BACKGROUND & AIMS: OBJECTIVE:To evaluate the maternal and neonatal outcomes of pregnancies complicated with isolated oligohydramnios at term, managed by induction of labor. METHODS:We conducted a retrospective case-control study. 138 women with uncomplicated oligohydramnios at term [amniotic fluid index (AFI) < or =5 cm] and a low Bishop score (< or =6) underwent induction of labor with prostaglandin E2. These women were compared to 67 women who underwent induction of labor at 42 weeks' gestation and 276 women at low-risk pregnancy and spontaneous onset of labor, matched for parity and race. RESULTS:Cesarean section (CS) rate was similar in the study and the post-date group (17.4 and 17.9%, respectively), but significantly higher than the spontaneous labor group (5.8%, OR 3.42, 95% CI 1.75-6.68). No differences were found with other outcomes. CONCLUSION:Pregnancies with isolated oligohydramnios at term apparently are not at higher risk of perinatal complications, but induction of labor is associated with increased rate of CS.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:In early-stage lung cancer, evidence is accumulating for the benefits of lobectomy by video-assisted thoracic surgery (VATS) over open lobectomy. Few thoracic training programs offer sufficient experience in this technically demanding procedure. This article describes the evolution of a new graduate's practice from open thoracotomy to VATS lobectomy. STUDY DESIGN:Our model involves a transition in technique from posterolateral thoracotomy to muscle-sparing thoracotomy and, ultimately, to VATS lobectomy. This approach was evaluated by examining outcomes of open thoracotomy patients before VATS lobectomy and outcomes of the initial 30 VATS patients. Data were collected prospectively. RESULTS:Before undertaking VATS lobectomy, 94 major pulmonary resections were performed by thoracotomy. Mortality was 1.2% for lobectomy and 0% for pneumonectomy. Use of the muscle-sparing thoracotomy increased from 17% of patients in the first half to 70% in the latter half of this group. For the first 30 VATS lobectomy patients, the mean operative time was 168 minutes. Median blood loss was 200 mL. Conversion rate to open thoracotomy was 13.3%. Mortality was 3.3% and morbidity was 26.7%. After short-term followup (mean followup 16 months), overall survival for stage I lung cancer was 96%. CONCLUSIONS:With our approach, new graduates of thoracic surgery programs can safely transition to VATS lobectomy. Gaining experience with the lateral muscle-sparing thoracotomy is an important step in the transition, as it offers similar operative exposure. Longterm disease-free and overall survival data are needed to evaluate our oncologic efficacy with this approach.

背景与目标：

BACKGROUND & AIMS: :Between February and April 2003, a total of 80 single-dwelling households close (< 70 m) to high-tension (161 or 345 kV) power lines in a northern community of Taiwan received measurements of indoor extremely low-frequency (ELF) magnetic field for 72 h. Measurements were performed with EMDEX II meter at a sampling rate of every 300 s, yielding some 860 readings of ELF magnetic field for each household. In addition to the 72-h mean ELF magnetic field, we also calculated arithmetic means of the first 2, 6, 12, and 288 readings taken in each household to represent the information on spot, 30-min, 60-min, and 24-h exposures, respectively. The mean 72-h exposure to ELF magnetic field for the 80 study households was estimated at 0.80 micro-Tesla (microT) with a standard deviation (SD) of 1.13 microT. The mean for pot, 30-min, 60-min, and 24-h exposure was 0.88 (SD 1.38), 0.90 (SD 1.40), 0.9 (SD 1.17), and 0.83 (SD 1.17) microT, respectively. There were high agreements, indicated by a nearly perfect intra-class correlation coefficient, between 72-h mean exposure and those short-term exposure measures. Additionally, the sensitivity and specificity of various short-term exposures in the prediction of 72-h exposure greater than 0.4 microT were similar at values of 0.82-0.87 and 0.93-0.95, respectively. This study indicates that short-term measurements of indoor ELF magnetic field seem adequate to represent the mean 72-h exposure, but tended to overpredict 72-h exposure greater than 0.4 microT. Further investigation is needed to assess whether these findings can be replicated in households far away from high-tension power lines.

