BACKGROUND & AIMS: BACKGROUND:Apathy is a common non-motor symptom in Parkinson's disease (PD), but little is known about apathy and white matter (WM) change. In this study, we investigated whether fractional anisotropy (FA) of the WM can distinguish apathetic patients from non-apathetic PD patients, and whether the FA value correlates with the severity of apathy in PD. METHODS:Thirty-nine PD patients participated in our study, of which 18 participants were with apathy symptom, and 21 without apathy symptom. Diffusion tensor imaging was performed on all the subjects. RESULTS:Compared to non-apathetic PD patients, the apathetic group had reduced FA values in the genu and body of corpus callosum, bilateral anterior corona radiata, left superior corona radiata and left cingulum. Furthermore, in these WM regions, the FA values were negatively correlated with the Lille Apathy Rating Scale scores in apathetic subjects. CONCLUSION:The WM change is associated with apathy in PD patients. In addition, the FA values of specific regions of WM could be a promising marker to predict the severity of apathy.

背景与目标： 背景：冷漠是帕金森氏病（PD）的常见非运动症状，但对冷漠和白质（WM）改变知之甚少。在这项研究中，我们调查了WM的分数各向异性（FA）是否可以区分无情感障碍的患者和无情感障碍的PD患者，以及FA值是否与PD的情感障碍的严重程度相关。
方法：39例PD患者参加了我们的研究，其中18例有冷漠症状，21例无冷漠症状。对所有受试者进行扩散张量成像。
结果：与非精神分裂症PD患者相比，精神分裂症组call体，双侧前冠状放射线，左上冠状放射线和左扣带的FA和值均降低。此外，在这些西医区，FA值与冷漠受试者的里尔冷漠评定量表得分负相关。
结论：WM改变与PD患者的冷漠有关。此外，WM特定区域的FA值可能是预测冷漠严重程度的有前途的标志。

BACKGROUND & AIMS: :Catalysing the reduction of oxygen in acidic media is a standing challenge. Although activity of platinum, the most active metal, can be substantially improved by alloying, alloy stability remains a concern. Here we report that platinum nanoparticles supported on graphite-rich boron carbide show a 50-100% increase in activity in acidic media and improved cycle stability compared to commercial carbon supported platinum nanoparticles. Transmission electron microscopy and x-ray absorption fine structure analysis confirm similar platinum nanoparticle shapes, sizes, lattice parameters, and cluster packing on both supports, while x-ray photoelectron and absorption spectroscopy demonstrate a change in electronic structure. This shows that purely electronic metal-support interactions can significantly improve oxygen reduction activity without inducing shape, alloying or strain effects and without compromising stability. Optimizing the electronic interaction between the catalyst and support is, therefore, a promising approach for advanced electrocatalysts where optimizing the catalytic nanoparticles themselves is constrained by other concerns.

背景与目标： ：在酸性介质中催化氧的还原是一项长期挑战。尽管可以通过合金化显着提高最活泼的金属铂的活性，但合金的稳定性仍然值得关注。在这里，我们报告说，与商业碳载铂纳米颗粒相比，负载在富含石墨的碳化硼上的铂纳米颗粒在酸性介质中的活性提高了50-100％，并且循环稳定性得到了改善。透射电子显微镜和X射线吸收精细结构分析证实了两种载体上相似的铂纳米颗粒形状，大小，晶格参数和簇堆积，而X射线光电子和吸收光谱表明电子结构发生了变化。这表明纯电子金属-载体相互作用可以显着改善氧还原活性，而不会引起形状，合金或应变效应，并且不会损害稳定性。因此，优化催化剂和载体之间的电子相互作用是用于高级电催化剂的有前途的方法，其中优化催化纳米颗粒本身受到其他问题的限制。

