BACKGROUND & AIMS: :R1H tumors were irradiated with a single dose of 15 Gy X rays using varying sizes of treatment fields. Damage to tumor cells and tumor stroma was determined separately by analysis of growth delay to ten times treatment volume (GD10vo) and net growth delay. GD10vo comprises irradiation effects on tumor parenchymal cells and on tumor stroma, whereas net growth delay only measures effects on tumor parenchymal cells. Stromal damage was observed to increase with increasing field size; the effect on the tumor parenchymal cells, however, was independent of the field size. An increase of GD10vo of 13 days per cm increase of field size diameter was observed. From this the velocity of neovascularization of the irradiated tumor bed was calculated to be 0.30 to 0.38 mm per day.

背景与目标： 使用不同大小的治疗区域，用15 Gy X射线单剂量照射：R1H肿瘤。通过分析至十倍治疗体积（GD10vo）的生长延迟和净生长延迟来分别确定对肿瘤细胞和肿瘤基质的损伤。 GD10vo包括对肿瘤实质细胞和肿瘤基质的辐射作用，而净生长延迟仅能测量对肿瘤实质细胞的作用。观察到间质损伤随田间大小的增加而增加。然而，对肿瘤实质细胞的影响与视野大小无关。观察到GD10vo的增加，每厘米田径直径的直径增加了13天。由此计算出被辐照的肿瘤床的新血管形成速度为每天0.30至0.38mm。

BACKGROUND & AIMS: CONTEXT:Chronic pain in patients with advanced cancer poses a serious clinical challenge. The Δ9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray (U.S. Adopted Name, nabiximols; Sativex(®)) is a novel cannabinoid formulation currently undergoing investigation as an adjuvant therapy for this treatment group. OBJECTIVES:This follow-up study investigated the long-term safety and tolerability of THC/CBD spray and THC spray in relieving pain in patients with advanced cancer. METHODS:In total, 43 patients with cancer-related pain experiencing inadequate analgesia despite chronic opioid dosing, who had participated in a previous three-arm (THC/CBD spray, THC spray, or placebo), two-week parent randomized controlled trial, entered this open-label, multicenter, follow-up study. Patients self-titrated THC/CBD spray (n=39) or THC spray (n=4) to symptom relief or maximum dose and were regularly reviewed for safety, tolerability, and evidence of clinical benefit. RESULTS:The efficacy end point of change from baseline in mean Brief Pain Inventory-Short Form scores for "pain severity" and "worst pain" domains showed a decrease (i.e., improvement) at each visit in the THC/CBD spray patients. Similarly, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 scores showed a decrease (i.e., improvement) from baseline in the domains of insomnia, pain, and fatigue. No new safety concerns associated with the extended use of THC/CBD spray arose from this study. CONCLUSION:This study showed that the long-term use of THC/CBD spray was generally well tolerated, with no evidence of a loss of effect for the relief of cancer-related pain with long-term use. Furthermore, patients who kept using the study medication did not seek to increase their dose of this or other pain-relieving medication over time, suggesting that the adjuvant use of cannabinoids in cancer-related pain could provide useful benefit.

背景与目标： 背景：晚期癌症患者的慢性疼痛提出了严峻的临床挑战。 Δ9-四氢大麻酚（THC）/大麻二酚（CBD）口腔粘膜喷雾剂（美国采用名称，nabiximols;Sativex®）是一种新型大麻素制剂，目前正在接受治疗，作为该治疗组的辅助疗法。
目的：这项随访研究调查了THC / CBD喷雾剂和THC喷雾剂在缓解晚期癌症患者的疼痛方面的长期安全性和耐受性。
方法：共有43例癌症相关疼痛患者尽管使用了阿片类药物长期服用，但仍没有足够的镇痛作用，他们参加了先前的三组试验（THC / CBD喷雾剂，THC喷雾剂或安慰剂），为期两周的父母随机对照试验，参加了这项开放性，多中心的后续研究。患者自行滴定THC / CBD喷雾剂（n = 39）或THC喷雾剂（n = 4）以缓解症状或最大剂量，并定期检查其安全性，耐受性和临床获益证据。
结果：THC / CBD喷剂患者每次就诊时，“疼痛严重程度”和“最严重疼痛”域的平均简短疼痛清单-简表得分的基线变化的功效终点显示出降低（即改善）。同样，欧洲癌症生活质量研究和治疗组织问卷-C30的得分显示，失眠，疼痛和疲劳程度较基线水平有所降低（即有所改善）。这项研究没有引起与THC / CBD喷雾剂的广泛使用相关的新安全隐患。
结论：这项研究表明，长期使用THC / CBD喷雾剂通常具有良好的耐受性，没有证据表明长期使用THC / CBD喷雾剂可减轻癌症相关疼痛。此外，继续使用研究药物的患者并未寻求随时间增加这种药物或其他缓解疼痛药物的剂量，这表明在与癌症相关的疼痛中辅助使用大麻素可提供有益的益处。

