血流感染患者表皮葡萄球菌与金黄色葡萄球菌的分布与耐药性分析

目的比较血流感染患者表皮葡萄球菌与金黄色葡萄球菌的耐药性差异,为临床合理选用抗菌药物提供参考。方法对贵州医科大学第三附属医院2011年6月至2014年11月血流感染标本中分离出的表皮葡萄球菌与金黄色葡萄球菌共140株进行比较分析,按照《全国临床检验操作规程》进行微生物鉴定,采用K-B纸片法进行药敏试验,药敏结果按美国临床和实验室标准化协会(CLSI)的标准判断,数据采用SPSS 17.0软件进行统计分析。结果血流感染标本共分离出表皮葡萄球菌与金黄色葡萄球菌140株,其中表皮葡萄球菌分离出88株,占62.86%;金黄色葡萄球菌分离出52株,占37.14%。血流感染表皮葡萄球菌与金黄色葡萄球菌对苯唑西林、头孢唑林、头孢噻肟、克林霉素、红霉素、阿奇霉素、环丙沙星、氧氟沙星、利福平、呋喃妥因、头孢噻吩、亚胺培南、左氧氟沙星、麦迪霉素、复方新诺明等耐药率分别为81.82%,45.15%;35.23%,15.38%;20.45%,5.77%;47.73%,26.92%;76.14%,51.92%;69.32%,50.00%;64.77%,9.62%;54.55%,28.85%;14.77%,0.00%;10.23%,0.00%;39.77%,3.85%;11.36%,0.00%;54.55%,28.85%;67.05%,5.77%;79.55%,32.69%;表皮葡萄球菌耐药率明显高于金黄色葡萄球菌,差异有性统计学意义(P0.05)。结论血流感染中表皮葡萄球菌的感染率与耐药率不断上升,耐药率明显高于金黄色葡萄球菌,应引起重视。     

Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study

Objectives To examine how lifestyle, hormonal, and other factors influence the sensitivity and specificity of mammography.Methods Women recruited into the Million Women Study completed a questionnaire about various personal factors before routine mammographic screening. A sample of 122 355 women aged 50-64 years were followed for outcome of screening and incident breast cancer in the next 12 months. Sensitivity and specificity were calculated by using standard definitions, with adjustment for potential confounding factors.Results Breast cancer was diagnosed in 726 (0.6%) women, 629 in screen positive and 97 in screen negative women; 3885 (3.2%) were screen positive but had no subsequent diagnosis of breast cancer. Overall sensitivity was 86.6% and specificity was 96.8%. Three factors had an adverse effect on both measures: use of hormone replacement therapy (sensitivity: 83.0% (95% confidence interval 77.4% to 87.6%), 84.7% (73.9% to 91.6%), and 92.1% (87.6% to 95.0%); specificity: 96.8% (96.6% to 97.0%), 97.8% (97.5% to 98.0%), and 98.1% (98.0% to 98.2%), respectively, for current, past, and never use); previous breast surgery v no previous breast surgery (sensitivity: 83.5% (75.7% to 89.1%) v 89.4% (86.5% to 91.8%); specificity: 96.2% (95.8% to 96.5%) v 97.4% (97.3% to 97.5%), respectively); and body mass index < 25 v ≥ 25 (sensitivity: 85.7% (81.2% to 89.3%) v 91.0% (87.5% to 93.6%); specificity: 97.2% (97.0% to 97.3%) v 97.4% (97.3% to 97.6%), respectively). Neither sensitivity nor specificity varied significantly according to age, family history of breast cancer, parity, past oral contraceptive use, tubal ligation, physical activity, smoking, or alcohol consumption.Conclusions The efficiency, and possibly the effectiveness, of mammographic screening is lower in users of hormone replacement therapy, in women with previous breast surgery, and in thin women compared with other women.     

