Age at first drink and the first incidence of adult-onset DSM-IV alcohol use disorders

Background: Existing studies of the association between age at first drink (AFD) and the risk of alcohol use disorders (AUD) suffer from inconsistent levels of control and designs that may inflate associations by failure to control for duration of exposure to risk. Methods: This study examined associations between AFD (ages <15 and 15–17 vs. 18+ years) and first incidence of DSM‐IV alcohol dependence, abuse, and specific AUD criteria over a 3‐year follow‐up in a longitudinal study of U.S. drinkers 18 years of age and older at baseline (n = 22,316), controlling for duration of exposure, family history, and a wide range of baseline and childhood risk factors. Results: After adjusting for all risk factors, the incidence of dependence was increased for AFD < 15 years (OR = 1.38) and for women only with AFD at ages 15 to 17 (OR = 1.54). The incidence of abuse was increased at AFD <15 and 15 to 17 years (OR = 1.52 and 1.30, respectively). Most dependence criteria showed significant associations with AFD, but hazardous drinking and continued drinking despite interpersonal problems were the only abuse criteria to do so. All associations were nonsignificant after controlling for volume of consumption, except that AFD at all ages <18 combined was associated with a reduced likelihood of impaired control, and AFD at ages 15 to 17 was associated with lower odds of drinking more/longer than intended among heavy‐volume drinkers. In a population of low‐risk drinkers that excluded those with positive family histories, personality disorders, and childhood risk factors, there were strong associations between early AFD (<18) and the incidence of dependence (OR = 3.79) and continued drinking despite physical/psychological problems (OR = 2.71), but no association with incidence of abuse. Conclusions: There is a robust association between AFD and the risk of AUD that appears to reflect willful rather than uncontrolled heavy drinking, consistent with misuse governed by poor decision‐making and/or reward‐processing skills associated with impaired executive cognitive function (ECF). Additional research is needed to determine causality in the role of impaired ECF, including longitudinal studies with samples of low‐risk adolescents.     

罗格列酮联合阿司匹林对糖尿病伴代谢综合征的疗效

目的:探讨罗格列酮联合阿司匹林对糖尿病伴代谢综合征的治疗效果。方法:纳入观察和统计的糖尿病伴代谢综合征患者80例,随机分为对照组与观察组,每组40例。对照组治疗药物为阿司匹林肠溶片,观察组治疗药物为罗格列酮分散片加阿司匹林肠溶片,比较两组治疗前后胰岛素、血脂、尿微量白蛋白(M-Alb)和不良反应发生率。结果:两组治疗后与治疗前比较,空腹血清胰岛素(F-INS)和胰岛素抵抗指数(HOMA-IR)水平均明显降低、胰岛素分泌指数(HOMA-IS)水平明显升高(P<0.05或P<0.01),总胆固醇(TC)、甘油三酯(TG)和尿M-Alb水平均明显降低(P<0.05或P<0.01)。观察组治疗后与对照组比较,F-INS和HOMA-IR水平降低更显著(P<0.05)、HOMA-IS水平升高更显著(P<0.01),TC、TG和尿M-Alb水平降低更显著(P<0.05或P<0.01)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:罗格列酮联合阿司匹林治疗糖尿病伴代谢综合征的疗效显著,可使机体血脂与胰岛素抵抗得到有效调节。     

The emergence of HIV-1 primary drug resistance genotypes among treatment-naïve men who have sex with men in high-prevalence areas in China

The prevalence of HIV-1 infection in men who have sex with men (MSM) in China has drastically increased, and circulating strains may have acquired transmitted drug resistance (TDR). We determined TDR genotypes among antiretroviral therapy (ART)-naïve MSM in 19 provinces/cities where HIV-1 prevalence among MSM is high, and found an overall 4.9 % TDR rate. Although protease inhibitors (PI) were not in the first-line antiretroviral drug list provided through the National ART Program, 70.4 % of the detected TDR belongs to this category. Our findings confirm the urgent need for TDR surveillance in order to optimize treatment effects of the National ART Program.     