BACKGROUND & AIMS: BACKGROUND:CT radiation dose reduction results in increased noise or graininess of images which affects the diagnostic information. One of the approaches to lower radiation exposure to patients is to reduce image noise with the use of image processing software in low radiation dose images. PURPOSE:To assess image quality and accuracy of non-linear adaptive filters (NLAF) at low dose chest CT. MATERIAL AND METHODS:In an IRB approved prospective study, 24 patients (mean age, 63 ± 7.3 years; M:F ratio, 11:13) gave informed consent for acquisition of four additional chest CT image series at 150, 110, 75, and 40 mAs (baseline image series) on a 64-slice MDCT over an identical 10-cm length. NLAF was used to process three low dose (110, 75, and 40 mAs) image series (postprocessed image series). Two radiologists reviewed baseline and postprocessed images in a blinded manner for image quality. Objective noise, CT attenuation values, patient weight, transverse diameters, CTDIvol, and DLP were recorded. Statistical analysis was performed using parametric and non-parametric tests for comparing postprocessed and baseline images. RESULTS:No lesions were missed on baseline or postprocessed CT images (n = 80 lesions, 73 lesions <1 cm). At 40 mAs, subjective noise in mediastinal window settings were graded as unacceptable in baseline images and acceptable in postprocessed images. Visibility of smaller structures improved from suboptimal visibility in baseline images at 40 mAs to excellent in postprocessed images at 40 mAs. No major artifacts were seen due to NLAF postprocessing, except for minor beam hardening artifacts not affecting diagnostic decision-making (14/22) in both baseline and postprocessed image series. Diagnostic confidence for chest CT was improved to fully confident in postprocessed images at 40 mAs. Compared to baseline images, postprocessing reduced objective noise by 26% (14.2 ± 4.7/19.2 ± 6.4), 31.5% (15.2 ± 4.7/22.2 ± 5.7), and 41.5% (16.9 ± 6/28.9 ± 10.2) at 110 mAs, 75 mAs, and 40 mAs tube current-time product levels. CONCLUSION:Applications of NLAF can help reduce tube current down to 40 mAs for chest CT while maintaining lesion conspicuity and image quality.

背景与目标： 背景：降低CT辐射剂量会导致图像的噪点或颗粒感增加，从而影响诊断信息。降低对患者辐射的方法之一是在低辐射剂量图像中使用图像处理软件来降低图像噪声。
目的：评估低剂量胸部CT下非线性自适应滤波器（NLAF）的图像质量和准确性。
材料与方法：在一项IRB批准的前瞻性研究中，有24例患者（平均年龄63±7.3岁； M：F比为11:13）在150、110、75，在64片MDCT上，在相同的10厘米长度上为40 mAs（基准图像系列）。 NLAF用于处理三个低剂量（110、75和40 mAs）图像系列（后处理图像系列）。两位放射科医生以不知情的方式检查了基线和后处理图像的图像质量。记录客观噪声，CT衰减值，患者体重，横向直径，CTDIvol和DLP。使用参数测试和非参数测试进行统计分析，以比较后处理图像和基线图像。
结果：在基线或后处理的CT图像上均未遗漏任何病变（n = 80个病变，73个<1 cm的病变）。在40 mA时，纵隔窗口设置中的主观噪声在基线图像中被评定为不可接受，而在后处理图像中则被评定为可接受。较小结构的可见性从40 mAs的基线图像中的次佳可见度提高到40 mAs的后处理图像中的出色。由于NLAF后处理，没有看到主要的伪影，除了较小的光束硬化伪影不会影响基线和后处理图像系列中的诊断决策（14/22）。胸部CT的诊断置信度提高到40 mAs的后处理图像完全置信度。与基线图像相比，后处理在110 mAs时降低了26％（14.2±4.7 / 19.2±6.4），31.5％（15.2±4.7 / 22.2±5.7）和41.5％（16.9±6 / 28.9±10.2）的客观噪声， 75 mAs和40 mAs的管电流时间乘积电平。
结论：NLAF的应用可帮助将胸部CT的管电流降低至40 mAs，同时保持病变的显眼性和图像质量。