我国不同产地红车轴草异黄酮含量的测定

本文通过HPLC法首次对产于我国11省的红车轴草中7种主要异黄酮单体含量进行了测定,结果表明,7种异黄酮总量变化范围为0.105%~1.725%。7种异黄酮单体含量随产地变化较显著,德鸢尾素、红车轴草素、毛蕊异黄酮、芒柄花素、大豆黄素、染料木素和鸡豆黄素A的含量变化范围分别为:0~0.189%、0~0.066%、0.020%~0.076%、0.004%~0.948%、0~0.089%、0.020%~0.073%和0~0.424%。     

Is diabetes mellitus related to undernutrition in rural Tanzania?

OBJECTIVE--To investigate the relation between undernutrition and diabetes. DESIGN--Survey of glucose tolerance in rural Tanzania. SETTING--Eight villages in three widely separated regions of Tanzania. SUBJECTS--8581 people aged 15 and above: 3705 men and 4876 women. MAIN OUTCOME MEASURES--Oral glucose tolerance, body mass index, height, and low haemoglobin and cholesterol concentrations. RESULTS--In the eight villages 42.7-56.9% of all men and 30.0-45.2% of all women had a body mass index below 20 kg/m2; the lowest quintile was 18.2 kg/m2 in men and 18.6 kg/m2 in women. The prevalence of diabetes did not change significantly from the lowest to the highest fifths of body mass index in men (lowest 1.6% (95% confidence interval 0.8% to 2.9%) v highest 1.3% (0.7% to 2.5%)) or women (1.1% (0.6% to 2.1%) v 0.5% (0.2% to 1.2%)). In men and in women prevalence of impaired glucose tolerance was greater in the lowest fifths of height (8.2% (6.3% to 10.6%), and 11.1% (9.2% to 13.3%)) respectively and body mass index (9.6% (7.5% to 12.1%), and 8.4% (6.7% to 10.5%)) than in the highest fifths (impaired glucose tolerance 4.7% (3.4% to 6.5%); and 5.1% (3.9% to 6.7%); body mass index 5.1% (3.7% to 7.0%), and 7.7% (6.2% to 9.6%). CONCLUSION--Rates of diabetes were not significantly associated with low body mass index or height, but overall rates were much lower than those in well nourished Western populations. Increased impaired glucose tolerance in the most malnourished people may reflect the larger glucose load per kilogram weight. The role of undernutrition in the aetiology of diabetes must be questioned.     

The cytology of the pouch of Douglas in polycystic ovarian disease

Cul-de-sac aspiration was performed for cytologic sampling in 137 cases of polycystic ovaries treated by wedge resection. Fifty patients undergoing abdominal tubal ligations also underwent aspiration of the pouch of Douglas as a control group. The cytodifferential count in polycystic ovarian disease showed 30% to 40% mesothelial cells, 15% to 20% polymorphonuclear leukocytes, 15% to 20% lymphocytes, 10% to 15% squamous cells and 1% to 5% histiocytes. The corresponding count in the control group showed 15% to 20% mesothelial cells, 20% to 25% polymorphonuclear leukocytes, 15% to 20% lymphocytes, 10% to 15% squamous cells and 1% to 3% histiocytes. Cells exfoliated from the fimbrial end of the tube were encountered in most smears. Abnormal cells were diagnosed in seven cases of polycystic ovarian disease due to a coexistent neoplasm, i.e., two dermoid cysts, a carcinoid tumor, a hilus cell tumor, a simple serous cyst, a pseudomucinous cystadenoma and endometriosis of the ovary. All tumors were histologically diagnosed in the resected wedges of the ovaries.     

Elimination of Iron Deficiency Anemia and Soil Transmitted Helminth Infection: Evidence from a Fifty-four Month Iron-Folic Acid and De-worming Program

Background

Intermittent iron-folic acid supplementation and regular de-worming are effective initiatives to reduce anemia, iron deficiency, iron deficiency anemia, and soil transmitted helminth infections in women of reproductive age. However, few studies have assessed the long-term effectiveness of population-based interventions delivered in resource-constrained settings.

