Escala de Percepción de Reforzamiento Medioambiental (EROS): evidencias de validez en una muestra colombiana

Introducción: El objetivo de esta investigación fue confirmar la estructura interna de la Environmental Reward Observation Scale (EROS) y recoger evidencias de su relación con otros constructos en una muestra colombiana de 902 adultos que consintieron participar voluntariamente. Método: Se realizaron análisis psicométricos con Teoría Clásica de los Test y el modelo de Rasch. Se recolectaron evidencias de validez de la estructura interna y de la relación de las puntuaciones con otras variables. Resultados: Se obtuvieron buenos índices en los coeficientes alfa y omega de McDonald, nueve de los 10 ítems tuvieron buenos ajustes en los índices infit y outfit, y el ítem ocho presentó DIF en el nivel educativo. Se confirmó la estructura unidimensional de la EROS y fue invariante respecto al sexo y nivel educativo. Los puntajes tuvieron correlaciones de magnitud alta con sintomatología emocional y variables afines a la Activación Conductual. Conclusiones: La EROS presentó altas calidades psicométricas para su uso en población colombiana; sin embargo, se recomienda su uso solo para evaluación de tamizaje, porque los niveles de información están centrados en un área reducida a lo largo de la métrica logit.

Introduction: The aim of this research was to confirm the internal structure of the Environmental Reward Observation Scale (EROS) and to collect evidence of its relationship with other constructs in a Colombian sample of 902 adults who voluntarily consented to participate. Method: Psychometric analyses were performed using Classical Test Theory and the Rasch model. Evidence of validity based on internal structure and relations of scores with other variables was collected. Results: Good indexes were obtained in McDonald's Alpha and Omega coefficients, 9 of the 10 items had good adjustments in the Infit and Outfit indexes, and item 8 presented DIF in the educational level. The unidimensional structure of the EROS was confirmed and was invariant with respect to sex and educational level. Scores had high magnitude correlations with emotional symptomatology and variables related to Behavioral Activation. Conclusions: The EROS presented high psychometric qualities for its use in the Colombian population; however, its use is recommended only for screening assessment because the levels of information are centered in a reduced area along the Logit scaling.

Differential item functioning analysis of the Bar-On Emotional Quotient Inventory (EQ-i) across gender and age groups: an iterative hybrid ordinal logistic regression / Funcionamiento diferencial de los ítems del Inventario de Cociente Emocional de Bar-On (EQ-i): una regresión logística ordinal híbrida iterativa

Abstract There has been a heated debate on emotional intelligence (EI) and, more particularly, on the Bar-On Emotional Quotient Inventory (EQ-i) measuring all dimensions of emotional intelligence. To ensure measurement equivalence of EQ-i, the present article evaluated whether statements phrased in EQ-i questionnaire have equivalent meaning across respondents, regardless of their sex and age group membership. For 2,078 participants, three EI subscale (item 50 in reality testing, items 4 and 19 in stress tolerance, and items 7, 52, and 82 in interpersonal) for age groups had clinically significant Differential item functioning (DIF). So previous observed associations between EI and age might be misleading and deserve further study after removing or replacing DIF items.

Resumen En medio del acalorado debate sobre la Inteligencia Emocional, este estudio retoma el Inventario de Cociente Emocional Bar-On (EQ-i), que mide todas las dimensiones de este constructo psicológico. Con el fin de comprobar la equivalencia de medición de EQ-i, se comprueba si las declaraciones formuladas en el cuestionario EQ-i tienen un significado equivalente entre los encuestados, independientemente de su sexo y grupo de edad. Se aplicó a los 2078 participantes las tres subescalas de IE. Se halló un funcionamiento diferencial de los ítems (DIF) clínicamente significativo. Por lo tanto, las asociaciones observadas anteriormente entre la IE y la edad pueden ser espurias y merecen un estudio adicional después de eliminar o reemplazar los elementos DIF.

Direct immunofluorescence findings in cicatricial alopecia: A retrospective study of 155 cases

Objectives: To study the direct immunofluorescence (DIF) in cicatricial alopecia (CA) patients. Materials and Methods: Approximately, 155 skin biopsies from CA patients examined over 7 years (2009–2015). Special stains and Hematoxylin and Eosin were performed, and final histopathological diagnosis was made. DIF (against anti-IgG, IgM, C3, IgA, and fibrinogen) on all these cases and patterns were noted. The descriptive statistics were applied along with ANOVA test. Results: Approximately, 155 patients with Male: Female = 1.24:1, age 7–65 years. In total, 57 cases were of Lichen planopilaris (LPP; 36.7%), 22 Lichen planus (LP; 14.2%), 22 Psuedopalade of Brocq (PPB; 14.2%),16 discoid lupus erythematosus (DLE; 10.3%), 8 end-stage scarring alopecia (ESSA; 5.2%), 2 cases each of Fungal folliculitis (FF), and Folliculitis decalvans (FD; 1.3% each), and in 26 cases, no specific diagnosis could be reached were collectively kept in the category of non-specific findings (NSP; 16.7%). On DIF: LPP positive for IgG = 4 cases (7%), IgM = 26 (45%), IgA = 11 (19.3%), C3 = 16 (28.1%), and fibrinogen = 11 (19.3%). LP positive for IgG = 2 (9%), IgM = 18 (81%), IgA = 2 (9.1%), C3 = 10 (45%), and fibrinogen = 1 (4.5%). DLE positive for IgG = 6 (37%), IgM = 8 (50%), IgA = 1 (6.3%), C3 = 9 (56%), and fibrinogen = 1 (4.5%). Limitations: Because this was a retrospective study, clinical follow-up and treatment history of the patient could not be retrieved. Conclusions: IgG positivity helps significantly in differentiating LPP from DLE (P 0.004) and NSP from DLE (P 0.005). IgM positivity helps significantly in differentiating LPP from LP (P 0.04), LP from PPB (P 0.00) and NSP (P 0.00). C3 positivity helps significantly in differentiating PPB from DLE (P 0.02).

