Sildenafil improves health-related quality of life in patients with pulmonary arterial hypertension

BACKGROUND: Sildenafil inhibits phosphodiesterase-5, enhancing cyclic guanosine monophosphate- mediated relaxation of pulmonary vasculature and is effective in treating patients with pulmonary arterial hypertension (PAH). METHODS: Patients with PAH (n = 278) received oral sildenafil (20, 40, or 80 mg three times daily) in a 12-week, double-blind, placebo-controlled study and an open-label extension. Health-related quality of life (HRQoL) was recorded by patients using the Medical Outcomes Study 36-item short form (SF-36) and EuroQol 5D (EQ-5D) questionnaires at baseline and after 12 and 24 weeks of therapy. Data are presented for patients who received sildenafil for up to 24 weeks. RESULTS: Sildenafil-treated patients, compared with placebo-treated patients, exhibited significant improvement in exercise capacity at week 12 (p < 0.001). Increases from baseline to week 12 were observed in all SF-36 domains for sildenafil-treated patients, with statistically significant improvements, compared with placebo-treated control subjects, in physical functioning (p < 0.001), general health (p < 0.001), and vitality (p < 0.05). Statistically significant improvements were also observed for the EQ-5D current health status (p < 0.01) and utility index (p < 0.01). These benefits were maintained for 24 weeks. Treatment groups were pooled for analyses as the results for the 6-min walk distance, SF-36, and EQ-5D were not dose dependent. CONCLUSIONS: Sildenafil improves HRQoL of PAH patients. These improvements appear to be maintained for at least 24 weeks. The effects are strongest in domains addressing the physical impact of health on daily activities and patients' overall perception of health.     

免疫性血小板减少症患者协同刺激分子的表达及意义

目的：探讨特发性血小板减少性紫癜（ITP）患者外周血淋巴细胞CD28、CD80及CD86的表达及意义。方法：采用免疫荧光标记和流式细胞术检测30例ITP患者和30例健康对照者外周血CD28细胞、CD80细胞和CD86细胞分别占淋巴细胞的比例及血小板表面相关抗体水平,并进行对比、分析。结果：与正常对照组相比,ITP患者外周血CD28细胞增多,差异有统计学意义（P〈0.05）;CD80细胞增多,但差异无统计学意义（P〉0.05）;CD86细胞显著增多,差异有统计学意义（P〈0.05）,此结果与ITP是否急慢性无关。治疗前后患者的CD28、CD80及CD86的表达率比较差异无统计学意义（P〉0.05）。患者与正常对照组PAIg A、PAIg G和PAIg M的水平比较差异有统计学意义（P〈0.05）;CD80、CD86表达与PAIg G水平之间存在显著的相关性,比较差异有统计学意义（P〈0.01）。结论：ITP患者外周血淋巴细胞CD28、CD80及CD86表达均异常,可能与其发病相关。     

Prise en charge actuelle de l’hypertension artérielle

Hypertension is a common health problem with serious consequences for individuals and a heavy attributable burden for populations. Reducing this burden requires preventive actions at the population level and early diagnosis at the individual level, followed by proactive interventions with proven benefits. Given the variability of blood pressure measurement, diagnosis is established only after repeated measurements under standardized conditions, if possible outside the clinic. Lifestyle changes can modestly reduce blood pressure; their impact is significant if they can be achieved on a large scale. Hypertension treatment requires a rational pharmacological approach, which can reach the target blood pressure within less than 6 months and three pharmacological classes at most in more than 80% of cases. Specialized consultation is required in the remaining 20% to detect secondary hypertensions, to optimize drug therapy and to discuss, in a minority of cases, non-pharmacological treatments. Recommendations are written by experts who select, interpret, and extrapolate the results of clinical research. As a consequence, they are sometimes unsuitable for primary care practice and frequently inconsistent across guidelines. Efforts are currently made to produce less disputable and more usable guidelines.     

