• 【用高分辨率计算机断层扫描对结节病中的炎症活动进行非侵入性评估。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Oberstein A,von Zitzewitz H,Schweden F,Müller-Quernheim J
    BACKGROUND & AIMS: PURPOSE:The value of high resolution computed tomography (HR-CT) in the recognition of pathologic changes of the lung parenchyma, especially in the diagnosis of sarcoidosis, is well established. The importance of these findings in regard to the inflammatory activity is not sufficiently documented, also because a direct histologic correlation is seldom possible.

    METHOD:In a prospective study twenty-one patients with suspected or known sarcoidosis were evaluated. The diagnostic work up comprised the clinical examination, lung function tests, the radiological evaluation, including GH-CT, and bronchoscopy for bronchoalveolar lavage (BAL) and transbronchial biopsy.

    RESULTS:The comparison of the HR-CT findings, like pathologic appearance of the bronchovascular bundle and intraparenchymal nodules, with serologic and BAL-parameters yielded high correlation coefficients with the total cell count in BAL and sIL-2R, and moderate correlations with the lavage lymphocyte count and the activity markers, like T4/T8 ratio, IL-2R and HLA-DR expression.

    CONCLUSION:As a non invasive method, HR-CT depicts pathologic findings of the lung parenchyma which are associated with the inflammatory activity of sarcoidosis.

    背景与目标: 目的:高分辨率计算机断层扫描(HR-CT)在识别肺实质的病理变化,特别是在结节病的诊断中的价值已得到很好的确立。这些发现对炎症活性的重要性没有得到充分的证明,也因为很少有直接的组织学相关性。

    METHOD :在一项前瞻性研究中,有21名患者对可疑或已知结节病进行了评估。诊断工作包括临床检查,肺功能检查,放射线评估(包括GH-CT)和支气管镜检查以进行支气管肺泡灌洗(BAL)和经支气管活检。

    结果: HR-CT结果的比较,如支气管血管束和实质内结节的病理表现,以及血清学和BAL参数,与BAL和sIL-2R中的总细胞数具有较高的相关系数,与灌洗淋巴细胞计数和活性标记,如T4 / T8比值,IL-2R和HLA-DR表达。

