BACKGROUND & AIMS: OBJECTIVE:This study was directed at identifying clinical features of chronic rhinosinusitis with asthma, and examining the differences of the postoperative outcomes in asthmatics and nonasthmatics. STUDY DESIGN AND SETTING:Twenty-one asthmatic and 77 nonasthmatic patients who underwent functional endoscopic sinus surgery (FESS) were entered into the study. The following six parameters were determined in asthmatic and nonasthmatic groups; the presence of allergy, previous sinus surgery, severity of preoperative rhinosinusitis symptoms, improvements in postoperative rhinosinusitis symptoms, preoperative disease extent, and postoperative endoscopic outcomes. RESULTS:Symptom scores improved significantly in both asthmatics and nonasthmatics postoperatively, and asthmatics exhibited significantly worse postoperative endoscopic outcomes compared with nonasthmatics. No difference was found in other parameters between two groups. Multivariate analysis revealed asthma continues to be an independent predictor of success. CONCLUSIONS:The present study found that chronic rhinosinusitis in asthmatics showed worse postoperative outcomes than in nonasthmatics, and every attempt should be made for the improvement of surgical results in these patients.

背景与目标： 目的：本研究旨在确定慢性鼻鼻窦炎合并哮喘的临床特征，并探讨哮喘患者和非哮喘患者的术后结局差异。
研究设计和设置：接受功能性内镜鼻窦手术（FESS）的21例哮喘患者和77例非哮喘患者进入研究。在哮喘和非哮喘组中确定了以下六个参数；过敏的存在，先前的鼻窦手术，术前鼻-鼻窦炎症状的严重程度，术后鼻-鼻窦炎症状的改善，术前疾病的程度以及术后内窥镜检查的结果。
结果：哮喘患者和非哮喘患者的症状评分均明显改善，与非哮喘患者相比，哮喘患者的术后内窥镜检查结果明显较差。两组之间其他参数无差异。多变量分析显示哮喘仍然是成功的独立预测因素。
结论：本研究发现哮喘患者的慢性鼻-鼻窦炎的术后预后较非哮喘患者差，因此应尽一切努力改善这些患者的手术效果。

BACKGROUND & AIMS: :This minireview considers the possibility that there is a correlation between the slow rate of morphological change and speciation events that has been occurred within the lungfish lineage since the Permian period, and the apparent slow rate of divergence in the amino acid sequences of lungfish opioid precursor sequences. The status of lungfish as "living fossils" is considered.

背景与目标： ：本篇小型综述认为，二叠纪以来在肺鱼谱系内发生的形态变化和物种形成的缓慢速率与形态上的缓慢变化与肺鱼阿片样物质前体的氨基酸序列的明显缓慢速率之间存在相关性的可能性序列。考虑到肺鱼作为“活化石”的地位。

BACKGROUND & AIMS: :The effects of colorectal distension (CRD) were examined on neurons located in and around the nucleus submedius (Sm) in the medial thalamus of urethane-anesthetized rats. A total of 66 units (49 in the Sm and 17 in immediately surrounding regions) responding to cutaneous pinch were tested to examine their responsiveness to the CRD. All the neurons that responded to cutaneous stimulation were nociceptive specific (NS) neurons. Based on their responses to the CRD the Sm neurons were classified into three types as follows: 23 (47%) of 49 neurons in the Sm and three (18%) of 17 neurons near the Sm had tonic excitatory responses with long-lasting after-discharges (type I); nine (18%) Sm neurons and four (24%) peri-Sm neurons were tonically excited but had no after-discharge (type II); and seven (14%) Sm neurons were inhibited (type III). Ten (20%) Sm neurons and 10 (59%) peri-Sm neurons did not respond to CRD. All the excitatory and inhibitory responses to CRD increased with increasing CRD pressure. Simultaneous application of CRD and cutaneous pinch did not produce a reduced response (nocigenic inhibition). These results demonstrate that most of the Sm neurons receive convergent viscerosomatic inputs from the colon and/or rectum and from the skin, suggesting that the Sm may participate in visceral nociception.

