• 【来自人类甲状腺的碘酪氨酸脱卤酶1 (DEHAL1) DEHAL1C的新型同工型的克隆和表征: 与DEHAL1和DEHAL1B的比较。】 复制标题 收藏 收藏
    DOI:10.1089/thy.2006.16.715 复制DOI
    作者列表:Gnidehou S,Lacroix L,Sezan A,Ohayon R,Noël-Hudson MS,Morand S,Francon J,Courtin F,Virion A,Dupuy C
    BACKGROUND & AIMS: :The human iodotyrosine dehalogenase 1 (DEHAL1) gene is composed of six exons. Two isoforms (DEHAL1 and DEHAL1B) have been published in GenBank, both of which have a nitroreductase domain and arise from differential splicing in exon 5. We recently showed that the DEHAL1 isoform is a transmembrane protein that efficiently catalyzes the NADPH-dependent deiodination of mono (L-MIT) and diiodotyrosine (L-DIT) in human embryonic kidney-293 (HEK293) cells. In the present study, we establish the existence of a new transcript, DEHAL1C, in the human thyroid with a terminal exon that lacks in the DEHAL1 transcript. This exon is the complete exon 5, which is spliced in the DEHAL1B mRNA variant. These two variants encode proteins with differing C-terminal domains. Using quantitative reverse transcription polymerase chain reaction, we found that the expression of the mRNA of DEHAL1C and DEHAL1B was lower than that of DEHAL1 mRNA in the thyroid. We also observed that human DEHAL1B and DEHAL1C proteins are rapidly degraded in stably transfected HEK293 cells, unlike the DEHAL1 protein, and that exposure to the proteasome inhibitor MG132 resulted in accumulation of these proteins that was markedly time- and concentration-dependent. These findings show that the cytoplasmic tail could play a role in the stability of the protein.
    背景与目标: : 人类碘酪氨酸脱卤酶1 (DEHAL1) 基因由六个外显子组成。GenBank上已发布了两种同工型 (DEHAL1和DEHAL1B),它们都具有硝基还原酶结构域,并且是由外显子5中的差异剪接引起的。我们最近发现DEHAL1亚型是一种跨膜蛋白,可有效催化人胚肾293 (HEK293) 细胞中mono (L-MIT) 和二碘酪氨酸 (L-DIT) 的NADPH依赖性脱碘作用。在本研究中,我们确定了人类甲状腺中存在一个新的转录本DEHAL1C,其末端外显子在DEHAL1转录本中缺乏。该外显子是完整的外显子5,在DEHAL1B mRNA变体中剪接。这两个变体编码具有不同C末端结构域的蛋白质。使用定量逆转录聚合酶链反应,我们发现DEHAL1C和DEHAL1B的mRNA在甲状腺中的表达低于DEHAL1 mRNA的表达。我们还观察到,与DEHAL1蛋白不同,人DEHAL1B和DEHAL1C蛋白在稳定转染的HEK293细胞中迅速降解,并且暴露于蛋白酶体抑制剂MG132导致这些蛋白的积累明显依赖于时间和浓度。这些发现表明,细胞质尾可能在蛋白质的稳定性中起作用。
  • 【睡眠障碍负担及其相关危险因素: 中国HIV感染者抗逆转录病毒治疗的横断面调查。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03968-3 复制DOI
    作者列表:Huang X,Li H,Meyers K,Xia W,Meng Z,Li C,Bai J,He S,Cai W,Huang C,Liu S,Wang H,Ling X,Ma P,Tan D,Wang F,Ruan L,Zhao H,Wei H,Liu Y,Yu J,Lu H,Wang M,Zhang T,Chen H,Wu H
    BACKGROUND & AIMS: :This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.