    结论:作为一种非侵入性方法,HR-CT描述了肺实质的病理发现与结节病的炎症活动有关。

  • 【基于相机的99mTc-MAG3和24小时肌酐清除率用于评估肾功能的比较。】 复制标题 收藏 收藏
    DOI:10.2214/AJR.05.1025 复制DOI
    作者列表:Esteves FP,Halkar RK,Issa MM,Grant S,Taylor A
    BACKGROUND & AIMS: OBJECTIVE:The 24-hour creatinine clearance is the standard clinical technique for measuring kidney function; however, this measurement is cumbersome and inconvenient for patients. We hypothesized that a camera-based technetium-99m mercaptoacetyltriglycine (MAG3) clearance obtained simultaneously with a standard MAG3 scan would correlate well with the 24-hour creatinine clearance and could serve as a simple marker of kidney function. MATERIALS AND METHODS:Data were obtained from a retrospective analysis of 28 patients with varying degrees of kidney dysfunction and 85 subjects evaluated for kidney donation. The MAG3 clearance was calculated using a camera-based technique without blood or urine sampling. The creatinine clearance was measured using the plasma creatinine and a 24-hour urine collection. The MAG3 and creatinine clearances were corrected for body surface area, and clearance values in healthy subjects and patients were compared using the paired Student's t test. The linear association between the MAG3 and creatinine clearances was expressed by Pearson's correlation coefficient. RESULTS:The mean MAG3 clearance in the potential kidney donors was 321 +/- 95 mL/min/1.73 m2 (95% CI, 171-546 mL/min/1.73 m2), significantly higher than the mean creatinine clearance of 152 +/- 51 mL/min/1.73 m2 (79-278 mL/min/1.73 m2, p < 0.001). The mean MAG3 clearance in patients was 153 +/- 70 mL/min/1.73 m2 (32-316 mL/min/1.73 m2) and was also significantly higher than the mean creatinine clearance of 74 +/- 36 mL/min/1.73 m2 (21-138 mL/min/1.73 m2, p < 0.001). The ratio of the mean creatinine clearance to the mean MAG3 clearance was essentially the same for volunteers and patients, 0.47 and 0.48, respectively. The Pearson's correlation between the MAG3 and creatinine clearances was 0.80 (0.72-0.86). CONCLUSION:The camera-based 99mTc-MAG3 clearance correlates well with the 24-hour creatinine clearance and can provide a simple and convenient index of kidney function.
    背景与目标: 目的:24小时肌酐清除率是衡量肾脏功能的标准临床技术。然而,这种测量对于患者而言是麻烦且不便的。我们假设与标准MAG3扫描同时获得的基于相机的tech 99m巯基乙酰基三甘氨酸(MAG3)清除率与24小时肌酐清除率相关性很好,并且可以用作肾脏功能的简单标记。
    材料与方法:数据来自对28位不同程度的肾功能不全患者的回顾性分析,并对85位受试者的肾脏捐赠进行了评估。 MAG3清除率是使用基于相机的技术计算的,无需进行血液或尿液采样。使用血浆肌酐和24小时尿液收集来测量肌酐清除率。校正了MAG3和肌酐的清除率以进行表面积测定,并使用配对的Student's t检验比较了健康受试者和患者的清除率值。 MAG3和肌酐清除率之间的线性关联由皮尔逊相关系数表示。
    结果:潜在肾脏供体的平均MAG3清除率为321 /-95 mL / min / 1.73 m2(95%CI,171-546 mL / min / 1.73 m2),显着高于平均肌酐清除率152 /-51 mL / min / 1.73平方米(79-278 mL / min / 1.73平方米,p <0.001)。患者的平均MAG3清除率为153 /-70 mL / min / 1.73 m2(32-316 mL / min / 1.73 m2),也显着高于平均肌酐清除率74 /-36 mL / min / 1.73 m2( 21-138 mL / min / 1.73 m2,p <0.001)。志愿者和患者的平均肌酐清除率与平均MAG3清除率之比基本相同,分别为0.47和0.48。 MAG3和肌酐清除率之间的Pearson相关性为0.80(0.72-0.86)。
    结论:基于相机的99mTc-MAG3清除率与24小时肌酐清除率相关性良好,可以提供简单便捷的肾脏功能指标。
  • 【接受高活性抗逆转录病毒疗法治疗的替诺福韦富马酸二甲氧呋酯(TDF)暴露和TDF未暴露的HIV感染门诊患者的低血磷评估。】 复制标题 收藏 收藏
    DOI:10.1111/j.1468-1293.2006.00407.x 复制DOI
    作者列表:Buchacz K,Brooks JT,Tong T,Moorman AC,Baker RK,Holmberg SD,Greenberg A,HIV Outpatient Study (HOPS) Investigators.
    BACKGROUND & AIMS: OBJECTIVES:Cases of hypophosphataemia (often coincident with renal dysfunction) have been reported in HIV-infected patients taking tenofovir disoproxil fumarate (TDF), but randomized placebo-controlled trials of HIV-infected persons with normal baseline renal function have found a comparable incidence of hypophosphataemia in the TDF and placebo groups. We assessed the incidence of grade 2 and higher hypophosphataemia in the HIV Outpatient Study (HOPS). METHODS:We analysed a prospective cohort of patients who initiated either a TDF-containing highly active antiretroviral therapy (HAART) regimen [TDF-exposed (TDF+) group; n = 165] or a TDF-sparing HAART regimen [TDF-unexposed (TDF-) group; n = 90], and who had normal baseline phosphate and creatinine values. RESULTS:The TDF+ and TDF- groups had comparable median follow-up times (10.9 vs 8.8 months, respectively; P = 0.18) and number of phosphate measurements (median = 3 for both) and were similar on most clinical and demographic factors. During follow up, 12.7% of TDF+vs 6.7% of TDF-patients developed grade 2 hypophosphataemia (2.0-2.4 mg/dL), and 2.4% of TDF+ patients vs 0% of TDF-patients developed grade 3 hypophosphataemia (1.0-1.9 mg/dL); none developed grade 4 hypophosphataemia (<1.0 mg/dL). The incidence of grade 2 or higher hypophosphataemia was 16.7 per 100 person-years among TDF+ patients vs 8.0 per 100 person-years among TDF-patients (P = 0.11). CONCLUSIONS:The incidence of hypophosphataemia was somewhat elevated in HOPS patients who took TDF-containing HAART compared with those who took TDF-sparing HAART during the first 1 to 2 years of observation, but the difference was not statistically significant. Longer follow-up of a larger population is needed to determine if this trend towards an association achieves statistical significance and to evaluate the clinical consequences of hypophosphataemia.
    背景与目标: 目的:已经报道了接受替诺福韦二富马酸富马酸酯(TDF)感染HIV的患者发生低血磷的情况(通常与肾功能不全同时发生),但基线肾功能正常的HIV感染者的随机安慰剂对照试验发现TDF和安慰剂组的低磷血症。我们在HIV门诊研究(HOPS)中评估了2级和更高的低血磷的发生率。
