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【关于淋巴结转移的存在，分析浸润性导管癌中CD34抗原的免疫反应水平。】
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BACKGROUND & AIMS: BACKGROUND:Angiogenesis is a basic process that enables neoplasms to thrive. Microvessel density (MVD) evaluation is an accepted parameter for assessing the angiogenesis process within a tumor. The aim of the present study has been to assess the number of microcapillaries in both invasive ductal breast cancer with the presence of metastases in regional lymph nodes and in invasive ductal breast cancer without such metastases. METHODS:The CD34 antigen immunoreactivity level was assessed by immunohistochemistry in both types of invasive ductal breast cancer. Tissue samples were obtained from 40 patients and were divided into two groups according to whether or not there were lymph node metastases. RESULTS:The patients with lymph node metastases exhibited statistically significantly higher numbers of stained microcapillaries than the patients who did not have lymph node metastases. CONCLUSION:Thus the number of stained microcapillaries as evaluated by using the CD34 immunoreactivity level seems to be a useful predictor for the development of local lymph node metastases in female invasive ductal breast cancer.背景与目标： 背景：血管生成是使肿瘤得以兴旺发展的基本过程。微血管密度（MVD）评估是用于评估肿瘤内血管生成过程的公认参数。本研究的目的是评估在区域性淋巴结中有转移的浸润性导管癌和没有转移的浸润性导管癌中微血管的数量。
方法：采用免疫组织化学方法评估两种浸润性导管癌中CD34抗原的免疫反应水平。从40例患者中获取组织样本，并根据是否有淋巴结转移将其分为两组。
结果：与没有淋巴结转移的患者相比，具有淋巴结转移的患者表现出显着更高的染色微毛细管数量。
结论：因此，通过使用CD34免疫反应水平评估的染色微毛细管数目似乎是女性浸润性导管癌局部淋巴结转移发展的有用预测指标。 -
【在1孔经椎间孔硬膜外注射类固醇激素注射中，Quincke和Whitacre针在血管内摄取风险方面的比较：1376例随机试验。】
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DOI：10.1213/ANE.0b013e3182a6d1bd
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BACKGROUND & AIMS: BACKGROUND:Transforaminal epidural steroid injection (TFESI) is a useful treatment modality for pain management. Most complications of TFESI are minor and transient. However, there is a risk of serious complications such as nerve injury, spinal cord infarct, or paraplegia. Some of the risks are related to direct injury to the vessel or intravascular injection of the particulate steroid. We prospectively tested the hypothesis that the intravascular injection rate of the Whitacre needle is lower than that of the Quincke needle during TFESI. METHODS:This study was a randomized trial of 1376 TFESIs at the S1 level. We collected data of age, gender, height, weight, laterality (right/left), history of lumbosacral spine operation, history of appropriate interval discontinuation of anticoagulation medicines, and underlying disease. During the S1 TFESI, intrasacral bone contact, a blood aspiration test, and real-time fluoroscopy of the intravascular injection using contrast media were investigated. RESULTS:There were no significant differences in the intravascular injection rate with respect to age, gender, height, weight, hypertension, diabetes mellitus, laterality, history of lumbosacral spine operation, or history of appropriate interval discontinuation of anticoagulation medicines. Intravascular injection was significantly associated with a blood aspiration test (P < 0.001), needle tip type (P = 0.002), intrasacral bone contact (P < 0.001), and physicians (some P < 0.05). The use of Quincke needles and intrasacral bone contact increased the rate of intravascular injection. CONCLUSIONS:To reduce the risk of intravascular injection, the use of Whitacre needles without intrasacral bone contact may be a safer and more effective approach.背景与目标： 背景：经椎间孔硬膜外注射类固醇激素（TFESI）是一种有效的疼痛治疗方法。 TFESI的大多数并发症是次要的和短暂的。但是，存在严重并发症的风险，例如神经损伤，脊髓梗塞或截瘫。一些风险与直接伤害血管或类固醇的血管内注射有关。我们前瞻性地检验了在TFESI期间Whitacre针的血管内注射速率比Quincke针的血管内注射速率低的假设。
方法：本研究是在S1级进行的1376个TFESI的随机试验。我们收集了年龄，性别，身高，体重，侧卧度（右/左），腰ac脊柱手术史，适当停用抗凝药物的间隔史以及潜在疾病的数据。在S1 TFESI期间，研究了contrast骨内接触，血液抽吸试验和使用造影剂对血管内注射进行实时荧光检查。
结果：在年龄，性别，身高，体重，高血压，糖尿病，侧卧，腰s部脊柱手术史或适当停用抗凝药物的历史方面，血管内注射率无显着差异。血管内注射与抽血试验（P <0.001），针尖类型（P = 0.002），s骨内接触（P <0.001）和医生（P ＜0.05）显着相关。使用Quincke针和s骨内接触可增加血管内注射的速度。
