• 【术前MRI对浸润性小叶乳腺癌的重复手术: 其他原位癌和背景实质增强的作用。】 复制标题 收藏 收藏
    DOI:10.1016/j.ejrad.2017.02.045 复制DOI
    作者列表:Preibsch H,Richter V,Bahrs SD,Hattermann V,Wietek BM,Bier G,Kloth C,Blumenstock G,Hahn M,Staebler A,Nikolaou K,Wiesinger B
    BACKGROUND & AIMS: OBJECTIVES:Analysing the influence of additional carcinoma in situ (CIS) and background parenchymal enhancement (BPE) in preoperative MRI on repeated surgeries in patients with invasive lobular carcinoma (ILC) of the breast. METHODS:Retrospective analysis of 106 patients (mean age 58.6±9.9years) with 108 ILC. Preoperative tumour size as assessed by MRI, mammography and sonography was recorded and compared to histopathology. In contrast-enhanced MRI, the degree of BPE was categorised by two readers. The influence of additionally detected CIS and BPE on the rate of repeated surgeries was analysed. RESULTS:Additional CIS was present in 45.4% of the cases (49/108). The degree of BPE was minimal or mild in 80% of the cases and moderate or marked in 20% of the cases. In 17 cases (15.7%) at least one repeated surgery was performed. In n=15 of these cases, repeated surgery was performed after BCT (n=9 re-excisions, n=6 conversions to mastectomy), in n=2 cases after initial mastectomy. The initial surgical procedure (p=0.008) and additional CIS (p=0.046) significantly influenced the rate of repeated surgeries, while tumour size, patient age and BPE did not (p=ns). CONCLUSIONS:Additional CIS was associated with a higher rate of repeated surgeries, whereas BPE had no influence.
    背景与目标:
  • 【背景二甲双胍单药治疗2型糖尿病患者卡格列净与安慰剂和西格列汀的疗效和安全性比较: 一项随机试验.】 复制标题 收藏 收藏
    DOI:10.1007/s00125-013-3039-1 复制DOI
    作者列表:Lavalle-González FJ,Januszewicz A,Davidson J,Tong C,Qiu R,Canovatchel W,Meininger G
    BACKGROUND & AIMS: AIMS/HYPOTHESIS:The aim of this work was to evaluate the efficacy and safety of canagliflozin vs placebo and sitagliptin in patients with type 2 diabetes who were being treated with background metformin. METHODS:This randomised, double-blind, four-arm, parallel-group, Phase 3 study was conducted at 169 centres in 22 countries between April 2010 and August 2012. Participants (N = 1,284) with type 2 diabetes aged ≥ 18 and ≤ 80 years who had inadequate glycaemic control (HbA1c ≥ 7.0% [53 mmol/mol] and ≤10.5% [91 mmol/mol]) on metformin therapy received canagliflozin 100 mg or 300 mg, sitagliptin 100 mg, or placebo (n = 368, 367, 366, 183, respectively) for a 26 week, placebo- and active-controlled period followed by a 26 week, active-controlled period (placebo group switched to sitagliptin [placebo/sitagliptin]) and were included in the modified intent-to-treat analysis set. Randomisation was performed using a computer-generated schedule; participants, study centres and the sponsor were blinded to group assignment. The primary endpoint was change from baseline in HbA1c at week 26; secondary endpoints included changes in HbA1c (week 52) and fasting plasma glucose (FPG), body weight, and systolic blood pressure (BP; weeks 26 and 52). Adverse events (AEs) were recorded throughout the study. RESULTS:At week 26, canagliflozin 100 mg and 300 mg reduced HbA1c vs placebo (-0.79%, -0.94%, -0.17%, respectively; p < 0.001). At week 52, canagliflozin 100 mg and 300 mg demonstrated non-inferiority, and canagliflozin 300 mg demonstrated statistical superiority, to sitagliptin in lowering HbA1c (-0.73%, -0.88%,-0.73%, respectively); differences (95% CI) vs sitagliptin were 0% (-0.12, 0.12) and -0.15% (-0.27, -0.03), respectively. Canagliflozin 100 mg and 300 mg reduced body weight vs placebo (week 26: -3.7%, -4.2%, -1.2%, respectively; p < 0.001) and sitagliptin (week 52: -3.8%, -4.2%, -1.3%, respectively; p < 0.001). Both canagliflozin doses reduced FPG and systolic BP vs placebo (week 26) and sitagliptin (week 52) (p < 0.001). Overall AE and AE-related discontinuation rates were generally similar across groups, but higher with canagliflozin 100 mg. Genital mycotic infection and osmotic diuresis-related AE rates were higher with canagliflozin; few led to discontinuations. Hypoglycaemia incidence was higher with canagliflozin. CONCLUSIONS/INTERPRETATION:Canagliflozin improved glycaemia and reduced body weight vs placebo (week 26) and sitagliptin (week 52) and was generally well tolerated in patients with type 2 diabetes on metformin. CLINICAL TRIAL REGISTRY:ClinicalTrials.gov NCT01106677 FUNDING: This study was supported by Janssen Research & Development, LLC.