    方法:我们分析了开始采用含TDF的高活性抗逆转录病毒疗法(HAART)方案[TDF暴露(TDF)组)的患者的前瞻性队列研究。 n = 165]或保留TDF的HAART方案[未暴露TDF(TDF-)的组; n = 90],并且基线磷酸盐和肌酐值正常。
    结果:TDF和TDF-组的中位随访时间(分别为10.9和8.8个月; P = 0.18)和磷酸盐测量次数(两者的中位数= 3)具有可比性,并且在大多数临床和人口统计学因素上相似。在随访期间,TDF的12.7%与TDF的患者的6.7%发生了2级低血磷(2.0-2.4 mg / dL),TDF的2.4%vs TDF的患者中出现了3级的低血磷(1.0-1.9 mg) / dL);没有一个发生4级低血磷(<1.0 mg / dL)。 TDF患者中2级或更高水平低血磷的发生率为每100人年16.7人,而TDF患者为每100人年8.0人(P = 0.11)。
    结论:在观察的头1至2年中,与含TDF的HAART的HOPS患者相比,接受含TDF的HAART的HOPS患者的低磷酸盐血症发生率有所升高,但差异无统计学意义。需要对更大的人群进行更长时间的随访,以确定这种联系趋势是否达到统计学意义并评估低血磷的临床后果。
  • 【腹腔镜Roux-en-Y胃搭桥手术学习曲线的评估。】 复制标题 收藏 收藏
    DOI:10.1016/j.soard.2005.01.003 复制DOI
    作者列表:Shin RB
    BACKGROUND & AIMS: BACKGROUND:The literature reports that the learning curve for laparoscopic Roux-en-Y gastric bypass (LRYGBP) is approximately 75-100 cases. This aim of the present study was to evaluate the safety and feasibility of shortening the learning curve for performing LRYGBP by an experienced laparoscopic surgeon. METHODS:This study analyzed retrospectively the first 100 consecutive LRYGBP cases performed by an experienced laparoscopic surgeon between April 2003 and September 2003. The surgeon performed these cases after first assisting in 30 cases, and the first 4 cases were proctored by an experienced laparoscopic bariatric surgeon. Two cases done after previous gastric stapling and Nissen fundoplication were excluded from the study. Outcome variables included operative time, complications, conversion, and mortality. RESULTS:For the first 100 LRYGBP patients, the mean age was 42.6 years (range, 22-62 years) and mean body mass index (BMI) was 47.6 kg/m2 (range, 36-71.8). The complications included 1 case of intestinal leak, 1 case of small bowel obstruction, 6 cases of gastrojejunal stenosis, 8 cases of wound infection, 1 case of wound seroma, and 2 cases of pulmonary embolism, resulting in 1 mortality. One case was converted to an open technique. Over the second 50 cases, there was a significant reduction in mean operative time, to 73 minutes (range, 39-145 minutes) from 113 minutes (range, 54-238 minutes) (P < .0001). However, despite the reduction in complication frequency (no gastrointestinal leak or obstruction, 2 cases of gastrojejunal stenosis, 2 cases of wound infection, no pulmonary embolism/deep venous thrombosis, and no mortality), there was no significant correlation between the mortality, conversion, and complication rates and the surgeon's experience. CONCLUSION:A bariatric surgical practice incorporating LRYGBP can be safely done by an experienced laparoscopic surgeon. With appropriate advanced laparoscopic skills, preparatory steps, proctorship, and adequate volume of cases, the learning curve for performing LRYGBP can be reduced to 50 cases. Further experience is associated with a significant reduction in operative time with acceptable mortality, complication, and conversion rates.
    背景与目标: 背景:文献报道腹腔镜Roux-en-Y胃旁路术(LRYGBP)的学习曲线约为75-100例。本研究的目的是评估由经验丰富的腹腔镜外科医生缩短进行LRYGBP学习曲线的安全性和可行性。
    方法:本研究回顾性分析了2003年4月至2003年9月由经验丰富的腹腔镜外科医生进行的前100例连续LRYGBP病例。在首次协助30例患者之后,外科医生进行了这些病例,前4例病例由经验丰富的腹腔镜肥胖手术医师指导。该研究排除了先前进行胃吻合术和尼森胃底折叠术后完成的两个病例。结果变量包括手术时间,并发症,转化率和死亡率。
    结果:前100名LRYGBP患者的平均年龄为42.6岁(范围22-62岁),平均体重指数(BMI)为47.6 kg / m2(范围36-71.8)。并发症包括肠漏1例,小肠梗阻1例,胃空肠狭窄6例,伤口感染8例,伤口血清肿1例和肺栓塞2例,导致1例死亡。一个案例被转换为开放技术。在后50例中,平均手术时间从113分钟(54-238分钟)减少到73分钟(39-145分钟)(P <.0001)。然而,尽管并发症发生率降低(无胃肠道渗出或阻塞,2例胃肠空肠狭窄,2例伤口感染,无肺栓塞/深静脉血栓形成,无死亡率),但死亡率,转化率之间无显着相关性。 ,并发症发生率和外科医生的经验。
    结论:有经验的腹腔镜外科医生可以安全地进行结合了LRYGBP的减肥手术。借助适当的高级腹腔镜检查技巧,准备步骤,指导以及适当的病例数量,可以将进行LRYGBP的学习曲线减少到50例。进一步的经验可以显着减少手术时间,并具有可接受的死亡率,并发症和转化率。
  • 【体内31P MRS评估更昔洛韦在稳定表达单纯疱疹胸苷激酶基因的C6胶质瘤中的毒性。】 复制标题 收藏 收藏
    DOI:10.1002/(SICI)1099-1492(199612)9:8<364::AID-NBM436 复制DOI
    作者列表:Stegman LD,Ben-Yoseph O,Freyer JP,Ross BD
    BACKGROUND & AIMS: :Phosphorus MRS was evaluated as a monitor of tumour therapeutic response to the herpes simplex virus thymidine kinase suicide gene therapy paradigm. In vivo 31P spectra were obtained from subcutaneous rat C6 gliomas constitutively expressing the HSVtk gene post treatment with ganciclovir (GCV, 15 mg/kg i.p., twice-daily). Significant regression (p < 0.1) of tumour volume was observed 10 days after beginning GCV administration. However, no changes in tumour pH or energy metabolites from pre-treatment values were observed. High-resolution 31P spectra of tumour extracts revealed a statistically significant reduction in the phosphocholine to phosphoethanolamine ratio six days post-GCV administration. These results indicate that the HSVtk/GCV-induced killing of tumours is not associated with corresponding changes in 31P MRS-observable energy metabolites and pH. The observed reduction in the PE/PC ratio may provide a non-invasive in vivo indicator of therapeutic efficacy.
    背景与目标: :磷MRS被评估为对单纯疱疹病毒胸苷激酶自杀基因治疗范例的肿瘤治疗反应的监测器。从更昔洛韦治疗后组成性表达HSVtk基因的皮下大鼠C6神经胶质瘤获得体内31P光谱(GCV,15 mg / kg i.p.,每天两次)。开始GCV给药10天后,观察到肿瘤体积显着消退(p <0.1)。但是,未观察到肿瘤pH值或能量代谢物相对于治疗前值的变化。肿瘤提取物的高分辨率31P光谱显示,GCV给药后六天,磷酸胆碱与磷酸乙醇胺的比率在统计学上显着降低。这些结果表明,HSVtk / GCV诱导的肿瘤杀伤与31P MRS可观察到的能量代谢产物和pH值的相应变化无关。所观察到的PE / PC比的降低可以提供治疗功效的非侵入性体内指标。
  • 【膜联蛋白V磁激活细胞分选分离后的精子回收率评估。】 复制标题 收藏 收藏
    DOI:10.1016/s1472-6483(10)61437-x 复制DOI
    作者列表:Said TM,Agarwal A,Grunewald S,Rasch M,Glander HJ,Paasch U