15-羟基硬脂酸聚乙二醇酯在参麦注射液中的应用研究

本文研究了助溶剂15-羟基硬脂酸聚乙二醇酯(Kolliphor HS 15)在参麦注射液中达到最佳助溶效果的用量,并与采用聚山梨酯80作为助溶剂的参麦注射液对比研究了灭菌前后产品质量与稳定性。结果表明,当Kolliphor HS 15在参麦注射液中用量为0.2%时,可以达到良好的助溶效果,且对产品的质量和稳定性没有影响。为使用安全性更好、助溶原理相同、且能达到等同助溶效果的助溶剂,替换中药注射液中现有安全性差的聚山梨酯80提供一定参考依据。     

川南地区汉族人群D1S80基因座多态性分析

目的了解川南地区汉族人群DIS80位点群体遗传多态性。方法采用PCR结合聚丙烯酰胺PAGE电泳及高灵敏度银染技术,即Amp—FLP方法对川南地区120名汉族无血缘关系个体D1S80位点进行多态性分析。结果在所调查的120名无关个体样本中,观察到D1S80基因座有18个等位基因,基因频率分布在0．004166667～0．1958333333之间,杂合度为0．7869,个体识别力为0．87,非父排除率为0．8152,其基因型频率分布符合Hardy—Weinberg平衡法则。结论D1S80基因座的PCR分型具有较好的准确性和灵敏度,为法医学个体识别和亲权鉴定、遗传病基因链锁分析等的研究及应用提供了川南地区有用的遗传信息。     

The prevalence of caries and tooth loss among participants in the Hispanic Community Health Study/Study of Latinos

Background.The Hispanic and Latino population is projected to increase from 16.7 percent to 30.0 percent by 2050. Previous U.S. national surveys had minimal representation of Hispanic and Latino participants other than Mexicans, despite evidence suggesting that Hispanic or Latino country of origin and degree of acculturation influence health outcomes in this population. In this article, the authors describe the prevalence and mean number of cavitated, decayed and filled surfaces, missing teeth and edentulism among Hispanics and Latinos of different national origins.Methods.Investigators in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)—a multicenter epidemiologic study funded by the National Heart, Lung, and Blood Institute with funds transferred from six other institutes, including the National Institute of Dental and Craniofacial Research—conducted in-person examinations and interviews with more than 16,000 participants aged 18 to 74 years in four U.S. cities between March 2008 and June 2011. The investigators identified missing, filled and decayed teeth according to a modified version of methods used in the National Health and Nutrition Examination Survey. The authors computed prevalence estimates (weighted percentages), weighted means and standard errors for measures.Results.The prevalence of decayed surfaces ranged from 20.2 percent to 35.5 percent, depending on Hispanic or Latino background, whereas the prevalence of decayed and filled surfaces ranged from 82.7 percent to 87.0 percent, indicating substantial amounts of dental treatment. The prevalence of missing teeth ranged from 49.8 percent to 63.8 percent and differed according to Hispanic or Latino background. Significant differences in the mean number of decayed surfaces, decayed or filled surfaces and missing teeth according to Hispanic and Latino background existed within each of the age groups and between women and men.Conclusions.Oral health status differs according to Hispanic or Latino background, even with adjustment for age, sex and other characteristics.Practical Implications.These data indicate that Hispanics and Latinos in the United States receive restorative dental treatment and that practitioners should consider the association between Hispanic or Latino origin and oral health status. This could mean that dental practices in areas dominated by patients from a single Hispanic or Latino background can anticipate a practice based on a specific pattern of treatment needs.     

Immunolocalization of CD80 and CD86 in Non-Small Cell Lung Carcinoma: CD80 as a Potent Prognostic Factor

It has been demonstrated that tumor cells express programed cell death protein 1 (PD-L1) to escape T lymphocytes that express programed cell protein 1 (PD-1), and PD-1/PD-L1 immune checkpoint inhibitors have been regarded in lung cancer patients. CD80 and CD86 are members of B7 superfamily which regulates T lymphocyte activation and tolerance. However, immunolocalization of CD80 and CD86 has not been examined in the lung carcinoma tissues and their clinical significance remains unknown. Therefore, to clarify clinical significance of CD80 and CD86, we immunolocalized these in 75 non-small cell lung carcinomas (NSCLC) in this study. Immunoreactivities of CD80 and CD86 were mainly detected in tumor-infiltrating macrophages. Immunohistochemical CD80 status was high in 56% of NSCLC, and it was positively associated with stage, pathological T factor, distant metastasis, histological type and PD-L1 status. Moreover, multivariate analysis turned out that the CD80 status was an independent worse prognostic factor. CD86 status was high in 53% of the cases, but it was not significantly associated with any clinicopathological parameters. These findings suggest that CD80 is a potent worse prognostic factor possibly in association with escape from immune attack in NSCLC.