香港高危青少年对滥用咳药水的信念

目的:探讨香港青少年对滥用咳药水的信念。方法:应用《滥用咳药水信念量表》(Beliefs about Cough Medicine Abuse Scale-BACMAS),了解160名滥用咳药水及65名非滥用咳药水的香港青少年,对滥用咳药水的信念。结果:研究显示,此量表有高的内在一致性信度及效度(包括同证效度及构念效度)。一般而言,参加者认为滥用咳药水并不会带来很多好处,而他们亦了解滥用咳药水的危害。不过,仍然有为数不少的参加者认为,长期滥用咳药水并不会上瘾,而他们亦认为跟滥用咳药水的朋友交往并不危险。结论:此量表具有可接受的心理测量特性。青少年对滥用咳药水的自相矛盾信念,对预防滥用咳药水的工作有重要的启示。     

Loperamide Associated Necrotising Enterocolitis

ABSTRACT. Two cases of necrotising enterocolitis (NEC) occurring in infants beyond the neonatal period were reported. They did not have any predisposing factors to NEC but both had paralytic ileus after loperamide therapy for their mild diarrhoea prior to the onset of NEC. The possible role of loperamide in the pathogenesis of NEC was discussed.     

Association of interleukin-18 promoter polymorphism and atherosclerotic diseases in Chinese patients with diabetic nephropathy

Aim: Interleukin‐18 (IL‐18) is a pro‐inflammatory cytokine and possibly plays an important role in the pathogenesis of cardiovascular disease. The relationship between two IL‐18 gene polymorphisms, namely C‐607A and G‐137C, and cardiovascular disease in patients with diabetic nephropathy was examined. Methods: Two hundred and twenty patients (91 male) with diabetic nephropathy were studied. The IL‐18 promoter genotypes were determined. All patients were then prospectively followed for the cardiovascular events. Cardiovascular mortality and all‐cause mortality were also compared. Results: Mean age was 64.3 ± 10.6 years; average follow up was 73.9 ± 33.6 months. The frequencies of CC, CA and AA genotypes of the C‐607A polymorphism were 25.5%, 48.2% and 26.8%, respectively; GG, GC and CC genotypes of the G‐137C polymorphism were 71.8%, 25.0% and 3.2%, respectively. Neither of the polymorphisms were associated with the development of primary cardiovascular end‐point. Cardiovascular survival was 84.8% and 70.6% at 60 months for GG and GC/CC genotypes of the G‐137C polymorphism, respectively (P = 0.027); the corresponding actuarial survival was 69.0% and 54.8%, respectively (P = 0.053). However, the G‐137C genotype was not an independent predictor of cardiovascular or actuarial survival after adjusting for confounders by multivariate analysis with the Cox model. The C‐607A polymorphism had no significant effect on cardiovascular or actuarial survival. Conclusion: The G‐137C polymorphism of the IL‐18 promoter is associated with the cardiovascular mortality, and a trend of association with all‐cause mortality, in patients with diabetic nephropathy. The association, however, becomes insignificant after adjusting for confounding factors. Further studies are needed to test other genetic determinants of the association between systemic inflammation and cardiovascular disease in renal failure patients.     

ICU护士照护机械通气病人的态度、主观行为规范及其行为意向研究

目的对成都地区三所三级甲等综合医院ICU护士照护机械通气病人的态度、主观行为规范及其行为意向进行研究,为相关的护士培训提供依据。方法应用《护士对照护机械通气病人的行为态度、主观行为规范和行为意向》量表中文修订版对近三个月内照护过机械通气病人的ICU护士进行测评,描述ICU护士照护机械通气病人的态度、主观行为规范和行为意向。结果分别有69．1％、91．3％、95．8％的ICU护士对照护机械通气病人的行为态度、主观行为规范和行为意向为正性。结果绝大多数ICU护士对照护机械通气病人持积极的行为态度、主观行为规范和行为意向。     

Early postoperative hyperglycaemia is not a risk factor for infectious complications and prolonged in-hospital stay in patients undergoing oesophagectomy: a retrospective analysis of a prospective trial

Introduction  

Treating hyperglycaemia in hospitalized patients has proven to be beneficial, particularly in those with obstructive vascular disease. In a cohort of patients undergoing resection for oesophageal carcinoma (a group of patients with severe surgical stress but a low prevalence of vascular disease), we investigated whether early postoperative hyperglycaemia is associated with increased incidence of infectious complications and prolonged in-hospital stay.     

