Concepts of body constitution,health and sub-health from traditional Chinese medicine perspective

This paper described and discussed the important literature and ideas about the concepts, types and measurement of body constitution, in terms of healthy, sub-healthy and disease status. In view of traditional Chinese medicine, ‘‘healthy” state is a status of relative balance of Yin and Yang to keep our bodily homeostasis. If there are significant physical and/or psychological stressors, such as loss of a beloved one and failure in study or work, the body can no longer keep its own bodily condition balanced and subsequently enter a state of ‘‘sub-health” (sub-optimal health). ‘‘unhealthy” body constitution such as ‘‘Dampness-heat”, ‘‘Cold-dampness” and ‘‘Heat- or Cold- dryness” with a subnormal body temperature and humidity and clinical manifestations such as insomnia, malaise and overweight will be presented. Immediate, appropriate strategies such as modification of life-style and seeking medical treatment can prevent evolution of an illness. Otherwise, the body will enter a disease status with a ‘‘pathological” body constitution of ‘‘Yin or Yang deficiency’’, ‘‘Blood-stasis” and/or ‘‘Phlegm-dampness”. To be complimentary with health promotion and disease prevention in Western medicine, understanding about an individual’s body constitution, together with its determinants (e.g., healthy eating and lifestyle behaviors), can contribute to a more proactive, holistic and individualized healthcare.     

Symptom clusters and quality of life among patients with advanced heart failure

Objectives To identify symptom clusters among patients with advanced heart failure (HF) and the independent relationships with their quality of life (QoL). Methods This is the secondary data analysis of a cross-sectional study which interviewed 119 patients with advanced HF in the geriatric unit of a regional hospital in Hong Kong. The symptom profile and QoL were assessed by using the Edmonton Symptom Assessment Scale (ESAS) and the McGill QoL Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Hierarchical regression analysis was used to examine the independent relationships with their QoL, after adjusting the effects of age, gender, and comorbidities. Results The patients were at an advanced age (82.9 ± 6.5 years). Three distinct symptom clusters were identified: they were the distress cluster (including shortness of breath, anxiety, and depression), the decondition cluster (fatigue, drowsiness, nausea, and reduced appetite), and the discomfort cluster (pain, and sense of generalized discomfort). These three symptom clusters accounted for 63.25% of variance of the patients’ symptom experience. The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting the age, gender and comorbidities, the distress (beta = ?0.635, P < 0.001), the decondition (beta = -0.148, P = 0.01), and the discomfort (beta = -0.258, P < 0.001) symptom clusters independently predicted their QoL. Conclusions This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimizing the symptom control for this life-limiting disease.     

腹腔鏡下子宫切除术46例

1 临床资料腹腔鏡下子宫次全切除(laparoscopic surgery on hyesterectomy, LSH)患者46例,年龄38～56岁. 诊断(B超、CT)子宫肌瘤37例,宫血9例,肌瘤均<12 cm. 手术取截石位,头低30°,采取口腔明视静脉复合麻醉. 气腹形成后,采用3～4 cm切口,下腹部左、右侧分别切口,位置取髂前上棘内上方2 cm处,用直径0.5 cm的穿刺针穿刺,置操作钳,于脐孔处用直径1 cm的穿刺针穿刺,经穿刺孔放置腹腔镜,在脐与耻骨结节连线中点处穿刺另一操作孔.     

飞行人员花粉症快速免疫治疗68例

1 临床资料现役飞行人员花粉症患者94例,男,年龄24～50岁,平均飞行时间1320(300～2200) h. 出现以打喷嚏、流涕、鼻塞等典型花粉症表现. 通过变应原皮肤试验对患者进行各种变应原测定. 标准变应原由北京协和医院变态反应科提供.     