    背景与目标: : 这项研究评估了中国大量HIV感染患者的患病率和与睡眠障碍相关的因素。在20个艾滋病诊所对接受抗逆转录病毒治疗的HIV感染患者进行了横断面研究。匹兹堡睡眠质量指数由受试者自行管理。收集了社会人口统计学特征,病史和与HIV相关的临床数据。4103患者有完整的数据进行分析。在43.1% 患者中观察到睡眠障碍。多变量分析的相关因素包括心理因素: 焦虑 (优势比 [OR],3.13; 95% 置信区间 [CI],2.44-4.00; P  <  0.001),抑郁 (OR,2.09; 95% CI,1.70-2.57; P  <  0.001),焦虑和抑郁 (OR,5.90; 95% CI,4.86-7.16; P  <  0.001); 社会人口统计学因素: MSM (OR,1.26; 95% CI,1.04-1.52; P   =   0.018),单身 (OR,1.45; 95% CI 1.21-1.74; P  <  0.001),高等教育 (OR, 1.25; 95% CI,1.03-1.53; P   =   0.025); 和临床因素: 次优依从性 (OR,1.51; 95% CI,1.23-1.85; P <  0.001),方案转换 (OR,1.94; 95% CI,1.12-3.35; P   =   0.018) 和抗抑郁药的使用 (或,1.98; 95% CI,1.47-2.67; P   =   0.044)。在这个庞大的中国人群中,睡眠障碍的患病率很高。相关因素似乎与心理和社会人口因素有关。卫生工作者可以考虑定期评估HIV感染患者的睡眠障碍,尤其是在HIV诊断后的前三个月,并推荐精神卫生服务,这可能会对治疗依从性产生积极影响。
  • 【姑息治疗中的标签外处方-姑息医学医生的横断面全国调查。】 复制标题 收藏 收藏
    DOI:10.1177/0269216312464263 复制DOI
    作者列表:To TH,Agar M,Shelby-James T,Abernethy AP,Doogue M,Rowett D,Ko D,Currow DC
    BACKGROUND & AIMS: BACKGROUND:Regulatory bodies including the European Medicines Agency register medications (formulation, route of administration) for specific clinical indications. Once registered, prescription is at clinicians' discretion. Off-label use is beyond the registered use. While off-label prescribing may, at times, be appropriate, efficacy and toxicity data are often lacking. AIM:The aim of this study was to document off-label use policies (including disclosure and consent) in Australian palliative care units and current practices by palliative care clinicians. DESIGN:A national, cross-sectional survey was conducted online following an invitation letter. The survey asked clinicians their most frequent off-label medication/indication dyads and unit policies. Dyads were classified into unregistered, off-label and on-label, and for the latter, whether medications were nationally subsidised. SETTING/PARTICIPANTS:All Australian palliative medicine Fellows and advanced trainees. RESULTS:Overall, 105 clinicians responded (53% response rate). The majority did not have policies on off-label medications, and documented consent rarely. In all, 236 medication/indication dyads for 36 medications were noted: 45 dyads (19%) were for two unregistered medications, 118 dyads (50%) were for 26 off-label medications and 73 dyads (31%) were for 12 on-label medications. CONCLUSIONS:Off-label prescribing with its clinical, legal and ethical implications is common yet poorly recognised by clinicians. A distinction needs to be made between where quality evidence exists but registration has not been updated by the pharmaceutical sponsor and the evidence has not been generated. Further research is required to quantify any iatrogenic harm from off-label prescribing in palliative care.
    背景与目标:
  • 【胆固醇目标的实现和更高成本的他汀类药物的处方: 一般实践中的横断面研究。】 复制标题 收藏 收藏
    DOI:10.3399/bjgp12X659286 复制DOI
    作者列表:Fleetcroft R,Schofield P,Duerden M,Ashworth M
    BACKGROUND & AIMS: BACKGROUND:There is conflicting evidence as to whether achievement of cholesterol targets at the population level is dependent on the choice and cost of statin. AIM:To investigate the practice-level relationship between cholesterol quality indicators in patients with heart disease, stroke, and diabetes and prescribing of low-cost statins. DESIGN AND SETTING:Correlations and linear regression modelling of retrospective cross-sectional practice-level data with potential explanatory variables in 7909 (96.4%) general practices in England in 2008-2009. METHOD:Quality indicator data were obtained from the Information Centre and prescribing data from the NHS Business Authority. A 'cholesterol quality indicator' score was constructed by dividing the numbers of patients achieving the target for cholesterol control of ≤5 mmol/l in stroke, diabetes, and heart disease by the numbers on each register. A 'low-cost statin' ratio score was constructed by dividing the numbers of defined daily doses of simvastatin and pravastatin by the total numbers of defined daily doses of statins. RESULTS:Simvastatin accounted for 83.3% (standard deviation [SD] = 15.7%) of low-cost statins prescribed and atorvastatin accounted for 85.7% (SD = 14.8%) of high-cost statins prescribed. The mean cholesterol score was 73.7% (SD = 6.0%). Practices using a higher proportion of the low-cost statins were less successful in achieving cholesterol targets. An increase of 10% in the prescribing of low-cost statins was associated with a decrease of 0.46% in the cholesterol quality indicator score (95% confidence interval = -0.54% to -0.38%, P<0.001). CONCLUSION:Greater use of low-cost statins was associated with a small reduction in cholesterol control.