背景与目标： ：检查了结直肠扩张（CRD）对氨基甲酸乙酯麻醉的大鼠内侧丘脑中下核（Sm）内和周围神经元的影响。总共测试了66个单位（Sm中为49个单位，周围区域为17个单位）对皮肤捏合的反应，以检查其对CRD的反应性。对皮肤刺激有反应的所有神经元均为伤害性特异性（NS）神经元。根据它们对CRD的反应，Sm神经元可分为以下三种类型：Sm中49个神经元中的23个（47％）和Sm附近17个神经元中的3个（18％）具有强直性兴奋性兴奋反应。 -放电（I型）； 9个（18％）Sm神经元和4个（24％）周围Sm神经元被强音刺激，但没有后放电（II型）；七个（14％）Sm神经元被抑制（III型）。十个（20％）Sm神经元和十个（59％）周围Sm神经元对CRD无反应。 CRD的所有兴奋性和抑制性反应都随着CRD压力的增加而增加。 CRD和皮肤捏合的同时应用不会产生降低的反应（致癌性抑制）。这些结果表明，大多数Sm神经元从结肠和/或直肠以及皮肤接收收敛的内脏体输入，表明Sm可能参与内脏伤害感受。

BACKGROUND & AIMS: :In this study, the contribution of the CD5+ B cell to the preferential expression of VH 7183 and Q52 observed early in development was determined. CD5+ and CD5- B cells from BALB/c mice were isolated by fluorescence-activated cell sorter and the expression of particular VH gene families was determined directly by in situ hybridization. The results indicate that CD5+ B cells obtained from both adult and neonatal animals express Q52 at increased levels compared with CD5- B cells. Preferential expression of VH 7183 was observed only in the neonatal CD5- B cell subset. Thus, the increased expression of VH 7183 early in development is caused by the CD5- subset whereas increased Q52 expression is caused by the CD5+ subset. These results indicate that the fetal/neonatal conventional B cell is distinct from conventional adult B cells in terms of Ig gene repertoire expression.

背景与目标： ：在这项研究中，确定了CD5 B细胞对发育早期观察到的VH 7183和Q52优先表达的贡献。通过荧光激活细胞分选仪分离来自BALB / c小鼠的CD5和CD5-B细胞，并通过原位杂交直接确定特定VH基因家族的表达。结果表明，与CD5-B细胞相比，从成年和新生动物身上获得的CD5 B细胞表达的Q52含量都增加了。仅在新生儿CD5-B细胞亚群中观察到VH 7183的优先表达。因此，VH 7183在发育早期的表达增加是由CD5-亚群引起的，而Q52表达的增加是由CD5亚群引起的。这些结果表明，就Ig基因全集表达而言，胎儿/新生儿常规B细胞与常规成人B细胞是不同的。

BACKGROUND & AIMS: Although nutrition is an important part of medical care, nutrition education is not provided in most training programs for physicians in the United States, resulting in limited nutrition knowledge among physicians and limited nutritional care of patients. A nutrition education program was provided by a physician nutrition specialist in a family practice residency program. For 6 mo, the nutrition specialist provided the family physicians with recommendations for nutritional care for their patients. The effects of the education program on residents' and faculty physicians' nutrition knowledge and nutritional patient care, patients' perceptions of the importance of nutrition, and physicians' dietary patterns were determined by pre- and post-intervention nutrition exams for physicians and patients, patient questionnaires about attitudes toward nutrition, chart reviews, and physicians' diet records. The nutrition education program resulted in an increase in physicians' nutrition knowledge scores (P < 0.01) and an increase in the frequency with which physicians discussed nutrition and recommended diets for their patients (P < 0.05). This suggests that nutrition education by a physician nutrition specialist within a family practice residency program can be effective in increasing nutritional care provided to patients.

背景与目标： 尽管营养是医疗保健的重要组成部分，但在美国大多数医师的培训计划中并未提供营养教育，这导致医师之间的营养知识有限，患者的营养保健也有限。营养保健教育计划是由医师营养专家在家庭执业驻留计划中提供的。营养专家在6个月内为家庭医生提供了有关为其患者提供营养护理​​的建议。通过干预前和干预后对医师和患者的营养检查来确定教育计划对住院医师和教职医师的营养知识和患者营养的影响，患者对营养重要性的看法以及医师的饮食方式的影响，有关营养态度的患者问卷调查表，图表评论以及医生的饮食记录。营养教育计划导致医师的营养知识得分增加（P <0.01），医师讨论营养和为患者推荐饮食的频率增加（P <0.05）。这表明在家庭执业住院医师计划中，由医生营养专家进行的营养教育可以有效地增加提供给患者的营养保健服务。