BACKGROUND & AIMS: OBJECTIVES:There are no direct comparisons of blood glucose values in samples collected with barrier serum tubes (SST) and NaF/potassium oxalate (NaF/KOx) plasma tubes. Collection of samples in SST tubes can offer considerable savings and specimen processing advantages for national level surveys. DESIGN AND METHODS:Serum and plasma samples were collected under 'field conditions' from a single draw of 3692 individuals participating in the Canadian Health Measures Survey. The samples were analyzed retrospectively using the VITROS GLU Slide method (glucose oxidase-based). RESULTS:There was a high rate of hemolysis in the NaF/KOx tubes (86.2%) while hemolysis was infrequently observed with the SST tubes (2%). Comparing only blood draws where no hemolysis was observed in both tubes (n=495; paired t-test) showed no effect of tube type on serum/plasma glucose concentrations. This was also observed when data was restricted to cases when only SST samples were not hemolyzed (n=3546; paired t-test). CONCLUSIONS:These data show that both collection tubes can be used under survey collection and processing conditions to measure glucose with our assay system with no difference in reported results.

背景与目标： 目的：尚无直接比较采用屏障血清试管（SST）和NaF /草酸钾（NaF / KOx）血浆试管收集的样本中血糖值的方法。在SST管中收集样品可以为国家级调查提供大量的节省和样品处理的优势。
设计与方法：在“现场条件”下从参加加拿大卫生措施调查的3692个人中抽取了血清和血浆样品。使用VITROS GLU Slide方法（基于葡萄糖氧化酶）对样品进行回顾性分析。
结果：NaF / KOx管的溶血率很高（86.2％），而SST管的溶血率很少（2％）。仅比较在两个试管中均未观察到溶血的抽血情况（n = 495；配对t检验）显示试管类型对血清/血浆葡萄糖浓度无影响。当数据仅限于仅不对SST样品进行溶血的情况时（n = 3546；配对t检验），也可以观察到这一点。
结论：这些数据表明，在我们的测定系统中，两个收集管均可在调查收集和处理条件下用于测量葡萄糖，报道的结果没有差异。

BACKGROUND & AIMS: BACKGROUND:The combinations of methotrexate, vinblastine, Adriamycin, cisplatin (Pharmanell, Athens, Greece) (MVAC) or gemcitabine, cisplatin (GC) represent the standard treatment of advanced urothelial cancer (UC). Dose-dense (DD)-MVAC has achieved longer progression-free survival (PFS) than the conventional MVAC. However, the role of GC intensification has not been studied. We conducted a randomized, phase III study comparing a DD-GC regimen with DD-MVAC in advanced UC. PATIENTS AND METHODS:One hundred and thirty patients were randomly assigned between DD-MVAC: 66 (M 30 mg/m(2), V 3 mg/m(2), A 30 mg/m(2), C 70 mg/m(2) q 2 weeks) and DD-GC 64 (G 2500 mg/m(2), C 70 mg/m(2) q 2 weeks). The median follow-up was 52.1 months (89 events). RESULTS:The median overall survival (OS) and PFS were 19 and 8.5 months for DD-MVAC and 18 and 7.8 months for DD-GC (P = 0.98 and 0.36, respectively). Neutropenic infections were less frequent for DD-GC than for DD-MVAC (0% versus 8%). More patients on DD-GC received at least six cycles of treatment (85% versus 63%, P = 0.011) and the discontinuation rate was lower for DD-GC (3% versus 13%). CONCLUSIONS:Although DD-GC was not superior to DD-MVAC, it was better tolerated. DD-GC could be considered as a reasonable therapeutic option for further study in this patient population. Clinical Trial Number ACTRN12610000845033, www.anzctr.org.au.