Methodology/Principal Findings

The objectives were to evaluate the impact of weekly iron-folic acid supplementation and de-worming on mean hemoglobin and the prevalence of anaemia, iron deficiency, and soil transmitted helminth infection in a rural population of women in northern Vietnam and to identify predictive factors for hematological outcomes. A prospective cohort design was used to evaluate a population-based supplementation and deworming program over 54 months. The 389 participants were enrolled just prior to commencement of the intervention. After 54 months 76% (95% CI [68%, 84%]) were taking the iron-folic acid supplement and 95% (95% CI [93%, 98%]) had taken the most recently distributed deworming treatment. Mean hemoglobin rose from 122 g/L (95% CI [120, 124]) to 131 g/L (95% CI [128, 134]) and anemia prevalence fell from 38% (95% CI [31%, 45%]) to 18% (95% CI [12%, 23%]); however, results differed significantly between ethnic groups. Iron deficiency fell from 23% (95% CI [17%, 29%]) to 8% (95% CI [4%, 12%]), while the prevalence of iron deficiency anemia was reduced to 4% (95% CI [1%, 7%]). The prevalence of hookworm infection was reduced from 76% (95% CI [68%, 83%]) to 11% (95% CI [5%, 18%]). The level of moderate or heavy infestation of any soil-transmitted helminth was reduced to less than 1%.

Conclusions/Significance

Population-based interventions can efficiently and effectively reduce anemia and practically eliminate iron deficiency anemia and moderate to heavy soil transmitted helminth infections, maintaining them below the level of public health concern.     

Progress in cancer survival across last two decades: A nationwide study of over 1.2 million Polish patients diagnosed with the most common cancers

BackgroundThe purpose of this study was to estimate the high incidence cancers survival in Poland between 2000 and 2018, with the following aim to monitor the national polish cancer control program 2020–2030 effectiveness. We calculated survival in cancer of lung, breast, prostate, colon, rectum, ovarian, cervical cancers, and skin melanoma.MethodsData were obtained from the Polish Cancer Registry (PLCR). We estimated age-standardized 5-year net survival (NS) with the life table method and the Pohar-Perme estimator using the International Cancer Survival Standard weights. The corresponding 95% confidence intervals (95% CI) were estimated with log transformation.ResultsOverall, 1,288,944 high incidence cancer cases were included in the study (622,486 men and 666,458 women). In 2015–2018 age-standardized 5-year NS was 85.2% (95% CI = 84.6% to 85.8%) in prostate cancer, 80.0% (79.5% to 80.4%) breast cancer, 77.3%(76.4% to 78.1%) melanoma, 58.5% (57.5% to 59.5%) cervical cancer, 57.9% (57.3% to 58.5%) colon cancer, 52.1% (51.3% to 52.9%) rectal cancer, 43.3% (42.4% to 44.3%) ovarian cancer, and 17.8% (17.4% to 18.1%) for lung cancer. Between the 2000–2004 and 2015–2018 the highest increase in survival was noted for prostate cancer (14.6% points [pp]; from 70.6% to 85.2%) and the lowest for lung cancer (4.5 pp; from 13.3% to 17.8%).ConclusionCancer survivorship has been consistently improving during the last two decades. Notwithstanding these overall encouraging results, more extraordinary efforts are needed to close the cancer survival gap in Poland.     

遮荫处理对芍药幼苗生长和矿质营养积累的影响

遮荫是保护芍药幼苗生长的重要措施。本试验研究了不同遮荫处理对多伦芍药幼苗生长特性和矿质营养积累的影响,以便为多伦芍药幼苗栽培提供指导。采用盆栽试验,研究不遮荫(CK)、出苗一周后20%遮荫、40%遮荫、60%遮荫和80%遮荫5个处理的多伦芍药幼苗生长和矿质营养积累的变化。结果表明:与CK相比,遮荫处理显著提高了幼苗株高,增幅分别为19.9%、31.1%、52.9%、63.7%;显著降低了根生物量比和根冠比,降幅分别为21.5%、23.6%、29.2%、41.8%和40.6%、44.0%、50.9%、63.2%。40%遮荫、60%遮荫和80%遮荫显著提高了比叶面积,增幅分别为77.0%、84.1%、65.2%,显著增加了叶绿素和类胡萝卜素含量,增幅分别为92.3%、128.7%、98.1%和86.9%、113.1%、90.5%,显著降低了根生物量,降幅分别为61.4%、74.3%、78.6%。与CK、20%遮荫、40%遮荫和80%遮荫处理相比,60%遮荫显著提高了根中磷含量,增幅分别为245.7%、65.9%、40.5%、10.3%;60%遮荫处理的根中钾和镁含量显著高于其他处理,比CK、20%遮荫、40%遮荫和80%遮荫处理分别高102.9%、131.7%、57.0%、63.3%和131.3%、55.1%、40.4%、7.7%。本试验条件下,60%遮荫是多伦芍药幼苗生长适宜的光照条件。     

