综合干预对原发性骨质疏松治疗依从性及生活质量的影响

目的:探讨骨质疏松防治综合干预对特需门诊原发性骨质疏松(POP)患者治疗依从性及生活质量的影响。方法:以2010年5月~2013年5月期间四川大学华西医院国际医疗中心收治的112例POP患者为研究对象,分为干预组和对照组,在药物治疗的同时给予不同的护理措施,6个月后比较两组干预前后POP知识掌握程度(OKT评分)、疼痛(VAS评分)、骨密度(BMD)以及生活质量(OQOLS评分)改善情况;随访1年后评价两组治疗依从性以及骨折发生率。结果:经过6个月的干预,干预组OKT评分、VAS评分以及BMD和治疗前比较差异均有统计学意义(P0.001),和对照组比较差异也均有统计学意义(P0.001)。干预组OQOLS评分的5个维度以及生活质量总评分和干预前比较差异均有统计学意义(P0.001),和对照组比较差异也均有统计学意义(P0.001),对照组心理维度和社会维度和干预前比较差异不大(P0.05)。两组随访1年,干预组完全依存比例明显高于对照组,不依从比例低于对照组(P0.001);干预组病理性骨折发生率低于对照组(P0.05)。结论:对特需门诊收治的原发性骨质疏松患者在药物治疗的基础上实施综合护理干预,能够明显提高患者的治疗依从性,提高骨密度增加比例,减少疼痛,降低骨折发生率,改善患者生活质量。     

Genetic relationship between Mongolian and Norwegian horses?

Human populations of Central Asian origin have contributed genetic material to northern European populations. It is likely that migrating humans carried livestock to ensure food and ease transportation. Thus, eastern genes could also have dispersed to northern European livestock populations. Using microsatellite data, we here report that the essentially different genetic distances DA and (deltamu)2 and their corresponding phylogenetic trees show close associations between the Mongolian native horse and northern European horse breeds. The genetic distances between the northern European breeds and Standardbred/Thoroughbred, representing a southern-derived source of horses, were notably larger. We suggest that contribution of genetic material from eastern horses to northern European populations is likely to have occurred.     

The effect of aortic valve replacement on quality of life in symptomatic patients with severe aortic stenosis

Background

Although symptomatic patients with severe aortic stenosis have a high disease burden and guidelines recommend aortic valve replacement, many are treated conservatively. This study describes to what extent quality of life is changed by aortic valve replacement relative to conservative treatment.

Methods

This observational study followed 132 symptomatic patients with severe aortic stenosis who were subjected to an SF-36v2TM Health Survey.

Results

At baseline 84 patients were treated conservatively, 48 were referred for aortic valve replacement. In the conservatively treated group 15 patients died during a mean follow-up of 18 months (Kaplan-Meier survival was 85 % and 72 % at one and 2 years respectively) and 22 patients crossed over to the surgical group. Of the resulting 70 patients in the surgical group 3 patients died during a mean follow-up of 11 months (survival 95 % at 1 year). Physical functioning, vitality and general health improved significantly 1 year after aortic valve replacement. In conservatively treated patients physical quality of life deteriorated over time while general health, vitality and social functioning showed a declining trend. Mental health remained stable in both groups.

Conclusions

Aortic valve replacement improves physical quality of life, general health and vitality in patients with symptomatic severe aortic stenosis. Besides having a low life expectancy, conservatively treated patients experience deterioration of physical quality of life. Health surveys such as the SF-36v2TM can be valuable tools in monitoring the burden of disease for an individual patient and offer additional help in treatment decisions.     