The alteration of lncRNA expression in peripheral blood mononuclear cells and the effects of anti-anxiety treatment on lncRNA expression of generalized anxiety disorder patients / 中华行为医学与脑科学杂志

Objective To confirm expression alteration of long non-coding RNA( lncRNA) in pe-ripheral blood mononuclear cells (PBMCs) of generalized anxiety disorder( GAD) patients and anti-anxiety treatment effects on aberrant expression of lncRNAs. Methods Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was employed in 80 GAD patients and 40 healthy participants to con-firm 10 aberrant lncRNAs screened by microarray expression profiling. And 26 out of all the 80 GAD patients were recruited for lncRNA expression level testing and Hamilton Anxiety Scale(HAMA) assessments before and after 6 weeks’ treatment. Results Six of ten lncRNAs selected by array profiling (lncRNA4(7. 44± 2. 26),lncRNA5(6. 83±2. 28),lncRNA6(8. 09±2. 30),lncRNA8(9. 10±2. 36),lncRNA9(7. 66±2. 12), lncRNA10(7. 34±2. 12)) were verified by qRT-PCR that the lncRNA expression levels were significantly up regulated in GAD patients compared with healthy controls ( Z=-3. 022--1. 996,P<0. 05 or 0. 01),and lncRNA4(9. 73 ± 2. 53),lncRNA6 ( 9. 91 ± 2. 01), lncRNA8 ( 10. 48 ± 1. 68), lncRNA9 ( 9. 02 ± 1. 58), lncRNA10(9. 04 ± 2. 08) were down regulated significantly after 6 weeks’ anti-anxiety treatment ( Z=-3. 180--2. 530,P<0. 05 or 0. 01) along with signicant reduction of total HAMA score (11. 19±8. 37),di-mension scores of somatic anxiety(5. 31±4. 76),psychic anxiety(5. 88±3. 82) (t=5. 502-5. 971,P<0. 01). The alterations of lncRNA4,lncRNA6,lncRNA8,lncRNA9,lncRNA10 were positively correlated with that of HAMA total score and psychic anxiety score(r=0. 39-0. 69,P<0. 05 or 0. 01),and alteration of lncRNA6, lncRNA8,lncRNA10 had positive correlation with that of somatic anxiety score(r=0. 44-0. 59,P<0. 01). Conclusion The expression level of lncRNA4,lncRNA5,lncRNA6,lncRNA8,lncRNA9,lncRNA10 are up-regulation in PBMCs of GAD patients and anti-anxiety treatment can reverse the expression level of lncRNAs. Alteration of lncRNA expression has osculatory association with improvement of anxious symptom.

Clinical pathology characteristics and prognostic analysis in 23 cases of breast solid papillary carcinoma / 实用医学杂志

Objective To explore the clinical pathological characteristics of breast solid papillary carcino-ma(SPC). Methods The clinical manifestation,pathology morphology,immunohistochemical characteristics and prognosis of 23 cases with SPC was reviewed. Results There were 16 cases with nipple discharge as the chief com-plaint while 7 cases were mass. 10 cases of ultrasonic examination showed 6 cases(60%)were above BI-RADS grade 4 while 8/13 in X-ray examination. In 8 cases of SPC with invasion,5 cases were luminal A and 3 cases were lumi-nal B. There were no significant differences in the mean age,mean diameter of the mass,neuroendocrine markers (CgA and Syn)and proliferation marker Ki67 between in situ SPC group and invasive SPC group(P > 0.05). The difference between P63 and CK5/6 was statistically significant(P = 0.001,P = 0.019). No recurrence was found in 21 patients. Conclusions SPC is a rare type of breast cancer with good prognosis. Imaging and ductosco-py are easy to make under-diagnosis while pathology is likely to make misdiagnosis,therefore clinical pathologists should pay more attention so as to treat it more accurately.

Comparative study of direct and indirect immunofluorescence for diagnosis of canine pemphigus foliaceus / Estudo comparativo da imunofluorescência direta e indireta para o diagnóstico do pênfigo foliáceo canino

Pemphigus foliaceus (PF) is the most common autoimmune skin disease in dogs. It is characterized by pustules, erosions, and crusts which occur due to the presence of autoantibodies that target intercellular adhesion. Histopathological examination is considered the gold standard pattern in the diagnosis, but may sometimes be inconclusive, especially when the characteristic findings are not identified. New diagnostic tests are continuously being developed and immunofluorescence assays, could be a valuable alternative diagnostic tool. This study aimed to evaluate the applicability of direct and indirect immunofluorescence (DIF and IIF) tests for the diagnosis of canine PF. Twenty eight dogs were divided into two groups: Group I with 14 dogs with PF and Group II (control) with 14 dogs with Superficial pyoderma (differential diagnoses of PF). All animals were submitted to skin biopsy to histopathological and DIF. Blood samples were collected to assess IIF. Comparing the DIF results against the histopathology test, there was an agreement of 75% (9/12) with a Kappa index of 0.77 (P<0.001). Considering IIF, the agreement was 100% (14/14), with a Kappa index of 1.0 (P<0.001). We conclude that DIF and IIF are highly effective and were useful and effective complementary examination tests for an improvement in the diagnosis of canine PF.(AU)

