Emergency department visits for asthma: the role of frequent symptoms and delay in care.

BACKGROUND: Use of the emergency department (ED) for asthma care is a costly form of health care that is largely preventable. However, little is known about how to reduce the number of people using the ED for asthma care. OBJECTIVE: To identify modifiable factors related to ED visits for asthma among a diverse nonelderly adult population. METHODS: This study used cross-sectional data from the 2001 California Health Interview Survey. A total of 4,359 adult respondents ages 18 to 64 years who reported being diagnosed as having asthma and experiencing symptoms in the past year were included. Any ED visits due to asthma in the previous 12 months among all nonelderly respondents with asthma, with stratification by those with daily or weekly symptoms and with less frequent symptoms, were examined. RESULTS: Adults with daily or weekly asthma symptoms, with fair or poor health status, and who delayed care for asthma because of cost or insurance issues were more likely to visit the ED for asthma. Stratification of the study population into those with daily or weekly symptoms and those with less frequent symptoms revealed that delay in care due to cost or insurance issues and fair or poor health status remained significant for both groups. Latinos and women were more likely to visit the ED in the severe asthma group, whereas Asian, African American, and uninsured adults were more likely to visit the ED in the group with less severe asthma. CONCLUSIONS: Results suggest that to prevent ED visits for asthma, it is important to control asthma symptoms. However, it is equally if not more important to reduce delays in receiving asthma care.     

His-tag 不影响 RSV 重组蛋白GIF/M2 的免疫原性

目的:观察 His-tag 是否影响 RSV 重组蛋白 GIF/M2 的免疫原性.方法:PCR 扩增 G1 和 F/M2 基因片段,插入表达载体 pET-His 和 pET-DsbA-His 中,转化E.coli BL21(DE3),IPrG 诱导表达,采用 Ni+螯合亲和层析法纯化得 His-GlF/M2 和 DsbA-His-GIF/M2,将后者用凝血酶消化,再经Ni+螯合亲和层析法纯化得 GIF/M2,将 His-GIF/M2 和 GIF/M2 免疫 BALB/c 小鼠,用 ELISSA 测定抗体滴度,MTT 法测定细胞毒性 T 细胞活性(CTL).结果:两种蛋白在BALB/ c 小鼠中诱导的 RSV 特异性抗体和 CTL 活性无显著差异.结论:His-tag 不影响 RSV 重组蛋白GIF/M2 的免疫原性.     

Pleiotropic genomic variants at 17q21.31 associated with bone mineral density and body fat mass: a bivariate genome-wide association analysis

Osteoporosis and obesity are two severe complex diseases threatening public health worldwide. Both diseases are under strong genetic determinants as well as genetically correlated. Aiming to identify pleiotropic genes underlying obesity and osteoporosis, we performed a bivariate genome-wide association (GWA) meta-analysis of hip bone mineral density (BMD) and total body fat mass (TBFM) in 12,981 participants from seven samples, and followed by in silico replication in the UK biobank (UKB) cohort sample (N = 217,822). Combining the results from discovery meta-analysis and replication sample, we identified one novel locus, 17q21.31 (lead SNP rs12150327, {"type":"entrez-nucleotide","attrs":{"text":"NC_000017.11","term_id":"568815581"}}NC_000017.11:g.44956910G > A, discovery bivariate P = 4.83 × 10⁻⁹, replication P = 5.75 × 10⁻⁵) at the genome-wide significance level (ɑ = 5.0 × 10⁻⁸), which may have pleiotropic effects to both hip BMD and TBFM. Functional annotations highlighted several candidate genes, including KIF18B, C1QL1, and PRPF19 that may exert pleiotropic effects to the development of both body mass and bone mass. Our findings can improve our understanding of the etiology of osteoporosis and obesity, as well as shed light on potential new therapies.Subject terms: Genome-wide association studies, Gene expression profiling     

Development of a Western Blot Assay for Detection of Antibodies against Coronavirus Causing Severe Acute Respiratory Syndrome