Frequency and distribution per species, biotypes, resistance to antibiotics and beta-lactamase production of the haemophils isolated from patients with respiratory diseases

A number of 150 samples were prelevated from respiratory tract secretions of 88 patients with respiratory infections and three healthy subjects; 162 haemophilus strains were isolated, identified and studied and the following results were obtained: H. parainfluenzae was isolated from tonsillitis and laryngitis--over 70%, bronchitis--58% and pharyngitis--56.6%; H. influenzae was isolated from pharyngitis--26.4%, bronchitis--16.1% and tonsillitis--13.6% cases; H. parahaemolyticus from bronchitis--19.3%, tonsillitis--13.6% and laryngitis. H. paraphrophilus was isolated (6.8%) from pharyngitis, tonsillitis, sinusitis, bronchitis and pulmonary abscess and H. paraphrohaemolyticus was isolated--4.5% from pharyngitis, synusitis, bronchitis and pulmonary sarcoidosis. Most of the isolates belonged to biotype II H. influenzae and biotypes II, I, III H. parainfluenzae. Haemophils were 100% sensitive to Ofloxacin and resistant to Cro--13.5%, Do--17.9%, C and Caz--22.2%, Aml--24.6%, Rd--40.7%, Amp--41.9% and Te--63.5%; varying according to the haemophilus species. H. influenzae was resistant to Do--14.2%, Caz and C--21.4%, H. parainfluenzae was resistant to Cro--11%, Do--22%, whilst H. parahaemolyticus was resistant to Do--9% and to Aml, Caz and Cro--13.6%. Haemophils isolated from sputum showed a resistance higher by 12-34% and 6-17% than those isolated from other specimens, such as pharyngeal exudate, where the resistance to rifadin was lower by 10%. beta-lactamases were present in 27.7% of the strains: H. parainfluenzae--36%, H. paraphrohaemolyticus--25%, H. influenzae--17.8% and H. parahaemolyticus--15.7%; in strains from sputum--34.2%, pharyngeal exudate--28.8% and from other specimens--6.6%. No correlations were noticed between the biotype and the clinical manifestation or the resistance to the antibiotic, a higher frequency of beta-lactamase production being reported in H. influenzae biotype V and H. parainfluenzae biotypes II and IV.     

绿洲灌区典型种植模式的水热利用与碳排放和能值分析

合理的种植模式可以提高资源利用效率,降低农业生产的生态环境风险,实现资源节约和增产增效的目的.本文运用能值分析的理论和方法,从资源利用、碳排放、经济效益、能值自给率和净能值产出率等方面对干旱灌区典型种植模式的生产效应进行综合分析与评价,以期为建立减投、减排、高产高效、可持续农田高效生产模式提供理论与实践依据.结果表明:集成免耕秸秆覆盖还田及地膜再利用的高效间作生产模式(NTSI)具有明显的增产效应,与地方传统间作(CTI)和单作玉米(CTM)相比,分别增产13.5%～16.9%和13.8%～17.1%.NTSI较CTI模式水分利用效率和光能利用率分别提高12.4%～17.2%和6.1%～8.1%.高效NTSI模式可降低系统碳排放、提高碳排放效率,与CTI和CTM相比,碳排放总量分别降低618～895和1804～2002 kg·hm^-2,降低幅度分别为12.1%～16.4%和28.6%～31.0%;相反,碳排放效率分别提高29.3%～40.1%和58.9%～71.4%.高效NTSI模式具有明显的资源减投潜力,与CTI和CTM相比,总投入分别降低1424～1431和501～1547 元·hm^-2,减投比例分别为12.6%～13.6%和4.9%～14.6%;总产值分别提高11.2%～11.8%和24.4%～36.3%(增加4309～4603和8439～11057元·hm^-2);纯收益分别增加19.6%～22.4%和40.1%～57.7%(增多5740～6027和9544～11558元·hm^-2).因而,NTSI模式具有较高的产投比和单方水效益,与CTI和CTM相比,产投比分别提高27.9%～29.0%和40.5%～45.6%;单方水效益提高幅度分别达到19.9%～23.2%和27.7%～39.3%.高效NTSI模式能值自给率达到57.2%,较CTI和CTM生产模式分别提高4.0%和12.2%,NTSI模式净能值产出率达到0.173,较CTI高10.0%,但比CTM低11.7%.从资源利用、碳减排、经济效益、可持续发展角度综合考虑,集成免耕秸秆覆盖还田及地膜两年利用的高效小麦间作玉米模式具有较高的经济活力,农业系统整体功能较好,运转效率较高,能值回报率较高,是适用于干旱绿洲灌区的资源减投、减排、高产高效的种植模式.     