结论：为减少血管内注射的风险，使用不带intra骨内接触的Whitacre针可能是一种更安全，更有效的方法。 -
【审查。相对于相同的抑制剂，癌症和细菌细胞的多药耐药性外排泵的比较。】
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BACKGROUND & AIMS: :Bacteria and cancer cells develop resistance to more than one agent as a consequence of being exposed to ineffective levels of the agent for a prolonged period of time. The resistance of these cells is mediated by over-expressed efflux pumps that have the ability to extrude a large variety of unrelated chemicals. This review discusses the main types of multidrug resistant (MDR) efflux systems of bacteria and cancer cells, and shows the similarity of specific efflux systems between them with respect to given agents that inhibit efflux, thus rendering these cells once more susceptible to agents to which they had developed MDR.背景与目标： 细菌和癌细胞会因长时间暴露于无效水平的试剂而对一种以上的试剂产生抗药性。这些细胞的抗性是由过表达的外排泵介导的，外排泵具有挤出多种无关化学物质的能力。这篇评论讨论了细菌和癌细胞的多药耐药性（MDR）外排系统的主要类型，并显示了它们之间的特定外排系统与给定的抑制外排的药物之间的相似性，从而使这些细胞再次易受细菌和癌细胞的侵害。他们开发了MDR。
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【对两种低剂量口服避孕药的功效，周期控制进行了为期十二个月的比较临床研究，这些口服避孕药分别含20毫克乙炔雌二醇/ 75毫克孕二烯和20毫克乙炔雌二醇/ 150毫克去氧孕烯。】
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DOI：10.1016/0010-7824(95)00191-c
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BACKGROUND & AIMS: The aim of this study was to compare contraceptive reliability, cycle control and tolerance of an oral contraceptive containing 20 micrograms ethinylestradiol and 75 micrograms gestodene, with a reference preparation containing the same dose of estrogen combined with 150 micrograms desogestrel. This article presents interim data from centers in France and Austria, involving a total of 479 women and 4,991 cycles. Contraceptive reliability was good with both preparations. Two pregnancies occurred in the gestodene group, but neither were due to method failure. In the desogestrel group there were also two pregnancies, of which one was due to method failure. With respect to cycle control, there is a trend towards a lower incidence of intermenstrual bleeding in the gestodene group. The incidence of spotting (scanty bleeding) during the important first three cycles was 3.5% lower in the gestodene group, and over the first six cycles, it was 7.6% lower. Amenorrhea was similar in both groups, but the incidence of dysmenorrhea was significantly lower in the gestodene group (p=0.001). Adverse events were similar in both groups, with headache, breast tension and nausea the most frequently reported symptoms. Body weight remained relatively constant during treatment in both groups, and no hypertension was reported for any woman during the course of the study. In each treatment group, 19 women discontinued because of adverse events. It is concluded that both preparation are reliable and well tolerated oral contraceptives are reliable and well tolerated oral contraceptives; however, there is a more favourable effect on dysmenorrhea by the gestodene formulation.
背景与目标： 这项研究的目的是比较含有20微克乙炔雌二醇和75微克孕二烯酮的口服避孕药的避孕可靠性，周期控制和耐受性，以及含有相同剂量雌激素和150微克去氧孕烯的参比制剂。本文介绍了来自法国和奥地利的中心的临时数据，涉及总共479名妇女和4,991个周期。两种制剂的避孕可靠性均良好。孕二烯酮组发生了两次怀孕，但都不是由于方法失败而引起的。在去氧孕烯组中也有两次怀孕，其中一次是由于方法失败而引起的。关于周期控制，孕二烯酮组月经间出血的发生率有降低的趋势。孕二烯酮组在重要的前三个周期中出现斑点（少量出血）的发生率降低了3.5％，而在前六个周期中，则降低了7.6％。两组的闭经情况相似，但孕二烯酮组的痛经发生率显着降低（p = 0.001）。两组的不良事件相似，头痛，乳房紧张和恶心是最常报告的症状。两组患者在治疗期间体重均保持相对恒定，并且在研究过程中未见任何女性患有高血压。在每个治疗组中，有19名妇女因不良事件而停药。结论是，两种制剂都是可靠且耐受性良好的口服避孕药；是可靠且耐受性良好的口服避孕药。但是，孕二烯酮制剂对痛经有更有利的作用。
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【猪屠宰中食源性细菌的危害识别。】
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DOI：10.1016/0168-1605(96)00988-9