BACKGROUND & AIMS: We have isolated and characterized the first Xenopus transmembrane Eph ligand, XLerk (Xenopus Ligand for Eph Receptor Tyrosine Kinases). While this ligand has 72% identity with the closest mammalian family member, Lerk-2, it is the cytoplasmic domain of this molecule that is the most conserved domain with 95% identity. XLerk exists as a maternally expressed mRNA, however, expression of transcripts and protein increase during gastrulation and again in the late swimming tadpole stage. In the adult, XLerk is expressed at low levels in most adult tissues with increased levels observed in the kidney, oocytes, ovary and testis. While low levels of XLerk expression are observed in the adult brain, in situ hybridization analysis demonstrates prominent expression in the developing olfactory system, retina, hindbrain, cranial ganglia, and somites. Furthermore, we have shown that XLerk transcripts are significantly elevated during mesoderm induction caused by activin and FGF, but not during noggin-induced neuralization. These results suggest a role for XLerk in the developing mesenchymal and nervous tissue.

背景与目标： 我们已经分离并鉴定了第一个非洲爪蟾跨膜Eph配体XLerk（用于Eph受体酪氨酸激酶的非洲爪蟾配体）。尽管该配体与最接近的哺乳动物家族成员Lerk-2具有72％的同一性，但该分子的胞质结构域是具有95％的同一性的最保守的结构域。 XLerk作为母体表达的mRNA存在，但是转录的表达和蛋白质在胃排泄过程中以及游泳increase后期再次增加。在成年人中，XLerk在大多数成年人组织中低水平表达，在肾脏，卵母细胞，卵巢和睾丸中观察到水平升高。尽管在成年大脑中观察到了低水平的XLerk表达，但原位杂交分析显示出在发育中的嗅觉系统，视网膜，后脑，颅神经节和体节中突出表达。此外，我们已经表明，在由激活素和FGF引起的中胚层诱导过程中，XLerk转录物显着升高，但在头蛋白诱导的神经化过程中却没有。这些结果表明XLerk在发育中的间充质和神经组织中的作用。

BACKGROUND & AIMS: :Insulin resistance affecting skeletal muscle metabolism is present in the prehypertensive state. The aim of our study was to test the hypothesis that blood pressure value is related to skeletal muscle composition, measured by (31)P magnetic resonance (MR) spectroscopy, and to insulin sensitivity in the offspring of hypertensive parents (OH) and healthy controls. Study groups consisted of 10 healthy young lean OH with normal glucose tolerance, confirmed with oral glucose tolerance test, and 13 controls matched for age, sex, and body mass index. Insulin action was estimated as glucose disposal (M), glucose metabolic clearance rate (MCR), and insulin sensitivity index (M/I) during a 10-hour hyperinsulinemic euglycemic clamp. The sum of immunoreactive insulin values from the oral glucose tolerance test was calculated. (31)P MR spectroscopy was performed on a whole-body MR scanner (Siemens Vision, Erlangen, Germany) operating at 1.5 T and equipped with actively shielded gradient coils. There were no differences in common metabolic and anthropometric parameters between OH and controls except for the blood pressure, which was in the range of normal to high-normal level in OH. Mean blood pressure was significantly higher in OH (95.73 +/- 4.39 vs 83.76 +/- 3.95 mm Hg; P < .001). Trend toward insulin resistance was registered in OH with significantly lower M/I (0.74 +/- 0.47 vs 1.42 +/- 0.65 mg x kg(-1) x min(-1) x mIU(-1) x L(-1); P < .05). There were no significant differences in total serum magnesium (sMg) levels between OH and controls, although a positive correlation exists between sMg and insulin sensitivity expressed as M (r = 0.63, P < .01), MCR (r = 0.54, P < .01), and M/I (r = 0.51, P < .05). No differences in signal intensities of phosphocreatine (PCr), phosphomonoesters, phosphodiesters, inorganic phosphates (Pi), adenosine triphosphates (Patp and betaATP), and calculated concentrations of intracellular ionized magnesium (Mgi) and H(+) ions between the groups were detected. Systolic blood pressure correlates positively with PCr/Patp (r = 0.43, P < .05), Pi/Patp (r = 0.413, P < .05), and Pi/betaATP (r = 0.48, P < .05). Diastolic blood pressure correlates positively only with the ratio Pi/betaATP (r = 0.42, P < .05). The sum of immunoreactive insulin values correlates with PCr/betaATP (r = 0.53, P < .01) and with Pi/betaATP (r = 0.6, P < .01). In conclusion, increase in blood pressure and insulin resistance were confirmed in offspring of OH. Insulin sensitivity is related to sMg and the elevation of blood pressure is associated with the activation of energy metabolism in skeletal muscle. The relationship between muscle energetic characteristics and markers of insulin resistance suggests that the alteration of energy metabolism may be present in early stages of metabolic syndrome.

