Heteroclitic peptides enhance human immunodeficiency virus-specific CD8 T cell responses

The inability of human immunodeficiency virus (HIV)-specific CD8⁺ T cells to durably control HIV replication due to HIV escape mutations and CD8⁺ T cell dysfunction is a key factor in disease progression. A few HIV-infected individuals termed elite controllers (EC) maintain polyfunctional HIV-specific CD8⁺ T cells, minimal HIV replication and normal CD4⁺ T lymphocyte numbers. Thus, therapeutic intervention to sustain or restore CD8⁺ T cell responses similar to those persisting in EC could relieve terminal dependence on antiretrovirals. Vaccination with HIV peptides is one approach to achieve this and our objective in this study was to determine whether certain HIV peptide variants display antigenic superiority over the reference peptides normally included in vaccines. Eight peptide sets were generated, each with a reference peptide and six variants harboring conservative or semi-conservative amino acid substitutions at positions predicted to affect T cell receptor interactions without affecting human class I histocompatibililty-linked antigen (HLA) binding. Recognition across peptide sets was tested with >80 HIV-infected individuals bearing the appropriate HLA alleles. While reference peptides were often the most antigenic, cross-reactivity with variants was common and in many cases, peptide variants were superior at stimulating interferon-γ production or selectively enhanced interleukin-2 production. Although such heteroclitic activity was not generalized for all individuals bearing the HLA class I allele involved, these data suggest that heteroclitic peptide variants could improve the efficacy of therapeutic peptide vaccines in HIV infection.     

Doping and musculoskeletal system: short-term and long-lasting effects of doping agents

Doping is a problem that has plagued the world of competition and sports for ages. Even before the dawn of Olympic history in ancient Greece, competitors have looked for artificial means to improve athletic performance. Since ancient times, athletes have attempted to gain an unfair competitive advantage through the use of doping substances. A Prohibited List of doping substances and methods banned in sports is published yearly by the World Anti‐Doping Agency. Among the substances included are steroidal and peptide hormones and their modulators, stimulants, glucocorticosteroids, β₂‐agonists, diuretics and masking agents, narcotics, and cannabinoids. Blood doping, tampering, infusions, and gene doping are examples of prohibited methods indicated on the List. Apart from the unethical aspect of doping, as it abrogates fair‐play’s principle, it is extremely important to consider the hazards it presents to the health and well‐being of athletes. The referred negative effects for the athlete’s health have to do, on the one hand, by the high doses of the performance‐enhancing agents and on the other hand, by the relentless, superhuman strict training that the elite or amateur athletes put their muscles, bones, and joints. The purpose of this article is to highlight the early and the long‐lasting consequences of the doping abuse on bone and muscle metabolism.     

Effects of resistance training on endurance capacity and muscle fiber composition in young top-level cyclists

Equivocal findings exist on the effect of concurrent strength (S) and endurance (E) training on endurance performance and muscle morphology. Further, the influence of concurrent SE training on muscle fiber-type composition, vascularization and endurance capacity remains unknown in top-level endurance athletes. The present study examined the effect of 16 weeks of concurrent SE training on maximal muscle strength (MVC), contractile rate of force development (RFD), muscle fiber morphology and composition, capillarization, aerobic power (VO2max), cycling economy (CE) and long/short-term endurance capacity in young elite competitive cyclists (n=14). MVC and RFD increased 12-20% with SE (P<0.01) but not E. VO2max remained unchanged. CE improved in E to reach values seen in SE. Short-term (5-min) endurance performance increased (3-4%) after SE and E (P<0.05), whereas 45-min endurance capacity increased (8%) with SE only (P<0.05). Type IIA fiber proportions increased and type IIX proportions decreased after SE training (P<0.05) with no change in E. Muscle fiber area and capillarization remained unchanged. In conclusion, concurrent strength/endurance training in young elite competitive cyclists led to an improved 45-min time-trial endurance capacity that was accompanied by an increased proportion of type IIA muscle fibers and gains in MVC and RFD, while capillarization remained unaffected.     

Can we predict top‐level sports performance in power vs endurance events? A genetic approach

The goal of our study was to discriminate potential genetic differences between humans who are in both endpoints of the sports performance continuum (i.e. world‐class endurance vs power athletes). We used DNA‐microarray technology that included 36 genetic variants (within 20 different genes) to compare the genetic profile obtained in two cohorts of world‐class endurance (N=100) and power male athletes (N=53) of the same ethnic origin. Stepwise multivariate logistic regression showed that the rs1800795 (IL6?174 G/C), rs1208 (NAT2 K268R) and rs2070744 (NOS3?786 T/C) polymorphisms significantly predicted sport performance (model χ²=25.3, df=3, P‐value <0.001). Receiver–operating characteristic (ROC) curve analysis showed a significant discriminating accuracy of the model, with an area under the ROC curve of 0.72 (95% confidence interval: 0.66–0.81). The contribution of the studied genetic factors to sports performance was 21.4%. In summary, although an individual's potential for excelling in endurance or power sports can be partly predicted based on specific genetic variants (many of which remain to be identified), the contribution of complex gene–gene interactions, environmental factors and epigenetic mechanisms are also important contributors to the “complex trait” of being an athletic champion. Such trait is likely not reducible to defined genetic polymorphisms.     