背景与目标： 背景：甲氨蝶呤，长春碱，阿霉素，顺铂（Pharmanell，雅典，希腊）（MVAC）或吉西他滨，顺铂（GC）的组合代表了晚期尿路上皮癌（UC）的标准治疗方法。与传统的MVAC相比，剂量密集（DD）-MVAC获得了更长的无进展生存期（PFS）。但是，尚未研究GC强化的作用。我们进行了一项随机III期研究，比较了DD-GC方案与DD-MVAC在晚期UC中的比较。
患者与方法：一百三十名患者被随机分配至DD-MVAC：66（M 30 mg / m（2），V 3 mg / m（2），A 30 mg / m（2），C 70 mg / m（2）q 2周）和DD-GC 64（G 2500 mg / m（2），C 70 mg / m（2）q 2周）。中位随访时间为52.1个月（89事件）。
结果：DD-MVAC的中位总体生存期（OS）和PFS为19和8.5个月，DD-GC的中位总体生存期（OS）和PFS为18和7.8个月（分别为P = 0.98和0.36）。与DD-MVAC相比，DD-GC的中性粒细胞减少感染频率较低（0％对8％）。使用DD-GC的患者更多，至少接受了六个周期的治疗（85％对63％，P = 0.011），DD-GC的停药率较低（3％对13％）。
结论：尽管DD-GC并不优于DD-MVAC，但其耐受性更好。 DD-GC被认为是对该患者人群进行进一步研究的合理治疗选择。临床试验编号ACTRN12610000845033，www.anzctr.org.au。

BACKGROUND & AIMS: :We investigated the effect of homogeneous and inhomogeneous static magnetic field (SMF) exposure on the thermal nociceptive threshold of snail in the hot plate test (43 °C). Both homogeneous (hSMF) and inhomogeneous (iSMF) SMF increased the thermo-nociceptive threshold: 40.2%, 29.2%, or 41.7% after an exposure of 20, 30, or 40 min hSMF by p < 0.001, p < 0.0001, or p < 0.001, and 32.7% or 46.2% after an exposure of 20 or 40 min iSMF by p < 0.05 or p < 0.0001. These results suggest that SMF has an antinociceptive effect in snail. On the other hand, naloxone as an atypical opioid antagonist in an amount of 1 μg/g was found to significantly decrease the thermo-nociceptive threshold (41.9% by p < 0.002), which could be antagonized by hSMF exposure implying that hSMF exerts its antinociceptive effect partly via opioid receptors.

背景与目标： ：我们在热板测试（43°C）中研究了均匀和不均匀的静磁场（SMF）暴露对蜗牛的热伤害感受性阈值的影响。均质（hSMF）和不均质（iSMF）SMF均可在暴露20、30或40分钟的hSMF时通过p <0.001，p <0.0001或p提高热伤害感受性阈值：40.2％，29.2％或41.7％ iSMF暴露p≤0.05或p≤0.0001后，<0.001，以及32.7％或46.2％。这些结果表明，SMF对蜗牛具有镇痛作用。另一方面，发现纳洛酮作为一种非典型的阿片类药物拮抗剂，可显着降低热伤害感受性阈值（41.9％，p <0.002），可被hSMF暴露所拮抗，暗示hSMF发挥了其作用。部分通过阿片样物质受体产生抗伤害感受作用。

BACKGROUND & AIMS: :Specification of limb field and initiation of limb development involve multiple steps, each of which is tightly regulated both spatially and temporally. Recent developmental analyses on various vertebrates have provided insights into the molecular mechanisms that specify limb field and have revealed several genetic interactions of signals involved in limb initiation processes. Furthermore, new approaches to the study of the developmental mechanisms of the lateral plate mesoderm of amphioxus and lamprey embryos have given us clues to understand the evolutionary scenarios that led to the acquisition of paired appendages during evolution. This review highlights such recent findings and discusses the mechanisms of limb field specification and limb bud initiation during development and evolution.

