Circulating inhibitor of interleukin 1 activity in patients with chronic renal diseases

The effects of sera derived from patients suffering from chronic renal diseases (endemic Balkan nephropathy, glomerulonephritis and pyelonephritis) on T cell proliferative response was studied. It was found that these sera contained factors which affect interleukin 1 (IL-1) dependent events in T cell proliferative response. The factors prevent costimulatory effects of IL-1 on T cells but do not bind to IL-1, nor do they affect interleukin 2 (IL-2) dependent T cell proliferation. These findings indicate that immuno-suppression observed in some kidney disorders may be partially due to serum immunoinhibitory factors affecting IL-1 activity.     

河北省4个地区广泛焦虑症的流行病学调查

目的:了解广泛焦虑症的患病率及人口学特点。方法:于2004-10/2005-03随机抽取河北省邯郸、保定、秦皇岛、承德4个地级市18岁以上人口进行全省精神疾病流行病学现场抽样调查工作,总样本24000人。调查筛选工具采用改编后的一般健康问卷12项,以《DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查》病人版为调查的诊断工具。根据被调查者一般健康问卷12项总分,把被调查者分为高危人群、中危人群、低危人群3类。根据预试验调查结果确定三段危险人群的分界分:总分≥4分属于高危人群,高危人群全部进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查;总分为2分或3分即属中危人群,中危人群约40%需进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查,总分为0分或1分即属低危人群,低危人群中10%需进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查。改编后的一般健康问卷12项分数及内容不变,另外增加8个问题均为高危因素,并进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查。结果:①实际完成调查20716人,其中男10343人(49.9%),女10373人(50.1%)。共诊断焦虑症患者127例。②按高中低危因素调整后时点患病率为7.69/1000(95%CI6.50/1000～8.88/1000)。城市患病率4.87/1000,农村患病率8.10/1000,两者差异无显著性意义(u=1.78,P>0.05)。女性患病率明显高于男性,差异有显著性意义(分别为10.42/1000,4.97/1000,u=4.49,P<0.01),男女患病率比例为1:2.10。按不同年龄阶段的人口计算出各年龄段的时点患病率,20～29岁患病率较低(3.17/1000),50～59岁患病率较高(15.56/1000)。③通过12个因素的Logistic回归分析发现,影响广泛焦虑症的危险因素有年龄50～59岁(OR=1.713);保护性因素男性(OR=0.431),年龄20～29岁(OR=0.393),收入10001～20000元(OR=0.568),收入20001～40000元(OR=0.117)。结论:广泛焦虑症的流行病学特征为女性、中老年人患病率较高,男性、青年、收入中等者患病率较低。     

自体移植静脉内皮细胞的缺血安全时限

目的:观察离体后不同缺血时间自体移植静脉内皮细胞的损伤程度,分析移植静脉内皮细胞缺血的安全时限。方法:实验于2005-07/2005-12在中国人民解放军胸心外科研究所完成。选择健康成年家犬29只,购自解放军第二军医大学实验动物中心。①不同缺血时间移植静脉内皮细胞损伤实验:按随机数字表法选取5只家犬,取双侧股静脉,按离体后0min,30min,60min,90min4个时间点行扫描电镜及透射电镜检查,观察内皮细胞的损伤程度,Ⅰ级正常,Ⅱ级轻度,Ⅲ级中度,Ⅳ级重度,Ⅴ级坏死,将Ⅰ,Ⅱ,Ⅲ级损伤归类为可逆性损伤;将Ⅳ,Ⅴ级损伤归类为不可逆损伤。②自体移植静脉内皮细胞缺血安全时限实验:将剩余24只家犬建立犬股静脉离体不同时间(30min,60min,90min)的自体移植模型,在术后1d,3d,7d,14d再次手术取出静脉,行扫描电镜检查,比较不同时间点移植静脉内皮覆盖率。结果:①缺血0min,30min,60min,90min组(n=60)不可逆性损伤内皮细胞数分别为12,6,28,33,缺血60min、90min组内皮细胞的损伤程度明显重于缺血0min和30min组。各组的内皮细胞覆盖率比较差异无显著性意义(P>0.05)。②24只模型犬全部存活,切口愈合佳,无红肿、溢脓或裂开。③移植术后1d,14d,缺血30min,60min及90min组内皮细胞覆盖率差异无显著性意义(P>0.05),而术后3d,7d,缺血30min组的内皮细胞覆盖率显著高于缺血60min及90min组[(62.21±3.52)%,(40.09±2.56)%,(36.17±4.55)%(P<0.01);(82.31±3.76)%,(60.22±3.23)%,(59.39±4.27)%(P<0.01)]。结论:缺血60min后静脉内皮细胞的超微结构会发生明显的不可逆性损害,移植静脉内皮细胞缺血的安全时限是60min。     