不同季节鹅喉羚昼间行为时间分配特征

2007 年11 月至2008 年10 月在新疆卡拉麦里山有蹄类野生动物保护区研究了鹅喉羚的昼间行为时间分配,共观察鹅喉羚有效个体1 917 只,采集行为数据时间319.5 h,将鹅喉羚的昼间行为分为采食、移动、警戒、休息和“其它”5 类。结果表明:春季雌性5 种行为分配时间所占比例分别为67.5%、2.5%、2.7%、25.9%、1.4%,雄性分别为63.5%、3.4%、4.3%、27.5%、1.3%; 夏季,雌性:43.7%、7.7%、5.6%、42.1%、1.0%; 雄性:51.9%、1.7%、3.1%、41.4%、1.9%; 秋季,雌性:66.3%、5.1%、4.3%、23.6%、0.7%;雄性:68.9%、6.0%、4.2%、20.7%、0.3%;冬季,雌性:68.0%、5.0%、7.0%、19.6%、0.4%;雄性:29.6%、20.6%、19.2%、29.3%、1.3%。采用卡方检验、秩和检验、方差分析比较同季节不同性别各自行为时间分配、同季节雌雄间行为时间分配、同性别不同季节的行为时间分配。结果表明:四季中雌雄各自5 种行为的时间分配均存在显著差异(P>0.05);比较两性间行为时间分配发现,在春夏季,雌雄间各行为时间分配无差异(P>0.05),秋季移动差异显著(P < 0. 05),而冬季5 种行为间均差异显著(P<0.05);季节因素对雌雄行为时间分配的影响显著。鹅喉羚以特定的行为时间分配模式适应季节更替或变化的生理周期,如温度、性别、水分状况、繁殖期、哺乳期等,满足能量及营养需求。     

Ethanol tolerances of Drosophila melanogaster populations selected on different concentrations of ethanol supplemented media

Summary Eight recently collected Australasian populations of D. melanogaster were each divided into eight selection lines. Two of these lines from each population were maintained on one of four types of selection media: standard food supplemented with 0%, 3%, 6% and 9% ethanol. After 30 generations the selection lines were tested for tolerance to 9% ethanol medium and after another 20 generations adults were tested for tolerance to concentrated ethanol fumes. Significant differences in tolerance were found among lines selected on different media which were consistent across the eight populations. On the 9% test media, the 6% and 9% selection lines, as compared with the control lines selected on 0% ethanol, were more likely to survive as pre-adults or adults, faster to develop as preadults, and heavier and more productive as adults. However, the tolerance of the 3% lines to the 9% test media was less than that of the 0% control lines in preadult and adult survival, intermediate between that of the 0% and the 6% and 9% lines in productivities, and apparently superior to the 6% and 9% lines in development times and adult weights. The 3%, 6% and 9% lines showed similar tolerances to the ethanol vapour. Previous work showed that 3% ethanol can be a metabolic benefit to D. melanogaster but 6% and 9% are metabolic costs. The present results suggest that the phenotype selected on 3% to obtain a metabolic benefit differs in many respects from that selected on 6% and 9% to minimise their detrimental effects.     