    背景与目标:
  • 【当存在较大背景脑活动时,一种用于MEG源重建的新型自适应波束形成器有效。】 复制标题 收藏 收藏
    DOI:10.1109/TBME.2006.878119 复制DOI
    作者列表:Sekihara K,Hild KE 2nd,Nagarajan SS
    BACKGROUND & AIMS: :This paper proposes a novel prewhitening eigenspace beamformer suitable for magnetoencephalogram (MEG) source reconstruction when large background brain activities exist. The prerequisite for the method is that control-state measurements, which contain only the contributions from the background interference, be available, and that the covariance matrix of the background interference can be obtained from such control-state measurements. The proposed method then uses this interference covariance matrix to remove the influence of the interference in the reconstruction obtained from the target measurements. A numerical example, as well as applications to two types of MEG data, demonstrates the effectiveness of the proposed method.
    背景与目标: : 本文提出了一种新型的预白化特征空间波束形成器,适用于存在大背景脑活动时的脑磁图 (MEG) 源重建。该方法的先决条件是仅包含来自背景干扰的贡献的控制状态测量是可用的,并且可以从这种控制状态测量中获得背景干扰的协方差矩阵。然后,所提出的方法使用此干扰协方差矩阵来消除从目标测量获得的重建中的干扰的影响。一个数值示例以及在两种类型的MEG数据中的应用证明了该方法的有效性。
  • 【背景强度的变化会影响非小细胞肺癌中基于PET的总肿瘤体积描绘: 对个体化信息的需求。】 复制标题 收藏 收藏
    DOI:10.1016/j.radonc.2013.08.033 复制DOI
    作者列表:Chen GH,Yao ZF,Fan XW,Zhang YJ,Gao HQ,Qian W,Wu KL,Jiang GL
    BACKGROUND & AIMS: PURPOSE:Efficient tumor volume delineation by the combined use of PET/CT scanning is necessary for the proper treatment of non-small cell lung cancer (NSCLC). To understand the effect of variation in background intensity on PET-based gross tumor volume (GTV) delineation, we determined the background standard uptake values (SUVs) in normal lung, aorta (blood pool), and liver tissues and determined GTVs using different methods. METHODS:Thirty-seven previously untreated patients with pathologically confirmed NSCLC underwent PET/CT scanning with (18)F-fluorodeoxyglucose ((18)F-FDG). To obtain (18)F-FDG uptake values in normal tissues, regions of interest in the lung lobes (left upper, left lower, right upper, right middle, and right lower), aorta, and liver zones (left, intermediate, and right) were measured. The coefficient of variation (CV) of the SUV was measured for each normal structure. The CT-based GTV (GTV(CT)) was considered as the standard to which all PET-based GTVs were compared, and the correlation coefficient was analyzed to compare GTV obtained by the various delineation methods. Linear and logarithmic regression analyses were used to determine the relationship between GTV(CT) and GTV(PET). RESULTS:Normal lung tissue showed a significantly lower SUV and less stability than tissue of the aorta or liver. For the lung, aorta, and liver, the maximum SUV (SUV(max)) was 0.82 ± 0.32, 2.35 ± 0.37, and 3.24 ± 0.50 (CV: 38.79%, 15.82%, and 15.30%) and average SUV (SUV(ave)) was 0.49 ± 0.18, 1.68 ± 0.32, and 2.34 ± 0.36 (CV: 36.38%, 18.92%, and 15.44%), respectively. The SUVs of the lung varied from lobe to lobe. The GTV delineation method using the SUV(ave) of the lung lobe in which the tumor was found as background in the source-to-background ratio (SBR) method showed the best correlation with the volume of CT-based GTV (r=0.81). CONCLUSIONS:Our results show vast variation in the SUV among normal tissues, as well as in the different lung lobes. The tumor volume delineated using the SBR method correlated well with the CT-based tumor volume. We conclude that it is reasonable and precise to contour GTV in patients with NSCLC after taking into account the background intensity of the lung lobe in which the tumor is found.