O pênfigo foliáceo (PF) é considerado uma das doenças tegumentares autoimunes mais frequentes em cães. Clinicamente, caracteriza-se pela presença de pústulas, erosões e crostas. O exame histopatológico é considerado o teste diagnóstico de eleição, porém pode se mostrar inconclusivo, sobretudo quando os achados característicos da doença não são observados. Novas ferramentas diagnósticas têm sido desenvolvidas e os testes de imunofluorecência são uma valiosa alternativa. Este estudo teve como objetivo avaliar a aplicabilidade das reações de imunofluorescência direta (IFD) e indireta (IFI) para o diagnóstico do PF canino. Vinte e oito cães foram divididos em dois grupos: grupo I com 14 cães com PF e grupo II (controle) com 14 cães com piodermite superficial (um dos principais diagnósticos diferenciais do PF). Todos os animais foram submetidos à biópsia cutânea, seguida de exame histopatológico e IFD. Amostras de sangue foram coletadas para realização da IFI. Comparando-se os valores de IFD com o histopatológico, obtiveram-se valores de concordância de 75% (9/12), com índice Kappa de 0,77 (P<0,001). Já na IFI, a concordância foi de 100% (14/14), com índice Kappa de 1,0 (P<0,001). Concluiu-se, então, que a IFD e a IFI apresentaram excelentes resultados e podem ser consideradas novas alternativas diagnósticas do PF canino.(AU)

Value of ADC in differential diagnosis of parotid pleomorphie adenoma and adenolymphoma / 医疗卫生装备

Objective To evaluate the differential diagnostic value of the apparent diffusion coefficient(ADC)for the parotid polymorphic adenoma and adenolymphoma. Methods Totally 31 parotid polymorphic adenoma patients and 20 adenol-ymphoma patients confirmed pathologically had their data on diffusion weighted imaging(DWI)analyzed retrospectively with b set as (0, 1 000 s/mm2). The mean values of ADC were obtained by measuring the solid parts for three times, and the difference between ADC values of the two kinds of tumors were analyzed and compared.SPSS 17.0 software was used for data analysis.Results The parotid polymorphic adenoma had the ADC value being(1.55±0.45)×10-3mm2/s,the parotid adenolym-phoma had the ADC value as(1.01±0.35)×10-3mm2/s,and there was statistical difference between the ADC values of parotid polymorphic adenoma and adenolymphoma(P=0.001).Conclusion ADC value is of great value for the identification of the parotid pleomorphie adenoma and adenolymphoma,and thus can be used for the selection of clinical surgical plans.

Diagnostic value of magnetic resonance multimode functional imaging in small hepatocellular carcinoma / 新乡医学院学报

Objective To investigate the magnetic resonance multimodal function imaging characteristics of small hepa-tocellular carcinoma and evaluate its diagnostic value in small liver cancer. Methods Thirty-nine patients with small hepato-cellular carcinoma were selected in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2018. The magnetic resonance plain scan data,dynamic enhance data and diffusion imaging data of all patients were analyzed. Results Forty-five lesions were found by plain scan,and 48 lesions(37 lesions were rapid rise and rapid descent type,6 le-sions were flatbed type,3 lesions were slow ascent and rapid descent type,2 lesions were not obvious strengthening type)were found by dynamic enhancement. The lesions were hyperintense or slightly hyperintense on the diffusion weighted imaging (DWI)image. The lesions were hyperintense or slightly hyperintense on the DWI. The main shape of lesions was round,irregu-lar ring and nodositas. The apparent diffusion coefficient(ADC)value of cancer tissue and normal liver tissue gradually de-creased with the increase of b value. Under the same b value,the ADC values of small hepatocellular carcinoma was significant-ly lower than that in the normal liver tissue(P < 0. 05). Conclusion Magnetic resonance multimodality functional imaging (magnetic resonance imaging dynamic enhanced combine with multi-b value DWI)can effectively improve the diagnostic effi-cacy of small hepatocellular carcinoma.

Abordaje fisicoquímico del estado ácido-base en pacientes críticamente enfermos después de la infusión de siete diferentes tipos de soluciones balanceadas / A physicochemical approach to acid-base balance in critically ill patients after infusion of seven different types of balanced fluids / Enfoque físico-químico do estado ácido-básico em pacientes em estado crítico depois da infusão de sete diferentes tipos de soluções balanceadas

Resumen: Introducción: El método simplificado de Fencl-Stewart puede ser empleado a la cabecera del paciente y es más exacto para la evaluación del balance ácido-base. Omron desarrolló un modelo fisicoquímico del cambio en el exceso de base posterior a la infusión de cristaloides con diferencia de iones fuertes (DIF) diferente; sin embargo, fue un trabajo experimental bajo condiciones controladas. Objetivo: Describir el cambio en el estado ácido-base inicial y a las 24 horas en personas críticamente enfermas tras la infusión de siete diferentes tipos de soluciones balanceadas. Material y métodos: Se realizó un estudio retrospectivo, observacional y descriptivo en una terapia intensiva de tercer nivel. Se incluyeron individuos mayores de 18 años de enero de 2015 a julio de 2016. Se evaluaron los efectos en el estado ácido-base a través del modelo fisicoquímico de Fencl-Stewart modificado al inicio y a las 24 horas de la infusión de cristaloides balanceados con DIF de 27 a 154 mEq/L. Se analizaron los gases arteriales a través del gasómetro ABL800 Flex y GEM Premier 3500. El análisis de electrolitos séricos se realizó a través de Architec plus c16,000. El análisis estadístico fue descriptivo a través del programa SPSS v21.0. Resultados: Se incluyeron 198 sujetos. Las soluciones utilizadas con mayor frecuencia fueron Hartmann y H25, en 27.8 y 26.3%, respectivamente. En general, al analizar la totalidad de la población estudiada, todos los parámetros relacionados con acidosis metabólica tuvieron mejoría a las 24 horas. Conclusiones: El uso de soluciones con DIF > 24 mEq/L mejora el estado ácido-base, sin mayor incidencia de hipercloremia a las 24 horas.