背景与目标： ：肢体场的规范和肢体发育的开始涉及多个步骤，每个步骤在空间和时间上都受到严格的调节。最近对各种脊椎动物的发育分析为指定肢体场的分子机制提供了见识，并揭示了参与肢体起始过程的信号的几种遗传相互作用。此外，研究文昌鱼胚和七lamp鳗胚的侧板中胚层发育机制的新方法为我们提供了线索，以了解导致进化过程中获得成对附件的进化情况。这篇综述突出了这些最新发现，并讨论了在发育和进化过程中肢体视野规范和肢芽萌发的机制。

BACKGROUND & AIMS: :The presence of pyrethroids in both urban and agricultural sediments at levels lethal to invertebrates has been well documented. However, variations in bioavailability among sediments make accurate predictions of toxicity based on whole sediment concentrations difficult. A proposed solution to this problem is the use of bioavailability-based estimates, such as solid phase microextraction (SPME) fibers and Tenax beads. This study compared three methods to assess the bioavailability and ultimately toxicity of pyrethroid pesticides including field-deployed SPME fibers, laboratory-exposed SPME fibers, and a 24-h Tenax extraction. The objective of the current study was to compare the ability of these methods to quantify the bioavailable fraction of pyrethroids in contaminated field sediments that were toxic to benthic invertebrates. In general, Tenax proved a more sensitive method than SPME fibers and a correlation between Tenax extractable concentrations and mortality was observed.

背景与目标： ：已有大量文献证明，拟除虫菊酯在城市和农业沉积物中均以无脊椎动物致死的水平存在。然而，沉积物之间生物利用度的变化使得基于整个沉积物浓度的准确的毒性预测变得困难。解决此问题的一种建议方法是使用基于生物利用度的估算值，例如固相微萃取（SPME）纤维和Tenax珠。这项研究比较了三种评估拟除虫菊酯农药的生物利用度和最终毒性的方法，包括现场部署的SPME纤维，实验室暴露的SPME纤维和24小时Tenax提取。当前研究的目的是比较这些方法对拟对底栖无脊椎动物有毒的被污染田间沉积物中拟除虫菊酯的生物利用度进行定量的能力。通常，Tenax被证明比SPME纤维更灵敏，并且可以观察到Tenax可提取浓度与死亡率之间的相关性。

BACKGROUND & AIMS: :Currently, rolling resistance and wheelchair stability during manual wheelchair propulsion can be assessed from the loads applied on the front and rear wheels, which are determined in a static condition. However, a user's actions on the wheelchair would change these loads during locomotion, which should affect both the rolling resistance and wheelchair stability. The goal of this study was to verify these assumptions and assess how much the rolling resistance and wheelchair stability are affected by the user's actions during propulsion. For that purpose, a mechanical model was developed using measurements of an instrumented wheelchair equipped with several six-component dynamometers. Experiments were performed by three subjects propelling the instrumented wheelchair over flat ground. The results showed variations over wide ranges of the fore-aft distribution of the total load, rolling resistance, wheelchair stability, wheelchair velocity and mechanical power dissipated by the rolling resistance during the propulsion cycle. In addition, the time courses of all these variables differed with the subject. Finally, this study demonstrated the possibility of assessing intra-cycle values of both rolling resistance and wheelchair stability during manual wheelchair displacements in the field, which provides a technical step towards evaluating a wheelchair user in his daily environment.

背景与目标： ：目前，可以通过在静态条件下确定的前后轮负载来评估手动轮椅推进过程中的滚动阻力和轮椅稳定性。但是，使用者在轮椅上的动作会在运动过程中改变这些负荷，这将同时影响滚动阻力和轮椅稳定性。这项研究的目的是验证这些假设，并评估用户在推进过程中的动作对滚动阻力和轮椅稳定性的影响。为此，使用配备了数个六分量测功机的器械轮椅的测量结果建立了机械模型。由三名受试者将实验轮椅推到平坦的地面上进行了实验。结果表明，在推进周期中，总载荷的前后分布在很大范围内变化，滚动阻力，轮椅稳定性，轮椅速度和由滚动阻力消耗的机械功率。此外，所有这些变量的时间过程都与主题不同。最后，这项研究证明了在野外手动轮椅移动期间评估滚动阻力和轮椅稳定性的周期内值的可能性，这为评估轮椅使用者的日常环境提供了技术上的一步。

BACKGROUND & AIMS: :Septic arthritis of the hip can be caused via a hematogenous route, by penetration of periarticular infections, open hip trauma, injections or operations. Ultrasound, hip puncture and elevation of inflammatory parameters lead to the diagnosis. Differentiation of septic arthritis from gout and chondrocalcinosis may be difficult. Nevertheless, early revision of the hip has to be performed to avoid joint destruction. Open revision is the therapy of choice in the majority of cases.