背景与目标： : 在2月和2003年4月之间，台湾北部社区共有80个靠近 (< 70 m) 高压 (161或345 kV) 电力线的单户家庭接受了室内极低频 (ELF) 的测量磁场72小时。使用EMDEX II仪表以每300 s的采样率进行测量，得出每个家庭的ELF磁场的一些860读数。除了72小时的平均ELF磁场外，我们还计算了每个家庭中获取的前2、6、12和288个读数的算术平均值，以分别表示现场，30分钟，60分钟和24小时的信息。估计80个研究家庭的ELF磁场平均暴露时间为0.80微特斯拉 (microT)，标准偏差 (SD) 为1.13微t。pot，30分钟，60分钟和24小时暴露的平均值分别为0.88 (SD 1.38)，0.90 (SD 1.40)，0.9 (SD 1.17) 和0.83 (SD 1.17) microT。在72小时平均暴露与那些短期暴露措施之间存在很高的一致性，这表明类内相关系数几乎是完美的。此外，各种短期暴露在预测大于0.4微特的72小时暴露中的敏感性和特异性分别在0.82-0.87和0.93-0.95的值处相似。这项研究表明，室内ELF磁场的短期测量似乎足以代表平均72小时暴露，但往往会高估大于0.4微特的72小时暴露。需要进一步调查，以评估这些发现是否可以在远离高压电线的家庭中复制。

BACKGROUND & AIMS: :In a patient with temporomandibular disorder who does not respond to conservative treatment, treatment with intra-articular injection of high molecular weight sodium hyaluronate can be suggested. In our study, 27 patients with nonreduced disc displacement were diagnosed clinically and confirmed by magnetic resonance imaging. The age range was from 21 to 63 years old, with a mean of 39.3 years. Two cycles of injection of high molecular weight sodium hyaluronate was performed on alternative weeks. Pain intensity was measured by the visual analog scale. Maximal mouth opening, clicking joint noise, and lateral movement were measured before and after injection for more than 6 months. Reduction of pain intensity and improvement in the maximum mouth opening parameter was statistically significant. In conclusion, this intra-articular injection using high molecular weight sodium hyaluronate looks very positive for patients affected by nonreduced disc displacement and is encouraged to be used as a primary treatment of temporomandibular joint dysfunction.

背景与目标： : 对于对保守治疗无反应的颞下颌疾病患者，建议使用关节内注射高分子量透明质酸钠进行治疗。在我们的研究中，临床诊断出27例椎间盘移位未减少的患者，并通过磁共振成像证实。年龄范围为21至63岁，平均39.3岁。在其他星期进行了两个周期的高分子量透明质酸钠注射。疼痛强度通过视觉模拟量表测量。注射前后6个月以上，测量最大张口，点击关节噪声和侧向运动。疼痛强度的降低和最大张口参数的改善具有统计学意义。总之，这种使用高分子量透明质酸钠的关节内注射对于受椎间盘移位不全影响的患者看起来非常积极，并被鼓励用作颞下颌关节功能障碍的主要治疗方法。

