• 【磨牙全冠制剂中的轴向壁倾斜角和垂直高度相互作用。】 复制标题 收藏 收藏
    DOI:10.1016/j.jdent.2006.06.002 复制DOI
    作者列表:Bowley JF,Kieser J
    BACKGROUND & AIMS: OBJECTIVE:This study has been designed to evaluate the interaction of axial wall heights with inclination angles in full crown tooth preparations. The interaction of these parameters was related to the resulting preparation surface area. MATERIALS AND METHODS:A right regular pyramid was used to simulate a single mandibular molar preparation with known convergence angles and vertical heights. Various combinations of these two variables allowed the calculation of surface areas with a formula for the area of a pyramid and right triangles through trigonometric manipulations. The pyramidal model system had a 9-mm square base with vertical heights from 3- to 5-mm and single-side inclination angles from 2 to 25 degrees. The occlusal surface was a flat, square or rectangular surface and was included in the total area. RESULTS:A percentage of surface area lost or gained served as the dependent variables. The significance levels were set at 10.0% or greater magnitude of loss/gain in a surface area compared to the ideal 2 degree-level. Significant area loss was demonstrated in all alpha-level comparisons. The largest change was found in the 5-mm height grouping compared to the 3-mm height grouping, -36.6% difference between groups at the 2 degree-level. CONCLUSIONS:Axial single-side inclination angles greater than 10 degrees in 3- and 4-mm height-molars are detrimental to maximum surface area in full crown restorations. The 5-mm axial wall height with < or = 10 degree single wall has been shown to maximize the luting agent surface area between restoration and tooth structure.
    背景与目标:
  • 【血管紧张素II体外诱导大鼠和人小肠壁肌肉组织收缩。】 复制标题 收藏 收藏
    DOI:10.1111/j.1748-1716.2006.01600.x 复制DOI
    作者列表:Ewert S,Spak E,Olbers T,Johnsson E,Edebo A,Fändriks L
    BACKGROUND & AIMS: BACKGROUND:Angiotensin II (Ang II) is a well-known activator of smooth muscle in the vasculature but has been little explored with regard to intestinal wall muscular activity. This study investigates pharmacological properties of Ang II and expression of its receptors in small-intestinal smooth muscle from rats and humans. METHODS:Isometric recordings were performed in vitro on small intestinal longitudinal muscle strips. Protein expressions of Ang II typ 1 (AT1R) and typ 2 (AT2R) receptors were assessed by Western blot. RESULTS:Ang II elicited concentration-dependent contractions of rat jejunal and ileal muscle preparations. The concentration-response curve (rat ileum, EC(50): 1.5 +/- 0.9 x 10(-8) M) was shifted to the right by the AT1R receptor antagonist losartan (10(-7) M) but was unaffected by the AT2R antagonist PD123319 (10(-7) M) as well as by the adrenolytic guanethidine (3 x 10(-6) M) and the anticholinergic atropine (10(-6) M). Human duodenal, jejunal and ileal longitudinal muscle preparations all contracted concentration-dependently in response to Ang II. The concentration-response curve (human jejunum, EC(50): 1.5 +/- 0.8 x 10(-8) M) was shifted to the right by losartan (10(-7) M) but was unaffected by PD123319 (10(-7) M). Both AT1R and AT2R were detected in all segments of the rat small intestinal wall musculature, whereas only AT1R was readily detectable in the human samples. CONCLUSION:Ang II elicits contractions of small-intestinal longitudinal muscle preparations from the small intestine of rats and man. The pharmacological pattern and protein expression analyses indicate mediation via the AT1R.