AMG－1对突触体内游离钙水平及大鼠尾动脉收缩力的影响

观察了ＡＭＧ－１对高钾所致大鼠脑突触体内游离钙浓度［Ｃａ２＋］ｉ升高，及去甲肾上腺素引起的离体大鼠尾动脉环收缩力的影响。结果表明，ＡＭＧ－１１０和１００μｍｏｌ·Ｌ－１可对抗高钾（３０ｍｍｏｌ·Ｌ－１）引起的［Ｃａ２＋］ｉ升高，使分别降低１９±１１％及５７±１２％；在无钙Ｋｒｅｂｓ－Ｈｅｎｓｌｅｌｅｉｔ液中，ＡＭＧ－１能抑制去甲肾上腺素引起大鼠尾动脉收缩力的作用。     

Neuropsychological predictors of everyday functioning in adults with intellectual disabilities

Background Very little is known about the neuropsychological correlates of adaptive functioning in people with intellectual disabilities (ID). This study examined whether specific cognitive deficits and demographic variables predicted everyday functioning in adults with ID. Method People with ID (n = 101; ages 19–41 years; mean education = 11 years; 34% women; 54% competitively employed; 41% with mild ID) completed a comprehensive neuropsychological battery grouped into four cognitive domains: processing speed, verbal memory and comprehension, visual perception/constructive function, and executive function. In addition, parents completed an 89‐item rating scale developed to assess a wide range of independent living skills. Results Confirmatory factor analysis results confirmed a correlated four‐factor model of cognitive function and a unidimensional model of everyday functioning. Furthermore, structural equation modelling results supported the predictive relationship of verbal memory/comprehension and employment status (standardized regression coefficients 0.45, 0.22, P ≤ 0.01 for each) to measures of everyday functioning. The two variables together explained 35% of the variance in everyday functioning. Conclusions Both general cognitive dysfunction and specific verbal memory and comprehension deficit impair daily functions in people with ID. These findings have implications for predictive models of adaptive functioning, and for cognitive rehabilitation and deficit compensation strategies for this group.     

Contribution of DNA sequence and CAG size to mutation frequencies of intermediate alleles for Huntington disease: evidence from single sperm analyses

New mutations for Huntington disease (HD) arise from intermediate alleles (IAs) with between 29 and 35 CAG repeats that expand on transmission through the paternal germline to 36 CAGs or greater. Using single sperm analysis, we have assessed CAG mutation frequencies for four IAs in families with sporadic HD (IANM) and IAs ascertained from the general population (IAGP) by analyzing 1161 single sperm from three persons. We show that IANM are more unstable than IAGP with identical size and sequence. Furthermore, comparison of different sized IAs and IAs with different sequences between the CAG and the adjacent CCG tracts indicates that DNA sequence is a major influence on CAG stability. These studies provide estimates of the likelihood of expansion of IANM and IAGP to > or = 36 CAG repeats for these individuals. For an IA with a CAG of 35 in this family with sporadic HD, the likelihood for siblings to inherit a recurrent mutation > or = 36 CAG is approximately 10%. For IAGP of a similar size, the risk of inheriting an expanded allele of > or = 36 CAG through the paternal germline is approximately 6%. These risk estimates are higher than previously reported and provide additional information for counselling in these families. Further studies on persons with IAs will be needed to determine whether these results can be generalized to other families.      

丁基苯酞对氯化钾及 N-甲基-D-门冬氨酸诱导的大鼠皮质神经细胞损伤的保护作用

用原代培养大鼠皮质神经细胞的方法，观察ｌ丁基苯酞（ｌＮＢＰ）和ｄ丁基苯酞（ｄＮＢＰ）对ＫＣｌ及Ｎ甲基Ｄ门冬氨酸（ＮＭＤＡ）诱导的大鼠皮质神经细胞损伤的保护作用。结果表明：ｌＮＢＰ和ｄＮＢＰ能剂量依赖性地抑制ＮＭＤＡ诱导的大鼠皮质神经细胞内乳酸脱氢酶的释放，降低细胞死亡率，改善受损细胞的形态；此外ｌＮＢＰ和ｄＮＢＰ还能明显减轻ＫＣｌ诱导的神经细胞损伤。提示：ｌＮＢＰ和ｄＮＢＰ对ＫＣｌ及ＮＭＤＡ诱导的大鼠皮质神经细胞损伤有明显保护作用。