BACKGROUND & AIMS: OBJECTIVES:This study assessed social and behavioural predictors for sexual risk taking and sexually transmitted infections (STIs) including HIV among adolescent female sex workers (FSWs) from Kunming, China. Additionally, health services needs and use were assessed. METHODS:A cross-sectional survey was conducted in 2010. Using snowball and convenience sampling, self-identified FSWs were recruited from four urban areas in Kunming. Women consenting to participate were administered a semi-structured questionnaire by trained interviewers identified from local peer-support organisations. Following interview, a gynaecological examination and biological sampling to identify potential STIs were undertaken. Descriptive and multivariable logistic regression analyses were performed. RESULTS:Adolescent FSWs had a mean age of 18.2 years and reported numerous non-paying sexual partners with very low rate of consistent condom use (22.2%). Half (50.3%) the respondents had sex while feeling drunk at least once in the past week, of whom 56.4% did not use condom protection. STI prevalence was high overall (30.4%) among this group. Younger age, early sexual debut, being isolated from schools and family, short duration in sex work, and use of illicit drugs were found to be strong predictors for unprotected sex and presence of an STI. Conversely, having access to condom promotion, free HIV counselling and testing, and peer education were associated with less unprotected sex. The majority reported a need for health knowledge, free condoms and low-cost STI diagnosis and treatment. CONCLUSIONS:There is an urgent need to improve coverage, accessibility and efficiency of existing interventions targeting adolescent FSWs.

背景与目标：

BACKGROUND & AIMS: :Repetitive transcranial magnetic stimulation (rTMS), a non-invasive form of brain stimulation, has shown experimental and clinical efficacy in a range of neuromodulatory models, even when delivered at low intensity (i.e. subthreshold for action potential generation). After central nervous system (CNS) injury, studies suggest that reactive astrocytes and microglia can have detrimental but also beneficial effects; thus modulating glial activity, for example through application of rTMS, could potentially be a useful therapeutic tool following neurotrauma. Immunohistochemistry was used to measure the effect of low intensity rTMS (LI-rTMS) on GFAP (astrocyte), IBA1 (microglial), and CS56 (proteoglycan) expression in a unilateral penetrating cortical stab injury model of glial scarring in young adult and aged male and female C57BL6/J mice. Mice received contralateral low frequency, ipsilateral low frequency, ipsilateral high frequency or sham LI-rTMS (4-5mT intensity), for two weeks following injury. There was no significant difference in the overall volume of tissue containing GFAP positive (+) astrocytes, IBA1+ microglia, or proteoglycan expression, between sham and LI-rTMS-treated mice of all ages and sex. Importantly however, the density of GFAP+ astrocytes and IBA1+ microglia immediately adjacent to the injury was significantly reduced following ipsilateral low and high frequency stimulation in adult and aged females (p≤0.05), but was significantly increased in adult and aged males (p≤0.05). LI-rTMS effects were generally of greater magnitude in aged mice compared to young adult mice. These results suggest that sex differences need to be factored into therapeutic rTMS protocols. In particular, more work analyzing frequency and intensity specific effects, especially in relation to age and sex, is required to determine how rTMS can best be used to modify glial reactivity and phenotype following neurotrauma.

背景与目标： 重复经颅磁刺激 (rTMS) 是一种非侵入性的脑刺激形式，即使在低强度 (即动作电位产生的亚阈值) 下，也已在一系列神经调节模型中显示出实验和临床功效。中枢神经系统 (CNS) 损伤后，研究表明反应性星形胶质细胞和小胶质细胞可能具有有害但有益的作用; 因此，例如通过应用rTMS调节神经胶质活性，可能是神经创伤后有用的治疗工具。免疫组织化学用于测量低强度rTMS (LI-rTMS) 对年轻成年和老年C57BL6/J小鼠单侧穿透性皮质瘢痕损伤模型中GFAP (星形胶质细胞)，IBA1 (小胶质细胞) 和CS56 (蛋白聚糖) 表达的影响。损伤后两周，小鼠接受对侧低频，同侧低频，同侧高频或假LI-rTMS (4-5mT强度)。在所有年龄和性别的sham和LI-rTMS治疗的小鼠之间，含有GFAP阳性 () 星形胶质细胞，IBA1小胶质细胞或蛋白聚糖表达的组织的总体积均无显着差异。然而，重要的是，在同侧低频和高频刺激后，与损伤紧邻的GFAP + 星形胶质细胞和IBA1 + 小胶质细胞的密度在成年和老年女性中显著降低 (p ≤ 0.05)，但在成年和老年男性中显著增加 (p ≤ 0.05)。与年轻的成年小鼠相比，老年小鼠的LI-rTMS效应通常更大。这些结果表明，需要将性别差异纳入治疗性rTMS方案。特别是，需要更多的工作来分析频率和强度的特定影响，尤其是与年龄和性别有关的影响，以确定rTMS如何最好地用于改变神经创伤后的神经胶质反应性和表型。