背景与目标： ：在高血压前状态下，会影响骨骼肌新陈代谢的胰岛素抵抗。我们研究的目的是检验以下假设：血压值与通过（31）P磁共振（MR）光谱法测量的骨骼肌成分以及高血压父母（OH）和健康对照的后代的胰岛素敏感性有关。研究组包括10名健康正常的年轻瘦肉OH，其葡萄糖耐量正常，经口服葡萄糖耐量试验确认，另有13个对照的年龄，性别和体重指数匹配。在10小时高胰岛素正常血糖钳制期间，胰岛素作用估计为葡萄糖处置（M），葡萄糖代谢清除率（MCR）和胰岛素敏感性指数（M / I）。计算来自口服葡萄糖耐量试验的免疫反应性胰岛素值的总和。 （31）P MR光谱是在全身MR扫描仪（Siemens Vision，Erlangen，德国）上以1.5 T操作并配备有源屏蔽梯度线圈进行的。 OH和对照组之间的共同代谢和人体测量学参数没有差异，除了血压处于OH正常水平到高正常水平的范围之内。 OH的平均血压显着升高（95.73 /-4.39与83.76 /-3.95 mm Hg； P <.001）。在OH中出现胰岛素抵抗的趋势，M / I显着降低（0.74 /-0.47对1.42 /-0.65 mg x kg（-1）x min（-1）x mIU（-1）x L（-1）; P <.05）。尽管sMg与胰岛素敏感性之间呈正相关，以M（r = 0.63，P <.01），MCR（r = 0.54，P < .01）和M / I（r = 0.51，P <.05）。在两组之间没有发现磷酸肌酸（PCr），磷酸单酯，磷酸二酯，无机磷酸盐（Pi），三磷酸腺苷（Patp和betaATP）的信号强度以及计算出的细胞内离子化镁（Mgi）和H（）浓度的差异。收缩压与PCr / Patp（r = 0.43，P <.05），Pi / Patp（r = 0.413，P <.05）和Pi / betaATP（r = 0.48，P <.05）正相关。舒张压仅与Pi / betaATP比率呈正相关（r = 0.42，P <.05）。免疫反应性胰岛素值的总和与PCr / betaATP（r = 0.53，P <.01）和Pi / betaATP（r = 0.6，P <.01）相关。总之，在OH的后代中证实了血压升高和胰岛素抵抗。胰岛素敏感性与sMg有关，血压升高与骨骼肌能量代谢的激活有关。肌肉能量特性与胰岛素抵抗标志物之间的关系表明，能量代谢的改变可能在代谢综合征的早期出现。

BACKGROUND & AIMS: Recent genome searches suggest a putative linkage of many loci to susceptibility to type I diabetes. The chromosome 2q31-35 region is reported to be linked to susceptibility to type I diabetes and is thought to contain several diabetes susceptibility loci. These candidate genes include the HOXD gene cluster, BETA2, CTLA4, CD28, IGFBP2, and IGFBP5. Association studies in populations and families are required to confirm and/or identify the actual susceptibility loci. We hereby report several previously unknown DNA polymorphisms for HOXD8, BETA2, and IGFBP5, which we have used along with previously known polymorphisms of HOXD8 and CTLA4 to test whether these candidate loci are the susceptibility genes on chromosome 2q31-35. Using a case-control design with a subsequent family-association approach to confirm associations, we find no evidence that these candidate genes are associated with susceptibility to type I diabetes.