BACKGROUND & AIMS: :Fludarabine and alemtuzumab are routinely used for treatment of B-cell chronic lymphocytic leukemia (B-CLL). The present study aimed to compare the expression of signaling molecules and cytokine production by T cells of B-CLL patients in long-term unmaintained remission/plateau phase following fludarabine or alemtuzumab treatment with that of indolent/untreated B-CLL patients and healthy donors. The frequency and intensity of TCR-CD3zeta chain, p56lck, p59fyn, ZAP-70, PI3-kinase and interferon (IFN)-gamma/interleukin (IL)-4 production in CD4 and CD8 T cells was examined by flow cytometry. T-cell function was assessed by stimulation with purified protein derivative (PPD) and phytohemagglutinin (PHA). Despite a reduction in number, the expression of IFN-gamma/IL-4 in T-cells in patients was significantly higher than in healthy donors. The intensity of most signaling molecules in treated patients was relatively unaffected vs. healthy donors but lower than untreated-indolent patients. However, the total number of T cells which expressed each of the signaling molecules was decreased in patients, with no difference between fludarabine- and alemtuzumab-treated patients. The T-cell response to PHA but not PPD was reduced in treated patients. The results suggest that, despite some alterations in signaling molecules and a reduction in T-cell number, overall T-cell functions may be relatively well preserved long-term after treatment with fludarabine and alemtuzumab.

背景与目标： : 氟达拉滨和阿仑单抗通常用于治疗b细胞慢性淋巴细胞白血病 (b-cll)。本研究旨在比较在氟达拉滨或阿仑单抗治疗后长期未维持缓解/平台期的b-cll患者的T细胞与惰性/未治疗的b-cll患者和健康的T细胞的信号分子表达和细胞因子产生供体。通过流式细胞术检查CD4和CD8 T细胞中TCR-CD3zeta链，p56lck，p59fyn，ZAP-70，PI3-kinase和干扰素 (IFN)-γ/白细胞介素 (IL)-4产生的频率和强度。通过纯化蛋白衍生物 (PPD) 和植物血凝素 (PHA) 刺激来评估T细胞功能。尽管数量减少，但患者T细胞中IFN-γ/IL-4的表达显着高于健康供体。与健康供体相比，接受治疗的患者中大多数信号分子的强度相对不受影响，但低于未经治疗的惰性患者。然而，在患者中表达每种信号分子的T细胞总数减少，而氟达拉滨和阿仑单抗治疗的患者之间没有差异。在治疗的患者中，T细胞对PHA的反应降低，但对PPD的反应降低。结果表明，尽管信号分子发生了一些变化，T细胞数量减少，但在用氟达拉滨和阿仑单抗治疗后，总体T细胞功能可能长期保持良好。

BACKGROUND & AIMS: :The failure of lesioned axons to regenerate over long distances in the mammalian central nervous system (CNS) is not due to an inability of central neurons to regenerate, but rather to the non-permissive nature of the CNS tissue environment. Regenerating CNS axons, which grow well within a peripheral nerve, for example, fail to penetrate mature CNS tissue by more than about 1 mm. Recent evidence indicates that this may be due to inhibitory membrane proteins associated with CNS oligodendrocytes and myelin. We report here that human telencephalic neuroblasts implanted into the excitotoxically lesioned striatum of adult rats can escape or neutralize this inhibitory influence of the adult CNS environment and extend axons along major myelinated fibre tracts for distances of up to approximately 20 mm. The axons were seen to elongate along the paths of the striato-nigral and cortico-spinal tracts to reach the substantia nigra, the pontine nuclei and the cervical spinal cord, which are the normal targets for the striatal and cortical projection neurons likely to be present in these implants.

背景与目标： : 受损的轴突在哺乳动物中枢神经系统 (CNS) 中无法长距离再生不是由于中枢神经元无法再生，而是由于CNS组织环境的非宽松性质。例如，在周围神经内良好生长的再生CNS轴突不能穿透成熟的CNS组织超过约1毫米。最近的证据表明，这可能是由于与CNS少突胶质细胞和髓磷脂相关的抑制性膜蛋白所致。我们在此报告，植入成年大鼠兴奋性毒性病变纹状体的人类端脑神经母细胞可以逃避或中和成年CNS环境的这种抑制作用，并沿主要有髓纤维束延伸轴突，距离可达约20毫米。可以看到轴突沿着纹状体-黑质和皮质-脊髓束的路径伸长，到达黑质，桥脑核和颈脊髓，这是纹状体和皮质投射神经元的正常目标。这些植入物。