BACKGROUND & AIMS: :Gender-specific associations between prenatal smoking and birthweight, and neonate intensive health care were studied. Cross-sectional data from 11,583 newborns in the continuous National Health and Nutrition Examination Survey (NHANES) 2003-2008 early childhood data sets were used. Change in infant birthweight and likelihood of receiving neonatal intensive care by prenatal smoking exposure were assessed. Multivariable regression models were used to assess the influence of prenatal smoking on birthweight and likelihood of receiving intensive neonatal health care. Compared with infants from nonsmoking mothers, prenatal smoking associated with significant decrease in infant birthweight, -203.0 g ± 32.5, P < 0.001. The change in birthweight differed between infant boys, -220.2 g ± 44.5, and girls, -184.1 g ± 38.8. Newborns exposed to prenatal smoking were more likely to have low birthweight, odds ratio 1.46, P < 0.03, and to receive neonatal intensive health care, odds ratio 1.20; P < 0.04. It is imperative that prenatal counseling emphasizes prenatal maternal smoking.

背景与目标： : 研究了产前吸烟与出生体重之间的性别特异性关联，以及新生儿重症监护。使用了连续国家健康和营养检查调查 (NHANES) 2003-2008幼儿数据集中的11,583个新生儿的横断面数据。评估了婴儿出生体重的变化以及通过产前吸烟暴露接受新生儿重症监护的可能性。多变量回归模型用于评估产前吸烟对出生体重的影响以及接受重症新生儿保健的可能性。与非吸烟母亲的婴儿相比，产前吸烟与婴儿出生体重显着降低有关，-203.0g ± 32.5，P <0.001。婴儿男孩 (-220.2g ± 44.5) 和女孩 (-184.1g ± 38.8) 的出生体重变化不同。暴露于产前吸烟的新生儿更有可能出生体重低，比值比1.46，P <0.03，并接受新生儿重症监护，比值比1.20; P <0.04。产前咨询必须强调产前母亲吸烟。

BACKGROUND & AIMS: :The possibility that endocrine factors may influence the clinical course of malignant melanoma is suggested by the superior survival data of women. In preclinical models we observed a higher rate of colony formation by human melanoma cells in male compared to female SCID mice, but only in the case of the liver and not in other organs. The gender difference could be seen at an early phase of colony formation. On the other hand, in our human melanoma cell lines we failed to detect steroid receptor protein expression, and treatment with sex hormones did not considerably influence their in vitro behavior. Investigating the possible contribution of host cells to the observed gender difference, we performed in vivo blocking experiments applying pretreatment of the animals with Kupffer cell inhibitor gadolinium chloride and the NK cell inhibitor anti-asialo GM1 antibody. While Kupffer cell blockade enhanced melanoma liver colonization equally in the two sexes, a more prominent increase was observed in female than in male mice in the case of NK cell inhibition. Further supporting the importance of NK cells in the lower liver colonization efficiency of melanoma cells in females, gender difference in colony formation was lost in NSG mice lacking NK activity. Although in humans no organ selectivity of gender difference in melanoma progression has been observed according to data in the literature, our results possibly indicate a contribution of natural host defense mechanisms to gender difference in survival of patients with melanoma or other tumor types as well.

