The fetal alcohol syndrome in adolescence

At present, alcohol is recognized as the leading teratogenic agent in long-lasting CNS dysfunction. Little is known about the long-term development and outcome of children with fetal alcohol syndrome (FAS). Forty-four FAS patients who were diagnosed in early childhood were followed up for 10–14 years. This study documents the developmental changes of the manifestations of FAS from childhood to adolescence and describes a characteristic "juvenile" pattern of FAS, which may help to identify this syndrome even in adolescence. This is especially relevant for patients who were not diagnosed earlier.     

The oncogenic potential of growth hormone.

A growing body of recent literature indicates that in addition to an essential role in growth and development, growth hormone may also play a more sinister role in oncogenic transformation and neoplastic progression. Here we review the accumulating evidence implicating growth hormone in the development and progression of cancer and describe what is known of the mechanisms utilised by this hormone in neoplastic transformation.     

Telmisartan in migraine prophylaxis: a randomized, placebo-controlled trial

We evaluated telmisartan 80 mg for migraine prophylaxis. Migraine patients ( n  = 95) with three to seven migraine attacks in 3 months were randomized, double-blind to telmisartan or placebo. The primary end-point was the reduction in the number of migraine days (i.e. a day with ≥ 1 h of symptoms) between the 4-week baseline period and the last 4 weeks of the 12-week treatment period. A responder was recorded when there was a symptom reduction of ≥ 50% in these 4-week baseline and treatment periods. The reduction in migraine days was 1.65 with telmisartan and 1.14 with placebo ( P  > 0.05). Post hoc analyses adjusting for baseline and centre showed a 38% reduction in migraine days with telmisartan vs. 15% with placebo ( P  = 0.03), and a borderline significant difference in responders (40% vs. 25%, P  = 0.07). The incidence of adverse events was similar between treatments. This study indicates that telmisartan might be effective in migraine prophylaxis.     

Factorial structure of the Chinese version of the 12‐item General Health Questionnaire in adolescents

Aims. To evaluate the underlying factor structure of the Chinese version of General Health Questionnaire‐12 using exploratory and confirmatory factor analyses in Chinese adolescents and find out which factor model proposed by previous empirical research is the best‐fit model. Background. The 12‐item General Health Questionnaire has been extensively used with adolescents in the West. Yet, it has not been used with adolescents in a Hong Kong Chinese context. Design. A cross‐sectional study was employed. Method. Chinese students between the ages of 12–19 from four secondary schools were invited to participate in the study using the multiple‐stage stratified random sampling method during the period from December 2007–February, 2008. The total sample size included in the final analysed was 1883. Results. The General Health Questionnaire‐12 was found to be internally consistent. The results of exploratory factor analysis showed that there are two factors underlying the General Health Questionnaire‐12. Of nine factor models were tested by means of confirmatory factor analysis, only three factor model: the eight‐item two‐factor model, 12‐item three‐factor model and 10‐item two‐factor model, demonstrated good model fit across all model fit indices. Conclusion. This study addressed a gap in the literature by evaluating the factorial structure of the Chinese version of General Health Questionnaire‐12 using exploratory and confirmatory factor analyses in Chinese adolescents. The findings revealed that the eight‐item two‐factor model is the best‐fit model. Relevance to clinical practice. The adolescent mental health problem is alarming and aggravating and warrants special attention. It is essential for community nurses to differentiate psychological distress in adolescents and to identify those adolescents who are at a higher risk of suffering from mental health problems. The availability of a valid and reliable instrument that measures adolescents’ psychological distress is crucial before any nursing interventions to promote their mental health can be appropriately planned, implemented and evaluated.     

