HIV among pregnant women in Moshi Tanzania: the role of sexual behavior, male partner characteristics and sexually transmitted infections

Background  

Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to this situation need to be identified. The objective of this study was to determine social, behavioral and biological risk factors of HIV infection among pregnant women in Moshi urban, Tanzania. In 2002 – 2004, consenting women (N = 2654), attending primary health clinics for routine antenatal care were interviewed, examined and biological samples collected for diagnosis of HIV and other sexually transmitted/reproductive tract infections.     

Transfection screening for primary defects in the pyruvate dehydrogenase E1alpha subunit gene

In a significant number of patients with biochemical evidence of a defect in the E1 (pyruvate dehydrogenase) component of the pyruvate dehydrogenase complex, it has not proved possible to identify a mutation in the gene coding regions. To assess the need for more extensive genetic analysis in these patients and to establish a test system in which to study the biochemical consequences of mutations in the E1alpha subunit gene (which is responsible for the great majority of defined cases of pyruvate dehydrogenase deficiency), we have developed a method to screen for E1alpha gene defects based on complementation of the enzyme deficiency in transformed fibroblast cell lines following transfection and expression of the normal cDNA. Using this system, cell lines from patients with a variety of different defined mutations in the E1alpha gene show restoration of enzyme activity. A number of patients have been identified in whom deficient enzyme activity is not restored by expression of the normal cDNA indicating that an alternative explanation for the enzyme defect must be sought.      

Analysis of the dynamic mutation in the SCA7 gene shows marked parental effects on CAG repeat transmission

The gene for spinocerebellar ataxia 7 (SCA7) includes a transcribed, translated CAG tract that is expanded in SCA7 patients. We have determined expansions in 73 individuals from 17 SCA7 kindreds and compared them with repeat lengths of 180 unaffected individuals. Subjects with abnormal expansions comprise 59 clinically affected individuals and 14 at-risk currently unaffected individuals predicted to carry the mutation by haplotype analysis. For expanded alleles, CAG repeat length correlates with disease progression and severity and correlates inversely with age of onset. Increased repeat lengths are seen in generational transmission of the disease allele, consistent with the pattern of clinical anticipation seen in these kindreds. Repeat lengths in expanded alleles show somatic mosaicism in leukocyte DNA, suggesting that these alleles are unstable within individuals as well as between generations. Although dynamic repeat expansions from paternal transmissions are greater than those from maternal transmissions, maternal transmission of disease is more common, suggesting germline or embryonic effects of the repeat expansion.      

Clinical verification of the superiority of the current International Union Against Cancer staging criteria in an Australian population of patients with nasopharyngeal carcinoma

The purpose of this study is to assess the prognostic abilities of the fourth and fifth edition International Union Against Cancer (UICC) staging systems for nasopharyngeal carcinoma (NPC) in Australian patients. All patients planned for curative treatment at the Peter MacCallum Cancer Centre from April 1985 to December 1999 were included in this study. There were 181 patients eligible for this study. The median follow up was 7.6 years. Histological subgroups were World Health Organization (WHO) 1 (23), WHO 2 (12), and WHO 3 (146). Presentation with stage IV disease was 83% by UICC fourth edition staging and 34% by UICC fifth edition staging. The 5 years failure‐free survival (FFS) rates for stage 1, 2, 3 and 4 disease by the fourth edition was 77, 100, 93, and 49% respectively,and by the fifth edition was 85, 76, 57 and 36%, respectively. The 5 years overall survival (OS) for stage 1, 2, 3, and 4 disease by the fourth edition was 77, 100, 100 and 61%; respectively, and by the fifth edition was 85, 82, 67 and 53%, respectively. Stage 4 patients by the fourth edition were reclassified as stages 2, 3 and 4 by the fifth edition with hazard ratios of 0.77, 1.01 and 1.79, respectively. In multifactor analysis, the fifth edition staging system was significantly related to FFS and OS after allowing for the fourth edition (FFS: P = 0.002; OS: P = 0.005), but the fourth edition was not significantly related to FFS or OS after allowing for the fifth edition (FFS: P = 0.96; OS: P = 0.96). This study confirms the prognostic superiority of the fifth edition UICC staging system over the fourth edition staging system in an Australian NPC population.     