    背景与目标:
  • 【遗传背景改变了2型大麻素受体缺乏症对骨量和骨转换的影响。】 复制标题 收藏 收藏
    DOI:10.1007/s00223-013-9793-8 复制DOI
    作者列表:Sophocleous A,Idris AI,Ralston SH
    BACKGROUND & AIMS: :Cannabinoid receptors and their ligands play significant roles in regulating bone metabolism. Previous studies of type 1 cannabinoid receptor-deficient mice have shown that genetic background influences the skeletal phenotype. Here, we investigated the effects of genetic background on the skeletal phenotype of mice with type 2 cannabinoid receptor deficiency (Cnr2 (-/-)). We studied Cnr2 (-/-) mice on a CD1 background and compared the findings with those previously reported in Cnr2 (-/-) C57BL/6 mice. Young female Cnr2 (-/-) CD1 mice had low bone turnover and high trabecular bone mass compared with wild-type (WT), contrasting with the situation in Cnr2 (-/-) C57BL/6 mice where trabecular bone mass has been reported to be similar to WT. The Cnr2 (-/-) CD1 mice lost more trabecular bone at the tibia with age than WT due to reduced bone formation, and at 12 months there was no difference in trabecular bone volume between genotypes. This differs from the phenotype previously reported in C57BL/6 Cnr2 (-/-) mice, where bone turnover is increased and bone mass reduced with age. There were no substantial differences in skeletal phenotype between Cnr2 (-/-) and WT in male mice. Cortical bone phenotype was similar in Cnr2 (-/-) and WT mice of both genders. Deficiency of Cnr2 has site- and gender-specific effects on the skeleton, mainly affecting trabecular bone, which are influenced by genetic differences between mouse strains. Further evaluation of the pathways responsible might yield new insights into the mechanisms by which cannabinoid receptors regulate bone metabolism.
    背景与目标: 大麻素受体及其配体在调节骨代谢中起重要作用。先前对1型大麻素受体缺陷小鼠的研究表明,遗传背景会影响骨骼表型。在这里,我们研究了遗传背景对2型大麻素受体缺乏症 (Cnr2 (-/-)) 小鼠骨骼表型的影响。我们研究了CD1背景下的Cnr2 (-/-) 小鼠,并将发现与先前在Cnr2 (-/-) C57BL/6小鼠中报道的结果进行了比较。与野生型 (WT) 相比,年轻的雌性Cnr2 (-/-) CD1小鼠的骨转换低,小梁骨量高,与Cnr2 (-/-) C57BL/6小鼠的情况相反,据报道小梁骨量与WT相似。Cnr2 (-/-) CD1小鼠由于骨形成减少,随着年龄的增长,胫骨的小梁骨损失比WT多,并且在12个月时,基因型之间的小梁骨体积没有差异。这与先前在C57BL/6 Cnr2 (-/-) 小鼠中报道的表型不同,在C57BL/6 Cnr2 (-/-) 小鼠中,随着年龄的增长,骨量增加,骨量减少。在雄性小鼠中,Cnr2 (-/-) 和WT之间的骨骼表型没有实质性差异。两种性别的Cnr2 (-/-) 和WT小鼠的皮质骨表型相似。Cnr2缺乏对骨骼有位点和性别特异性影响,主要影响小梁骨,小梁骨受小鼠品系之间遗传差异的影响。对负责途径的进一步评估可能会对大麻素受体调节骨代谢的机制产生新的见解。
  • 【129背景的小鼠对鼠疫耶尔森菌的抗性映射到1号染色体上的多个基因座。】 复制标题 收藏 收藏
    DOI:10.1128/IAI.00488-16 复制DOI
    作者列表:Tencati M,Tapping RI
    BACKGROUND & AIMS: :Yersinia pestis is a Gram-negative bacterium that is the causative agent of bubonic and pneumonic plague. It is commonly acquired by mammals such as rodents and humans via the bite of an infected flea. We previously reported that multiple substrains of the 129 mouse background are resistant to pigmentation locus-negative (pgm(-)) Yersinia pestis and that this phenotype maps to a 30-centimorgan (cM) region located on chromosome 1. In this study, we have further delineated this plague resistance locus to a region of less than 20 cM through the creation and phenotyping of recombinant offspring arising from novel crossovers in this region. Furthermore, our experiments have revealed that there are at least two alleles in this initial locus, both of which are required for resistance on a susceptible C57BL/6 background. These two alleles work in trans since resistance is restored in offspring possessing one allele contributed by each parent. Our studies also indicated that the Slc11a1 gene (formerly known as Nramp1) located within the chromosome1 locus is not responsible for conferring resistance to 129 mice.
