Defining mental health needs for black patients with AIDS in Alameda County

This study examines the impact of race and psychiatric symptomatology on the treatment of black patients with acquired immunodeficiency syndrome (AIDS). The study consisted of two parts: 1) focused group discussions with AIDS health professionals, and 2) a retrospective chart review of 44 hospitalized AIDS patients. The group discussions revealed that there are specific gaps in mental health services for all AIDS patients and that psychiatric and medical services must be delivered in an ethnically sensitive manner to be effective with black patients. The chart review revealed no statistically significant difference between black and white patients in terms of prevalence of psychiatric symptoms. The results of this study suggest that ethnically sensitive psychiatric diagnosis and treatment may have important clinical implications in the long-term management of black patients with AIDS.     

Influence of dietary conjugated linoleic Acid and fat source on body fat and apoptosis in mice

OBJECTIVE: To determine whether altered dietary essential fatty acid (linoleic and arachidonic acid) concentrations alter sensitivity to conjugated linoleic acid (CLA)-induced body fat loss or DNA fragmentation. RESEARCH METHODS AND PROCEDURES: Mice were fed diets containing soy oil (control), coconut oil [essential fatty acid deficient (EFAD)], or fish oil (FO) for 42 days, and then diets were supplemented with a mixture of CLA isomers (0.5% of the diet) for 14 days. Body fat index, fat pad and liver weights, DNA fragmentation in adipose tissue, and fatty acid profiles of adipose tissue were determined. RESULTS: The EFAD diet decreased (p < 0.05) linoleic and arachidonic acid in mouse adipose tissue but did not affect body fat. Dietary CLA caused a reduction (p < 0.05) in body fat. Mice fed the EFAD diet and then supplemented with CLA exhibited a greater reduction (p < 0.001) in body fat (20.21% vs. 6.94% in EFAD and EFAD + CLA-fed mice, respectively) compared with mice fed soy oil. Dietary FO decreased linoleic acid and increased arachidonic acid in mouse adipose tissue. Mice fed FO or CLA were leaner (p < 0.05) than control mice. FO + CLA-fed mice did not differ in body fat compared with FO-fed mice. Adipose tissue apoptosis was increased (p < 0.001) in CLA-supplemented mice and was not affected by fat source. DISCUSSION: Reductions in linoleic acid concentration made mice more sensitive to CLA-induced body fat loss only when arachidonic acid concentrations were also reduced. Dietary essential fatty acids did not affect CLA-induced DNA fragmentation.     

血府逐瘀汤对乳鼠心肌细胞缺血再灌注损伤的影响

目的为探讨血府逐瘀汤对乳鼠心肌细胞缺血再灌注损伤的影响。方法应用培养的乳鼠心肌细胞造成缺血再灌注损伤的动物模型,观察心肌细胞中超氧化物岐化酶(SOD)的水平,推断细胞内活性氧的生成量;观察培养液中乳酸脱氢酶(LDH)活性改变以判断细胞损伤情况;并进行DNA琼脂糖凝胶电泳及末端脱氧核苷酸介导的脱氧尿苷三磷酸缺口末端标记法(TUNEL),以判断细胞死亡类型及程度。结果血府逐瘀汤可显著升高缺血再灌注时SOD的水平,显著降低LDH的水平。DNA电泳图谱表明:血府逐瘀汤可使DNA的拖尾基本消失;TUNEL显示血府逐瘀汤可显著减少缺血再灌注所致的心肌细胞死亡。结论血府逐瘀汤有保护缺血再灌注时心肌细胞免于死亡之功效。     