β-榄香烯抑制大鼠血栓形成及其机理研究

目的;探讨β－榄香烯的抗血栓作用及其机理。方法：采用血栓法观察了大鼠口服β－Ｅｌｅ４０￣１６０ｍｇ／ｋｇ／ｄ１０ｄ后对血栓形成的影响,采用比浊法和放免法分别测定其抗血小板聚集性和ＴＸＡ２及ＰＧＩ２的含量。     

骨形态发生蛋白信号去除后Sonic hedgehog对小脑颗粒细胞发育的影响

目的:骨形态发生蛋白信号在神经细胞的生长、分化、增殖、凋亡等方面发挥作用,而Sonic hedgehog能调节小脑颗粒细胞的增殖,故实验设计了去除骨形态发生蛋白信号后Sonic hedgehog信号在小脑颗粒细胞发育中作用的观察。方法:实验于2004-11/2005-10在美国费城儿童医院Crenshaw实验室和北京大学医学部解剖学神经研究实验室完成。①实验材料:C57Bl/6J小鼠40只;Bmpr1b敲除鼠系来源于Karen Lyons博士。②实验过程:通过敲除骨形态发生蛋白Ⅰ型受体的Bmpr1a和Bmpr1b两个亚型基因,去除骨形态发生蛋白信号在小脑内的传导。③实验评估:使用原位杂交和免疫组织化学方法检测了新生幼鼠小脑中Sonic hedgehog信号的表达情况。结果:①在胚胎11.5d,磷酸化SMAD免疫阳性的细胞被观察到在正常鼠神经管背侧的菱形唇附近,受体基因双敲除的小鼠背侧神经管中未发现免疫阳性细胞,此结果提示通过骨形态发生蛋白Ⅰ型受体传导的骨形态发生蛋白信号已消失。当小鼠出生后,磷酸化SMAD免疫阳性细胞主要位于正常小鼠的内颗粒层,在基因敲除鼠只有一小部分区域有磷酸化SMAD蛋白的表达。②Sonic hedgehog表达在正常新生鼠小脑的颗粒细胞层和蒲肯野氏细胞层;基因敲除鼠Sonic hedgehog信号只表达在小脑一小部分区域的颗粒细胞层和蒲肯野氏细胞层,而大部分区域则缺少它的表达。PTCH和N-myc在小脑中的表达与Sonic hedgehog表达部位类似。这提示Sonic hedgehog信号及其PTCH和N-myc都参与了小脑颗粒细胞的发育。结论:实验阐明了骨形态发生蛋白信号去除后,Sonic hedgehog信号对小脑颗粒细胞发育所起到的重要作用。     

门诊病历抽评698份质量分析

0　引言　保证门诊病历书写质量是医院为患者提供全方位优质服务的组成部分 ,为使临床医师对门诊病历质量引起足够重视 ,并确保医院门诊病历质量管理制度化 ,要求标准化、书写规范化 ,我们对门诊各级医师的门诊病历书写质量进行了调查统计 ,分析出影响我院门诊病历质量的诸因素 ,提出改进管理措施 .1　材料和方法1 .1　材料　依照三级甲等医院门诊病历书写要求 ,我们制定了具体严格的评定标准 .门诊病历书写内容 :1就诊科室 ;2就诊时间 ;3主诉 (包括主要症状部位及持续时间 ) ;4)现病史 (包括与本次疾病有关的过去史、个人史及家族史 ) ;5 )…     

小儿烧伤输液中应用套管针37例

1 临床资料 2003-10/2004-07收治小儿烧伤37例,年龄1月龄-8岁.使用套管针静脉输液.选择粗直、有弹性、无静脉瓣易于固定的血管.常用上肢静脉有掌静脉、头静脉、前臂内侧静脉及重要静脉,下肢常用足背静脉弓及大隐静脉,头皮静脉常选用额正中静脉、颞浅静脉及耳后静脉、额角分支等较粗直的血管.促使血管充盈,以提高穿刺的成功率.     

Cervical dyskaryosis among women with and without HIV: prevalence and risk factors

Women in developing countries often present for medical care with advanced cervical cancer, although this condition is preventable through regular screening and early treatment. This study sought to identify the prevalence and risk factors for cervical dyskaryosis among women in Zimbabwe with and without HIV. In a cross-sectional study, 200 consenting women were screened for cervical dyskaryosis and sexually transmitted infections (STI). The relationship between various risk factors for cervical dyskaryosis was examined. The overall prevalence of cervical dyskaryosis was high (19%), and significantly higher among HIV-infected women at 30% compared with 13% among seronegative women, with a peak at a younger age among seropositive women. Use of intravaginal herbs, practising intravaginal cleansing, being single, a history of three or more lifetime sexual partners and a history of previous STI were associated with cervical dysplasia. The high frequency of cervical abnormality lends weight to the demand for implementation of regular screening programmes and health education.