    背景与目标:
  • 【花生对2型糖尿病高危肥胖女性血糖反应和食欲的急性和二餐影响: 一项随机交叉临床试验.】 复制标题 收藏 收藏
    DOI:10.1017/S0007114512004217 复制DOI
    作者列表:Reis CE,Ribeiro DN,Costa NM,Bressan J,Alfenas RC,Mattes RD
    BACKGROUND & AIMS: :Nut consumption is associated with a reduced risk of type 2 diabetes mellitus (T2DM). The aim of the present study was to assess the effects of adding peanuts (whole or peanut butter) on first (0-240 min)- and second (240-490 min)-meal glucose metabolism and selected gut satiety hormone responses, appetite ratings and food intake in obese women with high T2DM risk. A group of fifteen women participated in a randomised cross-over clinical trial in which 42·5 g of whole peanuts without skins (WP), peanut butter (PB) or no peanuts (control) were added to a 75 g available carbohydrate-matched breakfast meal. Postprandial concentrations (0-490 min) of glucose, insulin, NEFA, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), appetitive sensations and food intake were assessed after breakfast treatments and a standard lunch. Postprandial NEFA incremental AUC (IAUC) (0-240 min) and glucose IAUC (240-490 min) responses were lower for the PB breakfast compared with the control breakfast. Insulin concentrations were higher at 120 and 370 min after the PB consumption than after the control consumption. Desire-to-eat ratings were lower, while PYY, GLP-1 and CCK concentrations were higher after the PB intake compared with the control intake. WP led to similar but non-significant effects. The addition of PB to breakfast moderated postprandial glucose and NEFA concentrations, enhanced gut satiety hormone secretion and reduced the desire to eat. The greater bioaccessibility of the lipid component in PB is probably responsible for the observed incremental post-ingestive responses between the nut forms. Inclusion of PB, and probably WP, to breakfast may help to moderate glucose concentrations and appetite in obese women.
    背景与目标: : 食用坚果与降低2型糖尿病 (T2DM) 的风险相关。本研究的目的是评估添加花生 (全或花生酱) 对第一 (0-240分钟) 和第二 (240-490分钟) 膳食葡萄糖代谢和选定的肠道饱腹激素反应的影响,高T2DM风险肥胖女性的食欲等级和食物摄入。一组15名妇女参加了一项随机交叉临床试验,其中将42·5克不含皮 (WP),花生酱 (PB) 或无花生 (对照) 的全花生添加到75克可用的碳水化合物匹配早餐中。在早餐治疗和标准午餐后,评估餐后葡萄糖,胰岛素,NEFA,胰高血糖素样肽-1 (GLP-1),肽YY (PYY),胆囊收缩素 (CCK),食欲感和食物摄入量的浓度 (0-490分钟)。与对照早餐相比,PB早餐的餐后NEFA增量AUC (IAUC) (0-240分钟) 和葡萄糖IAUC (240-490分钟) 响应较低。PB消耗后120和370分钟的胰岛素浓度高于对照消耗后的胰岛素浓度。与对照摄入量相比,摄入PB后的饮食欲望等级较低,而PYY,GLP-1和CCK浓度较高。WP导致了类似但不显著的影响。早餐中添加PB可降低餐后葡萄糖和NEFA的浓度,增强肠道饱腹激素的分泌并降低进食欲望。PB中脂质成分的更大的生物可及性可能是观察到的坚果形式之间摄入后的增量反应的原因。在早餐中加入PB (可能是WP) 可能有助于减轻肥胖女性的葡萄糖浓度和食欲。
  • 【在美国军人中,轻度TBI后,脑震荡后的可变,并非总是持续的症状: 一项为期五年的横断面结局研究。】 复制标题 收藏 收藏
    DOI:10.1089/neu.2012.2743 复制DOI
    作者列表:Lange RT,Brickell TA,Ivins B,Vanderploeg RD,French LM
    BACKGROUND & AIMS: :This study examined postconcussion symptom reporting within the first 5 years after mild traumatic brain injury (mTBI). Participants were 167 U.S. military service members (mean age, 27.6 years; 74.3% blast; 96.4% male) who were evaluated subsequent to injuries sustained in theater during Operations Iraqi and Enduring Freedom (92.8%) or from other combat-related operations. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder Checklist within 3 months of injury and at least one follow-up telephone interview at 6 (n = 46), 12 (n = 89), 24 (n = 54), 36 (n = 42), 48 (n = 30), and/or 60 months (n = 25) postinjury. Approximately half of the sample (49.7%) met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) symptom criteria for postconcussion disorder (PCD) at baseline. At all six follow-ups, 46.1-72.0% met DSM-IV criteria for PCD. However, only 20.4-48.0% reported persistent PCD from baseline to follow-up. A substantial minority had also improved (4.0-24.1%) or "developed" new symptoms (16.9-27.8%). Using regression analyses, baseline symptoms were somewhat predictive of PCD symptom reporting at follow-up, though this was not always reliable. Follow-up for all service members who sustain a combat-related mTBI in the context of polytrauma, regardless of the presence or absence of symptom reporting in the acute recovery stage, should be considered the rule, not the exception.
