The relationship of suicide attempt history with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality in substance dependents

The aim of this study was to evaluate the prevalence of suicide in Turkish male substance dependents, and to investigate the relationship of suicide attempt history with childhood abuse and neglect, alexithymia, and temperament and character dimensions of personality. Participants were 154 consecutively admitted male substance dependents. Patients were investigated with the Childhood Abuse and Neglect Questionnaire, Toronto Alexithymia Scale (TAS-20) and Temperament and Character Inventory (TCI). Among substance-dependent patients, 28.6% was considered a group with suicide attempt history (SAH). Current age was lower and rate of being single was higher in the group with SAH. There were no significant differences between groups in terms of employment, educational status and duration of education. Rates of physical, emotional abuse and neglect, self-mutilation and being alexithymic were higher and ages at first substance use and regular substance use were lower in the group with SAH. Mean scores of "difficulty in identifying feelings" (DIF) and "difficulty in describing feelings" (DDF) subscale EOT of the TAS-20 were higher in the SAH group. Among temperament and character dimensions of the TCI, only "Self-directedness" and "Cooperativeness" were lower in SAH and there were no significant differences between groups in terms of other subscales. Age and Self-directedness score of TCI were determinants for suicide attempt. In particular, young drug users with low Self-directedness scores could be the target population in order to prevent suicidal behavior. This study also suggests that in substance-dependent patients, in the background of all suicidal behavior, childhood abuse and neglect must be evaluated.     

Behçet’s disease: immunological relevance with arthritis of ankylosing spondylitis

Behçet’s disease (BD) is a multi-system inflammatory disorder, in which cytokine balance is polarized to Th1. In this study, the cell surface molecule expression, Th1/Th2, inflammatory cytokine levels in blood, and synovial fluid of CD3⁺ T lymphocytes in BD were investigated. The study group consisted of 10 BD, 10 ankylosing spondylitis (AS) patients with peripheral arthritis, and 10 healthy subjects. Expression of cell surface molecules, intracellular IL-2, IL-5, IL-8, IL-10, IL-12, IFN-γ, and TNF-α levels in CD3⁺ T lymphocytes were determined by flow cytometry in synovial and peripheral blood mononuclear cells (PBMCs). Synovial and plasma cytokine levels were measured by ELISA and CBA. In PBMCs, CD4, CD25, HLA-DR expression and intracellular IL-12, and TNF-α levels of CD3⁺ T lymphocytes were statistically increased in BD patients compared to healthy subjects. Compare to AS patients, CD25 and HLA-DR surface expression and intracellular IFN-γ and TNF-α levels in T cells were significantly elevated in BD patients. In BD patients, there was an increase in IL-8 secretion; however, in AS patients, both Th1- and Th2-type cytokines were increased compare to healthy subjects. Intracellular cytokine expression did not show any difference in BD patients; however, IL-12 content of synovial fluid was significantly increased compared to AS patients. Our findings revealed that Th1 polarization occurred in both peripheral blood and synovial fluid of BD patients with arthritis. It is found no difference between synovial fluid analysis of BD and AS patients, showing the similarities in the pathogenesis of both diseases.     

Comparison of demographic and clinical characteristics of patients with early vs. adult vs. late onset ulcerative colitis

Background & aimsThere is limited data comparing influence of age on the presentation, clinical course, and therapeutic response of patients with ulcerative colitis. We aimed to compare the demographic and clinical characteristics of patients diagnosed with UC in older age vs. adulthood vs. early age.MethodsFive-hundred sixty one patients with UC seen at our center from 1995 to 2011 were categorized into early onset (EO), adult onset (AO) and late onset (LO) due to age at date of initial diagnosis. Patients diagnosed younger than age 17 were defined as EO, while those diagnosed between 17 and 60 were defined as AO and older than age 60 as LO. All patients were analyzed for demographic and clinical characteristics.ResultsThere was a male predominancy among LO patients (50% vs. 57.7% vs. 78.6%, p = 0.004). Patients with EO UC were more likely to be non-smokers (p < 0.001), and had higher family history of UC (p = 0.02). Patients with EO UC had more steroid use (p = 0.03), total colectomy (p = 0.04), presence of chronic active disease (p = 0.04) rates when compared with AO and LO groups. Patients in EO group had higher overall probability of surgery in 1, 5 and 10 years, when compared with patients in LO group (p = 0.02), but it wasn't different between EO and AO groups (p = 0.09).ConclusionsOur study showed that clinical course of UC was more aggressive in younger ages. Also the difference between the demographic characteristics suggests that different age groups have different risk factors for the disease development.     

