广西玉林市261例麻疹流行病学和临床特点分析

目的分析和总结2013—2014年本院收治的广西壮族自治区玉林市麻疹患儿的流行病学和临床特点。方法对2013年3月—2014年7月我院收治的麻疹患儿261例的资料进行回顾性分析。结果 2013—2014年玉林市麻疹发病人数增多,发病高峰季节为5月,其次为4月和6月;1岁以内婴儿发病占大多数,0~8月龄婴儿发病比例最高;大多数患儿未进行预防接种或发病前曾有就诊史。患儿均有麻疹的典型表现,肺炎是最常见合并症,严重合并症为重症肺炎及心肌炎。死亡病例均合并重症肺炎或心肌炎。结论年龄小于8月龄婴儿的麻疹发病率增高,因此接种月龄应提前,并且加强对大于8月龄婴幼儿的预防接种。2013—2014年麻疹发病人数增多,症状典型,合并症重,须引起临床重视。     

Plasma vaspin concentrations are decreased in acute coronary syndrome,but unchanged in patients without coronary lesions

Objective

Previous studies suggested that decreased serum vaspin levels were associated with coronary artery disease (CAD). The present study aimed to investigate the association between plasma vaspin levels and different states of CAD.

Design and methods

A total of 162 patients with coronary angiography (CAG) proved that CAD was enrolled. Additional 103 patients complained with “chest discomfort” with negative CAG, and 60 normal subjects were enrolled in this study. The levels of plasma vaspin, adiponectin, clinical parameters, lipid profile and C reactive protein (CRP) were measured.

Results

The levels of plasma vaspin were significantly lower in the CAD group (0.47 ± 0.63 μg/L) than those in the healthy group and CAG (−) group (all p < 0.001). In CAD group, the pos hoc analysis showed that serum vaspin concentration in acute myocardial infarction group (0.21 ± 0.19 μg/L) was significantly lower than that in the unstable angina pectoris group (0.40 ± 0.37 μg/L) (p = 0.012), and serum vaspin concentration in unstable angina pectoris was significantly lower than that in stable angina pectoris group (0.92 ± 0.94 μg/L) (p = 0.013). The plasma vaspin concentration was also negatively correlated with the severity of CAD (1-vessel: 0.86 ± 0.90 μg/L; 2-vessel: 0.36 ± 0.39 μg/L; 3-vessel: 0.21 ± 0.16 μg/L). The plasma vaspin concentration in CAG (−) group with “chest discomfort” (1.93 ± 2.57 μg/L) was similar to the healthy control group (2.18 ± 3.49 μg/L).

Conclusions

The plasma vaspin concentration correlated to the severity of CAD. Furthermore, plasma vaspin has a value of avoiding patients without CAD from unnecessary CAG.     

复方蜥蜴散对慢性萎缩性胃炎模型大鼠血清NO及iNOS水平影响的实验研究

目的:观察复方蜥蜴散对慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)模型大鼠血清NO及iNOS水平的影响,探讨其治疗CAG的作用机制。方法:采取55℃热盐水、2%水杨酸、20mmol/L脱氧胆酸钠三个致萎缩因素配合饥饱失常造成CAG模型。将实验动物分为正常对照组,模型对照组,维酶素组,复方蜥蜴散高、中、低剂量组。检测大鼠血液中NO和iNOS水平及观察胃黏膜组织学方面的改变。结果:模型组大鼠NO和iNOS水平明显高于正常组(P<0.01),病理组织学上也有较大改变,而经复方蜥蜴散治疗1个月后,NO和iNOS水平恢复正常,胃黏膜病理组织学改善明显。结论:复方蜥蜴散可以逆转萎缩胃黏膜的病理改变,发挥保护胃黏膜的作用。     

数字减影血管造影在经皮冠状动脉腔内成形术中的应用（附10例报道）

作者采用ＤＳＡ对９２例冠状动脉硬化性心脏病施行冠状动脉（冠脉）造影，其中５２例（７１支）冠脉（ＣＡ）发现不同程度的狭窄；选择其中１０例ＣＡＳ患者行经冠脉腔内成形（ＰＴＣＡ），８例成功，狭窄管腔均获明显扩张（＞３０％），２例失败。文中着重讨论了ＤＳＡ在ＰＴＣＡ应用中的价值、限度与采取的措施。     

Molecular epidemiology of spinocerebellar ataxias in Cuba: Insights into SCA2 founder effect in Holguin

