白细胞介素1及白细胞介素8在心肌缺血再灌注损伤中的动态演变及药物干预效果

目的:在心肌缺血再灌注损伤中,炎症细胞因子参与其过程的多个环节。实验拟验证白细胞介素1、白细胞介素8因子在此过程中的动态变化,并分析其与药物干预的关系。方法:实验于2005-10/2006-11在新乡医学院形态学实验室完成。①实验分组:选择健康Wistar成年大鼠70只,按随机数字表法分为3组:对照组(n=10)、模型组(n=30)和药物组(n=30)。后两组又分为缺血0.5h,再灌注2,4,8,12,24h6个时相点,每个时相点5只。对照组只设12h一个时相点作为总体对照。②实验方法:大鼠麻醉后,药物组在右股静脉注入甲泼尼龙(30mg/kg),对照组及模型组注入生理盐水(0.75mg/kg)。采用夹闭左冠状动脉前降支建立大鼠心肌缺血再灌注损伤模型。对照组只开胸不夹闭。③实验评估:在各时相点观察各组大鼠缺血再灌注后的心肌细胞改变;血清学检测白细胞介素1、白细胞介素8因子的动态表达。结果:①模型组缺血再灌注12h炎细胞浸润最显著,药物组炎细胞呈散在浸润。②模型组和药物组白细胞介素1、白细胞介素8因子质量浓度明显高于对照组[缺血再灌注8h为例,白细胞介素1分别为(99.21±14.37),(85.77±11.31),(21.87±10.32)ng/L;白细胞介素8分别为(794.85±24.07),(536.95±19.72),(103.94±11.59)ng/L,P<0.05],峰值分别在缺血再灌注4,8h;同时相点药物组白细胞介素1、白细胞介素8因子质量浓度明显低于模型组(P<0.05)。结论:白细胞介素1和白细胞介素8因子在心肌缺血再灌注损伤的炎症反应中发挥着重要作用;甲泼尼龙对缺血再灌注损伤心肌有保护作用。     

亮度知觉效应与视觉加工方式研究

目的:利用微持续与微间隔时间技术,设计了两组相关的实验,对亮度知觉效应和视觉加工方式进行探讨。方法:实验于2006-06在中南民族大学物理楼脑认知实验室进行,所有受试者为年龄20～25岁的大学本科生,视力(含矫正视力)正常,均为右利手。①实验1:被试为10名(男5名,女5名),要求被试分别对n屏依次呈现的亮块的明度和n 1屏依次呈现的亮块的明度进行比较(n≤17)。②实验2:被试为28名(男13名,女15名),实验涉及两个刺激物,先呈现的刺激物由左右两个大小相同、亮度不同的亮块a和b组成,后呈现的刺激物把a和b的位置进行对调,当这两个刺激物依次显示时,要求被试报告左右两边的明度是否存在差异,存在何种差异。结果:①实验1∶1≤n≤3时,100%的被试报告,n 1屏的明度大于n屏的亮度,即n 1>n;4≤n≤10时,70%～90%的被试报告n 1>n;n>10时,50%～70%的被试报告n 1>n;随着n值的增加明度差异也在减小,大约在n=17时达到稳定,n屏和n 1屏的明度区别将很难被看出。②实验2:在L(a)b a,随着a和b的亮度差异减小,左右两边呈现的明度越相似;同样当L(a)相似文献   

Selected Nonpharmacological Therapies for Chronic Pain: The Therapeutic Use of the Placebo Effect

Chronic pain is a common problem requiring a multidisciplinary approach. Nursing can offer diverse therapies complementary to the medical-surgical approach. Guidelines for practice and challenges for research are outlined for selected nonpharmacological chronic pain therapies. This article discusses the placebo effect, which is common to all therapies. Placebos can therapeutically empower patients to stimulate their psychophysiologic self-regulation abilities. Effects, theories, ethics, and therapeutic methods of stimulating the placebo effect are explored.     

Use of traditional health practices among Native Americans in a primary care setting

BACKGROUND: This study was undertaken to ascertain the extent that traditional health practices are used by urban American Indian/Alaska Native (AI/AN) primary care patients, to identify related patient characteristics, to determine associations with health status and functioning, and to describe attitudes about care received. METHODS: This study used a brief self-report survey of 869 adult AI/AN patients randomly sampled over a 14-month period from a comprehensive urban primary care program. Current medications were determined by follow-up medical record review. RESULTS: Seventy percent of urban AI/AN patients in primary care often used traditional health practices; use was strongly associated with cultural affiliation. In bivariate analyses, use was significantly associated with male gender, cultural affiliation, poor functional status, alcohol abuse, and trauma and, except for musculoskeletal pain, not with specific medical problems. The multiple logistic regression model for any use versus no use was significant (P < or =0.001). Being of male gender (P < or =0.001), having more than a high school education (P < or =0.05), visiting friends/relatives on a reservation (P < or =0.01), living the Native way of life (P < or =0.001) and not the white way (P < or =0.05), experiencing back pain (P < or =0.01), and having a physical injury inflicted by a family member (P < or =0.001) were predictive of use. CONCLUSIONS: The results in this clinical setting suggest that health care providers should anticipate use of traditional health practices among urban AI/AN patients. Use was predicted by important demographic, clinical, and cultural characteristics.     