    BACKGROUND & AIMS: :Magnetic-activated cell sorting (MACS) using paramagnetic annexin V-conjugated microbeads eliminates spermatozoa with externalized phosphatidylserine, which is considered one of the features of apoptosis. The objective of this study was to evaluate sperm recovery following the use of MACS as a sperm preparation technique. Mature spermatozoa were separated and divided into two fractions: the first was prepared by density gradient centrifugation (DGC) and MACS, while the second was prepared by DGC only. Following MACS, the percentage of cells collected in the annexin-negative fraction was significantly higher than the annexin-positive fraction and the sperm recovery rate was 73.8 +/- 12.1%. In conclusion, the integration of MACS with DGC can be considered as an effective sperm preparation technique that does not lead to significant cell loss. Separating a distinctive population of non-apoptotic spermatozoa with intact membranes may optimize the outcome of assisted reproduction.
    背景与目标: :使用顺磁性膜联蛋白V偶联的微珠进行磁激活细胞分选(MACS),消除了带有外部磷脂酰丝氨酸的精子,这被认为是细胞凋亡的特征之一。这项研究的目的是评估使用MACS作为精子制备技术后的精子回收率。将成熟的精子分离并分为两部分:第一部分通过密度梯度离心(DGC)和MACS制备,而第二部分仅通过DGC制备。进行MACS后,在膜联蛋白阴性组分中收集的细胞百分比显着高于膜联蛋白阳性组分,精子回收率为73.8 / 12.1%。总之,MACS与DGC的整合可以被认为是一种有效的精子制备技术,不会导致明显的细胞损失。用完整的膜分离非凋亡性精子的独特群体可以优化辅助生殖的结果。
  • 【验证了绿色荧光蛋白标记的创伤弧菌菌株,用于评估生牡蛎的捕捞后策略。】 复制标题 收藏 收藏
    DOI:10.1128/AEM.01091-06 复制DOI
    作者列表:Drake SL,Elhanafi D,Bang W,Drake MA,Green DP,Jaykus LA
    BACKGROUND & AIMS: :In this paper we describe a biological indicator which can be used to study the behavior of Vibrio vulnificus, an important molluscan shellfish-associated human pathogen. A V. vulnificus ATCC 27562 derivative that expresses green fluorescent protein (GFP) and kanamycin resistance was constructed using conjugation. Strain validation was performed by comparing the GFP-expressing strain (Vv-GFP) and the wild-type strain (Vv-WT) with respect to growth characteristics, heat tolerance (45 degrees C), freeze-thaw tolerance (-20(o) and -80 degrees C), acid tolerance (pH 5.0, 4.0, and 3.5), cold storage tolerance (5 degrees C), cold adaptation (15 degrees C), and response to starvation. Levels of recovery were evaluated using nonselective medium (tryptic soy agar containing 2% NaCl) with and without sodium pyruvate. The indicator strain was subsequently used to evaluate the survival of V. vulnificus in oysters exposed to organic acids (citric and acetic acids) and various cooling regimens. In most cases, Vv-GFP was comparable to Vv-WT with respect to growth and survival upon exposure to various biological stressors; when differences between the GFP-expressing and parent strains occurred, they usually disappeared when sodium pyruvate was added to media. When V. vulnificus was inoculated into shellstock oysters, the counts dropped 2 log(10) after 11 to 12 days of refrigerated storage, regardless of the way in which the oysters were initially cooled. Steeper population declines after 12 days of refrigerated storage were observed for both iced and refrigerated products than for slowly cooled product and product held under conservative harvest conditions. By the end of the refrigeration storage study (22 days), the counts of Vv-GFP in iced and refrigerated oysters had reached the limit of detection (10(2) CFU/oyster), but slowly cooled oysters and oysters stored under conservative harvest conditions still contained approximately 10(3) and >10(4) CFU V. vulnificus/oyster by day 22, respectively. The Vv-GFP levels in the oyster meat remained stable for up to 24 h when the meat was exposed to acidic conditions at various pH values. Ease of detection and comparability to the wild-type parent make Vv-GFP a good candidate for use in studying the behavior of V. vulnificus upon exposure to sublethal stressors that might be encountered during postharvest handling of molluscan shellfish.
    背景与目标: :在本文中,我们描述了一种生物指示剂,可用于研究创伤弧菌(一种与软体动物贝类有关的重要人类病原体)的行为。使用缀合构建表达绿色荧光蛋白(GFP)和卡那霉素抗性的V. vulnificus ATCC 27562衍生物。通过比较表达GFP的菌株(Vv-GFP)和野生型菌株(Vv-WT)的生长特性,耐热性(45°C),冻融耐受性(-20(o )和-80摄氏度),耐酸性(pH 5.0、4.0和3.5),冷藏(5摄氏度),冷适应(15摄氏度)和对饥饿的反应。使用有和没有丙酮酸钠的非选择性培养基(胰蛋白酶大豆琼脂含2%NaCl)评估回收水平。该指示菌株随后用于评估暴露于有机酸(柠檬酸和乙酸)和各种冷却方案的牡蛎中创伤弧菌的存活。在大多数情况下,就暴露于各种生物胁迫下的生长和存活而言,Vv-GFP可与Vv-WT媲美。当表达GFP的菌株和亲本菌株之间出现差异时,通常在向培养基中添加丙酮酸钠后它们消失。当将V. vulnificus接种到带壳牡蛎中时,无论最初冷却牡蛎的方式如何,在冷藏11至12天后,其计数都下降了2 log(10)。与冷藏产品和在保守收获条件下保存的产品相比,冷藏和冷藏产品在冷藏存储12天后的直立种群减少。到冷藏存储研究结束时(22天),冰牡蛎和冷藏牡蛎中的Vv-GFP数量已达到检测极限(10(2)CFU /牡蛎),但缓慢冷却的牡蛎和保守收获的牡蛎到第22天时,条件仍分别包含大约10(3)和> 10(4)CFU创伤弧菌/牡蛎。当将牡蛎肉暴露于各种pH值的酸性条件下时,牡蛎肉中的Vv-GFP水平保持稳定长达24小时。 Vv-GFP易于检测且与野生型亲本具有可比性,因此非常适合用于研究在捕食软体动物贝类后可能会遇到的亚致死应激源下的V. vulnificus行为。
  • 【对老年复发或难治性非霍奇金淋巴瘤患者长期口服口服小剂量依托泊苷的评估。】 复制标题 收藏 收藏
    DOI:10.1097/00000421-199706000-00022 复制DOI
    作者列表:Niitsu N,Umeda M
    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: 依托泊苷产生对拓扑异构酶II的可逆抑制,导致DNA裂解,因此具有抗肿瘤作用。该机制表明持续的治疗时间越长,抗肿瘤作用越大。在本研究中,对29岁年龄≥65岁的非霍奇金淋巴瘤(NHL)患者进行了长期低剂量口服依托泊苷的治疗,并对其不良反应进行了研究,这些患者对于标准化疗均无效或难治。这些患者尽可能长时间接受依托泊苷50 mg / d的剂量。继续治疗直至白细胞计数降低至<或= 2,000 / microL或血小板计数降低至<或= 5 x 10(4)/ microL。根据世界卫生组织(WHO)的治疗效果标准,这29例患者中有6例(20.7%)完全缓解,13例(44.8%)部分缓解,缓解率为65.5%。 ≥3级的不良反应包括24例白血球减少症(82.8%)和7例贫血(24.1%)。由于白细胞减少症(粒细胞计数<或= 1,000 / microL),八名患者与依托泊苷合用了粒细胞集落刺激因子(G-CSF)。鉴于出色的主观耐受性,严重不良反应的发生率低以及良好的活动性,长时间连续给予单剂口服依托泊苷对老年NHL患者是一种有用的治疗方法。