Phoenix dactylifera L. spathe essential oil: Chemical composition and repellent activity against the yellow fever mosquito

Date palm, Phoenix dactylifera L. (Arecaceae), grows commonly in the Arabian Peninsula and is traditionally used to treat various diseases. The aim of the present study was to identify chemical composition of the essential oil and to investigate the repellent activity. The essential oil of P. dactylifera was obtained by hydrodistillation from the spathe, a specialized leaf structure that surrounds the pollinating organs of the palm. The oil was subsequently analyzed by GC–FID and GC–MS. The oil showed promising repellent activity against yellow fever mosquito – Aedes aegypti. Sixteen components were characterized, constituting 99% of the oil. The main components were 3,4-dimethoxytoluene (73.5%), 2,4-dimethoxytoluene (9.5%), β-caryophyllene (5.5%), p-cresyl methyl ether (3.8%), and caryophyllene oxide (2.4%). The minimum effective dosage (MED) for repellency for the P. dactylifera oil was 0.051 mg/cm², which had moderately lower potency compared to reference standard N,N-diethyl-3-methylbenzamide, DEET (0.018 mg/cm²) in the “cloth patch assay”. The five major compounds were individually assayed for repellency to determine to what extent each is responsible for repellency from the oil. 3,4-Dimethoxytoluene and 2,4-dimethoxytoluene showed the best repellent activity with the same MED value of 0.063 mg/cm², respectively. The results indicate that these two constituents which comprise a large proportion of the P. dactylifera oil (83%) are likely responsible for the observed repellent activity. In this aspect, the P. dactylifera spathe oil is a sustainable, promising new source of natural repellents.     

Reference interval of pregnancy-associated plasma protein-A in healthy men and non-pregnant women

ObjectiveThe serum pregnancy-associated plasma protein-A (PAPP-A) concentration is a predictor of ischemic cardiac events and renal impairment. However, the reference interval of PAPP-A has not been determined. This study determined the reference interval of PAPP-A in men and non-pregnant women.MethodsThe study enrolled 126 apparently healthy individuals (52 males and 74 females). The mean age of the men and women was 34.7 (range 20–66) years and 34.6 (range 18–65) years, respectively. Serum PAPP-A concentrations were determined using an ultrasensitive enzyme-linked immunoassay kit. Reference intervals were calculated using the bootstrap method.ResultsThe results for three subjects were outliers, so the reference interval of PAPP-A was calculated using the data for 123 subjects. PAPP-A was undetectable in 26 subjects. The reference interval of PAPP-A for men and women (with the 90% confidence interval) was <22.9 ng/mL (19.7–23.3) and <33.6 ng/mL (25.2–36.7), respectively. In male subjects, serum PAPP-A levels of smokers [3.10 (UD, 7.30) ng/mL] were significantly lower than that of non-smokers [11.00 (UD, 24.4) ng/mL] (p < 0.001) and there was a positive correlation between serum PAPP-A levels and subjects’ age (r = 0.439; p < 0.001).ConclusionsThe reference interval of PAPP-A differed for men and non-pregnant women. In clinical practice, <22.9 ng/mL for men and <33.6 ng/mL for non-pregnant women may be used as reference intervals for PAPP-A.     

