Smoking and Intoxication after Alcohol Challenge in Women and Men: Genetic Influences

In an earlier analysis, men and women who were current or former smokers were found to report feeling less intoxicated on average than nonsmokers after ingestion of a challenge dose of alcohol. Here, we examine whether differences in subjective response to alcohol and a tendency to smoke cigarettes are transmitted together in families; and, if so, whether this association might be entirely explained by the same heritable factors that influence alcohol intake (as we might expect if both smoking and subjective intoxication are influenced by some general susceptibility for substance use). Alcohol challenge data on 388 Australian male and female twins (194 complete pairs) were reanalyzed using multivariate genetic analysis to evaluate the association between cigarette smoking and self-report intoxication after a standard dose of alcohol. In women, we could not reject the hypothesis of complete genetic overlap between effects on intoxication rating and history of smoking, and a significant residual genetic correlation between smoking and postalcohol intoxication persisted even when genetic influences on alcohol consumption were controlled for. In men, the familial association seemed to be largely environmentally mediated and associated with differences in drinking history. These findings prompt the question of whether, in some individuals, cigarette smoking may contribute to the development of tolerance to the effects of alcohol.     

Antibodies Against Human Tissue Transglutaminase and Endomysium in Diagnosing and Monitoring Coeliac Disease

Background: Coeliac disease (CD) patients often present a variety of uncharacteristic symptoms and therefore sensitive and specific screening tests are needed as an aid in making an accurate diagnosis. A recently developed ELISA, using human recombinant tissue transglutaminase (tTG) as antigen, was evaluated for its significance in the diagnosis of CD. The patient's compliance to a gluten-free diet and the serological reaction during gluten challenge were also monitored. The results were compared with IgA-endomysium antibody (EMA) results. Methods: Sera previously collected from 365 patients (0.4-76 years) with jejunal biopsy on a gluten-containing diet and from 41 patients on a gluten-free diet or challenge were tested for IgA anti-human tTG antibodies (IgA tTG ab) with Celikey ® (Pharmacia Diagnostics). The study population comprised 208 CD patients and 157 controls. The diagnostic performance and cut-off for the assay were estimated with ROC analysis. EMA was analysed by indirect immunofluorescence microscopy on cryostat sections of monkey oesophagus. Results: 200/208 patients with CD had positive IgA tTG ab (median >100 U/ml), while only 1/157 of the control patients were positive (median 1.67 U/ml). The area under the ROC curve was 98.3% and the sensitivity and specificity of the test were 96% and 99% for the study population. Only 4/365 patients (1%) presented discordant IgA tTG ab and EMA results, 2 of them had only IgA tTG ab and 2 only EMA. The IgA tTG ab levels and the EMA titres were closely correlated to the duration of gluten-free diet and gluten challenge, respectively. Conclusion: IgA tTG ab can be used as an accurate observer-independent alternative to EMA in diagnosing or monitoring CD.     

“挑战杯”大赛在中药学“阶梯式与创新中的作用”实践

中药学是研究中药的基本理论和临床应用的学科,是医学理论体系中的一个重要组成部分,也是理论与实践密切相结合的学科。本文主要阐述了以“挑战杯”创业大赛和“挑战杯”论文大赛为主要理论和实践特征的教学方式,建立了中药学“阶梯式”实践与创新培养模式在本学科教学的培养体系,对中药学学科在校大学生的科研创新思想体系和实践动手能力进行培育,并对“挑战杯”大赛现在存在的问题进行探讨。     

Something to gain, something to lose: The cardiovascular consequences of outcome framing

Previous findings support that cardiovascular markers of challenge/threat reflect one's relative balance of resource versus demand evaluations during task performance. We report a novel investigation of the effects of performance outcome framing (potential for gain vs. loss) on these cardiovascular markers. Before completing a test, participants learned they could gain or lose money, or neither, based on performance. Results revealed that during the test, gain and loss framings led to higher heart rate and lower pre-ejection period than no incentive, consistent with greater task engagement; gain framing led to lower total peripheral resistance and higher cardiac output than loss framing, consistent with relative challenge. Implications for challenge/threat and related research and theories are discussed.     

S-Citalopram in neuroendocrine challenge-tests: serotonergic responsivity in healthy male and female human participants

The aim of the present study was to assess the usefulness of the selective serotonin-reuptake-inhibitor S-Citalopram as a serotonergic challenge probe in 24 healthy male and 24 healthy female participants. The participants received a single oral dose of 10 and 20 mg of S-Citalopram in a placebo-controlled double blind crossover design. In female subjects phases of the menstrual cycle were controlled. Changes in concentrations of cortisol in saliva were used to indicate serotonergic reactivity. S-Citalopram induced a reliable dose dependent rise in cortisol concentrations. Results reveal a clear dose–response relationship in both sexes. However, in contrast to the 10 mg condition the dosage of 20 mg led to significantly higher cortisol levels in females, whereas no differences could be observed with respect to different phases of the menstrual cycle (follicular vs. luteal). Adverse side effects were reported only after 20 mg. The results clearly indicate that the dosage of 10 mg should be preferred when challenging males and females. Results will be discussed with regard to the further use of S-Citalopram in neuroendocrine challenge tests.     

基于广东医学院“挑战杯”活动分析在校大学生的科研现状

"挑战杯"活动是高等院校培养学生创新能力和实践能力的重要途径,本文以广东医学院的"挑战杯"活动为例,分析了学生科研创新活动的现状和制约因素,同时对如何更好的开展"挑战杯"创新活动提出了相应的对策。     

慢性咳嗽和/或胸闷并气道高反应性的诊断

目的:探讨具有气道高反应性的慢性咳嗽和/或胸闷的病人诊断思路。方法:应用乙酰甲胆碱激发试验筛查了378名慢性咳嗽和/或胸闷病人,112名激发试验阳性者作进一步的检查,包括血清IgE、过敏原皮试。排除其它疾病后,这些病人被拟诊为支气管哮喘,根据GINA方案进行规范治疗,并追踪24个月。结果:83名患者诊断为哮喘,25名诊断为非哮喘,4名未明确诊断。非哮喘病人中,上气道咳嗽综合征6例、胃食管反流5例、肺气肿4例、支气管内膜结核3例、慢性肺栓塞和支气管炎各2例,肿瘤、过敏性支气管肺曲菌病气道高反应综合征各1例;哮喘和非哮喘病人的临床特征如性别、吸烟史、哮喘家族史、症状和过敏性鼻炎的发生率等均无差异;两组间过敏原皮试的阳性率和血清中IgE的量无显著性差异。结论:有近1/3的具有咳嗽、胸闷等不典型症状的病人激发试验阳性,其中大部分病人诊断为哮喘;在临床实践中,根据排他性诊断和对药物治疗的反应,并进行相当长时间的追踪观察才能作出可靠的诊断。     

新医改对医院发展的挑战及对策

2009年4月,《中共中央国务院关于深化医药卫生体制改革的意见》正式出台。新医改政策的出台,给医院的发展和建设带来了机遇,也带来了挑战。本文对医院如何应对新医改政策带来的挑战进行探讨,使医院适应新医改政策的要求,促进医院建设不断向前发展。