Unbound immunoglobulins are a major source of error in the quantitation of platelet surface-bound immunoglobulin levels

Analysis of assays for the determination of platelet-associated immunoglobulins (PAIgs) has led to disagreement over the amount of surface-bound Igs in both normal controls and patients with elevated platelet Ig levels. By the use of radiolabeled platelets and platelet counts, it was demonstrated that more than 10(8) platelets are disrupted after each centrifugation during platelet isolation procedures, releasing intraplatelet contents into the fluid phase of resuspended platelets in buffer. It was shown that suspensions of whole washed platelets contain a significant, but generally overlooked, amount of unbound Igs that have been liberated from platelets disrupted during processing. When platelet suspensions are evaluated for Igs with assays that fail to incorporate a final separation of whole platelets from the suspension fluid, unbound Igs as well as those bound to the platelet surface are measured, which yields a logarithmic overestimation of surface-bound Igs. It has been further demonstrated that patients infected with human immunodeficiency virus type 1 can have elevations of PAIgG, PAIgA, and PAIgM in both the thrombocytopenic and nonthrombocytopenic states. These elevations are due to increased internal platelet pools of Igs and not to increased surface-bound Igs.     

男护士在妇产科实习体验的质性研究

目的探讨男护士在妇产科的实习体验。方法采用现象学研究方法,深入访谈2012年3月~2013年5月在妇产科实习的男护士12名,并用Colaizzi的7步分析法分析访谈资料。结果男护士在妇产科实习的主要体验有：得不到患者的理解与支持、失落感、学习积极性下降、生活学习不方便、对专科操作不满意等。结论男护士在妇产科实习期间有着多种不良体验,临床带教老师要积极采取措施帮助他们顺利完成在妇产科的实习。     

HPLC法测定葛根提取物片中葛根素含量的不确定度评定

目的建立HPLC法测定葛根提取物片中的葛根素的不确定度评定方法。方法采用HPLC法测定葛根素 含量,分析影响其不确定度的因素来源,量化不确定度分量,最终计算合成不确定度,并得出测量结果的扩展不确定度。结果 葛根素的不确定度评估为±6. 66%。结论本方法可用于HPLC法测定药物含量的不确定度分析,使测定结果更加可靠。     

Effect of hormone replacement therapy,tibolone and raloxifene on serum lipids,apolipoprotein A1, apolipoprotein B and lipoprotein(a) in Greek postmenopausal women

The aim of this study was to assess the effect of estrogen, two regimens of continuous combined hormone replacement therapy (HRT), tibolone and raloxifene on serum lipid, apolipoprotein A1 and B and lipoprotein(a) levels in Greek postmenopausal women. A total of 350 postmenopausal women were studied in a prospective open design. Women were assigned to one of the following regimens depending on the presence of risk factors for osteoporosis, climacteric symptoms and an intact uterus: conjugated equine estrogen 0.625 mg (CEE, n=34), continuous combined CEE 0.625 mg plus medroxyprogesterone acetate (MPA) 5 mg, (n=80), continuous combined 17β-estradiol 2 mg plus norethisterone acetate (NETA) 1 mg (n=58), tibolone 2.5 mg (n=83) and raloxifene HCl 60 mg (n=50). Forty-five postmenopausal women with no indications for HRT served as controls. Total cholesterol (TC), low-density lipoprotein (LDL) cholestrol and high-density lipoprotein (HDL) cholesterol, triglyceride (TG), apolipoprotein A1 (ApoA₁), apolipoprotein B (ApoB) and lipoprotein(a) (Lp(a)) levels were assessed in each subject at baseline, and at 6 and 12 months of therapy. All therapy regimens lowered TC levels compared to baseline (4.2-8.0% decrease). This effect was more prominent in the subgoup of women with high baseline TC levels (9.1-20.4% decrease). LDL cholesterol decreased significantly in CEE, CEE/MPA and raloxifene groups (?11.2%, ?11.9% and ?11.0%, respectively). Hypercholesterolemic women exhibited a steeper decrease in LDL cholesterol (10.6-27.8% in all therapy groups). TG levels increased significantly in the CEE and CEE/MPA groups (23.7% and 21.8%, respectively), while estradiol/NETA had no effect on TG levels. Tibolone decreased TG levels markedly, by 20.6%, while raloxifene had no TG-lowering effect. HDL cholesterol and ApoA₁ were increased by CEE and CEE/MPA (HDL cholesterol, 7.4% and 11.8%, respectively; ApoA₁, 17.8% and 7.9%, respectively) and decreased by tibolone (HDL cholesterol, ?13.6%; and ApoA₁, ?9.9%). All therapy regimens except raloxifene lowered Lp(a) levels, with tibolone having the more pronounced effect (?13.2 to ?29.0%). In conclusion, each therapy regimen had a different effect on lipid-lipoprotein levels, exerting favorable and unfavorable modifications. Hypercholesterolemic women seemed to benefit more from the cholesterol-lowering effect of estrogen replacement therapy/HRT. The choice for a particular regimen should be based on individual needs, indications and lipid-lipoprotein profile.     