5-氨基水杨酸结肠定位黏附微丸的制备及评价

制备5-氨基水杨酸结肠定位黏附微丸。以CP 940和HPC为黏附性材料,挤出滚圆工艺制备载药丸芯。考察丸芯最大载药量、赋形剂以及挤出滚圆工艺对成型性的影响。采用体外黏附性实验考察两种黏附性材料的比例对黏附性的影响。制备好的黏附性丸芯采用流化床包衣,乙基纤维素作为缓释防水内层,Eudragit^® S100作为pH敏感外层,在不同pH释放介质中进行溶出研究,评价微丸在结肠环境的释药性能。实验表明:丸芯最大载药量为70%,使用PH301作为赋形剂,CP 940与HPC质量比为1∶1时,黏附效果最佳;EC增重为16%~20%,S100增重为28%时,在盐酸溶液中有良好的耐酸性,在pH 6.0磷酸盐缓冲液中5 h的释放量小于10%,而在pH 7.4结肠液中迅速释放药物和发挥黏附作用。实验结果表明,5-氨基水杨结肠定位黏附微丸是一种良好的结肠定位黏附给药系统。     

寡肽阳离子脂质体作为基因载体的体外研究

采用阳离子寡肽脂质材料赖氨酰化谷氨酸双十四醇酯(T2GL)制备阳离子脂质体(CL),与增强型绿色荧光蛋白质粒(pEGFP)静电结合形成复合物(CL/pDNA),CL/pDNA粒径和表面电位分别为(132.3±1.0)nm和+(31.35±2.99)mV。考察CL/pDNA对肝素及脱氧核糖核酸酶Ⅰ(DNase I)的稳定性,结果表明,CL/pDNA可被适宜浓度的肝素竞争性解组装释放pDNA,其对DNase I的稳定性明显优于市售制剂Lipofectamine 2000。研究CL与pDNA的比例(N/P)及质粒用量对转染效率的影响,结果显示当N/P为3,质粒用量4μg时,CL/pDNA的转染效率最佳。采用CL/pDNA对3种不同的细胞进行转染,发现CL/pDNA在人源非小细胞肺癌A549细胞中转染效果最好,与Lipofectamine 2000相比,转染效率相当但细胞毒性更低,因此为进一步研究其体内行为提供了良好的基础。     

3257份首次病程记录书写内容与内涵质量关系的探讨

目的评估首次病程记录的书写状况,探讨其在诊疗中的重要作用与内涵质量的关系。方法随机检查2012年9月-12月期间,1596份出院病案首次病程记录的书写内容和1661份新入院病案首次病程记录完成时限。结果病例特点中无主诉、无现病史、无"三史"、体格检查不全面、无辅助检查分别占29.55%、18.18%、51.51%、59.85%、22.73%;8小时内未完成首次病程记录占10.48%;结论病例特点书写内容不完整,影响拟诊讨论的内涵质量;首次病程记录在病历中具有承上启下的特殊作用,是体现医疗内涵质量的重要窗口。     

“医学寄生虫学”分布式多媒体资源库的建立

介绍医学高等院校“医学寄生虫学”分布式多媒体资源库建立的过程,包括资源库设计、多媒体素材收集加工、利用BT技术构建资源库等,并对其使用效果进行分析.     

南京地区19家综合性医院鲍曼不动杆菌抗感染药物用药趋势分析

目的:分析2007~2010年南京地区19家综合性三级和二级医院鲍曼不动杆菌(Ab)抗感染药物使用趋势,为评价临床合理用药提供依据?方法:根据限定日剂量(DDD)计算7类15种抗菌药物的用药频度,采用SPSS17.0软件对用药趋势进行线性回归分析?结果:三级医院碳青霉烯类?喹诺酮类?哌拉西林/他唑巴坦用药频度(DDDs/1 000)呈增长趋势,头孢哌酮/舒巴坦呈减少趋势;二级医院碳青霉烯类?四环素类?头孢菌素类?舒巴坦和他唑巴坦酶抑制剂用量均为增长趋势;19家医院碳青霉烯类?四环素类?哌拉西林/他唑巴坦及抗菌药物总用药频度为增长趋势?三级医院平均每半年所有抗菌药物用药频度均大于二级医院,仅环丙沙星小于二级医院?结论:19家医院每种和总碳青霉烯类?哌拉西林/他唑巴坦和总抗菌药物用药频度显著增加,需加强本地区感染控制以及抗菌药物临床合理应用?