  • 【立体定向脑活检的冰冻切片评估:188例立体定向靶位的诊断率。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Brainard JA,Prayson RA,Barnett GH
    BACKGROUND & AIMS: OBJECTIVE:Use of the image-guided stereotactic brain biopsy has facilitated the diagnosis of previously inaccessible lesions with both safety and reliability. However, few studies have assessed the diagnostic yield of frozen section evaluation of the initial stereotactic target (FS-0). We describe our experience with 188 stereotactic brain biopsies in order to evaluate the diagnostic yield of FS-0.

    DESIGN:Retrospective study of 188 stereotactic brain biopsies from 185 patients.

    SETTING:Tertiary referral center with a high volume of neurosurgical cases including image-guided stereotactic brain biopsies.

    PATIENTS:One hundred eighty-five patients who underwent imaged-guided stereotactic brain biopsy over a 58-month period.

    RESULTS:The patients studied included 107 males and 78 females (mean age 48 years). Eleven (6%) biopsies were nondiagnostic. Diagnoses from FS-0 included a neoplastic condition in 96 (73%) of 131 cases and a nonneoplastic condition in 23 (50%) of 46 cases. In 119 (67%) of 177 cases, a diagnosis was reached at FS-0. A correct diagnosis was made on subsequent frozen section in 28 (16%) of cases, including 21 (16%) of 131 neoplasms and 7 (15%) of nonneoplastic conditions. In 15 (54%) of 28 cases, the correct diagnosis was made on the second frozen section; in 25 (89%) of 28, the correct diagnosis was made by the fourth frozen section. In 14 (11%) of 131 neoplastic cases, a sampling error relative to the lesion resulted in an inaccurate diagnosis at FS-0. A significant error in diagnosis occurred in three cases (1.7%).

    CONCLUSIONS:We conclude that (1) because 58 (33%) of 177 diagnosed cases in our series would have been potentially misdiagnosed if only one biopsy had been taken at the stereotactic target, frozen section evaluation or cytologic examination of material at the time of surgery should be performed routinely to ensure that adequate tissue has been obtained for purposes of diagnosis; (2) taking up to four biopsies increases the diagnostic yield (from 67% to 89% in this series); and (3) neoplastic lesions are more likely to be definitively diagnosed at FS-0 than non-neoplastic lesions.