Abstract: Introduction: Acid-base status in a body fluid is physically determined by several independent variables. These are: pCO2, the «strong ion difference¼ (SID), all the strong anions (among them is Cl-), and concentrations of nonvolatile weak acids (ATOT). Normal acid-base status is achieved when the independent variables have normal (empirically established) values. The simplified Fencl-Stewart's method can be used at the bedside of the patient and is more accurate in the assessment of acid-base balance. Omron developed a physicochemical model of the projected change in standard base excess (SBE) as a consequence of infused crystalloid solutions of common use (isotonic saline and balanced fluids); unfortunately this was a clinical simulation at standard physiological state. In addition, Kaplan evaluated acid-base balance after the administration of balanced fluids in trauma patients. Nevertheless, to our knowledge, there are no other clinical trials that evaluate the administration of other types of balanced fluids. Objective: To assess the acid-base status of critically ill patients after the infusion of seven different types of balanced solutions. Material and methods: This was a retrospective, observational and descriptive study conducted in an intensive care unit of a tertiary care hospital. We included all patients 18 years and older admitted to this department from January 2015 to July 2016. We evaluated the effects on acid-base balance after the infusion of seven different solutions: 1) Hartmann + 17.8 mEq/L sodium bicarbonate (NaHCO3) (SID 45.8), 2) Hartmann + 8.9 mEq/L NaHCO3 (SID 36.9), 3) Hartmann + 15 mEq/L NaHCO3 (SID 43), 4) Hartmann + 25 mEq/L NaHCO3 (SID 53), 5) Hartmann (SID 28), 6) normal saline 0.45% + 77 mEq/L NaHCO3 (SID 75), and 7) dextrose solution 5% + 154 mEq/L NaHCO3 (SID 154). Arterial blood gases, serum electrolytes, and proteins were measured in the same blood sample. Also SIDa, SEDe, SIG, ATOT, pCO2, change in standard base excess (SBE), pH, [HCO3], [Na]p and SOFA were calculated. pH, SBE and pCO2 were estimated with the ABL8000 FLEX blood gas analyzer. Data are mean ± SD or percents. We used the data analysis package SSPS. Results: One hundred ninety-eight patients were included. Of these, 54% were women and 45% men. The solutions most used were Hartmann (25%), Hartmann + 8.9 mEq/L NaHCO3 (21%), and Hartmann + 25 mEq/L NaHCO3 (18%). Before the infusion, SIDe was under 30 mEq/L in 30% of the patients and above in 23% of them. The effect on the SIDe was significant before the infusion of different solutions (p 0.01), SIDe > 30 ± 8 mEq/L. No metabolic alkalosis or greater decrease of SIDa/SIDe was observed. Conclusions: This study assesses additional varieties of fluids that have a different SID in the clinical setting. No major acid-base disturbances were observed.

Resumo: Introdução: O método simplificado de Fencl-Stewart pode ser usado no leito do paciente e é mais preciso para a avaliação do equilíbrio ácido-básico. Omron desenvolveu um modelo físico-químico da mudança do excesso de base após a infusão de cristalóide com DIF diferente; No entanto, foi um estudo experimental sob condições controladas. Objetivo: Descrever a mudança no estado ácido-básico inicial e às 24 horas em pacientes em estado crítico após a infusão de sete tipos diferentes de soluções equilibradas. Material e métodos: Realizou-se um estudo retrospectivo, observacional e descritivo em uma terapia intensiva. Incluiram-se pacientes maiores de 18 anos de janeiro de 2015 a julho de 2016. Avaliamos os efeitos no estado ácido-básico através do modelo físico-químico de Fencl-Stewart modificado no início e às 24 horas após a infusão de cristalóides equilibrados com DIF 27 a 154 mEq/L. Analizaram-se gases arteriais através do Gasômetro ABL800 Flex e GEM Premier 3500. A análise dos eletrólitos séricos foi feita através de Architec plus C16,000. A análise estatística foi descrita através do programa SPSS v21.0. Resultados: 198 pacientes. As soluções usadas com mais frecuência eram Hartmann e H25, com 27,8 e 26,3%, respectivamente. Em geral, ao analisar toda a população estudada, todos os parâmetros relacionados com acidose metabólica apresentou melhoria às 24 horas. Conclusão: O uso de soluções com DIF 24 mEq/L melhoraram o estado ácido-básico, sem maior incidência de hipercloremia em um intervalo de 24 horas.