BACKGROUND & AIMS: :The purpose of this study was to assess the possible role of muscles in offsetting the anterior shear forces caused by the load and upper body mass and their accelerations that act on the L 4L 5, intervertebral joint during dynamic squat lifts. Fifteen males lifted five loads from 5.8 to 32.4 kg. Anterior shear forces estimated to be acting on the lumber spine, based on model output, ranged from 492 N at 5.8 kg to 736 N at 32.4 kg. However, the peak shear force that had to be supported by the facets and possibly the disc remained relatively constant at approximately 200 N, regardless of the load mass. The posteriorly directed fascicles of the lumbar portions of the iliocostalis lumborum and longissimus thoracis muscles increased their force output, as estimated from an EMG driven model, in proportion to the anterior load shear force demands, thereby sharing the load on the intervertebral joint. It appears that the combination of anatomical design and neural control of the musculature leads to a situation where the resultant shear force on the joint can be maintained at a relatively constant and safe level in the types of lifts studied. This 'safety' mechanism is useful only with the preservation of lordosis during lifting, when the muscles must provide the majority of the support moment.

背景与目标： ：这项研究的目的是评估在动态下蹲举升过程中，肌肉在抵消由负荷和上半身及其在L 4L 5椎间关节上作用的加速度所引起的前剪切力中的可能作用。 15头雄性将五种负载从5.8公斤提升至32.4公斤。根据模型输出，估计作用在木材脊柱上的前剪力范围从5.8 kg的492 N到32.4 kg的736N。然而，无论负载质量如何，必须由刻面支撑并可能由圆盘支撑的峰值剪切力保持相对恒定，约为200N。根据肌电图驱动模型估计，the肌和腰最长肌的腰部向后束束的力输出与前部剪切力需求成正比，从而分担了椎间关节的负荷。看起来，肌肉组织的解剖学设计和神经控制的结合导致了这样一种情况，在所研究的举重类型中，在关节上产生的剪切力可以保持在相对恒定和安全的水平。这种“安全”机制仅在举重过程中保留脊柱前凸肌时有用，此时肌肉必须提供大部分的支撑力矩。

BACKGROUND & AIMS: PURPOSE:Determine if a "nondieting" intervention focused on intensive training in eliciting the relaxation response enhances health outcomes compared with nondieting interventions without such training. DESIGN:Randomized trial with follow-up at 10 weeks, 4 months, and 12 months. SETTING:General community. SUBJECTS:Total of 225 overweight and obese women with at least one other cardiovascular risk factor. INTERVENTIONS:Three 10-week nondieting interventions: a group program (P1) focused on intensive training in techniques for eliciting the relaxation response (n = 60), a group program (P2) focused on healthy eating and physical activity (n = 61), and a self-guided, mail-delivered version of P2 (P3; n = 101). MEASURES:The Revised Symptom Checklist measured psychological distress, the Medical Symptoms Checklist measured the experience of medical symptoms, and the Health-Promoting Lifestyle Profile measured a range of lifestyle behaviors. Self-efficacy for low-fat eating intuitive eating, and body mass index were also assessed. ANALYSIS:An intention-to-treat analysis was used. RESULTS:At 12 months, P1 produced statistically greater improvements in stress management behaviors and medical symptom discomfort and was the only program to significantly improve self-efficacy for low-fat eating. In P1, the effect sizes for reductions in depression (0.75) and interpersonal sensitivity (0.85) were large. At 12 months, mean weight was unchanged. CONCLUSION:Inclusion of intensive relaxation response training in a nondieting program for overweight women enhanced stress management and medical symptoms outcomes but not weight outcomes.