The effect of vaginal pH on labor induction with vaginal misoprostol

Objective.?To estimate the association of vaginal pH on the induction to vaginal delivery interval in labor induction with vaginal misoprostol.

Methods.?Women presenting at term with intact membranes for labor induction were recruited. The pH of the vagina was measured during a digital examination of the cervix to determine the Bishop Score. Labor was induced with 25?μg of vaginal misoprostol placed every 6?h until spontaneous rupture of membranes or active labor occurred. The primary outcome was the induction to vaginal delivery interval in the lower pH (?<?5) versus higher pH (???5) group. Secondary outcomes assessed maternal and neonatal morbidities. Sample size calculated a priori estimated 120 subjects were required for a power of 95% and a 2-tailed α of 0.05.

Results.?120 women met inclusion criteria and had available pH data. There was no difference in the induction to vaginal delivery interval in the lower pH (1455?min) versus higher pH group (1295 minutes, Mean difference 160[?147,468] P?=. 30). No difference was observed for operative delivery rates or neonatal outcomes.

Conclusion.?The pH of the vagina may not affect the length of the induction to vaginal delivery interval in women undergoing labor induction with vaginal misoprostol. Further research is required to determine factors that may influence the efficacy of vaginal misoprostol when used for labor induction.     

游离组织瓣移植修复头颈部肿瘤术后组织缺损的临床分析

目的探讨吻合血管的游离组织瓣在头颈肿瘤术后组织缺损修复中的应用。方法2 0 0 3年5月～2 0 1 2年4月收集头颈肿瘤术后组织缺损患者1 0 0例,其中口腔4 7例,口咽部1 6例,下颌骨9例,颌面部20例,颈部6例,项背部2例;所有患者应用吻合血管的游离组织瓣(101处)修复组织缺损,其中游离前臂皮瓣61处,游离背阔肌皮瓣18处,游离腓骨肌皮瓣7处,游离腹肌穿支皮瓣2处,游离股前外侧皮瓣1 0处,游离髂骨肌瓣2处,游离肩胛皮瓣1处;观察游离组织瓣修复组织缺损处后的愈合情况。结果术后随访2个月至5年,患者术后外形及功能均恢复正常,101处游离组织瓣术后成活98处,坏死3处,成功率97.03%。受区和供区的并发症12/101(11.8%)。结论游离组织瓣移植在头颈外科修复中应用安全灵活且可供选择的组织瓣多,提高了患者的生存质量。     

Study of the radio-opacity of base and liner dental materials using a digital radiography system

Objectives:

This study investigated the radio-opacity of commercially available glass ionomer cements (GICs), flowable resin composites (FRCs) and calcium hydroxide cements (CHCs) and compared this with the radio-opacity of enamel, dentine and aluminium stepwedge. 16 GICs, 8 FRCs and 4 CHCs were analysed.

Methods:

Three sets of three samples were prepared: 1 mm, 2 mm and 3 mm thickness for GIC and FRC and 1 mm thickness for CHC. Specimens of enamel and dentine with the same thicknesses were obtained. As a control, an aluminium stepwedge was used. Radiographs were taken with a digital Kodak RVG 5000 (0.32 s, 30 cm). The images were analysed using the Image Tool^® program (v. 2.00; The University of Texas Health Science Center, San Antonio, TV) to obtain the mean grey values.

Results:

Analysis of variance was used to investigate the significance of differences among the groups. For pairwise comparisons, the Tukey test was applied (p < 0.05). The GICs Ionomaster (Wilcos, Petrópolis, Brazil), Maxxion (FGM, Joinville, Brazil), Bioglass R (Biodinâmica, Ibiporã, Brazil), Bioglass F (Biodinâmica), Vidrion R (SS White, Rio de Janerio, Brazil) and Vidrion F (SS White), presented radio-opacity lower than that of dentine. All FRCs and CHCs studied showed radio-opacity higher than that of dentine. Vitro Fil (DFL, Rio de Janeiro, Brazil), Magic Glass (Vigodent, Rio de Janeiro, Brazil), Vitrebond (3M, Sumaré SP, Brazil), Riva Self Cure (SDI, Victoria, Australia), Riva Light Cure (SDI), Fill Magic (Vigodent), Opallis (FGM, Joinville, Brazil), Surefil SDR (Dentsply, Milford, DE), Tetric N (Ivoclar Vivadent, Schaan, Lichtenstein), Tetric (Ivoclar Vivadent), Hydro C (Dentsply, Petrópolis, Brazil), Hydcal (Technew, Madalena, Portugal) and Liner (Vigodent) showed radio-opacity similar to or greater than that of enamel for all thicknesses.

Conclusions:

The increased thickness of the materials studied increases their radio-opacity. Some commercially available GICs used as a base and liner for restorations have a very low radio-opacity (Ionomaster, Maxxion, Bioglass R, Bioglass F, Vidrion R and Vidrion F).