Regression analysis of recent changes in cardiovascular morbidity and mortality in The Netherlands.

OBJECTIVES: To test whether recent declines in mortality from coronary heart disease were associated with increased mortality from other cardiovascular diseases. DESIGN: Poisson regression analysis of national data on causes of death and hospital discharges. SETTING AND SUBJECTS: Population of the Netherlands, 1969-93. MAIN OUTCOME MEASURES: Annual changes in mortality from coronary heart disease, stroke, and other cardiovascular diseases and annual changes in hospital discharge rates for acute coronary events, stroke, and congestive heart failures. RESULTS: Patterns of cardiovascular mortality changed abruptly in 1987-93. Annual decline in mortality from coronary heart disease increased sharply for women and men: from -1.9% (95% confidence interval -2.2% to -1.6%) and -1.7% (-1.9% to -1.4%) respectively in 1979-86 to -3.1% (-3.5% to -2.6%) and -4.2% (-4.6% to -3.9%) in 1987-93. The longstanding decline in mortality from stroke levelled off: from annual change of -3.3% (-3.7% to -2.8%) and -3.2% (-3.7% to -2.8%) in 1979-86 to -0.1% (-0.7% to 0.4%) and -1.1% (-1.7% to -0.5%) in 1987-93. Mortality from other cardiovascular diseases, however, started to increase: from -2.0% (-2.4% to -1.6%) and -0.2% (-0.5% to 0.2%) in 1979-86 to 1.5% (1.0% to 2.0%) and 1.9% (1.5% to 2.3%) in 1987-93. Hospital discharge rates for acute coronary heart disease, congestive heart failure, and stroke increased during 1980-6. During 1987-93 discharge rates for stroke and coronary heart disease stabilised but rates for congestive heart failure increased. CONCLUSION: Improved management of coronary heart disease seems to have reduced mortality, but some of the gains are lost to deaths from stroke and other cardiovascular diseases. The increasing numbers of patients with coronary heart disease who survive will increase demands on health services for long term care.     

Reduced oxygen tension increases atrial natriuretic peptide release from atrial cardiocytes

To test the hypothesis that reduced oxygen tension stimulates cardiac atrial natriuretic peptide (ANP) secretion, we measured ANP release and expression in neonatal rat atrial and ventricular cardiac myocytes exposed to 45 min and 3, 6, and 24 hr of 3% or 21% oxygen. In atrial cardiocytes, the percentage of increase in culture media ANP concentration from baseline was greater in cells exposed to 3% than in cells exposed to 21% oxygen after 3 hr (814% +/- 52% vs. 567% +/- 33%, P < 0.05) and 6 hr of exposure (1639% +/- 91% vs. 1155% +/- 73%, P < 0.05). No differences in the percentage of increase in culture media ANP concentration was seen at 45 min (284% +/- 27% vs. 201% +/- 16%, P = NS) or 24 hr (2499% +/- 250% vs. 2426% +/- 195%). There was a significant increase in cellular ANP content between 3 and 24 hr in atrial cardiocytes exposed to 21% oxygen (105% +/- 40% vs. 296% +/- 60%, P < 0.05), but not in atrial cardiocytes exposed to 3% oxygen (118% +/- 20% vs. 180% +/- 26%, P = NS). Steady-state ANP mRNA levels in atrial cardiocytes were not affected by oxygen tension. In ventricular cardiocytes, oxygen tension did not affect ANP secretion, cellular ANP content, or steady-state ANP mRNA levels. We conclude that reduced oxygen tension increases release of ANP from atrial, but not ventricular cardiocytes and that this mechanism may contribute to the elevation in plasma ANP seen during acute hypoxia.     