背景与目标： 目的：确定与不进行此类训练的非减肥干预措施相比，“非减肥”干预是否专注于强化训练以引起放松反应，从而改善健康结果。
设计：随机对照试验，在10周，4个月和12个月时进行随访。
地点：一般社区。
研究对象：总共225名超重和肥胖妇女中至少有其他心血管危险因素。
干预措施：三项为期10周的非节食干预措施：小组课程（P1）专注于引起放松反应的技术强化训练（n = 60），小组课程（P2）专注于健康饮食和体育锻炼（n = 61） ，以及P2的自指导邮件交付版本（P3； n = 101）。
措施：修订后的症状清单测量了心理困扰，医学症状清单测量了医学症状的经历，健康促进生活方式概况测量了一系列生活方式。还评估了低脂饮食直觉饮食的自我效能和体重指数。
分析：使用意向治疗分析。
结果：在第12个月时，P1在压力管理行为和医学症状不适方面产生了统计学上更大的改善，并且是唯一显着提高低脂饮食自我效能的计划。在P1中，减少抑郁症的效果大小（0.75）和人际敏感性（0.85）大。在12个月时，平均体重没有变化。
结论：将超重女性的强化放松反应训练纳入一项非节食计划中可增强压力管理和医学症状结果，但不能改善体重结果。

BACKGROUND & AIMS: PURPOSE:To assess if local intra-arterial administration of paclitaxel using drug-coated balloons or an admixture of paclitaxel to contrast medium inhibits stenosis after percutanous transluminal angioplasty (PTA) of peripheral arteries in a porcine overstretch model. METHODS:Neointimal proliferation and stenosis were induced by overstretch and stenting of 40 peripheral arteries in 20 pigs. Paclitaxel was administered locally during PTA using coated balloons (n = 20) or dissolved in contrast medium (n = 10). Conventional balloons and contrast medium were used in a control group (n = 10). Reangiography with quantitative analysis was performed after 5 weeks. RESULTS:On reangiography diameter stenosis and late lumen loss were significantly reduced by both methods of local drug delivery compared with control group; minimal luminal diameter was significantly larger in the treatment groups. CONCLUSIONS:Local short-term administration of paclitaxel during PTA of peripheral arteries using balloons or contrast medium as drug carriers reduced stenosis due to intimal hyperplasia.

背景与目标： 目的：评估在猪过度伸展模型中，经药物涂层的球囊局部使用紫杉醇或将紫杉醇与造影剂混合后是否能抑制周围动脉经皮腔内血管成形术（PTA）后的狭窄。
方法：过度拉伸和支架置入20只猪可诱导新内膜增生和狭窄。紫杉醇在PTA期间使用包被的球囊（n = 20）局部给药或溶解在造影剂中（n = 10）。对照组（n = 10）使用常规气球和造影剂。 5周后进行血管造影定量分析。
结果：与对照组相比，两种局部给药方式均显着降低了血管造影的直径狭窄和晚期管腔丢失。在治疗组中，最小管腔直径明显更大。
结论：在外周动脉PTA期间局部短期给予紫杉醇，使用球囊或造影剂作为药物载体减少了由于内膜增生引起的狭窄。

BACKGROUND & AIMS: :BK virus nephropathy (BKVN) is increasingly recognized as a major cause of renal allograft failure. Recent reports demonstrate that prompt reduction of immunosuppression upon detection of persistent viremia can be associated with resolution of viremia, with minimal risk of acute rejection (AR). However, these experiences in general have occurred in centers with low baseline risks of AR. It is possible that a finer balance between overimmunosuppression and the risk of AR may exist in centers that routinely transplant patients with higher risk of AR. Thus the risk/benefit of this strategy may be altered in these centers. We report a case of antibody-mediated rejection that followed reduction of immunosuppression for BKVN diagnosed more than 3 months after the onset of viremia. This rejection episode resulted in a greater decrease in graft function than the initial BKVN episode. Issues relevant to the management of these patients are discussed, including the need for improved immune monitoring assays to determine more accurately the balance between infection and rejection.

