Identification of a Predictive Biomarker for the Beneficial Effect of Keishibukuryogan, a Kampo (Japanese Traditional) Medicine, on Patients with Climacteric Syndrome

Keishibukuryogan (KBG; Guizhi-Fuling-Wan in Chinese) is one of the Kampo (Japanese traditional) medicines used to treat patients with climacteric syndrome. KBG can be used by patients who cannot undergo hormone replacement therapy due to a history of breast cancer. We evaluated whether cytosine-adenine (CA) repeat polymorphism of the estrogen receptor β gene can be a predictor of the beneficial effect of KBG on climacteric syndrome. We also investigated the relationship between CA repeat polymorphism, the patients’ profiles, and the therapeutic effect. We found that CA was an SS, SL, or LL genotype according to the number of repeats. We studied 39 consecutive patients with climacteric disorders who took KBG for 12 weeks. The diagnosis of climacteric disorders was made on the basis of the Kupperman index. KBG significantly improved the patients’ climacteric symptoms (i.e., vasomotor symptoms in the patients with the LL genotype and melancholia in the patients with the SL genotype). No relationship between the patients’ profiles and CA repeat polymorphism was recognized. CA repeat polymorphism could thus be a potential biomarker to predict the efficacy of KBG in climacteric syndrome, and its use will help to reduce the cost of treating this syndrome by focusing the administration of KBG on those most likely to benefit from it

Ceruloplasmin Protects Against Rotenone-Induced Oxidative Stress and Neurotoxicity

To clarify the neuroprotective property of ceruloplasmin and the pathogenesis of aceruloplasminemia, we generated ceruloplasmin-deficient (CP−/−) mice on the C57BL/10 genetic background and further treated them with a mitochondrial complex I inhibitor, rotenone. There was no iron accumulation in the brains of CP−/− mice at least up to 60 weeks of age. Without rotenone treatment, CP−/− mice showed slight motor dysfunction compared with CP+/+ mice, but there were no detectable differences in the levels of oxidative stress markers between these two groups. A low dose of rotenone did not affect the mitochondrial complex I activity in our mice, however, it caused a significant change in motor behavior, neuropathology, or the levels of oxidative stress markers in CP−/− mice, but not in CP+/+ mice. Our data support that ceruloplasmin protects against rotenone-induced oxidative stress and neurotoxicity, probably through its antioxidant properties independently of its function of iron metabolism

統合カリキュラムの保健師教育が卒業後の看護実践で役立っている内容 ─調査票の自由記載から─

【目的】 大学における看護基礎教育において保健師養成が選択制に移行する一方で，国が行う地域包括ケアシステムの推進に向けて，地域を包括的・継続的に捉えて看護を展開する看護職の育成が求められている．本研究においては，統合カリキュラムで保健師教育を学修した卒業生は，卒業後の看護実践において統合カリキュラムの学修がどのように役立っていると捉えているかを明らかにする．【方法】 統合カリキュラムの教育を受けたA 大学看護学部の卒業生732 名のうち，調査の協力に同意を得られた123名に郵送法による質問紙調査を実施した．調査内容は，保健師教育は看護実践に役立っていますか，についての選択肢の回答とその内容の自由記載を求めた．「役に立っている」と回答のあった者について内容分析の手法を用いて分析した．【結果】 回答した卒業生（以下，卒業生）84名のうち，看護実践に「役立っている」と回答したのは63 名で，役立っていると捉えた内容は【退院後の具体像をイメージした退院調整の実施】【看護を幅広く捉えて看護実践に活用】【地域や保健師等との連携】【病院と地域を意識した捉え方】【保健師活動の理解】【保健師業務の実践】【職業選択の広がり】の7 のカテゴリーであった．【結論】 卒業生の4 分の3は，保健師教育は看護実践に役立っていると捉えているが，内容は退院支援に関するものが多く，保健師活動に関するものはわずかであった．退院支援は看護師教育の学修内容でもあり，保健師教育のみの学びとは言い難い点がある．しかし，公衆衛生看護学実習を通して，保健師活動の理解が深まることで，地域における多職種との連携を理解していることが示唆され，地域のシステムづくりを学んで，在宅看護と公衆衛生看護の両者の視点から幅広い看護の提供に役立つ可能性が示された．また，看護師から保健師への転職者がおり，職業選択の広がりに役立っていることが示された

Annual two-dose tetanus toxoid vaccination induces protective humoral immunity to all age groups of rhesus macaques

A tetanus outbreak occurred during 2014–2015 in the rhesus macaques reared in an open enclosure in our facility. As the soil of the facility was suspected to be contaminated with Clostridium tetani spores, there was a risk of further tetanus occurring among the macaques. To protect them from tetanus, a tetanus toxoid vaccination was recommended; however, the vaccinated elderly animals might not be effectively protected due to insufficient humoral immune responses. Hence, we evaluated the dynamics of antibody responses among rhesus macaques of all age groups vaccinated with two-dose tetanus toxoid at a 1-year interval during a 3-year follow-up study. The vaccination developed anti-tetanus toxin-specific antibodies in animals of all age groups, the antibody levels peaked 1 year after the second vaccination, and the peak levels decreased with age. However, the levels among elderly individuals (aged ≥13 years) were still higher than the threshold level, which was supposed to protect them from tetanus development. Although the rhesus macaques in our facility had a risk of occasional exposure to the spores due to the outbreak, no incidence of tetanus has ever occurred to date. These results indicate that the vaccination protocol is effective in protecting not only younger but also older animals from tetanus

Acupuncture Alleviated the Nonmotor Symptoms of Parkinson’s Disease including Pain, Depression, and Autonomic Symptoms

A woman started to feel intractable pain on her lower legs when she was 76. At the age of 78, she was diagnosed as having Parkinson’s disease (PD). The leg pain was suspected to be a symptom of PD after eliminating other causes. The patient also suffered from nonmotor symptoms, depression, anxiety, hot flashes, and paroxysmal sweating. Though the patient had received pharmacotherapy including levodopa for 5 years, she still suffered from the nonmotor symptoms and was referred to our department. We treated her with acupuncture based on the Chinese traditional medicine and electroacupuncture five times per week. After the 2-week treatment, the assessment for the symptoms was as follows; visual analogue scale (VAS) score of the leg pain was 16 mm (70 mm, before), Hamilton’s rating scales for depression (HAM-D) score was 9 (18, before), timed 3 m Up and Go took 20 steps in 30 sec (24 steps in 38 sec, before), and the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part 1 score was 13 (21, before). Autonomic symptoms, hot flashes and paroxysmal sweating, were also alleviated. Acupuncture may be a good treatment modality for nonmotor symptoms in PD