Associations between childhood biomedical factors,maternal smoking,personality traits,Body and Mass Index and the prevalence of asthma in adulthood

Objective: The study set out to investigate socio-economic, biomedical, health and behavioural and psychological factors in childhood and adulthood associated with the prevalence of asthma in adulthood, drawing data from The National Child Development Studies (NCDS), a birth cohort in the UK.

Design: The National Child Development Study, a nationally representative sample of 17,415 babies born in Great Britain in 1958 and followed up at 7, 11, 33 and 50 years was used.

Main Outcome Measure: The prevalence of asthma at age 50 was the outcome measure. The analytic sample consists of 5118 participants with complete data on a set of measures at birth, at ages 7, 11, 33 and 50 years.

Results: Using logistic regression analyses, results showed that childhood asthma (OR = 6.77: 4.38–10.48, p < .001) and respiratory symptoms (OR = 1.83: 1.18–2.86, p < .01), maternal smoking during pregnancy (OR = 1.26: 1.00–1.59, p < .05), Body and Mass Index (BMI) (OR = 1.03: 1.02–1.05, p < .001), traits Neuroticism (OR = 1.13: 1.01–1.21, p < .05) and Conscientiousness (OR = 0.76: 0.76–0.96, p < .01), as well as sex (OR = 1.49: 1.15–1.94, p < .001) were all significantly associated with the prevalence of asthma in adulthood.

Conclusion: The study shows that both childhood and adulthood psychological and sociological factors are significantly associated with the prevalence of asthma in adulthood, though more work need to be done in this area.     

早期目标血糖管理下严重脓毒症患者HMGB1的变化及其临床意义

探讨早期目标血糖管理对严重脓毒症患者HMGB1变化的影响.严重脓毒症患者随机分为血糖控制A（4.4mmol/L~6.1mmol/L）、B（6.2mmol/L~8.3mmol/L）、C（8.4mmol/L~10.0mmol/L）三组.给予早期目标血糖管理,入ICU后0d、1d、3d、5d、7d采血测TNF-α、HMGB1浓度.三组TNF-α、HMGB1浓度及APACHEⅡ评分均呈下降趋势,A组HMGB1浓度及APACHEⅡ评分在第7d较B、C组明显降低（P＜0.05）.A组28d病死率较B、C组降低（P＆gt;0.05）.严重脓毒症患者在早期目标血糖管理下,显著降低HMGB1浓度,降低病死率和改善预后,HMGB1可用来评价脓毒症的严重程度及预后.     

要注意中药对肝的损伤作用

含有生物碱类、皂苷类、萜类、毒蛋白类、重金属类成分的中药易致急性肝损伤.中药对肝脏损伤的原因及机制较为复杂,可能与药物对肝脏的直接毒性或特异性体质有关.此外,中药炮制方法、给药途径、剂型、剂量、疗程及配伍不当也会引起药物性肝损伤.中药所致的药物性肝损伤的诊断主要依据用药史、发病的时间、过程和临床表现并排除其他因素.治疗可选用还原型谷胱甘肽、S-腺苷蛋氨酸、多烯磷脂酰胆碱、熊去氧胆酸、水飞蓟素等药物,重症可选择人工肝脏支持治疗.     

血红素氧合酶-1与动脉粥样硬化和高血压的关系

血红素氧合酶-1（HO-1）是血红素分解的起始酶和限速酶,它分解血红素最终生成胆红素、一氧化碳和铁.这三种产物通过抗炎症损伤、抗氧化应激、抗细胞增殖、抗细胞凋亡、抑制血小板聚集、调节血管张力及细胞内信号传递等途径对心血管系统起着重要的保护作用.研究显示,HO的诱导剂及多种能降低心血管病风险的药物能诱导 HO-1表达增加,从而起到抗动脉粥样硬化的发生发展及调节血压的作用.因此开发临床可应用的HO诱导剂,甚至开发HO的基因治疗方法是目前研究的方向.     

