Increased Ca2+ sensitivity of myofibrillar tension in ischaemic vs dilated cardiomyopathy

1. There is evidence that different aetiologies of heart failure, especially ischaemic vs dilated cardiomyopathy (ICM and DCM, respectively), may influence the prognosis of patients with this disease. Patients with ICM have a worse prognosis than those with DCM; the mechanisms underlying this difference have not yet been clarified. The aim of the present study was to investigate whether there are changes in myofibrillar function depending on the aetiology of human heart failure. 2. Ca²⁺‐dependent tension (DT) and actomyosin ATPase acitivity (MYO) in Triton X‐skinned fibre preparations of the left ventricular myocardium from patients with heart failure due to ICM (n = 5) and DCM (n = 5) were measured. Tension‐dependent ATP consumption was calculated by the ratio of DT and MYO (‘tension cost’). Non‐failing myocardium (NF) from donor hearts, which could not be transplanted because of technical reasons, was evaluated as a control. 3. Although DT was reduced, the myofibrillar Ca²⁺ sensitivity of DT and MYO, as well as tension cost, were increased in preparations from ICM and DCM myocardium compared with NF. The Ca²⁺ sensitivity of DT and MYO was significantly increased in ICM compared with DCM preparations, resulting in more economic cross‐bridge cycling in ICM than in DCM. 4. In conclusion, ICM is associated with an increased Ca²⁺ sensitivity of myofibrillar tension and ATPase activity accompanied by decreased tension cost compared with DCM. Thus, the worse prognosis associated with ICM does not seem to be due to differences in myofibrillar function.     

To Explore the Validity of Change Scores of the Children's Hand-use Experience Questionnaire (CHEQ) in Children with Unilateral Cerebral Palsy

Aims: To explore the validity of change scores of the Children's Hand-use Experience Questionnaire (CHEQ). Methods: Analysis of the CHEQ included 44 children (15 girls) between 6–16 years (median 9.0; IQR 8–11) with unilateral cerebral palsy, with baseline and post- (two-week intensive) intervention assessments using the Goal Attainment Scale (GAS) as external anchor for change. Hypotheses on the magnitude of expected change were formulated and correlation coefficients and effect sizes calculated. Receiver operating curve analysis was performed and the area under the curve (AUC) calculated to investigate the ability of CHEQ to discriminate between improvement and non-improvement according to GAS. Results: All hypotheses about the magnitude of change were confirmed supporting longitudinal validity of CHEQ scales to measure change in the perception of bimanual performance. AUCs for the Grasp efficacy and the Time utilization were slightly below, and for the Feeling bothered slightly above the threshold. The latter one accurately discriminating between children that improved and did not improve according to the GAS. Conclusions: Evidence was found that CHEQ scales capture change in bimanual performance but with limited accuracy for two out of three scales. The validity of CHEQ change scores needs to be further explored in a wider population.     

Synaptic plasticity of 5-hydroxytryptamine–immunoreactive terminals in the phrenic nucleus following spinal cord injury: A quantitative electron microscopic analysis

The present study was conducted to examine the plasticity of 5-hydroxytryptamine (5-HT)–immunoreactive terminals in the rat phrenic nucleus following an ipsilateral C2 spinal cord hemisection and 30-day survival period. A retrograde horseradish peroxidase (HRP) labeling technique was used to identify the phrenic motoneurons at the electron microscopic (EM) level. After employing a pre-embedding immunocytochemical technique, the ultrastructural characteristics of 5-HT–immunoreactive terminals were qualitatively and then quantitatively analyzed with a computerized morphometric system before and after injury in separate groups of rats. The results indicated that the majority of the 5-HT–labeled terminals formed axodendritic contacts, but some 5-HT–labeled terminals made axosomatic contacts. 5-HT terminals were associated with either asymmetrical or symmetrical synapses, and some displayed postsynaptic dense bodies. Approximately 2% of the 5-HT terminals had dense-core vesicles. Although the total number of labeled and unlabeled terminals in the phrenic nucleus was reduced after hemisection, the number of 5-HT terminals in the hemisected group was greater than that of the control group. Moreover, the total number and length of asymmetrical and symmetrical synaptic active zones per 5-HT terminal were significantly greater after injury. Finally, the total number of 5-HT terminals with multiple synapses was significantly greater in the hemisected group as compared to controls. It is possible that 5-HT synaptic plasticity may be part of the morphological substrate for the unmasking of the latent crossed phrenic pathway which mediates recovery of the ipsilateral hemidiaphragm paralyzed by C2 spinal cord hemisection. J. Comp. Neurol. 386:613–624, 1997. © 1997 Wiley-Liss, Inc.     