BACKGROUND & AIMS: PURPOSE:Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. DESIGN AND METHODS:We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we asked the professional to recommend the appropriate forms of long-term care. RESULTS:Although the professional respondents used the full spectrum of options offered to them, some professionals tended to favor the sector they worked in. Advanced practice nurses recommended day care and homemaking more and adult foster care less. Gerontologists used skilled nursing-facility placement more actively and rehabilitation, homemaking, and home health care less actively. Geriatricians and primary care physicians both favored rehabilitation and skilled nursing-facility care and were both less enthusiastic about assisted living, homemaking, and informal care, but the geriatricians favored day care more than did the primary care physicians. Registered nurses were highly supportive of assisted living, adult foster care, homemaking, and home health care, and they opposed skilled nursing-facility care. Social workers were less likely than other participants to endorse rehabilitation and adult foster care. IMPLICATIONS:Because consumer preference should be a major factor in making long-term-care decisions, many consumers need information about what options may best fit their situation. In the absence of empirical data on which types of long-term care work best for whom, consumers have to rely on expert judgment-but that judgment varies. Clients should be aware that an expert's background (as defined by discipline and work situation) may affect his or her recommendations. Each discipline appears to have its own set of experiences and beliefs that may influence recommendations.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The combination of inhaled corticosteroids (ICS) and long-acting beta2-agonists (LABA) is recommended by treatment guidelines for the treatment of persistent asthma. Two such combination products, salmeterol/fluticasone propionate (SFC, Seretide GSK, UK) and formoterol/budesonide (FBC, Symbicort, AstraZeneca, UK) are commercially available. OBJECTIVES:The purpose of these studies was to evaluate and compare the duration of bronchodilation of both combination products up to 24 hours after a single dose. METHODS:Two randomised, double blind, placebo-controlled, crossover studies were performed. Study A was conducted in 33 asthmatic adults receiving 400-1200 mcg of budesonide or equivalent. Serial forced expiratory volume in one second (FEV1) was measured over 24 hours to determine the duration of effect of both SFC (50/100 mcg) and FBC (4.5/160 mcg). Study B was conducted in 75 asthmatic adults receiving 800-1200 mcg of budesonide or equivalent and comprised a 4 week run-in of 400 mcg bd Becotide followed by 4 weeks treatment with either SFC 50/100 mcg bd or FBC 4.5/160 mcg bd taken in a cross-over manner. Serial 24-hour FEV1 was measured after the first dose and the last dose after each 4-weeks treatment period to determine the offset of action of each treatment. RESULTS:In study A, a single inhalation of SFC and FBC produced a sustained bronchodilation at 16 hours with an adjusted mean increase in FEV1 from pre-dose of 0.22 L (95% CI 0.19, 0.35 L) for SFC and 0.25 L (95% CI 0.21, 0.37 L) for FBC, which was significantly greater than placebo for both treatments (-0.05 L; p < 0.001). In study B, the slope of decline in FEV1 from 2-24 hours post dose was -16.0 ml/hr for SFC and -14.2 ml/hr for FBC. The weighted mean AUC over 24 hours was 0.21 Lxmin and 0.22 Lxmin and mean change from pre-dose FEV1 at 12 hours was 0.21 L for SFC and 0.20 L for FBC respectively CONCLUSION:Both SFC and FBC produced a similar sustained bronchodilator effect which was prolonged beyond 12 hours post dose and was clearly measurable at 24 h.