    背景与目标:
  • 【舒张期颈动脉纵向壁运动对衰老和冠状动脉疾病状态均敏感,而与动脉僵硬无关。】 复制标题 收藏 收藏
    DOI:10.1016/j.ultrasmedbio.2017.04.026 复制DOI
    作者列表:Au JS,Valentino SE,McPhee PG,MacDonald MJ
    BACKGROUND & AIMS: :We investigated the ability of systolic and diastolic carotid artery longitudinal wall motion (CALM) to delineate expected differences in arterial health in individuals representing a range of both age and health status. We recruited 161 younger healthy adults (aged 24 ± 5 y), 51 older healthy adults (aged 70 ± 5 y) and 14 adults with coronary artery disease (aged 67 ± 8 y) for resting assessment of CALM and arterial stiffness. All CALM parameters were reduced in the old healthy adults and adults with coronary artery disease compared with the young healthy adults (p < 0.01), with diastolic velocity and maximum diastolic acceleration being further reduced in the adults with coronary artery disease than in the older healthy adults (p < 0.01). Diastolic CALM parameters were more strongly related to age (β range: -0.46 to -0.53) than systolic CALM parameters (β range: -0.24 to -0.44). In contrast to previous examinations of a variety of CALM parameters, diastolic CALM may provide superior promise in terms of characterizing arterial wall properties, with additional sensitivity to cardiovascular disease status.
    背景与目标: : 我们研究了收缩期和舒张期颈动脉纵向壁运动 (CALM) 描绘代表年龄和健康状况范围的个体的动脉健康预期差异的能力。我们招募了161名年轻的健康成年人 (24 ± 5岁),51名老年健康成年人 (70 ± 5岁) 和14名患有冠状动脉疾病的成年人 (67 ± 8岁) 进行静息评估平静和动脉僵硬度。与年轻健康成年人相比,老年健康成年人和患有冠状动脉疾病的成年人的所有CALM参数均降低 (p <0.01),与老年健康成年人相比,患有冠状动脉疾病的成年人的舒张速度和最大舒张加速度进一步降低 (p <0.01)。舒张期平静参数与年龄 (β 范围: -0.46至-0.53) 的相关性高于收缩期平静参数 (β 范围: -0.24至-0.44)。与以前对各种平静参数的检查相比,舒张期平静在表征动脉壁特性方面可能具有出色的前景,并且对心血管疾病状态具有额外的敏感性。
  • 【Isg-geis四肢和躯干壁软组织肉瘤试验中的手术质量和新辅助联合治疗。】 复制标题 收藏 收藏
    DOI:10.1093/annonc/mds501 复制DOI
    作者列表:Gronchi A,Verderio P,De Paoli A,Ferraro A,Tendero O,Majò J,Martin J,Comandone A,Grignani G,Pizzamiglio S,Quagliuolo V,Picci P,Frustaci S,Dei Tos AP,Palassini E,Stacchiotti S,Ferrari S,Fiore M,Casali PG
    BACKGROUND & AIMS: BACKGROUND:To explore correlation between the quality of surgery and outcome in high-risk soft tissue sarcoma (STS) patients treated within a phase III randomized trial. PATIENTS AND METHODS:In the trial, all patients received three cycles of preoperative chemotherapy (CT) with epirubicin 120 mg/m(2) and ifosfamide 9 g/m(2) and were randomly assigned to receive two further postoperative cycles. Radiotherapy (RT) could be delivered in the preoperative or postoperative setting. The association between surgical margins and overall survival (OS) was studied in a univariate and multivariate fashion. RESULTS:Two hundred and fifty-two patients completed the whole treatment and were operated conservatively. At a median follow-up of 60 months (IQR, 45-74 months), the 5-year OS was 0.73, even in patients with positive and negative margins. The 5-year cumulative incidence (CI) of local recurrence (LR) in patients with positive and negative microscopic margins was 0.17 (standard error, SE, 0.08) and 0.03 (SE, 0.01), respectively. In the subgroup of patients receiving combined preoperative CT-RT and with positive surgical margins, the CI of LR was 0. CONCLUSIONS:In this setting of high-risk STS treated by preoperative CT or CT-RT, the negative impact of positive margins on the outcome was limited. When close margins can be anticipated preoperative CT-RT may be a reasonable option to maximize the chance of cure.