背景与目标： 最近的基因组搜索表明，许多基因位点与I型糖尿病易感性的推测联系。据报道，染色体2q31-35与I型糖尿病易感性相关，并被认为含有几个糖尿病易感性基因座。这些候选基因包括HOXD基因簇，BETA2，CTLA4，CD28，IGFBP2和IGFBP5。需要在人群和家庭中进行协会研究，以确认和/或识别实际的易感基因座。我们在此报告了HOXD8，BETA2和IGFBP5的几种先前未知的DNA多态性，并将其与HOXD8和CTLA4的先前已知多态性一起用于测试这些候选基因座是否为2q31-35染色体上的易感性基因。使用病例对照设计和随后的家庭关联方法来确认关联，我们没有发现这些候选基因与I型糖尿病易感性相关的证据。

BACKGROUND & AIMS: :Some alleles of the wtf gene family can increase their chances of spreading by using poisons to kill other alleles, and antidotes to save themselves.

背景与目标： ：wtf基因家族的某些等位基因可以通过使用毒药杀死其他等位基因和解毒剂来拯救自己，从而增加传播的机会。

BACKGROUND & AIMS: :In order to investigate the mode of interaction between the N-quarternized cytosine base and the aromatic amino acid, the crystal structure of the 3-methyl-cytidine-5'-monophosphate:tryptamine complex was analyzed by X-ray diffraction. The complex crystals were stabilized by extensive hydrogen bond formations in which eight independent water molecules per complex pair participated. A prominent stacking interaction, characterized by a parallel alignment of both rings with a separation distance of ca. 3.4 A, was observed between the cytosine base and the indole ring. Combining the present results with X-ray crystallographic data on the adenine--and guanine--aromatic amino acid interactions, we summarize the structural characteristics observed in the stacking interaction of the N-quarternized nucleic acid base with the aromatic amino acid and discuss their biological implications, especially in connection with the significance of N-protonation of nucleic acid base for selective recognition by protein.

背景与目标： ：为了研究N-季铵化的胞嘧啶碱基与芳族氨基酸之间的相互作用方式，通过X射线衍射分析了3-甲基胞苷-5'-单磷酸酯：色胺的配合物的晶体结构。复杂的晶体通过广泛的氢键形成而稳定，其中每个复杂对参与八个独立的水分子。突出的堆叠相互作用，其特征在于两个环的平行排列的间隔距离为ca。在胞嘧啶碱基和吲哚环之间观察到3.4A。结合本研究结果与X射线晶体学数据进行的关于腺嘌呤-鸟嘌呤-芳香族氨基酸相互作用的研究，我们总结了在N-季铵化核酸碱基与芳香族氨基酸的堆叠相互作用中观察到的结构特征，并对其进行了讨论生物学意义，特别是与核酸碱基的N质子化对于蛋白质选择性识别的意义有关。

BACKGROUND & AIMS: OBJECTIVE:Provoked deep venous thrombosis (DVT) is precipitated by a specific event. This paper compares the characteristics of provoked DVT in patients with transient risk (TR) factors and patients with continuous risk (CR) factors. METHODS:A retrospective review of records of all consecutive patients diagnosed with DVT between January 2013 and August 2014 was performed. Patients with provoked DVT were included in the TR group if the provoking event resolved in 2 weeks and they did not have ongoing risk of thrombosis. Patients in the CR group had a provoked DVT with ongoing risk of thrombosis due to individual factors deemed to be ongoing risks of thrombosis, such as cancer, hypercoagulable disorder, and prolonged immobilization. Demographics, risk factors, association with pulmonary embolism (PE) and its severity, risk of recurrent venous thromboembolism (VTE), and mortality were compared between the two groups. RESULTS:A total of 838 patients were diagnosed with DVT, and 50.7% (425) were provoked. There were 127 (29.9%) patients with TR and 298 (70.1%) with CR. TR patients were younger (60.4 ± 16.3 vs 65.9 ± 16.0; P = .001). TR was more likely to be provoked by surgery (70.9% vs 55.4%; P = .003), whereas CR was more likely to be provoked by immobilization (21.5% vs 12.6%; P = .032). CR patients were affected by cancer (48.7%) and hypercoagulable disorders (4.4%). TR patients were more likely to have calf DVTs (36.2% vs 26.2%; P = .047). There was a trend toward lower association with PE on presentation in TR (17.3% vs 21.1%; P = .072), but that did not reach statistical significance. However, TR factors were more likely to be associated with low-risk PE compared with CR factors (30.2% vs 54.6%; P = .040). After mean follow-up of 7.2 months, CR had higher risk of recurrent VTE (14.0% vs 6.8%; P = .045) and mortality (23.5% vs 7.1%; P < .0001). CONCLUSIONS:Provoked DVT with CR factors affects older patients and is associated with high recurrence of VTE and mortality compared with provoked DVT with TR factors.

