Disability,depression and somatization in a low back pain population

Objective: The aim of this study was to determine the prevalence of low back pain (LBP) in a primary care setting population and examine its association with the symptoms of depression and somatization. Methods: This is a cross‐sectional study, utilising a survey carried out in primary health care clinics (PHCs) in Al‐Ain, United Arab Emirates (UAE). A multistage stratified sampling design was used and a representative sample of 1304 UAE nationals aged 18–65 years who attended PHC clinics for any reason were included and 1103 (84.5%) subjects agreed to participate and responded to the questionnaire during a period from June 2001 to January 2002. A specially designed questionnaire with three parts was used for the data collection: socio‐demographic information of the studied subjects, modified version of the Roland‐Morris scale for evaluating back‐related functional disability and SCL‐90 R for depression and somatization subscales was used to assess depressive and somatic symptoms. Results: Of the total number of subjects surveyed (1103), 586 (53.1%) were men and 517 (46.9%) women. The mean age was 34.9 ± 13.4 years for men and 33.5 ± 11.8 years for women. The prevalence of LBP in the studied subjects was 64.7% (95% CI, 60.7–68.5] with 46.7% among men and 53.3% among women. There were a significant differences between the subjects with LBP and without LBP with respect to gender (P < 0.001), body mass index (BMI) (P < 0.001), occupational status (P < 0.001) and living environment (P = 0.016). Functional disability was higher in patients with LBP. Young patients in aged 15–34 years, patients with preparatory/secondary educational level and students showed higher depressive symptoms. A similar pattern was found in patients with somatic symptoms. Factor analysis revealed a strong association between depression and somatization in LBP patients. Conclusions: Functional disability was higher in with LBP. Furthermore, symptoms of depression and somatization are prevalent among LBP patients.     

“病理生理窗”指导下的溶栓干预模式探讨

目的:分析“时间窗指导下的溶栓治疗”的局限性,提出新型溶栓干预模式。方法:本研究通过对比分析5例急性缺血性脑血管病患者“时间窗”、“缺血半暗带”和“溶栓干预疗效”之间的相关关系。阐释“时间窗指导下溶栓治疗”的局限性,进而提出新型急性脑血管病溶栓干预模式的设想。结果:“时间窗”指导下的溶栓治疗有其固有的局限性,集中体现在以下两个方面。其一,对于那些发病虽然在经典溶栓干预时间窗内。但已经无缺血半暗带存在的患者实施了溶栓治疗,增加出血并发症发生的机率。其二,对于那些发病虽然超过经典时间窗,但仍然有可挽救脑组织存在的患者却放弃了溶栓治疗,降低了患者从溶栓治疗中受益的机会。结论:“病理生理窗指导下的溶栓治疗”,倡导根据缺血的病理生理特点进行溶栓决策,实施个体化的溶栓治疗,是一种更为理想的溶栓干预模式。     

Further support for changes in chloroquine disposition and metabolism between a low and a high dose

Summary The kinetics of chloroquine and its major metabolite desethylchloroquine were studied in patients with rheumatoid disease after single oral doses of chloroquine phosphate corresponding to 150 and 300 mg chloroquine base. The findings strengthen the previous finding that the disposition of chloroquine involves rate limiting steps.     

含淡豆豉中成药的微生物限度标准考察

本文追踪考察了云南省含淡豆豉中成药的细菌数、霉菌数和控制菌的染菌情况，考察结果表明：含淡豆豉经煎煮或制成浸膏的中成药片剂的含菌量已基本达到或高于现行标准。但该类药品中的丸剂和散剂由于淡豆豉未经处理，其染菌量仍难以控制。     

Respiratory effects and serum type III procollagen in potato sorters exposed to diatomaceous earth

Exposure to diatomaceous earth with low crystalline silica content (< 1%) is rarely reported to cause pneumoconiotic disease, whereas airway obstruction and bronchitis are more frequently reported. We investigated the occurrence of pneumoconiosis and airflow limitation in 172 male workers from 5 potato sorting plants (55 controls, 29 salesmen, 72 currently exposed, and 16 retired exposed) exposed to inorganic dust from former sea terraces (7.7–15.4 mg/m³), high in diatomaceous earth. The presence of fibrosis was evaluated by chest radiographs (exposed only) and serum levels of type III procollagen (P-III-P) were measured as an estimate of fibrogenetic activity. Lung function was assessed by flow volume curves and impedance measurements. A validated questionnaire was used to record respiratory symptoms. No pneumoconiotic abnormalities were demonstrated by chest radiographs. In line with this finding, serum P-III-P levels were not elevated in exposed workers as compared to controls, suggesting no differences in fibrogenetic activity. In fact, serum P-III-P levels decreased significantly (P < 0.03) with increasing cumulative exposure. Flow volume parameters indicated airflow obstruction, dose-related to (cumulative) dust exposure; the annual decline in forced expiratory flow volume (FEV₁) was estimated at 10.5 m1/year (P < 0.05). Airway obstruction was confirmed by impedance analysis: In the retired group impedance changes were compatible with airway obstruction extending into the peripheral airways. We conclude that this exposure to quartz during potato sorting does not result in an increased risk for pneumoconiosis, but that (prolonged) surveillance in this group is desirable in order to detect early indications of airflow obstruction.     