背景与目标： : 女性的优越生存数据表明内分泌因素可能会影响恶性黑色素瘤的临床进程。在临床前模型中，与雌性SCID小鼠相比，我们观察到雄性黑素瘤细胞的集落形成率更高，但仅在肝脏而不是其他器官的情况下。性别差异可以在菌落形成的早期阶段看到。另一方面，在我们的人类黑素瘤细胞系中，我们未能检测到类固醇受体蛋白的表达，并且用性激素治疗不会显着影响其体外行为。研究宿主细胞对观察到的性别差异的可能贡献，我们进行了体内阻断实验，应用了Kupffer细胞抑制剂氯化g和NK细胞抑制剂抗asialo GM1抗体对动物进行预处理。尽管Kupffer细胞阻滞在两种性别中平等地增强了黑素瘤的肝脏定植，但在NK细胞抑制的情况下，雌性小鼠的增加比雄性小鼠的增加更为明显。进一步支持NK细胞在雌性黑色素瘤细胞较低的肝脏定植效率中的重要性，在缺乏NK活性的NSG小鼠中，集落形成的性别差异消失了。尽管根据文献中的数据，在人类中没有观察到黑素瘤进展中性别差异的器官选择性，但我们的结果可能表明自然宿主防御机制对黑素瘤或其他肿瘤类型患者生存中的性别差异也有贡献。

BACKGROUND & AIMS: :Imidacloprid was sprayed on mango cv. Dashehari at 0.3 mL L(-1) of water during pre-bloom stage with 6-8 cm panicle size (first week of March) to control hopper and carbosulfan was sprayed at 2.0 mL L(-1) of water in the trees of mango hybrid (H-1000) during fruit development stage (first week of May) to control leaf webber. Residues of both the insecticides were analysed in peel, pulp and fruit at different stages of fruit development and maturity. The initial residues of imidacloprid, after 30 days of spraying, were 1.21, 0.56 and 1.77 mg kg(-1) in peel, pulp and whole fruit, respectively. The residues persisted in peel for 60 days and in pulp for 50 days and dissipated with a half-life of 38 days. Mature Dashehari fruits at harvest (after 85 days of spraying) were free from imidacloprid residues. Carbosulfan in mango peel dissipated from 5.30 mg kg(-1) (after 1 h of spraying) to 0.05 mg kg(-1) at the time of harvest (after 45 days of spraying). Carbosulfan residue in pulp was very low (0.08 mg kg(-1)) after 1 h of spraying, which increased gradually to 0.90 mg kg(-1) after 10 days and finally came down to 0.04 mg kg(-1) after 26 days of spraying. The insecticide residue was not detected in the pulp at the time of harvest. The residues persisted in pulp for 26 days and in peel for 45 days and degraded with a half-life of 7 days. The dissipation of both imidacloprid and carbosulfan followed first order rate kinetics in whole fruit (peel + pulp). Therefore, the safe pre-harvest intervals were suggested to be 55 days for imidacloprid and 46 days for carbosulfan before consumption of mango fruits after spraying of these insecticides.

背景与目标： : 吡虫啉喷洒在芒果上。在开花前阶段以0.3 mL L(-1) 的水进行Dashehari，穗大小为6-8厘米 (3月的第一周) 以控制料斗，并在果实发育阶段 (第一个) 的芒果杂种 (H-1000) 的树木中喷洒2.0 mL L(-1) 的水5月的一周) 来控制叶韦伯。在果实发育和成熟的不同阶段，分析了两种杀虫剂在果皮，果肉和果实中的残留。喷洒30天后，吡虫啉的初始残留量分别为1.21，0.56和1.77 mg kg(-1)，在果皮，果肉和整个水果中。残留物在果皮中持续60天，在纸浆中持续50天，并消散，半衰期为38天。收获时成熟的Dashehari果实 (喷洒85天后) 不含吡虫啉残留物。芒果果皮中的硫丹从5.30 mg kg(-1) (喷雾1小时后) 消散至收获时 (喷雾45天后) 的0.05 mg kg(-1)。喷洒1小时后，纸浆中的硫丹碳残留量非常低 (0.08 mg kg(-1))，10天后逐渐增加到0.90 mg kg(-1)，最后在喷洒26天后降至0.04 mg kg(-1)。收获时未在果肉中检测到杀虫剂残留物。残留物在纸浆中持续26天，在果皮中持续45天，半衰期为7天。吡虫啉和硫丹的耗散均遵循整个果实 (果皮果肉) 的一级速率动力学。因此，建议在喷洒这些杀虫剂后食用芒果果实之前，吡虫啉的安全收获前间隔为55天，而硫丹的安全收获前间隔为46天。

