Effects of an acaricide on mite allergen levels in the homes of asthmatic children

Previous study by the current authors has shown that treating homes with D'Allergen, an acaricidal agent, can reduce bronchial hyper-reactivity in asthmatic children with house dust mite allergy. In the present study, the effects of a single D'Allergen treatment on the levels of major dust mite allergens, Der p I and Der f I was evaluated, and the duration of its effectiveness in the environment determined. Twenty randomly selected homes were treated with the acaricide and ten remained untreated. Dust samples were collected from mattresses, upholstered sofas and carpets of these homes before and 1, 2 and 4 months after treatment. The samples were then assayed for Der p I and Der f I allergens using a sandwich enzyme immunoassay. The results showed that D'Allergen was effective in reducing dust mite allergen levels in all three niches by 1.5–22.3 times below baseline values. This effect, however, was only present for 2 months, and the dust mite allergen levels increased to those of the baseline by the fourth month after treatment. These results indicated that repeated applications of the acaricide were required at 2–3 monthly intervals to obtain optimal effectiveness.     

农村肇事重性精神病人临床特征分析

目的 了解农村肇事重性精神病人的临床特征。方法对我院2010年9-12月收治的125例农村肇事重性精神病人的一般资料及临床资料包括姓名、性别、年龄、户籍、病程、入院次数、入院原因、精神疾病诊断、简明精神病量表（BPRS）及日常生活能力量表（ADL）评分、及合并躯体疾病等进行统计学分析。结果农村肇事重性精神病人入院原因以伤人毁物、骚扰他人行为具前列,分别占40．8％、40．0％;精神疾病诊断以精神分裂症、精神发育迟滞、躁狂发作占前三位,分别占57．6％、16．8％、12．8％;入院时合并低钠／低钾、贫血、营养不良、传染病及外伤者分别占20．O％、11．2％、2．4％、15．2％、13．6％;男女病人人院原因及精神疾病诊断构成比比较,差异均有极显著性（P〈0．01）;BPRS量表评分比较男病人比女病人高,差异均有显著性（P〈0．05）;ADL量表评分比较男病人比女病人低,差异均有极显著性（P〈0．01）;首次人院病人与复入院病人入院原因比较,差异有极显著性（P〈0．01）。结论农村肇事重性精神病人精神症状较为严重且多合并躯体疾病,需对其进行有效治疗与监管。     

取象比类法治疗烫伤性溃疡的体会

以取象比类法解析临床诊治运用体会, 贯穿中医天人整体恒动观思维模式, 运用阴阳五行学说, 总归阴、阳、表、里、寒、热、虚、实八纲辨证的灵活应用。     

Allergenic differences between the domestic mites Blomia tropicalis and Dermatophagoides pteronyssinus

BACKGROUND: House dust mite allergens are the most important indoor allergens associated with asthma and rhinitis in Singapore and the tropics. Recent data to suggest that besides the Dermatophagoides spp., the domestic mite Blomia tropicalis (Bt) is also an important source of allergens in these regions. OBJECTIVE: To evaluate the degree of allergenic cross-reactivity between Bt and D. pteronyssinus (Dp). METHODS: Cross-reactivity between extracts of Bt and Dp was evaluated by fluorescent allergosorbent (FAST) inhibition studies and cross enzyme immunoelectrophoresis. Additionally, the major Dp allergens - Der p 1, Der p 2 and Der p 5, were also compared with the Bt extract by dot blot inhibition. Skin prick and intradermal end-point titration were then carried out to compare the homologous allergens of the mite species, Blo t 5 and Der p 5. RESULTS: FAST inhibition studies showed low to moderate cross-reactivity between the two dust mite extracts (maximum cross-inhibition, 60%). Native allergens studied by cross enzyme immunoelectrophoresis using mite allergic sera also showed similar results but with at least four cross-reactive IgE binding antigens. Dot blot inhibition studies using allergens of Dp, Der p 1, Der p 2, and Der p 5, showed little cross-reactivity between these allergens with components of the crude Bt extracts. Further, evaluation of a recombinant allergen of Bt, Blo t 5, showed low levels of cross-reactivity even with its homologous Dp counterpart, Der p 5. CONCLUSION: These results provide evidence that Bt allergens are distinct and have relatively low to moderate cross-reactivity with Dermatophagoides spp. allergens. Bt allergens should therefore be included in the diagnostic panel for the evaluation of allergic disorders in the tropics, and the development of new diagnostic and therapeutic strategies should include allergens of Bt.     

Overnight Heart Rate and Cardiac Function in Patients with Dual Chamber Pacemakers

Animal data indicate that chronic, overnight pacing at normal evening heart rates impairs cardiac function. We examined the relationship of pacing rate and cardiac function in nine patients with dual-chamber pacemakers. We investigated two, 3-week pacing regimens (80 and 50 ppm: DDD mode) in a cross-over design. Doppler echocardiograms were performed at 1700 hours (PM) and 0600 hours (AM) at the end of each regimen. Ventricular function and preload decreased overnight (PM vs AM) with both pacing regimens. Compared to the morning values, the ratio of preejection to ejection time (PEP/ET) rose (0.43 vs 0.46), while the mean velocity of circumferential fiber shortening (V_cf) fell (1.16 cm/s vs 1.11 cm/s). Stroke volume (SV) (61 mL vs 53 mL) and ejection fraction (EF) also fell (0.56 vs 0.53) in the morning, End-diastolic volume (EDV) (94 mL vs 88 mL) decreased in the morning, as did the ratio of passive to active filling (E/A) (1.06 vs 0.96). Iscvolumic relaxation time(91 msvs 101 ms) increased overnight at both pacing rates. Systolic function decreased at 80 ppm relative to 50 ppm at both times of day. SV fell (54 mL vs 61 mL), while both EDV (92 mL vs 90 mL) and end-systolic volume (ESV) increased (43 mL vs 40 mL). Contractility measured by V_cf(1.09 cm/s vs 1.18 cm/s) and PEP/ET (0.49 vs 0.41) was reduced at 80 ppm. The heart needs to rest at night by slowing its rate of contraction. Pacing at 80 ppm impairs systolic and diastolic ventricular function compared to 50 ppm. Longer term consequences of ostensibly physiological pacing rates merit inquiry, particularly in those with preexisting cardiac dysfunction.     

A study of maxillofacial injuries in the elderly resulting from falls

SUMMARY Falls are a major problem for the elderly, both in terms of the injuries sustained and the consequent loss of confidence and independence. Many studies, both prospective and retrospective, have investigated the possible causes and the resulting injuries following falls. However, no specific consideration appears to have been given to maxillofacial injuries. This survey examines the incidence of such injuries, over a three year period, in elderly patients presenting at an Accident and Emergency Department, and reviews the causes. Recognition of old age abuse is an essential aspect of the assessment of injuries in this group of patients.     

中药钩藤原植物的研究

钩藤为中医的兒科要藥,早在第五、六世紀时我國学者已有論及。藥用部分是钩藤植物花序柄变成的钩狀物以及相連的一小部分枝条。李时珍称“古方多用皮,后世多用钩,取其力銳耳”。可見枝皮的效力不及鉤,钩多枝少則效强,钩少枝多则效弱。現时广州市售的钩藤,多为钩与枝混雜,未見出售純钩,只是枝的夾雜量多寡有異。据作者調查,廣州市中藥店所售鉤藤有“單钩”与“双钩”之別,双钩的价格比單鈎的貴兩倍。又据中國藥学大辞典載,純用嫩钩,效力要大十倍,但現时中藥店內並無嫩鈎与