A STD/HIV prevention trial among adolescents in managed care

OBJECTIVE: To determine if sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection, risk assessment, and education tools provided as part of office-based primary care reduce adolescent risky sexual behaviors. DESIGN: A randomized intervention trial with 3- and 9-month follow-up. SETTING: Five staff-model managed care sites in Washington, DC (n = 19 pediatricians). PATIENTS: Consecutive 12- to 15-year-olds receiving a general health examination; 81% minority. Participation rate = 215/432 (50%). Nine-month follow-up rate = 197/215 (92%). INTERVENTION: Audiotaped STD risk assessment and education about staying safe (safer = condoms, safest = abstinence). MAIN OUTCOME MEASURES: Adolescent-reported sexual intercourse and condom use. RESULTS: More intervention adolescents reported pediatrician discussion on 11/13 sexual topics. Although more vaginal intercourse (odds ratio [OR] = 2.46, 95% confidence interval [CI] = 1.04-5.84) was reported in the intervention group at 3 months, this was not true of overall sexual intercourse (OR = 1.55, 95% CI =.73-3.32). More sexually active adolescents reported condom use in the intervention group at 3 months (OR = 18.05, 95% CI = 1.27-256.03). At 9 months, there were no group differences in sexual behaviors; however, more signs of STD were reported by the control (7/103) than the intervention group (0/94). CONCLUSIONS: STD risk assessment and education tools administered in a single office visit facilitated STD/HIV prevention education. Any impact on sexual activity and condom use was short-lived. Further research is needed to develop brief, office-based sexual risk reduction for young adolescents.     

Growth hormone treatment during suppression of early puberty in adopted girls

Girls adopted from developing countries often have early or precocious puberty, requiring treatment with gonadotropin-releasing hormone (GnRH) analogues. During such treatment decreased growth velocity is frequent. The aim of this investigation was to study whether the addition of growth hormone (GH) to GnRH analogue treatment improves height velocity and final height in girls with early or precocious puberty. Forty-six girls with early or precocious puberty adopted from developing countries were randomized for treatment with GnRH analogue or a combination of GH and GnRH analogue. After 2 y of treatment the mean growth in the GH/GnRH analogue group was significantly higher, 14.6 cm, compared to 10.9 cm in the control group. The increase in bone age did not differ, while the difference in predicted adult height increased by 2.7 cm in favour of the combination group. Although data on final height are not yet available, combined GH/GnRH analogue treatment for 2 y resulted in a higher growth velocity and predicted final height compared to GnRH analogue treatment alone.     

广州市荔湾区青少年脊柱侧凸患病率的调查研究

目的了解广州市荔湾区青少年脊柱侧凸的患病率。方法 2011年7月~2012年1月对荔湾区8351名7~15岁在校中小学生进行了脊柱侧凸普查,应用脊柱侧凸两检法（体检、X线照片）,体检阳性或可疑阳性者到医院照脊柱全长正侧位X片,采用Cobb法测量,Cobb角≥10°诊断为脊柱侧凸。结果一检阳性结果 175名（2.1%）,二检阳性为85名（1.02%）,男性31名,女性54名,男∶女患病率比为1∶1.76,其中特发性脊柱侧凸81名,占95.3%,先天性侧凸3名,神经肌肉源性1名。结论荔湾区中小学生脊柱侧凸发病率为1.02%,通过普查,可以早发现、早诊断青少年脊柱侧凸,及时选择适当方法进行治疗。     

The anti-nausea effects of CB1 agonists are mediated by an action at the visceral insular cortex

BACKGROUND AND PURPOSE

Conditioned gaping reactions reflect nausea-induced behaviour in rats. Cannabinoid 1 receptor (CB₁) agonists interfere with the establishment of nausea-induced conditioned gaping; however, it is not known if their effects are mediated by an action at peripheral or central CB₁ receptors.

EXPERIMENTAL APPROACH

We utilized the conditioned gaping model of nausea to evaluate the effect of peripheral and central administration of the peripherally restricted CB₁ agonist, CB13, on the establishment of LiCl-induced gaping in rats. We further evaluated the ability of HU-210 administered to the gustatory insular cortex (GIC) or visceral insular cortex (VIC) to interfere with LiCl-induced conditioned gaping and determined if this effect was mediated by CB₁ receptors.

KEY RESULTS

Central, but not peripheral, CB13 suppressed LiCl-induced conditioned gaping. Central administration of the potent CB₁ agonist, HU-210, delivered to the VIC, but not the GIC, suppressed the establishment of LiCl-induced gaping reactions, but not LiCl-induced suppression of hedonic reactions or conditioned taste avoidance. This pattern of results suggests that HU-210 delivered to the VIC prevented LiCl-induced nausea, but not learning per se. The suppression of LiCl-induced conditioned gaping by HU-210 was mediated by CB₁ receptors because it was prevented by co-administration of CB₁ antagonist/inverse agonist, AM-251, into the VIC. A high dose of AM-251 (20 µg) administered alone into the VIC did not produce conditioned gaping reactions.

CONCLUSIONS AND IMPLICATIONS

The nausea-relieving effects of CB₁ agonists, but not the nausea-inducing effects of CB₁ inverse agonists, are mediated, at least in part, by their action at the VIC in rats.     