原位肝移植术后并发症10例报告

目的:观察10例原位肝移植患者术后并发症的发生及诊治情况。方法:选择2001-04/2005-07在安徽省淮北市人民医院肝胆外科行原位背驮式肝移植的患者10例,患者均知情同意。术后加强重要脏器的功能监测,早期应用免疫抑制剂。术后定期随访,测定肝肾功能、血常规、血生化、病毒载量及免疫药物剂量,复查肝脏彩超,采用内镜技术和介入疗法诊疗肝移植术后并发症。结果:①10例患者肝移植手术均获得成功。②术后并发症:腹腔内出血1例,胃肠道出血1例,急性排斥反应1例,慢性排斥反应1例,肺部感染、胸腔积液2例,腹腔感染、左膈下脓肿1例,真菌感染1例,下腔静脉狭窄1例,胆管吻合口漏并胆管狭窄1例,胆管狭窄并胆泥形成1例,胆管吻合口狭窄1例,乙肝复发1例。③10例患者中死亡2例,术后1个月肝癌腹腔广泛转移自动出院1例,存活7例。7例患者均获随访,随访时间分别为65,60,43,36,28,24,21个月。随访结束时7例患者均健康生存,其中1例存活已超过5年5个月,且正常妊娠分娩,新生儿生长发育良好(已超过3周岁)。结论:对肝移植术后并发症的及时诊断和有效治疗是提高肝移植术后成功率的关键。     

Risk factors for anaemia in human immunodeficiency virus/hepatitis C virus-coinfected patients treated with interferon plus ribavirin

The most frequent and the most troublesome adverse effect of interferon plus ribavirin-based therapy is anaemia. The aim of this analysis was to determine the incidence and risk factors of anaemia (Hb < 10 g/dL) in human immunodeficiency virus/hepatitis C virus (HCV)-coinfected patients receiving anti-HCV therapy. We reviewed all cases of anaemia occurring among 416 patients participating in a randomized, controlled 48-week trial comparing peginterferon (peg-IFN) alpha 2b plus ribavirin with interferon alpha-2b plus ribavirin. Univariate and multivariate analyses were used to identify links with antiretroviral treatments, HCV therapy and clinical and laboratory findings. Sixty-one (15.9%) of the 383 patients who received at least one dose of anti-HCV treatment developed anaemia. In multivariate analysis the risk of anaemia was significantly associated with zidovudine (OR, 3.27 95% CI, 1.64-6.54, P = 0.0008) and peg-IFN (OR, 2.35; 95% CI, 1.16-4.57, P = 0.0179). The risk of anaemia was lower in patients with higher baseline haemoglobin levels (OR, 0.35 95% CI, 0.26-0.49, P < 0.0001) and in patients receiving protease inhibitor-based antiretroviral therapy (OR, 0.51 95% CI, 0.30-0.86, P = 0.0114). Zidovudine discontinuation could help to avoid anaemia associated with anti-HCV therapy.     

Significance of hepatitis virus infection in the oncogenic initiation of hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is one of the most common causes of cancer-related death worldwide. Chronic infection of hepatitis B virus(HBV) and/or hepatitis C virus(HCV) is a major risk factor in the development of the HCC, independently from excessive alcohol abuse and metabolic disease. Since the biology of HBV and HCV is different, their oncogenic effect may go through different mechanisms, direct and/or indirect. Viral hepatitis infection is associated with cellular inflammation, oxidative stress, DNA damage, that may lead to subsequent hepatic injuries such as chronic hepatitis, fibrosis, cirrhosis, and finally HCC. Direct oncogenic properties of these viruses are related with their genotypic characteristics and the ability of viral proteins to interact with host proteins, thus altering the molecular pathways balance of the cells. In addition, the integration of HBV DNA, especially the gene S and X, in a particular site of the host genome can disrupt chromosomal stability and may activate various oncogenic mechanisms, including those in hematopoietic cells. Recently, several studies also had demonstrated that viral hepatitis could trigger the population of hepatic cancer stem cells. This review summarize available pre-clinical and clinical data in literature regarding oncogenic properties of HBV and HCV in the early initiation of HCC.     

Fixation methods for electron microscopy of human and other liver

For an electron microscopic study of the liver,expertise and complicated,time-consuming processing of hepatic tissues and cells is needed.The interpretation of electron microscopy(EM) images requires knowledge of the liver fine structure and experience with the numerous artifacts in fixation,embedding,sectioning,contrast staining and microscopic imaging.Hence,the aim of this paper is to present a detailed summary of different methods for the preparation of hepatic cells and tissue,for the purpose of preserv...