理科大学生网络成瘾与人格特质的关系

目的:分析理科大学生网络成瘾与其人格特质的关系。方法:于2005-09/11在上海某高校以班级为单位,对4个理科专业的220名学生进行问卷调查,4个专业分别是数学教育、计算机教育、物理师范和应用心理学。采用大学生因特网成瘾量表、交往焦虑量表、UCLA孤独量表和YG性格测验等4份问卷进行调查。大学生上网情况调查表共有52个题目,5级计分,成瘾诊断标准有耐受性、脱瘾综合症、计划性、控制性、行为特征、危害性、主观认识和行为等7个维度。按1,2,3,4,5记分,即每题填什么数记什么分,然后将各题得分相加得到维度分。判断标准:每题得1～3分转化为0分,4分转化为1分,5分转化为2分。测验每一部分导出分相加。若测验7部分中有3部分以上得分超过4分,则可基本诊断该大学生为因特网成瘾障碍患者。交往焦虑量表包含15个自陈条目,5级计分,总分从15(社交焦虑程度最低)到75(社交焦虑程度最高)。UCLA孤独量表(第3版)包含20个自陈条目,4级计分,总分从20(孤独程度最低)到80(孤独程度最高)。需要补充说明的是,交往焦虑量表是测量独立于行为的社交焦虑,UCLA孤独量表也主要是特质量表,因此这两个量表所测量的都是焦虑和孤独的人格特质而不是状态。YG性格测验问卷包含12个分量表,每个分量表有10个题目,测量一种特质。结果:共发出220份问卷,收回有效问卷211份。①成瘾者和非成瘾者在焦虑和孤独量表上的得分差异没有显著性意义。②成瘾者和非成瘾者在YG性格测验中的抑郁性、循环性、神经质、非合作性和攻击性等特质得分上,差异十分显著[(9.81±4.97),(5.95±5.10)分;(10.81±4.56),(6.78±4.46)分;(9.63±4.72),(6.51±4.67)分;(11.15±4.19),(7.28±4.43)分;(12.41±4.05),(8.69±3.69)分,均P<0.001],自卑感、主观性和细致性等特质得分上差异显著[(9.15±4.51),(6.83±4.49)分;(10.04±3.50),(7.63±4.09)分;(12.67±3.45),(10.26±4.23)分,P<0.01或P<0.05],在一般活动性、思维外向性、支配性和社会外向性等特质得分上两者没有差异。结论:理科大学生的部分人格特质和网络成瘾密切相关。     

有症状门诊病人深静脉血栓形成的诊断,临床评价和D-二聚体分析可能减少对影像学诊断的需要

深静脉血栓形成(DVT)的年发病率为48-182／10万,一般估计为1／1000。DVT病死率为1%-5%,发病率和病死率与年龄密切相关。慢性疼痛、肿胀、偶尔腿部皮肤溃疡等血栓后综合征见于1／3发生过DVT的患者。血栓后综合征可出现较早,也可迟至10年才出现,总的发病率为2年23%,5年28%。患者如使用弹力加压袜至少2年以上,腿部病变的发生率可     

Is the Routine Check Nephrostogram Following Percutaneous Antegrade Ureteric Stent Placement Necessary?

Our aim was to review our experience with percutaneous antegrade ureteric stent (PAUS) placement and to determine if the routinely conducted check nephrostogram on the day following ureteric stent placement was necessary. Retrospective review of patients who had undergone PAUS placement between January 2004 and December 2005 was performed. There were 83 subjects (36 males, 47 females), with a mean age of 59.9 years (range, 22–94 years). Average follow-up duration was 7.1 months (range, 1–24 months). The most common indications for PAUS placement were ureteric obstruction due to metastatic disease (n = 56) and urinary calculi (n = 34). Technical success was 93.2% (96/103 attempts), with no major immediate procedure-related complications or mortalities. The Bard 7Fr Urosoft DJ Stent was used in more than 95% of the cases. Eighty-one of 89 (91.0%) check nephrostograms demonstrated a patent ureteric stent with resultant safety catheter removal. Three check nephrostograms revealed distal stent migration requiring repositioning by a goose-snare, while five others showed stent occlusion necessitating permanent external drainage by nephrostomy drainage catheter reinsertion. Following PAUS placement, the serum creatinine level improved or stabilized in 82% of patients. The serum creatinine outcome difference between the groups with benign and malignant indications for PAUS placement was not statistically significant (p = 0.145) but resolution of hydronephrosis was significantly better (p = 0.008) in patients with benign indications. Percutaneous antegrade ureteric stent placement is a safe and effective means of relief for ureteric obstruction. The check nephrostogram following ureteric stent placement was unnecessary in the majority of patients.     

血浆置换显示干细胞移植后环孢素A引起的微血管病溶血性贫血和利福平的相应颜色反应

患者为1例39岁女性,患T/NK细胞淋巴瘤,在外周血异基因干细胞移植后15天,发生环孢素A(CSA)毒性相关的微血管病溶血性贫血(MAHA).因血清肌酐从移植前的0.4mg/dL,上升至移植后第9和15天的1.0和2.9 mg/dL.故停用CSA.