Telephone vs Face-to-Face Interviews for Quantitative Food Frequency Assessment

Objective To develop and test a quantitative food frequency method for administration by telephone.Design A comparison study of telephone and face-to-face interviews was conducted among a representative sample of the five major ethnic groups in Oahu, Hawaii. Two interviews were administered 4 to 6 months apart by trained interviewers using identical questionnaires and color photographs of food items showing three different portion sizes. The order of the interviewing methods was randomly assigned. The questionnaire included 115 food items selected to estimate 80% or more of usual dietary intakes. Frequencies and quantities of each item consumed during the past year were obtained.Subjects/setting Subjects were recruited from the Health Surveillance Program of the Hawaii State Department of Health and consisted of 167 men and 158 women, aged 45 to 74 years, who provided a telephone number. Eighty percent of the face-to-face interviews were conducted in the subjects’ homes and 20% were conducted at the workplace or the University of Hawaii Cancer Research Center, if requested.Statistical analyses The paired t test was used to compare the mean daily intakes obtained by the telephone and face-to-face methods. Agreement was measured by the intraclass correlation coefficient (ICC), Pearson correlation coefficient, and weighted κ statistic.Results The means of energy and each nutrient were slightly higher in the first interview than the second, regardless of the interviewing method. Because of close correspondence among all 3 statistical measures of agreement, only the ICCs are reported. The ICCs ranged from .61 for protein and vitamin A to .69 for dietary cholesterol among men, and from .61 for vitamin C to .74 for saturated fat among women. Agreement was not significantly affected by age, gender, ethnicity, order of interview, or educational level.Applications Telephone interviews to obtain quantitative food frequencies are cost-efficient methods for estimating usual dietary intakes among persons in widely scattered geographic areas. Photographs of the foods in 3 portion sizes mailed in advance help the respondents estimate amounts eaten. J Am Diet Assoc. 1998;98:44-48.     

Lability of N-alkylated peptides towards TFA cleavage

Trifluoroacetic acid (TFA) is a common reagent in both solid-phase and solution peptide synthesis. It is used for the deprotection and/or cleavage of the synthesized peptide from the resin. The use of TFA under these standardized conditions is thought to be sufficiently mild, thereby preventing degradation of the desired product. However, peptides of the general structure R¹-(N-alkyl X₁)-X₂-R² are hydrolyzed by standard TFA solid-phase peptide synthesis (SPPS) cleavage/deprotection conditions providing fragments R¹-(N-alkyl X₁)-OH and H-X₂-R². The fragmentation is observed during a TFA cleavage both from the resin and in solution. The hydrolysis is proposed to proceed via an oxazolone-like intermediate in which equilibration of the chiral center of the N-alkylated residue occurs. This mechanism is supported by H/D exchange as observed by MS and NMR in conjunction with HPLC. © Munksgaard 1996.     

Intestinal Absorption Studies on Peptide Mimetic α-Methyldopa Prodrugs

Two dipeptide mimetic prodrugs, 1 and 2 , and two tripeptide mimetic prodrugs, 3 and 4 , of l -α-methyldopa were evaluated for intestinal absorption by in-situ single-pass rat jejunal perfusion studies and by in-vitro uptake experiments in brush-border membrane vesicles (BBMVs) prepared from rat intestine. In the perfusion studies, compound 1 demonstrated a 3.5-fold increase in permeability (P_m* = 2.27) as compared with that of α-methyldopa (P_m* = 0.65), indicating that this prodrug was better absorbed in the intestine than its parent drug. Other prodrugs showed no significant improvement in intestinal permeability. The results correlated with the results of BBMV uptake studies. In the presence of an inward proton gradient, compound 1 showed Michaelis-Menton saturable kinetics of BBMV uptake with a low value of K_m (0.06 ± 0.13 mm ) and a high value of V_max/K_m (36.38 nmol (mg protein)^?1/30 s mm ^?1) at a low concentration range and a linear uptake at high concentrations with K_d = 0.14 ± 0.02 mm . Compounds 2 and 3 were mainly taken up in BBMVs via passive diffusion. Compound 4 was taken up in BBMVs basically via the carrier-mediated transport system, while the rate of uptake was much lower than that of compound 1 . The uptake of compounds 1 and 4 was significantly inhibited by dipeptides l -Gly-l -Pro and l -Gly-l -Phe, and cephradine, a β-lactam known to be transported via the dipeptide carrier system, indicating that both compounds were taken up in BBMVs via the H⁺-coupled dipeptide-mediated transport system. In contrast to the complicated uptake profile of α-methyldopa, the higher rate of BBMV uptake with less variation demonstrated on compound 1 suggested that the attached nonessential amino acid moiety, d -phenylglycine, is a feasible delivery tool in carrying the parent drug through the intestine.     

