异基因造血干细胞移植受者代谢综合征的发生情况

异基因造血干细胞移植（hematopoieticcelltransplantation,HCT）后代谢综合征的发生主要由预处理导致的神经激素系统紊乱、血管内皮损伤、移植物的免疫和炎症作用以及继发的移植物抗宿主病及其治疗等引起。对代谢综合征及其组分（糖尿病、高血压、血脂紊乱等）的筛查可以尽早地调整治疗策略,控制危险因素的发生,进而降低远期的心血管疾病的发生率和致死率。为此,美国的研究人员回顾性分析了86例异基因HCT受者代谢综合征的发生情况,并与代谢综合征在普通人群中的流行情况进行比较。     

CAOS contribution to understanding cultural/ethnic differences in the prevalence of bipolar affective disorder in New Zealand

OBJECTIVE: To examine whether data on the clinical profiles of psychiatric service users can inform the claim that Māori in the New Zealand community have an increased rate of bipolar disorder. METHOD: The standardized recordings of a variety of clinical phenomena previously collected in a New Zealand study of psychiatric service users was extracted for those persons who were diagnosed with a bipolar mental disorder. The individual clinical phenomena were then compared by ethnicity. RESULTS: The most dramatic result was the increased recording of high levels of overactivity or disruptive aggressive behaviour in Māori compared with European in psychiatric service users, despite which, the rates of the disorder did not significantly differ by ethnicity. CONCLUSION: In the community survey lay raters were deciding on the presence or absence of phenomena including hyperactivity without the contextual knowledge that clinicians use. It is possible that the Composite International Diagnostic Interview decision tree was being fed an excessive amount of that criterion.     

Classification in Psychiatry: Does it deliver in schizophrenia and depression?

The global situation for people with mental illness – in developing and developed countries – is dire. Legislative and human rights protections are frequently lacking. Mental health budgets are inadequate. There are insufficient numbers of skilled policy makers, managers and clinicians. Communities are poorly informed about mental health and illness and not well organised for purposes of advocacy. In most of the world, mental health services are inaccessible or of poor quality. Most people who would benefit from psychiatric treatment and rehabilitation do not have affordable access to such services. Leadership – at all levels – for mental health system development needs to be greatly strengthened.     

A novel polymorphism in the factor XIII B-subunit (His95Arg): relationship to subunit dissociation and venous thrombosis

BACKGROUND: Factor (F)XIII B-subunit, which plays a carrier role for zymogen FXIIIA, is highly polymorphic, but the molecular basis for these polymorphisms and their relationship to disease remains unknown. OBJECTIVES: To screen the FXIIIB gene coding region for common variation and analyze possible functional effects. METHODS AND RESULTS: We examined the FXIIIB gene by PCR-SSCP and identified three common single nucleotide polymorphisms: A8259G, C29470T and A30899G. A8259G results in substitution of His95Arg in the second Sushi domain. An FXIII tetramer ELISA was developed to analyze B-subunit dissociation from A-subunit (leading to access to the catalytic site of FXIII). Increased subunit dissociation, 0.51 vs. 0.45 (fraction of total tetramer), was found in plasma from subjects possessing the Arg-allele. However, when the variants were purified to homogeneity and binding was analyzed by steady-state kinetics, no difference was observed. The relationship between His95Arg and venous thrombosis was investigated in 214 patients and 291 controls from Leeds. His/Arg + Arg/Arg genotypes were more frequent in patients than controls (22.4% vs. 15.1%). His95Arg was also investigated in the Leiden Thrombophilia Study, in which a similar difference was observed for 471 patients vs. 472 controls (18.5% vs. 14.0%), for a pooled odds ratio (OR) of 1.5 (CI95 1.1-2.0). CONCLUSIONS: We have identified three FXIIIB polymorphisms, one of which codes for substitution of His95Arg. The Arg95 variant associates with a moderately increased risk for venous thrombosis, and with increased dissociation of the FXIII subunits in plasma, although in vitro steady-state binding between purified subunits was not affected.     