背景与目标： 目的：诱发深静脉血栓形成（DVT）是由特定事件引起的。本文比较了短暂风险（TR）因子和持续风险（CR）因子引起的DVT的特征。
方法：回顾性分析2013年1月至2014年8月间所有诊断为DVT的连续患者的病历。如果挑衅事件在2周内解决并且他们没有持续的血栓形成风险，则将挑衅性DVT的患者纳入TR组。 CR组的患者患有诱发性DVT，具有持续的血栓形成风险，原因是被认为是持续的血栓形成风险的个体因素，例如癌症，高凝性疾病和长时间的固定。比较了两组的人口统计学，危险因素，与肺栓塞（PE）的关联及其严重性，复发性静脉血栓栓塞（VTE）的风险和死亡率。
结果：总共诊断为DVT的838例患者，引起了50.7％（425）的挑衅。有127名（29.9％）的TR患者和298名（70.1％）的CR患者。 TR患者较年轻（60.4±16.3 vs 65.9±16.0; P = .001）。 TR更有可能由手术引起（70.9％vs 55.4％; P = .003），而CR更有可能由固定引起（21.5％vs 12.6％; P = .032）。 CR患者受癌症（48.7％）和高凝性疾病（4.4％）的影响。 TR患者更有可能患有小腿深静脉血栓（36.2％vs 26.2％; P = .047）。在TR中出现与PE的关联性较低的趋势（17.3％对21.1％; P = .072），但这没有统计学意义。然而，与CR因子相比，TR因子更可能与低风险PE相关（30.2％vs 54.6％; P = .040）。平均随访7.2个月后，CR复发VTE（14.0％vs 6.8％; P = .045）和死亡率（23.5％vs 7.1％; P <.0001）的风险更高。
结论：诱发性DVT伴CR因素会影响老年患者，与诱发性DVT伴TR因素相比具有较高的VTE复发率和死亡率。

BACKGROUND & AIMS: BACKGROUND:The prevalence of lithiasis is increasing at all ages. This study aimed to assess the crystallization risk in urine from healthy school children and to determine urinary parameters that are most associated with it. METHODS:Urine samples were obtained from 184 children aged 5-12 years: a spot sample collected in the afternoon, and a 12-h overnight sample. Information was obtained regarding family histories of lithiasis. Urine volume, pH, and biochemical parameters of stone risk were measured. Crystallization risk was defined by the presence of specific urine conditions that had previously been associated with stone formation in vitro. RESULTS:Crystallization risk was observed in 15 % of spot urine samples and 54 % of 12-h samples. Metabolic abnormalities and a low urinary volume were more frequently detected in children with crystallization risk. Calcium excretion and calcium/citrate ratio were higher in children with a family history of lithiasis. CONCLUSIONS:We observed a high prevalence of crystallization risk in urine, especially in children with a family history of the disease. Low urinary volume was the factor most associated with increased risk. Adequate fluid intake at an early age may be a simple and effective measure to reduce the incidence of nephrolithiasis.

背景与目标： 背景：石斑症的患病率在各个年龄段都在增加。这项研究旨在评估健康学童尿液中结晶的风险，并确定与其最相关的尿液参数。
方法：从184名5-12岁的儿童中获取尿液样本：下午收集现场样本，并收集12小时的过夜样本。获得了有关石尿症家族史的信息。测量尿液体积，pH值和结石风险的生化参数。结晶风险是由以前与体外结石形成有关的特定尿液条件定义的。
结果：在15％的现货尿液样本和54％的12小时样本中观察到结晶风险。具有结晶风险的儿童更经常检测到代谢异常和尿量低。有结石病家族史的儿童的钙排泄和钙/柠檬酸比更高。
结论：我们观察到尿液中结晶风险的患病率很高，尤其是在有该病家族史的儿童中。低尿量是与增加风险最相关的因素。早期摄入足够的液体可能是减少肾结石症发生率的一种简单有效的措施。