    背景与目标: 目标:使用图像引导的立体定向脑活检技术,既安全又可靠,有助于诊断先前难以接近的病变。但是,很少有研究评估初始立体定位目标(FS-0)的冷冻切片评估的诊断率。为了描述FS-0的诊断结果,我们描述了188例立体定向脑活检的经验。

    DESIGN :对185例患者的188例立体定向脑活检进行了回顾性研究。
    设置:拥有大量神经外科病例的三级转诊中心,包括图像引导的立体定向脑活检。

    患者:一百八十五

    结果:接受影像引导的立体定向脑活检的患者。研究的患者包括107例男性和78例女性(平均年龄48岁)。 11例(6%)活检未确诊。 FS-0的诊断包括131例中的96例(73%)为肿瘤性疾病和46例中23例(50%)为非肿瘤性疾病。在177例病例中,有119例(67%)达到了FS-0的诊断。在随后的冰冻切片中,有28例(16%)做出了正确的诊断,包括131例肿瘤中的21例(16%)和7例(15%)的非肿瘤性疾病。在28例病例中,有15例(54%)对第二个冷冻切片做出了正确的诊断。 28例中有25例(89%)通过第四次冰冻切片做出了正确的诊断。在131例肿瘤病例中,有14例(11%)相对于病变的采样错误导致FS-0诊断不准确。结论3例诊断错误(1.7%)。

    结论:我们得出结论:(1)因为本系列177例诊断病例中有58例(33%)如果仅在立体定向目标上进行了一次活检,可能会被误诊,在手术时应常规进行冰冻切片评估或材料的细胞学检查,以确保获得足够的组织用于诊断; (2)最多进行四次活检可以提高诊断率(在本系列中从67%增至89%); (3)FS-0比非肿瘤性病变更有可能明确诊断出肿瘤性病变。