BACKGROUND & AIMS: :G protein-coupled receptors (GPCRs) interact with heterotrimeric G proteins and initiate a wide variety of signaling pathways. The molecular nature of GPCR-G protein interactions in the clinically important thromboxane A2 (TxA(2)) receptor (TP) and prostacyclin (PGI(2)) receptor (IP) is poorly understood. The TP activates its cognate G protein (Gαq) in response to the binding of thromboxane, while the IP signals through Gαs in response to the binding of prostacyclin. Here, we utilized a combination of approaches consisting of chimeric receptors, molecular modeling, and site-directed mutagenesis to precisely study the specificity of G protein coupling. Multiple chimeric receptors were constructed by replacing the TP intracellular loops (ICLs) with the ICL regions of the IP. Our results demonstrate that both the sequences and lengths of ICL2 and ICL3 influenced G protein specificity. Importantly, we identified a precise ICL region on the prostanoid receptors TP and IP that can switch G protein specificities. The validities of the chimeric technique and the derived molecular model were confirmed by introducing clinically relevant naturally occurring mutations (R60L in the TP and R212C in the IP). Our findings provide new molecular insights into prostanoid receptor-G protein interactions, which are of general significance for understanding the structural basis of G protein activation by GPCRs in basic health and cardiovascular disease.

背景与目标： : g蛋白偶联受体 (gpcr) 与异三聚体g蛋白相互作用，并启动多种信号通路。临床上重要的血栓烷A2 (TxA(2)) 受体 (TP) 和前列环素 (PGI(2)) 受体 (IP) 中gpcr-g蛋白相互作用的分子性质知之甚少。TP响应血栓烷的结合而激活其同源g蛋白 (G α q)，而IP响应前列环素的结合而通过G α s发出信号。在这里，我们结合了由嵌合受体，分子建模和定点诱变组成的方法来精确研究g蛋白偶联的特异性。通过用IP的ICL区域替换TP细胞内环 (ICL) 来构建多个嵌合受体。我们的结果表明，ICL2和ICL3的序列和长度均影响g蛋白的特异性。重要的是，我们在前列腺素受体TP和IP上确定了一个精确的ICL区域，可以切换g蛋白特异性。通过引入临床相关的自然发生突变 (TP中的R60L和IP中的R212C)，证实了嵌合技术和衍生分子模型的有效性。我们的发现为前列腺素受体-g蛋白相互作用提供了新的分子见解，这对于理解GPCRs在基础健康和心血管疾病中激活g蛋白的结构基础具有普遍意义。

BACKGROUND & AIMS: :Self-regulation processes and violent contexts play an important role in predicting adolescents' aggressive behavior; less clear is how all three constructs are linked to each other over time. The present study examined the longitudinal relations among adolescents' self-reported effortful control (EC), exposure to community violence, both as a witness and as a victim, and aggressive behavior. Participants were 768 Italian adolescents (358 males) living in a high-risk context, with a mean age at T1 of 11 years in the younger cohort and 14 years in the older cohort. In a four-wave cross-lagged panel design, low EC was a strong predictor of aggressive behavior across each time point, whereas aggressive behavior was found to positively predict adolescents' violence exposure both as witnesses and victims. Some evidence of transactional relations was also found between adjustment problems and exposure to community violence and between EC and externalizing problems. Moreover, EC was indirectly related to exposure to violence through externalizing problems, and mediated the relation of witnessing community violence to aggression, thus supporting the view that top-down regulatory processes play a complex role in the development of violence and other externalizing problems. The importance of considering interventions that take in account these complex relations is discussed.

背景与目标： : 自我调节过程和暴力环境在预测青少年的攻击行为中起着重要作用; 不太清楚的是随着时间的推移，所有三个结构如何相互联系。本研究调查了青少年自我报告的努力控制 (EC)，作为证人和受害者暴露于社区暴力以及攻击行为之间的纵向关系。参与者为768名生活在高风险环境中的意大利青少年 (358名男性)，在T1时，年轻队列的平均年龄为11岁，而老年队列的平均年龄为14岁。在四波交叉滞后面板设计中，低EC是每个时间点攻击行为的有力预测指标，而攻击行为被发现可以积极预测青少年作为证人和受害者的暴力暴露。在调整问题和社区暴力暴露之间以及欧共体和外部化问题之间，也发现了一些交易关系的证据。此外，欧共体通过外部化问题与暴力接触间接相关，并调解了目睹社区暴力与攻击的关系，从而支持自上而下的监管程序在暴力和其他外部化问题的发展中起着复杂作用的观点。讨论了考虑这些复杂关系的干预措施的重要性。