BACKGROUND & AIMS: OBJECTIVES:Patients with heartburn and normal upper gastrointestinal endoscopy, normal oesophageal acid exposure, no symptom-reflux association and who fail to respond to a proton-pump inhibitor are classified as having functional heartburn (FH). This study aimed (i) to characterize the symptoms and functional abnormalities of patients with FH and (ii) to describe their clinical outcome. MATERIALS AND METHODS:Among all patients referred for 24 h multichannel intraluminal impedance-pH (MII-pH), patients with FH were identified. The clinical characteristics and high-resolution oesophageal pressure topography recordings of FH patients were analyzed at the time of the 24-h MII-pH test. A symptom-related and health-related quality-of-life questionnaire was then sent to FH patients to assess the long-term outcome. RESULTS:Forty patients fulfilled the criteria for FH, representing 8.5% of the referred population. Twenty-two months after initial testing, 66% of patients still suffered from heartburn. The rate of mixed reflux (liquid/gas) was higher in patients with persisting heartburn at the final evaluation (63 vs. 50%, P=0.04). Sixty-six per cent of patients had one or more manometric abnormalities. Acid clearance time in MII-pH was significantly higher in patients with weak peristalsis than patients with normal peristalsis (60 ± 45 vs. 31 ± 19 s, P=0.03). A high rate of mixed reflux and/or a manometric abnormality were associated with a higher risk of persistent heartburn. CONCLUSION:FH is a chronic disorder with persisting symptoms in two-thirds of patients. An increased rate of mixed reflux and/or the presence of manometric abnormalities are associated with a higher risk of persisting symptoms and may help to identify the population with unmet therapeutic needs.

背景与目标： 目的：患有胃灼热和正常上消化道内窥镜检查，正常食道酸暴露，无症状-反流关联且对质子泵抑制剂无反应的患者被归类为功能性胃灼热（FH）。这项研究旨在（i）表征FH患者的症状和功能异常，以及（ii）描述其临床结局。
材料与方法：在所有接受24 h多通道管腔内阻抗pH（MII-pH）治疗的患者中，均鉴定出FH患者。在24小时MII-pH测试时分析了FH患者的临床特征和高分辨率的食管压力地形图记录。然后将症状相关和健康相关的生活质量调查表发送给FH患者，以评估其长期预后。
结果：40例患者符合FH标准，占推荐人群的8.5％。初始测试后的22个月，仍有66％的患者患有胃灼热。在最终评估中，持续性烧心患者的混合反流（液体/气体）比率更高（63％vs. 50％，P = 0.04）。 66％的患者有一个或多个压力异常。蠕动较弱的患者在MII-pH中的酸清除时间明显长于正常蠕动的患者（60±45 vs. 31±19 s，P = 0.03）。混合反流率高和/或测压异常与持续性烧心的风险较高相关。
结论：FH是一种慢性疾病，在三分之二的患者中持续存在症状。混合反流率的增加和/或压力异常的存在与持续存在症状的风险较高有关，可能有助于确定治疗需求未得到满足的人群。

BACKGROUND & AIMS: :A Gram-negative, rod shaped, motile bacterium, was isolated from a marine solar saltern sample collected from Kakinada, India. Strain AK2(T) was determined to be positive for nitrate reduction, catalase, Ala-Phe-Pro-arylamidase, β-galactosidase, β-N-acetylglucosaminidase, β-glucosidase, β-xylosidase, α-glucosidase, α-galactosidase and phosphatase activities, hydrolysis of aesculin, Tween 20/40/60/80 and urea. It was determined to be negative for oxidase, lysine decarboxylase and ornithine decarboxylase activities and could not hydrolyze agar, casein, gelatin and starch. The predominant fatty acids were identified as iso-C(15:0) (28.2 %), anteiso-C(15:0) (23.2 %), iso-C(13:0) (19.9 %) and iso-C(15:0) 3-OH (13.9 %). Strain AK2(T) was found to contain menaquinone with seven isoprene units (MK-7) as the sole respiratory quinone and phosphatidylethanolamine, one unidentified phospholipid and three unidentified lipids as polar lipids. The 16S rRNA gene sequence analysis indicated the strain AK2(T) as a member of the genus Marinilabilia and is closely related to Marinilabilia salmonicolor with pair-wise sequence similarity of 98.2 %. Phylogenetic analysis of 16S rRNA gene revealed that the strain AK2(T) clustered with M. salmonicolor. However, DNA-DNA hybridization with M. salmonicolor JCM 21150(T) showed a relatedness of 48 ± 0.5 % with respect to strain AK2(T). The DNA G+C content of the strain was determined to be 40.2 mol%. Based on the phenotypic characteristics and phylogenetic inference, it is proposed that the strain AK2(T) represents a novel species of the genus Marinilabilia, for which the name Marinilabilia nitratireducens sp. nov. is proposed. The type strain of M. nitratireducens sp. nov. is AK2(T) (= MTCC 11402(T) = JCM 17679(T)).

