Living with Marfan syndrome I. Perceptions of the condition

We present data from an exploratory study of 174 adults with Marfan syndrome regarding their cognitive perceptions of the condition as postulated by the self-regulatory model (Leventhal H, Benyamini Y, Brownlee S et al. In: Petrie KI, Weinman JA, eds. Perceptions of Health and Illness: Current Research and Applications. Amsterdam, The Netherlands: Harwood Academic, 1997: 19-45; Leventhal H, Nerenz DR, Steele DJ. In: Baum A, Taylor SE, Singer JE, eds. Handbook of Psychology and Health. Hillsdale, NJ: Lawrence Erlbaum Associates, 1984: 219-252). The vast majority of the respondents had adequate general knowledge about Marfan syndrome. Eighty-three percent of the respondents perceived Marfan syndrome as having had significant adverse consequences on their lives. Having striae, pain (sore joints), and depression were each independently correlated with this view. Fifty-eight percent of the respondents indicated that they felt they had low to moderate control over their condition, demonstrating variability. History of aortic dissection, pain (sore joints), and depressive symptoms were each negatively correlated with the view that Marfan syndrome is a curable/controllable condition. Moreover, approximately 28% view the condition as a lethal condition, whereas 67% view it as a serious condition. Forty-four percent of the cohort were found to have significant symptomatology of depression independent of beta- and Ca2+-channel blockade use. Respondents cited both advantages and disadvantages of being affected. Genetic counseling that addresses patients' perceptions of Marfan syndrome, and its associated pain, fatigue, and depressive symptoms, may enhance patient adaptation to the condition.     

社区双向转诊模式的实施及护理体会

目的：探讨社区双向转诊模式的实施情况与护理体会。方法：对社区双向转诊模式实施前后的240例患者的转诊率及再入院率进行统计分析。根据分析结果．对双向转诊模式的进一步完善提出建议。结果：实施双向转诊护理后,患者的转诊率由干预前的30．8％（37/120）提高到68.3％（82/120）,差异有统计学意义（P〈0．01）,再人院率也由干预前的63．7％降低到22．1％。结论：实行双向转诊,有利于医疗资源的合理利用,同时也有利于促进基层社区医院医疗卫生事业的发展。     

Prediction of response to antiretroviral therapy by human experts and by the EuResist data‐driven expert system (the EVE study)

Objectives

The EuResist expert system is a novel data‐driven online system for computing the probability of 8‐week success for any given pair of HIV‐1 genotype and combination antiretroviral therapy regimen plus optional patient information. The objective of this study was to compare the EuResist system vs. human experts (EVE) for the ability to predict response to treatment.

Methods

The EuResist system was compared with 10 HIV‐1 drug resistance experts for the ability to predict 8‐week response to 25 treatment cases derived from the EuResist database validation data set. All current and past patient data were made available to simulate clinical practice. The experts were asked to provide a qualitative and quantitative estimate of the probability of treatment success.

Results

There were 15 treatment successes and 10 treatment failures. In the classification task, the number of mislabelled cases was six for EuResist and 6–13 for the human experts [mean±standard deviation (SD) 9.1±1.9]. The accuracy of EuResist was higher than the average for the experts (0.76 vs. 0.64, respectively). The quantitative estimates computed by EuResist were significantly correlated (Pearson r=0.695, P<0.0001) with the mean quantitative estimates provided by the experts. However, the agreement among experts was only moderate (for the classification task, inter‐rater κ=0.355; for the quantitative estimation, mean±SD coefficient of variation=55.9±22.4%).

Conclusions

With this limited data set, the EuResist engine performed comparably to or better than human experts. The system warrants further investigation as a treatment‐decision support tool in clinical practice.     

儿童癌症幸存者成年后的慢性疾病

由于治疗方法的进步,近80%的儿童和青少年癌症患者能够长期生存。在美国,约有270000例儿童癌症的幸存者,即每640名20至39岁成年人中就有一名幸存者。大量的幸存者有利于儿童癌症治疗后长期健康结果的研究。现在可以明确的是,化疗和放疗所致的儿童各器官系统损害在临床上可能潜伏多年。为了全面了解治疗儿童癌症而继发的健康问题,重要的是衡量三项长期结果:健康状况、死亡率和患病率。这三项中,关于前两项已有相当好的研究报道。在一项对20227例癌症5年生存者的回顾性分析中,Mertens等发现以下原因导致的超额死亡率具有统计学意义:继发癌症(…     