BACKGROUND & AIMS: :This review describes epidemiology, pathophysiology, risk factors, treatment and prevention of suicidal behavior in adolescents. As one of the leading causes of death of young adults, adolescent suicide has become a public health problem and an increase in the adolescent suicide rate has been observed over the past several decades. One important risk factor thought to contribute to the recent rise in suicidal behavior among young adults is increasing alcohol abuse among adolescents. The link between alcohol and suicide in adolescents is complicated and multiple risk factors are important in explaining and understanding suicidal behavior among adolescents. Comorbid psychopathology, which is common among adolescent alcohol abusers, substantially increases the risk for suicide behavior. Availability of alcohol and guns at home may also contribute to suicide risk in adolescents. Studies of stress hormones, brain neurotransmitters, hereditary factors, behavioral measures and gender differences shed light in understanding this complex phenomenon. Ideally, treatment of adolescents who receive a diagnosis of an alcohol use disorder and co-occurring suicidality should follow an integrated protocol that addresses both conditions. Future studies of psychological and neurobiological mechanisms of suicidality in adolescents with alcohol and/or substance abuse are merited.

背景与目标： : 这篇综述描述了青少年自杀行为流行病学，病理生理学，危险因素，治疗和预防。作为年轻人死亡的主要原因之一，青少年自杀已成为公共卫生问题，并且在过去几十年中观察到青少年自杀率上升。被认为是导致年轻人自杀行为最近上升的一个重要危险因素是青少年酗酒增加。青少年酒精与自杀之间的联系很复杂，多种危险因素对于解释和理解青少年的自杀行为很重要。在青少年酗酒者中常见的合并症精神病理学大大增加了自杀行为的风险。家里有酒精和枪支也可能导致青少年自杀风险。对应激激素，脑神经递质，遗传因素，行为措施和性别差异的研究为理解这一复杂现象提供了启示。理想情况下，接受酒精使用障碍和同时发生自杀的诊断的青少年的治疗应遵循解决这两种情况的综合方案。值得对酗酒和/或滥用药物的青少年自杀的心理和神经生物学机制进行进一步研究。

BACKGROUND & AIMS: :Dunking, the softening of dry food in water to speed up consumption time, is normally a very rare behaviour in wild Carib grackles (Quiscalus lugubris) of Barbados. Its frequency can be experimentally increased when large numbers of dry items are repeatedly placed near a standing source of water in conditions that minimize intraspecific competition and risk of theft. To reconcile the normally low frequency of the behaviour in the wild with the high rates obtained in previous experiments, we tested three conditions where dunking varied between 0 and 70%. Dunking was very rare when it had been made unnecessary by pre-soaking the food, water was far from the dry items offered and only one food item was given, focusing all competitive interactions and theft attempts on a single individual. In contrast, dunking rate was high when food was not pre-soaked, water was close to dry food and more than one item (and hence target for competition and theft) was given. These experiments confirm that dunking rates, like other proto-tool-like food-processing techniques, depend on the costs and benefits of the situation where they are used.

背景与目标： : 在巴巴多斯的野生加勒比grackles (Quiscalus lugubris) 中，浸泡是将干粮在水中软化以加快食用时间的行为，通常是非常罕见的行为。当在最大程度地减少种内竞争和盗窃风险的条件下将大量干燥物品反复放置在站立的水源附近时，可以通过实验提高其频率。为了使野外行为的正常频率与先前实验中获得的高比率相协调，我们测试了三个条件，其中扣篮在0到70% 之间变化。当预先浸泡食物而变得不必要时，扣篮是非常罕见的，水远离提供的干物品，只提供了一种食物，将所有竞争互动和盗窃企图集中在一个人身上。相反，当未预先浸泡食物，水接近干粮并且给出了多个物品 (因此是竞争和盗窃的目标) 时，扣篮率很高。这些实验证实，与其他类似原始工具的食品加工技术一样，灌篮率取决于使用它们的情况的成本和收益。

BACKGROUND & AIMS: :Non-compliance with oral self-care recommendations, despite education and motivation, is a major problem in preventive dentistry. Forming concrete if-then action plans has been successful in changing self-care behavior in other areas of preventive medicine. This is the first trial to test the effects of a brief planning intervention on interdental hygiene behavior. Two hundred thirty-nine participants received a packet of floss, information, and a flossing guide. They were randomly assigned to a control or an intervention group. The intervention took 1.16 minutes and consisted of forming a concrete plan of where, when, and how to floss. Baseline measures and two-week and two-month follow-ups included self-report, residual floss, and theory of planned behavior variables. The intervention significantly affected flossing in that group at two-week and two-month follow-ups, as compared with the control group. This study provides evidence for the effects of a concise intervention on oral self-care behavior.