背景与目标： ：髋部感染性关节炎可通过血行途径，穿透关节周围感染，开放性髋部创伤，注射或手术引起。超声，髋部穿刺和炎症参数升高可导致诊断。化脓性关节炎与痛风和软骨钙化病的鉴别可能很困难。尽管如此，必须尽早髋关节翻修以避免关节破坏。在大多数情况下，开放翻修是首选的治疗方法。

BACKGROUND & AIMS: We previously reported that the BARF1 (BamH1-A right frame 1) gene product from Epstein-Barr Virus (EBV) may have oncogenic properties since injection into new-born rats of transfected cell lines resulted in the development of BARF1 expressing tumors, which were aggressive in the case of murine fibroblasts and transient in that of human B lymphocytes. As EBV has been associated with nasopharyngeal carcinoma (NPC) and evidence of BARF1 transcription in this cancer was emerging from our biopsy analyses, we examined the effects of BARF1 transfection into primate primary epithelial cells. The expression of the BARF1 open reading frame in primary monkey kidney epithelial cells led us to the establishment of continuously dividing lines. The BARF1 transfectants showed the major characteristics of immortalized cellsmorphological change, short cell doubling time, ability to divide at low cell density and continuous growth over 50 passages. Injection of BARF1 transfectants into nude mice did not induce any tumor. Established subclones were shown to be epithelial cells expressing known keratins as well as the BARF1 coded mRNA and protein. This is the first report indicating that expression of the BARF1 gene product in primary epithelial cells may contribute to the establishment of cell lines.

背景与目标： 我们先前曾报道，爱泼斯坦-巴尔病毒（EBV）的BARF1（BamH1-A右框架1）基因产物可能具有致癌特性，因为向新生大鼠转染的细胞系中注射导致表达BARF1的肿瘤的发展，鼠成纤维细胞具有侵袭性，人B淋巴细胞具有瞬时侵袭性。由于EBV与鼻咽癌（NPC）相关，并且从我们的活检分析中发现了该癌症中BARF1转录的证据，因此我们检查了BARF1转染到灵长类动物原代上皮细胞中的作用。 BARF1开放阅读框在原代猴肾上皮细胞中的表达使我们建立了连续分裂系。 BARF1转染子显示出永生化细胞形态变化，短细胞倍增时间，在低细胞密度下分裂的能力以及在50代以上连续生长的主要特征。向裸鼠中注射BARF1转染子不会诱导任何肿瘤。已建立的亚克隆显示为表达已知角蛋白以及BARF1编码的mRNA和蛋白质的上皮细胞。这是第一个报告，表明BARF1基因产物在原代上皮细胞中的表达可能有助于细胞系的建立。

BACKGROUND & AIMS: BACKGROUND:Women have a relatively high risk of experiencing depressive episodes during the perimenopause. Indications for and acceptance of hormone replacement therapy (HRT) are increasingly controversial, and serotonin reuptake inhibitor antidepressants are an attractive potential treatment option for both the mood and somatic symptoms of perimenopause. METHODS:This study is an open-label, 8-week trial of escitalopram for perimenopausal depression and somatic symptoms associated with perimenopause. Twenty women received escitalopram and were serially assessed with the Hamilton Rating Scale for Depression (HAMD, 30-item), the Greene Climacteric Scale (GCS), and the Clinical Global Impression (CGI). RESULTS:There were significant differences between pretest and posttest scores for each measure, as demonstrated in an intent-to-treat analysis: GCS (p < 0.0001), HAM-D30 (p < 0.0001), and CGI (p < 0.0001). Two subjects dropped out prior to the second visit because of drug side effects. In this study, benefits of treatment were observed in several domains of perimenopausal symptoms, including those representative of psychological, vasomotor, and somatic symptoms. The limitations of this study are small sample size and lack of placebo control. CONCLUSIONS:Larger, long-term, controlled trials of antidepressants are warranted for the treatment of perimenopausal depression and associated somatic symptoms.