背景与目标： ：从印度Kakinada收集的海洋太阳能盐分离器样本中分离出革兰氏阴性，棒状，能动细菌。确定菌株AK2（T）对硝酸盐还原，过氧化氢酶，Ala-Phe-前芳酰胺酶，β-半乳糖苷酶，β-N-乙酰氨基葡糖苷酶，β-葡萄糖苷酶，β-木糖苷酶，α-葡萄糖苷酶，α-半乳糖苷酶和磷酸酶活性，七叶皂苷，Tween 20/40/60/80和尿素的水解。它被确定为氧化酶，赖氨酸脱羧酶和鸟氨酸脱羧酶活性阴性，并且不能水解琼脂，酪蛋白，明胶和淀粉。主要脂肪酸被鉴定为iso-C（15：0）（28.2％），anteiso-C（15：0）（23.2％），iso-C（13：0）（19.9％）和iso-C（ 15：0）3-OH（13.9％）。发现菌株AK2（T）含有具有七个异戊二烯单元（MK-7）的甲基萘醌作为唯一的呼吸醌和磷脂酰乙醇胺，一个未确定的磷脂和三个未确定的脂质作为极性脂质。 16S rRNA基因序列分析表明，菌株AK2（T）是马里尼布拉马氏菌属的成员，与马里尼拉鲑鱼色密切相关，成对序列相似性为98.2％。 16S rRNA基因的系统发育分析表明，菌株AK2（T）与沙门氏菌成簇。但是，与鲑鱼支原体JCM 21150（T）的DNA-DNA杂交显示出与菌株AK2（T）的相关性为48±0.5％。测得该菌株的DNA G C含量为40.2mol％。根据表型特征和系统发育推论，建议菌株AK2（T）代表Marinilabilia属的一个新种，其名称为Marinilabilianitroatireducens sp。十一月被提议。硝化分枝杆菌的类型菌株。十一月是AK2（T）（= MTCC 11402（T）= JCM 17679（T））。

BACKGROUND & AIMS: :A specific form of family therapy (family-based treatment) is the leading treatment for adolescents with anorexia nervosa. As this treatment has certain limitations, alternative approaches are needed. "Enhanced" cognitive behaviour therapy (CBT-E) is a potential candidate given its utility as a treatment for adults with eating disorder psychopathology. The aim of the present study was to establish, in a representative cohort of patients with marked anorexia nervosa, the immediate and longer term outcome following CBT-E. Forty-nine adolescent patients were recruited from consecutive referrals to a community-based eating disorder clinic. Each was offered 40 sessions of CBT-E over 40 weeks from a single therapist. Two-thirds completed the full treatment with no additional input. In these patients there was a substantial increase in weight together with a marked decrease in eating disorder psychopathology. Over the 60-week post-treatment follow-up period there was little change despite minimal subsequent treatment. These findings suggest that CBT-E may prove to be a cost-effective alternative to family-based treatment.

背景与目标： ：一种特殊形式的家庭治疗（基于家庭的治疗）是神经性厌食症青少年的主要治疗方法。由于这种治疗有一定的局限性，因此需要其他方法。鉴于“增强型”认知行为疗法（CBT-E）可用于患有饮食失调症的心理病理学成年人，因此是一种潜在的候选药物。本研究的目的是在具有明显神经性厌食症的患者的代表性队列中建立CBT-E术后的近期和长期预后。从连续转诊到社区饮食失调诊所招募了49名青少年患者。一位治疗师在40周内为每位患者提供了40次CBT-E疗程。三分之二的人完成了全部治疗，没有其他投入。在这些患者中，体重显着增加，而进食障碍的精神病理学显着下降。在治疗后的60周随访期内，尽管后续治疗最少，但变化不大。这些发现表明，CBT-E可能被证明是替代基于家庭的治疗的一种经济有效的选择。