    背景与目标:
  • 【布鲁氏菌壁根提取物的体外和体内抗血浆活性。ex Kurz。】 复制标题 收藏 收藏
    DOI:10.1007/s00436-012-3178-1 复制DOI
    作者列表:Prakash A,Sharma SK,Mohapatra PK,Bhattacharjee K,Gogoi K,Gogoi P,Mahanta J,Bhattacharyya DR
    BACKGROUND & AIMS: :Malaria control is compromised worldwide by continuously evolving drug-resistant strains of the parasite demanding exploration of natural resources for developing newer antimalarials. The northeastern region of India is endemic for malaria characterized by high prevalence of drug-resistant Plasmodium falciparum strains. Many plants are used by the indigenous communities living in the northeast India in their traditional system of medicine for the treatment of malarial fever. Folklore claim of antimalarial property of one such plant Brucea mollis was evaluated in vitro and in vivo for antiplasmodial activity. Crude extracts from dried B. mollis root powder were prepared through soxhlet extraction using petroleum ether, methanol, and water sequentially. Methanol extract was further partitioned between chloroform and water. These extracts were tested in vitro against laboratory-adapted chloroquine-sensitive and chloroquine-resistant strains of P. falciparum. In in vitro evaluation, extracts were found more active on the chloroquine-sensitive strain. Methanolic-chloroform (IC(50) 5.1 μg ml(-1)) and methanolic-aqueous (IC(50) 13.9 μg ml(-1)) extracts recorded significant in vitro antiplasmodial activity which was also supported by their promising in vivo activity (ED(50) 72 and 30 mg kg(-1) bw day(-1), respectively) against chloroquine-resistant Plasmodium yoelli N-67 strain in Swiss albino mice. Methanolic-aqueous extract-treated mice survived on average for 14 days that was comparable to the reference drug chloroquine. This is the first report of antiplasmodial activity of B. mollis validating the traditional use of this plant as antimalarial in the northeast India and calls for further detailed investigations.
    背景与目标: : 疟疾控制在世界范围内受到不断发展的寄生虫耐药菌株的损害,需要探索自然资源来开发新型抗疟药。印度东北部地区是疟疾的地方病,其特征是抗药性恶性疟原虫菌株的高流行。生活在印度东北部的土著社区在其传统医学系统中使用了许多植物来治疗疟疾发热。在体外和体内评估了一种此类植物布鲁氏菌的抗疟特性的民间传说声称具有抗疟原虫活性。通过依次使用石油醚,甲醇和水进行索氏萃取,制备了干燥的B. mollis根粉末的粗提取物。甲醇提取物在氯仿和水之间进一步分配。这些提取物在体外针对实验室适应的恶性疟原虫对氯喹敏感和对氯喹耐药的菌株进行了测试。在体外评估中,发现提取物对氯喹敏感的菌株更具活性。甲醇-氯仿 (IC(50) 5.1 μ gml (-1)) 和甲醇-水性 (IC(50) 13.9 μ gml (-1)) 提取物记录了显着的体外抗血浆活性,这也受到其有希望的体内活性的支持 (ED(50) 72和30 mg kg(-1) bw日 (-1),分别) 针对瑞士白化病小鼠中抗氯喹的疟原虫yoelli N-67株。甲醇水提取物处理的小鼠平均存活14天,与参考药物氯喹相当。这是关于B. mollis抗疟原虫活性的第一份报告,证实了该植物在印度东北部作为抗疟药的传统用途,并呼吁进行进一步的详细研究。
  • 【使用支撑技术重建粉碎性后壁骨折: 对32例骨折的回顾。】 复制标题 收藏 收藏
    DOI:10.1007/s00264-006-0246-0 复制DOI
    作者列表:Ebraheim NA,Patil V,Liu J,Sanford CG Jr,Haman SP
    BACKGROUND & AIMS: :Fractures of the posterior wall are the most common of the acetabular fractures. The aim of this study was to assess the medium-term results of reconstruction of comminuted posterior wall fractures of the acetabulum by using the buttress technique. This is a retrospective review conducted at a level 1 trauma centre. Thirty-two patients (25 men, 7 women, mean age 41 years, range 14-80 years) with comminuted posterior wall fracture of the acetabulum underwent reconstruction of the posterior wall during the period of July 1998 to February 2004. The average follow-up was 43 months (range 24-70 months). Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Radiographic evaluation was according to criteria developed by Matta. The postoperative reduction was graded as anatomical in 28 patients (88%) and imperfect in 4 patients (12%). The clinical outcome was excellent in 11 (34% ), very good in 9 (28%), good in 4 (12%), fair in 3 (9%) and poor in 5 (15%). Radiological grading at the final follow-up was excellent 12 (37%), good 11 (34%), fair 4 (12%) and poor 5 (15%). Reconstruction of comminuted posterior wall acetabular fractures by buttress technique can be expected to produce good results. It can provide a stable fixation of the posterior wall amenable to early range of motion and weight bearing.
