吸烟与中国人膀胱癌相关性的多中心病例对照研究

目的 调查吸烟与中国人膀胱癌发病的相关性。方法 2005年9月至2008年6月期间运用多中心病例对照研究调查432例膀胱癌患者和392例对照者（非泌尿系统恶性肿瘤患者）,通过问卷调查的方式对吸烟方式、开始吸烟年龄、戒烟时间、吸烟量、烟雾吸入深度等项目进行调查,评估所有关联因素导致膀胱痛发生的危险性及所对应的95％可信区间。结果 主动、被动吸烟者均会增加膀胱癌的危险性(P＜0.05),现吸烟组的比例高于对照组（40. 7％和28. 1％）,与非吸烟者相比主动吸烟的膀胱癌危险相关性增加1.89倍。吸烟数量增加与膀胱癌发生的风险具有明显相关性(P＜0.05),膀胱癌发生的危险性随着烟龄的延长而增加(P＜0.05),但与最初开始吸烟的年龄无关(P＞0. 05),而将烟雾吸入口或喉会明显增加膀胱癌的危险性(P＜0.05)。结论 吸烟是中国人膀胱癌的明显致病因素,且主/被动吸烟、烟龄、吸烟的数量及烟雾吸入位置均与膀胱癌的发生具有明显相关性,不吸烟是预防膀胱癌发生最好的方式。     

Effects of acupoints TENS on heat pain threshold in normal subjects

Objective To delineate the influence of transcutaneous electrical nerve stimulation (TENS) on heat pain threshold and vibration threshold in human. Methods Twenty healthy, young subjects, aged from 20 to 39, participated in the study. They were randomly allocated into either TENS or placebo group. Thirty minutes of conventional TENS (200 μs pulses at 100 Hz and 2-3 times sensory threshold) or placebo stimulation was applied to the acupuncture points (LI4) on each subject’s left hand. Heat pain and vibration thresholds were measured using Medoc TSA-2001 and VSA-3000 respectively on the thenar eminence of each subject’s left hand. These assessments were done at 30, 20 and 10 minutes before and 0, 10, 20, 30, 40 and 50 minutes after 30 minutes of TENS or placebo treatment. Results This study showed a significant increase in heat pain threshold by 0.81℃ and 1.54℃ respectively at 0 (P=0.002) and 20 minutes (P=0.004) after 30 minutes of TENS application to the LI4 acupoint of young healthy subjects, compared with placebo stimulation. Interestingly, no significant difference in vibration threshold was found between the TENS and placebo groups. Conclusion The effect of TENS on the acupoint is to reduce pain but not tactile (specifically vibration) sensibility.     

Clinical and genetic features of variegate porphyria in a Chinese patient

Acute porphyria is rare in orientals. We describe a Chinese woman with recurrent generalised tonic-clonic seizures and abdominal pain. Genomic DNA studies identified a heterozygous base substitution from guanine to adenine at nucleotide position 503, resulting in substitution of arginine by histidine at position 168 of the protein (R168H). This genetic abnormality is similar to the mutation reported in Caucasians with variegate porphyria. To the best of our knowledge, this is the first report in the English literature a Chinese patient with variegate porphyria with an identifiable mutation. A brief review of porphyria is presented.     

Chemoattractant-induced changes in surface expression and redistribution of a functional ligand for P-selectin on neutrophils

Adhesion between platelets and neutrophils is mediated through the interaction of P-selectin on activated platelets with a carbohydrate- containing structure on neutrophils, and occurs under both static and shear conditions. Recent studies using flow chambers have shown that neutrophils become activated after binding to surface-adherent platelets expressing P-selectin. The objective of the present study was to investigate the effect of such activation on the interactions of platelet P-selectin with its ligand on neutrophils. Flow cytometric analyses using P-selectin chimeras revealed that activation induced a rapid and marked reduction in chimera binding, with levels of binding decreased by 71% after 15 minutes of stimulation with the chemotactic agent, FMLP. Using a visual assay of platelet-neutrophil rosetting, we showed that the P-selectin ligand was translocated and clustered at the uropod of neutrophils following the shape changes and polarization induced by chemotactic stimulation. Activated neutrophils bound to surface-adherent platelets also displayed the clustering of P-selectin ligand at the uropod, and these neutrophils detached from the platelets when a shear stress (2 dynes/cm2) was applied through the adhesion chamber. These results indicate that chemotactic stimulation of neutrophils induces changes in the surface expression and distribution of a biologically relevant ligand for P-selectin, and that these changes might influence the adhesive interactions occurring between neutrophils and activated platelets.     