Alcohol Consumption Levels as Compared With Drinking Habits in Predicting All-Cause Mortality and Cause-Specific Mortality in Current Drinkers

ObjectiveTo investigate the joint associations of amounts of alcohol consumed and drinking habits with the risks of all-cause mortality and cause-specific mortality.Patients and MethodsA total of 316,627 healthy current drinkers, with baseline measurements between March 13, 2006, and October 1, 2010, were included in this study. We newly created a drinking habit score (DHS) according to regular drinking (frequency of alcohol intake ≥3 times/wk) and whether consuming alcohol with meals (yes).ResultsDuring a median follow-up of 8.9 years, we documented 8652 incident cases of all-cause death, including 1702 cases of cardiovascular disease death, 4960 cases of cancer death, and 1990 cases of other-cause death. After adjustment confounders and amount of alcohol consumed, higher DHS was significantly associated with a lower risk of all-cause mortality, cardiovascular disease mortality, cancer mortality, or other-cause mortality (P_trend<.001, P_trend=.03, P_trend<.001, and P_trend<.001, respectively). We observed that the amount of alcohol consumed have different relationships with the risks of all-cause mortality and cause-specific mortality among participants with distinct drinking habits, grouped by DHS. For example, in the joint analyses, a J-shaped association between the amount of alcohol consumed and all-cause mortality was observed in participants with unfavorable DHS (P_{quadratic trend}=.02) while the association appeared to be U-shaped in participants with favorable DHS (P_{quadratic trend}=.003), with lower risks in those consuming greater than or equal to 50 g/wk and less than 300 g/wk.ConclusionOur results indicate that alcohol consumption levels have different relationships with the risk of mortality among current drinkers, depending on their drinking habits.     

Evaluating Community-Based Translational Interventions Using Historical Controls: Propensity Score vs. Disease Risk Score Approach

Many community-based translations of evidence-based interventions are designed as one-arm studies due to ethical and other considerations. Evaluating the impacts of such programs is challenging. Here, we examine the effectiveness of the lifestyle intervention implemented by the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project, a translational lifestyle intervention among American Indian and Alaska Native communities. Data from the landmark Diabetes Prevention Program placebo group was used as a historical control. We compared the use of propensity score (PS) and disease risk score (DRS) matching to adjust for potential confounder imbalance between groups. The unadjusted hazard ratio (HR) for diabetes risk was 0.35 for SDPI-DP lifestyle intervention vs. control. However, when relevant diabetes risk factors were considered, the adjusted HR estimates were attenuated toward 1, ranging from 0.56 (95% CI 0.44–0.71) to 0.69 (95% CI 0.56–0.96). The differences in estimated HRs using the PS and DRS approaches were relatively small but DRS matching resulted in more participants being matched and smaller standard errors of effect estimates. Carefully employed, publicly available randomized clinical trial data can be used as a historical control to evaluate the intervention effectiveness of one-arm community translational initiatives. It is critical to use a proper statistical method to balance the distributions of potential confounders between comparison groups in this kind of evaluations.

     

A “modified whitehead” hemorrhoidectomy

Conclusion Is there a place for the “modified White-head” hemorrhoidectomy? Some factors have been found to mitigate against the procedure: 1) inadequate extent of hemorrhoidal disease; 2) excess scar from previous disease or operation; 3) concurrent abscess or fistula: 4) unusually thin, tight anoderm (or conversely, moderately healthy anoderm with some tissue resiliency is an important factor in healing); 5) irritable-bowel disease. However, there is no greater discomfort or disability with this technique than with lesser procedures. We have found acceptable incidences of postoperative wound complications and have created no “wet anus.” We are aware that definitive measures directed toward alleviating postoperative urinary retention are indicated. Attention is being directed to this. We have not had “recurrent” hemorrhoids with this circumferential procedure, which removes all hemorrhoid-bearing tissue and leaves a smooth, unbunched anal canal. Therefore, we feel that this is the surgical procedure of choice for the patient who has advanced hemorrhoidal disease. Read at the meeting of the American Society of Colon and Rectal Surgeons, San Francisco, California, May 4 to 8, 1975.     

Predictors of performance on the MMSE and the DRS-2 among American Indian elders

Little is known about factors that predict older American Indians' performance on cognitive tests. This study examined 137 American Indian elders' performance on the MMSE and the Dementia Rating Scale-Second Edition (DRS-2). Multivariate regression identified younger age, more education, not receiving Supplemental Security Income, and frequent receipt of needed health care as predictors of better performance on the MMSE. Better performance on the DRS-2 was predicted by more education, boarding school attendance, not receiving Supplemental Security Income, and frequent receipt of needed health care. This study points to the importance of economic and educational factors on cognitive test performance among American Indian elders.