底物限制对杂交瘤细胞生长、代谢和单抗生成的影响

考察了葡萄糖或谷氨酰胺限制的批培养中杂交瘤细胞的生长、代谢和单抗生成。葡萄糖或谷氨酰胺限制时最大活细胞密度基本相同,为(1.0±0.1)×106cells/mL。葡萄糖限制时,乳酸生成减少,YLac/Glc降低,YCell/Glc增加,提示葡萄糖更多地参与三羧酸循环。谷氨酰胺限制时,氨和丙氨酸生成减少,YAmm/Gln增加,YAla/Gln减小,提示谷氨酰胺的能量利用率提高。谷氨酰胺缺失时异亮氨酸、亮氨酸、胱氨酸、缬氨酸、色氨酸、组氨酸等替代谷氨酰胺,维持细胞生长和单抗合成,产物是甘氨酸和天冬氨酸。单抗生成与细胞生长关联,并且细胞停止生长后单抗仍生成。细胞死亡阶段的qMAb约是生长阶段的一半。葡萄糖和谷氨酰胺共限制下细胞对单抗的生产能力比葡萄糖和谷氨酰胺单独限制时小。     

Association between airflow limitation and leukoaraiosis of the brain

BackgroundPatients with chronic obstructive pulmonary disease (COPD) have several comorbidities. Leukoaraiosis (LA) is an abnormal appearance of brain white matter on neuroimaging, and it has been linked to microangiopathy of the brain. In this study, we explored the association between airflow limitation (AL) and LA volume and localization.MethodsThis observational cross-sectional study included 3,945 subjects who underwent medical check-ups between January 2015 and December 2017. LA was automatically assessed and quantified on brain MRI images using a morphometric program. Spirometry without bronchodilator was performed, and AL was defined as the ratio of forced expiratory volume in 1 s/forced vital capacity <0.70.ResultsIn the multivariate analysis, AL was an independent predictor of LA volume (t = 3.06, P < 0.01), in addition to age, hypertension, and dyslipidemia. Compared with the propensity-matched subjects without AL, the subjects with AL (n = 157) had significantly higher LA volumes (4.65 cm³ vs. 3.26 cm³, P < 0.05) and frequency of LA in the frontal lobe, but not in the parietal, temporal, and occipital lobes.ConclusionsOur findings suggest that AL is associated with increased LA volume and with more frequent localization of LA in the frontal lobe.     

The status,limitation and improvement of adoptive cellular immunotherapy in advanced urologic malignancies

In recent years, immunotherapy has been gradually established as the fourth frequently adopted antitumor therapy, following surgery, chemotherapy and radiotherapy, for advanced urologic malignancies with an improved understanding of theoretical basis, such as molecular biology and immunology. Thereinto, adoptive cellular immunotherapy (ACI) has become one of the hotspots, which comprises a variety of treatment approaches, such as TIL, CIK cell, γδ T cell, CAR-engineered T cell and Allogeneic stem cell transplantation (alloSCT). Although preclinical efficacy has been demonstrated remarkably, clinical trials could not consistently show the benefit due to multi-factors in complex immunosuppressive microenvironment in vivo compared to that of in vitro. Here we review some timely aspects of ACI for advanced urologic malignancies, and describe the current status and limitation of immunotherapy from the cellular level. It’s our expectation to provide prompting consideration of novel combinatorial ACI strategies and a resurgence of interest in ACI for advanced urologic malignancies.     

Premedication with the opioid analgesic butorphanol raises the threshold for ischemic preconditioning in dogs

Elucidation of the subcellular mechanism of myocardial ischemic preconditioning should be facilitated by precise knowledge of the biology of the cardioprotective response. Any proposed molecular mechanism for preconditioning must be initiated during the required ischemic stress period. The studies reported in this paper were under-taken to determine whether the infarct-limiting effect of four 5-min episodes of ischemia interspersed by reperfusion can be achieved by a single 5-min episode. Adult openchest mongrel dogs, premedicated with the analgesic butorphanol, and anesthetized with sodium pentobarbital, underwent occlusion of the circumflex coronary artery for 60 min, followed by reperfusion for 3 h. Treated dogs were preconditioned with one, two or four cycles of 5-min occlusion followed by reperfusion. Additional dogs, not premedicated with butorphanol, were either untreated (not preconditioned) or preconditioned with one cycle of ischemia. Infarcts were identified using triphenyl-tetrazolium chloride (TTC) macrochemistry and infarct size (as % of area-at-risk, AAR) was measured and analyzed (using analysis of covariance [ANCOVA]) with respect to coronary collateral blood flow (measured using radio active microspheres). Four 5-min cycles of preconditioning ischemia markedly limited infarct size. Two cycles were as effective as four. In contrast, infarct size was not different from control infarct size after a single episode of preconditioning ischemia. However, when pentobarbital anesthesia was used without premedication with butorphanol, a single 5-min ischemic stress did induce cardioprotection. Thus, the ischemic stress required for myocardial preconditioning in dogs is dependent on the anesthetic and premedication protocol employed. A single 5-min stimulus is effective in dogs anesthetized with pentobarbital. Premedication with the opioid analgesic, butorphanol, increases the threshold for induction of cardioprotection.