Nitric oxide synthase induction by ouabain in vascular smooth muscle cells from normotensive and hypertensive rats

OBJECTIVE: To investigate the effect of ouabain on inducible nitric oxide synthase (iNOS) activity and expression in cytokine-stimulated vascular smooth muscle cells (VSMC) from normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). METHODS: VSMC were treated for 24 h and afterwards, nitric oxide (NO) release was determined by the production of nitrite, a stable metabolite of NO. Activity of iNOS was measured by the conversion of [3H]-L-arginine to [3H]-L-citrulline and iNOS protein expression by Western blotting. RESULTS: Ouabain (0.01-1 mmol/l) further enhanced interleukin-1beta (II-1beta)-induced nitrite production by WKY and SHR VSMC, although a more pronounced effect was observed in SHR cells (maximum response 52.1 +/- 5.2 and 71.2 +/- 6.4% of 11-1beta effect in WKY and SHR cells, respectively). Such response on NO release was mimicked by the calcium ionophore A 23187 (0.01-1 micromol/l) and abolished by the voltage-operated calcium channels (VOCC) nifedipine (0.1 micromol/l). Expression of iNOS showed that ouabain increased the synthesis of the enzyme in WKY and SHR VSMC stimulated with II-1beta, and this effect was higher in SHR cells. The increased iNOS expression was significantly reduced by nifedipine. CONCLUSIONS: Ouabain stimulation of iNOS expression and activity in II-1beta-stimulated VSMCs from WKY rats and SHR seems to be related to increased intracellular calcium influx through VOCC. The more pronounced effect observed in SHR VSMC could be explained by an altered calcium entry in the hypertensive strain.     

WHO生存质量评估简表的等价性评价

目的评价WHO生存质量评估简表(WHOQOL-BREF)在13个国家的等价性。方法采用多组验证性因子分析方法,对世界卫生组织生存质量研究小组提供的13个国家的数据进行分析,评价WHOQOL-BREF不同国家的等价性。结果各个国家的各个领域的Cronbachα系数均大于0·7,分布在0·7至0·88之间。除了英国和挪威之外,其它国家的社会关系领域的Cronbachα系数均大于0·65。采用根据世界卫生组织生存质量研究小组研制量表时构建的四因子模型对数据分别进行拟合,拟合优度指数(CFI)均大于0·8,其中德国、西班牙和美国的拟合优度指数大于0·9。多组验证性因子分析发现模型拟合尚可,CFI等于0·88,各个国家的因子负荷不全相等,因子负荷的轮廓相似。结论WHOQOL-BREF在13个国家具有相同的因子结构,且有等价性。     

针式腹腔镜下胆囊切除术的临床应用

目的 与开腹胆囊切除术相比,腹腔镜胆囊切除术（ＬＣ）有减少术后不适和较少的创作,但仍有改进的余地。方法：为进一步减轻手术创伤,我们引进了针式腹间胆囊切除术,共２９例。结果 平均手术时间为７５分钟,１９例当天出院,１０例隔天出院,其中１例是胆总管探查。结论 针式航空 镜胆囊切除术是一种可靠的技术。     

Long‐term effects of rapid weight gain in children,adolescents and young adults with appropriate birth weight for gestational age: the kiel obesity prevention study

Aim: This study investigates the effect of rapid weight gain in term children, adolescents and young adults born appropriate for gestational age. Methods: In all, 173 girls and 178 boys aged 6.1–19.9 (12.5 ± 3.1)years participated. Rapid weight gain (group 1) was defined as a change in weight‐SDS (standard deviation score) from birth till two years >0.67, ‘no change’ as ≥?0.67 and ≤0.67 (group 2) vs ‘slow weight gain’ as 90th age‐/sex‐specific BMI‐percentile was defined as overweight. Parental BMI, socio‐economic status and lifestyle were assessed as confounders. Results: A total of 22.8% gained weight rapidly, and 15.7% was overweight. Group 1 compared with group 2 and 3 subjects was taller, heavier and had a higher prevalence of overweight (girls/boys: 26.2%/28.9% vs 11.6%/19.0% vs 2.8%/5.0%; p < 0.01/p < 0.05). Concomitantly, a higher WC, %FM and FFM were observed. Rapid weight gain was positively associated with REE (adjusted for FFM) in boys (r = 0.26; p < 0.01), but not with cardio‐metabolic risk factors. Conclusion: Rapid weight gain was related to increases in height, weight, a higher prevalence of overweight and central fat distribution. In addition, rapid weight gain was related to a higher REE in boys, but not to cardio‐metabolic risk factors.     

Manubriosternal subluxation/dislocation can lead to manubriosternal septic arthritis in patients with kyphoscoliosis

Locally deranged joint anatomy can predispose to septic arthritis which can be managed by surgical debridement. We present a case of manubriosternal subluxation/dislocation caused by kyphoscoliosis leading to manubriosternal septic arthritis.     

Growth after ventricular septal defect repair: does defect size matter? A 10‐year experience

Aim: To evaluate whether the ventricular septal defect (VSD) size, along with the degree of preoperative growth impairment and age at repair, may influence postoperative growth, and if VSD size can be useful to identify children at risk for preoperative failure to thrive. Methods: Sixty‐eight children submitted to VSD repair in a Brazilian tertiary‐care institution were evaluated. Weight and height measurements were converted to Z‐scores. Ventricular septal defect size was normalized by dividing it by the aortic root diameter (VSD/Ao ratio). Results: Twenty‐six patients (38%) had significantly low weight‐for‐height, 10 patients (15%) had significantly low height‐for‐age and 13 patients (19%) had both conditions at repair. Catch‐up growth occurred in 82% of patients for weight‐for‐age, in 75% of patients for height‐for‐age and in 89% of patients for weight‐for‐height. Weight‐for‐height Z‐scores at surgery were significantly lower in patients who underwent repair before 9 months of age. The VSD/Ao ratio did not associate with any other data. On multivariate analysis, weight‐for‐age Z‐scores and age at surgery were independent predictors of long‐term weight and height respectively. Conclusion: The VSD/Ao ratio was not a good predictor of preoperative failure to thrive. Most patients had preoperative growth impairment and presented catch‐up growth after repair. Preoperative growth status and age at surgery influenced long‐term growth.     

The Consumer Quality Index Hip Knee Questionnaire measuring patients' experiences with quality of care after a total hip or knee arthroplasty

Background  

The Dutch Consumer Quality Index Hip Knee Questionnaire (CQI Hip Knee) was used to assess patients' experiences with and evaluations of quality of care after a total hip (THA) or total knee arthroplasty (TKA). The aim of this study is to evaluate the construct validity and internal consistency reliability of this new instrument and to assess its ability to measure differences in quality of care between hospitals.