"Stem cell" origin of the hematopoietic defect in dyskeratosis congenita

We have used the long-term bone marrow culture (LTBMC) system to analyze hematopoiesis in three patients with dyskeratosis congenita (DC), two of whom had aplastic anemia, and the third had a normal blood count (apart from mild macrocytosis) and normal BM cellularity. Hematopoiesis was severely defective in all three patients, as measured by a low incidence of colony-forming cells and a low level of hematopoiesis in LTBMC. The function of the marrow stroma was normal in its ability to support the growth of hematopoietic progenitors from normal marrows seeded onto them in all three cases, but the generation of hematopoietic progenitors from patients marrow cells inoculated onto normal stromas was reduced, thus suggesting the defect to be of stem cell origin. The parents and unaffected brother of one of the families have also been studied in LTBMC and all showed normal hematopoietic and stromal cell function. From this study we speculate that there are some similarities between DC and the defect in the W/Wv mouse.     

Additive effect of erythropoietin and heme on murine hematopoietic recovery after azidothymidine treatment [see comments]

The ability of combination treatment with erythropoietin (Epo) and heme to rescue hematopoietic activity in mice from the suppressive effect of azidothymidine (AZT) was determined. Exposure of mice to AZT for 5 weeks produced marked anemia, thrombocytopenia, neutropenia, and weight loss, whereas mice that received Epo and heme for 3 subsequent weeks showed significant alleviation of AZT cytotoxicity. Treatment with Epo (10 U for 5 times/week) stimulated hematopoietic recovery in the AZT- treated animals and reduced the severe anemia and thrombocytopenia by 3 weeks. Administration of a lower Epo dose (1 U Epo) resulted in only a modest retardation of AZT-induced anemia, although, when combined with heme, there was a great improvement in recovery of erythropoiesis. The combination of heme with Epo (10 U) produced the optimum response, resulting in almost normal recovery of bone marrow cellularity as well as recovery of burst-forming units-erythroid (BFU-E) and splenic hematopoietic progenitor content (colony-forming unit-spleen [CFU-S]) by the end of 3 weeks of post-AZT treatment. Treatment with heme alone markedly enhanced the recovery of BFU-E and CFU-S, as well as body weight post-AZT; however, this recovery was not to the extent seen in combination with Epo (10 U). Long-term bone marrow cultures (LTBMCs) established from mice exposed to AZT for 8 weeks showed a marked reduction in cellularity and this was completely alleviated when mice received heme and Epo (10 U) for 3 weeks after 5 weeks of AZT administration. The additive effect of heme and Epo was seen in BFU-E production, as well as in CFU-S production, in LTBMCs. Thus, heme exerts a significant protective effect on hematopoietic progenitors in vivo and may be of potential clinical use in combination with Epo to promote effective erythropoiesis in the setting of AZT therapy.     

Effects of partial neuromuscular blockade on sympathetic nerve responses to static exercise in humans

We used intraneural recordings of sympathetic nerve activity in conscious humans to determine if central command increases sympathetic discharge to resting skeletal muscle during static exercise. In nine healthy subjects, we measured arterial pressure, heart rate, and muscle sympathetic nerve activity with microelectrodes in the peroneal nerve of the resting leg during 1) static handgrip at 15% and 30% maximal voluntary contraction and 2) attempted handgrip during partial neuromuscular blockade produced by systemic administration of tubocurarine chloride (0.075 mg/kg i.v.). During curare, subjects reported that they used near-maximal motor effort to attempt a sustained handgrip contraction, but they generated almost no force. Without sustained contraction, the intent to exercise alone, that is, central command, caused statistically significant (p less than 0.05) increases in muscle sympathetic nerve activity as well as in arterial pressure and heart rate. However, the increases in muscle sympathetic nerve activity (+ 56 +/- 16% over control) and in mean arterial pressure (+ 12 +/- 2 mm Hg) during attempted handgrip were much smaller (p less than 0.05) than the sympathetic nerve response (+ 217 +/- 37% over control) and pressor response (+ 25 +/- 3 mm Hg) during an actual static handgrip at 30% maximal voluntary contraction. In contrast, heart rate increased as much during the attempted contraction (+ 18 +/- 2 beats/min) as during the actual contraction at 30% maximal voluntary contraction (+ 16 +/- 4 beats/min). In 11 additional subjects, the heart rate responses during curare were greatly attenuated (p less than 0.05) by atropine but were not significantly affected by propranolol.(ABSTRACT TRUNCATED AT 250 WORDS)     

军队大型综合性医院床位规模效益实证分析

目的分析我国军队大型综合性医院床位规模效益,指导医院改革。方法描述性分析我国20多年来大型综合性医院床位规模现状,运用对我国军队6所大型综合性医院床位规模效益进行分析。结果军队大型综合性医院总体效率较高,但存在投入过多或产出不足,导致部分医院低效率。结论随着社会经济的不断发展,医院床位规模的增长成为必然趋势。医院应根据区域卫生规划、病床的使用情况等因素调整规模。     

