Rash Impulsiveness and Reward Sensitivity as predictors of treatment outcome in male substance dependent patients

Recent theories hypothesize that the impulsivity observed in addictive behaviors is a two-factor construct, consisting of Rash Impulsiveness and Reward Sensitivity. There is some evidence for this distinction, but it is unknown what the clinical relevance of this distinction is. The present study examines the predictive value of the two-factor model regarding drop-out from treatment and relapse into substance use in a clinical population of male substance dependent patients. Both behavioral and self-report measures of Rash Impulsiveness and Reward Sensitivity were measured during treatment while substance use relapse was measured after 90 days. Results indicate that treatment drop-out could be predicted by a behavioral index of Reward Sensitivity (Card Playing Task); self-reported Rash Impulsiveness only approached significance as predictor drop-out. In contrast, relapse could not be predicted in the present study. These findings might have implications for the early identification and treatment of patients at risk of treatment drop-out.     

Interest of home blood pressure measurements (HBPM) to establish degree of hypertensive control

Aims: To establish the validity and clinical value of home blood pressure measurements (HBPM) in the treatment follow-up of patients with essential hypertension to rule out or to confirm poor control of blood pressure obtained in the doctor's office with a mercury sphygmomanometer. Material and methods: Observational, cross-sectional study was carried out to validate HBPM in treated hypertensive patients poorly controlled by office-based casual blood pressure measurements. Measurements were made on 2 consecutive days with six readings taken per day. To do this, 2 × 2 tables were drawn up to validate the HBPM using ABPM as the reference method. Sensitivity (S), specificity (Sp), positive probability quotient (+PQ) and negative probability quotient (-PQ) were calculated. The study population (n = 149) was selected by consecutive sampling of the hypertensive patients seen in the Vallada Health Centre. Only 124 patients could be evaluated. Results: Values obtained with HBPM were: S 97.3% (95% CI 90.4-99.7%), Sp 62.7% (48.1-75.9%), +PQ 2.61 (1.82-3.73) and -PQ 0.04 (0.01-0.71). Conclusions: Home monitoring of blood pressure is a useful alternative to ABPM to rule out office-based poor control of hypertensive patients, but not to confirm it.     

Diagnostic performance of a computer-based ECG rhythm algorithm

We examined the accuracy of computer-based rhythm interpretation from one electrocardiograph manufacturer (GE Healthcare Technologies MUSE software 005C) in 4297 consecutive recordings in a university hospital setting. Overreading was performed by either of 2 experienced cardiologists, and all disagreements with the initial computer rhythm statement were reviewed by the second cardiologist to achieve physician consensus used as the "gold standard" for rhythm diagnosis. Overall, 13.2% (565/4297) of computer-based rhythm statements required revision, but excluding tracings with pacemakers, the revision rate was 7.8% (307/3954), including 3.8% involving the primary rhythm diagnosis and 3.9% involving definition of ectopic complexes. The false-negative rate for sinus rhythm was only 1.3%, but a computer diagnosis of sinus rhythm was incorrect in 9.9% of other rhythms. The false-negative rate for atrial fibrillation was 9.2%, whereas a computer diagnosis of atrial fibrillation was incorrect in 1.1% of other rhythms, including sinus. Computer diagnosis of paced rhythms remains problematic, and physician overreading to correct computer-based electrocardiogram rhythm diagnoses remains mandatory.     

弓形虫抗体免疫印迹试剂盒的研制

目的 研制敏感、特异的检测弓形虫IgM和IgG抗体免疫印迹试剂盒。 方法 收集人工感染RH株弓形虫速殖子昆明系小鼠的腹腔液，提取弓形虫胞质蛋白，采用十二烷基磺酸钠-聚丙烯酰胺凝胶电泳（SDS-PAGE）分离弓形虫可溶性抗原，并经电泳转印至硝酸纤维膜，以无毒灵敏的四甲基联苯胺（TMB）为底物分别检测30份弓形虫IgM和28份IgG阳性血清，40份健康人血清。通过比较抗原制备方法和使用剂量、封闭剂、洗涤和稀释剂、工作浓度、作用时间以及反应带出现率，选择最佳实验条件，以敏感性、特异性、Youden指数以及稳定性作为试剂盒评价标准。 结果 用免疫印迹试剂盒检测30份弓形虫IgM和28份IgG阳性血清，敏感性分别为90.0%（27/30）和85.7%（24/28），40份健康对照者血清的弓形虫IgM和IgG抗体均为阴性，特异性均为100%，Youden指数分别为0.9和0.86。试剂盒于4℃ 保存约6个月的检测结果一致。 结论 该免疫印迹试剂盒敏感性和特异性均较高，且操作简便、快速。     

Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease: the Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial.

