The effect of prematurity on tear production

PURPOSE: To evaluate the effect of the birth weight and the postconceptional age on the tear production of preterm and term newborn infants and to evaluate the changes in tear production during the first two months of life. SUBJECTS--METHODS: Both eyes of medically stable term and preterm infants were included in the study. Based on postconceptional age and birth weight, we divided preterm infants into three groups. Then, we measured the basal and reflex tear secretions of both eyes by Schirmer tests before and after instillation of topical anesthetic agent. We performed initial tear measurements on the second day of life (between first 24 hours to first 48 hours after birth): and at 2 weeks, 4 weeks and 8 weeks after birth. RESULTS: We tested a total of 138 infants (63 preterm and 75 term), 72 males and 66 females. Schirmer-1-test of preterm and terms on the 2nd day of life revealed a mean basal tear secretion (BTS) of 4.8 +/- 4.1 and 8.8 +/- 3.2 mm, respectively (p < 0.0001). The mean reflex tear secretion (RTS) within 48 hours of life was 6.1 +/- 3.9 mm and 10.3 +/- 4.4 mm in preterm and term infants, respectively (p < 0.0001). The mean values of both basal and reflex tear secretion were significantly lower in the preterm than the term infants during the first two months of the life. In preterm infants, both basal and reflex tear secretions were found to be highly correlated with postconceptional age (r: 0.79 and 0.74, respectively, both p values: 0.001); however, there was a weak correlation with birth weight (r: 0.16 and 0.19, respectively, both p values: 0.01). Statistically significant differences for both BTS and RTS existed among the three postconceptional age groups: there were no such difference among the three different birth weight groups. We found no gender or laterality dependent (side of the eyes) differences in the tear production (both p values >0.05). CONCLUSIONS: Preterm infants have significantly reduced tear secretion compared with term infants. Postconceptional age, rather than birth weight, seems to be more correlated with the tear secretion. Sex and laterality does not appear to have an effect on tear production in infants. Tear production of preterm infants is significantly reduced than that of term infants during the first two months of life. Term infants increased their tear production significantly in each examination during the neonatal period while the preterms increase tear production significantly only at mean postconceptional age of eight and a half (8.5) months.     

Panel reactive antibody positivity and associated HLA antibodies in Turkish renal transplant candidates

Pre- and post-renal transplantation panel reactive antibody (PRA) screening is associated with increased incidence of hyperacute or acute graft rejection and graft loss. This study was designed to find any relationship PRA sensitization and associated human leukocyte antigen (HLA)-specific antibodies in Turkish renal transplant candidates. We included 340 patients who were in the renal transplantation waiting list in the study. We determined PRA sensitization ratio and the associated anti-HLA IgG antibody distribution of the patient group. The PRA testing was currently performed and levels above 30% were accepted to be positive. The PRA class I positivity was determined in 24 (7%) and class II in 34 (10%) of the patients. The most frequent HLA antibodies for class I were B56, A2, A34, A1, A23, A24 and B61; and for class II were DR11, DR14, DQ7, DR10, DQ5, DR1 and DR7, respectively. From these, the increase of the numbers of anti-HLA class II antibodies was significantly correlated with the increase of PRA sensitization ratio. In conclusion, the identification of the associated HLA-specific antibodies and correlation with the Turkish population HLA antigen distribution will identify the high-risk patients who are candidates for transplantation.     

Effect of simvastatin in the treatment of highly sensitized dialysis patients: the pre and post-renal transplantation follow-up outcomes

The graft survival rates of sensitized kidney recipients have been shown to be lower than non-sensitized patients. Therefore, panel reactive antibody (PRA) and cross-match determination is accepted as mandatory screening for renal transplantation candidates. Our recent previous study has shown that simvastatin had a significant immunosuppressive effect in PRA-positive and/or crossmatch-positive patients. We present the pre and post-transplantation follow-up outcomes of simvastatin treatment in the highly sensitized dialysis patients. Thirty patients were followed for a mean period of 26 months. The PRA and flow cytometric measurements were performed at monthly intervals. Ten patients underwent successful kidney transplantation (eight living-related and two cadaveric). None of the patients developed hyperacute or acute rejection, and there was no graft loss during 19.8+/-6.2 months of post-transplantation follow-up. Of the 18 patients who stayed on dialysis throughout the study with PRA positivity, six were lost to follow-up and three spontaneously stopped taking the simvastatin. In the latter three cases, the PRA levels rose significantly after the drug was discontinued. Eight of the remaining nine PRA-positive patients showed significant drops in mean PRA level over the study period, and entered the range considered acceptable for transplantation. Only one patient showed persistently high PRA levels throughout the study. In one patient, the drug had to be discontinued due to acute toxic hepatitis. In conclusion, the results indicate that continuous simvastatin therapy effective in immunized and highly sensitized dialysis patients. Meanwhile, it has beneficial effect on 1-year graft survival in sensitized renal transplantation group.     