Induction of diapause and seasonal morphs in butterflies and other insects: knowns,unknowns and the challenge of integration

The ‘choice’ of whether to enter diapause or to develop directly has profound effects on the life histories of insects, and may thus have cascading consequences such as seasonal morphs and other less obvious forms of seasonal plasticity. Present knowledge of the control of diapause and seasonal morphs at the physiological and molecular levels is briefly reviewed. Examples, mainly derived from personal research (primarily on butterflies), are given as a starting point with the aim of outlining areas of research that are still poorly understood. These include: the role of the direction of change in photoperiod; the role of factors such as temperature and diet in modifying the photoperiodic responses; and the role of sex, parental effects and sex linkage on photoperiodic control. More generally, there is still a limited understanding of how external cues and physiological pathways regulating various traits are interconnected via gene action to form a co‐adapted complete phenotype that is adaptive in the wild despite environmental fluctuation and change.     

Agistemus exsertus Gonzalez (Acari: Stigmaeidae) as a predator of two scale insects of the family Diaspididae (Homoptera: Diaspididae)

Abstract

The predacious mite Agistemus exsertus Gonzalez completed its life-span when fed on eggs and crawlers of the Florida red scale Chrysomphalus ficus Ashmead and the white date scale Parlatoria blanchardi (Targioni). The development was faster when individuals were maintained on eggs and crawlers of C. ficus, compared with both stages of P. blanchardi. The average number of eggs/female/day was 2.5 and 1.1 on eggs and crawlers of C. ficus, respectively. Eggs and crawlers of P. blanchardi were an unsuitable food for egg laying for A. exsertus. Life table parameters showed that A. exsertus preferred eggs of C. ficus to the crawlers as prey. The population of the predator feeding on eggs and crawlers of Florida red scale multiplied 45 and 7 times in a generation time of 23 and 20.5 days, respectively. Under these conditions, the intrinsic rate of increase (r _m) was (0.17 and 0.098) individuals/female/day on eggs and crawlers of C. ficus, while the finite rate of increase (λ) was (1.18 and 1.11) on both stages of C. ficus.     

Nightmares, life stress, and anxiety: An examination of tension reduction.

Do nightmares increase or decrease anxiety? Theoretical views of nightmares suggest that nightmares play out stressful events, decathecting their energy. A more pragmatic view suggests that nightmares that result in waking distress add to the burden of anxiety. The current study investigates whether negative life events are associated with an increase or decrease in anxiety attributable to nightmares in 624 adolescents aged between 12 and 19. The results indicate no support for a tension reduction hypothesis. There seems no relief from anxiety if a person reports nightmares, and the stronger the distress of waking (from nightmares), the more likely a person is to report anxiety, controlling for life events and the distress associated with life events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Abiotic influences on embryo growth: statoliths as experimental tools in the squid early life history

Statolith size and growth was used to determine the influence of abiotic factors on the growth of Loligo vulgaris and Sepioteuthis australis embryos. Recently spawned egg masses collected from the field were incubated in the laboratory under different levels of light intensity, photoperiod, or short periods of low salinity (30‰). Double tetracycline staining was used to follow statolith growth. In L. vulgaris constant light conditions produced significantly slower growth in the embryonic statoliths and embryos held at summer photoperiod had slower statolith growth than those held at winter photoperiods. However once they hatched out there was no evidence that photoperiod affected statolith growth. After hatching, in all photoperiods statolith growth rates decreased in comparison with late embryonic rates. In S. australis embryos, differences between the high and medium light intensities for summer and intermediate photoperiods were found, suggesting that under summer incubation temperature, longer daylengths at medium light intensity favoured higher statolith growth for this species. In comparison to controls, slower statolith growth in S. australis embryos due to low salinity only occurred when exposed for 72 h. Comparison with previous studies indicates that temperature seems to be the main abiotic factor influencing statolith growth during early stages, however, interactions among all abiotic factors needs to be determined as well as the unknown influence of other isolated factors, e.g., oxygen concentration within the egg mass.     

