Effects of breast cancer risk counseling for sexual minority women

Sexual minority women (lesbian and bisexual) represent a vulnerable group regarding their breast health. The participants in this study were 150 women aged 18-74 recruited via public announcements in mainstream and sexual minority communities in the greater Seattle metropolitan area. Potential participants were recruited to participate in a randomized trial of a breast cancer risk counseling intervention for sexual minority women. The counseling intervention produced significant reductions in perceived risk of breast cancer, anxieties and fears about breast cancer at 6 and 24 months, and increases in breast screening rates at 24 months in the intervention arm, compared with the control arm participants. These data add to the growing body of knowledge on sexual minority women's health and point to areas of community action and future research.     

Coming in From the Cold—Physician Professional Development as Deepening Participation in the Healthcare Community

This Conversation Starters article presents a selected research abstract from the 2016 Association of American Medical Colleges Southern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the pilot study. These thoughts probe the concept of patient “ownership” and suggest an alternative way of conceptualizing physicians' total dedication to patient care.     

电针治疗围绝经期抑郁症(肝郁型)的临床疗效分析

目的:观察电针配合舒肝解郁胶囊治疗围绝经期抑郁症的临床疗效。方法:选取符合纳入标准的60例围绝经期抑郁症的患者,按照随机数字表随机分为治疗组与对照组,各30例。治疗组采用电针配合舒肝解郁胶囊治疗,对照组则单纯口服舒肝解郁胶囊治疗,两组均治疗8周。观察两组患者治疗前后汉密尔顿(HAMD)抑郁量表以及改良Kupperman评分的变化情况,并对比临床疗效。结果:治疗后,治疗组总有效率为96.67%(29/30),明显优于对照组总有效率80%(24/30),差异具有统计学意义(P<0.05);治疗后两组的HAMD抑郁量表评分与改良Kupperman评分均较治疗前降低(P<0.05);治疗组治疗后HAMD抑郁量表评分和改良Kupperman评分均低于对照组,两组比较有统计学意义(P<0.05)。结论:电针配合舒肝解郁胶囊治疗围绝经期抑郁症疗效确切,可明显缓解临床症状,值得推广使用。     

从“免疫编辑”角度探讨恶性肿瘤的五期演变生物学基础

免疫逃逸是肿瘤的十大特征之一,在肿瘤的发生发展中发挥着至关重要的作用。免疫编辑指肿瘤细胞通过免疫清除-免疫平衡-免疫逃逸的模式,对机体免疫系统进行重塑与编辑,将肿瘤微环境中的免疫细胞“改造”成免疫抑制细胞,实现免疫逃逸。五期演变是李杰教授对肿瘤病机发展的总结,认为肿瘤的渐次发展遵循“虚-寒-毒-闭-衰”的核心病机,其中“郁”贯穿始终,癌毒是核心。该文以免疫编辑为切入点,将肿瘤细胞的表型特征与李杰老师的五期演变核心病机相结合,揭示恶性肿瘤五期演变的生物学基础,分析从虚到寒阶段的突出变化是机体免疫监视功能下降,从毒到闭阶段的突出变化是免疫逃逸,而五期演变的最终阶段——衰,是机体免疫衰竭的最终结局,郁是肿瘤免疫编辑的助推剂。以此提出扶正解毒法调控免疫编辑截断肿瘤的五期演变,益气温阳扶正气,恢复机体免疫监视功能;解毒宣闭转毒势,逆转免疫逃逸;以和为法,维持免疫细胞/免疫抑制细胞的动态平衡;解郁之法,截断肿瘤免疫编辑,为中医药的微观辨证施治提供一定的借鉴。在未来的研究中,还需要对益气温阳法、解毒宣闭法、两者联合及解郁法对免疫编辑调控的具体机制进一步地探索,寻找出特异性的中药及作用靶点,为中医药调...     

Incidence of Cronobacter spp. Infections,United States, 2003–2009

During 2003–2009, we identified 544 cases of Cronobacter spp. infection from 6 US states. The highest percentage of invasive infections occurred among children <5 years of age; urine isolates predominated among adults. Rates of invasive infections among infants approximate earlier estimates. Overall incidence of 0.66 cases/100,000 population was higher than anticipated.     

Replication and Shedding of MERS-CoV in Upper Respiratory Tract of Inoculated Dromedary Camels

In 2012, a novel coronavirus associated with severe respiratory disease in humans emerged in the Middle East. Epidemiologic investigations identified dromedary camels as the likely source of zoonotic transmission of Middle East respiratory syndrome coronavirus (MERS-CoV). Here we provide experimental support for camels as a reservoir for MERS-CoV. We inoculated 3 adult camels with a human isolate of MERS-CoV and a transient, primarily upper respiratory tract infection developed in each of the 3 animals. Clinical signs of the MERS-CoV infection were benign, but each of the camels shed large quantities of virus from the upper respiratory tract. We detected infectious virus in nasal secretions through 7 days postinoculation, and viral RNA up to 35 days postinoculation. The pattern of shedding and propensity for the upper respiratory tract infection in dromedary camels may help explain the lack of systemic illness among naturally infected camels and the means of efficient camel-to-camel and camel-to-human transmission.