hospital settings reported in the research literature.
Background  Front-line staff nurse absenteeism contributes to discontinuity of patient care, decreased staff morale and is costly to healthcare.
Evaluation  A systematic review of studies from 1986 to 2006, obtained through electronic searches of 10 online databases led to inclusion of 16 peer-reviewed research articles. Seventy potential predictors of absenteeism were examined and analysed using content analysis.
Key issue  Our findings showed that individual 'nurses' prior attendance records', 'work attitudes' (job satisfaction, organizational commitment and work/job involvement) and 'retention factors' reduced nurse absenteeism, whereas 'burnout' and 'job stress' increased absenteeism. Remaining factors examined in the literature did not significantly predict nurse absenteeism.
Conclusions  Reasons underlying absenteeism among staff nurses are still poorly understood. Lack of robust theory about nursing absenteeism may underlie the inconsistent results found in this review. Further theory development and research is required to explore the determinants of short-term absenteeism of nurses in acute care hospitals.
Implications for nursing management  Work environment factors that increase nurses' job satisfaction, and reduce burnout and job stress need to be considered in managing staff nurse absenteeism.     

扩增片段长度多态性分析用于霍乱弧菌分子分型的方法建立和应用评价

目的建立霍乱弧菌的基于红外荧光标记引物的扩增片段长度多态性(AFLP)分型方法,评价脉冲场凝胶电泳(PFGE)和AFLP对霍乱弧菌的分型能力。方法选择PFGE带型均不相同的47株霍乱弧菌作为评价菌株,建立AFLP对于霍乱弧菌的分型方法;确定操作程序后选择83株分离自1962-2005年11个省的霍乱弧菌,进行AFLP和PFGE对于霍乱弧菌分型能力的比较。AFLP分型方法采用了红外荧光标记PCR引物,利用LI-COR4300自动测序仪完成电泳、SagaMX软件对电泳图谱进行编辑。PFGE采用PulseNet提供的标准化程序。结果AFLP用于霍乱弧菌分型时选择性引物携带碱基数为1,最优引物组合为EcoRⅠ-G／MseⅠ-T,AFLP分型实验的重复性达到99．2％。AFLP将83株霍乱弧菌分为52个型别,D值为0．9545;PFGE将此83株菌分为44种带型,D值为0．9251。结论优化固定了AFLP对于霍乱弧菌的分型程序,重复性好;AFLP比PFGE具有更好的分型能力,能够用于分离菌株的分子分型。结合已成为实验室网络监测标准分析方法的PFGE,可对分离株做更细致的分型比较。     

大豆蛋白体外酶解物中血管紧张素转化酶抑制剂活性肽研究

目的:体外模仿部分胃肠道消化酶解过程,考察大豆蛋白酶解消化能否产生血管紧张素转化酶抑制剂(ACEI)活性肽及其活性状况,以揭示大豆蛋白体内消化酶解与ACEI的活性关系。方法:模拟人体胃肠道消化过程,以胃蛋白酶结合胰蛋白酶,相继酶解大豆分离蛋白(SPI),经色谱分离,动态检测不同阶段ACEI肽片段及其活性大小。结果:胃蛋白酶酶解过程前20min内,酶解液ACEI活性达到最高点,随后在胰蛋白酶酶解阶段其抑制活性下降。180min后的酶解产物,其半抑制活性浓度IC50值为0.28±0.06 mg/ml。同时,未经酶解的SPI液在0.73mg/ml时无ACEI活性。SPI酶解液经各种色谱分离后的组分,其IC50值从0.13±0.03到0.93±0.08 mg/ml。低分子量和伴有疏水性基团的肽类最具ACE抑制活性。结论:体外模仿胃肠消化过程使用胃蛋白酶和胰蛋白酶酶解SPI可产生不同ACEI活性的肽片段,说明人体正常摄食消化大豆蛋白可产生血管紧张素转化酶抑制剂活性肽。     

Determination of the required HLB values of some essential oils

The required HLB values of eucalyptus, lippia and peppermint essential oils were determined using droplet size analysis and turbidimetric method on emulsions prepared with emulsifier blends of varying HLB values. The percentage increase in mean droplet diameter and the degree of dispersion of droplet sizes were determined before and after centrifugation of the emulsions. The HLB value of the emulsion with the least dispersion ratio or the least percentage increase in mean droplet diameter was taken as the required HLB of the respective essential oil. The turbidimetric method was validated by the existence of correlation (r=-0.958) between the mean droplet diameter and the turbidity of the emulsions. The turbidity curve went through a maximum at the HLB value where the mean droplet diameter was least. Based on these methods, the required HLB values of eucalyptus, lippia and peppermint oils were determined as 9.8, 12.1 and 12.3, respectively (P<0.05). Liquid paraffin was used as a reference standard and its required HLB fell within literature value.     

Palpable lymph nodes of the neck in Swedish schoolchildren

We studied 3592 Swedish schoolchildren, 8 or 9 years old, examined for palpable submandibular, cervical and supraclavicular lymph nodes. All children were skin tested with 2 TU PPD RT23 and with 0.1 μ g of Mycobacterium avium sensitin or 0.1 μ g of M. scrofulaceum sensitin. A total of 991 children had palpable lymph nodes in any of the three locations. Among them, 811 had lymph nodes in one location, 162 in two locations and 18 in three. In 312 children, the lymph nodes were ± 5 mm in size in any location. The most common location was submandibular. Boys had a significantly higher prevalence of palpable lymph nodes than girls. There was also seasonal variation. Children infected by atypical mycobacteria (sensitin reaction ±6 mm) did not have a higher prevalence of palpable lymph nodes than those not infected.     

Pediculocidal and scabicidal properties of Lippia multiflora essential oil

The essential oil from the leaves of Lippia multiflora Moldenke (Verbenaceae) was tested for its pediculocidal and scabicidal activites against bodylice, headlice and scabies' mites. The 'knockdown' times obtained for bodylice and headlice using lippia oil preparations were comparatively shorter than those obtained using benzyl benzoate and Delvap Super, a brand of dichlorvos. The lethal effect of the lippia oil on headlice was increased when applied in an enclosed system that prevented volatilization of the oil while allowing maximum contact of the vapour with the headlice. A 20% v/v preparation of lippia oil applied to scabietic subjects for 5 consecutive days gave 100% cure compared with 87.5% cure obtained for benzyl benzoate preparation of the same concentration. The GC-MS analysis of oil revealed, among others, the presence of terpineol, alpha- and beta-pinene which are known to be lethal to body and headlice.     

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.