背景与目标： ：BK病毒性肾病（BKVN）被越来越多地认为是同种异体肾功能衰竭的主要原因。最近的报道表明，检测到持续的病毒血症后，免疫抑制的迅速降低可与病毒血症的消退相关，而急性排斥反应（AR）的风险最小。但是，这些经验通常发生在AR基线风险较低的中心。在常规移植AR风险较高的患者的中心中，过度免疫抑制和AR风险之间可能存在更好的平衡。因此，在这些中心可以改变这种策略的风险/利益。我们报告了一例抗体介导的排斥反应，随后在病毒血症发作后3个月内诊断为BKVN的免疫抑制降低。与最初的BKVN发作相比，该排斥发作导致移植物功能的下降更大。讨论了与这些患者的治疗有关的问题，包括需要改进免疫监测方法以更准确地确定感染和排斥反应之间的平衡。

BACKGROUND & AIMS: OBJECTIVE:Functional near-infrared spectroscopy (fNIRS) is a non-invasive optical technique for bedside evaluation of cerebral metabolism that has clinical potential for monitoring the efficacy of pharmacological treatment. In this pilot study, we investigated the cognitive effects of methylphenidate (MP) on prefrontal function using fNIRS in healthy subjects. METHODS:Thirteen right-handed healthy subjects underwent working memory tasks (0-back and 2-back) after a single oral dose of MP (20 mg) or placebo administered in a double-blind crossover design on two different days separated by 1-3 days. We measured changes in oxyhemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) concentrations during the tasks in bilateral prefrontal regions after MP or placebo administration using two-channel fNIRS. RESULTS:There were significantly more correct responses and fewer missed responses during the 2-back task performance after MP treatment as compared with placebo. Baseline-corrected oxy-Hb was significantly decreased after MP treatment compared with the placebo in the 2-back task in the right frontal region but was not different in the 0-back task. Baseline-corrected deoxy-Hb and total-Hb concentrations were not significant between MP and placebo conditions in either of the cognitive tasks. CONCLUSIONS:These data are consistent with previous positron emission tomography findings of MP-mediated reduction in lateral prefrontal activity accompanied by improved cognitive performance.

背景与目标： 目的：功能性近红外光谱法（fNIRS）是一种非侵入性光学技术，可在床头评估脑部新陈代谢，具有监测药理学疗效的临床潜力。在这项初步研究中，我们调查了健康受试者中使用fNIRS的哌醋甲酯（MP）对前额叶功能的认知作用。
方法：13名右撇子健康受试者在双日交叉设计中以单盲口服（20毫克）或安慰剂以双盲交叉设计方式给药后，分别在两个工作日内接受了工作记忆任务（0背和2背）。 3天。我们在使用双通道fNIRS进行MP或安慰剂给药后，测量了双侧前额叶区域任务期间氧合血红蛋白（oxy-Hb）和脱氧血红蛋白（deoxy-Hb）浓度的变化。
结果：与安慰剂相比，MP治疗后的2背任务执行过程中，正确的反应明显多，漏掉的反应少。与安慰剂相比，MP处理后基线校正的oxy-Hb在右额叶区域的2后卫任务中较安慰剂显着降低，但在0后卫任务中无差异。在任一认知任务中，MP和安慰剂条件之间经基线校正的脱氧血红蛋白和总血红蛋白浓度均不显着。
结论：这些数据与以前的正电子发射断层扫描所发现的MP介导的侧前额叶活动减少以及认知能力改善相一致。

BACKGROUND & AIMS: :Prevention of ovarian cancer is the best approach for reducing the impact of this deadly disease. The laying hen is a robust model of spontaneous ovarian cancer that recapitulates the human disease. Dietary intervention with flaxseed, the richest vegetable source of omega-3 fatty acids (OM-3FAs) and phytoestrogen lignans, demonstrate the potential for effective prevention and amelioration of ovarian cancer by targeting inflammatory prostaglandin pathways. Prostaglandin E2 (PGE2) is the most pro-inflammatory ecoisanoid and one of the downstream products of two isoforms of cyclooxygenase (COX) enzymes: COX-1 and COX-2. Our objective was to investigate the effect of flaxseed supplementation for one year on ovarian cancer and correlate its effects to expression of COX enzymes and concentrations of prostaglandins. White Leghorn hens were fed 10% flaxseed-enriched or standard diet for one year. The severity of ovarian cancer was determined by gross pathology and histology. COX-1 and COX-2 localization and protein and mRNA expression and PGE2 and PGE3 concentrations in ovaries were measured by IHC, western blot, quantitative real-time PCR and LC-MS-MS, respectively. The results demonstrated a significant reduction in late stage ovarian tumors in the flaxseed-fed hens compared with the control diet-fed hens. In correlation with decreased ovarian cancer severity, concentrations of PGE2 and expression of COX-2 were diminished in ovaries of flaxseed-fed hens. PGE3 concentrations were below the level of detection. The results demonstrated that in normal ovaries, COX-1 was localized to the granulosa cell layer surrounding the follicles and ovarian surface epithelium (OSE) whereas COX-2 protein was localized to the granulosa cell layer in the follicle. Extensive COX-1 and COX-2 protein expression was found throughout the ovarian carcinoma. Our findings suggest that the flaxseed-mediated reduction in the severity of ovarian cancer in hens is correlated to the reduction in PGE2 in the ovaries of flaxseed-fed hens. These findings may provide the basis for clinical trials of dietary intervention targeting prostaglandin biosynthesis for the prevention and treatment of ovarian cancer.