BACKGROUND: Non-invasive coronary angiography by multislice spiral computed tomography (MSCT) is a promising method for the diagnosis of coronary artery disease (CAD). However, the clinical role of this method has not been established for specific patient cohorts. Therefore, the objective of the current prospective, blinded study was to investigate the diagnostic value of coronary MSCT angiography in patients with an intermediate pre-test probability for having CAD when compared with invasive angiography. METHODS AND RESULTS: A total of 243 patients with an intermediate pre-test probability for having CAD were asked to undergo coronary 16- or 64-slice CT angiography before planned invasive angiography from 12 September 2003 to 13 July 2005. The primary end point was defined as the diagnostic accuracy in the detection of significant coronary stenosis (> or =50% lumen diameter reduction) on a per-patient and an 'intention-to-diagnose'-based analysis. Secondary end points comprised per-artery and per segment-based analyses as well as the comparison of diagnostic accuracy of 16- vs. 64-slice MSCT angiography. Of 243 enrolled patients, 129 and 114 patients were studied by 16- and 64-slice CT angiography, respectively. The overall sensitivity, negative predictive value, and specificity for CAD detection by MSCT were 99% (95% CI, 94-99%), 99% (95% CI, 94-99%), and 75% (95% CI, 67-82%), respectively. On a per-segment basis, the use of 64-slice CT was associated with significantly less inconclusive segments (7.4 vs. 11.3%, P < 0.01), resulting in a trend to an improved specificity (92 vs. 88%, P = 0.09). CONCLUSION: In patients with an intermediate pre-test probability for having CAD this large, prospective trial demonstrates that non-invasive coronary CT angiography is a very sensitive method for CAD detection. Furthermore, this method allows ruling out CAD very reliably and safely. Finally, 64-slice CT appears to be superior for CAD detection when compared with 16-slice CT.     

ATP生物荧光法监测手卫生效果指标的研究

目的研究ATP生物荧光法监测手卫生效果指标。方法 6家医疗机构在岗工作的医务人员812名,经过六步洗手法,采用ATP仪器检测。100名医务人员在工作1小时以上未洗手情况下,随机分为洗手组和非洗手组,分别采用ATP仪器检测。结果 812个"手卫生"样本,采用ATP仪器测定结果 RLU范围为1¹ 466,中位数是20,算术均数为59。P95=238,P90=146。分布不呈正态分布。男性高于女性,手的大小有差别。采用238 RLU作为手卫生参考值,其敏感度0.86;特异度0.92;准确度0.89。结论以238RLU作为ATP生物荧光法监测手卫生效果指标可行。     

MRA检查在脑梗死诊断中的敏感性与特异性研究

目的：探讨MR血管造影术（MRA）在脑梗死中的应用价值。方法：选取120例已经过DSA检查确诊的脑梗死患者,并与其术前脑血管MRA检查结果进行分析比较。结果：以DSA为标准,MRA对诊断脑梗死的敏感性83.3%,特异性93.6%,符合率91.4%,MRA与DSA检出率有一致性。结论：MRA与DSA检查结果之间有较高的符合率,可作为脑梗死诊断的重要参考。     

MiR-129-5p通过靶定胸苷酸合成酶调节结肠癌细胞对5-氟尿嘧啶的敏感性

目的 研究miR-129-5p通过靶定胸苷酸合成酶（TYMS）调控结肠癌细胞对5-氟尿嘧啶（5-Fu）敏感性的分子机制.方法 构建结肠癌耐药细胞株LoVo/5-Fu,并用实时荧光定量聚合酶链反应（PCR）检测miR-129-5p的表达水平.流式细胞术和MTT毒性实验检测过表达miR-129-5p对LoVo/5-Fu凋亡和半数致死剂量（IC50）的影响.构建TYMS 3＇UTR区荧光素酶报告载体,验证miR-129-5p对TYMS的靶向调控作用.Western Blot检测转染miR-129-5p后LoVo/5-Fu细胞中TYMS的蛋白表达.在LoVo/5-Fu内转染miR-129-5P siRNA,抑制其表达,检测LoVo/5-Fu细胞的IC50和凋亡.结果 过表达miR-129-5p后,LoVo/5-Fu细胞用5-Fu处理后凋亡增加,IC50降低.荧光素酶活性检测表明miR-129-5p能够抑制TYMS的荧光素酶活性.在LoVo/5-Fu细胞中miR-129-5p与TYMS的表达呈负相关.敲减TYMS后,LoVo/5-Fu细胞用5-Fu处理后凋亡增加,IC50降低.结论 MiR-129-5p能够通过靶定TYMS而增加结肠癌细胞对5-Fu的敏感性.