养老机构老年人健康素养与身体健康和心理健康状况的关系

目的了解养老机构老年人健康素养与身体健康、心理健康状况的关系,为进一步提高老年人身体健康和心理健康状况提供科学依据。方法于2011年9月至2012年6月,采用整群抽样法对新疆乌鲁木齐市、昌吉市、石河子市、克拉玛依市44所养老机构1396名老年人进行调查,将其中符合纳入标准的1452名老年人作为研究对象,发放健康素养量表、健康状况问卷及一般状况量表。结果单因素分析结果显示,养老机构老年人身体健康在性别、教育水平、家庭收入、婚姻状况方面差异均有统计学意义（P〈0．01,P〈0．05）;心理健康在教育水平、家庭收入、婚姻状况、曾经从事职业方面差异均有统计学意义（P〈0．01）。进一步分析表明,教育水平低、家庭收入少及丧偶老年人身体健康、心理健康状况较差。养老机构老年人健康素养总分数为（71．74±28．35）分,4个维度分别为健康知识（32．49±16．88）分、健康信念（22．80±7．41）分、健康行为（9．60±3．91）分、健康技能（6．22±5．09）分,均处于较低水平。多元线性回归分析表明,养老机构老年人身体健康的独立影响因素有健康行为、教育水平、婚姻状况、曾经从事职业（P〈0．05）,心理健康的独立影响因素有健康行为、曾经从事职业、家庭人口数、健康技能、教育水平、婚姻状况（P〈0．05）。结论健康素养是影响老年人身体、心理健康状况的重要因素,提高老年人健康素养是促进老年人自我健康管理和健康状况的重要途径。     

健康教育在冠心病心绞痛患者中的应用

目的探讨健康教育在冠心病心绞痛患者中的临床价值。方法将100例冠心病心绞痛患者随机分为观察组和对照组各50例,根据病情、病程对观察组实施系统的健康教育,对照组给予传统的护理措施,比较两组的治疗效果、相关知识的知晓率以及患者满意度。结果观察组总有效率明显高于对照组．观察组的心绞痛知识、饮食知识及用药知识的知晓率均明显高于对照组患者,观察组的宣教满意度、态度满意度、操作满意度及结果满意度等评分亦明显高于对照组;差异均有统计学意义（P〈0．05）。结论健康教育能显著提高冠心病心绞痛患者的临床疗效、相关知识掌握程度以及患者满意度。     

高三酰甘油腰围表型与糖尿病前期及2型糖尿病发病风险的关系

摘要：目的探讨高三酰甘油（TG）腰围表型与糖尿病前期及2型糖尿病（T2DM）发病风险的关系。方法从参与2011年4—11月四川省泸州地区2型糖尿病患者肿瘤发生风险流行病学调查研究的基线调查者中筛选出1 722例糖耐量正常者,以血TG≥1.7 mmol/L、男性腰围≥90 cm或女性腰围≥80 cm为切点,分为TG和腰围正常组（856例）、单纯高三酰甘油血症组（133例）、单纯腹型肥胖组（518例）、高三酰甘油血症-腰围表型（HTWC）组（215例）,行5年随访观察,比较各组间糖尿病前期及T2DM发病情况。结果随访5年后,1 722例糖耐量正常者中共445例发展为糖尿病前期,67例发展为T2DM。TG和腰围正常组、单纯高三酰甘油血症组、单纯腹型肥胖组、HTWC组糖尿病前期发病率分别为20.7%（177/856）、21.1%（28/133）、30.5%（158/518）、38.1%（82/215）,T2DM发病率分别为2.9%（25/856）、3.8%（5/133）、4.4%（23/518）、6.5%（14/215）。在调整了年龄、性别、空腹血糖、餐后2 h血糖、收缩压、糖化血红蛋白后,多分类无序Logistic回归分析结果显示,HTGW表型人群的糖尿病前期及T2DM发病风险较正常组升高,其OR（95%CI）分别为1.961（1.387～2.773）与2.638（1.279～5.441）。结论HTWC表型是糖尿病前期及T2DM患病的危险因素,可作为筛选两者高风险人群的简便指标。     

Anaphylaxis: an update for dental practitioners

Anaphylaxis is an acutely presenting life‐threatening medical emergency. Surveys indicate that dentists feel inadequately able to recognize and treat anaphylaxis. This paper reviews the terminology and pathophysiology of anaphylaxis, and describes the recognition and initial management of anaphylaxis for dentists. Dentists should be able to administer intramuscular adrenaline during anaphylaxis at the appropriate dose. The role of further medical care is also explained. Six cases of anaphylaxis arising from dental oral maxillofacial surgery practice are discussed.     

环孢素 A 对大鼠牙槽骨内 DMP1 C 末端和 OPN 表达的影响

目的：观察环孢素A（cyclosporinA,CsA）对大鼠牙槽骨内牙本质基质蛋白1（dentinmatrixprotein,DMP1）C末端和骨桥蛋白（osteopontin,OPN）表达的影响。方法：30只7周龄健康雄性Wistar大鼠,随机等分为对照组和实验组,每组再随机等分为20d、30d和40d3个亚组,实验组大鼠喂饲CsA（30mg／k·d）。免疫组化法染色下颌第一磨牙颊舌向石蜡切片,光镜下观察DMP1C末端和OPN在牙槽骨内的表达情况。结果：与对照组大鼠比较,实验组大鼠牙槽骨内DMP1C末端表达明显下调,OPN表达明显上调;在本实验周期内,上述变化随实验时间的延长而加重。结论：CsA影响大鼠牙槽骨内矿化相关非胶原蛋白DMP1C末端和OPN的表达,推测CsA可能抑制大鼠牙槽骨的矿化。     

卵巢早衰危险因素的病例对照研究

目的：广泛探索卵巢早衰的危险因素,为卵巢早衰的预防提供科学依据.方法：采用1：2配比的病例对照研究方法.结果：单因素条件Logistic回归分析显示婚姻状况、人工流产次数等14个变量与卵巢早衰的发生有关;而多因素条件Logistic回归调整后的结果显示婚姻状况（OR=6.098）、人工流产次数（OR=2.176）、吸烟（OR=3.203）、染发（OR=2.759）、心情（OR=0.157）、蔬菜的摄入频率（OR=0.313）、腮腺炎病史（OR=10.475）与卵巢早衰的发生仍有关联.结论：婚姻状况、人工流产次数、蔬菜摄入频率、吸烟、染发、心情、腮腺炎病史是卵巢早衰发生的主要影响因素.