背景与目标： : 尽管受过教育和动机，但不遵守口腔自我保健建议是预防牙科的主要问题。制定具体的if-then行动计划已成功地改变了预防医学其他领域的自我护理行为。这是第一个测试简短计划干预对齿间卫生行为影响的试验。两百三十九名参与者收到了一包牙线，信息和牙线指南。他们被随机分配到对照组或干预组。干预花费了1.16分钟，包括在哪里，何时以及如何使用牙线形成具体计划。基线测量以及两周和两个月的随访包括自我报告，残留牙线和计划行为变量理论。与对照组相比，该干预在两周和两个月的随访中显着影响了该组的牙线。这项研究为简明干预对口腔自我护理行为的影响提供了证据。

BACKGROUND & AIMS: :The Criminal Sentiments Scale (CSS) purports to measure attitudes and values pertaining to and in support of criminal conduct (Andrews & Bonta, 2003). A sample of 72 sex offenders treated in a high intensity sex offender program completed the CSS pre- and post-treatment and was followed up for approximately 3 years. The CSS demonstrated high internal consistency. Correlational and ROC analyses indicated that the CSS is a robust predictor of non-sexual violent and non-violent recidivism. The CSS also correlated significantly with the General Statistical Information on Recidivism Scale which assesses non-sexual recidivism risk. Similar analyses showed that the CSS did not predict sexual recidivism nor did it correlate with a tool that assesses sexual recidivism risk-the Static 99. The CSS scores changed significantly in the predicted direction following treatment. The present results suggest that the CSS is an internally consistent tool for the assessment of criminal sentiments among sex offenders and that it predicts non-sexual but not sexual recidivism.

背景与目标： : 犯罪情绪量表 (CSS) 旨在衡量与犯罪行为有关并支持犯罪行为的态度和价值观 (Andrews & Bonta，2003)。在高强度性犯罪者计划中接受治疗的72名性犯罪者的样本完成了CSS的治疗前和治疗后，并进行了大约3年的随访。CSS显示出很高的内部一致性。相关分析和ROC分析表明，CSS是非性暴力和非暴力累犯的可靠预测指标。CSS还与累犯量表上的一般统计信息显着相关，该量表评估了非性累犯风险。类似的分析表明，CSS不能预测性累犯，也不能与评估性累犯风险的工具-静态99相关。治疗后，CSS得分在预测方向上发生了显着变化。目前的结果表明，CSS是一种内部一致的工具，用于评估性犯罪者的犯罪情绪，并且可以预测非性行为，而不是性累犯。

BACKGROUND & AIMS: :Growth hormone (GH) is a major regulator of growth, somatic development and body composition. Sex steroids can act centrally by regulating GH secretion and peripherally modulating GH responsiveness. This review addresses data of potential clinical relevance on how sex steroids modulate GH secretion and action, aiming to increase the understanding of sex steroid/GH interactions and leading to improved management of patients. Sex steroids regulate GH secretion directly as well as indirectly through IGF-I modulation. Testosterone stimulates GH secretion centrally, an effect dependent on prior aromatization to oestrogen. Oestrogen stimulates GH secretion indirectly by reducing IGF-I feedback inhibition. Whether oestrogen stimulates GH secretion centrally in females is unresolved. Gonadal steroids modify the metabolic effects of GH. Testosterone amplifies GH stimulation of IGF-I, sodium retention, substrate metabolism and protein anabolism while exhibiting similar but independent actions of its own. Oestrogen attenuates GH action by inhibiting GH-regulated endocrine function of the liver. This is a concentration-dependent phenomenon that arises invariably from oral administration of therapeutic doses of oestrogen, an effect that can be avoided by using a parenteral route. This strong modulatory effect of gonadal steroids on GH responsiveness provides insights into the biological basis of sexual dimorphism in growth, development and body composition and practical information for the clinical endocrinologist. It calls for an appraisal of the diagnostic criteria for GH deficiency of GH stimulation tests, which currently are based on arbitrary cut-offs that do not take into account the shifting baseline from the changing gonadal steroid milieu. In the management of GH deficiency in the hypopituitary female, oestrogen should be administered by a nonoral route. In hypopituitary men, androgens should be replaced concurrently to maximize the benefits of GH. In the general population, the metabolic consequences of long-term treatment of women with oral oestrogen compounds, including selective oestrogen receptor modulators, are largely unknown and warrant study.