Biological and immunological characterization of ATG and ALG

Antithymocyte globulin (ATG) and antilymphocyte globulin (ALG) are effective therapies in aplastic anemia; their mechanism of action is undefined. We assayed multiple properties of ATG and ALG to address the biological and immunological bases for differences between ATG and ALG and lot variation. In addition, we studied a lot reported to be inactive in an American clinical trial; however in retrospect, this lot appeared to be active in patients treated in Europe. Immunoprecipitation of thymocyte and lymphocyte membrane proteins with ATG and ALG showed between 14 and 18 major bands on SDS-PAGE, but the patterns for ATG and ALG were not identical. The ability of ATG and ALG to block binding of labeled monoclonal antibodies was assessed using flow cytometry and a radioimmunoassay. In general, there was more lot variation among ALGs than ATGs; however, all ALG lots were more potent blockers of binding of anti-HLA-DR and anti-Leu 1 antibodies than was ATG. Both ALG and ATG effectively blocked binding of anti-Leu 2a, anti- Leu 3a, anti-Leu 4, anti-Leu 5b, and anti-IL 2 receptor abs; neither blocked binding of anti-Leu 7. All preparations were capable of inducing T-cell blastogenesis, although there was considerable lot variation. All lots lysed 60% to 75% T cells in a rabbit complement- mediated cytotoxicity assay, with most having a plateau of activity at 5 to 10 ug/mL. Two lots of ALG, including the lot reported to be clinically inactive, showed less toxicity at suboptimal concentrations and did not plateau even at 80 ug/mL. In total, these results indicate important differences between ATG and ALG in general, more lot variation among ALGs than ATGs and only differences in cytotoxicity between an "inactive" lot of ALG and most, but not all, other active ATG and ALG preparations.     

地理信息系统应用于血吸虫病的监测 Ⅰ.应用预测模型的可能性

目的：建立血吸虫病地理信息系统，利用气象参数建立模型来探讨预测血吸虫病的流行区的可能性。方法：以世界粮农组织出版的FAOCLIM数据库中的数据为基础，以血吸虫发育扩散关系密切的温度和潜在蒸发指数（地面水平衡系统）为基础的改良Malone公式计算血吸虫传播指数，结合AVHRR卫星图片资料，获得校正植被指数（NDVI）和第4频道地面温度指数、高程分布图，在ArcView3．0a和ERDAS软件支持下，进行GIS数据空间分析和地图重叠分析，以某一类别值显示出流行区的地理分布图。结果：血吸虫传播指数（指数值大于900）的分布基本上与中国南部地区的血吸虫病流行区相吻合。多层重叠分布图显示了红色区域的高危地区与长江流域的血吸虫病高发地区基本一致。结论：血吸虫病的流行范围与温度、高程、雨量等因素密切相关。利用气象资料模型和卫星遥感资料对预测血吸虫病的潜在流行区具有可能。准确、快速地利用AVHRR遥感资料来预测、预报血吸虫病流行范围和强度具有应用前景，值得作进一步探讨。     

Human parvovirus B19-induced epidemic acute red cell aplasia in patients with hereditary hemolytic anemia

From March to August 1984, 26 patients with hereditary hemolytic anemia in northeastern Ohio developed acute, profound red cell aplasia. The patients included 14 males and 12 females 2 to 23 years old, with sickle cell anemia (20 cases), hemoglobin SC-disease (4 cases), sickle- beta-thalassemia (1 case), or hereditary spherocytosis (1 case). All had an acute onset of severe reticulocytopenia and anemia and prodromal symptoms of illness including fever, abdominal symptoms, headache, and arthralgias. Twenty-two received transfusions. Reticulocytosis occurred spontaneously within 2 to 14 days of presentation. In five acute-phase sera, 10(8) to 10(12) viral particles/mL were detected by electron microscopy. Human parvovirus B19 DNA was demonstrated in high concentration by hybridization in the same five acute-phase sera and in low concentration in sera of eight additional patients. The five highly viremic sera inhibited erythroid colony formation in vitro. B19- specific IgM was detected in sera of 24/26 patients, and B19-specific IgG in 21 of 22 patients tested. Our results indicate that human parvovirus B19 was the etiologic agent in this large epidemic of life- threatening acute red cell aplasia in patients with hereditary hemolytic anemia.