两仪拱辰丹对老化鼠生殖能力的影响

目的测定两仪共振丹对老化鼠生殖能力的作用。材料与方法我们给8周和18周大的雄鼠服用两仪共振丹溶液8天；给4周和18周大的雌鼠服用4天或8天。我们按雄鼠附睾精液的浓度、运动能力和形态毕以及交配频率测定雄鼠的生殖能力，并按完全排卵的卵母细胞和卵母细胞常态测定雌鼠的生殖能力。同时．对雌雄鼠体外受精和胚胎发育也进行了检测。为了比较差异．我们设立了对照组．以同样的方式给予等量纯水。为测量两仪共振丹的抗氧化作用．对睾丸的n—NOS基因表达、卵巢的i—NOS和e-NOS基因表达进行了测定。结果18周大的雌鼠服用两仪共振丹4—8天，完整排卵的母卵细胞和正常母卵细胞的数量明显增加。服用4天和8天两仪共振丹溶液提高了4周和18周大雌鼠的受精率。服用8天的4周鼠和服用4天和8天的18周鼠．体外受精的胚胎发育率有所提高。用两仪共振丹治疗4周和18周的雄鼠．对精液的浓度、活动性和形态学的改善都是有效的。两仪共振丹溶液可以提高4周和18周鼠的交配率、受精率和体外受精的胚胎发育。两仪共振丹溶液会极大地限制8周鼠睾丸组织的n-NOS基因表达。卵巢组织的i-NOS在8周鼠和18周鼠的基因表达均下降．但是e-NOS只在18周鼠中下降。结论我们可以说．两仪共振丹溶液对鼠的生殖能力的改善具有有益的作用．特别是对老化鼠更为有效。     

Pharmacogenetics of response to simvastatin in Chinese patients with hyperlipidaemia

Objective To examine the relationship of single-nucleotide polymorphisms(SNPs)in candidate genes with the lipid responses to simvastatin.Methods Chinese patients were treated with simvastatin 40 mg daily for at least 6 weeks.20 SNPs in 11 genes were genotyped.Results 95 patients age(mean±SD)57.5±10.6 years completed the treatment.The Adiponectin 45T>G polymorphism was significantly related to absolute reductions in total cholesterol(TC)and LDL-cholesterol with a trend(P=0.053)for percentage reductions in TC(TT∶TG∶GG=-38.4%∶-35.6%∶-32.6%).Similar findings were seen with LDL-Receptor(LDLR)SNPs(2052T>C and 1866C>T)with absolute reductions in TC and LDL-cholesterol significantly associated.The Breast Cancer Resistance Protein(ABCG2)421C>A polymorphism was related(P<0.05)to HDL-cholesterol response(CC∶CA∶AA=+0.50%∶-5.73%∶-11.41%).Conclusions Adiponectin,LDLR and ABCG2 SNPs had some influence on the lipid responses to simvastatin.     

经方的理论特点

现在一般以"仲景方"作为经方的概念范围,对于经方的理论特点则甚少讨论。较多观点认为经方"药少精炼、功专力宏",但这是相对于临床处方而言,而时方亦有此特点,经方与时方界线不清。若从经方自身深入分析,可知经方的药味加减严谨,一药变化即成新方;比例严谨,加减一药方中剂量亦变;剂量严格,比例不同亦为新方。由此进一步讨论,经方的特点在于"方与方之间"的关系,重视不同方药之间的关系,经方的价值在于整体的理论体系,而非零碎的用方经验。因此,临床上如何处方才算使用经方还必须要严格按照原方的要求,对药物组成以及剂量比例有所遵从,除原方外更重视原意。提倡经方实际是倡导对于整套中医经典理论的高水平掌握。     

The development and validation of a new coeliac disease quality of life survey (CD‐QOL)