    背景与目标: 鼠疫耶尔森菌是一种革兰氏阴性细菌,是鼠疫和肺鼠疫的病原体。它通常是由啮齿动物和人类等哺乳动物通过被感染的跳蚤叮咬而获得的。我们先前报道了129小鼠背景的多个亚株对色素沉着位点阴性 (pgm(-)) 鼠疫耶尔森氏菌具有抗性,并且该表型映射到位于1号染色体上的30厘摩根 (cM) 区域。在这项研究中,我们通过在该区域产生新的交叉产生的重组后代的创建和表型分析,进一步将鼠疫抗性基因座描述为小于20 cM的区域。此外,我们的实验表明,在该初始基因座中至少存在两个等位基因,这两个等位基因都是易感C57BL/6背景上的抗性所必需的。这两个等位基因在反式中起作用,因为在每个亲本贡献一个等位基因的后代中恢复了抗性。我们的研究还表明,位于染色体1基因座内的Slc11a1基因 (以前称为Nramp1) 不负责赋予129小鼠抗性。
  • 【第四阶段开放标签可行性研究方案,研究HIV-1和非酒精性脂肪肝患者肝纤维化的非侵入性标志物,随机分配接受优化背景治疗 (OBT) 加maraviroc或OBT】 复制标题 收藏 收藏
    DOI:10.1136/bmjopen-2019-035596 复制DOI
    作者列表:Bradshaw D,Gilleece Y,Verma S,Abramowicz I,Bremner S,Perry N
    BACKGROUND & AIMS: INTRODUCTION:At least 30% of people living with HIV (PLWH) infection have non-alcoholic fatty liver disease (NAFLD), which has now become a leading cause of hepatic fibrosis and cirrhosis. Management is based largely on lifestyle modifications, which are difficult to achieve, and therapeutic options are urgently needed. Maraviroc (MVC), through antagonism of CCR5 receptors, may reduce hepatic fibrosis progression and could be an effective treatment for NAFLD. However, dosing is usually two times per day, unlike most currently recommended antiretroviral therapies. This study will investigate the feasibility and acceptability of addition of MVC to combination antiretroviral therapy in PLWH and NAFLD as a treatment for NAFLD. METHODS AND ANALYSIS:This is a phase IV, randomised, open-label, non-invasive feasibility study. Sixty individuals with well-controlled HIV-1 and NAFLD will be recruited from UK HIV clinics and randomised 1:1 to receive either optimised background therapy (OBT) plus MVC or OBT alone. Follow-up will be every 24 weeks for 96 weeks. The primary outcome measures will include recruitment and retention rates, adverse events and adherence. Secondary outcomes will include changes in markers of hepatic fibrosis, including the Enhanced Liver Fibrosis score, median liver stiffness measurement and controlled attenuation parameter scores on Fibroscan, and quality of life assessments. Analyses will be performed according to intention-to-treat principles. For secondary outcomes, estimated differences and 95% CIs between the groups using a t-method will be presented for continuous variables and as exact 95% binomial CIs for categorical variables. ETHICS AND DISSEMINATION:Ethical approval was obtained through the London Dulwich UK Research Ethics Committee (reference 17/LO/2093). Results will be disseminated both through community groups and peer-reviewed scientific literature.Trial registration number SRCTN31461655. EudraCT number 2017-004141-24; Pre-results.
    背景与目标:
  • 【镉本底浓度,以建立巴西圣保罗州土壤的参考质量值。】 复制标题 收藏 收藏
    DOI:10.1007/s10661-013-3462-2 复制DOI
    作者列表:de Oliveira VH,de Abreu CA,Coelho RM,Melo LC
    BACKGROUND & AIMS: :Proper assessment of soil cadmium (Cd) concentrations is essential to establish legislative limits. The present study aimed to assess background Cd concentrations in soils from the state of São Paulo, Brazil, and to correlate such concentrations with several soil attributes. The topsoil samples (n = 191) were assessed for total Cd contents and for other metals using the USEPA 3051A method. The background concentration was determined according to the third quartile (75th). Principal component analysis, Spearman correlation, and multiple regressions between Cd contents and other soil attributes (pH, cation exchange capacity (CEC), clay content, sum of bases, organic matter, and total Fe, Al, Zn, and Pb levels) were performed. The mean Cd concentration of all 191 samples was 0.4 mg kg(-1), and the background concentration was 0.5 mg kg(-1). After the samples were grouped by parent material (rock origin) and soil type, the background Cd content varied, i.e., soils from igneous, metamorphic, and sedimentary rocks harbored 1.5, 0.4, and 0.2 mg kg(-1) of Cd, respectively. The background Cd content in Oxisols (0.8 mg kg(-1)) was higher than in Ultisols (0.3 mg kg(-1)). Multiple regression demonstrated that Fe was primarily attributed to the natural Cd contents in the soils (R (2) = 0.79). Instead of a single Cd background concentration value representing all São Paulo soils, we propose that the concentrations should be specific for at least Oxisols and Ultisols, which are the primary soil types.
