Different Risk of Tuberculosis and Efficacy of Isoniazid Prophylaxis in Rheumatoid Arthritis Patients with Biologic Therapy: A Nationwide Retrospective Cohort Study in Taiwan

Increasing evidence indicates an increased risk of tuberculosis (TB) for rheumatoid arthritis (RA) patients receiving biologic therapy, and the effectiveness of isoniazid prophylaxis (INHP) in TB prevention. We aimed to examine 1) the incidence rate (IR) and risk factors for TB among RA patients receiving different therapies; 2) INHP effectiveness for TB prevention; 3) mortality rates after TB diagnosis in patients receiving different therapies. This retrospective study was conducted using a nationwide database: 168,720 non-RA subjects and a total of 42,180 RA patients including 36,162 csDMARDs-exposed, 3,577 etanercept-exposed, 1,678 adalimumab-exposed and 763 rituximab-exposed patients. TB risk was 2.7-fold higher in RA cohort compared with non-RA group, with an adjusted hazard ratio (aHR) of 2.58. Advanced age, male, the use of corticosteroids≧5mg/day, and the presence of diabetes mellitus (DM), chronic obstructive pulmonary disease and chronic kidney disease were risk factors for developing TB. Using csDMARDs-exposed group as reference, aHR of TB was the highest with adalimumab treatment (1.52), followed by etanercept (1.16), and the lowest with rituximab (0.08). INHP could effectively reduce TB risk in biologics-exposed patients. Mortality rates after TB diagnosis were higher in RA patients, particularly the elderly and those with DM, with lower rates in adalimumab-exposed patients compared with csDMARDs-exposed patients. In conclusion, TB risk was increased in patients receiving TNF-α inhibitors, but the risk associated with rituximab therapy was relatively low. With the effectiveness of INHP shown in the prevention of biologics-associated TB, stricter implementation of INHP should be beneficial. The mortality from biologics–associated TB may be efficiently reduced through increased awareness.     

心房钠尿因子对麻醉家兔局部血流的影响

在42只麻醉家兔,观察了静脉注射心房肽Ⅱ(AtriopeptinⅡ,APⅡ)对局部血流量以及动脉内注射 AP Ⅱ 对局部血管阻力的影响。结果如下:(1)静脉注射 APⅡ(30μg/kg)5min后,平均动脉压(MAP)降低11.0±1.5mmHg(n=8,M±SE,下同),与溶剂对照组相比有明显差异(P相似文献   

取食雄蜂蛹粉对龟纹瓢虫和异色瓢虫卵黄发生的影响

本文比较了龟纹瓢虫Proylea japonica和异色瓢虫Harmonia axyridis取食蚜虫和取食雄蜂蛹粉时的卵黄发生情况.当取食雄蜂蛹粉时,体内卵黄蛋白出现迟,积累速度慢,产卵前期长.但用保幼激素类似物ZR512点滴处理后则能达到与食蚜对照相当的水平.ZR512对取食雄蜂蛹粉瓢虫的作用显著大于取食岈虫者.进一步的研究表明,ZR512能促进这两种瓢虫取食雄蜂蛹粉,但对成虫的体重没有明显的影响.因此推论,雄蜂蛹粉基本能够满足这两种瓢虫生殖的营养需要,但对其内分泌有一定的影响,使瓢虫处于类似生殖滞育的状态.本文根据不同食物条件对卵黄蛋白发生的影响不同,建议用卵黄蛋白的量作为生理指标,以快速初步筛选和评估人工饲料.     

云南栉眼蚤属一新种：蚤目：多毛蚤科

本文记述了从滇西北边陲担打力卡山脉采获的栉眼蚤属一新种——解氏栉眼蚤Ctenophthalmus(Sinoctenophthalmux)xiei。本新种与端凹栉眼蚤Ctenophthalmus(S.)parcus Jordan,1932近缘,但可根据其下唇须,可动突、第九腹板和阳茎端侧叶以及第七腹板后缘的形态等特征与后者区分。     