背景与目标： 背景：妇女在围绝经期经历抑郁发作的风险相对较高。激素替代疗法（HRT）的适应症和接受方法引起越来越多的争议，5-羟色胺再摄取抑制剂抗抑郁药对于围绝经期的情绪和躯体症状都是有吸引力的潜在治疗选择。
方法：本研究是一项艾司西酞普兰治疗围绝经期抑郁症和与围绝经期相关的躯体症状的开放性，为期8周的试验。二十名妇女接受艾司西酞普兰治疗，并用汉密尔顿抑郁量表（HAMD，30项），格林更年期量表（GCS）和临床总体印象（CGI）进行系列评估。
结果：每种方法的测试前和测试后得分之间存在显着差异，如意向分析所示：GCS（p <0.0001），HAM-D30（p <0.0001）和CGI（p <0.0001）。由于药物的副作用，两名受试者在第二次就诊之前退出了研究。在这项研究中，在围绝经期症状的多个领域中观察到了治疗的益处，包括那些代表心理，血管舒缩和躯体症状的领域。该研究的局限性在于样本量小和缺乏安慰剂对照。
结论：抗抑郁药用于围绝经期抑郁症和相关躯体症状的大型，长期，对照试验是必要的。

BACKGROUND & AIMS: BACKGROUND:Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet. OBJECTIVE:The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity. METHODS:Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests. RESULTS:Retention rates were good for both groups-85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F(1,415) = 7.104, P = .008) and Dietary Stage of Change (F(1,408) = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F(2,203) = 5.270, P = .003), Attitudes Toward a Healthful Diet (F(2,204) = 2.585, P = .045), and Dietary Stage of Change (F(2,200) = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical activity, although t tests of pretest-posttest changes indicated that both groups improved on several of these measures. The Web-based group gave significantly higher ratings to the program materials than the print group on all health topics and in their overall evaluation (F(1,410) = 9.808, P = .002). CONCLUSIONS:The Web-based program was more effective than print materials in producing improvements in the areas of diet and nutrition but was not more effective in reducing stress or increasing physical activity. The higher ratings given to the Web-based program suggest that workers preferred it to the print materials. Both groups showed numerous pretest-posttest improvements in all health topics, although such improvements might be attributable in part to a Hawthorne effect. Results suggest that a multimedia Web-based program can be a promising means of delivering health promotion material to the workforce, particularly in the area of diet and nutrition.

背景与目标： 背景：大多数工作场所都参与某种形式的健康促进计划，旨在改善工人的健康状况并降低医疗成本。尽管这些程序通常是通过研讨会和印刷材料的组合来交付的，但越来越多的工作场所健康促进程序是通过Internet交付的。
目的：本研究的目的是评估针对工作场所的基于Web的多媒体健康促进计划的有效性，该计划旨在改善饮食习惯，减轻压力并增加体育锻炼。
方法：使用随机对照试验设计，在每个组中进行前测后测比较，将419名人力资源公司的员工随机分配到基于Web的条件或提供相同主题印刷材料的条件。通过在线问卷对所有受试者进行测试前和测试后评估，该问卷包含健康行为和态度的多种测量。测试期为3个月。问卷数据主要通过协方差分析和t检验进行分析。
结果：两组的保留率均良好，基于Web的组为85％，而印刷组为87％。使用基于Web的程序的受试者的表现要明显优于印刷组的“健康饮食态度（F（1,415）= 7.104，P = .008）和饮食变化阶段（F（1,408）= 6.487，P = 0.01）”。 ），但其他五种饮食措施之间没有显着的群体差异。正如显着的t检验所示，两组在大多数饮食措施上均显示从测试前到测试后的改善。在基于网络的小组中，剂量分析显示受试者访问该计划的次数对饮食自我效能的测量具有显着影响（F（2,203）= 5.270，P = .003），对健康饮食的态度（F （2,204）= 2.585，P = .045）和饮食变化阶段（F（2,200）= 4.627，P = .005）。两组在压力或身体活动的测量方法上没有发现显着差异，尽管前测-后测变化的t检验表明，两组在其中一些测量方法上均有改善。在所有健康主题及其总体评估中，基于网络的小组对计划材料的评分均比印刷小组高得多（F（1,410）= 9.808，P = .002）。
结论：基于Web的程序在饮食和营养方面的改进比印刷材料更有效，但在减轻压力或增加体育锻炼方面却没有更有效。基于Web的程序获得的较高评级表明，工人更喜欢它而不是印刷材料。两组在所有健康主题上均表现出无数的测试前-测试后改善，尽管这种改善可能部分归因于霍桑效应。结果表明，基于多媒体Web的程序可能是向员工提供健康促进材料的一种有前途的手段，特别是在饮食和营养领域。