Clinical implications of procalcitonin in Kawasaki disease: a useful candidate for differentiating from sepsis and evaluating IVIG responsiveness

Clinical and Experimental Medicine - Kawasaki disease (KD) is an acute systemic vasculitis and suspected to be triggered by several potential infections in which procalcitonin (PCT) experiences an...     

Interpretation of the mechanism of 3,3′-dichloro-4,4′-diamino diphenylmethane synthesis over HY zeolites

Catalytic activities of zeolites HY, Hβ and HZSM-5 in the heterogeneous synthesis of 3,3′-dichloro-4,4′-diaminodiphenyl methane (MOCA) from o-chloroaniline and formaldehyde were pre-screened in an autoclave, and HY demonstrated better performance than others. Kinetic behaviors of MOCA synthesis over HY(11) were further investigated in a fixed bed continuous flow reactor, and under the conditions of the catalyst bed volume = 20 mL (8.14 g), n(o-chloroaniline) : n(HCHO) = 4 : 1, LHSV = 3.5 h⁻¹, 0.5 MPa and 443 K, HCHO conversion and MOCA selectivity steadily fluctuated at high levels of 90–92% and 75–77% during 16 h, respectively. Catalysts were characterized by BET, NH₃-TPD and XRD, products analyzed by HPLC, and reaction intermediates identified by LC/MS and ¹H NMR. The mechanism of MOCA synthesis has been interpreted in detail, which also suggested that deposition of basic intermediates on active sites and accumulation of polymeric by-products in pore channels of the catalyst could cause significant decay of HY(11) activity and selectivity under severe conditions. Supplementary tests on catalyst regeneration confirmed that the acidity and surface area of spent HY(11) could be well recovered after burning off the deposited by-products.

Catalytic activities of zeolites HY, Hβ and HZSM-5 in the heterogeneous synthesis of 3,3′-dichloro-4,4′-diaminodiphenyl methane (MOCA) from o-chloroaniline and formaldehyde were pre-screened in an autoclave, and HY demonstrated better performance than others.     

The 50 Most-cited Articles in Orthopaedic Surgery From Mainland China

Background

Citation analysis has been widely used to evaluate the impact of articles in medical and surgical specialties. Although China is the most populous country in the world, and although more than 50,000 orthopaedic surgeons practice there, to our knowledge no formal citation analysis of Chinese orthopaedic articles has been performed.

Questions/purposes

We identified the 50 most-cited orthopaedic articles from mainland China and evaluated these articles in terms of their language of publication, source journals, and topics.

Methods

Science Citation Index Expanded was searched in July 31, 2014 for citations of articles published in 70 selected journals since the inception of the database. The 50 most-cited orthopaedic articles originating in mainland China were identified. Basic information, including title, authors, year of publication, article type, journal in which the work was published, city, institution, number of citations, decade published, and topic or subspecialty of the research were recorded.

Results

The number of citations for the top 50 papers ranged from 181 to 31 (mean, 52). These articles were published between 1981 and 2010. The decade of 2000 to 2009 was the most prolific, with 36 of the top 50 articles published during this time. All articles were written in English and they were published in a total of 16 journals. The journal Spine published the largest number of articles (12), followed by Clinical Orthopaedics and Related Research^® (seven). The journal Lancet had the highest impact factor (39.207 for 2013) among any of the journals that published articles we identified. The top 50 articles originated mainly from Beijing (16) and Shanghai (12), with basic research being the focus of the majority (27 of 50; 54%); the remaining were clinical studies. Bone was the most-investigated topic in basic research; the spine was the most-common topic among the identified clinical studies.

Conclusions

The 50 most-cited articles that we identified should be considered influential, although a large gap remains between mainland China and the global orthopaedic community in terms of citations per article. Nevertheless, insofar as the most-recent decade of our survey generated the most articles in this top-50 list, we would characterize mainland China’s effect on musculoskeletal research as increasing, and as funding increases to programs in mainland China, we anticipate this trend will continue in the future.