背景与目标： ：预防卵巢癌是减少这种致命疾病影响的最佳方法。产蛋鸡是自发性卵巢癌的有力模型，可概括人类疾病。亚麻籽的膳食干预（omega-3脂肪酸（OM-3FAs）和植物雌激素木脂素的最丰富的植物来源）通过靶向炎症性前列腺素途径，证明了有效预防和改善卵巢癌的潜力。前列腺素E2（PGE2）是最易炎症的类二十烷酸，是环氧合酶（COX-1）和COX-2两种同工型的下游产物之一。我们的目标是研究亚麻籽对卵巢癌一年的治疗作用，并将其与COX酶的表达和前列腺素的浓度相关联。白来回鸡只母鸡饲喂10％亚麻籽或标准饮食，为期一年。卵巢癌的严重程度由总体病理学和组织学确定。通过IHC，蛋白质印迹，实时荧光定量PCR和LC-MS-MS分别检测卵巢中COX-1和COX-2的定位以及蛋白质和mRNA的表达以及PGE2和PGE3的浓度。结果表明，与对照饮食饲喂的母鸡相比，亚麻饲喂母鸡的晚期卵巢肿瘤显着减少。与卵巢癌严重程度降低相关，亚麻籽母鸡卵巢中的PGE2浓度和COX-2的表达降低。 PGE3浓度低于检测水平。结果表明，在正常卵巢中，COX-1位于卵泡和卵巢表面上皮（OSE）周围的颗粒细胞层，而COX-2蛋白则位于卵泡中的颗粒细胞层。在整个卵巢癌中发现了广泛的COX-1和COX-2蛋白表达。我们的发现表明，亚麻籽介导的母鸡卵巢癌严重程度的降低与亚麻籽母鸡卵巢中PGE2的降低有关。这些发现可为针对前列腺素生物合成的预防和治疗卵巢癌的饮食干预临床试验提供依据。

BACKGROUND & AIMS: :One of the worst HIV/AIDS epidemics in the world is occurring in South Africa, where heterosexual exposure is the main mode of HIV transmission. Young people 15-24 years of age, particularly women, account for a large share of new infections. Accordingly, there is an urgent need for behavior-change interventions to reduce the incidence of HIV among adolescents in South Africa. However, there are few such interventions with proven efficacy for South African adolescents, especially young adolescents. A recent cluster-randomized controlled trial of the 'Let Us Protect Our Future!' HIV/STD risk-reduction intervention for Grade 6 South African adolescents (mean age = 12.4 years) found significant decreases in self-reported sexual risk behaviors compared with a control intervention. This article describes the intervention, the use of the social cognitive theory and the reasoned action approach to develop the intervention, how formative research informed its development and the acceptability of the intervention. Challenges in designing and implementing HIV/STD risk-reduction interventions for young adolescents in sub-Saharan Africa are discussed.