    背景与目标: : 正确评估土壤镉 (Cd) 浓度对于建立立法限制至关重要。本研究旨在评估巴西圣保罗州土壤中的背景Cd浓度,并将这些浓度与几种土壤属性相关联。使用USEPA 3051A方法评估表土样品 (n   =   191) 的总Cd含量和其他金属含量。根据第三个四分位数 (第75个) 确定背景浓度。进行了主成分分析,Spearman相关性以及Cd含量与其他土壤属性 (pH,阳离子交换能力 (CEC),粘土含量,碱,有机质和总Fe,Al,Zn和Pb含量) 之间的多元回归。所有191样品的平均Cd浓度为0.4 mg kg(-1),背景浓度为0.5 mg kg(-1)。根据母体材料 (岩石来源) 和土壤类型对样品进行分组后,背景Cd含量变化,即来自火成岩,变质岩和沉积岩的土壤分别藏有1.5,0.4和0.2 mg kg(-1) 的Cd,分别。背景Cd在Oxisols (0.8 mg kg(-1)) 中的含量高于在Ultisols (0.3 mg kg(-1)) 中的含量。多元回归表明,Fe主要归因于土壤中的天然Cd含量 (R (2)  =   0.79)。代替代表所有圣保罗土壤的单个Cd本底浓度值,我们建议该浓度应至少针对主要土壤类型的oxisol和ultisol特定。
  • 【癌症模拟模型中吸烟和肥胖背景死亡率的推导。】 复制标题 收藏 收藏
    DOI:10.1177/0272989X12458725 复制DOI
    作者列表:Wang YC,Graubard BI,Rosenberg MA,Kuntz KM,Zauber AG,Kahle L,Schechter CB,Feuer EJ
    BACKGROUND & AIMS: BACKGROUND:Simulation models designed to evaluate cancer prevention strategies make assumptions on background mortality-the competing risk of death from causes other than the cancer being studied. Researchers often use the U.S. life tables and assume homogeneous other-cause mortality rates. However, this can lead to bias because common risk factors such as smoking and obesity also predispose individuals for deaths from other causes such as cardiovascular disease. METHODS:We obtained calendar year-, age-, and sex-specific other-cause mortality rates by removing deaths due to a specific cancer from U.S. all-cause life tables. Prevalence across 12 risk factor groups (3 smoking [never, past, and current smoker] and 4 body mass index [BMI] categories [<25, 25-30, 30-35, 35+ kg/m(2)]) were estimated from national surveys (National Health and Nutrition Examination Surveys [NHANES] 1971-2004). Using NHANES linked mortality data, we estimated hazard ratios for death by BMI/smoking using a Poisson regression model. Finally, we combined these results to create 12 sets of BMI and smoking-specific other-cause life tables for U.S. adults aged 40 years and older that can be used in simulation models of lung, colorectal, or breast cancer. RESULTS:We found substantial differences in background mortality when accounting for BMI and smoking. Ignoring the heterogeneity in background mortality in cancer simulation models can lead to underestimation of competing risk of deaths for higher-risk individuals (e.g., male, 60-year old, white obese smokers) by as high as 45%. CONCLUSION:Not properly accounting for competing risks of death may introduce bias when using simulation modeling to evaluate population health strategies for prevention, screening, or treatment. Further research is warranted on how these biases may affect cancer-screening strategies targeted at high-risk individuals.
    背景与目标:
  • 【胎盘脐带血输血: 一种治疗贫血背景下糖尿病和微量白蛋白尿患者的新方法。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bhattacharya N
    BACKGROUND & AIMS: :Diabetes mellitus is the commonest endocrine disease in all populations and all age groups. It is a syndrome of disturbed intermediary metabolism caused by inadequate insulin secretion or impaired insulin action, or both. Anemia is a common accompaniment of diabetes, particularly in those with albuminuria justifying tubulointestitial injury or reduced renal function. There are other additional factors present in diabetes, which may contribute to the development of an increased risk of anemia. Cord blood, because of its rich mix of fetal and adult hemoglobin, high platelet and WBC counts, hypo-antigenic nature, altered metabolic profile and high affinity for oxygen, may be an ideal choice for cases of diabetes with severe anemia necessitating blood transfusion. This article presents my team's experience with 78 units of placental umbilical cord whole blood (from 1 April 1999 to April 2005), collected after lower uterine cesarean section (LUCS) from consenting mothers (56 ml-138, ml mean 82 ml +/- 5.6 ml SD, median 84 ml, mean packed cell volume 49.7 +/- 4.2 SD, mean percent hemoglobin concentration 16.6 g/dl +/- 1.5 g/dl SD) and transfused to diabetes patients with microalbuminuria and severe anemia necessitating transfusion. After collection, the blood was transfused, in most cases immediately after completion of the essential norms of transfusion. In rare cases, it was kept in the refrigerator and transfused within 72 hours of collection to a suitable recipient. For inclusion in this study, the patient's percent plasma hemoglobin had to be 8 g/dl or less (the pretransfusion hemoglobin in this series varied from 5.2 g/dl to 7.8 g/dl) in the background of type two diabetes (fasting sugar 200 mg or more), along with features of microalbuminuria (albumin excretion 30-299 mg/g creatinine). This study included 39 informed consenting patients (22 males + 17 females, aged 48-74 yrs, mean 59.6 yrs). The patients were randomized into two groups: Group A (control cases N = 15, males = 8 and females = 7) and Group B (study group N = 24, males = 14 and females = 10). In Group A the rise of hemoglobin (Hgb) after two units of adult blood transfusion was 1.5 to 1.8 g/dl, as seen after a 72-hour blood sample assessment. The rise of Hgb as noted after 72 hours of two units of freshly collected cord blood transfusion was .6 g/dl to 1.5 g/dl. Each patient received two of four units of freshly collected cord blood transfusion (two units at a time), depending on availability and compatibility. Microalbuminuria was assessed in both groups after one month of treatment with transfusion and other identical support. The mean result was 152 +/- 18 m SD of albumin per gram of creatinine excreted through 24-hour urine (pre-transfusion mean excretion was 189 +/- 16 mg) in Group A and 103 +/- 16 mg SD of albumin excretion per gram of creatinine in 24-hour excretion of urine in Group B (pretransfusion mean excretion was 193 +/- 21 mg). Univariate analysis using Fisher's exact test was performed for the results of Groups A and B. The difference between Group A and B values and its comparison with the pre-transfusion microalbuminuria appeared to be statistically significant (p < less than .003). We have not encountered any clinical, immunological or non-immunological reaction so far in either group. Fetomaternal cell traffic has been implicated as the cause of scleroderma in mothers delivering male babies. In the present series, we did not see any such rare and unusual complication due to neonatal blood transfusion in the adult system in Group B patients in the six years from the initiation of the study.