Aliment Pharmacol Ther 31 , 666–675

Summary

Background Previous studies on coeliac disease (CD)‐related quality of life (QOL) have been limited by their use of a ‘generic’ rather than coeliac disease‐specific assessment instruments. Aim To develop and psychometrically validate a new coeliac disease‐specific instrument, the CD‐QOL. Methods Through a series of focus groups, we elicited items from patients that related to the specific nature of their disease and its impact on their basic needs. Through expert review, cognitive debriefing with patients and pilot testing, a scale was developed, refined and administered to 387 patients on a gluten‐free diet from both community‐based support groups and a tertiary care referral centre. Finally, a formal validation study was conducted to assess the psychometric properties of the CD‐QOL. Results The final CD‐QOL has 20 items across four clinically relevant subscales (Limitations, Dysphoria, Health Concerns, and Inadequate Treatment). The CD‐QOL has high internal consistency, reliability, and psychometric validation indicates both convergent and discriminate validity. Conclusions The CD‐QOL is a reliable and valid measure of coeliac disease related QOL. As a new disease‐specific instrument, it is likely to be a useful tool for evaluating patients with this disorder.     

Bartter's syndrome and diabetes mellitus

Abstract. We here report a case of Bartter's syndrome occurring in association with diabetes mellitus. The patient, an insulin-dependent diabetic, presented with hypokalaemia, inappropriate kaliuresis and metabolic alkalosis. He had high plasma renin activity, relatively low plasma aldosterone, and resistance to infused angiotensin II. A high potassium diet raised total body potassium and serum potassium, did not affect plasma renin activity, but raised plasma aldosterone significantly and did not alter the resistance to angiotensin II. Indomethacin administered acutely reduced urinary potassium and kallikrein excretion and, on chronic administration, lowered plasma renin activity, urinary chloride excretion, and raised serum potassium. Salt restriction resulted in a prompt and significant reduction in urinary sodium and chloride excretion. Urinary kallikrein excretion was very high throughout, increased with sodium restriction, and decreased with sodium loading. Oral potassium supplementation partially corrected the hypokalaemia, but did not affect blood sugar control. In this patient the primary defect appears to have been primary urinary potassium wasting, rather than sodium or chloride wasting. The striking effects of indomethacin suggest that prostaglandins may play a fundamental role in the genesis of the syndrome.     

COMPARISON OF THE INCIDENCE AND NATURE OF CARDIAC ARRHYTHMIAS OCCURRING DURING ISOFLURANE OR HALOTHANE ANAESTHESIA: Studies During Dental Surgery

Seventy-six Chinese patients aged between 15 and 30 yr, undergoing3rd molar extraction, were randomly allocated to two groups.One group received halothane and the other isoflurane. The incidenceof arrhythmia during surgery under anaesthesia with isofluranewas significantly less than with halothane. Sinus tachycardiawas a significant feature under anaesthesia with isoflurane.Under anaesthesia with halothane, the arrhythmias occurringmost frequently during surgery were ventricular ectoplcs, thecommonest being ventricular bigemlny. The frequency and natureof arrhythmias during surgery on right and left sides were similar.In three patients a slight decrease in arterial pressure wasrecorded in association with the arrhythmia, but on stoppingthe stimulus, both rhythm and arterial pressure returned tonormal. The incidence of arrhythmia with halothane in the Chinesepopulation in this study was significantly higher than thatreported previously in non-Chinese patients.     

Snake skin pattern gastropathy in cirrhotic patients

Gastric mucosal lesions are common in patients with cirrhosis. Among them, snake skin pattern gastropathy (SSPG) is the most distinguishing one. A prospective study was conducted to investigate the incidence of SSPG in cirrhotic patients, the relationship between the degree of portal pressure and SSPG, and the possible association of SSPG with serum levels of gastrin and pepsinogen I. SSPG was found to be significantly more common in 100 cirrhotic patients than in 100 age- and sex-matched healthy controls (41% vs 0%, P less than 0.0001). Hepatic venous pressure gradient and serum gastrin and pepsinogen I levels were measured in 21 cirrhotic patients with SSPG and 25 cirrhotics without SSPG. There was no significant difference in hepatic venous pressure gradient (16.1 +/- 4.4 mmHg vs 16.1 +/- 4.9 mmHg, P greater than 0.05), serum gastrin level (78.0 +/- 26.7 pg/mL vs 80.1 +/- 32.5 pg/mL, P greater than 0.05) and serum pepsinogen I level (69.5 +/- 26.6 ng/mL vs 65.2 +/- 26.1 ng/mL, P greater than 0.05) in cirrhotic patients with or without SSPG. In conclusion, SSPG is common in cirrhotic patients. Portal pressure per se may not be the only factor causing SSPG--other aggressive factors may be needed together to cause the gastropathy. There is no evidence of correlation between serum gastrin or pepsinogen I level and SSPG.