    背景与目标: : 这项研究检查了轻度创伤性脑损伤 (mTBI) 后头5年内的脑震荡后症状报告。参与者是167名美国军人 (平均年龄,27.6岁; 74.3% 爆炸; 96.4% 男性),他们在伊拉克和持久自由行动 (92.8%) 或其他与战斗有关的行动中在战区受伤后接受了评估。参与者在受伤后3个月内完成了神经行为症状清单和创伤后应激障碍清单,并在6 (n = 46),12 (n = 89),24 (n = 54),36 (n = 42),受伤后48 (n = 30) 和/或60个月 (n = 25)。大约一半的样本 (49.7%) 在基线时符合精神疾病诊断和统计手册第四版 (dsm-iv) 脑震荡后障碍 (PCD) 的症状标准。在所有六次随访中,46.1-72.0% 符合dsm-iv PCD标准。然而,从基线到随访,只有20.4-48.0% 报告了持续的PCD。相当一部分也改善了 (4.0-24.1%) 或 “发展” 新症状 (16.9-27.8%)。使用回归分析,基线症状在一定程度上可以预测随访时的PCD症状报告,尽管这并不总是可靠的。对于在多发伤情况下维持与战斗相关的mTBI的所有服务人员,无论在急性恢复阶段是否存在症状报告,都应视为规则,而不是例外。
  • 【中国膜性肾病患者血清anti-PLA2R抗体和肾小球PLA2R沉积: 一项横断面研究。】 复制标题 收藏 收藏
    DOI:10.1097/MD.0000000000007218 复制DOI
    作者列表:Pang L,Zhang AM,Li HX,Du JL,Jiao LL,Duan N,Liu Y,Yu D
    BACKGROUND & AIMS: :M-type phospholipase A2 receptor (PLA2R) is the major target antigen in primary membranous nephropathy (PMN). Previous studies have evaluated the diagnostic value of serum anti-PLA2R antibody. However, the correlation of serum anti-PLA2R antibody and glomerular PLA2R deposition, and their association with clinical characteristics need to be further evaluated.A total of 136 patients were involved as inception group because serum anti-PLA2R antibody and glomerular PLA2R antigen were simultaneously measured. We examined serum anti-PLA2R antibody by ELISA and glomerular PLA2R deposition by immunofluorescence assay.Positive serum anti-PLA2R antibody and glomerular PLA2R deposition were seen in 58.8% (80/136) and 95.6% (130/136) patients, respectively (P < .001). Proteinuria, serum total protein, serum albumin, serum creatinine, and estimated glomerular filtration rate (eGFR) had significant differences between patients with serum anti-PLA2R antibody and those without. Serum anti-PLA2R antibody levels were correlated with serum albumin, serum creatinine, eGFR, and proteinuria. Glomerular PLA2R deposition intensities were weakly correlated with proteinuria. Unexpectedly, there was a positive correlation rather than a negative correlation between glomerular PLA2R deposition intensity and eGFR.In conclusion, serum anti-PLA2R antibody is more closely correlated with disease activity and renal function than glomerular PLA2R deposition.