To identify a major antigenic determinant for use in the development of a rapid serological diagnostic test for severe acute respiratory syndrome (SARS) coronavirus infection and to study the immune response during SARS coronavirus infection in humans, we cloned the full length and six truncated fragments of the nucleocapsid gene, expressed them, and purified them as glutathione S-transferase-tagged recombinant proteins. The reactivities of the recombinant proteins to a panel of antibodies containing 33 SARS coronavirus-positive sera and 66 negative sera and to antibodies against other animal coronaviruses were screened. A truncated 195-amino-acid fragment from the C terminus of the nucleocapsid protein (N195) was identified that had a strong ability to detect antibodies against SARS coronavirus. No cross-reaction was found between the N195 protein and antibodies against chicken, pig, and canine coronaviruses. The N195 protein was used to develop a Western blot assay to detect antibodies against SARS coronavirus in 274 clinically blinded samples. The specificity and sensitivity of this test were 98.3 and 90.9%, respectively. The correlation between our Western blotting assay and an immunofluorescence assay (IFA) was also analyzed. The results of our Western blot assay and IFA for the detection of SARS coronavirus-positive sera were the same. Thus, the N195 protein was identified as a suitable protein to be used as an antigen in Western blot and other possible assays for the detection of SARS coronavirus infection.     

Springer Link及其收录的医学期刊分析

目的：向图书馆员和用户介绍Springer Link，对其收录的医学期刊进行深入分析，使该数据库得到更好的利用。方法利用《外国报刊目录》和美国《医学索引》(IM)的《引用期刊一览表》等对Springer Link收录的英文医学期刊从权威性、出版地分布、学科分布和收藏年限等方面进行考查。结果86％的期刊被IM引用，欧洲——尤其是德国的期刊较多，医学各学科都有相应的期刊被收录，但数量分布不均，有所偏重，72．7％的期刊可以保证至少近5年或自创刊以来的文献。结论Springer Link所提供的全文医学期刊服务质量较上乘，并有自己的特色。     

澳门中学生精神信仰的现状研究

目的考察澳门中学生精神信仰的现状与特点。方法采用中学生精神信仰问卷对1379名澳门中学生的精神信仰进行调查。结果1澳门中学生在一级信仰因素上的均值排列顺序由高到低依次是实用信仰、社会信仰、超自然信仰。在7个二级信仰维度上的均值排列顺序由高到低依次为家庭主义、生命崇拜、国家民族、政治信仰、神灵崇拜、金钱物质、宗教信仰。2女生在宗教信仰和神灵崇拜上的得分显著高于男生。3高三年级学生在金钱物质和国家民族的信仰程度最高,得分高于其他年级。4学生干部在国家民族、政治信仰、生命崇拜和家庭主义上的得分显著高于非学生干部。5学习成绩好的学生和成绩中等的学生在国家民族、政治信仰和家庭主义上的得分显著高于学习成绩差的学生。结论澳门中学生的精神信仰总体上是积极健康向上的。     

A study on facial features of children with Williams syndrome in China based on three‐dimensional anthropometric measurement technology

To describe special facial features of children with Williams syndrome in China by using method of three‐dimensional craniofacial anthropometry. Using three‐dimensional stereo photogrammetric device, 14 craniofacial anthropometric measurements were performed and five indices were calculated in 52 children with Williams syndrome and 208 age and sex matched controls of Han Chinese ethnicity. Except intercanthal width, mouth breadth, morphological face height, nasal height‐breadth index, nasal breadth‐depth index, morphological ear index, the Williams syndrome group under 3 years old were smaller than the control group in the other 12 variables. Compared with the control group, the Williams syndrome group aged 3–5 years old had smaller biocular breadth, nasal length, nasorostral angle, bitragal breadth, ear width, morphological ear index and face depth. The Williams syndrome group aged above 6 years old had smaller biocular breadth, nasal breadth, bitragal breadth, ear width, ear length and face depth than the control group. The craniofacial variability index of the Williams syndrome group was greater than the control group. Greater variation was found among children with Williams syndrome than normal in China, specifically at eye, nose, ear and face shape, which demonstrate the usefulness of three‐dimensional stereo photogrammetric analysis in supporting accurate diagnose of the patient with Williams syndrome.     