BACKGROUND & AIMS: :The aim of our study was to determine, using histological and stereological methods, whether photoperiodism has any impact on the effects that chronic (three-month long) exposure to LF-EMF (50Hz) has on morphological characteristics on rat's pineal gland. The experiment was performed on 48 Mill Hill male rats (24 experimental and 24 control). Upon birth, 24 rats were exposed for 7h a day, 5 days a week for 3 months to LF-EMF (50 Hz, 50-500microT, 10V/m). In the winter (short days, long nights), the activity of the pineal gland and neuroendocrine sensitivity is increased. The study was performed both during summer and winter, following the identical protocol. After sacrifice of animals, samples of pineal gland were processed for HE staining and then were analyzed using the methods of stereology. The most significant changes in epiphysis in the first group of animals in wintertime are: altered glandular feature, hyperemia, reduced pinealocytes with pale pink, poor cytoplasm and irregular, stick-form nuclei. In the second group (II) pinealocytes are enlarged, with vacuolated cytoplasm and hyper chromatic, enlarged nucleus. Morphological changes of pineal gland at rats in the summertime were not as intense as in the winter and finding of the gland in the group II is compatible with those from the control group. Stereological results show both in winter and summer in the first group the decrease of volume density of pinealocytes, their cytoplasm and nuclei and in the second group in winter increase the volume density of pinealocytes, cytoplasm and nuclei, while in the second group the results in summertime are equal to those from the control group. Photoperiodism is modifier of effect of LF-EMF on morphological structure of pineal gland, because the gland recovery is incomplete in winter and reversible in summer.

背景与目标： ：我们的研究目的是使用组织学和立体学方法确定光周期是否对长期（三个月以上）长期暴露于LF-EMF（50Hz）的大鼠松果体形态特征有影响。实验在48只Mill Hill雄性大鼠上进行（24只实验动物和24只对照组）。出生后，将24只大鼠每天，每周5天，每天7h，3个月暴露于LF-EMF（50 Hz，50-500microT，10V / m）。在冬季（短日，长夜），松果体的活动和神经内分泌敏感性增加。按照相同的方案，在夏季和冬季均进行了该研究。处死动物后，对松果体样品进行HE染色处理，然后使用立体学方法进行分析。冬季，第一组动物的骨physi最明显的变化是：腺体特征改变，充血，松果体细胞减少，呈浅粉红色，胞质差，核形不规则，呈棒状。在第二组（II）中，松果体细胞增大，具有空泡的细胞质和高色度，扩大的核。夏季，大鼠松果体的形态学变化不像冬季那样强烈，并且在第二组中发现的腺体与对照组的相符。立体学结果表明，第一组在冬季和夏季均降低了松果体细胞，其胞质和细胞核的体积密度，第二组在冬季中均升高了松果体细胞，细胞质和细胞核的体积密度，而第二组的结果则是夏季的时间与对照组的时间相同。光周期是LF-EMF对松果体形态结构影响的调节剂，因为冬季腺体恢复不完全，夏天可逆。

BACKGROUND & AIMS: Percutaneous tracheostomy was initiated as an alternative to open tracheostomy at our institution in December 1993. To assess safety, operative time, and cost, a comparative analysis of percutaneous and open tracheostomies was performed. A retrospective evaluation of all patients who underwent percutaneous tracheostomy (P) from December 1993 to March 1996 was completed. Patients were evaluated for indications for tracheostomy, length of operation, morbidity, and cost. The results were compared with patients who underwent open tracheostomy (O) during the 12 months prior to introduction of the percutaneous technique. Tracheostomy was performed percutaneously in 74 patients and by a standard open technique in 109 patients. Indications for tracheostomy includedchronic ventilator dependence (P, 49 vs O, 58); airway protection (P, 19 vs O, 42); laryngeal dysfunction (P, 2 vs O, 7); and facial trauma (P 6 vs O, 2). The length of operation was 21 +/- 6 minutes and 46 +/- 21 minutes for percutaneous and open tracheostomy, respectively (P < 0.05). Perioperative morbidity occurred in 2 patients (3%) following percutaneous tracheostomy compared to 10 patients (9%) following open tracheostomy (P > 0.05). The mean operating room costs per patient were $1093 and $1370 for percutaneous and open tracheostomy, respectively. Percutaneous tracheostomy is a safe procedure that can be performed in less time and at a lower cost than standard open tracheostomy.