The expression and clinical significance of p53,C-myc and CerbB-2 in thyroid papillary carcinoma / 重庆医学

Objective To investigate the expression level and clinical significance of p53 ,C-myc and CerbB-2 in papillary thy-roid carcinoma patients .Methods The expression level of p53 ,C-myc and CerbB-2 were detected in 45 cases of papillary thyroid carcinoma tissue specimens and 45 cases of nodular goiter tissue specimens by using immunohistochemical staining .Their correla-tions with clinic pathological features in papillary thyroid carcinoma were analyzed further .Results The positive expression rates of p53 ,C-myc and CerbB-2 in the papillary thyroid carcinoma tissue specimens were significantly higher than that of the nodular goiter tissue specimens(all P< 0 .01) .The expression of C-myc and CerbB-2 significantly correlated with lymph node metastasis(P< 0 . 05) .The expression of CerbB-2 significantly correlated with tumor size ,local infiltration ,TNM stage ,differentiated degree and lymph node metastasis (all P< 0 .05) .p53 positive expression ,C-myc positive expression and CerbB-2 positive expression were the independent factors of cervical lymph node metastasis .Conclusion p53 ,C-myc and CerbB-2 were highly expressed in papillary thy-roid carcinoma and correlated with cervical lymph nody metastasis .The detection of p53 ,C-myc and CerbB-2 might be helpful for diagnosis of papillary thyroid carcinomas .

Discussion on the Treatment of Children with Asthma in Remission Stage from Healthy Qi Deficiency and Pathogenic Factor Excess / 浙江中医药大学学报

Objective] The treatment of pediatric asthma in remission period is summarized from the positive and negative aspects, in order to provide new ideas and methods for clinical treatment. [Methods] By consulting the related literatures on the traditional Chinese medicine treatment of children with asthma in remission phase, the paper mainly summarized the different physicians' understanding of pathogenesis and approaches to the treatment of pediatric asthma in remission stage. [Results]The treatment of physicians for pediatric asthma in remission phase can be divided into asthenia healthy qi and sthenia pathogenic factor syndrome.The treatment of healthy qi deficiency mainly includes treating lung,spleen,kidney seperately;curing lung-spleen,lung- kidney, spleen-kidney ;treating three viscera meanwhile.The therapy of pathogenic excess contains treating wind,phlegm,stasis respectively;curing phlegm-stasis. [Conclusion]The treatment of traditional Chinese medicine for pediatric asthma has a unique advantage in improving children's physique, reducing the frequency of asthma attacks, and improve children's life quality which has significant clinical effect.

Funcionamento diferencial dos itens na Escala de Motivos para Evasão do Ensino Superior (M-ES) / Differential item functioning in the Higher Education Dropout Reasons Scale (M-ES) / Funcionamiento diferencial del ítem en la Escala de Razones para Deserción de la Educación Superior (M-ES)

O estudo visou verificar a adequação da Escala de Motivos para Evasão do Ensino Superior via rating scale model e investigar a presença de funcionamento diferencial dos itens (DIF) de acordo com o tipo das instituições dos participantes da pesquisa, pública ou particular. Participaram da pesquisa 327 estudantes universitários, de universidades públicas e particulares, de todos os estados brasileiros, incluindo o Distrito Federal. As idades variaram entre 17 e 58 anos, sendo 80,1% do sexo feminino. O instrumento utilizado foi a Escala de Motivos para Evasão do Ensino Superior (M-ES). Os resultados apontaram que em relação à adequação do instrumento as análises foram satisfatórias e que houve a presença de funcionamento diferencial em alguns itens, sendo que a maior parte dos itens com presença de DIF tiveram como grupo privilegiado os alunos de instituição pública. Os resultados são discutidos de acordo com a literatura e novos estudos são sugeridos.

The study aimed verify the adequacy of the Reasons for Higher Education Dropout Scale through rating scale model and investigated the presence of items differential functioning (DIF) according to the type of institutions of research participants, public or private. The participants were 327 college studants from public and private universities from all Brazilian states, including the Federal District. The ages ranged from 17 to 58 years and 80,1% were female. The instrument used was the Reasons for Higher Education Dropout Scale. The results showed that the analyzes appropriateness of the satisfactory and that there was the presence of items differential functioning some items of the scale with most of the items with the presence of DIF had a privileged group of the public institution students. The results are discussed according to the literature and studies are suggested.

El objetivo del estudio fue comprobar la adecuación de la Escala de Razones para Deserción de la Educación Superior a través de calificación maqueta e investigar la presencia de funcionamiento diferencial de los ítems (DIF) de acuerdo con el tipo de instituciones de participantes en la investigación, públicas o privadas. Los participantes fueron 327 estudiantes de las universidades públicas y privadas de todos los estados brasileños, incluyendo el Distrito Federal. Las edades oscilaron entre 17 a 58 años, y el 80,1% eran mujeres. El instrumento utilizado fue la Escala de Razones para Deserción de la Educación Superior (M-ES). Los resultados mostraron que comparado de la idoneidad de los análisis de instrumentos fueron satisfactorios y que no había presencia de funcionamiento diferencial del ítem en algunos artículos, con la mayoría de los elementos con la presencia de DIF tenían un grupo privilegiado de los estudiantes de instituciones públicas. Los resultados se discuten de acuerdo con la literatura y se sugieren nuevos estudios.