硫酸软骨素酶ABC对大鼠脊髓损伤修复的影响

为了探讨硫酸软骨素酶ABC对脊髓损伤后损伤局部瘢痕形成和脊髓传导功能修复的影响,本研究首先制作大鼠脊髓全横断损伤动物模型,并将其分为脊髓损伤组(A组)和脊髓损伤治疗组(B组)。在观察期内对动物的行为学表现进行BBB评分;用免疫荧光组织化学方法观察损伤4周后硫酸软骨素酶ABC对损伤局部的硫酸软骨素蛋白聚糖(CSPGs)的裂解作用;用辣根过氧化物酶(HRP)示踪法观察损伤8周后神经纤维的再生情况。结果显示:A组与B组之间动物的行为学评分B组优于A组,有显著性差异(P<0.01);B组动物脊髓内硫酸软骨素蛋白聚糖阳性物质的表达明显低于A组,具有显著性差异(P<0.05),而硫酸软骨素核心蛋白的表达无显著性差异(P>0.05);HRP示踪法显示B组脊髓损伤头端可见少量HRP标记的神经元胞体和纤维。本研究结果提示硫酸软骨素酶ABC能够裂解CSPGs中的葡胺聚糖链,减少瘢痕,促进损伤的神经纤维再生。     

卡维地洛对氧自由基诱导的内皮细胞内源性一氧化氮合酶抑制物代谢的影响

目的： 观察卡维地洛对氧自由基（OFR）培养的人脐静脉内皮细胞（HUVECs）二甲精氨酸-二甲赖氨酸水解酶 (DDAH)活性及表达的影响，以探讨卡维地洛对不对称二甲精氨酸（ADMA）代谢机制的影响。 方法： 采用改良的Jaffe法培养原代人脐静脉内皮细胞（HUVECs），取生长良好的3-6代HUVECs用于实验，分为①空白对照组：加DMEM培养液；②OFR组:加入OFR（0.01 mmol/L,0.1 mmol/L）；③OFR+卡维地洛组: 同时加入0.1 mmol/L OFR及卡维地洛（10 μmol/L）共孵24 h后, 检测上清液中一氧化氮（NO）、内皮素（ET）、ADMA含量、L-胍氨酸(L-cit)浓度及一氧化氮合酶（NOS）活性。用Western blotting法测定细胞裂解液中二甲基精氨酸-二甲基赖氨酸水解酶 (DDAH)的蛋白表达。 结果： OFR条件培养下,内皮细胞的代谢产物ADMA、ET的量均高于空白对照组,而NO的量及NOS的活性少于空白对照组;反映DDAH酶活性的L-cit浓度显著降低,且有浓度依赖性，而DDAH的表达无明显变化。卡维地洛干预组的ADMA、ET的量均低于OFR组，NOS活性及NO、L-cit浓度明显高于OFR组。 结论： OFR培养下，内皮损伤ADMA的增加与DDAH的活性减弱有关，而与DDAH的表达无关。卡维地洛通过增加DDAH活性促进ADMA代谢，使NOS活性增加，抑制OFR对内皮功能的损伤。     

多重耐药鲍曼不动杆菌相关耐药基因检测分析

目的为了解多重耐药鲍曼不动杆菌β-内酰胺酶（BLA）基因、氨基糖苷类修饰酶（AMFs）基因、消毒剂与磺胺类耐药基因（qacE△1-sul1）和1类整合子酶基因（intl1）存在情况。方法对2005年1—6月份临床分离的31株多重耐药菌株（耐哌拉西林、第三代头孢菌素、环丙沙星和阿米卡星），应用聚合酶链反应及序列分析方法分析其BLA、AMEs、qacE△1．sull和intl1基因类型。结果31株多重耐药鲍曼不动杆菌对多黏菌素B敏感，有3株（9．7％）对受试的其他18种抗菌药物均耐药。19株（61．3％）检出了β-内酰胺酶基因，其中TEM、PER、DHA阳性率分别为61．3％、19．4％、3．2％，未检出SHV、OXA-23、OXA-24、GES、IMP和VIM等基因。25株（80．6％）检出氨基糖苷类修饰酶基因，其中aac（3）-I、aac（6’）-I、ant（3”）-I、ant（2”）-I、aac（3）-Ⅱ、aac（6’）-Ⅱ阳性率分别为67．7％、45．2％、29．0％、22．6％、9．7％、3．2％。qacE△A1-sul1、intl1阳性率分别为80．6％、58．1％。分离株常见的基因组合是TEM＋qacE△1-sul1＋intl1和TEM＋PER＋qacE△1-sull＋intl1，分别占25．8％和19．4％。分离株AMEs的常见的基因组合是aac（3）-I＋aac（6’）-I和nnc（3）-I＋aac（6’）-I＋ant（2”）-I，分别占19．4％和12．9％。结论临床分离的多重耐药鲍曼不动杆菌TEM、nnc（3）-I、nnc（6’）-I、ant（3”）-I、ant（2”）-I、qacE△1-sul1和intl1基因携带率高。