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BACKGROUND & AIMS: Swine slaughter is an open process with many opportunities for the contamination of the pork carcass with potentially pathogenic bacteria; however, it does not contain any point where hazards are completely eliminated. Data on the prevalence of various pathogenic bacteria (Aeromonas hydrophila, Campylobacter coli/jejuni, Listeria monocytogenes, Salmonella spp., Staphylococcus aureus and Yersinia enterocolitica) in pigs, their growth and survival characteristics and ability to become established on the slaughter line are presented. The presentation covers the processing steps from lairage to chilling and is based on swine slaughter practices in Denmark, Norway and Sweden. The major contamination points during swine slaughter are pig-related, such as faecal and pharyngeal, and environmental. HACCP (Hazard Analysis Critical Control Point) and GMP (Good Manufacturing Practice) in swine slaughter must be focused on limiting this spread. The pathogenic bacteria show differences in their general mechanism of distribution. The major contamination source of Campylobacter spp., Salmonella spp. and Y. enterocolitica is the pig, and the contamination of carcasses with these bacteria may be limited, provided that only strict slaughtering procedures are used. Other organisms such as Aeromonas spp., L. moncytogenes/Listeria spp. and S. aureus can be endemic in the processing environment. Since endemic bacteria can be controlled by proper cleaning and disinfection, these organisms are useful as indicators for the success of GMP rules. The following affiliation to CPs or CCPs made for specific steps during slaughter and dressing may serve as a guidance(i) lairage (CP), (ii) killing (CP), (iii) scalding (CP), (iv) dehairing (CP), (v) singeing/flaming (CP), (vi) polishing (CP), (vii) circumanal incision and removal of the intestines (CCP), (viii) excision of the tongue, pharynx, and in particular the tonsils (CCP), (ix) splitting (CP), (x) post mortem inspection procedures (CCP) and (xi) deboning of the head (CCP).
背景与目标： 猪屠宰是一个开放的过程，有很多机会使猪肉potentially体被潜在的病原菌污染。但是，它不包含任何可以完全消除危害的地方。给出了猪中各种致病细菌（亲水性气单胞菌，弯曲杆菌/空肠，单核细胞增生性李斯特氏菌，金黄色葡萄球菌，金黄色葡萄球菌和小肠结肠炎耶尔森菌）的流行率，生长和存活特征以及在屠宰线上确立的能力的数据。演示内容涵盖了从熟食到冷藏的加工步骤，并基于丹麦，挪威和瑞典的生猪屠宰实践。猪宰杀过程中的主要污染点与猪有关，例如粪便和咽部以及环境。猪屠宰中的HACCP（危害分析关键控制点）和GMP（良好生产规范）必须集中于限制这种传播。病原菌在其一般分布机制上显示出差异。弯曲杆菌属，沙门氏菌属的主要污染源。小肠结肠炎耶尔森氏菌是猪，如果仅使用严格的屠宰程序，则可以限制尸体受到这些细菌的污染。其他生物，如气单胞菌属，单核细胞增生李斯特氏菌/李斯特菌。金黄色葡萄球菌和金黄色葡萄球菌在加工环境中可能是地方性的。由于地方性细菌可以通过适当的清洁和消毒来控制，因此这些生物可用作GMP规则成功的指标。在屠宰和穿衣过程中针对特定步骤的CP或CCP的以下隶属关系可作为指导（i）抓人（CP），（ii）杀人（CP），（iii）烫伤（CP），（iv）脱毛（CP ），（v）烧毛/发炎（CP），（vi）抛光（CP），（vii）环行切口并去除肠（CCP），（viii）切除舌头，咽部，尤其是扁桃体（ CCP），（ix）劈裂（CP），（x）验后检查程序（CCP）和（xi）头部去骨（CCP）。
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【基于规则的大麦形态发生模型，特别涉及阴影和赤霉素信号转导。】
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DOI：10.1093/aob/mcm172
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BACKGROUND & AIMS: BACKGROUND AND AIMS:Functional-structural plant models (FSPM) constitute a paradigm in plant modelling that combines 3D structural and graphical modelling with the simulation of plant processes. While structural aspects of plant development could so far be represented using rule-based formalisms such as Lindenmayer systems, process models were traditionally written using a procedural code. The faithful representation of structures interacting with functions across scales, however, requires a new modelling formalism. Therefore relational growth grammars (RGG) were developed on the basis of Lindenmayer systems. METHODS:In order to implement and test RGG, a new modelling language, the eXtended L-system language (XL) was created. Models using XL are interpreted by the interactive, Java-based modelling platform GroIMP. Three models, a semi-quantitative gibberellic acid (GA) signal transduction model, and a phytochrome-based shade detection and object avoidance model, both coupled to an existing morphogenetic structural model of barley (Hordeum vulgare L.), serve as examples to demonstrate the versatility and suitability of RGG and XL to represent the interaction of diverse biological processes across hierarchical scales. KEY RESULTS:The dynamics of the concentrations in the signal transduction network could be modelled qualitatively and the phenotypes of GA-response mutants faithfully reproduced. The light model used here was simple to use yet effective enough to carry out local measurement of red:far-red ratios. Suppression of tillering at low red:far-red ratios could be simulated. CONCLUSIONS:The RGG formalism is suitable for implementation of multi-scaled FSPM of plants interacting with their environment via hormonal control. However, their ensuing complexity requires careful design. On the positive side, such an FSPM displays knowledge gaps better thereby guiding future experimental design.