背景与目标：

BACKGROUND & AIMS: :Like other thalamic nuclei, the primate pulvinar is considered not to have long-range intrinsic connections, either excitatory or inhibitory. Injections of biotinylated dextran amine (BDA) in the medial pulvinar, however, reveal retrogradely filled neurons up to 2.0 mm from the injection edge. Serial section reconstruction (n = 18) confirmed that retrogradely filled neurons projected to the injection site and showed that they had additional long-range collaterals within the posterior pulvinar. Arrays of small, beaded terminations occurred in multiple foci along the collaterals. Terminal arrays were up to 1.0 mm in length; foci were separated by about 0.7 mm. Somata were large (average area = 220 microm2), and dendritic arbors were radiate and also large (about 1.0 mm in diameter), but without either the appendages of classical interneurons or the hairlike spines characteristic of radiate pulvinocortical projection neurons. Double labeling for BDA and parvalbumin (PV) or BDA and gamma-aminobutyric acid (GABA) indicated that these large neurons were positive for both PV and GABA. Double labeling for PV and GABA, or PV and glutamic acid decarboxylase 67 (GAD67) revealed a small number of similarly large neurons in the posterior pulvinar that were positive for both substances. Thus, we propose that these neurons are a novel class of inhibitory interneuron, longer range than the classic thalamic local circuit interneurons. Future questions include how these neurons relate to other inhibitory systems and specific postsynaptic populations and whether they are located preferentially within the posterior pulvinar, possibly related to the multimodal character of this thalamic region.

背景与目标： : 与其他丘脑核一样，灵长类脉冲被认为不具有兴奋性或抑制性的远距离内在联系。然而，在内侧髓中注射生物素化的葡聚糖胺 (BDA) 显示出从注射边缘到2.0毫米的逆行填充的神经元。连续切片重建 (n = 18) 证实，逆行填充的神经元投射到注射部位，并显示它们在后牙髓内有其他远距离侧支。沿侧支的多个病灶中出现了一系列小的串珠末端。末端阵列的长度可达1.0毫米; 病灶间隔约0.7毫米。躯体很大 (平均面积 = 220 microm2)，树突状乔木辐射且也很大 (直径约1.0毫米)，但没有经典中间神经元的附属物或辐射的皮质投射神经元的毛状刺特征。BDA和小白蛋白 (PV) 或BDA和 γ-氨基丁酸 (GABA) 的双重标记表明，这些大神经元对PV和GABA均为阳性。对PV和GABA或PV和谷氨酸脱羧酶67 (GAD67) 的双重标记显示，后牙髓中少量类似的大神经元对两种物质均呈阳性。因此，我们建议这些神经元是一类新型的抑制性中间神经元，其范围比经典的丘脑局部电路中间神经元更长。未来的问题包括这些神经元与其他抑制系统和特定的突触后种群之间的关系，以及它们是否优先位于后牙髓内，这可能与该丘脑区域的多模式特征有关。

BACKGROUND & AIMS: INTRODUCTION AND OBJECTIVES:Positive outcome of patients with spastic cerebral palsy treated with botulinum toxin reported in the last three years has led us to perform this study with the aim to show our experience in the management of spastic cerebral palsy with the toxin, determine its indications, analyze the results and propose new possible indications in the future.

MATERIAL AND METHODS:We include 10 hemiplegic and 17 diplegic patients with an average age of 6 years and 7 months, followed up between 5 and 17 months. Clinical improvement was monitored using the PRS and EVFEL scales and articular motion range was measured 6 months before and after the injection while continuing physiotherapy. The injected muscles were adductor, hamstrings, triceps and posterior tibialis, and the doses were 1-2 U/muscle/kg body weight.

RESULTS:The values on PRS improved an average of 24%, adductor angle 66% (p < 0.01), knee angle 40% (p = 0.05) and ankle angle 52% (p < 0.01); 96% of patients could get more physiological static or walking patterns because of the decrease of spasticity and those persisted after the effect of the toxin had worn off. It was maximum at 2 months, stabilized 4 to 6 months later and decreased during further 2 months.

CONCLUSIONS:This experience leads us to propose higher starting dosage and to take into account the stability of postural pattern of each patient to choice the muscle to be injected. Other therapeutic possibilities are also proposed in children with fixed shortening e.g. combining the toxin with stretching casts.