Clostridium difficile infection in chilean patients submitted to hematopoietic stem cell transplantation

Introduction: Patients submitted to hematopoietic stem cell transplantation have an increased risk of Clostridium difficile infection and multiple risk factors have been identi- fied. Published reports have indicated an incidence from 9% to 30% of transplant patients however to date there is no information about infection in these patients in Chile. Methods: A retrospective analysis was performed of patients who developed C. difficile infection after hematopoietic stem cell transplantations from 2000 to 2013. Statistical analysis used the Statistical Package for the Social Sciences software. Results: Two hundred and fifty patients were studied (mean age: 39 years; range: 17-69), with 147 (59%) receiving allogeneic transplants and 103 (41%) receiving autologous trans- plants. One hundred and ninety-two (77%) patients had diarrhea, with 25 (10%) cases of C. difficile infection being confirmed. Twenty infected patients had undergone allogeneic trans- plants, of which ten had acute lymphoblastic leukemia, three had acute myeloid leukemia and seven had other diseases (myelodysplastic syndrome, chronic myeloid leukemia, severe aplastic anemia). In the autologous transplant group, five patients had C. difficile infection; two had multiple myeloma, one had amyloidosis, one had acute myeloid leukemia and one had germinal carcinoma. The overall incidence of C. difficile infection was 4% within the first week, 6.4% in the first month and 10% in one year, with no difference in overall survival between infected and non-infected groups (72.0% vs. 67.6%, respectively; p-value = 0.56). Patients infected after allogeneic transplants had a slower time to neutrophil engraftment compared to non-infected patients (17.5 vs. 14.9 days, respectively; p-value = 0.008). In the autologous transplant group there was no significant difference in the neutrophil engraftment time between infected and non-infected patients (12.5 days vs. 11.8 days, respectively; p-value = 0.71). In the allogeneic transplant group, the median time to acute graft-versus- host disease was similar between the two groups (p-value = 0.08), as was the incidence of grades 1-4 acute graft-versus-host disease (40% vs. 48%; p-value >0.05). Conclusion: The incidence of C. difficile infection after hematopoietic stem cell transplantation was low, with a significant number of cases occurring shortly after transplantation. Allogeneic transplants had a three-time higher risk of infection compared to autologous transplants, but this was not associated with increased mortality, decreased overall survival or higher risk of acute graft-versus-host disease.

A meta-analysis of metronidazole and vancomycin for the treatment of Clostridium difficile infection, stratified by disease severity

The aim of this meta-analysis was to compare the efficacy of metronidazole and vancomycin for the treatment of Clostridium difficileinfection, especially to investigate which agent was superior for treating either mild or severe C. difficileinfection. A meta-analysis of randomized controlled trials and cohort studies identified in Pubmed, Embase, and the Cochrane Library was conducted. Four randomized controlled trials and two cohort studies involving 1218 patients were included in this meta-analysis. Metronidazole was inferior to vancomycin for treating C. difficileinfection in terms of both initial clinical cure rates (risk ratio, RR = 0.91, 95% confidence interval, CI = 0.84-0.98, p= 0.02) and sustained cure rates (RR = 0.88, 95% CI = 0.82-0.96, p= 0.003). For mild C. difficileinfection, the efficacy of metronidazole and vancomycin resulted in similar clinical cure rates (RR = 0.94, 95% CI = 0.84-1.04, p= 0.21) and sustained cure rates (RR = 0.93, 95% CI = 0.83-1.05, p= 0.26). For severe C. difficileinfection the efficacy of vancomycin was superior to metronidazole in terms of clinical cure rates (RR = 0.81, 95% CI = 0.69-0.95, p= 0.009), whereas sustained cure rates were similar (RR = 0.86, 95% CI = 0.72-1.02, p= 0.08). Regarding microbiological cure metronidazole therapy was as effective as vancomycin therapy (RR = 0.88, 95% CI = 0.64-1.21, p= 0.43). Recurrence rates with metronidazole and vancomycin for both mild C. difficileinfection (RR = 0.95, 95% CI = 0.56-1.60, p= 0.85) and severe C. difficileinfection (RR = 1.27, 95% CI = 0.85-1.91, p= 0.25) were not different. Likewise, no difference in all-cause mortality was found as well (RR = 0.87, 95% CI = 0.56-1.35, p= 0.53). In conclusion, vancomycin provides improved initial clinical and sustained cure rates in patients with C. difficileinfection compared with metronidazole, especially in patients with severe C. difficileinfection. In view of these data, vancomycin may be considered first line therapy for severe C. difficileinfection.

Application of the ATLAS score for evaluating the severity of Clostridium difficile infection in teaching hospitals in Mexico

Background: For clinicians, a practical bedside tool for severity assessment and prognosis of patients with Clostridium difficileinfection is a highly desirable unmet medical need.Setting: Two general teaching hospitals in northeast Mexico.Population: Adult patients with C. difficileinfection.Methods: Prospective observational study.Results: Patients included had a median of 48 years of age, 54% of male gender and an average of 24.3 days length of hospital stay. Third generation cephalosporins were the antibiotics most commonly used prior to C. difficileinfection diagnosis. Patients diagnosed with C. difficileinfection had a median ATLAS score of 4 and 56.7% of the subjects had a score between 4 and 7 points. Patients with a score of 8 through 10 points had 100% mortality.Conclusion: The ATLAS score is a potentially useful tool for the routine evaluation of patients at the time of C. difficileinfection diagnosis. At 30 days post-diagnosis, patients with a score of ≤3 points had 100% survival while all of those with scores ≥8 died. Patients with scores between 4 and 7 points had a greater probability of colectomy with an overall cure rate of 70.1%.