    背景与目标: : 后壁骨折是髋臼骨折中最常见的。这项研究的目的是评估使用支撑技术重建髋臼粉碎性后壁骨折的中期结果。这是在一级创伤中心进行的回顾性审查。在1998年7月至2004年2月期间,对32例髋臼粉碎性后壁骨折患者 (男性25例,女性7例,平均年龄41岁,范围14-80岁) 进行了后壁重建。平均随访43个月 (24-70个月)。临床评估基于改良的Merle d'Aubigne和Postel评分。射线照相评估是根据Matta制定的标准进行的。术后复位分为解剖型28例 (88% 例),不完美的4例 (12% 例)。临床结果优11例 (34% 例),好9例 (28% 例),好4例 (12% 例),好3例 (9% 例),差5例 (15% 例)。最终随访的放射学分级为优秀12 (37%),良好11 (34%),一般4 (12%) 和较差5 (15%)。通过支撑技术重建粉碎性后壁髋臼骨折有望产生良好的效果。它可以提供稳定的后壁固定,适合早期的运动范围和承重。
  • 【用非线性自适应滤波器降低胸部CT的辐射剂量。】 复制标题 收藏 收藏
    DOI:10.1258/ar.2012.120045 复制DOI
    作者列表:Singh S,Digumarthy SR,Back A,Shepard JA,Kalra MK
    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:
  • 【动脉壁低密度脂蛋白氧化动力学模型及其在动脉粥样硬化病变预测中的应用。】 复制标题 收藏 收藏
    DOI:10.1016/j.chemphyslip.2013.07.006 复制DOI
    作者列表:Karimi S,Dadvar M,Modarress H,Dabir B
    BACKGROUND & AIMS: :Oxidation of low-density lipoprotein (LDL) is one of the major factors in atherogenic process. Trapped oxidized LDL (Ox-LDL) in the subendothelial matrix is taken up by macrophage and leads to foam cell generation creating the first step in atherosclerosis development. Many researchers have studied LDL oxidation using in vitro cell-induced LDL oxidation model. The present study provides a kinetic model for LDL oxidation in intima layer that can be used in modeling of atherosclerotic lesions development. This is accomplished by considering lipid peroxidation kinetic in LDL through a system of elementary reactions. In comparison, characteristics of our proposed kinetic model are consistent with the results of previous experimental models from other researches. Furthermore, our proposed LDL oxidation model is added to the mass transfer equation in order to predict the LDL concentration distribution in intima layer which is usually difficult to measure experimentally. According to the results, LDL oxidation kinetic constant is an important parameter that affects LDL concentration in intima layer so that existence of antioxidants that is responsible for the reduction of initiating rates and prevention of radical formations, have increased the concentration of LDL in intima by reducing the LDL oxidation rate.