背景与目标： 背景和目的：功能结构工厂模型（FSPM）构成了工厂建模的范例，该模型将3D结构和图形建模与工厂过程的仿真相结合。到目前为止，虽然可以使用基于规则的形式主义（例如Lindenmayer系统）来表示工厂开发的结构方面，但是传统上使用过程代码来编写过程模型。但是，要忠实地表示结构与尺度之间相互作用的结构，就需要一种新的建模形式主义。因此，关系增长语法（RGG）是在Lindenmayer系统的基础上开发的。
方法：为了实现和测试RGG，创建了一种新的建模语言，即扩展的L系统语言（XL）。使用XL的模型由基于Java的交互式建模平台GroIMP解释。以三个模型，半定量赤霉素（GA）信号转导模型，以及基于植物色素的阴影检测和避免对象模型与现有的大麦（Hordeum vulgare L.）形态形成结构模型相结合为例。 RGG和XL的多功能性和适用性代表了跨层次尺度的各种生物过程的相互作用。
关键结果：可以定性地模拟信号转导网络中浓度的动态变化，并忠实地复制GA反应突变体的表型。此处使用的光照模型易于使用，但足以进行红色：远红色比率的局部测量。可以模拟低红：远红比率下的分till抑制。
结论：RGG形式主义适用于通过激素控制与环境相互作用的植物的多尺度FSPM的实施。但是，其随后的复杂性需要仔细设计。从积极的方面来看，这样的FSPM可以更好地显示知识差距，从而为将来的实验设计提供指导。 -
【环丙沙星和其他十三种抗菌药物对近期分离的病原体的体外抗菌活性的比较研究。】
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DOI：10.1080/1120009x.1990.11738977
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BACKGROUND & AIMS: :The in vitro antibacterial activity of ciprofloxacin and 13 other antimicrobial drugs was evaluated with respect to 569 pathogens, mainly isolated from urine. Ciprofloxacin was found active in 96.1% of all of the Gram-positive and Gram-negative strains tested, amikacin in 90.6%, ceftazidime in 89.8%, ceftriaxone in 85.3%, piperacillin in 82.7%, tobramycin in 82.6%, gentamicin in 81.5%, aztreonam in 78.3%, nitrofurantoin in 72.6%, cotrimoxazole in 71.6%, cinoxacin in 71.0%, pipemidic acid in 70.6%, nalidixic acid in 66.7%, ampicillin in 50.1%. Ciprofloxacin was found to be the most active of the drugs studied against the bacterial strains which cause urinary, respiratory and other infections.背景与目标： ：对主要从尿液中分离出来的569种病原体，评估了环丙沙星和其他13种抗菌药物的体外抗菌活性。环丙沙星在所有测试的革兰氏阳性和革兰氏阴性菌株中占96.1％，阿米卡星占90.6％，头孢他啶占89.8％，头孢曲松占85.3％，哌拉西林占82.7％，妥布霉素占82.6％，庆大霉素占81.5％。 ，氨曲南，78.3％，呋喃妥因，72.6％，卡曲美唑，71.6％，西沙星，71.0％，哌米酸，70.6％，萘啶酸，66.7％，氨苄青霉素，50.1％。已发现环丙沙星是研究的最有效的药物，可抵抗引起尿，呼吸道和其他感染的细菌菌株。
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【关于致突变性和致癌性的综合决策树测试策略，符合欧盟REACH法规的要求。】
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DOI：10.1177/026119290803601s05
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BACKGROUND & AIMS: :Liverpool John Moores University and FRAME recently conducted a research project sponsored by Defra, on the status of alternatives to animal testing with regard to the European Union REACH (Registration, Evaluation and Authorisation of Chemicals) system for the safety testing and risk assessment of chemicals. The project covered all the main toxicity endpoints associated with the REACH system. This paper focuses on the prospects for using alternative methods (both in vitro and in silico) for mutagenicity (genotoxicity) and carcinogenicity testing--two toxicity endpoints, which, together with reproductive toxicity, are of pivotal importance for the REACH system. The manuscript critically discusses well-established testing approaches, and in particular, the requirement for short-term in vivo tests for confirming positive mutagenicity, and the need for the rodent bioassay for detecting non-genotoxic carcinogens. Recently-proposed testing strategies focusing on non-animal approaches are also considered, and our own testing scheme is presented and supported with background information. This scheme makes maximum use of pre-existing data, computer (in silico) and in vitro methods, with weight-of-evidence assessments at each major stage. The need for the improvement of in vitro methods, to reduce the generation of false-positive results, is also discussed. Lastly, ways in which reduction and refinement measures can be used are also considered, and some recommendations are made for future research to facilitate the implementation of the proposed testing scheme.背景与目标： ：利物浦约翰摩尔大学和FRAME最近进行了由Defra赞助的研究项目，该研究项目涉及欧盟REACH（化学品注册，评估和授权）系统中动物测试替代品的现状，以进行化学品安全性测试和风险评估。该项目涵盖了与REACH系统相关的所有主要毒性终点。本文重点介绍了使用替代方法（体外和计算机模拟）进行致突变性（遗传毒性）和致癌性测试的前景-两个毒性终点以及生殖毒性对于REACH系统至关重要。该手稿严格地讨论了已建立的测试方法，尤其是对短期的体内测试以确认阳性诱变性的要求，以及对啮齿动物生物测定法以检测非遗传毒性致癌物的需求。还考虑了最近提出的针对非动物方法的测试策略，并提出了我们自己的测试方案并提供了背景信息的支持。该方案最大程度地利用了现有数据，计算机（计算机模拟）和体外方法，并在每个主要阶段进行了证据权重评估。还讨论了改进体外方法以减少假阳性结果的产生的需求。最后，还考虑了减少和改进措施的使用方法，并为将来的研究提出了一些建议，以促进拟议的测试方案的实施。
