Cytomegalovirus-seronegative blood components for the prevention of primary cytomegalovirus infection after marrow transplantation. Considerations for blood banks

The authors report 2.5 years' experience with the use of cytomegalovirus (CMV)-seronegative blood components for the prevention of primary CMV infection after allogeneic marrow transplantation from seronegative marrow donors to 104 CMV-seronegative patients. Patients and blood donors were screened for CMV-seronegativity by a combination of passive latex agglutination, complement fixation, and indirect hemagglutination CMV antibody screening methods. Changes in blood banking procedures necessary to provide CMV-seronegative components are detailed. Providing CMV-seronegative components was a considerable undertaking; a mean, per patient, of 19 units of red cells and 105 units of platelets was required. Twenty percent of the platelet support was provided by family members and 80 percent by volunteer donors. CMV-infection was eliminated in all but one patient not considered infected at the time of transplantation. The capability to provide CMV-seronegative components depends on an adequate supply of seronegative donors, a sensitive and practical screening method for CMV antibody, a major commitment by the blood bank, and close communication between the blood bank and the patients' physicians.     

音乐疗法对门诊输液患者心理的影响

目的探讨中医五行音乐疗法对门诊输液患者心理安抚的作用与效果。方法2006年3月-2007年3月，按四时节气的不同，依据中医的五行相克理论，对治疗组的408例门诊输液患者进行音乐干预，而同期对照组396例门诊输液患者不接受音乐疗法。采用自制的调查表，获取他们对环境和服务的满意程度。结果治疗组患者，对门诊输液的满意度较对照组高，差异有统计学意义，P〈0.01。治疗组患者，对医院和本部的投诉率较对照组低，差异有统计学意义，P〈0.01。结论音乐疗法对门诊输液患者的心理有一定的安抚作用。     

组胺支气管激发试验在咳嗽变异性哮喘中的应用

目的探讨咳嗽变异性哮喘患者（CVA）组胺支气管激发试验的结果。方法对244例拟诊CVA用肺功能仪测定基础肺功能及吸入不同剂量组胺后的肺功能，对照激发前后结果。结果244例患者支气管激发试验阳性160例（65．57％），阴性77例（31．56％），可疑阳性7例（2．87％）。160例支气管激发试验阳性患者按支气管哮喘予吸入糖皮质激素及支气管舒张剂治疗，症状缓解。结论组胺支气管激发试验对咳嗽变异性哮喘的诊断具有临床意义，此方法安全适用。     

Primary care provider management of patients with obesity at an integrated health network: A survey of practices,views, and knowledge

Background

Obesity is a serious health problem that affects a wide range of patients and disease processes.

Total radical trapping antioxidant potential (TRAP) and exercise

The relationship between physical activity, physical fitness and total radical trapping antioxidant potential (TRAP) was examined in the Northern Ireland Health and Activity Survey. This was a cross-sectional population study (n = 1600) using a two-stage probability sample of the population. TRAP was calculated using the sum of the individual serum antioxidant concentrations (urate, protein thiols, ascorbate, alpha tocopherol and bilirubin) multiplied by their respective stoichiometric values. Physical fitness was determined by estimation of VO2max by extrapolation from submaximal oxygen uptake, and physical activity was recorded by computer-assisted interview. Mean serum TRAP concentrations were significantly higher in males (653 +/- 8.2 mumol/l, mean +/- SEM) compared to females (564 +/- 8.0 mumol/l) (p < 0.0001). Both male and female smokers had significantly lower TRAP values than non-smokers (males p < 0.0001, females p = 0.02). In females, there was a positive relationship of TRAP with age (p < 0.001) and body mass index (p < 0.001) but a negative relationship with physical fitness (p < 0.05). The known beneficial effects of exercise and activity do not appear to be directly mediated through increased antioxidant status.      