    背景与目标: : 低密度脂蛋白 (LDL) 的氧化是动脉粥样硬化过程的主要因素之一。内皮下基质中捕获的氧化LDL (Ox-LDL) 被巨噬细胞摄取,并导致泡沫细胞的产生,从而形成动脉粥样硬化发展的第一步。许多研究人员使用体外细胞诱导的LDL氧化模型研究了LDL氧化。本研究提供了内膜层LDL氧化的动力学模型,可用于模拟动脉粥样硬化病变的发展。这是通过通过基本反应系统考虑LDL中的脂质过氧化动力学来实现的。相比之下,我们提出的动力学模型的特征与其他研究的先前实验模型的结果一致。此外,我们提出的LDL氧化模型被添加到传质方程中,以预测内膜层中的LDL浓度分布,这通常很难通过实验进行测量。根据结果,LDL氧化动力学常数是影响内膜层中LDL浓度的重要参数,因此抗氧化剂的存在负责降低起始速率和防止自由基形成,通过降低LDL氧化速率来增加内膜中LDL的浓度。
  • 【与骨科胸壁重建相关的人肋骨的几何形状。】 复制标题 收藏 收藏
    DOI:10.1016/j.jbiomech.2006.05.017 复制DOI
    作者列表:Mohr M,Abrams E,Engel C,Long WB,Bottlang M
    BACKGROUND & AIMS: :Orthopedic reconstruction of blunt chest trauma can aid restoration of pulmonary function to reduce the mortality associated with serial rib fractures and flail chest injuries. Contemporary chest wall reconstruction requires contouring of generic plates to the complex surface geometry of ribs. This study established a biometric foundation to generate specialized, anatomically contoured osteosynthesis hardware for rib fracture fixation. On human cadaveric ribs three through nine, the surface geometry pertinent to anatomically conforming osteosynthesis plates was characterized by quantifying the apparent rib curvature C(A), the longitudinal twist alpha(LT) along the diaphysis, and the unrolled curvature C(U). In addition, the rib cross-sectional geometry pertinent to intramedullary fixation strategies was characterized in terms of cross-section height, width, area, and cortex thickness. The rib surface exhibited a curvature C(A) ranging from 3.8 m(-1) in the anteromedial section of rib seven to 17.3 m(-1) in the posterior section of rib three. All ribs had in common a longitudinal twist alpha(LT), ranging from 41-60 degrees. The unrolled curvature C(U) decreased gradually from ribs three to five, and increased gradually with reversed orientation from rib six to nine. The cross-sectional area remained constant along the rib diaphysis. However, the medullary canal increased in size from 29.9 mm(2) posteriorly to 41.2 mm(2) in anterior rib segments. Results of this biometric rib characterization describe a novel strategy for intraoperative plate contouring and provide a foundation for the development of specialized rib osteosynthesis strategies.
    背景与目标: : 钝性胸部创伤的矫形重建可以帮助恢复肺功能,以降低与系列肋骨骨折和连枷胸损伤相关的死亡率。当代的胸壁重建需要将通用板轮廓绘制到肋骨的复杂表面几何形状。这项研究建立了生物识别基础,以生成用于肋骨骨折固定的专门的,解剖学轮廓的骨合成硬件。在人体尸体肋骨的三到九个肋骨上,与解剖学上符合的骨接骨板相关的表面几何形状的特征是量化了明显的肋骨曲率C(A),沿骨干的纵向扭曲 α (LT) 和展开的曲率C(U)。此外,与髓内固定策略相关的肋骨横截面几何形状的特征在于横截面高度,宽度,面积和皮质厚度。肋骨表面的曲率C (a) 的范围为7肋的前内侧部分的3.8 m(-1) 至3肋的后部的17.3 m(-1)。所有肋骨的共同纵向扭曲 α (LT) 在41-60度之间。展开的曲率C(U) 从肋骨3逐渐减小到肋骨5,并随着方向从肋骨6逐渐减小到肋骨9。沿肋骨骨干的横截面积保持恒定。然而,前肋骨段的延髓管大小从后29.9毫米 (2) 增加到41.2毫米 (2)。这种生物特征的结果描述了一种用于术中钢板轮廓的新策略,并为开发专门的肋骨骨合成策略提供了基础。
  • 【[主动脉壁夹层的组织病理学研究]。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Niitsuya M,Kuwao S,Sato B,Kameya T,Kikawada R
