Sexually Transmitted Infection (STI) screening,case and contact treatment,and condom promotion resulting in STI Reduction two years later in rural Malawi

As part of a longitudinal cohort study in rural Malawi in 2000, 469 men and 758 women were asked to respond to a series of surveys, were tested for gonorrhea and chlamydia, and received their results and treatment, if applicable, for themselves and up to 2 partners if positive for either sexually transmitted infection (STI). Two years later, in 2002, 328 men and 525 women were again asked to respond to survey questions, tested again for gonorrhea and chlamydia, and were also tested for HIV - of these, 247 men and 453 women had also given urine samples in 2000. In 2000, the gonorrhea and chlamydia prevalence was 6.2% and 5.8% among men, and 3.6% and 4.9% among women. Two years later, prevalence of gonorrhea and chlamydia was 0.7% and 1.4% among men, and 1.3% and 1.1% among women. Although we did not test for HIV in the first round, the HIV prevalence in 2002 was 19.2%. The implications of the findings are discussed in the context of interventions for STI prevention and to reduce HIV transmission in sub-Saharan Africa.     

四妙勇安汤加味对脑卒中患者复中的预防作用研究

目的观察四妙勇安汤加味方对脑卒中患者复发中风（复中）的预防作用。方法选取复中患者184例,分为对照组与治疗组。对照组予常规西药治疗,治疗组在西医治疗基础上或停用西医治疗情况下予四妙勇安汤加味治疗。观察两组复中与死亡情况,同时比较四妙勇安汤对两组患者血压、精神、情绪等的影响。结果对照组5年内复中率为17.39%、死亡率为34.78%,治疗组复中率为4.35%,死亡率为14.13%。经比较,治疗组的复中率和死亡率明显低于对照组。结论四妙勇安汤是预防脑卒中患者的复中的有效方剂,可降低患者血压,稳定患者情绪。长期使用未发现不良反应或副作用。     

大剂量黄芪注射液与激饲液治疗肝硬化的临床研究

目的探讨黄芪注射液与激饲液治疗肝硬化的疗效.方法68例肝硬化(肝功能失代偿期)患者配对分组治疗组34例,给予黄芪注射液40～50 ml,激饲液(维生素K1注射液40mg,维生素C3 g),1天1次,25天一疗程,30天后重复.对照组34例,给肝胺注射液250ml,维生素C3g,肌苷0.6 g,1天1次,疗程同治疗组.两个月后观察疗效.结果治疗组从临床症状到血清各项指标改善情况均优于对照组(P＜0.05～0.01).两组均无不良反应.结论大剂量黄芪注射液与激饲液治疗肝硬化(肝功能失代偿期),近期疗效显著,且无副作用.     

Prognostic significance of cholestatic alcoholic hepatitis

Tissue cholestasis is a histologic feature in some patients with alcoholic liver disease, but its significance is unknown. We studied prospectively the clinical, laboratory, and histologic findings of 306 chronic male alcoholics in whom liver tissue was available. Tissue cholestasis permitted identification of two groups: group I, absent or mild cholestasis (239 patients), and group II, moderate to severe cholestasis (67 patients). Statistical evaluation was performed by Student's ttest and regression analyses. In patients with tissue cholestasis, 97% had elevated serum cholylglycine levels, while only 61% had significant jaundice (serum bilirubin > 5 mg/dl). In patients without tissue cholestasis, 66% had elevated serum cholylglycine and 13.5% jaundice. Highly significant statistical correlations (P <0.0001) were found between cholestasis and malnutrition, prothrombin time, AST, alkaline phosphatase, bilirubin, Maddrey's discriminant function, serum cholylglycine level, albumin, and histologic severity score. In group I, 54% survived 60 months versus 22% in group II (P <0.0001). Highly significant statistical correlations (P <0.0001) were noted between serum cholylglycine levels and the parameters enumerated earlier, but not with survival. We conclude that tissue cholestasis is a highly significant prognostic indicator of outcome in alcoholic hepatitis and is more consistently associated with bile salt retention than jaundice.     

Histatins,wound healing,and cell migration

Wounds in the oral mucosa heal faster and more efficiently than those in the skin, although the mechanisms underlying these differences are not completely clear. In the last 10 years, a group of salivary peptides, the histatins, has gained attention on behalf of their ability to improve several phases of the wound‐healing process. In addition to their roles as anti‐microbial agents and in enamel maintenance, histatins elicit other biological effects, namely by promoting the migration of different cell types contained in the oral mucosa and in non‐oral tissues. Histatins, and specifically histatin‐1, promote cell adhesion and migration in oral keratinocytes, gingival and dermal fibroblasts, non‐oral epithelial cells, and endothelial cells. This is particularly relevant, as histatin‐1 promotes the re‐epithelialization phase and the angiogenic responses by increasing epithelial and endothelial cell migration. Although the molecular mechanisms associated with histatin‐dependent cell migration remain poorly understood, recent studies have pointed to the control of signaling endosomes and the balance of small GTPases. This review aimed to update the literature on the effects of histatins in cell migration, with a focus on wound healing. We will also discuss the consequences that this increasing field will have in disease and therapy design.     

Novel Assessment (BlueDop) Device for Detection of Lower Limb Arterial Disease: A Prospective Comparative Study

According to National Institute of Clinical Excellence guidelines, the ankle‐brachial pressure index coupled with a full clinical evaluation has been the mainstay of detecting peripheral arterial disease on its suspicion. However, this technique is not free of its own limitations in calcified arteries, ulcerative and diabetic patients. We introduce a new, novel, and effective assessment device (BlueDop) with a minimal learning curve that could overcome such barriers and serve as a valid replacement in perihospital settings.