新生儿重症监护病房患儿家属心理状况分析

探讨新生儿重症监护病房（NICU）住院患儿家属的心理状况及影响因素。采用焦虑自评量表（SAS）及自行设计的调查问卷对190名NICU住院患儿家属进行调查。结果显示患儿家属表现出不同程度的焦虑,与全国常模（29．78±0．46）相比,其焦虑情绪标准分49．54±1．07,高于常模组（P〈O．05）。影响因素主要包括文化水平、家庭人均收入及患儿病情严重程度等。患儿父母关注的主要问题包括：病情严重程度、预后、医护人员解释病情满意度及病房探视制度。笔者认为医护人员应加强与患儿家属的有效沟通,满足其心理需求,提高医疗护理质量,促进医患关系和谐。     

妊娠合并结核临床诊治的决策

妊娠合并结核是一种对母婴健康危害极大的妊娠期疾病。在妊娠期结核病中,多数患者无明显症状,早期症状与妊娠期某些生理反应相似,加之妊娠与结核病的相互影响,x线、CT等重要的影像学检查受限,致使本病易被误诊或误治。某些抗结核药物对母婴的不良影响,使其治疗难以实施,由于结核病本身及治疗后可能对胎儿的影响,在临床上是否终止妊娠往往难以决策。本文就妊娠合并结核诊治过程中的相关问题进行综述,以期为临床诊治决策提供帮助。     

急性泪囊炎不同排脓途径的疗效观察

由于急性泪囊炎的一期处理过程中经泪小管引流脓液与经皮肤切开排脓对治疗效果的影响不同,将我院2007年以来接诊的急性泪囊炎患者随机分为观察组与对照组:患者抗感染治疗后经泪小管引流脓液,成人行经鼻内镜泪囊开窗引流术,先天性泪囊炎患儿行泪道探通;对照组患者急性期经皮肤切开排脓、放置引流条和消炎处理后再行泪囊鼻腔吻合术.观察组患者治疗成功率98.46％,外观满意率98.25％;对照组患者治疗成功率89.11％,外观满意率54.35％.观察组患者较对照组患者疗程缩短约7天～10天.急性泪囊炎经全身抗感染治疗后行泪小管引流脓液能更有效地控制炎症,不给患者带来新的创伤,值得临床推广应用.     

The immunoenhancing effects of humor on secretory IgA and resistance to respiratory infections

Abstract

In three different studies involving exposun to two differcot humorous and comparison videotapes, it was demonstrated that humor arousal signiticantly increases S-IgA in college students. Furthermore significantly more of the subjects exposed to the humor films showed an increese in S-IgA than the subjects exposed to the comparison films. A good sense of humor, measured as a trait, was associated with higher baseline concentrations of S-IgA and with greater increases in S-IgA in response to a humor arousing film. Higher bascline kvels and gains in S-IgA in respoase to humor were associated with lower reported severity of colds in the past twelve months and in the three months following assessment. However, a good sense of humor was related to lesser cold incidence and severity only if it involved appreciation rather than production of humor. While those who actively tell jokes also show higher S-IgA levels, they show greater susceptibility to colds than those who only appreciate humor probably because they sodalize more often under conditions that expose them more to cold infections.     

Acute stress disorder among civilians during a war and post-traumatic growth six years later: the impact of personal and social resources

Background and Objectives: Various studies suggest a link between stress response to a traumatic event and post-traumatic growth (PTG), but little is known about their long-term relationship. In this study, the relationship between acute stress disorder (ASD) among civilians during a war on the home front and PTG six years later was examined for the first time. Based on the conservation of resources (COR) theory, the role of personal and social resource loss and gain as moderating factors was investigated. Design and Methods: At Time 1 of the research (the Second Lebanon War in 2006), a structured questionnaire was administered to 370 civilians living within rocket range. At Time 2, 6 years later, 301 participants from Time 1 were again examined. The data analysis refers to the 301 respondents who participated at Time 2. Results: The findings indicate a significant relationship between ASD and PTG. Examination of the interaction revealed that resource gain (but not resource loss) moderates (strengthens) the relationship between the two. Conclusions: These findings are not consistent with the COR view that resource loss has a greater effect on stress responses than resource gain.     

A preliminary study of the comfort of paced respiration

In order to obtain basal information about what type of externally paced respiration is comfortable, 25 male and 25 female undergraduate students were asked to practice self‐paced respiration. After a 1‐min rehearsal following instructions on comfortable self‐paced respiration, subjects carried out 2 min of self‐paced respiration and rated their level of comfort on a scale of 1–5. This was repeated (up to a maximum of seven times) until the subject recorded a high rating. Results indicated that self‐paced respiration was most comfortable, irrespective of sex, when a respiratory pattern was attained of half the respiratory rate and nearly twice the tidal volume of the trainee's resting condition. Although respiratory sinus arrhythmia and heart rate were indicative of a decrease in cardiac vagal activity and end‐tidal PCO₂ was suggestive of a reduction in anxiety, these effects were small. The results have implications for the utilization of externally paced respiration.