The effect of local cooling on pain perception during infiltration of local anaesthetic agents, a prospective randomised controlled trial

The effect of pre-infiltration local cooling of the site of inguinal herniorrhaphy on pain perception during infiltration of local anaesthetic was studied in a prospective randomised controlled trial. One hundred patients were randomly allocated to receive topical application of either a cooled saline bag (study group) or a saline bag at room temperature (control group) prior to injection of local anaesthetic. Pain scores were recorded using a visual analogue scale following application of the saline bags and again on completion of infiltration with local anaesthetic. There was no significant difference in pain scores following topical saline bag application. However, a highly significant difference (p = 0.0001, Mann-Whitney U) was observed between post-infiltration pain scores of the study group (median = 2) and the control group (median = 6).     

Effects of Naotan Pill on repair of neural cells and cognitive disorders in juvenile rats following hypoxia and ischemia

BACKGROUND:Hypoxia and ischemia induce neuronal damage,decreased neuronal numbers and synaptophysin levels,and deficits in learning and memory functions.Previous studies have shown that lycium barbarum polysaccharide,the most effective component of barbary wolfberry fruit,has protective effects on neural cells in hypoxia-ischemia.OBJECTIVE:To investigate the effects of Naotan Pill on glutamate-treated neural cells and on cognitive function in juvenile rats following hypoxia-ischemia.DESIGN,TIME AND SETTING:The randomized,controlled,in vivo study was performed at the Cell Laboratory of Lanzhou University,Lanzhou Institute of Modern Physics of Chinese Academy of Sciences,and Department of Traditional Chinese Medicine of Gansu Provincial Rehabilitation Center Hospital,China from December 2005 to August 2006.The cellular neurobiology,in vitro experiment was conducted at the Institute of Human Anatomy,Histology,Embryology and Neuroscience,School of Basic Medical Sciences,Lanzhou University,and Department of Traditional Chinese Medicine of Gansu Provincial Rehabilitation Center Hospital,China from March 2007 to January 2008.MATERIALS:Naotan Pill,composed of barbary wolfberry fruit,danshen root,grassleaf sweetflag rhizome,and glossy privet fruit,was prepared by Gansu Provincial Rehabilitation Center,China.Rabbit anti-synaptophysin,choline acetyl transferase polyclonal antibody,streptavidin-biotin complex kit and diaminobenzidine kit (Boster,Wuhan,China),as well as glutamate (Hualian,Shanghai,China) were used in this study.METHODS:Cortical neural cells were isolated from neonatal Wistar rats.Neural cell damage models were induced using glutamate,and administered Naotan Pill prior to and following damage.A total of 54 juvenile Wistar rats were equally and randomly assigned into model,Naotan Pill,and sham operation groups.The left common carotid artery was ligated,and then rat models of hypoxic-ischemic injury were assigned to the model and Naotan Pill groups.At 2 days following model induction,rats in the Naotan Pill group were administered Naotan Pill suspension for 21 days.In the model and sham operation groups,rats received an equal volume of saline.MAIN OUTCOME MEASURES:Neural cell morphology was observed using an inverted phase contrast microscope.Survival rate of neural cells was measured by MTT assay.Synaptophysin and choline acetyl transferase expression was observed in the hippocampal CA1 region of juvenile rats using immunohistochemistry.Cognitive function was tested by the Morris water maze.RESULTS:Pathological changes were detected in glutamate-treated neural cells.Neural cell morphology remained normal after Naotan Pill intervention.Absorbance and survival rate of neural cells were significantly greater following Naotan Pill intervention,compared to glutamate-treated neural cells (P<0.05).Synaptophysin and choline acetyl transferase expression was lowest in the hippocampal CA1 region in the model group and highest in the sham operation group.Significant differences among groups were observed (P<0.05).Escape latency and swimming distance were significantly longer in the model group compared to the Naotan Pill group (P<0.05).CONCLUSION:Naotan Pill exhibited protective and repair effects on glutamate-treated neural cells.Naotan Pill upregulated synaptophysin and choline acetyl transferase expression in the hippocampus and improved cognitive function in rats following hypoxia-ischemia.     