    背景与目标: : M型磷脂酶A2受体 (PLA2R) 是原发性膜性肾病 (PMN) 的主要靶抗原。先前的研究已经评估了血清anti-PLA2R抗体的诊断价值。但是,血清anti-PLA2R抗体与肾小球PLA2R沉积的相关性及其与临床特征的相关性有待进一步评估。共有136例患者作为起始组,因为同时测量了血清anti-PLA2R抗体和肾小球PLA2R抗原。ELISA法检测血清anti-PLA2R抗体,免疫荧光法检测肾小球PLA2R沉积,58.8% 例 (80/136例) 和95.6% 例 (130/136例) 血清anti-PLA2R抗体和肾小球PLA2R沉积阳性 (p  < .001)。蛋白尿,血清总蛋白,血清白蛋白,血清肌酐和估计的肾小球滤过率 (eGFR) 在具有血清anti-PLA2R抗体的患者与没有血清白蛋白的患者之间具有显着差异。血清anti-PLA2R抗体水平与血清白蛋白,血清肌酐,eGFR和蛋白尿相关。肾小球PLA2R沉积强度与蛋白尿的相关性较弱。不料,肾小球PLA2R沉积强度与eGFR呈正相关而非负相关,结论血清anti-PLA2R抗体与疾病活动和肾功能的相关性比肾小球PLA2R沉积更密切。
  • 【探索已发表的关于运动训练和体育锻炼的指导的横断面样本的方法学质量和临床实用性,以进行冠心病的二级预防。】 复制标题 收藏 收藏
    DOI:10.1186/s12872-017-0589-z 复制DOI
    作者列表:Abell B,Glasziou P,Hoffmann T
    BACKGROUND & AIMS: BACKGROUND:Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. METHODS:We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. RESULTS:Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other guidance types (mean score 33%). CONCLUSIONS:While a large number of guidance documents provide recommendations for exercise-based cardiac rehabilitation, most have limitations in either methodological quality or clinical usefulness. The lack of rigorously developed guidelines which also contain necessary detail about exercise training remains a substantial problem for clinicians.
    背景与目标:
  • 【澳大利亚全科注册服务商的程序技能: 横断面分析。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Aghajafari F,Tapley A,Sylvester S,Davey AR,Morgan S,Henderson KM,van Driel ML,Spike NA,Kerr RH,Catzikiris NF,Mulquiney KJ,Magin PJ
    BACKGROUND & AIMS: BACKGROUND:Procedural skills are an essential component of general practice vocational training. The aim of this study was to investigate the type, frequency and rural or urban associations of procedures performed by general practice registrars, and to establish levels of concordance of procedures performed with a core list of recommended procedural skills in general practice training. METHODS:A cross-sectional analysis of a cohort study of registrars' consultations between 2010 and 2016 was undertaken. Registrars record 60 consecutive consultations during each six-month training term. The outcome was any procedure performed. RESULTS:In 182,782 consultations, 19,411 procedures were performed. Procedures (except Papanicolaou [Pap] tests) were performed more often in rural than urban areas. Registrars commonly sought help from supervisors for more complex procedures. The majority of procedures recommended as essential in registrar training were infrequently performed. DISCUSSION:Registrars have low exposure to many relevant clinical procedures. There may be a need for greater use of laboratory-based training and/or to review the expectations of the scope of procedural skills in general practice.
    背景与目标:
  • 【出生时间是围产期不良结局的预测指标吗?坦桑尼亚资源匮乏的医院横断面研究。】 复制标题 收藏 收藏
    DOI:10.1186/s12884-017-1358-9 复制DOI
    作者列表:Mgaya A,Hinju J,Kidanto H
    BACKGROUND & AIMS: BACKGROUND:Inconsistent evidence of a higher risk of adverse perinatal outcomes during off-hours compared to office hours necessitated a search for clear evidence of an association between time of birth and adverse perinatal outcomes. METHODS:A cross-sectional study conducted at a tertiary referral hospital compared perinatal outcomes across three working shifts over 24 h. A checklist and a questionnaire were used to record parturients' socio-demographic and obstetric characteristics, mode of delivery and perinatal outcomes, including 5th minute Apgar score, and early neonatal mortality. Risks of adverse outcomes included maternal age, parity, referral status and mode of delivery, and were assessed for their association with time of delivery and prevalence of fresh stillbirth as a proxy for poor perinatal outcome at a significance level of p = 0.05. RESULTS:Off-hour deliveries were nearly twice as likely to occur during the night shift (odds ratio (OR), 1.62; 95% confidence interval (CI), 1.50-1.72), but were unlikely during the evening shift (OR, 0.58; 95% CI, 0.45-0.71) (all p < 0.001). Neonatal distress (O.R, 1.48, 95% CI; 1.07-2.04, p = 0.02), early neonatal deaths (OR, 1.70; 95% CI, 1.07-2.72, p = 0.03) and fresh stillbirths (OR, 1.95; 95% CI, 1.31-2.90, p = 0.001) were more significantly associated with deliveries occurring during night shifts compared to evening and morning shifts. However, fresh stillbirths occurring during the night shift were independently associated with antenatal admission from clinics or wards, referral from another hospital, and abnormal breech delivery (OR 1.9; 95% CI, 1.3-2.9, p = 0.001, for fresh stillbirths; OR, 5.0; 95% CI 1.7-8.3, p < 0.001, for antenatal admission; OR, 95% CI, 1.1-2.9, p < 0.001, for referral form another hospital; and OR 1.6; 95% CI 1.02-2.6, p = 0.004, for abnormal breech deliveries). CONCLUSION:Off-hours deliveries, particularly during the night shift, were significantly associated with higher proportions of adverse perinatal outcomes, including low Apgar score, early neonatal death and fresh stillbirth, compared to morning and evening shifts. Labour room admissions from antenatal wards, referrals from another hospital and abnormal breech delivery were independent risk factors for poor perinatal outcome, particularly fresh stillbirths.