背景与目标： 生长激素 (GH) 是生长，体细胞发育和身体成分的主要调节剂。性类固醇可以通过调节GH分泌和外周调节GH反应性来集中作用。这篇综述探讨了有关性类固醇如何调节GH分泌和作用的潜在临床相关性数据，旨在增进对性类固醇/GH相互作用的了解，并改善患者的管理。性类固醇通过igf-i调节直接或间接调节GH分泌。睾丸激素会刺激GH的分泌，这取决于先前对雌激素的芳构化作用。雌激素通过减少igf-i反馈抑制间接刺激GH分泌。雌激素是否刺激女性的GH分泌尚未解决。性腺类固醇改变GH的代谢作用。睾丸激素可增强GH对igf-i的刺激，钠保留，底物代谢和蛋白质合成代谢，同时表现出相似但独立的作用。雌激素通过抑制肝脏的GH调节内分泌功能来减弱GH的作用。这是一种浓度依赖性现象，总是由口服治疗剂量的雌激素引起，这种作用可以通过使用肠胃外途径避免。性腺类固醇对GH反应性的这种强大调节作用为临床内分泌学家提供了对生长，发育和身体成分中性二态性的生物学基础以及实用信息的见解。它要求评估GH刺激测试中GH缺乏症的诊断标准，该标准目前基于任意的临界值，而这些临界值并未考虑改变性腺类固醇环境的基线变化。在治疗垂体功能低下女性的GH缺乏症时，应通过非口服途径施用雌激素。在垂体功能低下的男性中，应同时更换雄激素，以最大程度地提高GH的益处。在一般人群中，口服雌激素化合物 (包括选择性雌激素受体调节剂) 长期治疗女性的代谢后果在很大程度上是未知的，值得研究。

BACKGROUND & AIMS: :Millions of people worldwide use over-the-counter analgesics on a regular basis; yet little is known about how decisions to self-medicate are made. This study used the theory of planned behavior to explore the influence of beliefs about medicines (Beliefs about Medicines Questionnaire) and individual pain experience as predictors of intent to self-medicate. Both emerged as significant predictors of intent to self-medicate. Furthermore, intent to self-medicate significantly predicted reported use of analgesics. These findings indicate that use of over-the-counter pain medication is more likely when the value of the pain relief is greater than concerns about harm.

背景与目标： : 全世界有数百万人定期使用非处方止痛药; 然而，对于如何做出自我药物的决定知之甚少。这项研究使用计划行为理论来探索对药物的信念 (关于药物的信念问卷) 和个人疼痛体验的影响，以此作为自我治疗意图的预测指标。两者都成为自我治疗意图的重要预测指标。此外，自我药物治疗的意图显著预测了镇痛药的使用。这些发现表明，当缓解疼痛的价值大于对伤害的担忧时，使用非处方止痛药的可能性更大。

BACKGROUND & AIMS: :The cytogenetic characteristics of Eigenmannia aff. trilineata were analyzed by basic and molecular cytogenetics, applying fluorescent in situ hybridization, with 18S and 5S rDNA and U2 snRNA probes. The species revealed a kind of polymorphism associated to ZZ/Z0 type sex chromosomes, with 2n = 32 (8m+2sm+22a, NF = 42) in all males under analysis, whereas females evidenced 2n = 31 (8m+1sm+22a, NF = 40). C-banding showed constitutive heterochromatin restricted to the pericentromeric region of all chromosomes and single-nucleolus organized regions on pair 11. A site for rDNA 5S was synthetic with a cluster of rDNA 18S near the centromere on the long arm of only one homologue of pair 11. Other clusters for 5S rDNA were sited on pairs 7, 10, 12, 13, and 16. Further, 5S rDNA was co-located with U2 cluster in the pericentromeric region of pair 12. Joint analysis of DNA barcoding from cytochrome c oxidase subunit I (COI) sequences, generated from the karyotyped samples of E. aff. trilineata, and sequences of other Gymnotiforms recognized E. aff. trilineata as an Operational Taxonomic Unit. Results foreground the hypothesis that cytotypes are independent evolution units as cryptic species with a low morphological differentiation level, although with high genetic/karyotype differentiation rates.

