Adolescent pregnancy--current trends and issues: 1998 American Academy of Pediatrics Committee on Adolescence, 1998-1999

Although the prevention of unintended adolescent pregnancy is a primary goal of the American Academy of Pediatrics and society, many adolescents continue to become pregnant. Since the last statement on adolescent pregnancy was issued by the Academy in 1989, new observations have been recorded in the literature. The purpose of this new statement is to review current trends and issues on adolescent pregnancy to update practitioners on this topic.     

肠源性内毒素血症与肝病

近年来,肠源性内毒素血症(intestinal endotoxemia,IETM)与肝病的关系日益受到重视.临床观察表明,各种急、慢性肝炎、肝硬变和重型肝炎患者内毒素血症(endotoxemia,ETM)发生率有不同程度升高.内毒素与肝损害之间存在着密切的关系[1-3].二者可互为因果,从而对肝病的发生发展产生重要影响.特别是内毒素作用于肝脏后,引起多种细胞因子分泌与释放,导致肝脏损害进一步加重,甚至出现黄疸、出血、肾功能衰竭与肝性脑病等肝功能衰竭临床综合征.     

抗溃疡药瑞巴匹特的合成

目的：合成抗溃疡药２－（４－氯苯甲酰胺基）－３－（１,２－二氢－２－氧代－４－喹啉基）丙酸）瑞巴匹特）。方法：以乙酰乙酰苯胺为起始原料,经溴化,成环,取代,酸解,及缩合等五步反应合成该化合物。结果：合成产物经元素分析,经外光谱,核磁共振谱,质谱等确证。结论：此合成路线是完全可行的。     

Delay in platelet recovery after bone marrow transplantation: impact of cytomegalovirus infection

The effect of cytomegalovirus (CMV) infection on hematopoietic recovery after marrow-ablative chemoradiotherapy followed by autologous bone marrow transplantation (BMT) was studied in patients with non-Hodgkin's lymphoma of high-grade malignancy and in patients with acute leukemia. The recovery of platelets after autologous BMT occurred significantly quicker in CMV-negative patients than in CMV-positive patients (platelets greater than 50,000 per cubic millimeter after 21 1/2 v 40 days, respectively). No differences in the recovery of neutrophils were found between those with or without CMV infection. CMV-positive patients required significantly more transfusion support with thrombocyte concentrates than CMV-negative patients (three v six thrombocyte concentrates). In conclusion, CMV infections do not influence neutrophil recovery but do delay platelet recovery. As a consequence, patients with a CMV infection, whether primary, reactivated, or latent, require more thrombocyte concentrates, which increases the risk of transfusion-related infections.     

Carpal predominance in rheumatoid arthritis

Radiographic and clinical evaluation of the relative severity of wrist versus hand involvement in 101 patients with rheumatoid arthritis revealed more severe changes in the wrists in 60%, equal involvement in wrists and hands in 37%, and more severe changes in the hands in 3%. There were severe changes in the wrists but little or no bone or joint change in the metacarpophalangeal and proximal interphalangeal joints in 43 (21%) of the 202 extremities studied. Serial examinations showed that, in time, the hand changes tended to overtake those in the wrist. Appreciation of this progression of wrist and hand changes can help the physician avoid diagnostic difficulties in a significant percentage of patients.     

Genome‐Wide Haplotype Association Mapping in Mice Identifies a Genetic Variant in CER1 Associated With BMD and Fracture in Southern Chinese Women

BMD is a heritable trait and risk indicator for osteoporosis. In this study, we used a genome‐wide haplotype association mapping (HAM) approach to identify a haplotype block within Cer1 that partitions inbred mice strains into high and low BMD groups. A cohort of 1083 high and low BMD human subjects were studied, and a nonsynonymous SNP (rs3747532) in human CER1 was identified to be associated with increased risk of both low BMD in premenopausal women (OR: 2.2; 95% CI: 1.0–4.6; p < 0.05) and increased risk of vertebral fractures (OR: 1.82, p = 0.025) in the postmenopausal cohort. We also showed that Cer1 is expressed in mouse bone and growth plate by RT‐PCR, immunohistochemistry, and in situ hybridization, consistent with polymorphisms potentially influencing BMD. Our successful identification of an association with CER1 in humans together with our mouse study suggests that CER1 may play a role in the development of bone or its metabolism. Our study highlights the use of publicly available databases for rapidly surveying the genome for quantitative trait loci.