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【关于queussine，癌症中转移RNA的过修饰。】
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DOI：10.4161/rna.2.4.2417
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BACKGROUND & AIMS: :Queuosine is a highly modified nucleoside analogue of guanosine. It is present only in the first position of anticodon loop of specific tRNA i.e., tRNA(his), tRNA(asp), tRNA(asn) and tRNA(tyr) and post transcriptionally modified with base-for-base exchange of guanine to queuine. The transfer RNA modifying enzyme transfer RNA guanine transglycosylase (TGTase) catalyzes the modification of tRNAs. Transfer RNA is completely modified with respect to queuosine in mature tissue, however modification is often incomplete in mitotically active cells. Hypomodification of transfer RNA is correlated with cell proliferation and malignancy. In the present study queuosine modification of transfer RNA and TGTase activity is compared in normal, Dalton's lymphoma ascites transplanted (DLAT) cancerous and queuine treated DLAT cancerous mouse liver. Transfer RNA of cancerous mouse is hypomodified in terms of queuosine modification. TGTase activity of cancerous mouse is found to decrease to less then half of enzyme activity of normal mouse; suggesting that the enzyme may be responsible for transfer RNA hypomodification. Exogenous treatment of queuine during development of cancer improves the queuosine modification of transfer RNA. The activators NaPP and ATP enhance TGTase activity of normal and DLAT cancerous mouse, where as 7mG inhibits the TGTase activity.背景与目标： ：Queuosine是鸟苷的高度修饰的核苷类似物。它仅存在于特定tRNA的反密码子环的第一个位置，即tRNA（his），tRNA（asp），tRNA（asn）和tRNA（tyr），并经鸟嘌呤至奎宁的碱基对碱基交换而被转录后修饰。转移RNA修饰酶转移RNA鸟嘌呤转糖基酶（TGTase）催化tRNA的修饰。相对于成熟组织中的奎宁，转移RNA已被完全修饰，但是在有丝分裂活性细胞中修饰通常是不完全的。转移RNA的过低修饰与细胞增殖和恶性肿瘤相关。在本研究中，比较了正常，道尔顿氏淋巴瘤腹水移植（DLAT）癌性和队列治疗的DLAT癌性小鼠肝中转移RNA和TGTase活性的队列蛋白修饰。就槲皮素修饰而言，癌小鼠的转移RNA被修饰不足。发现癌性小鼠的TGTase活性降低至正常小鼠的一半以下；提示该酶可能是导致转移RNA修饰不足的原因。在癌症发生过程中对奎因进行外源治疗可改善转移RNA的奎因修饰。 NaPP和ATP激活剂可增强正常小鼠和DLAT癌小鼠的TGTase活性，而7mG则可抑制TGTase活性。
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【在法医精神病学护理中尊重患者的自主权。】
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DOI：10.1111/j.1939-3938.2005.tb00007.x
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BACKGROUND & AIMS: :A fundamental issue that forensic psychiatric nurses struggle with is respect for patient autonomy, as the two liberal prerequisites for autonomy, liberty and rationality, are either absent or compromised in forensic psychiatric settings. In this paper, a contemporary feminist perspective of autonomy, relational autonomy, will be advanced as an alternative approach to the traditional liberalist, Kantian, perspective of autonomy. The concepts of autonomy, paternalism, and justice will be discussed in relation to forensic psychiatric nursing.背景与目标： ：法医精神科护士努力解决的一个基本问题是对患者自治的尊重，因为在法医精神病学环境中，自治，自由和合理性这两个自由先决条件不存在或受到损害。在本文中，将提出当代女性主义的自治观点关系自治，作为对传统的自由主义康德式自治观点的替代方法。自治，家长式和正义的概念将与法医精神病学护理相关地进行讨论。
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【大肠肿瘤中微血管的形态分析与肝转移的形成有关。】
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DOI：10.1002/jso.1164
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BACKGROUND & AIMS: BACKGROUND AND OBJECTIVES:Overexpression of VEGF and proliferation of microvessels are strongly related to liver metastases, however, morphologic analyses of microvessels in liver metastases have not been reported. The purpose of the present study was to examine the correlation between liver metastases and the diameters of microvessel lumens in the tumor tissue.