背景与目标： 我们的机构于1993年12月开始采用经皮气管切开术代替开放式气管切开术。为评估安全性，手术时间和成本，对经皮和开放式气管切开术进行了比较分析。回顾性评估了所有从1993年12月至1996年3月行经皮气管切开术（P）的患者的情况。对患者进行气管切开术，手术时间，发病率和费用的指征进行评估。将结果与在引入经皮技术之前的12个月内接受开放气管切开术（O）的患者进行比较。 74例患者经皮气管切开术，109例患者采用标准开放技术进行气管切开术。气管切开术的适应症包括慢性呼吸机依赖性（P，49 vs O，58）；气道保护（P，19 vs O，42）;喉功能不全（P，2 vs O，7）;和面部创伤（P 6 vs O，2）。对于经皮气管切开术和开放式气管切开术，手术时间分别为21/6分钟和46-21分钟（P <0.05）。经皮气管切开术后2例（3％）发生围手术期发病，相比之下，开放气管切开术后10例（9％）发生围手术期发病（P> 0.05）。经皮和气管切开术每位患者的平均手术室费用分别为$ 1093和$ 1370。经皮气管切开术是一种安全的方法，与标准的开放式气管切开术相比，可在更短的时间内完成，且成本更低。

BACKGROUND & AIMS: This paper reports on the application of an artificial neural network to the clinical analysis of ophthalmological data. In particular a 2-dimensional Kohonen self-organising feature map (SOM) is used to analyse visual field data from glaucoma patients. Importantly, the paper addresses the problem of how the SOM can be utilised to accommodate the noise within the data. This is a particularly important problem within longitudinal assessment, where detecting significant change is the crux of the problem in clinical diagnosis. Data from 737 glaucomatous visual field records (Humphrey Visual Field Analyzer, program 24-2) are used to train a SOM with 25 nodes organised on a square grid. The SOM clusters the data organising the output map such that fields with early and advanced loss are at extreme positions, with a continuum of change in place and extent of loss represented by the intervening nodes. For each SOM node 100 variants, generated by a computer simulation modelling the variability that might be expected in a glaucomatous eye, are also classified by the network to establish the extent of noise upon classification. Field change is then measured with respect to classification of a subsequent field, outside the area defined by the original field and its variants. The significant contribution of this paper is that the spatial analysis of the field data, which is provided by the SOM, has been augmented with noise analysis enhancing the visual representation of longitudinal data and enabling quantification of significant class change.

背景与目标： 本文报道了人工神经网络在眼科数据临床分析中的应用。特别是，二维Kohonen自组织特征图（SOM）用于分析来自青光眼患者的视野数据。重要的是，本文解决了如何利用SOM来容纳数据中的噪声的问题。这在纵向评估中是一个特别重要的问题，在纵向评估中，检测到重大变化是临床诊断中问题的症结所在。来自737青光眼视野记录（汉弗莱视野分析仪，程序24-2）的数据用于训练SOM，并在一个正方形网格上组织25个节点。 SOM对组织输出图的数据进行聚类，以使具有早期和晚期损失的字段处于极端位置，并且中间节点代表的损失位置和程度的连续变化。对于每个SOM节点100，通过计算机模拟生成的变量也可以通过网络进行分类，以建立分类后的噪声范围，这些变量是在青光眼中可能预期的可变性建模而成的。然后根据原始字段及其变体定义的区域之外的后续字段的分类，测量字段变化。本文的重要贡献在于，由SOM提供的现场数据的空间分析已通过噪声分析得到了增强，从而增强了纵向数据的可视化表示并能够量化重大的类别变化。