灰毡毛忍冬化学成分研究V灰毡毛忍冬素F和G的结构测定

灰毡毛忍冬化学成分研究Ｖ灰毡毛忍冬素Ｆ和Ｇ的结构测定陈敏，吴威巍，沈国强，罗思齐，李惠庭（上海医药工业研究院２０００４０）灰毡毛忍冬（ＬｏｉｎｃｅｒａｍａｃｒａｎｔｈｏｉｄｅｓＨａｎｄ．－Ｍａｚｚ）系忍冬科忍冬属植物，别名大花忍冬，分布于贵州、广西、...     

Malawian midwives' perceptions of occupational risk for HIV infection

In this study, Malawian midwives' perceptions of occupational risk of human immunodefiency virus (HIV) infection are described. Knowledge of perceptions of HIV risk in developing countries and consequences on patient care is limited. A qualitative approach using purposive sampling was undertaken with 7 midwives. Participants considered their occupational risk to be high, encompassing these four themes: exposure to body fluids, availability of resources, hand washing practices, and support from management. Additional themes related to the impact of high risk on clinical practice: working in a climate of fear, refraining from touch, loss of interest in midwifery, and improvising care practices.     

Activation of the CPP32 protease in apoptosis induced by 1-beta-D- arabinofuranosylcytosine and other DNA-damaging agents

The response of human myeloid leukemia cells to treatment with 1-beta- arabinofuranosylcytosine (ara-C) includes the induction of apoptosis. Ara-C induced apoptosis is associated with proteolytic cleavage of poly(ADP-ribose) polymerase (PARP) and protein kinase C (PKC) delta. However, the signals involved in this response are unknown. The present studies show that ara-C treatment of U-937 cells is associated with induction of a protease activity that cleaves the tetrapeptides Ac-DEVD- pNA and Ac-DMOD-pNA found at the cleavage sites of PARP and PKC delta, respectively. The ara-C-induced protease activity was sensitive to overexpression of the anti-apoptotic protein Bcl-xL and the baculovirus protein p35. By contrast, overexpression of the cowpox virus protein CrmA blocked apoptosis induced by engagement of the Fas receptor but not that induced by ara-C. CrmA overexpression also had no detectable effect on ara-C-induced cleavage of PKC delta. The results further show that ara-C induces activation of the CPP32 protease by a CrmA- insensitive and p35-sensitive mechanism. Similar results were obtained with cisplatinum, etoposide, and camptothecin. These findings indicate that ara-C and other DNA-damaging agents activate a CrmA-insensitive apoptotic pathway involving CPP32 and that these signals differ from those associated with apoptosis induced by the Fas receptor.     

Organic anions and the diarrhea of inflammatory bowel disease

To determine if organic anions contribute to the diarrhea of inflammatory bowel disease, we measured osmolality, electrolytes, short-chain fatty acids, lactic acid, and some Krebs cycle anions in 24-hr fecal collections from 18 patients with chronic ulcerative colitis, 20 with Crohn's disease of the colon, and 16 normals. Mean lactic acid concentration was significantly elevated in ulcerative and Crohn's colitis, but values correlated with fecal weight only in the former syndrome. In ulcerative colitis, concentrations of each short-chain fatty acid, especially butyrate, were decreased compared with those from normals or Crohn's disease. Lactate and short-chain fatty acids accounted for nearly half the variability in fecal weight in ulcerative colitis. Crohn's patients had elevated mean fecal water osmolality and osmotic gap not observed in ulcerative colitis. Increased lactic acid and/or deficient short-chain fatty acids may modulate the diarrhea of ulcerative colitis. This mechanism seems less important in Crohn's colitis where an additional osmotic component may be significant.This work was supported in part by grant 3651 from an endowment of the T.T. Dee and G.F. Moody Fund through Evanston Hospital, Evanston, Illinois.     

Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative

PURPOSE: We examine 6-month effects of the Environmental Skill-Building Program on caregiver well-being and care recipient functioning and whether effects vary by caregiver gender, race (White or non-White), and relationship (spouse or nonspouse). DESIGN AND METHODS: We enrolled 255 family caregivers of community-residing persons with Alzheimer's disease or related disorders, of whom 190 participated in a follow-up interview. Caregivers were randomized to a usual care control group or intervention group that received five home contacts and one telephone contact by occupational therapists, who provided education, problem-solving training, and adaptive equipment. Baseline and 6-month follow-up included self-report measures of caregiver objective and subjective burden, caregiver well-being, and care recipient problem behaviors and physical function. RESULTS: Compared with controls (n = 101), intervention caregivers (n = 89) reported less upset with memory-related behaviors, less need for assistance from others, and better affect. Intervention spouses reported less upset with disruptive behaviors; men reported spending less time in daily oversight; and women reported less need for help from others, better affect, and enhanced management ability, overall well-being, and mastery relative to control group counterparts. Statistically significant treatment differences were not found for hours helping with instrumental activities of daily living, upset with providing assistance with instrumental activities of daily living and activities of daily living, perceived change in somatic symptoms, White versus non-White caregivers, or care recipient outcomes. IMPLICATIONS: The Environmental Skill-Building Program reduces burden and enhances caregiver well-being in select domains and has added benefit for women and spouses.     

Confidence intervals for seroprevalence determined from pooled sera.

In population surveys of seroprevalence, it may not be most efficient to test all individual samples. The laboratory and statistical issues encountered when one first pools individual samples into groups of samples before laboratory analyses were discussed recently in relation to the seroprevalence of human immunodeficiency virus. In particular, point and confidence interval estimates for seroprevalence from pooled sera were derived. A potential problem with these confidence intervals is that they may contain negative values. This problem is most likely to occur in low-prevalence populations where pooling is most efficient. An alternative method of obtaining confidence intervals that cannot contain negative values is proposed and an example provided.     

Antiobstruktive antiinflammatorische Therapie: ohne Probleme in der Pneumologie, problematisch in der Kardiologie?

Zusammenfassung Hintergrund: Für Asthma bzw. chronisch obstruktive Lungenerkrankungen (COPD) bieten sich medikamentöse Therapiemöglichkeiten an, mit denen sich eine sehr gute bzw. gute Symptomkontrolle bei niedrigem Nebenwirkungspotential erzielen lässt. Kardiovaskuläre Nebenwirkungen von #-Agonisten: Da sich mit fortschreitendem Lebensalter insbesondere Komorbiditäten mit kardiovaskulären Erkrankunen vermehren, kann ein therapeutisches Risikopotential entstehen, wenn kurz wie auch lang wirksame #-Agonisten sowie Theophyllin eingesetzt werden, zumal beide Medikamentengruppen auch am Herzen die adrenerge Signaltransduktion verstärken könne. Insbesondere werden positiv chronotrope wie auch inotrope Wirkungen vermittelt, es können das Arrhythmiepotential gesteigert, die QT-Zeit verlängert und das Myokardinfarktrisiko erhöht werden. Auch die Verringerung des Serumkaliumspiegels kann kardiologisch von Relevanz sein. Vermeidung von Nebenwirkungen: Hinsichtlich der Vermeidung derartiger Nebenwirkungen scheinen partielle #-Agonisten gegenüber vollen Agonisten einen Vorteil zu besitzen, ebenso wie dies für inhalativ anzuwendende Substanzen gilt im Vergleich zur oralen Verabreichungsform. Wichtig ist es, die minimal erforderliche Dosierung der adrenerg wirkenden Pharmaka einzusetzen und sie zu diesem Zweck auch mit anderen Wirkstoffen zu kombinieren. Herzgesunde Patienten scheinen unter therapeutischer Dosierung kein erhöhtes Risikopotential für das Auftreten kardialer Nebenwirkungen zu besitzen. Abstract Background: Treatment options for bronchial asthma and chronic obstructive pulmonary disease (COPD) are similar and can achieve adequate improvement or even control of symptoms with a relatively low risk of side effects. Cardiovascular Side Effects of #-Agonists: However, cardiovascular co-morbidities which increase with age lead to an increasing prevalence of therapy-related side effects especially when long- and short-acting #₂-agonists and theophylline are being used. Both drugs can also mediate unwanted side effects on the heart. They increase heart rate and contractile properties as well as arrhythmias and the QT-interval and have been associated with myocardial infarction. In addition, their influence on serum potassium levels can be problematic and have the potential to increase side effects of other drugs. Prevention of Side Effects: In order to minimize cardiovascular side effects partial #-agonists appear to have advantages over full agonists as do inhaled preparations compared to oral administration. While #-adrenergic antiobstructive therapy administered in therapeutic doses is safe in patients without cardiac comorbidities, their use should be limited to the smallest effective dose in patients with cardiac diseases.