    背景与目标: : 糖尿病是所有人群和所有年龄组中最常见的内分泌疾病。它是由胰岛素分泌不足或胰岛素作用受损或两者同时引起的中间代谢紊乱综合征。贫血是糖尿病的常见伴随,尤其是在那些蛋白尿证明肾小管损伤或肾功能降低的患者中。糖尿病中还有其他其他因素,可能会导致贫血风险增加。脐带血由于其丰富的胎儿和成人血红蛋白,高血小板和WBC计数,低抗原性,改变的代谢特征和对氧气的高亲和力,可能是糖尿病严重贫血需要输血的理想选择。本文介绍了我的团队对78单位胎盘脐带全血 (从1999年4月1日到2005年4月) 的经验,这些血液是在下子宫剖宫产 (LUCS) 后从同意的母亲 (56毫升-138,ml平均82毫升/-5.6毫升SD,中位数84毫升,平均包装细胞体积49.7 +/- 4.2 SD,平均血红蛋白浓度百分比16.6g/dl +/- 1.5g/dl SD),并被输血给患有微量白蛋白尿和需要输血的严重贫血的糖尿病患者。收集后,在大多数情况下,在完成基本输血规范后立即输血。在极少数情况下,将其保存在冰箱中,并在收集后72小时内输注给合适的接收者。为了纳入这项研究,在2型糖尿病 (空腹血糖200毫克或更多) 的背景下,患者的血浆血红蛋白百分比必须为8g/dl或更少 (本系列中的输血前血红蛋白从5.2g/dl到7.8g/dl不等),以及微量白蛋白尿 (白蛋白排泄30-299 mg/g肌酐) 的特征。这项研究包括39名知情同意的患者 (22名男性17名女性,年龄48-74岁,平均59.6岁)。将患者随机分为两组: A组 (对照组N = 15,男性 = 8,女性 = 7) 和B组 (研究组N = 24,男性 = 14,女性 = 10)。在A组中,两个单位的成人输血后血红蛋白 (Hgb) 的升高1.5为1.8g/dl,如在72小时的血液样本评估后所见。在两单位新鲜收集的脐带血输血72小时后,Hgb的升高为0.6g/dl至1.5g/dl。根据可用性和兼容性,每位患者接受四个单位的新鲜脐带血输血中的两个 (一次两个单位)。在接受输血和其他相同支持治疗一个月后,两组均评估了微量白蛋白尿。A组的平均结果是每克通过24小时尿液排泄的肌酐中白蛋白152 +/- 18 m SD (输血前平均排泄为189 +/- 16 mg),每克肌酐中白蛋白排泄103 +/- 16 mg SD在24小时排泄中B组的尿液 (输血前平均排泄为193 +/- 21 mg)。对A组和B组的结果进行了使用Fisher精确检验的单变量分析。A组和B组之间的差异及其与输血前微量白蛋白尿的比较似乎具有统计学意义 (p <小于.003)。到目前为止,我们在任何一组中都没有遇到任何临床,免疫学或非免疫学反应。胎儿的细胞流量被认为是分娩男婴的母亲中硬皮病的原因。在本系列研究中,在研究开始后的六年中,由于B组患者的成人系统中新生儿输血,我们没有发现任何这种罕见和异常的并发症。
  • 【音乐背景对发音障碍判断的影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.jvoice.2008.04.008 复制DOI
    作者列表:Eadie TL,Van Boven L,Stubbs K,Giannini E
    BACKGROUND & AIMS: :The objectives of this study were to determine the effect of musical background on both pitch discrimination abilities and the reliability of judging voice quality in dysphonic speakers, and to determine the relationship between pitch discrimination abilities and the reliability of voice quality judgments. Twenty musicians and 20 nonmusicians performed pitch discrimination tests. They also made judgments of dysphonic vowels and speech samples for breathiness and roughness using 100-mm visual analog scales. Musicians demonstrated significantly smaller pitch discrimination thresholds than nonmusicians. For measures of intrarater agreement, musicians were significantly more consistent than nonmusicians for judgments of breathiness in both vowels and speech produced by dysphonic speakers. Musicians also showed significantly better interrater agreement for judgments of breathiness in vowels. Weak to moderate relationships were found between pitch discrimination abilities and agreement values for voice quality judgments. Results suggest that musical background may affect a listener's reliability in making judgments of dysphonia, particularly for judgments of breathiness. However, simple pitch discrimination skills of pure tones do not explain these differences. More complex stimuli should be used in future investigations to help determine the nature of underlying differences.