The objective of this study was to determine the prevalence of hereditary ataxias in Cuba, with a special focus on the clinical and molecular features of SCA2. Clinical assessments were performed by neurological examinations and application of the SARA scale. Molecular analyses of genes SCA1–3, SCA6, SCA17 and DRPLA identified 753 patients with SCA and 7173 asymptomatic relatives, belonging to 200 unrelated families. 86.79% of all SCA patients were affected with SCA2. In the Holguin province, the average population prevalence of SCA2 is 40.18 × 10⁵ inhabitants, with the remarkable figure of 141.66 × 10⁵ in the Baguanos municipality. The high prevalence of the SCA2 mutation in Holguin reflects most likely a founder effect. The stabilization of the prevalence along time suggests the existence of premutated chromosomes with pure CAG, acting as reservoir for further expansions. CAG repeat length correlated inversely with age at onset, accounting for 80% of the variability. Genetic anticipation was observed in the 80% of transmissions. Repeat instability was greater in paternal transmissions whereas CAG expansions without anticipation was observed in 10.97% suggesting the effect of CAA interruptions in the CAG segment, which decrease the toxicity of the abnormal ataxin-2, and/or other protective factors.     

Saving lives versus life‐years in rural Bangladesh: an ethical preferences approach

Using a random sample of individuals in rural Bangladesh, this paper investigates people's ethical preferences regarding relative values of lives when it comes to saving lives of individuals of different ages. By assuming that an individual has preferences concerning different states of the world, and that these preferences can be described by an individual social welfare function, the individuals' preferences for life‐saving programs are elicited using a pair‐wise choice experiment involving different life‐saving programs. In the analyses, we calculate the social marginal rates of substitution between saved lives of people of different ages. We also test whether people have preferences for saving more life‐years rather than only saving lives. In particular, we test and compare the two hypotheses that only lives matter and that only life‐years matter. The results indicate that the value of a saved life decreases rapidly with age and that people have strong preferences for saving life‐years rather than lives per se. Overall, the results clearly show the importance of the number of life‐years saved in the valuation of life. Copyright © 2010 John Wiley & Sons, Ltd.     

Factors Associated With Involvement in Marriage Preparation Programs

Abstract: Little is known empirically about the characteristics of couples who do and do not participate in marriage preparation. This study assessed the individual, couple, family, and sociocultural context variables that distinguish couples who become involved in marriage preparation from those who do not, using a sample of 7,331 couples. The results showed that the individual characteristics of valuing marriage, being kind and considerate, and being mature, and the couple context factor of perceived relationship problems, predicted involvement. Implications for increasing attendance in marriage preparation interventions include maximizing efforts to reach the “likely‐to‐attend group,” as identified in our findings. With this base of support for the value of interventions, we can then look to the less‐likely‐to‐attend group, who will take more resources of time, energy, and money to get to attend.     

Technical skills for weight loss: preliminary data from a randomized trial

BACKGROUND: Optimal behavioral interventions for sustainable weight loss are uncertain. We therefore conducted a study among overweight/obese women comparing conventional dietary counseling of individuals (counseling-based intervention) to a novel, group-based skill-building intervention. METHODS: Eighty subjects were randomly assigned to either the counseling-based or to the skill-building intervention. Outcomes included weight loss, dietitian hours per group and per unit weight loss, and dollars spent per group and per unit weight lost. RESULTS: Weight loss at 6 months (follow-up rate 61.3%) in the counseling-based group was 8.8 lb (P = 0.0001), and in the skill-building group was 3.8 lb (P = 0.01). A total of 160 dietitian hours were required for the counseling-based group, and 131 for the skilled-building group. The counseling-based group cost an average of $21 per pound lost, while the skill-building cost an average of $48 per pound lost (P = 0.16). CONCLUSIONS: At 6 months, individualized office-based counseling produced more weight loss than a skill-building approach and cost less than half as much per pound of weight loss. Longer-term follow-up is required to determine if, as hypothesized, the skill-building intervention produces more sustainable weight loss.     

Analysis of SCA8 and SCA12 loci in 134 Italian ataxic patients negative for SCA1–3, 6 and 7 CAG expansions

Spinocerebellar ataxias (SCA) are a heterogeneous group of neurodegenerative disorders, six of which are caused by expansion of a polyglutamine-coding CAG repeats (SCA1- 3, 6, 7 and 17). In addition, expansions of a CAG triplet in the 5' region of a gene and a CTG triplet in an antisense RNA have been demonstrated in the SCA12 and SCA8 genes respectively. Our series of 134 ataxic patients (22 familial and 112 sporadic, tested negative for SCAI–3, 6, 7) was investigated for the presence of triplet expansions in the SCA8 and SCA12 genes. No SCA12 expansion was identified. A moderate SCA8 expansion (85–97 repeats) was found in two unrelated families with slowly progressive cerebellar ataxia. The frequency of SCA8 expansion accounts for ∼4.3 % of the whole pool of our ataxia families (2 out of 46), while none of the 127 controls screened carried > 35 CTG+CTA repeats. Our data suggest a possible pathogenetic role of this mutation, which at present is still controversial, and confirm the rarity of the SCA12 expansion in Italian patients. Received: 30 March 2001, Received in revised form: 20 November 2001, Accepted: 15 January 2002