Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

Background

Schizophrenia is a chronic illness which brings detrimental effects in the caregivers' health. This study was aimed at highlighting the socio-demographic, clinical and psychosocial factors associated with the subjective Quality of Life (QOL) of Malaysian of primary family caregivers of subjects with schizophrenia attending an urban tertiary care outpatient clinic in Malaysia.

Methods

A cross-sectional study was performed to study patient, caregiver and illness factors associated with the QOL among 117 individuals involved with caregiving for schizophrenia patients. The study used WHOQOL-BREF to assess caregivers' QOL and Brief Psychiatric Rating Scale (BPRS) to assess the severity of patients' symptoms. Social Readjustment Rating Scale (SRRS) assessed the stress level due to life events.

Results

The mean scores of WHOQOL-BREF in physical, psychological, social and environmental domains were 66.62 (14.36), 61.32 (15.52), 62.77 (17.33), 64.02 (14.86) consecutively. From multiple regression analysis, factors found to be significantly associated with higher QOL were higher educational level among caregivers in social and environmental domains; caregivers not having medical problem/s in physical and psychological domains; later onset and longer illness duration of illness in social domains; patients not attending day care program in environmental domain; lower BPRS score in physical and environmental domains. SRRS score of caregivers was also found to have a significant negative correlation with QOL in environmental and psychological domains. Other factors were not significantly associated with QOL.

Conclusion

Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL.     

攻毒扶正法对非酒精性脂肪性肝炎大鼠瘦素、胰岛素的影响

目的：观察攻毒扶正法对非酒精性脂肪性肝炎（NASH）大鼠瘦素（LEP）、胰岛素（INS）的影响。方法：用高脂饲料与四氯化碳（CCl4）制备NASH大鼠模型,分别用乙肝系列中成药（乙肝清热解毒颗粒、乙肝益气解郁颗粒、乙肝养阴活血颗粒）、辛伐他丁溶液进行灌胃。分为正常组,模型组,辛伐他丁组,清热解毒组,益气解郁组,养阴活血组,清热解毒合益气解郁组（简称清解合益气组）,清热解毒合养阴活血组（简称清解合养阴组）共8组,每组12只。用药4周后显微镜下观察NASH大鼠肝脏HE染色切片,并对肝组织病变程度评分。检测肝功能、血脂、LEP、INS情况。结果：模型组肝组织病变程度评分明显高于正常组（P〈0.01）,丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）升高,总胆固醇（TCh）升高明显（P〈0.01）,LEP、INS水平均升高（P〈0.05）。治疗组均可降低LEP水平,肝组织病变评分降低。中药组的ALT、AST、TC、LEP、INS含量有下降趋势（P〈0.05或〈0.01）;辛伐他丁组能降低ALT、INS含量,差异无显著性意义。结论：NASH大鼠体内有明显LEP、INS水平升高趋势。各治疗组均能降低大鼠体内LEP、INS水平。通过各类指标的检测,中药组改善作用更为明显。证明攻毒扶正法治疗NASH大鼠有切实的作用。     

Estimation of undernutrition and mean calorie intake in Africa: methodology, findings and implications

Background  

As poverty and hunger are basic yardsticks of underdevelopment and destitution, the need for reliable statistics in this domain is self-evident. While the measurement of poverty through surveys is relatively well documented in the literature, for hunger, information is much scarcer, particularly for adults, and very different methodologies are applied for children and adults. Our paper seeks to improve on this practice in two ways. One is that we estimate the prevalence of undernutrition in sub-Saharan Africa (SSA) for both children and adults based on anthropometric data available at province or district level, and secondly, we estimate the mean calorie intake and implied calorie gap for SSA, also using anthropometric data on the same geographical aggregation level.     