人脂肪间充质干细胞生物学特征及体外向类角质细胞的分化

目的：在体外不同培养条件下，脂肪来源问充质干细胞可以向成骨细胞、成软骨细胞、神经细胞、内皮细胞、肌肉细胞、脂肪细胞和肝脏细胞等不同胚层来源的细胞分化。观察脂肪间充质干细胞在体外培养并向类角质细胞分化的能力。方法：实验于2005—06／2006—03在解放军军事医学科学院完成。实验方法：取20-45岁健康女性（已取得患者同意）脂肪组织行脂肪抽吸术后的脂肪颗粒。参照Zuk等方法分离脂肪问充质干细胞。取培养的第3代细胞，采用流式细胞仪鉴定细胞表面分子及细胞周期。取状态良好、融合至瓶底80％的第20代细胞，在5mg／L的秋水仙素处理后采集分裂细胞，以Giemsa染色进行核型分析。取第3代细胞以5μm维甲酸和5μg／L表皮细胞生长因子培养基向角质细胞诱导分化。对照组用含体积分数为0．05胎牛血清的L-DNMEM培养基。实验评估：采用倒置显微镜观察细胞形态，免疫组织化学方法检测角质细胞的标志物CK19。结果：①脂肪来源问充质干细胞表面分子CD29、CD90、CD44呈阳性，而CD34呈阴性。②细胞增殖曲线呈S型，接种的前3d细胞处于滞留期，3d后进入对数生长期，6d后进入平台期，细胞的群体倍增时间约为29h。处于对数生长期的细胞80％以上处于G0和G1期。③细胞染色体核型分析显示，染色体数目2n=46，核型46，xx，为女性正常核型。④对照组细胞贴壁后，呈成纤维细胞样，细胞呈长梭形，排列成漩涡状，贴壁较好。诱导组从诱导的第3天开始，细胞逐渐变成不规则，诱导第10天出现铺路石改变，形似角质细胞。⑤免疫组织化学方法检测显示，部分细胞专一地对CK19抗体呈阳性反应，有棕色染色。结论：可从人脂肪抽吸物中分离出间充质干细胞，脂肪间充质干细胞在体外一定条件下可向类角质细胞分化。     

面神经损伤后面神经核中黏附分子CD44表达与穴位电针刺激的影响

目的:观察穴位电针在面神经损伤后面神经再生中的作用及对黏附分子CD44表达的影响。方法:实验于2005-09/2006-02在泸州医学院神经生物学实验室完成。①实验材料:普通级6～8个月龄新西兰家兔36只,体质量2～2.75kg,雌雄不拘。②实验方法:采用随机数字法取兔32只,压榨损伤右侧面神经上颊支制备面神经损伤模型。③实验分组:随机分为手术对照组16只,不作穴位电针刺激,自然恢复;针刺组16只术后立即行翳风、颧髎、颊车、地仓、阳白、四白及合谷穴位电针治疗,1次/d,30min/次;另取4只家兔做正常对照组。④实验评估:于术后1,4,7,14d每组分别取4只兔麻醉后,经心灌注处死动物,苏木精-伊红染色观察面神经核的改变,免疫组织化学观察CD44的表达。结果:36只兔全部进入结果分析。①手术对照组和针刺组兔面神经核运动神经元的形态学改变:术后1d,两组细胞形态正常;术后4d,两组细胞肿胀、胞浆空泡化、染色质溶解、核仁偏移、尼氏小体消失;术后7d,手术对照组有明显神经元的死亡,针刺组仅有神经元变性表现,并出现核仁回归、尼氏小体重现;术后14d,手术对照组神经元的坏死更为明显,针刺组神经元肿胀及变性程度有明显改善。②各组CD44标记阳性面神经核运动神经元数目:正常组,面神经核中有CD44表达。术后1d,针刺组和手术对照组CD44有明显增加;术后4d,针刺组CD44阳性细胞数较手术对照组显著性增加(P<0.01);术后7d,手术对照组的CD44阳性细胞数目较针刺组增加(P<0.05)。术后14d,两组比较无差别,阳性细胞免疫染色着色不一。结论:穴位电刺激能促进黏附分子CD44在损伤面神经核的表达。     