背景与目标： 简介和目标 : 最近三年报道的肉毒杆菌毒素治疗痉挛性脑瘫患者的积极结果导致我们进行这项研究，目的是展示我们在治疗痉挛性脑瘫方面的经验毒素，确定其适应症，分析结果并在将来提出新的可能适应症。
材料和方法 : 我们包括10例偏瘫和17例双瘫患者，平均年龄为6岁7个月，随访5至17个月。使用PRS和EVFEL量表监测临床改善，并在注射前和注射后6个月测量关节运动范围，同时继续理疗。注射的肌肉是内收肌，绳肌，三头肌和胫后肌，剂量为1-2 U/肌肉/kg体重。
结果 : PRS上的值平均提高了24%，内收角66% (p <0.01)，膝角40% (p = 0.05) 和踝角52% (p < 0.01); 96% 患者由于痉挛程度的降低而获得更多的生理静态或行走模式，并且在毒素作用消失后持续存在。在2个月时达到最大值，在4到6个月后稳定下来，在接下来的2个月内下降。
结论 : 这种经验使我们提出更高的起始剂量，并考虑到每位患者的姿势模式的稳定性，以选择要注射的肌肉。对于固定缩短的儿童，还提出了其他治疗可能性，例如将毒素与拉伸铸型结合使用。

BACKGROUND & AIMS: :A number of groups have developed libraries of siRNAs to identify genes through functional genomics. While these studies have validated the approach of making functional RNAi libraries to understand fundamental cellular mechanisms, they require information and knowledge of existing sequences since the RNAi sequences are generated synthetically. An alternative strategy would be to create an RNAi library from cDNA. Unfortunately, the complexity of such a library of siRNAs would make screening difficult. To reduce the complexity, longer dsRNAs could be used; however, concerns of induction of the interferon response and off-target effects of long dsRNAs have prevented their use. As a first step in creating such libraries, long dsRNA was expressed in mammalian cells. The 250 nt dsRNAs were capable of efficiently silencing a luciferase reporter gene that was stably transfected in MDA-MB-231 cells without inducing the interferon response or off-target effects any more than reported for siRNAs. In addition, a long dsRNA expressed in the same cell line was capable of silencing endogenous c-met expression and inhibited cell migration, whereas the dsRNA against luciferase had no effect on c-met or cell migration. The studies suggest that large dsRNA libraries are feasible and that functional selection of genes will be possible.

背景与目标： : 许多小组已经开发了sirna文库，以通过功能基因组学鉴定基因。尽管这些研究已经验证了制作功能性RNAi文库以了解基本细胞机制的方法，但由于RNAi序列是合成生成的，因此它们需要现有序列的信息和知识。另一种策略是从cDNA创建RNAi文库。不幸的是，这种sirna库的复杂性将使筛选变得困难。为了降低复杂性，可以使用更长的dsrna; 然而，对干扰素反应的诱导和长dsrna的脱靶效应的担忧阻止了它们的使用。作为创建此类文库的第一步，长dsRNA在哺乳动物细胞中表达。250 nt dsrna能够有效地沉默在MDA-MB-231细胞中稳定转染的荧光素酶报告基因，而不会比sirna所报道的更多诱导干扰素应答或脱靶效应。此外，在同一细胞系中表达的长dsRNA能够沉默内源性c-met表达并抑制细胞迁移，而针对荧光素酶的dsRNA对c-met或细胞迁移没有影响。研究表明，大型dsRNA文库是可行的，并且基因的功能选择将是可能的。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: The clinical outcome of treatment using conical crown-retained dentures was evaluated. Of the initial 25 patients provided with 26 conical crown-retained dentures, 18 patients with 18 restorations could be examined after a time ranging between 73 and 92 months. Of the eight restorations lost, four had been changed as a result of factors that might have been related to the prosthodontic care. Most of the patients were very satisfied with the restorations both functionally and esthetically and found their chewing comfort to be better after treatment with conical crown-retained dentures. However, 50% of the patients reported speech problems related to treatment. Technical failures were not insignificant but were treatable. The survival rate after 73 to 92 months was 78.3%.