骨髓基质细胞分化为神经元样细胞后与皮质神经元间突触的建立

目的 观察与大脑皮质神经元共培养的骨髓基质细胞(BMSCs)经诱导分化成神经元样细胞后,与脑皮质神经元之间形成功能性突触的情况.方法 无菌条件下取绿色荧光蛋白(GFP)转基因小鼠骨髓,用贴壁筛选法体外培养获得GFP转基因小鼠BMSCs(GFP-GM-BMSCs),在体外培养、扩增、纯化.取第3代GFP-GM-BMSCs,种植到源于小鼠大脑的原代皮质神经元和胶质细胞中,培养介质为加有20 ng/mL表皮生长因子(EGF)、20 ng/mL碱性成纤维细胞生长因子(bFGF)的无血清培养基(Neurobasal-A+2%B27),体外模拟建立细胞移植的共培养体系.共培养第10天,利用FM1-43荧光染料染色活动突触小泡的特性,通过荧光显微镜观察共培养的两种细胞之间形成的突触.结果 与神经元共培养的GFP-GM-BMSCs在含有EGF、bFGF的无血清培养基中7 d后分化为神经元样细胞.共培养10 d后,FM1-43染色阳性的突触囊泡明显增加,主要位于神经元样细胞胞体、突起及其末端结构上.结论 在体外模拟细胞移植共培养体系中,分化自GFP-GM-BMSCs的神经元样细胞能与神经元之间形成突触样连接.     

重组腺病毒介导的人野生型p53,GM-CSF和B7-1基因在胰腺癌细胞中的表达

目的: 以复制缺陷型重组腺病毒为载体,使用人野生型p53基因、人GM-CSF基因和B7-1基因为目的基因,探讨三基因在胰腺癌细胞BxPC-3中的表达.方法: 免疫组织化学方法检测外源性p53蛋白在BxPC-3细胞中表达.ELISA方法测定GM-CSF表达量;流式细胞术(flow cytometry,FCM)检测BxPC-3细胞转染B7-1的表达效果.结果: 重组腺病毒介导的p53基因、GM-CSF基因、B7-1基因在BxPC-3细胞中得到高效表达.结论: 重组腺病毒介导的外源基因在BxPC-3细胞中得到高效的表达,为进一步探讨其体内外治疗胰腺癌的实验研究提供了理论基础.     

人胎盘间充质干细胞的生物学特性及超微结构

目的 研究胎盘间充质干细胞生物学特性和超微结构,并探讨其在骨组织工程学中修复重建的应用前景.方法 胎盘间充质干细胞,测定其细胞周期及凋亡率情况,原子力显微镜观察细胞的表面结构,及向成骨细胞诱导分化.结果 人胎盘间充质干细胞为成纤维细胞样,增殖能力强,9.7％的细胞处于G2/M期或者S期.超微结构分析显示其细胞代谢活跃,黏附能力强,能被诱导分化为成骨细胞.结论 人胎盘间充质干细胞具备适合应用于骨组织工程学的良好生物学特性,并避免了免疫排斥和伦理问题,可望成为骨组织修复重建中的一个新的治疗途径.     

Another tool in the genome-wide association study arsenal: population-based detection of somatic gene conversion

The hunt for the genetic contributors to complex disease has used a number of strategies, resulting in the identification of variants associated with many of the common diseases affecting society. However most of the genetic variants detected to date are single nucleotide polymorphisms (SNPs) and copy number variants (CNVs) and fall far short of explaining the full genetic component of any given disease. An as yet untapped genomic mechanism is somatic gene conversion and deletion, which could be complicit in disease risk but has been challenging to detect in genome-wide datasets. In a recent publication in BMC Medicine by Kenneth Ross, the author uses existing datasets to look at somatic gene conversion and deletion in human disease. Here, we describe how Ross's recent efforts to detect such occurrences could impact the field going forward.     

