The impact of family experience on the duration of untreated psychosis (DUP) in Hong Kong

BACKGROUND: Previous family experience of psychotic illness may play an important role in whether and when a patient seeks help in first-episode psychosis. This study investigated the relationship between family experience of psychosis and the duration of untreated psychosis in a prospective sample of first-episode psychosis patients in Hong Kong. We also studied the effects of pre-morbid adjustment, educational level, living alone, and mode of onset as potential determinants of the duration of untreated psychosis (DUP). METHODS: A total of 131 first-episode psychosis patients in Hong Kong were recruited in a study of the DUP and related factors. The Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS) was used to measure the DUP and to provide a structured assessment of family history, educational level, household arrangement, and mode of onset. RESULTS: Previous family experience of psychiatric illness (the presence of another family member who has been receiving psychiatric treatment) and an acute mode of onset were significant predictors of a shorter DUP. Educational level had a modest effect on its own, but was not significant in the binary logistic regression model. Living alone had a moderate effect size, but was non-significant, possibly because of the small proportion of single-person households in the sample. The symptom profile, pre-morbid adjustment, and other demographic factors were not significantly related to the DUP. CONCLUSION: In addition to the mode of onset, previous family experience plays an important role in the presentation of early psychosis. Educational efforts that target the family should be an important part of any strategy for the early detection of psychosis.     

A prospective 3-year longitudinal study of cognitive predictors of relapse in first-episode schizophrenic patients

BACKGROUND: Cognitive predictors of relapse have been extensively explored only in few long term longitudinal studies of first-episode schizophrenia. METHOD: This study prospectively followed 93 patients with first-episode schizophrenia, schizophreniform disorder, and schizoaffective disorder for 3 years after their first-episode illness. Cognitive domains including verbal intelligence, verbal and visual memory, verbal fluency, and Wisconsin Card Sorting Test performance were investigated as potential predictors of relapse. RESULTS: We found that by the first year 21% patients had relapsed, by the second year 33% had relapsed, and by the third year 40% had relapsed. There was a significant difference in the relapse rate between patients with good adherence and patients with poor adherence to medication regimes. A multiple logistic regression analysis revealed that after controlling for medication adherence, perseverative error in the Wisconsin Card Sorting Test was the only cognitive function that significantly predict relapse with an odds ratio of 2.4. CONCLUSIONS: Cognitive flexibility in set shifting is related to tendency towards relapse in first-episode schizophrenic patients. Other cognitive factors appear not to be related to relapse. Possible mechanisms included the link between prefrontal dysfunction and sub-cortical dopamine system stability, as well as the effects of executive dysfunction on insight impairment and adherence behavior.     

Generation and characterization of a recombinant single chain Fv antibody to von Willebrand factor A1 domain from phage display library

In this study, cDNA of von Willebrand factor domain A1 (VWF-A1) was cloned from human umbilical vein endothelial cells, and expressed in E. coli. The expressed VWF-A1 was used as antigen to immunize Balb/c mice. Reverse transcribed-polymerase chain reaction (RT-PCR) was used to amplify VH and VL gene segment from the RNA isolated from the immunized mouse spleens. Single chain Fv (ScFv) genes were generated by splicing overlap extension and subcloned into a phagemid vector pHEN-1. Phage display library of repertoire single chain antibodies of anti-VWF-A1 was then constructed and screened for ScFvs that interact with VWF-A1. The ScFv gene of phage clone 28 that has best binding activity to VWF-A1 was cloned into pET20b vector for higher expression in E. coli strain BL-21(DE3) pLysS. The recombinant ScFv specifically reacted with VWF, rVWF-A1 and rVWF-A1/A3, but not with rVWF-A3, P-selectin and BSA. It inhibited ristocetin-induced platelet aggregation with an IC50 of 0.75 micromol/l, and its maximal extent of inhibition is 62.5%. The ScFv had no effect on thrombin-induced platelet aggregation. These data show that the ScFv is specific against VWF-A1 and could have a potential to be used as an antithrombotic agent.     

Stage-dependent effect of pancreatic transplantation on diabetic ocular complications in the Spontaneously Diabetic Torii rat

BACKGROUND: In terms of the temporal relationship between pancreas transplantation (PTx) and reversal of diabetic ocular complications, it has been difficult but important to determine a "point of no return." Thus, it is of great clinical interest to evaluate the efficacy of PTx on diabetic ocular complications. METHODS: A spontaneous type 2 diabetic model of Spontaneously Diabetic Torii (SDT; RT1) rats was used in the present study, and syngeneic PTx was performed. RESULTS: In the control SDT rats that received no treatment, hyperglycemia (>250 mg/dL) was developed from 25.2+/-3.9 weeks of age. Lens opacity was observed in all rats at 15 weeks after the onset of diabetes. Fluorescein angiography and immunohistochemistry detected the nonperfusion area and neovascularization in the retina at 5 weeks of diabetes. Daily insulin treatment could not prevent or reverse the ocular changes in our experiment. Fluorescein filling defect of the retinal vessels was observed at 10 weeks of diabetes. However, in the PTx rats, normoglycemia was achieved at all experimental time points. Diabetic cataract and retinopathy could have been prevented and improved if PTx had been performed at 5 weeks, but not at 10 weeks after the onset of diabetes. With PTx treatment, an inhibition of angiogenesis in the retina at 5 weeks after the onset of diabetes was demonstrated by immunohistochemistry. CONCLUSIONS: Our results indicate that the potential use of the SDT rat for diabetes study and the positive effect of PTx performed before the "point of no return" could prevent and cure diabetic ocular complications.     