Comparison of methods to identify individuals at increased risk of coronary disease from the general population

Objectives To evaluate the guidelines on measurement of cholesterol in the national service framework for coronary heart disease and to compare alternative strategies for identifying people at high risk of coronary disease in the general population.Design Comparison of methods (national service framework criteria, Sheffield tables, age threshold of 50 years, estimated risk assessment using fixed cholesterol values) for identifying people with a 10 year coronary event risk of 15% or greater.Setting Health survey for England 1998.Subjects 6307 people aged between 30 and 74 years with no history of myocardial infarction, stroke, or angina.Main outcome measures Proportion of the total population selected for measurement of cholesterol and proportion of people at 15% or greater risk identified.Results The national service framework guidelines selected 43.4% (95% confidence interval 42.2% to 44.6%) of the study population for cholesterol measurement and identified 81.2% (80.2% to 82.2%) of those at 15% or greater risk. The Sheffield tables selected 73.1% (72.0% to 74.2%) for cholesterol measurement and identified 99.91% (99.83% to 99.99%) of those at 15% or greater risk. An age threshold of 50 years selected 46.3% (45.1% to 47.5%) for cholesterol measurement and identified 92.8% (92.1% to 93.4%) of those at 15% or greater risk. Estimated risk assessments using fixed cholesterol values selected 17.8% (16.8% to 18.7%) for cholesterol measurement and identified 75.9% (74.8% to 76.9%) of those at 15% or greater risk.Conclusion Measuring the cholesterol concentration of everyone aged 50 years and over is a simple and efficient method of identifying people at high risk of coronary disease in the general population.     

Synaptosomal Calcium Metabolism During Hypoxia and 3,4-Diaminopyridine Treatment

A decline in the calcium-dependent release of neurotransmitters appears to underlie the decreased neuronal function that accompanies reduced oxygen tensions (hypoxia). To determine if alterations in calcium uptake are primary to these changes, synaptosomal calcium uptake was measured in the presence of 100%, 2.5%, or 0% oxygen. Calcium uptake declined 60.2 +/- 0.1 and 82.4 +/- 2.5% with 2.5% and 0% when compared with 100% oxygen, respectively. 3,4-Diaminopyridine stimulated calcium uptake by synaptosomes when they were incubated in low-potassium media. It also diminished the hypoxic-induced decline in calcium uptake to 30.6 +/- 3.1 and 33.5 +/- 3.1% with 2.5% and 0% oxygen, respectively. External binding to the synaptosomal plasma membrane declined to 29.2 +/- 0.3 or 11.8 +/- 0.9% when the oxygen tension was reduced to 2.5% or 0% oxygen. 3,4-Diaminopyridine increased this superficial binding from 111.7 +/- 0.3 to 86.5 +/- 0.9 or 23.4 +/- 0.9% with 100%, 2.5%, or 0% oxygen when compared with 100% oxygen without 3,4-diaminopyridine, respectively. Thus, the decline in neuronal processing that accompanies acute hypoxia may be due to altered calcium homeostasis, which diminishes neurotransmitter release.     

Response of piglets to the standardized ileal digestible isoleucine,histidine and leucine supply in cereal–soybean meal-based diets

Improving the amino acid (AA) profile of the diet by using l-Lys, l-Thr, dl-Met, l-Trp and l-Val helps to reduce the dietary CP content, thereby reducing nitrogen excretion while maintaining the performance of pigs. Valine is the fifth limiting AA in cereal–soybean meal-based diets. The extent to which the CP content in the diet can be reduced further without compromising performance depends on the requirement of the next limiting AA. In cereal–soybean meal-based diets, Ile, His and Leu may be the limiting AAs after Val, although information on the requirements for these AAs is scarce. Six experiments were conducted to determine the effect of supplementing a low-CP diet with l-Ile, l-His and l-Leu on the performance of pigs weighing 10 to 20 kg. Experiment 1 was designed to determine the most limiting AA with respect to performance among Ile, His and Leu. A diet 10% deficient in Ile, Leu and His relative to the National Research Council (NRC, 1998) requirement estimates tended to decrease daily feed intake and daily gain by 6% and 8%, respectively. A 10% deficiency in His alone had no effect, whereas a 10% deficiency in Ile or Leu slightly reduced daily feed intake and gain. In the remaining experiments, the standardized ileal digestible (SID) Ile : Lys, His : Lys and Leu : Lys requirements were estimated. In Experiments 2, 3, 4, 5 and 6, 14 blocks of six pigs each were assigned to six levels of SID Ile : Lys (40%, 43%, 46%, 49%, 52% and 55%), His : Lys (20%, 24%, 28%, 32%, 36% and 40%), His : Lys (21%, 24%, 27%, 30%, 33% and 36%), Leu : Lys (70%, 78%, 86%, 94%, 102% and 110%) and Leu : Lys (80%, 90%, 100%, 110%, 120% and 130%), respectively. Across experiments, the estimated SID Ile : Lys, His : Lys and Leu : Lys requirements for maximizing daily gain were 49%, 32% and 102%, respectively, using a curvilinear plateau model. When Ile, His and Leu levels were 10% below the requirement estimate, daily gain was reduced by 9%, 3% and 3%, respectively. The results of this study indicate that the Ile requirement estimate is lower than the current NRC requirement estimate, whereas the Leu and His requirements correspond to those proposed by the NRC.     