Differential response of two cell lines sequentially irradiated with low X-ray doses

An experiment was designed to compare the effect of repeated low doses of X-rays in two different cell lines: one transformed, epithelial like and aneuploid Chinese hamster ovary K-1 (CHO-K1); the other originated from a human primary culture, fibroblast, diploid and non-transformed, MRC-5. CHO and MRC-5 cells were cultured for 14 or eight passages, respectively. Irradiation was performed once per passage when cells were in the quiescent state (90?–?95% in G1/G0). Cells were exposed to 10.0 mSv X-ray doses. Ionizing radiation did not induce apoptosis or necrosis in the exposed CHO cell population. Significant increases of low-level damaged cells (degrees 1 and 2) were found for the 14 cycles of radiation when compared with controls, except for the first irradiation cycle. No significant increases in the frequency of cells with severe damage were observed. The frequency of MRC-5 cells with low-level damage increased significantly when compared with controls for radiation cycles seven and eight. Significant increases of apoptosis, necrosis and severe damage were found only for the highest dose. Transformed and non-transformed cell types responded differently to direct and indirect damage using low-dose repeat exposures to ionizing radiation. Though more investigation is needed to understand the mechanisms of radiation effects in chronic low-dose-exposed cell populations, cellular type should be taken into account in the design of in vitro experiments for understanding low-dose-irradiation effects.     

音乐疗法对门诊输液患者心理的影响

目的探讨中医五行音乐疗法对门诊输液患者心理安抚的作用与效果。方法2006年3月-2007年3月，按四时节气的不同，依据中医的五行相克理论，对治疗组的408例门诊输液患者进行音乐干预，而同期对照组396例门诊输液患者不接受音乐疗法。采用自制的调查表，获取他们对环境和服务的满意程度。结果治疗组患者，对门诊输液的满意度较对照组高，差异有统计学意义，P〈0.01。治疗组患者，对医院和本部的投诉率较对照组低，差异有统计学意义，P〈0.01。结论音乐疗法对门诊输液患者的心理有一定的安抚作用。     

sHLA-G1重链分子、β_2m的体外表达及纯化研究

目的获得sHLA-G1重链分子及轻链β2微球蛋白(β2m)基因体外表达并纯化的相关蛋白质。方法RT-PCR扩增可溶性HLA-G1重链分子及人β2m轻链的cDNA序列,构建表达载体pET28a(+)/sHLA-G1及pET28a(+)/β2m,导入大肠杆菌BL21(DE3),IPTG诱导sHLA-G1及β2m蛋白表达,并以Ni-NTA亲和层析和CM-FF弱阳离子柱分别纯化,透析后浓缩保存。SDS-PAGE,Western-Blot鉴定目的蛋白的表达和纯化。结果成功克隆了sHLA-G1及2βm基因并构建了pET28a(+)-sHLA-G1、pET28a(+)-β2m原核高效表达载体;表达产物以可溶性形式存在,表达量>30%,纯化后产物纯度达到95%。结论成功表达并纯化出的sHLA-G1重链分子及轻链β2m有助于阐明可溶性HLA-G1的功能。     

组胺支气管激发试验在咳嗽变异性哮喘中的应用

目的探讨咳嗽变异性哮喘患者（CVA）组胺支气管激发试验的结果。方法对244例拟诊CVA用肺功能仪测定基础肺功能及吸入不同剂量组胺后的肺功能，对照激发前后结果。结果244例患者支气管激发试验阳性160例（65．57％），阴性77例（31．56％），可疑阳性7例（2．87％）。160例支气管激发试验阳性患者按支气管哮喘予吸入糖皮质激素及支气管舒张剂治疗，症状缓解。结论组胺支气管激发试验对咳嗽变异性哮喘的诊断具有临床意义，此方法安全适用。     

两种不同固位结构附着体义齿修复游离端缺失基牙及缺牙区牙槽嵴应力分布的比较

目的探讨不同固位结构的附着体义齿应力分布特点,为临床应用附着体义齿种类的选择提供依据。方法应用三维有限元的方法分别测定并比较应用键槽缓冲式附着体和柱状附着体修复下颌单侧游离端缺失基牙及牙槽嵴应力分布情况。结果键槽缓冲式附着体义齿对基牙产生应力值小于柱状附着体义齿,对缺牙区牙槽嵴应力大于柱状附着体义齿。结论键槽缓冲式附着体义齿较适合于基牙条件差的义齿修复,柱状附着体义齿较适合于缺牙区牙槽嵴条件差的义齿修复。