    BACKGROUND & AIMS: :To determine the etiology of aortic wall dissection, a histopathological study of the aorta in 20 cases with dissecting aortic aneurysm (DA), 3 cases with Marfan syndrome and 3 cases with annulo-aortic ectasia (AAE) was performed. Controls consisted of 348 cases of normally-aging aorta. In cases with aortic wall dissection, the histopathological changes in the undissected media were also carefully examined. In Marfan syndrome and AAE, there was a marked accumulation of acid mucopolysaccharide (AMPS) and its distribution in the wall was diffuse in patients under 50 years old, resulting in changes in elastic fibers including fragmentation, elastolysis and reticulation. In contrast, DA was histopathologically characterized by zonal fibrosis and abnormally-dilated vessels in the aortic media. These lesions were found in 8 (40%) of the 20 DA cases. The remaining 12 cases also had increased vascularization and fragmentation of elastic fibers. This medial fibrosis and increased vascularization were particularly marked in older patients. Among the 3 diseased entities responsible for aortic wall dissection, DA differed distinctly from Marfan syndrome or AAE as to the amount and site of AMPS accumulation in the media as well as fibrosis and hypervascularity in the outer half of the aortic media. In conclusion, aortic wall dissection in younger patients may be etiologically associated with the increased AMPS accumulation in the aortic media which may always be accompanied by degeneration of elastic fibers in this study, however, in older patients zonal fibrosis and abnormal vessels developing in the media are responsible for the dissection.
    背景与目标: : 为了确定主动脉壁夹层的病因,对20例夹层主动脉瘤 (DA),3例Marfan综合征和3例环状主动脉扩张 (AAE) 的主动脉进行了组织病理学研究。对照组包括348例正常老化的主动脉。在主动脉壁夹层的情况下,还仔细检查了未解剖介质的组织病理学变化。在Marfan综合征和AAE中,在50岁以下的患者中,酸性粘多糖 (AMPS) 明显积累,并且其在壁中的分布是弥漫性的,导致弹性纤维的变化,包括碎片,弹性分解和网状。相反,DA的组织病理学特征是主动脉介质中的带状纤维化和异常扩张的血管。在20例DA病例中,有8例 (40% 例) 发现了这些病变。其余12例也有血管化和弹性纤维碎裂的增加。这种内侧纤维化和血管化增加在老年患者中尤为明显。在负责主动脉壁夹层的3个患病实体中,DA与Marfan综合征或AAE在培养基中AMPS积累的数量和部位以及主动脉培养基外半部的纤维化和血管增生方面明显不同。总之,年轻患者的主动脉壁夹层可能与主动脉介质中AMPS积累增加在病因学上有关,在本研究中,这可能总是伴随着弹性纤维的变性,但是,在老年患者中,带状纤维化和异常血管在主动脉介质中发展是造成夹层的原因。
  • 【胸部理疗可延长重症患者通气时间超过48小时。】 复制标题 收藏 收藏
    DOI:10.1007/s00134-007-0762-4 复制DOI
    作者列表:Templeton M,Palazzo MG
    BACKGROUND & AIMS: OBJECTIVE:This study aimed to determine the impact of providing chest physiotherapy after routine clinical assessment on the duration of mechanical ventilation, outcome and intensive care length of stay. DESIGN AND SETTING:Single-centre, single-blind, prospective, randomised, controlled trial in a university hospital general intensive care unit. PATIENTS AND PARTICIPANTS:180 patients requiring mechanical ventilation for more than 48 h. INTERVENTIONS:Patients randomly allocated, one group receiving physiotherapy as deemed appropriate by physiotherapists after routine daily assessments and another group acting as controls were limited to receiving decubitus care and tracheal suctioning. MEASUREMENTS AND RESULTS:Primary endpoints were initial time to become ventilator-free, secondary endpoints included intensive care unit (ICU) and hospital mortality and ICU length of stay. Kaplan-Meier analysis censored for death revealed a significant prolongation of median time to become ventilator-free among patients receiving physiotherapy (p=0.047). The time taken for 50% of patients (median time) to become ventilator-free was 15 and 11 days, respectively, for physiotherapy and control groups. There were no differences between groups in ICU or hospital mortality rates, or length of ICU stay. The number of patients needing re-ventilation for respiratory reasons was similar in both groups.