    背景与目标: : 这项研究的目的是确定音乐背景对音高辨别能力和判断语音质量的可靠性的影响,并确定音高辨别能力与语音质量判断可靠性之间的关系。20位音乐家和20位非音乐家进行了音高辨别测试。他们还使用100毫米视觉模拟标度来判断呼吸困难的元音和语音样本的呼吸和粗糙度。音乐家表现出比非音乐家小得多的音高辨别阈值。对于内部协议的衡量标准,音乐家在语音发音者产生的元音和语音的呼吸判断方面比非音乐家更加一致。音乐家在判断元音的呼吸方面也表现出更好的内部一致性。在音高辨别能力和语音质量判断的一致性值之间发现了弱到中等的关系。结果表明,音乐背景可能会影响听众对发声障碍的判断的可靠性,尤其是对呼吸的判断。但是,纯音的简单音高辨别技巧并不能解释这些差异。在未来的研究中应使用更复杂的刺激来帮助确定潜在差异的性质。
  • 【VEGF,Ang-1,Ang-2和MMP-9对具有乙型肝炎病毒背景的肝细胞癌的血管生成和预后意义。】 复制标题 收藏 收藏
    DOI:10.1007/s12032-008-9130-7 复制DOI
    作者列表:Chen ZB,Shen SQ,Ding YM,Wang WX,Tao JP,Liang LJ,Hu WJ
    BACKGROUND & AIMS: :The objective of this study was to investigate the expressions of angiogenic factors and elucidate their angiogenic and prognostic roles in hepatocellular carcinoma (HCC) with background of hepatitis B virus (HBV). We evaluated microvessel density (MVD) of HCC, and investigated immunohistochemical expression of vascular endothelial growth factor (VEGF), angiopoietins (Ang-1 and Ang-2), and matrix metalloproteinases-9 (MMP-9) in 67 specimens of surgically resected HCC, which were all positive for hepatitis B surface antigen. We investigated the relationship between their expressions and clinicopathological factors or prognosis. The microvessel density (MVD) of tumor tissue and surrounding normal liver tissue was 93.1 +/- 43.8/mm2 and 30.4 +/- 14.8/mm2, respectively. The MVD of well-differentiated HCC was significantly less than that of poorly differentiated HCC. MVD was positively correlated with VEGF and Ang-2 expression (P = 0.0023 and 0.0265, respectively). There was less tumor recurrence in low Ang-2 and low MMP-9 group than high Ang-2 and/or high MMP-9 group (P = 0.002). In Cox regression model, portal vein thrombus and intrahepatic metastasis was the risk factors of tumor recurrence (P = 0.003 and 0.001, respectively). Our study showed that the expression of VEGF and Ang-2 were positively correlated with MVD. Ang-2 expression and/or MMP-9 expression might be a significant predictive factor for recurrence after resection in HCC patients with the background of HBV.
    背景与目标: : 这项研究的目的是研究血管生成因子的表达,并阐明其在具有乙型肝炎病毒 (HBV) 背景的肝细胞癌 (HCC) 中的血管生成和预后作用。我们评估了HCC的微血管密度 (MVD),并在67例手术切除的HCC标本中研究了血管内皮生长因子 (VEGF),血管生成素 (Ang-1和Ang-2) 和基质metalloproteinases-9 (MMP-9) 的免疫组织化学表达。乙肝表面抗原。我们调查了它们的表达与临床病理因素或预后之间的关系。肿瘤组织和周围正常肝组织的微血管密度 (MVD) 分别为93.1 +/- 43.8/mm2和30.4 +/- 14.8/mm2。高分化HCC的MVD明显小于低分化HCC。MVD与VEGF和Ang-2表达呈正相关 (分别为P = 0.0023和0.0265)。低Ang-2和低MMP-9组的肿瘤复发率低于高Ang-2和/或高MMP-9组 (P = 0.002)。在Cox回归模型中,门静脉血栓和肝内转移是肿瘤复发的危险因素 (分别为P = 0.003和0.001)。我们的研究表明,VEGF和Ang-2的表达与MVD呈正相关。Ang-2表达和/或MMP-9表达可能是HBV背景的HCC患者切除后复发的重要预测因素。
  • 【评估孕早期生长: 种族背景和产妇年龄的影响。】 复制标题 收藏 收藏
    DOI:10.1093/humrep/den389 复制DOI
    作者列表:Bottomley C,Daemen A,Mukri F,Papageorghiou AT,Kirk E,Pexsters A,De Moor B,Timmerman D,Bourne T
    BACKGROUND & AIMS: BACKGROUND:First trimester growth restriction may predict miscarriage or adverse outcome later in the pregnancy, but determinants of early growth are not well described. Our objective was to examine factors influencing fetal and gestational sac size in the first trimester. METHODS:Prospective observational study of 1828 singleton pregnancies before 12 weeks gestation. Maternal characteristics (ethnicity, maternal age, obstetric history, abdominal pain and vaginal bleeding), crown rump length (CRL) and mean gestational sac diameter (MSD) were recorded. A stepwise linear mixed effects analysis was performed to determine factors influencing rate of change in CRL and MSD. RESULTS:1063 scans, in 464 women, were included. Rate of increase in CRL was higher in women of black ethnic origin (P = 0.0261) compared with white, and increased with advancing maternal age (P = 0.0046). Maternal age also influenced MSD: older women had gestational sacs which were 0.118 mm larger for each one year increase in maternal age (P = 0.0073). Bleeding, pain and prior obstetric history did not influence CRL or MSD. CONCLUSIONS:Rate of increase in CRL was greater in fetuses of black versus white women and increased with advancing maternal age. As CRL is used to date pregnancies, and this influences further growth assessment, consideration should be given to the use of individualized growth charts which take account of maternal factors found to influence first trimester growth.