sHLA-G1重链分子、β_2m的体外表达及纯化研究

目的获得sHLA-G1重链分子及轻链β2微球蛋白(β2m)基因体外表达并纯化的相关蛋白质。方法RT-PCR扩增可溶性HLA-G1重链分子及人β2m轻链的cDNA序列,构建表达载体pET28a(+)/sHLA-G1及pET28a(+)/β2m,导入大肠杆菌BL21(DE3),IPTG诱导sHLA-G1及β2m蛋白表达,并以Ni-NTA亲和层析和CM-FF弱阳离子柱分别纯化,透析后浓缩保存。SDS-PAGE,Western-Blot鉴定目的蛋白的表达和纯化。结果成功克隆了sHLA-G1及2βm基因并构建了pET28a(+)-sHLA-G1、pET28a(+)-β2m原核高效表达载体;表达产物以可溶性形式存在,表达量>30%,纯化后产物纯度达到95%。结论成功表达并纯化出的sHLA-G1重链分子及轻链β2m有助于阐明可溶性HLA-G1的功能。     

两种不同固位结构附着体义齿修复游离端缺失基牙及缺牙区牙槽嵴应力分布的比较

目的探讨不同固位结构的附着体义齿应力分布特点,为临床应用附着体义齿种类的选择提供依据。方法应用三维有限元的方法分别测定并比较应用键槽缓冲式附着体和柱状附着体修复下颌单侧游离端缺失基牙及牙槽嵴应力分布情况。结果键槽缓冲式附着体义齿对基牙产生应力值小于柱状附着体义齿,对缺牙区牙槽嵴应力大于柱状附着体义齿。结论键槽缓冲式附着体义齿较适合于基牙条件差的义齿修复,柱状附着体义齿较适合于缺牙区牙槽嵴条件差的义齿修复。     

Mechanism of action of doxepin in the treatment of chronic urticaria

The present study examined 15 patients previously resistant to conventional antihistamines, in which doxepin at doses in the range of 50-75 mg/day was shown to be effective in treatment of chronic urticaria and without significant adverse side effects. However, some controversy remains about its mechanism of action in this particular disease. The aim of the present study was to examine the muscarinic, H1 and H2 blocking activity of doxepin. The following methods were used: a) gastric acid hypersecretion induced by histamine and carbachol in the pylorus-ligated rat preparation; b) contractile dose-response curves to histamine and carbachol in the guinea pig ileum; c) dimaprit-stimulated guinea pig atrium in vitro. pA2 values were determined for atropine, mepyramine, cimetidine and doxepin. As regards histamine, doxepin (50 mg/kg, po) increased gastric pH and decreased secretion volume, gastric acid concentration and total acid output; with carbachol, doxepin weakly antagonized those values. In the ileum, doxepin competitively antagonized carbachol (pA2 = 7.08) and histamine (pA2 = 9.72); pA2 values for atropine and mepyramine against carbachol and histamine were 9.11 and 8.82, respectively. In the atria, the dose-response curve to dimaprit was also competitively displaced by cimetidine (pA2 = 6.69) and doxepin (pA2 = 6.00). Doxepin displayed a very high affinity for H1 histamine receptor, being 8-fold more potent than mepyramine. Doxepin showed significant H2 blocking activity which was 5 times less potent than that of cimetidine. Doxepin competitively antagonized carbachol in the guinea pig ileum, and was 107 times less potent than atropine. The combined H1, H2 and muscarinic blocking activities of doxepin may contribute towards explaining its clinical efficacy in the treatment of chronic urticaria.     

A study of confidential unit exclusion

The effectiveness of the confidential unit exclusion (CUE) procedure recommended by the Food and Drug Administration has been questioned by the blood banking community. The purpose of this study was to determine whether donors were informing the blood center correctly regarding the disposition (transfuse or do not transfuse) of their donated blood. A letter explaining the confidential study and requesting permission to send the participant a questionnaire noting his or her self-exclusion choice was mailed to 230 donors who had chosen transfuse and 276 donors who had chosen do not transfuse. After consent was obtained, participants were sent a second packet and asked to indicate whether they had chosen correctly and, if not, to identify reasons for that incorrect choice. A seven-word terminology quiz made up of words from the CUE form was also enclosed. All participants who had chosen transfuse indicated that this was the correct choice. Approximately 50 percent of those who had chosen do not transfuse indicated that this was an incorrect choice; the most common reason was that "I was not paying attention." The most frequently misunderstood term was "confidential." Donors who chose do not transfuse had a significantly higher rate of error on the terminology quiz (p less than 0.01) than did those who chose transfuse.