METHODS:Fifty-nine patients with liver metastases from colorectal cancers and 112 patients who underwent curative colorectal resection and survived without any recurrence were reviewed. Microvessel density (MVD) and the diameters of the lumens of individual microvessels were assessed.
RESULTS:There was a significant difference in terms of the mean MVD of primary tumors between patients with liver metastases and those without liver metastases. The numbers of patients with liver metastases who had microvessels 100-200 microm in diameter and microvessels more than 200 microm in diameter were significantly greater than patients without liver metastases. Microvessels with lumens more than 100 microm in diameter were not detected in the liver metastatic lesion.
CONCLUSION:Large microvessels in the primary tumor favor intravasation of cancer cells.
背景与目标： 背景和目的：VEGF的过表达和微血管的增殖与肝转移密切相关，但是，尚未见有关肝转移中微血管的形态学分析的报道。本研究的目的是研究肝转移与肿瘤组织中微血管腔直径之间的相关性。
方法：59例大肠癌肝转移患者回顾了112例行结直肠癌根治性切除术且未复发的患者。评估了微血管密度（MVD）和单个微血管的内腔直径。
结果：肝病患者之间原发性肿瘤的平均MVD有显着差异转移和无肝转移者。直径为100-200微米的微血管和直径大于200微米的微血管的肝转移患者人数明显高于无肝转移的患者。在肝转移病灶中未检测到管腔直径大于100微米的微血管。
结论：原发性肿瘤中的大微血管有利于癌细胞的浸润。
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【牙医和牙科学生对处方抗生素预防感染性心内膜炎的相关指南的知识和依从性：系统评价。】
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DOI：10.1016/j.jebdp.2019.01.007
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BACKGROUND & AIMS: BACKGROUND:It is essential that dental clinicians, including dental students, have sufficient knowledge of and adhere to relevant prophylactic guidelines for the prevention of infective endocarditis. Because the overprescription of antibiotics contributes to the development of drug resistance, antibiotic stewardship should be at the forefront of patient care. The aim of this review is to determine the level of knowledge and compliance of dentists and dental students to relevant guidelines regarding antibiotic prophylaxis for the prevention of infective endocarditis. In addition, we aim to identify the factors that influence the level of knowledge and compliance. MATERIALS AND METHODS:The following electronic databases were searched: MEDLINE (OvidSP), Scopus, Web of Science, CINAHL (EBSCOhost), and Informit Health Database. Inclusion criteria were (1) published quantitative studies that assessed dentists' and dental students' knowledge of and compliance with relevant guidelines for prescribing antibiotic prophylaxis for the prevention of infective endocarditis; (2) studies in English; and (3) studies published on any date. The National Institutes of Health, National Heart, Lung and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to appraise each of the included studies. The required data were collected and formatted to provide a narrative synthesis. RESULTS:A total of 3427 articles were identified, 167 full-text articles were reviewed, and 43 articles from 37 studies were included. Overall knowledge of guidelines ranged from as low as 1.9% to as high as 100% depending on the detail being examined. No statistically significant difference was found between dental students' and qualified dentists' knowledge. Overall compliance with guidelines ranged from 40% to 81%. Respondents' age and postgraduate training were the variables most associated with dentists' knowledge of guidelines for infective endocarditis. A limitation of this review is that only quantitative studies in English were assessed. CONCLUSION:Knowledge levels of guidelines for antibiotic prophylaxis varied greatly depending on the study design, respondent characteristics, and time period factors. There is a lack of research published on compliance rates for dentists and dental students with respect to guidelines for the prevention of infective endocarditis.