85例Stanford B型主动脉夹层腔内修复治疗体会

目的 探讨胸主动脉腔内修复术(TEVAR)治疗Stanford B型主动脉夹层(AD)方法与疗效.方法 回顾性分析2010年1月至2016年4月采用TEVAR治疗的85例Stanford B型AD患者临床资料.85例患者均常规行左肱动脉穿刺,右侧股动脉直切口,升主动脉DSA造影明确AD破口位置、真假腔及与重要器官血管开口位置关系;置入覆膜血管内支架,封堵原发破口,升主动脉造影复查观察近端破口封闭情况及主动脉弓部分支血管、真假腔血流变化情况.结果 84例患者TEVAR手术成功,成功率100％;1例术前麻醉过程中突发AD破裂死亡.9例部分覆盖左锁骨下动脉,1例左锁骨下动脉“烟囱”支架完全封闭左颈总动脉和左锁骨下动脉,2例行无名动脉至左颈总动脉和左锁骨下动脉转流.Ⅰ型内漏2例,无住院期间死亡.术后随访3个月至3年,患者均存活,远端再发新破口2例.结论 TEVAR术治疗Stanford B型AD安全有效,严格把握手术指征、术中精细操作及加强术后院外管理是手术成功、提高远期生存率关键.     

彩色多普勒超声诊断良恶性甲状腺结节的参考价值

目的分析良、恶性甲状腺结节的彩色多普勒超声表现,以提高超声诊断和鉴别诊断良、恶性甲状腺结节的价值。方法回顾性分析经手术、病理明确诊断的157个良、恶性甲状腺结节的彩色多普勒超声表现,良、恶性结节的形态、回声、钙化特点、彩色多普勒血流图血流信号分布等。结果157个甲状腺结节经病理诊断,其中 90个为良性结节,67个为恶性结节;本组病例彩色多普勒超声检查的特异性为92.2%,敏感性为80.6%,诊断符合率为87.2%;彩色多普勒超声图像显示甲状腺良、恶性结节的形态、边界、包膜、回声、血流信号分布、内部钙化情况、血流阻力指数值比较,差异比较均具有统计学意义（P<0.05）。结论彩色多普勒超声可诊断甲状腺病变,依据重要的参考指标,可评价甲状腺结节的良、恶性。     

Genetics of Bone Mass in Childhood and Adolescence: Effects of Sex and Maturation Interactions

We aimed to determine if adult bone mineral density (BMD) susceptibility loci were associated with pediatric bone mass and density, and if sex and pubertal stage influenced any association. We analyzed prospective areal BMD (aBMD) and bone mineral content (BMC) data from the Bone Mineral Density in Childhood Study (n = 603, European ancestry, 54% female). Linear mixed models were used to assess if 77 single‐nucleotide polymorphisms (SNPs) near known adult BMD susceptibility loci interacted with sex and pubertal stage to influence the aBMD/BMC; adjusting for age, BMI, physical activity, and dietary calcium. The strongest main association was observed between an SNP near C7orf58 and distal radius aBMD. However, this association had a significant sex?SNP interaction, revealing a significant association only in females (b = –0.32, p = 1.8 × 10^–6). Furthermore, the C12orf23 locus had significant interactions with both sex and pubertal stage, revealing associations in females during Tanner stage I for total hip aBMD (b = 0.24, p = 0.001) and femoral neck aBMD (b = 0.27, p = 3.0 × 10^–5). In contrast, the sex?SNP interactions for loci near LRP5 and WNT16 uncovered associations that were only in males for total body less head BMC (b = 0.22, p = 4.4 × 10^–4) and distal radius aBMD (b = 0.27, p = 0.001), respectively. Furthermore, the LRP5 locus interacted with both sex and pubertal stage, demonstrating associations that were exclusively in males during Tanner V for total hip aBMD (b = 0.29, p = 0.003). In total, significant sex?SNP interactions were found at 15 loci; pubertal stage?SNP interactions at 23 loci and 19 loci interacted with both sex and pubertal stage. In conclusion, variants originally associated with adult BMD influence bone mass in children of European ancestry, highlighting the fact that many of these loci operate early in life. However, the direction and magnitude of associations for a large number of SNPs only became evident when accounting for sex and maturation. © 2015 American Society for Bone and Mineral Research.