    背景与目标:
  • 【健康年轻人脑电图背景活动和 α 节律的缩放和组织。】 复制标题 收藏 收藏
    DOI:10.1007/s00422-006-0094-4 复制DOI
    作者列表:Lin DC,Sharif A,Kwan HC
    BACKGROUND & AIMS: :The coexistence of the broad-band fluctuation and alpha rhythm of the brain dynamics is studied based on the zero-crossing property of the local electroencephalographic (EEG) recording in eyes closed and eyes open. A two-component zero-crossing scenario, consisting of a broad-band fractal and narrow-band rhythm components, is assumed. Scaling is found in the power law distribution p(tau) approximately tau(-nu) of the crossing time interval tau of the broad-band fluctuation. In alpha dominant brain state, the alpha rhythm interval L also exhibits scaling in the form of power law distribution: p(L) approximately L(phi). Our main result is the relationship nu + phi approximately 3 that characterizes the organization of these two prominent features of the brain dynamics. The possible role of self-organized criticality of punctuated equilibrium in this organization is discussed.
    背景与目标: : 基于闭眼和睁眼局部脑电图 (EEG) 记录的零交叉特性,研究了大脑动力学的宽带波动和 α 节律的共存。假设由宽带分形和窄带节奏分量组成的两分量过零方案。在宽带波动的交叉时间间隔tau的幂律分布p(tau) 中发现了约tau(-nu) 的缩放。在 α 显性大脑状态下,α 节律间隔L还表现出幂律分布形式的缩放: p(L) 近似L(phi)。我们的主要结果是nu phi大约3的关系,该关系表征了大脑动力学这两个突出特征的组织。讨论了点状平衡的自组织临界性在该组织中的可能作用。
  • 【遗传背景影响PMD/spg2的rumpshaker模型中的UPR,但不影响PLP处理。】 复制标题 收藏 收藏
    DOI:10.1007/s11064-006-9122-y 复制DOI
    作者列表:McLaughlin M,Karim SA,Montague P,Barrie JA,Kirkham D,Griffiths IR,Edgar JM
    BACKGROUND & AIMS: :Mutations of the proteolipid protein gene (PLP1) cause Pelizaeus-Merzbacher disease (PMD) and Spastic paraplegia type 2 (SPG2). The rumpshaker mutation is associated with mild forms of PMD or SPG2 in man and the identical mutation occurs in mice, the phenotype depending on genetic background. The mild phenotype in C3H mice becomes a lethal disease when expressed on the C57BL/6 background. rumpshaker PLP is synthesised at a similar rate to wild type but is rapidly degraded by the proteasome. We show that the rates of synthesis, degradation and myelin incorporation of PLP/DM20 are similar in mutants on both backgrounds and therefore differences in PLP processing are unlikely to be the basis of the phenotypic variation. An unfolded protein response (UPR) is activated in rumpshaker. Whereas activation of CHOP correlates with phenotypic severity, we find no difference in the response of BiP and X-box protein1 (Xbp1) between the two strains.
    背景与目标: 蛋白脂蛋白基因 (PLP1) 的突变导致Pelizaeus-Merzbacher病 (PMD) 和2型痉挛性截瘫 (SPG2)。rumpshaker突变与人类轻度形式的PMD或SPG2相关,并且相同的突变发生在小鼠中,其表型取决于遗传背景。当在C57BL/6背景上表达时,C3H小鼠的轻度表型成为致命疾病。rumpshaker PLP的合成速度与野生型相似,但被蛋白酶体迅速降解。我们表明,在两种背景下,PLP/DM20的突变体的合成,降解和髓鞘掺入速率相似,因此PLP加工的差异不太可能成为表型变异的基础。未折叠的蛋白质反应 (UPR) 在rumpshaker中被激活。尽管CHOP的激活与表型严重程度相关,但我们发现两个菌株之间BiP和X-box蛋白1 (Xbp1) 的反应没有差异。

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