背景与目标： 背景：至关重要的是，包括牙科学生在内的牙科临床医生必须具有足够的知识并遵守相关的预防性指南，以预防感染性心内膜炎。由于抗生素的过量处方会导致耐药性的发展，因此抗生素管理应成为患者护理的重中之重。这篇综述的目的是确定牙医和牙科学生对预防感染性心内膜炎的抗生素预防相关指南的了解程度和依从性。此外，我们旨在确定影响知识水平和合规性的因素。
材料和方法：搜索以下电子数据库：MEDLINE（OvidSP），Scopus，Web of Science，CINAHL（EBSCOhost）和Informit Health数据库。纳入标准是：（1）已发表的定量研究评估了牙医和牙科学生对预防感染性心内膜炎的抗生素预防处方的了解和遵守情况； （2）英语学习； （3）在任何日期发表的研究。美国国立卫生研究院，国家心脏，肺和血液研究所用于观察性队列研究和跨学科研究的质量评估工具用于评估每个纳入的研究。收集所需数据并格式化以提供叙述性综合。
结果：共鉴定了3427篇文章，审查了167篇全文文章，并纳入了来自37个研究的43篇文章。根据所检查的细节，指南的总体知识范围从低至1.9％到高至100％。牙科学生的知识和合格的牙医的知识之间没有发现统计学上的显着差异。总体上符合准则的范围从40％到81％。受访者的年龄和研究生培训是与牙医了解感染性心内膜炎指南最相关的变量。该评论的局限性在于仅评估了英语的定量研究。
结论：根据研究设计，应答者特征和时间因素，抗生素预防指南的知识水平差异很大。关于预防感染性心内膜炎的指南，目前还缺乏关于牙医和牙科学生的依从率的研究。 -
【经假肢排列改变的经胫截肢者的稳定性极限。】
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DOI：10.1016/j.apmr.2013.05.019
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BACKGROUND & AIMS: OBJECTIVES:To evaluate the limits of stability (LOS) in persons with transtibial amputation (TTA), and to determine the effects of prosthetic alignment alterations on motor control strategies. DESIGN:Before-and-after trial. SETTING:A kinesiology laboratory at a university hospital. PARTICIPANTS:Male patients with TTA (n=10) and controls (n=17). INTERVENTIONS:Prosthetic alignment. MAIN OUTCOME MEASURES:For the LOS test, the maximum excursion, endpoint excursion, direction control, movement velocity, and reaction time with inclination in the forward direction, toward the amputated leg/right leg, and in the backward direction, and toward the nonamputated leg/left leg. Measurements were performed using the following 5 prosthetic alignments: the optimal alignment, with the prosthesis shorter by 1cm, with the prosthesis longer by 1cm, and with the prosthetic foot in 5° of extra plantar flexion and 5° of extra dorsiflexion. RESULTS:Compared with the control group, maximum excursion and direction control were lower (P<.05) in patients with TTA with backward body inclination for all tested prosthetic alignments. Direction control in backward inclination was reduced (P<.05) compared with other tested directions for all assessed prosthetic alignments. Differences between the tested alignments were not significant in any of the tested directions. CONCLUSIONS:Patients with TTA have decreased voluntary body inclination backward within the LOS for all tested prosthetic alignments. Compared with controls, changes in prosthetic foot settings by means of rotation in the sagittal plane had a larger impact on movement strategy in patients with TTA than did changes to the length of the prosthesis.背景与目标： 目的：评估胫骨截肢（TTA）患者的稳定性（LOS）极限，并确定假体排列改变对运动控制策略的影响。
设计：试用前后。
地点：大学医院的运动机能实验室。
参与者：男性TTA患者（n = 10）和对照组（n = 17）。
干预：假体对齐。
主要观察指标：对于LOS测试，最大偏移，端点偏移，方向控制，运动速度和反应时间，向前，向截肢/右腿，向后截肢，向后，向非截肢倾斜腿/左腿。使用以下5种假体对齐方式进行测量：最佳对齐方式，假体短1cm，假体长1cm，假脚足底弯曲5°，背背弯曲5°。
结果：与对照组相比，对于所有测试的假体排列，TTA身体向后倾斜的患者的最大偏移和方向控制均较低（P <.05）。对于所有评估的假体排列，与其他测试方向相比，向后倾斜的方向控制减少了（P <.05）。在任何测试方向上，测试对齐之间的差异均不显着。
结论：对于所有测试的假体排列，患有TTA的患者在LOS内向后减少了自愿的身体倾斜。与对照组相比，在TTA患者中，通过矢状面旋转引起的假脚设置改变对假肢长度的影响更大。 -