背景与目标： : 特征甘草aff的细胞遗传学特征。用18s和5S rDNA和U2 snRNA探针进行荧光原位杂交，通过基本和分子细胞遗传学分析了三叶草。该物种揭示了一种与ZZ/Z0型性染色体相关的多态性，在所有分析的雄性中，2n   =   32 (8m + 2sm + 22a，nf   =   42)，而雌性则表现出2n   =   31 (8m + 1sm + 22a，nf   =   40)。C带显示组成型异染色质仅限于对11上所有染色体的着丝粒周围区域和单核仁组织区域。仅在一对11的一个同源物的长臂上，在着丝粒附近合成了rDNA 5s的位点。5S rDNA的其他簇位于对7、10、12、13和16上。此外，5S rDNA与U2簇位于对12的着丝粒周围区域。从E. aff的核型样品产生的细胞色素c氧化酶亚基I (COI) 序列的DNA条形码的联合分析。三叶形，以及其他可识别的裸体型E. aff的序列。三叶草作为一个可操作的分类单元。结果提出了一种假说，即细胞类型是独立的进化单位，具有较低的形态分化水平，尽管具有较高的遗传/核型分化率。

BACKGROUND & AIMS: :A prospective evaluation of 333 consecutive patients undergoing isolated mitral valve replacement between 1982 and 1985 was performed to identify the predictors of survival and valve failure. Follow-up between 2 and 6 years postoperatively (mean, 32 +/- 17 months) was 98% complete. Four prostheses were inserted to permit a prospective evaluation of alternative valves: Björk-Shiley mechanical (n = 118), Ionescu-Shiley pericardial (n = 146), Carpentier-Edwards porcine (n = 38), and Hancock pericardial (n = 31). Hospital mortality was 6%, and actuarial survival at 5 years was 74% +/- 5%. Multivariate Cox regression analysis identified advancing age (less than 40 years, 88% +/- 7%; greater than 70 years, 50% +/- 14%) and poor left ventricular function (ejection fraction less than 0.20, 62% +/- 17%; ejection fraction greater than 0.60, 80% +/- 7%) as independent predictors of postoperative survival. Freedom from structural valve dysfunction, prosthetic valve endocarditis, reoperation, and valve-related mortality and morbidity were 86% +/- 4%, 91% +/- 4%, 81% +/- 4%, and 72% +/- 5%, respectively, at 5 years. The actuarial incidence of valve failure was inordinately high with the Hancock pericardial valve (p less than 0.05). Freedom from thromboembolic events (78% +/- 8% at 5 years) was significantly lower in patients with poor ventricular function (ejection fraction (less than 0.20, 54% +/- 20%; ejection fraction greater than 0.60, 73% +/- 11%; p less than 0.05). Survival after mitral valve replacement was determined by age and left ventricular function. Premature failure of the Hancock pericardial valve resulted in an unacceptable rate of valve-related complications.

背景与目标： : 对333例接受单独二尖瓣置换1982年和1985的连续患者进行了前瞻性评估，以确定生存和瓣膜衰竭的预测因素。术后2至6年 (平均32/- 17个月) 的随访98% 完成。插入四个假体以对替代瓣膜进行前瞻性评估: bj ö rk-Shiley机械 (n = 118)，Ionescu-Shiley心包 (n = 146)，Carpentier-Edwards猪 (n = 38) 和Hancock心包 (n = 31)。医院死亡率为6%，5年时的精算生存率为74% +/- 5%。多因素Cox回归分析发现年龄 (小于40岁，88% +/- 7%; 大于70岁，50% +/- 14%) 和左心室功能差 (射血分数小于0.20，62% +/- 17%; 射血分数大于0.60，80% +/- 7%) 作为术后生存率的独立预测因子。在5年时，免于结构瓣膜功能障碍，人工瓣膜心内膜炎，再次手术以及瓣膜相关的死亡率和发病率分别为86%/- 4%，91%/- 4%，81%/- 4% 和72%/- 5%。汉考克心包瓣膜的精算发生率过高 (p小于0.05)。无血栓栓塞事件 (5年时78% +/- 8%) 在心室功能差的患者中显著降低 (射血分数小于0.20，54% +/- 20%; 射血分数大于0.60，73% +/- 11%; p小于0.05)。二尖瓣置换后的存活率取决于年龄和左心室功能。汉考克心包瓣膜过早衰竭导致瓣膜相关并发症的发生率不可接受。