The Clinico-pathologic Features of Hepatitis B Virus-associated Glomerulonephritis

The frequency of hepatitis B Surface antigen (HBsAg) was studiedin the sera of 311 patients with various forms of primary glomerulonephritisand 43 patients with lupus nephritis. HBs antigenaemia was detectedin 69 of the 311 patients (22 per cent) with primary glomerulonephritisand this prevalence of HBaAg carrier was significantly higherthan that in the general population (p<0. 001). These patientshad no clinical or biochemical findings to suggest acute orchronical liver disease. A higher HBs antigenaemia carrier ratewas not observed in patients with lupus nephritis. Three glomerulopathologicalentities, membranous nephropathy. IgA nephropathy, and mesangialproliferative glomerulonephrities, were found to be associatedwith a higher prevalence of HBs antigenaemia compared with thegeneral population (p<0. 001). Glomerular deposits of HBsAgand/or hepatitics core antigen (HBcAg) were detected in 41,61, and 60 per cent of renal biopsy specimens from patientswith membranous nephropathy, Iga nephropathy, and mesangialproliferative glomerulonephritis associated with persistentHBs antigenaemia respectively. During the mean study periodof 40 months (range 12–180), 14 per cent of these patientswith hepatitis-associated glomerulonephrities developed progressiverenal failure, althrough none required maintenanece dialysis.Our study suggests that hepatitis B virus antigenaemia may playa significant role in the developement of specific forms ofglomerulonephritis and that these hepatities B virus-associatedglomerulonephritides can run an indolent but relentless progressiveclinical course.     

Predictors of corticosteroid-dependent and corticosteroid-refractory inflammatory bowel disease: analysis of a Chinese cohort study

Background  Patients with inflammatory bowel disease (IBD) who are corticosteroid-dependent or -refractory are at higher risk of developing disease- and treatment-related complications.
Aims  To identify retrospectively clinical factors present at diagnosis that predict the occurrence of corticosteroid dependency and refractoriness in Crohn's disease (CD) and ulcerative colitis (UC) patients.
Methods  A total of 310 IBD patients (134 CD, 176 UC) were observed for 2140 person years and their use of systemic corticosteroids was determined. Outcomes of corticosteroid dependency and refractoriness were recorded. Univariate and multivariate analyses were performed to determine the clinical factors associated with outcomes.
Results  Seventy-seven (57.5%) CD and 95 (54.0%) UC patients had received corticosteroids during study period. In CD, thrombocytosis [Hazard ratio (HR):3.0] predicted, whereas colonic CD (HR:0.3) negatively predicted corticosteroid dependency. Stricturing phenotype (HR:4.5) predicted corticosteroid-refractory CD. For UC, thrombocytosis (HR:3.9) and extensive colitis (HR:1.7) predicted corticosteroid dependency. Presence of anaemia (HR:10.8) at diagnosis and initial requirement of total parenteral nutrition (TPN) (HR:18.8) predicted corticosteroid-refractory UC. The cumulative risks of surgery were 17.8% and 5.4% for CD and UC patients respectively at 1 year after starting corticosteroids.
Conclusions  Thrombocytosis at diagnosis predicted corticosteroid-dependency in IBD. Stricturing phenotype of CD and the presence of anaemia in UC predicted subsequent course of corticosteroid refractoriness.     

Human erythrocyte antigens: II. The In(Lu) gene regulates expression of an antigen on an 80-kilodalton protein of human erythrocytes

We have previously shown that a murine monoclonal antibody (A3D8) identifies a human erythrocyte protein antigen whose expression is regulated by the Lutheran inhibitor [In(Lu)] gene. In the present study, we demonstrated by immunoprecipitation and Western blot techniques that the antigen defined by A3D8 was on an 80-kD erythrocyte membrane protein. A second 170-kD protein was coprecipitated with the 80-kD protein but failed to show antigen activity by Western blot analysis. The 170-kD protein, when analyzed by sodium dodecyl sulfate- polyacrylamide gel electrophoresis in two dimensions, was composed of 50- and 30-kD disulfide-linked subunits. In(Lu) Lu[a-b-) erythrocytes differed from Lu(a+b+) or Lu(a-b+) erythrocytes in that In(Lu) deoxycholate erythrocyte membrane extracts contained trace amounts of immunoprecipitable 80-kD protein compared with detergent-solubilized erythrocyte membrane extracts prepared from Lu(a+b+) or Lu(a-b+) subjects.