14 Immunomodulatory role of TIITS in respect to cytotoxic lymphocytes in four grades of human glioma.
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【TIITS对人类四级神经胶质瘤中细胞毒性淋巴细胞的免疫调节作用。】
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DOI：10.1016/j.cellimm.2012.05.006
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BACKGROUND & AIMS: :T11 target structure (T11TS), a membrane glycoprotein has been documented with antineoplastic activity in animal model in our lab. Previously, in animal study we have documented T11TS induced cytotoxic abrogation of tumor cells. Encouraged by these established findings by our group and as prerequisite for clinical trial, this study has been designed to assess the cytotoxic potential of the patient's lymphocytes in in vitro study of autologous human glioma as modulated by T11TS. Meningioma samples were chosen as disease control group. The data produced indicates T11TS induced up regulation of cytotoxicity of T lymphocytes in grade I and II glioma. Significant enhancement of cytotoxic protein, perforin and granzyme suggest cytotoxic death of T11TS induced target tumor. Also, T11TS downregulates the TGF-β secretion in grade I and II tumor cells. These preliminary findings may help in pushing this molecule into pharmaceutical domain.背景与目标： ：T11靶结构（T11TS），一种膜糖蛋白已在我们实验室的动物模型中被证明具有抗肿瘤活性。以前，在动物研究中，我们已经记录了T11TS诱导的肿瘤细胞细胞毒素消除。受我们小组这些既定发现的鼓舞，并作为临床试验的前提，本研究旨在评估在体外研究受T11TS调节的自体人类神经胶质瘤患者淋巴细胞的细胞毒性潜力。选择脑膜瘤样品作为疾病对照组。产生的数据表明，T11TS诱导了I级和II级神经胶质瘤中T淋巴细胞的细胞毒性上调。细胞毒性蛋白，穿孔素和颗粒酶的显着增强表明T11TS诱导的靶肿瘤的细胞毒性死亡。同样，T11TS下调I级和II级肿瘤细胞中TGF-β的分泌。这些初步发现可能有助于将该分子推入药物领域。 -
【设施接生员对孕产妇和新生儿健康技能的了解与自我评价的信心：尼日利亚初级卫生保健机构的经验。】
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DOI：10.4314/mmj.v31i3.8
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BACKGROUND & AIMS: Background:Competent and skilled birth attendants are critical in the reduction of maternal and infant morbidity and mortality at delivery. This study aimed to determine the association between knowledge and self-rated confidence in facility birth attendants affiliated with maternal and neonatal health (MNH) interventions. Methods:A descriptive cross-sectional study was conducted in 24 primary healthcare facilities in Osun state, Nigeria among 128 consenting facility birth attendants who were selected via a multi-stage sampling technique. Each attendant received a semi-structured interviewer-administered questionnaire. The dependent variables included the respondent's level of knowledge in MNH interventions and their self-rated confidence in MNH skills such as the provision of antenatal care service, normal labour, use of a partograph and the management of obstetric complications and post-partum haemorrhage. Bivariate analysis of factors associated with knowledge and self-rated confidence in MNH skills was performed with statistical significance set at p<0.05. Results:Only 48 (37.5%) of the respondents had good knowledge of all of the assessed interventions; worse performances were reported with regards to the respondent's knowledge of normal labour and partograph use. However, 96 (75%) of respondents were confident in performing 75% of the skills assessed. Our analysis identified two factors that were significantly associated with a good knowledge of MNH skills: the cadre of the birth attendants (p<0.001) and training in life-saving skills (p=0.001). The knowledge of our respondents relating to most of the MNH interventions assessed was not significantly associated with their self-rated confidence in the required skills. Conclusion:The confidence of facility birth attendants in MNH skills was not knowledge-based and could frustrate national efforts to reduce maternal and perinatal deaths. We recommend effective and evidence-based training of all cadres of facility birth attendants to ensure that the skills being practiced clinically are based on adequate knowledge.背景与目标： 背景：合格和熟练的接生员对于降低产妇和婴儿的发病率和死亡率至关重要。这项研究旨在确定与产妇和新生儿健康（MNH）干预相关的设施接生员的知识与自评信心之间的关联。
方法：描述性横断面研究在尼日利亚奥森州的24家主要医疗机构中进行，该研究采用多阶段抽样技术从128名同意的机构接生员中选出。每位服务员都收到了由访谈员管理的半结构化问卷。因变量包括受访者对MNH干预的知识水平，以及他们对MNH技能的自评信心，例如提供产前护理服务，正常分娩，使用分形仪以及管理产科并发症和产后出血。对与MNH技能的知识和自我评估的自信心相关的因素进行双变量分析，统计学显着性设为p <0.05。
结果：只有48（37.5％）位被调查者对所有评估的干预措施都有很好的了解；据报告，关于受访者的正常劳动和零件使用情况，表现较差。但是，有96名（75％）的受访者对完成所评估技能的75％有信心。我们的分析确定了与MNH技能的良好知识显着相关的两个因素：接生人员的干部（p <0.001）和救生技能的培训（p = 0.001）。我们的受访者对大多数MNH干预措施的了解与他们对所需技能的自我评价信心没有显着相关。
结论：设施接生员对MNH技能的信心不是基于知识的，可能会挫伤国家减少孕产妇和围产儿死亡的努力。我们建议对设施接生的所有干部进行有效且循证的培训，以确保临床实践的技能是基于足够的知识。
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