Transportation of 8-isopropylaminomethyl hesperitin(IPHP) across human intestinal epithelial by using Caco-2 cells / 中国药理学通报

Aim To study the mechanism of 8-isopro-pylaminomethyl hesperitin ( IPHP ) intestinal absorp-tion using Caco-2 cell lines. Methods Using Caco-2 cell lines as an intestinal epithelial cell model, the effects of drug concentration, temperature, pH, P-gly-coprotein ( P-gp) inhibitor verapamil and multidrug re-sistance protein 2 ( MRP2 ) inhibitors MK-571 or pro-benecid on IPHP transport across Caco-2 cell lines were all investigated. Results The transportation of IPHP was related to drug concentration. The Papp ( AP-BL) ( × 10 -5) was (2. 21 ± 0. 200) cm·s-1,(3. 56 ± 0. 306) cm·s-1,(3. 81 ± 0. 179) cm·s-1,(4. 23 ± 0. 229 ) cm · s-1 , ( 4. 17 ± 0. 262 ) cm · s-1 , re-spectively, and Papp(BL-AP) ( × 10 -5) was (3. 57 ±0. 209) cm·s-1,(4. 51 ± 0. 113) cm·s-1,(4. 97 ± 0. 229) cm·s-1,(5. 24 ± 0. 550) cm·s-1,(5. 07 ± 0. 557) cm·s-1,respectively. Efflux rate was 1. 61, 1. 26,1. 3,1. 23,1. 21,respectively. Temperature and pH both influenced the transport, While the P-gp in-hibitor verapamil had no effect on the transport of IPHP. MRP2 inhibitors MK-571 or probenecid led to an apparent decrease in the efflux of IPHP. Conclu-sion The results suggest that the transport of IPHP is mainly passive diffusion, and MRP2 but not P-gp may be involved in the transport of IPHP.

Diffusion Tensor Imaging Study on Cervical Spinal Cord Injury without Radiographic Abnormality / 中国康复理论与实践

Objective To apply MR diffusion tensor imaging (DTI) to quantitatively analyze cervical spinal cord injury without radio-graphic abnormality (CSCIWORA). Methods 15 patients with CSCIWORA and 20 healthy controls were scanned with MRI of convention-al scans and DTI. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured. Results FA and ADC of the pa-tients were (0.475±0.109) and (1.438±0.252)×10-3 mm2/s, respectively. Whereas, they were (0.604±0.096) and (1.371±0.280)×10-3 mm2/s in the controls. Compared with the controls, the FA was less (P<0.05) in the patients, but the ADC was not significantly different (P=0.267). The fiber tracking (FT) showed the abnormality of white matter fiber tracts of cervical spinal cord in the patients. Conclusion DTI can de-tect the CSCIWORA, and FT can directly display the injuries of white matter fiber tracts of cervical spinal cord, which provide more infor-mation to evaluate the clinical severity of CSCIWORA.

Analysis of the transcriptome in a multi-drug resistant uropathogenic Escherichia coli strain treated with water decoction of rhizoma coptidis by using RNA-seq / 中华微生物学和免疫学杂志

Objective To investigate the molecular mechanism of the inhibitory effects of rhizoma coptidis on multi-drug resistant uropathogenic Escherichia coli.Methods High-throughput RNA sequencing ( RNA-seq ) was performed to investigate the transcriptome in a multi-drug resistant uropathogenic Escherichia coli strain (NB8) treated with water decoction of rhizoma coptidis .Agar dilution test was used to determine the minimal inhibitory concentration ( MIC) of water decoction of rhizoma coptidis against the NB 8 strain.A growth curve was drawn to evaluate the effects of water decoction of rhizoma coptidis on the growth of NB8 strain.Total RNAs were extracted from the NB 8 strain after treated with the water decoction of rhizo-ma coptidis for 30 minutes and then synthetized to cDNA by reverse transcription after screening out the rRNAs.The HiSeq 2000 sequencing system was used for transcriptome sequencing .The TopHat software was used to map and analyze the RNA-Seq reads, and then Cufflinks was run to assemble transcripts and es-timate their abundances .The differential expression , GO enrichment and KEGG metabolic pathway were fur-ther analyzed .The NB8 strain dealt with normal saline was used as negative control .Results The MIC of water decoction of rhizoma coptidis to NB 8 strain was 12.5 mg/ml.There were 3665 genes expressed in NB8 strain treated with water decoction of rhizoma coptidis and 3430 genes expressed in NB8 strain treated with normal saline .The number of differentially expressed genes was 1428 including 921 up-regulated genes and 507 down-regulated genes .Those differentially expressed genes mainly enriched in the modules of binding and catalysis.The genes concerning cell adhesion , apoptosis and multicellular process were up-regulated, while those concerning the regulation of enzyme activities were down-regulated.Results of the KEGG meta-bolic pathway enrichment analysis showed that the genes concerning synthetic pathway of LPS were signifi -cantly up-regulated as well as those encoding the repair polymerase Ⅲthat was involved in DNA replication . However , the genes concerning fatty acid metabolism , histidine metabolism , thiamine metabolism , folate metabolism and iron carrier in ribosome synthesis showed overall down-regulation.Conclusion The tran-scriptome in uropathogenic Escherichia coli strain treated with rhizoma coptidis was profiled .The main mo-lecular mechanism of the inhibitory effects of rhizoma coptidis on uropathogenic Escherichia coli was to de-stroy the cell wall of Escherichia coli, affect the replication of DNA and regulate the transcription and transla-tion of proteins .This study illustrated that the inhibitory effects of rhizoma coptidis on uropathogenic Esche-richia coli were achieved in multiple levels .