孟河医家新探

明末至近代 ,江苏孟河名医辈出 ,逐渐形成以费、马、巢、丁四大家族为主的孟河医派。以四大家为核心的孟河医派 ,以其高深的学术造诣 ,丰富的临床经验 ,对中国医学的发展作出了卓越的功绩。广泛收集的资料涉及中国各大图书馆及欧洲、美国、港台图书馆馆藏的有关孟河医学的著作、方志、家谱百十余种 ,采访孟河医家的子孙、传人、学生或门徒 2 0 0余人。由此说明 ,孟河医派似一颗灿烂的明星 ,照耀在清代末年、民国初年的医坛上 ,学术相传 ,至今未衰。     

细胞色素P450c 17α基因启动子区Msp AI多态性与上海市汉族男性骨量、骨大小的关系

目的探讨细胞色素P450c 17α(CYP17)基因启动子区Msp AI多态性与上海市汉族男性骨量、骨大小的关系.方法应用聚合酶链反应-限制性片段长度多态性检测上海市397例46～80岁无亲缘关系的汉族男性(其中324例健康男性,73例骨质疏松患者)CYP17基因Msp AI多态性,并用双能X线吸收仪检查研究对象腰椎1～4和股骨近端股骨颈、大转子区及Ward's三角部位骨密度(BMD)、骨矿含量(BMC)和骨截面大小(CSA).结果397例男性CYP17 Msp AI基因型频率分布依次为TC(51.1%)、CC(33.8%)和TT(15.1%),等位基因T和C频率分布分别为40.7%和59.3%,等位基因频率分布符合Hardy-Weinberg定律.未发现该多态性在73例骨质疏松患者和324例健康男性之间频率分布的差异.通过协方差分析,在397例受试者、73例骨质疏松患者或324例健康男性中,均未显示CYP17基因Msp AI多态性与腰椎1～4和股骨近端各部位BMD、BMC和CSA的相关性.结论CYP17基因MspAI多态性不是影响上海市汉族男性骨量和骨大小变异的遗传因素.     

Sulfated polymannuroguluronate, a novel anti-acquired immune deficiency syndrome (AIDS) drug candidate, targeting CD4 in lymphocytes

Sulfated polymannuroguluronate (SPMG), a marine sulfated polysaccharide, has entered the Phase II clinical trial in China as the first anti-acquired immune deficiency syndrome (AIDS) drug candidate obtained from marine organisms. To determine the binding site(s) (receptors) of SPMG in lymphocytes mediating its anti-AIDS activities, fluorescein-5-isothiocyanate (FITC)-labeled SPMG was used to investigate SPMG binding to lymphocytes. Flow cytometry (FCM) and fluorescence microscopy analysis showed that the SPMG binds to lymphocytes in a rapid, specific, reversible, and saturable fashion. Several SPMG binding proteins were purified by affinity chromatography from lymphocyte membrane preparations. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting analysis revealed that a 55kDa lymphocyte membrane protein is CD4. To characterize the SPMG and CD4 interaction, inhibition assay and surface plasmon resonance (SPR) assay were carried out. SPMG bound to CD4 in a multivalent fashion with specificity. The binding of SPMG to human lymphocyte CD4 was competitively inhibited by human soluble CD4 (hsCD4). Likewise, the binding between hsCD4 and immobilized SPMG was blocked by excess free SPMG. These results indicate that CD4 is one of the specific SPMG binding sites (receptors) in lymphocytes. The interaction between SPMG and CD4 may provide a mechanistic explanation of the immunopotentiating and anti-AIDS activities of SPMG in human immunodeficiency virus (HIV) infected individuals.     

D609 induces vascular endothelial cells and marrow stromal cells differentiation into neuron-like cells

AIM: To investigate the effect of tricyclodecane-9-yl-xanthogenate (D609) on cell differentiation in vascular endo- thelial cells (VECs) and marrow stromal cells (MSCs). METHODS: Morphological changes were observed under phase contrast microscope. Electron microscope and immunostaining were used for VECs identification. The expressions of neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) were examined by immunohistochemistry. RESULTS: After 6 h of induc…     

针刺对肥胖大鼠下丘脑神经肽含量的影响

目的 :探讨针刺对肥胖机体下丘脑神经肽含量的影响。方法 :观察针刺治疗前后肥胖大鼠体重、Lee’s指数和体脂量以及下丘脑β 内啡肽 ( β EP)、α 促黑激素 (α MSH)、铃蟾肽 (BOM )、神经肽Y(NPY)、血管紧张素Ⅱ (ATⅡ )、心房肽 (ANP)、降钙素基因相关肽 (CGRP)的含量的变化。结果 :肥胖大鼠体重、Lee’s指数、体脂以及下丘脑β EP、NPY和AngⅡ的含量均显著高于正常大鼠水平 ,而下丘脑α MSH、BOM、ANP和CGRP的含量均显著低于正常大鼠水平。相关分析显示 ,下丘脑 β EP、NPY和AngⅡ的含量与肥胖指标呈正相关 ;而下丘脑α MSH、BOM、ANP和CGRP的含量与肥胖指标呈负相关。针刺治疗取得良好减肥疗效的同时 ,肥胖大鼠下丘脑 β EP、NPY和AngⅡ的含量明显回降 ,而下丘脑α MSH、BOM、ANP和CGRP的含量明显回升。结论 :生物机体下丘脑β EP、NPY和AngⅡ水平异常增高和下丘脑α MSH、BOM、ANP和CGRP的水平异常低下可能是产生肥胖的重要因素。针刺对肥胖机体下丘脑神经肽的良性调整作用可能是针刺减肥的重要作用机制。