General practitioners' views about the statutory annual practice report.

OBJECTIVE--To ascertain the views of primary care professionals about the current purpose, uses, potential, and workload implications of the statutory general practice annual report. DESIGN--Postal questionnaire survey. SETTING--General practices in the Northern region. SUBJECTS--All practices in the region that were singlehanded, fundholding, non-fundholding and with more than five partners, and a one in three random sample of all non-fundholding practices (n = 318). RESULTS--263 practices responded (83%). The report took a median of 12 hours to produce (95% confidence interval 11 to 15 hours; interquartile range 7-35). The main perceived purpose of the report was to monitor practice activity (165 respondents; 63% (95% confidence interval 57% to 69%)), but 44 respondents (17%; 13% to 22%) produced it only because it was contractually required. Practices included statutory and non-statutory data in these reports and would have liked comparative practice activity information (155 respondents; 59%) and "good ideas" (165 respondents; 63%) fed back to them. Respondents would have liked the annual report used to improve practice development planning (122 respondents; 46% (40% to 52%)), to facilitate audit (115 respondents; 44% (38% to 50%)), and to influence resource allocation (104 respondents; 40% (34% to 46%)). One hundred and eighteen practices (45%; 39% to 51%) would produce an annual report even if not contractually required. Data collected were perceived to be already available elsewhere. CONCLUSIONS--Primary care professionals have concerns about the current annual report. They would prefer to collect relevant, standardised data which could lead to better audit, planning, and resource allocation.     

Lymphocyte subset analyses in healthy adults vaccinated with yellow fever 17DD virus

In this study the kinetics of humoral and cellular immune responses in first-time vaccinees and re-vaccinees with the yellow fever 17DD vaccine virus was analyzed. Flow cytometric analyses were used to determine percentual values of T and B cells in parallel to the yellow fever neutralizing antibody production. All lymphocyte subsets analyzed were augmented around the 30th post vaccination day, both for first-time vaccinees and re-vaccinees. CD3+ T cells increased from 30.8% (SE +/- 4%) to 61.15% (SE +/- 4.2%), CD4+ T cells from 22.4% (SE +/- 3.6%) to 39.17% (SE +/- 2%) with 43% of these cells corresponding to CD4+CD45RO+ T cells, CD8+ T cells from 15.2% (SE +/- 2.9%) to 27% (SE +/- 3%) with 70% corresponding to CD8+CD45RO+ T cells in first-time vaccinees. In re-vaccinees, the CD3+ T cells increased from 50.7% (SE +/- 3%) to 80% (SE +/- 2.3%), CD4+ T cells from 24.9% (SE +/- 1.4%) to 40% (SE +/- 3%) presenting a percentage of 95% CD4+CD45RO+ T cells, CD8+ T cells from 19.7% (SE +/- 1.8%) to 25% (SE +/- 2%). Among CD8+CD38+ T cells there could be observed an increase from 15 to 41.6% in first-time vaccinees and 20.7 to 62.6% in re-vaccinees. Regarding neutralizing antibodies, the re-vaccinees presented high titers even before re-vaccination. The levels of neutralizing antibodies of first-time vaccinees were similar to those presented by re-vaccinees at day 30 after vaccination, indicating the success of primary vaccination. Our data provide a basis for further studies on immunological behavior of the YF 17DD vaccine.