Funcionamiento diferencial de ítemes: Examen de matemática - Universidad Jorge Tadeo Lozano / Differential item functioning: Math test Universidad Jorge Tadeo Lozano

La Universidad Jorge Tadeo Lozano aplica el Examen de Clasificación en Matemáticas Básicas, como evaluación diagnóstica, a los aspirantes y estudiantes provenientes de transferencias internas o externas, cuyo plan de estudios precise conocimientos básicos de Aritmética y Algebra Elemental. Dicho examen favorece el análisis de las condiciones académicas de los admitidos y permite a la Universidad, ofrecer opciones apropiadas para cada caso particular, al mismo tiempo que al evaluado le proporciona la posibilidad de reconocer su nivel de apropiación del conocimiento de los dominios conceptuales requeridos. Consecuentemente con el carácter decisorio del Examen de Clasificación de Matemáticas Básicas, se examinó si los ítemes utilizados presentan funcionamiento diferencial, esto es, se analizó si la diferencia de habilidades entre los evaluados podría deberse a las variables de contexto seleccionadas: sexo, edad, naturaleza jurídica del colegio de procedencia y facultad en la que el aspirante tramita su ingreso. Para ello, se procesaron 1.623 cadenas de respuestas para 61 ítemes, obtenidas en las pruebas comprendidas entre el tercer período lectivo de 2011 y el primero de 2012. La metodología incluyó la implementación de tres técnicas: Contraste del DIF (diferencia entre los centros de dificultades), Contraste del DIF (diferencia entre los extremos más próximos para los intervalos de dificultad) y prueba estadística Mantel-Haenszel. La conjunción de estas técnicas permitió determinar un ítem con funcionamiento diferencial en categoría moderada a grande, para la variable edad. Finalmente, para este ítem se exhiben sus parámetros estadísticos y su curva característica, estimados en la calibración.

The following article presents an application of differential item functioning (DIF), using results obtained from the qualifying test developed by the Jorge Tadeo Lozano University and taken by students to classify them at a level of mathematical knowledge and to define an academic route for them based on their cognitive status shown on the test. The analysis is part of a perspective to estimate the difficulty and others characteristics of items, and the skills and level of students through the use of the Rasch model of the one parameter item response theory (IRT) and the parameters of a sample of 1623 students taking a test composed of 61 items. The article analyzes both the statistical performance of the items in terms of the parameters of item-test correlation, misfits (infit and outfit), and discrimination, as well as the behavior of the set of items depending on the construct validity or dimensionality, reliability, internal consistency, and separation parameters. A method is then shown to examine which items display DIF, associated with the conditions of the students' origin and not of their academic ability, which could lead to bias in the results of the test. The employed methods estimate the relative difficulty of each item, for students of similar ability but who belong to different groups, according to four variables studied: sex, age, intended major, and whether the high school of origin is public or private. The value of the difference in relative difficulty between the groups mentioned is associated with a level of DIF and recognizes whether the item in question has bias and which groups this bias is favoring. The difference in relative difficulty is graded in terms of severity according to three categories proposed by the Educational Testing Service: (1) moderate to large, if the difference in relative difficulty between groups (for students of similar ability) is greater than or equal to .64 logits, (2) small to moderate, if the difference is greater than or equal to .43 and less than .64 logits, and (3) not significant, if this difference is less than .43 logits. In order to validate the detection of DIF, the calculations are performed using three techniques. Two are chosen from those available in the literature and the third one is a proposal by the authors of this article to consider the size of the error in the estimations of difficulty difference. The three techniques used are: (1) the measurement of the difference between the core values of the difficulty intervals, ignoring the value of the estimation error, (2) the difference between the nearest extremes of the difficulty intervals, taking into account the estimation error, and (3) the Mantel-Haenszel statistical test. Regarding databases formed for the analysis, two aspects were considered: (1) chains of responses corresponding to missing data or especially small groups, which would not have allowed an effective and reliable comparison, were omitted, and (2) random samples with uniform distribution were selected to create groups of the same size for each study variable. The analysis with the technique of difference between core values showed that two items (34 and 59) displayed DIF with moderate to large severity, regarding the age variable for item 34 and the intended major and high school of origin variables for item 59. The technique about difference between the nearest extremes confirmed DIF with moderate to large severity for item 34, with respect to the age variable. The Mantel-Haenszel test detected DIF with moderate to large severity for items 13, 20, 34, and 61 for the age variable, and for items 4, 30, 36, 43, and 59 for the major variable.

Analysis of Clinicopathological Features and Prognosis of Gastric Carcinoma with Neuroendocrine Differentiation and Mixed Gonadal Neuroendocrine Carcinoma of the Stomach / 天津医药

Objective To investigate the clinical pathological features and prognosis of gastric carcinoma with neu-roendocrine differentiation (NED) and mixed gonadal neuroendocrine carcinoma of the stomach (MANECs). Methods A retrospective analysis of 61 cases of gastric carcinoma with NED and 34 cases of MANECs and their histochemistry and im-munohistochemistry were also observed. Prognosis of the 2 groups were compared by the Kaplan-Meiers survival analysis. Prognostic factors associated with patients with gastric cancer were analyzed by COX proportional hazards model. Results Tumor location, distant metastasis and lymph node metastasis were statistically different between these 2 groups (P<0.05). Syn positive expression rate is higher than CgA and CD56 in the gastric carcinoma with NED group;Postoperative survive pe-riod of the gastric carcinoma with NED is shorter than that of MANECs (P<0.05). Lymph node metastasis and distant region-al transfer is obviously correlated with prognosis (P<0.05). Conclusion Immunohistochemistry is important for the diag-nosis of these two tumor. The number of neuroendocrine cells can help to assess prognosis and guide treatment.