加味桂枝人参汤对胰岛素抵抗HepG2细胞葡萄糖消耗量的影响

目的:探讨加味桂枝人参汤(MGD)溶液对胰岛素抵抗(IR)HpeG-2细胞模型的保护作用及机理。方法:成功复制HepG2细胞IR模型后,采用MGD溶液进行干预,并与罗格列酮进行对照,观察细胞形态学变化、各孔细胞的葡萄糖消耗量、细胞的数目与活力。结果:MGD对模型细胞的增殖并无明显影响(P0.05),但可以增加其葡萄糖消耗量(P0.01),与西药组比较无显著性差异(P0.05)。结论:中药MGD与罗格列酮具有同等的改善模型细胞IR的作用,可能与其增加HepG2细胞的葡萄糖消耗量,促进葡萄糖的摄取有关。     

秦艽醇提取物抗炎镇痛作用的实验研究

目的:研究秦艽醇提取物的抗炎及镇痛作用。方法:采用二甲苯致小鼠耳廓肿胀,角叉菜胶致大鼠足趾肿胀及冰醋酸致小鼠扭体反应,观察秦艽醇提物的抗炎及镇痛作用。结果:秦艽醇提物能降低二甲苯炎症模型小鼠的耳廓肿胀度(P<0.01),对角叉菜胶模型大鼠的急性炎症有一定的抑制作用,从第3小时起足趾容积和肿胀度与模型组比较具有统计学意义(P<0.05),秦艽醇提物还能提高小鼠的痛阈,减少冰醋酸致小鼠扭体次数,与模型组比较具有统计学意义(P<0.05)。结论:秦艽醇提物对二甲苯及角叉菜胶所致的炎症具有一定的抑制作用,同时具有明显的镇痛作用。     

五子降糖方对T2DM模型大鼠骨骼肌GLUT4蛋白表达的影响

目的: 观察五子降糖方对2型糖尿病模型大鼠血糖及骨骼肌葡萄糖转运蛋白4(GLUT4)表达的影响,初步探讨其改善糖代谢的分子机制。 方法: 采用高脂饮食喂养6周联合ip小剂量链脲佐菌素(STZ)的方法建立2型糖尿病大鼠模型,随机分为模型组、二甲双胍(0.1 g·kg^-1)组、五子降糖方低、中、高剂量组(3.5,7.0,14.0 g·kg^-1),另设正常组,各组大鼠分别ig相应的药物,容量为7.5 mL·kg^-1。模型组及正常组ig纯净水;二甲双胍组ig盐酸二甲双胍混悬液;五子降糖方低、中、高剂量组ig五子降糖方混悬液,干预6周。分别在ig前、ig后2周、4周、6周测空腹血糖及餐后2 h血糖。ig后6周处死大鼠,取其左后肢大腿股直肌组织,检测GLUT4蛋白的表达。 结果: 与正常组比较,模型组T2DM大鼠空腹和餐后2 h血糖升高,骨骼肌GLUT4蛋白表达水平降低,差异均具有统计学意义(P<0.05);五子降糖方能够降低T2DM大鼠空腹血糖及餐后2 h血糖水平,提高T2DM大鼠骨骼肌GLUT4蛋白表达水平,差异均具有统计学意义(P<0.05)。 结论: 五子降糖方可降低T2DM模型大鼠空腹及餐后2 h血糖,作用机制可能与提高骨骼肌GLUT4蛋白表达水平有关。     

经颅多谱勒超声在位置性缺血性眩晕中的应用

目的:探讨经颅多谱勒超声(TCD)在颈椎病(椎动脉型)所致位置性缺血性眩晕中的诊断价值.方法:利用TCD对颈椎病所致位置性缺血性眩晕76例患者进行双侧大脑后动脉(PCA)的平均血流速度分析,并结合转颈试验,探测双侧PCA平均血流速的动态变化情况.结果:颈椎病所致位置性缺血性眩晕患者当头侧向转动时,双侧PCA的平均血流速度暂时性降低,当头转回中立位时,平均血流速度逐渐回升.结论:TCD有助于识别位置性眩晕中的真性位置性缺血患者,是一种无创、简便、价廉、可靠,并可床旁操作和提供实时动态血流动力学资料的重要检查方法.     

蒙成药嘎日迪-5味丸方源考证及其现代研究进展

目的：对蒙药嘎日迪-5味丸的方源考证及其现代研究进展进行综述,为该复方的进一步开发与利用提供依据。方法:采用蒙医文献研究与考证、文献综述方法,从基源、方解、临床应用以及化学成分等方面对蒙药嘎日迪-5味丸研究现状进行总结和分析。结果:蒙药嘎日迪-5最早收载于藏医学家宇妥·云丹贡布于公元8世纪下旬撰写的藏医经典著作《四部医典》,属于蒙药、藏药传统验方,由诃子、麝香、草乌（制）、石菖蒲、木香配伍组成,其他处方都是在使用的过程中,根据临床应用演变而来,具有杀黏、止痛、消肿、燥协日乌素功效。蒙医临床用于治疗黏引起的瘟疫热症、黏虫病、黏性刺痛、维生素C缺乏病、风湿、白喉炭疽、瘰疬疮疡、正偏头痛、疥癣等疾病,疗效显著。结论:蒙药嘎日迪-5方出自《四部医典》,属传统验方,对瘟疫热症、黏虫病、黏性刺痛等黏性疾病疗效显著,具有潜在的开发利用价值。