    背景与目标:
  • 【血清 β-hCG水平和胎龄是否可以作为预测未破裂壶腹妊娠滋养细胞侵入输卵管壁程度的指示因素?】 复制标题 收藏 收藏
    DOI:10.1007/s00404-012-2566-1 复制DOI
    作者列表:Turgut EN,Celik E,Celik S,Arikan DC,Altuntas H,Leblebici C,Purisa S,Dansuk R
    BACKGROUND & AIMS: OBJECTIVE:To evaluate the predictive value of gestational age and maternal serum β-hCG concentration for the determination of the depth of trophoblastic invasion into the tubal wall. METHODS:This is a retrospective trial conducted on women with a diagnosis of ampullary pregnancy (71) who were submitted to salpingectomy. Serum β-hCG measurements were obtained at the initial admission of hospital. Histological investigation was performed by a single well-experienced pathologist who was blind to the clinical and laboratory characteristics of the patients. Ampullary pregnancy was classified histologically according to the depth of trophoblastic infiltration into tubal wall: trophoblast limited to the tubal mucosa (stage I), extended to muscularis layer (stage II) and complete tubal wall infiltration up to serosal layer (stage III). RESULTS:There was a significant difference in maternal serum β-hCG concentrations regarding the histological stages of trophoblastic invasion. The serum β-hCG concentrations that the best predicted for stage III trophoblastic invasion was 6,475 mIU/ml, with a sensitivity of 100 %, a specificity of 92 %. CONCLUSION:The depth of trophoblastic tissue infiltration into tubal wall is correlated with serum β-hCG levels, but not with gestational age. These findings may explain the reason for conservative management failure of EP in women with high β-hCG concentrations.
    背景与目标:
  • 【石蒜科不同发育阶段孢子组织和花药壁的超微结构研究。】 复制标题 收藏 收藏
    DOI:10.1590/s0001-37652012005000061 复制DOI
    作者列表:Ekici N,Dane F
    BACKGROUND & AIMS: :In this study, ultrastructures of anther wall and sporogenous tissue of Leucojum aestivum were investigated during different developmental stages. Cytomictic channels were seen between pollen mother cells during prophase I. Polar distribution was described in the organelle content of pollen mother cells and microspores in early phases of microsporogenesis and also in pollen mitosis. Active secretion was observed in tapetal cells. Previous reports about developmental stages of male gametophyte were compared with the results of this study.
    背景与目标: : 在这项研究中,研究了不同发育阶段的花药壁和孢子组织的超微结构。在前期I期间,在花粉母细胞之间观察到了细胞分化通道。在小孢子发生的早期阶段以及花粉有丝分裂中,花粉母细胞和小孢子的细胞器含量描述了极性分布。在绒毡层细胞中观察到活跃的分泌。将先前有关雄配子体发育阶段的报道与本研究结果进行了比较。
  • 【急诊科胸痛: 与我们目前的常规无创检测做法背道而驰。】 复制标题 收藏 收藏
    DOI:10.1001/archinternmed.2012.4037 复制DOI
    作者列表:Prasad V,Cheung M,Cifu A
    BACKGROUND & AIMS: :Current clinical practice for patients presenting to the emergency department with a resolved episode of chest pain and no electrographic or biomarker abnormalities is to conduct routine noninvasive testing, in accordance with American College of Cardiology and American Heart Association guidelines. The rationale is to further reduce the risk of missing a myocardial infarction, a major source of suits filed against emergency department physicians. Patients with negative stress test results may be reassured, with low event rates in the subsequent 30 days. Patients with positive stress test results have higher 30-day event rates, and a small fraction undergo revascularization procedures. Despite this endorsement, open questions remain. Does our current practice lead to the stenting of asymptomatic patients in the inevitable cases where the inciting pain was noncardiac? And, most importantly, does our practice improve outcomes? Randomized trials evaluating routine stress testing in other contexts have yielded negative results, despite diagnosing significant coronary artery disease. Population data suggest that our current practice may be increasing the diagnosis of coronary artery disease and the rate of intervention while failing to decrease rates of myocardial infarction. We propose that randomized trials be conducted to evaluate whether any testing is better than no further intervention. Data from such an evidence-based approach has the potential to reverse our current practice.