Management of fear and anxiety in the dental clinic: a review

People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non‐pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful individuals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non‐pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.     

PALB2 variants in hereditary and unselected Finnish Prostate cancer cases

Background  

PALB2 1592delT mutation is associated with increased breast cancer and suggestive prostate cancer (PRCA) risk in Finland. In this study we wanted to assess if any other PALB2 variants associate to increased PRCA risk and clinically describe patients with formerly found PALB2 1592delT mutation.     

Radical Scavenging Activity of Selected Medicinal Plants From Limpopo Province of South Africa

Plants collected from Limpopo province of South Africa were investigated for their antioxidative potential using the DPPH radical scavenging assay. Acetone extracts of Flueggea virosa had the highest antioxidant activity with an IC₅₀ value of 30 µg/ml, closely matching the ascorbic acid with an IC₅₀ value of 25 µg/ml. The lowest antioxidant readings were observed with extracts of Rhynchosia venulosa (root extract) and Ficus ingens (leaf extract). Acetone extract of Bridelia virosa leaves had the highest phenolic content (156 mg GAE/g extract), while the lowest content was recorded for R. venulosa root extract and leaf extract of F. ingens (8.3 and 17.7 mg GAE/g extract, respectively). There was a linear correlation between antioxidant activity and total phenolic content. Extracts with high phenolic content had low IC₅₀ values, while extracts with low phenolic concentrations had high IC₅₀ values.     

The National Stroke Strategy – Is it Achievable?

INTRODUCTION

Timing of intervention in symptomatic carotid disease is critical. The UK Department of Health''s National Stroke Strategy published in December 2007 recommends urgent carotid intervention within 48 h, in appropriate patients, who have suffered a transient ischaemic attack (TIA), amaurosis fugax or minor stroke. Despite the running of a rapid-access clinic for patients with symptoms of TIA, the time from symptom to surgery is rarely less than 2 weeks. To date, there has been little published research on the UK public response to the symptoms of TIA, and no study at all of the response of primary care to such patients. The aim of this study was to ascertain both these responses to see whether a 48-h target is achievable.

PATIENTS AND METHODS

A total of 402 men attending our aortic aneurysm screening sessions were asked to complete a questionnaire requesting their most likely response to an episode of amaurosis fugax or TIA. All 45 GP practices in the hospital catchment area were asked how they would respond to patients requesting to be seen with the symptoms used in the questionnaire.

RESULTS

Nearly one in six patients would ignore the symptom unless it recurred, approximately half would request a GP appointment and a third would see an optician if they had amaurosis fugax. The mean waiting time to see a GP was 2 days for a routine appointment and within 24 h for an emergency appointment.

CONCLUSIONS

It is clear that a significant number of people would ignore the first symptom of carotid ischaemia; for those with amaurosis fugax, nearly a third would initially seek help from their optician. Those given a routine GP appointment would have to wait a minimum of 2 days. If the Department of Health is serious about reducing the incidence of stroke and introducing a target of 48 h from symptom to treatment, then there needs to be a wide-spread public and healthcare education programme, in particular alerting opticians and GP receptionists that these symptoms constitute a medical emergency.