  • 【瑞典国家早产儿视网膜病变登记册(SWEDROP)和瑞典的筛查评估。】 复制标题 收藏 收藏
    DOI:10.1001/archophthalmol.2012.2357 复制DOI
    作者列表:Holmström GE,Hellström A,Jakobsson PG,Lundgren P,Tornqvist K,Wallin A
    BACKGROUND & AIMS: OBJECTIVES:To evaluate screening for retinopathy of prematurity (ROP) in Sweden and to investigate possible modifications of the present screening guidelines. METHODS:Infants in Sweden with a gestational age (GA) of 31 weeks + 6 days or less are screened for ROP. Data from the Swedish national register for ROP (SWEDROP) during 2008 and 2009 were extracted and compared with a national perinatal quality register. RESULTS:In SWEDROP, there were 1791 infants born before a GA of 32 weeks from January 1, 2008, through December 31, 2009. Another 70 infants were registered in the perinatal quality register but not in SWEDROP (dropout rate, 3.8% [70 of 1861 infants]). Seven infants died before termination of screening. In the final study cohort (1784 infants), 15.6% had mild ROP and 8.5% had severe ROP. Treatment was performed in 4.4% of the infants, none of whom had a GA at birth of more than 28 weeks. Nine infants with a GA of more than 28 weeks at birth developed stage 3 ROP, which regressed spontaneously. The total number of examinations was 9286 (964 in infants with a GA of 31 weeks), and the mean (range) number of examinations of each infant was 5.2 (1-30). CONCLUSIONS:The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more "mature" infants.
    背景与目标: 目的:评估瑞典早产儿视网膜病变(ROP)的筛查,并调查对本筛查指南的可能修改。
    方法:对瑞典的胎龄(GA)为31周6天或更短的婴儿进行ROP筛查。提取了瑞典国家ROP注册机构(SWEDROP)在2008年至2009年期间的数据,并将其与国家围产期质量注册机构进行了比较。
    结果:在SWEDROP中,从2008年1月1日到2009年12月31日,在32周的GA之前出生的婴儿为1791名。另外70名婴儿在围产期质量注册中进行了注册,但未在SWEDROP中进行注册(辍学率为3.8%[70的1861名婴儿])。在终止筛查之前,有7名婴儿死亡。在最后的研究队列中(1784名婴儿),轻度ROP为15.6%,重度ROP为8.5%。在4.4%的婴儿中进行了治疗,这些婴儿出生时都没有GA超过28周。 9例出生时GA超过28周的婴儿发生了3期ROP,并自发性退步。总检查次数为9286次(GA为31周的婴儿为964次),每名婴儿的平均检查(范围)为5.2次(1-30次)。
    结论:SWEDROP是ROP的质量注册机构,其全国覆盖率(即参与率)为96%。 2008年至2009年的数据表明,瑞典的筛查上限似乎有可能降低1周,仅包括GA≥30周6天或更短的婴儿。但是,这种改变应与对新生儿科医生的强烈建议相结合,以推荐重病和更“成熟”的婴儿。
  • 【某些derivatives衍生物作为新的抗癌和抗癌剂的合成和生物学评价。】 复制标题 收藏 收藏
    DOI:10.1016/j.ejmech.2012.10.011 复制DOI
    作者列表:Altıntop MD,Özdemir A,Turan-Zitouni G,Ilgın S,Atlı Ö,İşcan G,Kaplancıklı ZA
    BACKGROUND & AIMS: :New hydrazone derivatives were synthesized via the nucleophilic addition-elimination reaction of 2-[(1-methyl-1H-tetrazol-5-yl)thio)]acetohydrazide with aromatic aldehydes/ketones. The compounds were tested in vitro against various Candida species and compared with ketoconazole. Genotoxicity of the most effective anticandidal compounds was evaluated by umuC and Ames assays. All compounds were also investigated for their cytotoxic effects on NIH3T3 and A549 cell lines. Compound 8 was the most effective antifungal derivative against C. albicans (ATCC-90028) with a MIC value of 0.05 mg/mL. Compound 5 can be identified as the most promising anticancer agent against A549 cancer cell lines due to its inhibitory effect on A549 cell lines and low toxicity to NIH3T3 cells.
    背景与目标: :通过2-[((1-甲基-1H-四唑-5-基)硫基)]乙酰肼与芳香族醛/酮的亲核加成消除反应合成了新的衍生物。该化合物在体外针对各种念珠菌进行了测试,并与酮康唑进行了比较。通过umuC和Ames分析评估了最有效的抗候选化合物的基因毒性。还研究了所有化合物对NIH3T3和A549细胞系的细胞毒性作用。化合物8是针对白色念珠菌的最有效的抗真菌衍生物(ATCC-90028),MIC值为0.05 mg / mL。化合物5由于其对A549细胞系的抑制作用和对NIH3T3细胞的低毒性而可以被确定为最有前途的针对A549癌细胞系的抗癌剂。
  • 【根据不同年龄组对嘴唇的首选位置进行评估。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijom.2012.10.005 复制DOI
    作者列表:Park NS,Park JH,Bayome M,Mo SS,Kim Y,Kook YA
    BACKGROUND & AIMS: :The purpose of this study was to compare preferred facial profiles rated by different age groups. An average profile of each gender was constructed from subjects with normal occlusions. Each average profile was located in the centre, and then the lips were protruded or retruded in six 1mm increments in each direction. 70 lay people were divided into 3 groups: young adult (20-39 years); middle-aged (40-54 years); and senior (55-70 years). They were asked to rank their 3 most preferred profiles for each gender. The distribution of the most pleasing profile was compared according to age groups by the Kruskal-Wallis test and according to the rater's gender by the Mann-Whitney U-test. There was a significant difference between the three age groups regarding the preferred male and female profiles (P<0.001). Both the middle-aged and the senior groups tended to select a slightly more retruded lip/flat profile than the young adult group. There was no gender dimorphism in the selection of the preferred profile. The young adult group preferred the straight profile while the middle-aged and senior groups favoured the slightly retruded profile. This may provide useful information for treatment planning in orthodontics and orthognathic surgery.
    背景与目标: :这项研究的目的是比较不同年龄组的首选面部轮廓。从具有正常咬合的受试者中构造出每种性别的平均轮廓。每个平均轮廓位于中心,然后沿每个方向以6个1mm的增量突出或突出嘴唇。 70个外行人分为3组:年轻的成年人(20-39岁);年轻的成年人(20-39岁)。中年(40-54岁);和高级(55-70岁)。他们被要求对每种性别的3个最喜欢的个人资料进行排名。 Kruskal-Wallis检验根据年龄组比较了最令人愉快的分布,Mann-Whitney U检验根据评分者的性别进行了比较。三个年龄组之间在偏好的男性和女性形象方面存在显着差异(P <0.001)。中青年组和老年人组都倾向于选择比年轻人组略微突出的嘴唇/扁平轮廓。在选择偏好的个人资料时没有性别二态性。年轻的成年人群喜欢笔直的轮廓,而中年人和老年人群则偏爱略微突出的轮廓。这可能为正畸和正颌外科手术治疗计划提供有用的信息。
  • 【饮食中锌的摄入量和肾结石的形成:NHANES III的评估。】 复制标题 收藏 收藏
    DOI:10.1159/000345550 复制DOI
    作者列表:Tang J,McFann K,Chonchol M