背景与目标： 评估了使用锥形冠保留义齿治疗的临床结果。在最初提供26个圆锥形冠保留义齿的25例患者中，可以在73至92个月的时间内检查18例具有18个修复体的患者。在丢失的八个修复物中，有四个由于可能与口腔修复有关的因素而被更改。大多数患者在功能和美学上都对修复体感到非常满意，并发现在使用圆锥形冠保留义齿治疗后，其咀嚼舒适度更好。然而，50% 患者报告了与治疗相关的言语问题。技术故障并非微不足道，但可以治愈。73 ~ 92个月后的生存率为78.3%。

BACKGROUND & AIMS: Etoposide produces reversible inhibition of topoisomerase II, leading to cleavage of DNA, and thereby has an antitumor effect. This mechanism suggests that the longer treatment is continued, the greater the antitumor effect will be. In the present study, both therapeutic and adverse effects of long-term treatment with low-dose oral etoposide were studied in 29 patients aged > or = 65 years with non-Hodgkin's lymphoma (NHL) for whom standard chemotherapy was not effective or refractory. These patients received etoposide at a dose of 50 mg/d for as long as possible. Treatment was continued until white blood cell count decreased to < or = 2,000/microL or the platelet count decreased to < or = 5 x 10(4)/microL. According to the World Health Organization (WHO) criteria of therapeutic effects, 6 (20.7%) of the 29 patients achieved complete remission and 13 patients (44.8%) had partial remission, for a response rate of 65.5%. Adverse effects of > or = grade 3 included leukopenia in 24 patients (82.8%) and anemia in 7 (24.1%). Granulocyte colony-stimulating factor (G-CSF) was given in combination with etoposide to eight patients because of leukopenia (granulocyte count < or = 1,000/microL). In view of the excellent subjective tolerance, low incidence of serious adverse effects, and good activity, single agent oral etoposide given continuously over prolonged periods represents a useful treatment for elderly patients with NHL.

背景与目标： 依托泊苷产生拓扑异构酶II的可逆抑制，导致DNA裂解，从而具有抗肿瘤作用。这种机制表明，持续治疗的时间越长，抗肿瘤作用就越大。在本研究中，对29例年龄> 或 = 65岁的非霍奇金淋巴瘤 (NHL) 患者进行了低剂量口服依托泊苷长期治疗的治疗和不良反应的研究，这些患者的标准化疗无效或难治性。这些患者尽可能长时间地接受依托泊苷50 mg/d的剂量。继续治疗直到白细胞计数降低至 <或 = 2,000/microL或血小板计数降低至 <或 = 5 × 10(4)/microL。根据治疗效果的世卫组织标准，29例患者中有6例 (20.7% 例) 完全缓解，13例 (44.8% 例) 部分缓解，缓解率为65.5%。> or = 3级的不良反应包括白细胞减少24例 (82.8%) 和贫血7例 (24.1%)。由于白细胞减少 (粒细胞计数 <或 = 1,000/microL)，将八名患者与依托泊苷联合给予粒细胞集落刺激因子 (g-csf)。鉴于其良好的主观耐受性，低的严重不良反应发生率和良好的活性，长期连续给予单药口服依托泊苷代表了对老年NHL患者的有用治疗。

BACKGROUND & AIMS: BACKGROUND:Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. METHODS:Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all) who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. RESULTS:Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30) received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%). CONCLUSION:The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but rebounded quickly to above pre-shortage rates. In this community the only long term impact of the varicella vaccine shortage may be on the small number of children who still had not received catch-up varicella immunizations by 36 months of age.

背景与目标：