小地老虎及粘虫幼虫对灭幼脲表现自然耐药力的体壁结构和生化基础

小地老虎Agrotis ypsilon rottem.幼虫对灭幼脲具有一定的自然耐药力。本文以粘虫Mythimna separata(Walker)作为敏感性虫种与之进行比较,实验结果表明,灭幼脲对两种试虫的室内毒力相差4倍左右,引起差异的原因,在体壁结构方面主要在于:(1)小地老虎幼虫的表皮层较粘虫的厚4.2倍左右;(2)上表皮不是匀质结构,依靠少数蜡道与体表沟通;(3)几丁质片层内的孔道数较少,仅及粘虫的1/4。由此构成了表皮对疏水性的灭幼脲表现抗穿透的性能。小地老虎幼虫体壁还含有较强的生化防卫体系,灭幼脲对多功能氧化酶、芳基酰胺酶有明显激活效应,这两种酶都是灭幼脲的降解酶。由此认为,小地老虎幼虫对灭幼脲所表现的自然耐药力,是由体壁的抗穿透性能以及由灭幼脲所激活的适应酶所造成。     

小麦幼苗根系镉螯合素

从经Cd~(2+)处理的小麦幼苗根系中分离得到一种镉结合复合物(Cd-BC)。通过SephadexG75,DEAE-52柱层析纯化,鉴定了此复合物性质:(1)紫外吸收光谱在255～265 tim间有一个“肩”,A_(250)/A_(280)>1;(2)在Sephadex G75柱层析上的表观分子量约为10kD,但在SDS-聚丙烯酰胺凝胶电泳上呈现的条带紧接着前沿,分子量非常小;(3)氨基酸组分分析,约90％的氨基酸残基为Glu/Gln,Cys和Gly,三者比例约为4:4:1。结果说明小麦幼苗根系Cd-BC是寡聚肽,是植物镉螯合素(Cd-PCs)的聚合体。     

氧自由基对大鼠心肌α1肾上腺素受体及其亚型的影响

采用放射配体结合方法观察外源性氧自由基对大鼠心肌α_１肾上腺素受体（α_１受体）及其亚型α_（１Ａ）与α_（１Ｂ）的影响和对β肾上腺素受体（β受体）的影响。发现：（１）·ＯＨ,使α_１受体与~（１２５）ＩＢＥ２２５４最大结合量（Ｂ_（ｍａｘ））分别下降５５％与３６％。（２）·ＯＨ可使α_１受体与~（１２５）ＩＢＥ２２５４结合的Ｋ_ｄ值增高１７１％,而对Ｋ_ｄ值无影响。（３）·ＯＨ,均使α_１受体亚型α_（１Ａ）与α_（１Ｂ）之间的比例增加。（４）·ＯＨ,对β受体与~（１２５）ＩＰＩＮ最大结合量Ｂ_（ｍａｘ）和Ｋ_ｄ值均无影响。（５）氧自由基清除剂甘露醇或超氧化物歧化酶均可对抗氧自由基引起α_１受体及其亚型的改变。上述结果提示,氧自由基可直接作用于心肌膜,引起α_１受体数量和亲和性下降,α_１受体亚型α_（１Ａ）与α_（１Ｂ）之间的比例改变。     

肝再生的调控及原癌基因表达

肝脏再生过程中受到多种体液因素的调控。肝细胞生长因子（ＨＧＦ）、肝刺激因子（ＨＳＳ）等对肝细胞有促分裂作用;转化生长因子β１（ＴＧＦβ１）等则具有抑制作用。此外,肝再生还需要去甲肾上腺素（ＮＥ）、胰岛素等辅助分裂原的存在,共同调节肝再生。肝细胞分裂增殖与原癌基因表达密切相关。肝细胞从静息期进入细胞周期,以及在整个细胞周期中,某些原癌基因有特征性的表达。     

从玉米胚中大量制备植物钙调素

从每公斤萌发２４ｈ的玉米胚丙酮粉中可提纯得６３ｍｇ的钙调素（ＣａＭ）,这是目前从每公斤植物材料中所提纯得ＣａＭ的最高记录。对其理化性质的研究表明,玉米胚ＣａＭ 有较高的生物学活性,能较好地激活磷酸二酯酶,其紫色吸收光谱,ＳＤＳ－ＰＡＧＥ电泳行为及氨基酸组成与其它的植物ＣａＭ相似。上述结果表明玉米胚是１个提取植物ＣａＭ相似。上述结果表明玉米胚是１个提取植物ＣａＭ的适宜材料。