Assessing advance directives in the homebound elderly

We studied the prevalence of specific barriers that prevent indigent homebound older adults from obtaining advance directives and tested the effectiveness of clinical reminders for lowering the number of clients without advance directives. Case managers interviewed 1569 clients to determine whether they had an advance directive. All 530 clients without advance directives were contacted 3 months later to determine if advance directives had been obtained. Clients who still did not have advance directives were asked to list 1 or more reasons they did not have advance directives. About 57.8% of the barriers identified may reflect reluctance on the part of clients to address their own mortality. Reminders by the case managers were ineffective at lowering the number of homebound older adults without advance directives. Further studies are needed to identify and design strategies for convincing this population of homebound elderly to establish advance directives.     

Evaluation of a portable hemoglobin photometer in pregnant women in a high altitude area: a pilot study

Background  

Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women. This study examined the agreement between a portable hemoglobin photometer and a laboratory analyzer in determining hemoglobin level in pregnant women.     

Evaluation of Echinococcus multilocularis tetraspanins as vaccine candidates against primary alveolar echinococcosis

Echinococcus multilocularis causes an important zoonotic cestode disease. The metacestode stage proliferates in the liver of intermediate hosts including human and rodents and forms multiple cysts. Recently, members of a transmembrane protein tetraspanin (TSP) family have been used as vaccines against schistosomosis, or as diagnostic antigens for cysticercosis. In this study, seven tetraspanins of E. multilocularis, designated as TSP1 to TSP7, were evaluated for their protective potential against primary alveolar echinococcosis. The large extracellular loop (LEL) region of these tetraspanins was cloned from a full-length enriched cDNA library of E. multilocularis metacestodes and expressed in Escherichia coli as a fusion protein with thioredoxin. Recombinant TSPs were applied as vaccines against an E. multilocularis primary experimental infection in BALB/c mice. Cyst lesions in the livers of vaccinated and non-vaccinated mice were counted. The cyst lesion reduction rates induced by the seven tetraspanins in vaccinated vis-à-vis non-vaccinated mice were: 87.9%, 65.8%, 85.1%, 66.9%, 73.7%, 72.9% and 37.6%. Vaccination conferred protective rates to mice ranging from 0% (TSP5, 6, 7) to maximally 33% (TSP1, 3). The results indicated that recombinant tetraspanins have varying protective effects against primary alveolar echinococcosis and could be used in vaccine development.     

Lower cellular immune responses to influenza A (H3N2) in the elderly

Influenza epidemic is an important cause of severe illness in the elderly. Age‐dependent morbidity of influenza in the elderly is associated with weakened immunity. The baseline age‐related memory T cell activity in Chinese persons who are exposed to influenza virus through natural infection, are associated with the protective response to the virus after vaccination, thus providing important pre‐vaccination information. A cohort from the general population was established at the end of an influenza season in an area where influenza occurs regularly, and followed for 24 weeks. The subjects had no vaccination history for 5 years. Memory T cell responses were evaluated using a set of peptides spanning the influenza A (H3N2) entire proteome in a gamma interferon (IFN‐γ)‐enzyme‐linked immunospot (ELISPOT) assay, prior to the next influenza season. Changes of hemagglutination inhibition (HI) antibody titers were also evaluated. IFN‐γ⁺ T cell responses against influenza peptides were significantly lower in subjects of 60 years and older. Although the age‐related decline of cellular immune response was clear, no significant association of antibody titers with age was found. The pre‐vaccination baseline of memory IFN‐γ⁺ T cell immunity state in elderly Chinese was significantly lower than in people younger than 60 years. Measurement of the ex vivo cellular immune responses to influenza should be incorporated into the evaluation of protective immunity in elderly persons. J. Med. Virol. 81:1471–1476, 2009. © 2009 Wiley‐Liss, Inc.