    背景与目标: : 根据美国心脏病学会和美国心脏协会的指南,针对急诊就诊的胸痛发作且无电子照相或生物标志物异常的患者,目前的临床实践是进行常规的无创检测。理由是进一步降低错过心肌梗死的风险,心肌梗死是针对急诊科医生提起诉讼的主要来源。负压力测试结果的患者可能会放心,随后30天的事件发生率较低。具有积极压力测试结果的患者的30天事件发生率较高,并且一小部分患者接受了血运重建手术。尽管有这种认可,但悬而未决的问题仍然存在。在不可避免的非心脏性疼痛情况下,我们目前的做法是否导致无症状患者支架置入?而且,最重要的是,我们的实践是否改善了结果?尽管诊断出明显的冠状动脉疾病,但在其他情况下评估常规压力测试的随机试验却产生了阴性结果。人口数据表明,我们目前的做法可能会增加对冠状动脉疾病的诊断和干预率,而未能降低心肌梗塞的发生率。我们建议进行随机试验以评估是否有任何测试比没有进一步干预更好。来自这种基于证据的方法的数据有可能扭转我们目前的做法。
  • 【左,右,近或远壁颈总动脉内膜中层厚度测量: 与心血管疾病和下肢动脉粥样硬化的关系。】 复制标题 收藏 收藏
    DOI:10.1016/s0895-4356(97)00059-0 复制DOI
    作者列表:Bots ML,de Jong PT,Hofman A,Grobbee DE
    BACKGROUND & AIMS: :We evaluated the differences in strength of the associations of prevalent cardiovascular disease and lower extremity arterial atherosclerosis to common carotid intima-media thickness, assessed by near wall measurements only, by far wall measurements only, and by the average of near and far wall measurements. The study was based on data from 1500 participants of the Rotterdam Study, a single-center-population-based prospective follow-up study among 7983 subjects, aged 55 years or over. Comparison of the strength of the associations of near wall intima-media thickness and of combined near and far wall intima-media thickness to cardiovascular disease and lower extremity arterial atherosclerosis revealed significantly stronger associations compared to associations observed for far wall intima-media thickness, in particular for stroke and lower extremity arterial disease. We conclude that near wall common carotid intima-media thickness measurement provides at least as good an indicator of atherosclerosis elsewhere and of cardiovascular risk as the far wall intima-media thickness measurement.
    背景与目标: : 我们评估了流行的心血管疾病和下肢动脉粥样硬化与颈总动脉内膜中层厚度的相关性的强度差异,仅通过近壁测量,仅通过远壁测量以及近壁和远壁测量的平均值来评估。该研究基于鹿特丹研究的1500名参与者的数据,该研究是一项基于单中心人群的前瞻性随访研究,涉及7983名年龄在55岁或以上的受试者。比较近壁内膜-中膜厚度以及近壁和远壁内膜-中膜厚度与心血管疾病和下肢动脉粥样硬化的相关性,发现与观察到的远壁内膜-中膜厚度的相关性相比,相关性明显更强,特别是对于中风和下肢动脉疾病。我们得出的结论是,近壁颈总动脉内膜中层厚度的测量至少与远壁内膜中层厚度的测量一样,可以很好地指示其他地方的动脉粥样硬化和心血管风险。

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