金藤清痹颗粒治疗急性痛风性关节炎的作用机制研究

目的 应用网络药理学分析金藤清痹颗粒治疗急性痛风性关节炎（acute gouty arthritis,AGA）的作用机制,并建立AGA大鼠模型进行验证。方法 在清热解毒、活血止痛治法指导下,通过TCMSP数据库搜集金藤清痹颗粒的活性成分及靶点,利用GeneCards、NCBI数据库等搜集AGA相关靶点,与金藤清痹颗粒作用靶点整合后,构建共有靶点蛋白质-蛋白质相互作用（protein-protein interaction,PPI）网络和“金藤清痹颗粒-中药-活性成分-靶点-AGA”网络,并进行基因本体（gene ontology,GO）功能及京都基因与基因组百科全书（Kyoto encyclopedia of genes and genomes,KEGG）通路富集分析。雄性SD大鼠随机分为空白组、模型组、秋水仙碱（0.3 mg/kg）组和金藤清痹颗粒低、中、高剂量（1.05、2.10、4.20 g/kg）组,每组6只,踝关节注射单钠尿酸盐（monosodium urate,MSU）晶体建立AGA大鼠模型。采用游标卡尺测量大鼠踝关节直径,计算踝关节肿胀度;采用全自动生化仪检测血清尿酸（serum uric acid,SUA）、C反应蛋白（C-reactive protein,CRP）水平;采用苏木素-伊红（HE）染色观察踝关节组织病理变化;采用qRT-PCR、ELISA和Western blotting检测踝关节组织及血清中关键靶点和信号通路的表达。结果 共检索到金藤清痹颗粒110种活性成分、212个作用靶点,272个AGA治疗靶点,共有靶点29个,关键靶点有白细胞介素-1β（interleukin-1β,IL-1β）、肿瘤坏死因子（tumor necrosis factor,TNF）及IL-6,涉及TNF信号通路、IL-17信号通路和NOD样受体信号通路等。大鼠踝关节注射MSU晶体后明显肿胀（P<0.01）,SUA及CRP显著升高（P<0.05、0.01）,滑膜组织增生明显、结构紊乱,有大量炎症细胞浸润,NOD样受体热蛋白结构域相关蛋白3（NOD-like receptor thermal protein domain associated protein 3,NLRP3）、NIMA相关蛋白激酶7（NIMA-related kinases 7,NEK7）、凋亡相关斑点样蛋白（apoptosis-associated speck-like protein containing a CARD,ASC）、半胱氨酸天冬氨酸蛋白酶-1（cystein-asparate protease-1,Caspase-1）、消皮素D（gasdermin D,GSDMD）、IL-18、IL-1β、IL-6及TNF-α表达水平明显升高（P<0.01）;秋水仙碱或金藤清痹颗粒治疗后,有效缓解踝关节肿胀（P<0.05、0.01）,SUA及CRP均显著降低（P<0.05、0.01）,关节滑膜增生、炎症细胞浸润均得到改善,同时显著抑制IL-1β、TNF-α及IL-6等靶点和NOD样受体信号通路的表达（P<0.05、0.01）。结论 金藤清痹颗粒对AGA大鼠具有明显的保护作用,其机制可能与抑制NOD样受体信号通路的异常激活,降低炎症因子水平,改善关节滑膜增生、炎症细胞浸润有关。     

新疆维吾尔族成人支气管哮喘的影响因素研究

摘要:目的　探讨新疆乌鲁木齐市维吾尔族人群成人支气管哮喘的影响因素。方法　本研究采用成组匹配病例对照研究方法,病例组为新疆医科大学第一附属医院呼吸内科在2014年1-12月确诊的维吾尔族支气管哮喘成人患者（n＝120例）,对照组为同期体检中心健康维吾尔族体检者（n＝126例）,两组在年龄、性别相匹配。采用问卷调查的方法收集相关暴露资料,并采用单因素分析及多因素非条件Logistic回归模型分析成人支气管哮喘影响因素。结果　多因素Logistic回归分析显示,吸烟（OR＝1.88,95% CI:1.28～2.96）、家族支气管哮喘史（OR＝6.20,95% CI:2.10～18.31）、家中铺有纯毛地毯数量多（OR＝1.87,95% CI:1.18～2.95）,睡眠质量（OR＝1.46,95% CI:1.22～1.75）,患慢性支气管炎（OR＝13.43,95% CI:6.65～25.34）及过敏性鼻炎（OR＝6.27,95% CI:3.63～10.81）是维吾尔族成人支气管哮喘的主要影响因素。结论　维吾尔族成人支气管哮喘是生活方式、环境及遗传等多种因素共同作用的结果,应加强对相关影响因素的预防及治疗,减少哮喘的发生,改善哮喘患者生活质量。     

模拟后路椎间盘镜下腰椎间盘摘除术与传统术式治疗腰椎间盘突出症对腰椎生物力学稳定性的影响

目的探讨后路椎间盘镜下腰椎间盘摘除术(MED)及传统开放腰椎间盘摘除术对腰椎生物力学稳定性的影响。方法选用6具新鲜尸体脊柱标本,模拟后路腰椎间盘摘除的不同术式,依次对标本腰3～4间隙进行处理,共设计5种减压情况:MED、半椎板切除、半椎板切除并下关节突1/2切除、半椎板切除并下关节突全部切除和全椎板切除髓核摘除术。在力学实验机上分别对实验标本进行前屈/后伸、左/右侧屈及左/右轴向旋转运动,测量不同运动的最大范围。结果模拟MED手术脊柱标本向各个方向的运动与正常对照组比较差异无统计学意义(P>0.05);半椎板切除术、半椎板切除并下关节突1/2切除后,标本向各个方向的运动除半椎板切除并下关节突1/2切除后右侧旋转外与正常对照组差异无统计学意义(P>0.05),半椎板切除并下关节突全部切除后,标本向各个方向运动与正常对照组比较差异均有统计学意义(P<0.05,右侧旋转P<0.01);模拟全椎板切除标本向各个方向的运动与正常对照组比较差异均有统计学意义(P<0.01)。结论MED手术对脊柱破坏性较小,对稳定性无影响,而半椎板并小关节切除则破坏了稳定性。