区域联合预约就诊平台的设计与应用

针对互联网预约挂号医院各自为政的现状,提出了区域联合预约挂号平台的建设方案．分别对联合预约的意义、信息类型、接口方案、预约流程等方面进行了阐述,并从诊间按序就诊是前提、门诊排班管理是基础、医生停诊需慎重、正确处理患者爽约、身份验证防盗号等方面对医院的预约注意事项,以及后续服务功能进行了经验介绍。     

抑制素与妇女围绝经期综合征

抑制素是一种糖蛋白激素,在妇女主要由卵巢产生,它可以调节促卵泡生成素分泌。文章综述了抑制素的生理功能,与妇女围绝经期综合征发病机理的关系,对妇女围绝经期分期的影响,以及中医药治疗围绝经期综合征对抑制素的调节作用的研究概况。     

门诊部实施电话预约护士报号服务的做法与体会

目的 探讨对服务中心电话预约有效管理的方法,提高电话预约率和病人满意度.方法 将护士编号,实行报号服务;进行个人月工作量统计,实行按劳分配;规范文明用语;加强护士素质的培训.结果 电话预约人数上升;病人满意度增加.结论 电话预约护士报号服务有利于提高工作效率和病人满意度.     

网上预约挂号实施过程中存在的问题及对策

根据襄阳市中心医院网上预约挂号实施过程中的亲身体会,对网上预约挂号实施过程中遇到的问题提出对策,以期推动预约诊疗服务平台的建设与发展步伐,有助于预约挂号的实施。     

预约就诊在高危儿随访门诊中的作用

【目的】 观察规范预约随访管理就诊在高危儿随访门诊中对其随访率及随防效果中的促进作用,为该制度的推广应用提供依据。 【对象】 按照自愿原则,选择2009年5月-2010年4月在本院新生儿科住院并建档的、自愿参加预约就诊的4 755例高危儿入选预约组,选择同期住院并建档的按原常规就诊的2 929例高危儿作为对照组。 【方法】 对预约组进行有计划的预约随诊时间,并通过出院宣教,专科护士电话预约、现场预约、医院预约网络平台等形式预约随诊。对照组按照常规无预约随访就诊。 【结果】 预约随访管理1年来,初次随访率达到82.72%,增长了26.99％,一年随访率达到了63.4％,增长了30.82％,经处理差异有统计学意义(P<0.001)。通过就诊时间的预约,患儿的非医疗等候时间由原来的(18.965±20.048) min,明显缩短到(6.125±8.048) min。 【结论】 有计划的预约高危儿随诊时间,可缩短等候时间,提高高危儿的随访率及随防效果。     

Epidemiology of Cheerleading Fall-Related Injuries in the United States

Context:

Over the past several decades, cheerleaders have been performing fewer basic maneuvers and more gymnastic tumbling runs and stunts. As the difficulty of these maneuvers has increased, cheerleading injuries have also increased.

Objective:

To describe the epidemiology of cheerleading fall-related injuries by type of cheerleading team and event.

Design:

Prospective injury surveillance study.

Setting:

Participant exposure and injury data were collected from US cheerleading teams via the Cheerleading RIO (Reporting Information Online) surveillance tool.

Patients or Other Participants:

Athletes from 412 enrolled cheerleading teams who participated in official, organized cheerleading practices, pep rallies, athletic events, or cheerleading competitions.

Main Outcome Measure(s):

The numbers and rates of cheerleading fall-related injuries during a 1-year period (2006–2007) are reported.

Results:

A total of 79 fall-related injuries were reported during the 1-year period. Most occurred during practice (85%, 67/79) and were sustained by high school cheerleaders (51%, 40/79). A stunt or pyramid was being attempted in 89% (70/79) of cases. Fall heights ranged from 1 to 11 ft (0.30–3.35 m) (mean  =  4.7 ± 2.0 ft [1.43 ± 0.61 m]). Strains and sprains were the most common injuries (54%, 43/79), and 6% (5/79) of the injuries were concussions or closed head injuries. Of the 15 most serious injuries (concussions or closed head injuries, dislocations, fractures, and anterior cruciate ligament tears), 87% (13/15) were sustained while the cheerleader was performing on artificial turf, grass, a traditional foam floor, or a wood floor. The fall height ranged from 4 to 11 ft (1.22–1.52 m) for 87% of these cases (13/15).

Conclusions:

Cheerleading-related falls may result in severe injuries and even death, although we report no deaths in the present study. The risk for serious injury increases as fall height increases or as the impact-absorbing capacity of the surfacing material decreases (or both).