    BACKGROUND & AIMS: AIMS:We aimed to determine whether there is an association between dietary zinc intake (DZI) and prevalent kidney stone disease defined as self-report of any previous episode of kidney stone. METHODS:We examined The Third National Health and Nutrition Examination Survey (NHANES III), a large US population-based cross-sectional study, and used logistic regression analyses to determine the independent association between DZI and prevalent kidney stone disease. RESULTS:A total of 15,444 men and women over 18 years of age were eligible for analysis. Among them, 710 participants reported a history of kidney stones. Stone formers tended to have higher DZI than non-stone formers among NHANES III participants, though this difference did not reach statistical significance (p = 0.1). Multivariate adjusted logistic regression analysis revealed that higher DZI (log transformed) was associated with a significantly increased risk of kidney stone disease (odds ratio, OR = 1.41, 95% confidence interval, CI: 1.10-1.81, p = 0.01). After categorizing zinc intake into three groups, those with highest DZI (>15 mg/day) were also associated with a significantly increased risk of kidney stone disease, compared to those with lower DZI (<7 mg/day; OR = 1.70, 95% CI: 1.13-2.57, p = 0.01). CONCLUSIONS:Our study suggests that higher DZI is associated with increased risk of kidney stone disease. Future prospective studies are needed to clarify the causal relationship between zinc intake and kidney stone formation.
    背景与目标: 目的:我们旨在确定饮食锌摄入量(DZI)与普遍存在的肾结石疾病之间是否存在关联,该疾病定义为先前发生的任何肾结石自我报告。
    方法:我们审查了第三次全国健康和营养检查调查(NHANES III),这是一项基于美国人群的大型横断面研究,并使用Logistic回归分析确定DZI与普遍的肾结石病之间的独立关联。
    结果:共有15444名18岁以上的男性和女性符合分析条件。其中,有710名参与者报告了肾结石病史。在NHANES III参与者中,结石形成者的DZI倾向于比非结石形成者高,尽管这种差异没有统计学意义(p = 0.1)。多元校正的logistic回归分析显示,较高的DZI(经对数转换)与肾结石疾病的风险显着增加相关(优势比,OR = 1.41,95%置信区间,CI:1.10-1.81,p = 0.01)。将锌的摄入量分为三组后,与DZI较低(<7 mg /天;或= 1.70,95)相比,DZI最高(> 15毫克/天)的人与肾结石疾病的风险也显着增加。 %CI:1.13-2.57,p = 0.01)。
    结论:我们的研究表明,较高的DZI与肾结石疾病的风险增加有关。需要进一步的前瞻性研究来阐明锌摄入量与肾结石形成之间的因果关系。
  • 【在北京评估了两种用于检测2009年H1N1大流行病毒的商业实时PCR试剂盒。】 复制标题 收藏 收藏
    DOI:10.1016/j.jviromet.2012.11.042 复制DOI
    作者列表:Lu G,Yan H,Yang Y,Cui S,Lü Y,Zhang X,Zhang D,Yang P,Huang F,Wang J,Wang Q
    BACKGROUND & AIMS: :Active surveillance and diagnosis of the influenza pandemic (H1N1) 2009 (pH1N1) have played a critical role in the effective control and prevention of the pandemic in China. Although several commercially available real-time PCR kits for pH1N1 virus have been used in diagnostic laboratories in Beijing, little has been known about the performance of these kits for detecting pH1N1 virus. In this study, the performance of two commercial real-time PCR kits in Beijing was evaluated. Analysis of clinical samples showed that the positive detection rate for the AgPath-ID™ kit (38.2%) was significantly higher than that for the Da An H1N1 kit (30.0%) (McNemar's chi-square test, P=0.000). The limit of detection (LOD) of the AgPath-ID™ kit was 10(2), 10(2), and 10(3) copies/reaction for the Influenza A (set 1), H1N1 Influenza A (set 2) and H1N1 Influenza A Sub H1 (set 3) genes, respectively, whereas the LOD of the Da An kit was 10(3) copies/reaction for both H1 and N1 genes. Although the AgPath-ID™ kit exhibited a significantly higher detection rate for pH1N1 than the Da An kit, cross-reactivity to A/PR8/34 was found for the AgPath-ID™ kit for H1N1 Influenza A (set 2).
    背景与目标: :积极监测和诊断2009年H1N1流感大流行(pH1N1)在有效控制和预防中国大流行中发挥了关键作用。尽管北京的诊断实验室已经使用了几种针对pH1N1病毒的实时PCR试剂盒,但对于这些试剂盒检测pH1N1病毒的性能知之甚少。在这项研究中,评估了北京两种商业实时PCR试剂盒的性能。临床样品分析表明,AgPath-ID™试剂盒的阳性检出率(38.2%)大大高于大安H1N1试剂盒的检出率(30.0%)(McNemar卡方检验,P = 0.000)。对于甲型流感(第1组),甲型H1N1流感(第2组)和甲型流感(组1),AgPath-ID™试剂盒的检测限(LOD)为10(2),10(2)和10(3)拷贝/反应。 H1N1甲型流感亚H1(第3组)基因,而大安试剂盒的LOD对H1和N1基因均为10(3)拷贝/反应。尽管AgPath-ID™试剂盒对pH1N1的检测率比Da An试剂盒高得多,但发现针对H1N1甲型流感的AgPath-ID™试剂盒(组2)与A / PR8 / 34有交叉反应。
  • 【评估荷兰亨廷顿氏病的排除性产前和排除性植入前遗传学诊断。】 复制标题 收藏 收藏
    DOI:10.1111/cge.12058 复制DOI
    作者列表:van Rij MC,de Die-Smulders CE,Bijlsma EK,de Wert GM,Geraedts JP,Roos RA,Tibben A
    BACKGROUND & AIMS: :Individuals at 50% risk of Huntington's disease (HD) who prefer not to know their carrier status, might opt for exclusion prenatal diagnosis (ePND) or exclusion preimplantation genetic diagnosis (ePGD). This study aims to provide a better understanding of couples' motives for choosing ePND or ePND, and surveys couples' experiences in order to make recommendations for the improvement of counselling for exclusion testing. This qualitative retrospective interview study focussed on couples who underwent ePND or ePGD for HD in the period 1996-2010. Seventeen couples were included of which 13 had experienced ePND and 6 ePGD. Mean time-interval since exclusion-testing was 3.9 years. Couples' moral reservations regarding termination of pregnancy (TOP) or discarding healthy embryos were counterbalanced by the wish to protect their future child against HD. Seven couples had terminated a total of 11 pregnancies with a 50% HD risk, none showed regret. ePGD was used by couples who wanted to avoid (another) TOP. ePND and ePGD are acceptable reproductive options for a specific group of counsellees. To guarantee sound standards of care, it is imperative that candidate couples be given in-depth non-directive counselling about all possible scenarios, and adequate professional and psychological support prior to, during and after ePND/ePGD.
    背景与目标: :那些不知道自己的携带者状况,患亨廷顿氏病(HD)风险为50%的个体,可能会选择排除产前诊断(ePND)或排除植入前遗传学诊断(ePGD)。这项研究旨在更好地了解夫妻选择ePND或ePND的动机,并调查夫妻的经历,以便为改善排除测试的咨询意见提供建议。这项定性的回顾性访谈研究的重点是在1996-2010年期间接受HD的ePND或ePGD的夫妇。其中包括17对夫妇,其中13对有ePND经历和6对ePGD。自排除测试以来的平均时间间隔为3.9年。保护夫妻免于高清的愿望抵消了夫妻在终止妊娠(TOP)或丢弃健康胚胎方面的道德保留。 7对夫妇共终止了11例妊娠,HD风险为50%,没有人表示遗憾。希望避免使用(另一种)TOP的夫妇使用了ePGD。 ePND和ePGD是特定人群的可接受的生殖选择。为了保证合理的护理标准,在ePND / ePGD之前,之中和之后,必须为候选夫妇提供有关所有可能情况的深入非指导性咨询,并提供适当的专业和心理支持。

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