    背景与目标:
  • 【股内侧横截面积的增加与膝关节骨关节炎的疼痛,软骨损失和关节置换风险降低有关。】 复制标题 收藏 收藏
    DOI:10.1002/art.34681 复制DOI
    作者列表:Wang Y,Wluka AE,Berry PA,Siew T,Teichtahl AJ,Urquhart DM,Lloyd DG,Jones G,Cicuttini FM
    BACKGROUND & AIMS: OBJECTIVE:Although there is evidence for a beneficial effect of increased quadriceps strength on knee symptoms, the effect on knee structure is unclear. We undertook this study to examine the relationship between change in vastus medialis cross-sectional area (CSA) and knee pain, tibial cartilage volume, and risk of knee replacement in subjects with symptomatic knee osteoarthritis (OA). METHODS:One hundred seventeen subjects with symptomatic knee OA underwent magnetic resonance imaging of the knee at baseline and at 2 and 4.5 years. Vastus medialis CSA was measured at baseline and at 2 years. Tibial cartilage volume was measured at baseline and at 2 and 4.5 years. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index at baseline and at 2 years. The frequency of knee joint replacement over 4 years was determined. Regression coefficients (B) and odds ratios were determined along with 95% confidence intervals (95% CIs). RESULTS:After adjusting for confounders, baseline vastus medialis CSA was inversely associated with current knee pain (r = -0.16, P = 0.04) and with medial tibial cartilage volume loss from baseline to 2 years (B coefficient -10.9 [95% CI -19.5, -2.3]), but not with baseline tibial cartilage volume. In addition, an increase in vastus medialis CSA from baseline to 2 years was associated with reduced knee pain over the same time period (r = 0.24, P = 0.007), reduced medial tibial cartilage loss from 2 to 4.5 years (B coefficient -16.8 [95% CI -28.9, -4.6]), and reduced risk of knee replacement over 4 years (odds ratio 0.61 [95% CI 0.40, 0.94]). CONCLUSION:In a population of patients with symptomatic knee OA, increased vastus medialis size was associated with reduced knee pain and beneficial structural changes at the knee, suggesting that management of knee pain and optimizing vastus medialis size are important in reducing OA progression and subsequent knee replacement.