中西部地区社区卫生服务的现状与对策

中西部地区社区卫生服务工作经过几年的摸索实践,有了一定的发展,积累了一些经验,但在具体实践中仍存在诸多问题。本文就目前存在的认识问题、政策问题和机构问题提出相应的对策,以推动该区社区卫生服务工作。     

Septate uterus with a double cervix and longitudinal vaginal septum

OBJECTIVE: To report the clinical features of 9 cases and review the previously reported 8 cases of an uncommon müllerian anomaly, characterized by the presence of a complete uterine septum with cervical duplication and represent a a longitudinal vaginal septum. STUDY DESIGN: Retrospective clinical study. RESULTS: Nine patients aged 21-32 presented to our clinic with complaints of dyspareunia, dysmenorrhea, and primary or secondary infertility. All 9 patients displayed a single uterus with smooth fundal contour, double cervix and longitudinal vaginal septum. Some additional abnormal findings were associated with these anomalies in some patients: polycystic ovaries in 3 cases and different degrees of endometriosis in 2 cases. Most of the patients had normal tubal patency. CONCLUSION: According to a MEDLINE search, only 8 cases of septate uterus with cervical duplication and a longitudinal vaginal septum have been reported to date. We report 9 more cases, which suggest that this atypical septate uterus type is probably more frequent than reported. These cases support the bidirectional müllerian theory and may imply the presence of another type of mullerian anomaly.     

Diagnostic value of plasminogen activity level in acute mesenteric ischemia

AIM： To investigate the changes in plasminogen activity level during mesenteric ischemia. METHODS： We performed laparotomy in 90 female Wistar-Albino rats （average weight 230 g）. In sham groups （SL） （GroupsⅠand Ⅱ） the superior mesenteric artery （SMA） and vein （SMV） were explored, but not tied. In SMA groups （Groups Ⅲ and Ⅳ） the SMA was ligated, and in SMV groups （Groups Ⅴ and Ⅵ） the SMV was ligated. On re-laparatomy 2 mL of blood was drawn at 1 h in groupsⅠ, Ⅲ and Ⅴ, and at 3 h in groups Ⅱ, Ⅳ and Ⅵ. Plasminogen levels were assessed and comparisons were made between groups and within each group. RESULTS： The mean plasminogen activity in the SL group was significantly higher than SMA （25.1 ± 10.8 vs 11.8 ± 4.6, P 〈 0.001） or SMV （25.1 ± 10.8 vs 13.7 ± 4.4, P 〈 0.001） groups both at 1 h and at 3 h （29.8 ± 8.9 vs 15.1 ± 5.7, P 〈 0.0001; 29.8 ± 8.9 vs 14.2 ± 2.9, P 〈 0.0001）. There were no significant differences between the values of SMA and SMV groups at 1 h （P = 0.28） and at 3 h （P = 0.71）. In each group, plasminogen activity levels did not change significantly between the two measurements performed at 1 h and 3 h. CONCLUSION： We conclude that blood plasminogen activities decrease during early phases of both arterial and venous mesenteric ischemia which may be a useful marker for early diagnosis.     

The fetal cerebellar vermis: assessment for abnormal development by ultrasonography and magnetic resonance imaging

Fetal magnetic resonance provides a new tool in the imaging of the posterior fossa and is proving useful in cases that are difficult to assess sonographically by allowing further assessment of the fourth ventricle, cisterna magna, and vermian growth and development. We describe various criteria with which to evaluate vermian growth, including vermian biometry and the relationship between the superior and inferior lobes. We demonstrate 2 markers of normal vermian development: the primary fissure and fastigial point. We illustrate the tegmento-vermian angle, "closure" of the fourth ventricle, and communication of the fourth ventricle with the basal cisterns during development and in several disorders. We correlate those features with the expected embryological course of development and illustrate identification of these features and associated abnormalities of the posterior fossa, brain stem, and central nervous system in mid-trimester scans of fetuses with abnormal development. Correlation with contemporaneous ultrasound examinations is demonstrated.     

响应面法优化提取卡西卡甫枣总黄酮的工艺

目的优化提取卡西卡甫枣总黄酮工艺条件。方法选取料液比、提取温度和提取时间3个因素为考察指标,采用响应面法分析优化卡西卡甫枣总黄酮的提取工艺。结果提取卡西卡甫枣总黄酮的最佳工艺条件为提取时间1.7 h、提取温度74℃、料液比1∶27,得到卡西卡甫枣总黄酮含量平均为1.403 mg/g,相对误差0.31%,与理论预测值较接近。结论本法简便、可行,可为卡西卡甫枣总黄酮的高效提取以及后续工业生产提供参考。     

新疆维吾尔族女性乳腺癌与HLA-DRB1基因多态性的关系及临床意义

目的:研究新疆维吾尔族女性乳腺癌的发生与人类白细胞抗原(HLA) DRB1等位基因多态性的关系,探讨乳腺癌的遗传易感性。方法:分别收集维吾尔族女性乳腺癌患者和健康人外周血标本196和230例,提取细胞基因组DNA,采用序列特异性引物聚合酶链反应(PCR- SSP)和毛细管电泳测序(CE)的方法进行HLA-DRB1基因多态性鉴定。结果：乳腺癌患者外周血DNA的HLA-DRB1*01多态性频率显著高于健康对照(χ²=10.180,OR=4.550,P<0.05),HLA-DRB1*16多态性低于对照(χ²=4.792,OR=0.492,P<0.05),而其他位点多态性两组间的差异无统计学意义(P>0.05)。结论:维吾尔族女性乳腺癌的发生可能与HLA-DRB1等位基因多态性存在密切关系,对于揭示乳腺癌发病机制及临床诊断提供了客观依据。     

The attitude toward tobacco dependence and barriers to discussing smoking cessation: a survey among Turkish general practitioners

Objectives  

To evaluate the general attitude of a sample of Turkish general practitioners (GPs) toward tobacco dependence and to assess their knowledge and behavior regarding smoking cessation (SC).