Burdens and Psychological Health of Family Caregivers of People with Schizophrenia in Two Chinese Metropolitan Cities: Hong Kong and Guangzhou

Family members charged with the care of those suffering from schizophrenia experience considerable stress due to their multiple responsibilities. Research regarding the burdens of caregiving is scant in Hong Kong and China. The present study quantified the association of the duties of caregivers with mental health symptoms in two Asian cities having distinct health care systems (i.e., Hong Kong and Guangzhou, China). Thirty nine caregivers in Hong Kong and 70 caregivers in Guangzhou were recruited from nongovernmental mental health organizations. They were assessed using the Chinese version of the Involvement Evaluation Questionnaire and the General Health Questionnaire. While the Guangzhou family caregivers had a significantly higher burden than the Hong Kong sample, there was no significant difference in the psychological health status of family caregivers in the two cities. Result of correlational analyses, however, revealed high associations between burden of care variables and the psychological health of the caregivers. Findings for the present study have implications regarding the physical and mental health needs of those caring for seriously disturbed relatives.     

Clinical features and outcome in childhood T-cell leukemia-lymphoma according to stage of thymocyte differentiation: a Pediatric Oncology Group Study

The immunophenotypes of lymphoblasts from children with newly diagnosed T-cell acute lymphoid leukemia (T-ALL, n = 101) or T-cell non-Hodgkin lymphoma (T-NHL, n = 31) were analyzed to correlate stage of thymocyte differentiation with clinical features and outcome. The 67 boys and 34 girls with T-ALL were 1 month to 18 years old (median, 8 years) with leukocyte counts ranging from 2 to 810 x 10(9)/L (median, 55 x 10(9)/L). Eighteen of these patients were black, and 70 had a mediastinal mass. Twenty-six boys and five girls with a median age of 9 years (range, 1 to 20 years) had T-NHL. Seven of these patients were black, and 24 had a mediastinal mass. The distributions of thymocyte developmental stages (early [CD7+], intermediate [CD1+ and/or CD4+ and/or CD8+], and mature [CD3+]) in cases of T-ALL and T-NHL were significantly different: 34%, 43%, and 23% v 6%, 62%, and 32% (P = .02). A comparison of the patients' clinical features according to the maturational stage of thymocytes failed to disclose significant differences in the majority of characteristics studied. However, patients with mature-stage T-NHL, with or without the addition of subjects with mature-stage T-ALL, were less likely to have a mediastinal mass (P = .02 for both comparisons). Those with intermediate-stage T-cell malignancy (T-ALL and T-NHL combined) were the subgroup most likely to have a mediastinal mass (P = .01). Response to remission induction therapy was significantly worse in the T-ALL subgroup with an early-stage phenotype: a failure rate of 21% v 0% and 6% for the two more differentiated phenotypic subgroups (P = .007). Event-free survival was not affected by thymocyte maturational stage in cases of either T-ALL or T-NHL. Despite evidence of clinical heterogeneity among the maturational stages of T-cell malignancies in children, these developmental subdivisions do not appear to be critical determinants of outcome once remission is achieved. We conclude that such phenotypes need not be included in the stratification plans for clinical trials using common induction treatment.     

Bamboo skewer perforation of the bowel: Computed tomography appearances

A 25-year-old Chinese woman presented with a painful left-lower-quadrant abdominal mass. Computed tomography (CT) demonstrated a dense forked foreign body within an extraluminal mass. A 2.5 cm bamboo skewer surrounded by inflamed omentum was found at laparotomy. Different CT densities of bamboo skewers were obtained when exposed to air, water and 2% Gastrografin in an in vitro experiment. Awareness of the possible variations in appearances of wooden foreign bodies in and around the bowel may aid their CT diagnoses.