    背景与目标:
  • 【努力控制、暴露于社区暴力和攻击行为: 探索青春期的交叉滞后关系。】 复制标题 收藏 收藏
    DOI:10.1002/ab.21717 复制DOI
    作者列表:Esposito C,Bacchini D,Eisenberg N,Affuso G
    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。
  • 【索马里兰哈尔格萨大学本科生的精神困扰和相关因素: 一项横断面研究。】 复制标题 收藏 收藏
    DOI:10.1186/s13033-017-0146-2 复制DOI
    作者列表:Hersi L,Tesfay K,Gesesew H,Krahl W,Ereg D,Tesfaye M
    BACKGROUND & AIMS: BACKGROUND:Mental distress is a common finding among University students. Empirical research has confirmed that the University student population has a higher prevalence of mental disorder than the general population. However, no previous study has examined the mental health conditions of students in Somaliland. METHODS:An institution based cross-sectional study was conducted on a sample of 570 undergraduate students at the University of Hargeisa in October, 2013. Study subjects were selected using a stratified random sampling. The Self-reporting questionnaire (SRQ-20) was used to assess mental distress. Multiple logistic regression analysis was carried out to identify factors independently associated with mental distress. RESULTS:The point prevalence of mental distress was found to be 19.8%. Mental distress was associated with being female (AOR = 3.52, 95% CI 1.94, 6.39), having a monthly income of 100 United States dollars (USD) or less (AOR = 2.19, 95% CI 1.12, 4.28), and not having a satisfying relationship with the family (AOR = 11.52, 95% CI 3.18, 41.72) and friends (AOR = 7.33, 95% CI 2.83, 18.93). Nearly one in five students (18.6%) has been using Khat in the previous 12 months. Khat use was also associated with greater likelihood of mental distress (AOR = 2.87, 95% CI 1.26, 6.56). In addition, financial difficulties and the poor prospect of finding a job were common sources of stress among the students. CONCLUSIONS:A significant proportion of the students at the University of Hargeisa suffer from mental distress which might have a detrimental effect on their academic performance. The mental health needs of the University students require attention with special emphasis on female students, students experiencing financial hardships, students who use Khat and those who have interpersonal problems.
    背景与目标:
  • 【组蛋白伴侣Asf1的C末端与酵母中的组蛋白H3交联,并促进与组蛋白H3和h4的相互作用。】 复制标题 收藏 收藏
    DOI:10.1128/MCB.01053-12 复制DOI
    作者列表:Dennehey BK,Noone S,Liu WH,Smith L,Churchill ME,Tyler JK
    BACKGROUND & AIMS: :The central histone H3/H4 chaperone Asf1 comprises a highly conserved globular core and a divergent C-terminal tail. While the function and structure of the Asf1 core are well known, the function of the tail is less well understood. Here, we have explored the role of the yeast (yAsf1) and human (hAsf1a and hAsf1b) Asf1 tails in Saccharomyces cerevisiae. We show, using a photoreactive, unnatural amino acid, that Asf1 tail residue 210 cross-links to histone H3 in vivo and, further, that loss of C-terminal tail residues 211 to 279 weakens yAsf1-histone binding affinity in vitro nearly 200-fold. Via several yAsf1 C-terminal truncations and yeast-human chimeric proteins, we found that truncations at residue 210 increase transcriptional silencing and that the hAsf1a tail partially substitutes for full-length yAsf1 with respect to silencing but that full-length hAsf1b is a better overall substitute for full-length yAsf1. In addition, we show that the C-terminal tail of Asf1 is phosphorylated at T270 in yeast. Loss of this phosphorylation site does not prevent coimmunoprecipitation of yAsf1 and Rad53 from yeast extracts, whereas amino acid residue substitutions at the Asf1-histone H3/H4 interface do. Finally, we show that residue substitutions in yAsf1 near the CAF-1/HIRA interface also influence yAsf1's function in silencing.