Using the composite variables of reproductive morphology, histology and steroid hormones to determine age and size at sexual maturity for the thorny skate Amblyraja radiata in the western Gulf of Maine

Age at size was linked to sexual maturity in 77 male and 93 female thorny skates Amblyraja radiata from the western Gulf of Maine using three criteria: 1) gross reproductive morphology, 2) histology and 3) steroid hormone concentrations. Age-bias plots and the coefficient of variation from vertebral band counts suggested that the ageing method represented a non-biased and precise approach to the age assessment of A. radiata . Maturity ogives for males, based on data gathered for clasper length, circulating testosterone concentrations and proportion of mature spermatocysts within the testes, predicted that 50% maturity occurred at a total length ( L _T) of 865 mm and c. 10·90 years of age. For females, maturity ogives, based on data gathered for ovary mass, shell gland mass, follicle size and circulating oestradiol concentrations, predicted that 50% maturity occurred at 875 mm L _T and c. 11·00 years of age. Collectively, the results suggest that analysis of several contemporaneous reproductive variables offers an accurate determination of sexual maturity in the thorny skate.     

Holocene vegetation history of the Sahel: pollen, sedimentological and geochemical data from Jikariya Lake, north-eastern Nigeria

Aim This study aims to separate regional and local controls on Holocene vegetation development and examine how well pollen records reflect climate change in a semi‐arid region. The relative importance of climate and human activity as agents of vegetation change in the Sahel during the late Holocene is also considered. Location Jikariya Lake, an inter‐dune depression in the Manga Grasslands of north‐eastern Nigeria. Methods Pollen and charcoal were used to provide a record of Holocene vegetation history. Palaeoclimate and hydrological changes were reconstructed from sedimentary and geochemical data. Regional and local influences were separated by comparing the evidence obtained from Jikariya Lake with previously published data from the Manga Grasslands. Results The Manga Grasslands experienced a prolonged wet period during the early and mid‐Holocene, during which swamp forest vegetation with Guinean affinities (Alchornea, Syzygium, Uapaca) occupied the inter‐dune depressions. However, variation in the pollen records between sites suggests that their establishment was dependent on conditions being locally favourable, rather than being directly coupled to regional climate. The pollen records from the Manga Grasslands are more consistent in suggesting the colonization of the dunefields by trees associated with Sudanian savanna (Combretaceae, Detarium) c. 8700 cal. yr bp . The Jikariya Lake pollen data are in accordance with the sedimentological and geochemical data from the region in indicating that the onset of arid conditions occurred progressively during the late Holocene (from c. 4700 cal. yr bp ). Abrupt changes in pollen stratigraphy, recorded at other Manga Grasslands sites 3500 cal. yr bp , appear to be the product of the local passing of ecological thresholds. The dunefield vegetation (Sahelian savanna) appears to have been resilient to (or at least palynologically silent regarding) to the climatic variability of the late Holocene. Main conclusions While climate appears to have been the primary control on vegetation development in the Manga Grasslands during the Holocene, local conditions (particularly depression size and sand influx) had a strong influence on the timing of pollen stratigraphic changes. Anthropogenic influences are difficult to detect, even during the late Holocene.     

Evolved psychology in a novel environment

The human “environment of evolutionary adaptedness” can only be inferred indirectly. In contrast, the behavior of some nonhuman animals can be compared among “natural” and various altered environments. As an example, male immigration tactics in unprovisioned versus provisioned macaque (Macaca) populations are compared using Tooby and Cosmides’s (1992) framework for evolutionary functional analysis. In unprovisioned populations, social groups contain few males, and immigrant male takeovers of alpha rank occur frequently. In provisioned populations, groups contain many males, and males almost invariably enter social groups at very low rank and rise in rank only as more dominant males emigrate or die. Male conformity to the “seniority rule” is hypothesized to represent the behavioral output of an evolved decision-making algorithm (psychological mechanism) that takes into account (1) the net payoff of each rank in the dominance hierarchy and (2) the power of male group size as a predictor of the likelihood of successful immigrant takeover. Joseph H. Manson is Assistant Professor of Anthropology at the University of California, Los Angeles. His research interests are social relationships in nonhuman primates and humans, with particular emphases on mate choice, courtship tactics, intrasexual competition, and (currently) mother-infant relationships and infant handling. He has conducted fieldwork on rhesus macaques at Cayo Santiago and white-faced capuchins in Costa Rica.