背景与目标： ：南非是世界上最严重的HIV / AIDS流行病之一，异性接触是HIV传播的主要方式。 15-24岁的年轻人，尤其是妇女，在新感染中占很大比例。因此，迫切需要采取行为改变干预措施，以减少南非青少年中艾滋病毒的发生。但是，很少有这类干预措施对南非青少年特别是年轻青少年具有有效的疗效。最近一项“让我们保护我们的未来！”的集群随机对照试验。与对照组相比，南非6级（平均年龄= 12.4岁）青少年的HIV / STD降低风险干预措施发现自我报告的性风险行为显着降低。本文介绍了干预措施，社会认知理论的使用以及采取合理的行动方法来开发干预措施，形成性研究如何告知其发展以及干预措施的可接受性。讨论了为撒哈拉以南非洲地区的青少年设计和实施减少艾滋病毒/性病风险的干预措施所面临的挑战。

BACKGROUND & AIMS: BACKGROUND:Lipoprotein(a) [Lp(a)], which structurally resembles-tissue-type plasminogen, is reported to be associated with coronary atherosclerosis. We examined whether the acute change in Lp(a) by percutaneous transluminal coronary angioplasty (PTCA) is related to restenosis after PTCA.

METHODS AND RESULTS:We measured serum Lp(a) and other lipid parameters (triglycerides and total, LDL, and HDL cholesterol) before and 1 day after PTCA in 143 procedures and 3 days after and 4 months after PTCA in 62 procedures. Quantitative coronary angiography was performed, and restenosis was defined according to three criteria: (1) clinical recurrence of ischemic symptoms, (2) a final stenosis > 50%, and (3) an absolute decrease in minimal lumen diameter > 1/2 of the acute gain in the dilated segment. Restenosis was recognized in 25.9%, 35.7%, and 38.5% of the cases 4 months after PTCA for each criterion, respectively. Although triglyceride and LDL, HDL, and total cholesterol levels were similar in the restenosis and no-restenosis groups before PTCA, Lp(a) was significantly higher in the restenosis group. We found a significant reduction in Lp(a) in the restenosis but not the no-restenosis group 1 day after PTCA. At 3 days after and 4 months after PTCA, Lp(a) was similar in the two groups. A multivariate-analysis revealed that the absolute change in Lp(a) (before versus 1 day after PTCA) to be the sole significant predictor of restenosis among the clinical, angiographic, and plasma lipid parameters examined.

CONCLUSIONS:Lp(a) levels were significantly higher in the restenosis group, and they fell significantly after PTCA in the restenosis group.

背景与目标： 背景：脂蛋白（a）[Lp（a）]在结构上类似于组织型纤溶酶原，据报道与冠状动脉粥样硬化有关。我们检查了经皮腔内冠状动脉成形术（PTCA）引起的Lp（a）急性变化是否与PTCA后再狭窄有关。

方法和结果：我们测量了血清Lp（a）和其他脂质参数（甘油三酸酯和总胆固醇，LDL和HDL胆固醇）在143例手术中PTCA之前和之后1天，在62例手术中PTCA之后3天和之后4个月。进行了定量的冠状动脉造影，并根据三个标准定义了再狭窄：（1）缺血症状的临床复发，（2）最终狭窄> 50％，和（3）最小管腔直径绝对减小> 1/2扩张段的急性获益。对于每个标准，分别在PTCA后4个月的病例中分别发现了25.9％，35.7％和38.5％的再狭窄。尽管在PTCA之前在再狭窄和无再狭窄组中甘油三酯和LDL，HDL和总胆固醇水平相似，但再狭窄组中Lp（a）明显更高。我们发现PTCA后1天，再狭窄中Lp（a）显着降低，但未再狭窄组中Lp（a）却没有降低。在PTCA后3天和术后4个月，两组的Lp（a）相似。多变量分析显示，在检查的临床，血管造影和血浆脂质参数中，Lp（a）的绝对变化（PTCA之前与术后1天相比）是再狭窄的唯一重要预测指标。

结论：再狭窄组中Lp（a）的水平显着升高，而再狭窄组中PTCA后Lp（a）的水平显着下降。