    背景与目标: : 中央组蛋白H3/H4伴侣Asf1包含高度保守的球状核和发散的C末端尾巴。虽然Asf1核心的功能和结构是众所周知的,但尾部的功能却知之甚少。在这里,我们探索了酵母 (yAsf1) 和人 (hAsf1a和hAsf1b) Asf1尾巴在酿酒酵母中的作用。我们显示,使用光反应性的非天然氨基酸,Asf1尾残基在体内与组蛋白H3 210交联,并且进一步地,与279 211的C末端尾残基的丢失在体外削弱了yAsf1-histone结合亲和力近200倍。通过几种yAsf1 C末端截短和酵母-人嵌合蛋白,我们发现残基处的截短210增加转录沉默,并且hAsf1a尾巴在沉默方面部分替代了全长yAsf1,但是全长hAsf1b是全长yAsf1的更好的整体替代品。此外,我们显示了酵母中Asf1的C末端尾部在T270处被磷酸化。该磷酸化位点的丢失并不能阻止酵母提取物中yAsf1和Rad53的共免疫沉淀,而Asf1-histone H3/H4界面处的氨基酸残基取代则可以。最后,我们表明yAsf1中CAF-1/HIRA界面附近的残基取代也会影响yAsf1的沉默功能。
  • 【结直肠肿瘤发生过程中的信号转导串扰。】 复制标题 收藏 收藏
    DOI:10.1097/01.pap.0000213046.61941.5c 复制DOI
    作者列表:Liu X,Lazenby AJ,Siegal GP
    BACKGROUND & AIMS: :Colorectal carcinoma (CRC) is the second leading cause of cancer-related death in the United States in the general population (men and women combined). Epidemiologic data obtained over the last several decades shows convincing evidence for the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in the reduction of risk of CRC through the inhibition of cycloxygenase (COX). Recent research has also demonstrated that prostaglandin E2 (PGE2), a predominant product of COX, plays a critical role in tumorigenesis of CRCs through its guanine nucleotide-binding protein (G protein)-coupled receptors (GPCRs), EP2, and EP4. Molecular analysis of CRC and its precursor lesions have shown that mutation of Adenomatous Polyposis Coli (APC), a gene involved in the wingless type signaling pathway, is an early event during the neoplastic progression in the majority of sporadic CRCs. The fundamental questions are: why is wild type APC so important in adult colorectal tissues in preventing this tumorigenesis, and what are the mechanisms by which NSAIDs prevent colorectal tumorigenesis? We reviewed the recent literature concerning the PGE2-GPCR signaling pathway and the APC-beta-catenin (wingless type) pathway in CRC cells and propose a unifying schema regarding the tumorigenesis of CRC. Colorectal epithelia are continuously exposed to various extracellular agonists (including low levels of PGE2). The binding of these agonists to their corresponding GPCRs leads to formation of activated Galphas, which in turn activates beta-catenin. In normal colorectal epithelia, wild type APC blocks the Galphas-induced activation of beta-catenin, and therefore maintains homeostasis and prevents tumorigenesis. In contrast, in the absence of functional APC, continuous formation of activated Galphas by the binding of various extracellular agonists to their receptors leads to the activation and nuclear accumulation of beta-catenin. This elevated nuclear beta-catenin in turn increases transcription of many genes (COX-2, C-myc, Cyclin D1, vascular endothelial growth factor, T cell factor, etc.) involved in tumorigenesis. Increased transcription of COX-2 also leads to excessive production of PGE2 that in turn forms a stimulatory loop with many biologic functions (proliferation, migration, invasion, angiogenesis, and inhibition of apoptosis), which may result in the development of CRC. Because NSAIDs inhibit COX and decrease the production of PGE2, interruption of the cycle helps prevent colorectal tumorigenesis.
    背景与目标: : 大肠癌 (CRC) 是美国普通人群 (男性和女性合计) 中癌症相关死亡的第二大原因。在过去几十年中获得的流行病学数据显示了令人信服的证据,证明非甾体类抗炎药 (NSAIDs) 通过抑制环氧化酶 (COX) 降低CRC风险。最近的研究还表明,COX的主要产物前列腺素E2 (PGE2) 通过其鸟嘌呤核苷酸结合蛋白 (g蛋白) 偶联受体 (GPCRs),EP2和ep4在crc的肿瘤发生中起关键作用。CRC及其前体病变的分子分析表明,腺瘤性息肉病 (APC) 的突变是参与无翅型信号通路的基因,是大多数散发性CRC肿瘤进展过程中的早期事件。基本问题是: 为什么野生型APC在成人结直肠组织中预防这种肿瘤发生如此重要,NSAIDs预防结直肠肿瘤发生的机制是什么?我们回顾了有关CRC细胞中PGE2-GPCR信号通路和APC-β-catenin (无翼型) 通路的最新文献,并提出了有关CRC肿瘤发生的统一方案。结直肠上皮细胞持续暴露于各种细胞外激动剂 (包括低水平的PGE2)。这些激动剂与其相应的gpcr的结合导致形成活化的galpha,进而激活 β-catenin。在正常的结直肠上皮中,野生型APC可阻断galpha诱导的 β-catenin激活,从而维持体内平衡并防止肿瘤发生。相反,在没有功能性APC的情况下,通过各种细胞外激动剂与其受体的结合连续形成活化的galpha导致 β-catenin的活化和核积累。这种升高的核 β-连环蛋白反过来增加了参与肿瘤发生的许多基因 (COX-2,C-myc,Cyclin D1,血管内皮生长因子,T细胞因子等) 的转录。COX-2的转录增加也导致PGE2的过量产生,进而形成具有许多生物学功能 (增殖,迁移,侵袭,血管生成和凋亡抑制) 的刺激环,这可能导致CRC的发展。由于NSAIDs抑制COX并减少PGE2的产生,因此中断周期有助于预防结直肠肿瘤的发生。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录