高糖对体外培养兔视网膜Müller细胞AQP4表达的影响

目的：观察体外培养兔视网膜Müller细胞在高糖条件下水通道蛋白-4（AQP4）表达的变化。方法：采用体外培养的兔视网膜Müller 细胞,分为正常对照组及高糖组（葡萄糖浓度：30、40和50 mmol•L^-1）,分别培养1、3和5 d;采用免疫细胞化学、流式细胞术及RT-PCR方法对Müller 细胞AQP4的表达情况进行检测。结果：高糖组Müller 细胞AQP4表达的绿色荧光明显弱于正常对照组（P<0.01）;流式细胞仪检测中波峰位置明显提前,AQP4表达强度较对照组明显减弱（P<0.01）,且随着葡萄糖浓度的增高和作用时间的延长,AQP4表达强度逐渐减弱;血糖浓度50 mmol•L^-1培养3 d时,RT-PCR半定量分析显示,AQP4 mRNA的表达比对照组明显降低（P<0.01）。结论：高糖能降低视网膜Müller细胞AQP4的表达,且随着葡萄糖浓度的增高和作用时间的延长,AQP4的表达强度也逐渐减弱;高糖时AQP4的表达下降可能是机体对糖尿病视网膜病变的一种保护性反应。     

Endovascular stenting for nutcracker syndrome

Nutcracker syndrome (NCS) is a rare pathology manifested by pain or hematuria in males and females alike. It can be easily overlooked, and should be considered in young men or women with symptoms of extended duration. We present a case of a 54-year-old female with chronic lower abdominal pain radiating to the left thigh of 4 years in duration. Computed tomography (CT) eventually revealed engorged left renal, gonadal, and uterine veins due to compression between the superior mesenteric artery (SMA) and the abdominal aorta, consistent with NCS. After a successful endovascular stenting and a 6-month period of antiplatelet and anticoagulant therapy, the patient returned to stable health. NCS, while rare, should be suspected in patients of both sexes with persistent pain or hematuria.     

Predictors of Adherence to an Antidepressant Medication Regimen Among Patients Diagnosed with Depression in Taiwan

This study explored the predictors of medication adherence among Taiwanese people with major depression and dysthymic disorder. Previous research indicates that depressed patients vary in compliance with their medication regimen. Poor compliance reduces the therapeutic effect of medication. Self-report questionnaires were used for this cross-sectional study conducted with 181 outpatients diagnosed with major depression or dysthymic disorder. About 50% of depressed patients reported good medication adherence. The predictors of adherence were patient income, treatment efficacy, and understanding the importance of continuing medication. Professionals should use collaborative communication and cultural values clarification with depressed patients and their families to improve the awareness of illness and to increase the likelihood of medication compliance.     

Lower Education Level Is a Major Risk Factor for Peritonitis Incidence in Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study with 12-Year Follow-Up

♦ Background: Peritoneal dialysis (PD)-related peritonitis remains an important complication in PD patients, potentially causing technique failure and influencing patient outcome. To date, no comprehensive study in the Taiwanese PD population has used a time-dependent statistical method to analyze the factors associated with PD-related peritonitis.♦ Methods: Our single-center retrospective cohort study, conducted in southern Taiwan between February 1999 and July 2010, used time-dependent statistical methods to analyze the factors associated with PD-related peritonitis.♦ Results: The study recruited 404 PD patients for analysis, 150 of whom experienced at least 1 episode of peritonitis during the follow-up period. The incidence rate of peritonitis was highest during the first 6 months after PD start. A comparison of patients in the two groups (peritonitis vs null-peritonitis) by univariate analysis showed that the peritonitis group included fewer men (p = 0.048) and more patients of older age (≥65 years, p = 0.049). In addition, patients who had never received compulsory education showed a statistically higher incidence of PD-related peritonitis in the univariate analysis (p = 0.04). A proportional hazards model identified education level (less than elementary school vs any higher education level) as having an independent association with PD-related peritonitis [hazard ratio (HR): 1.45; 95% confidence interval (CI): 1.01 to 2.06; p = 0.045). Comorbidities measured using the Charlson comorbidity index (score >2 vs ≤2) showed borderline statistical significance (HR: 1.44; 95% CI: 1.00 to 2.13; p = 0.053).♦ Conclusions: A lower education level is a major risk factor for PD-related peritonitis independent of age, sex, hypoalbuminemia, and comorbidities. Our study emphasizes that a comprehensive PD education program is crucial for PD patients with a lower education level.     

马利兰治疗慢粒导致继发再障临床分析

目的：探讨马利兰导致继发再障的原因及安全使用马利兰的方法。方法：通过6例因慢粒而使用马利兰治疗后导致继发再障临床资料分析。结果：马利兰导致继发再障与药物剂量、用药时间及个体敏感性有关。结论：遵循小剂量、长疗程的原则使用马利兰治疗慢粒,可减少继发再障的发生。     

Immunotyping of Chlamydia trachomatis with monoclonal antibodies

Rapid and precise immunotyping of Chlamydia trachomatis was achieved by testing whole organisms (elementary bodies) in the microimmunofluorescence test with monoclonal antibodies. Monoclonal antibodies were produced with standard techniques by using an immunization schedule that encouraged the development of immunotype-specific antibodies. Fifteen monotypic or multitypic (subspecies) monoclonal antibodies were chosen for use in a two-step typing system that required strains of C. trachomatis to be tested against six to eight monoclonal antibodies for classification. Immunotyping with monoclonal antibodies was studied by testing 313 strains, typed with the previous method that utilized immunized mouse antisera, that represented each of the 15 established serovars. The two-step monoclonal antibody method resulted in a classification similar to the current one. Only one strain typed differently with the two methods. With the monoclonal antibody method, available lymphogranuloma venereum (LGV) serovars L1 and L3 could not be differentiated from trachoma serovars E and G, respectively, unless the strains had been identified as LGV. Monoclonal antibody typing was simpler to perform and more precise; it allowed easy differentiation between closely related serovars. Three new types were discovered among the strains previously classified as serovars D, I, and L2. These are tentatively being considered subtypes and are labeled D', I', and L2'.     

The origins of surgery: 1. From prehistory to Renaissance*

The art, craft and science of surgery is a highly interpersonal skill, central to a variety of traditions and cultures throughout human history. The development of surgery parallels the evolution of the human race from prehistory to the present time. This review attempts to examine the changing concepts and practices in surgery from the earliest era, enshrouded in mysticism and magic, through a manual craft performed by barbers and artisans, to a dignified profession based on science and technology. The evolution of surgery in the previous millennia is reviewed against the culture and morals, the politics and religion, and the philosophy and science of its period; in so doing assessing its perspective on the threshold of a new millennium.