• 【长距离食管闭锁:空肠插入,结肠插入和胃上拉的荟萃分析。】 复制标题 收藏 收藏
    DOI:10.1055/s-0032-1331459 复制DOI
    作者列表:Gallo G,Zwaveling S,Groen H,Van der Zee D,Hulscher J
    BACKGROUND & AIMS: AIM:There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU). METHODS:Review of the English-language literature published in the past 5 years about esophageal replacement in children was done. The focus was on postoperative survival rate, morbidity (gastrointestinal complications such as anastomotic stenosis/leakage and respiratory complications such as pneumothorax, pneumonia, and atelectasis), and long-term follow-up when available. Among long-term gastrointestinal outcomes were dysphagia, reflux, and dumping; among long-term respiratory outcomes were recurrent pneumonia and recurrent aspiration leading to chronic lung disease. Data were computed by Comprehensive Meta-Analysis software (Version 2.2.064). MAIN RESULTS:A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI. Among these 15 studies, 9 provided data about long-term follow-up. CONCLUSION:Proper prospective comparative studies are lacking. GPU and CI appear comparable regarding postoperative mortality, anastomotic complications, and graft loss. On the long-term, GPU seems to be associated with a higher respiratory morbidity but fewer gastrointestinal complications than CI. Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure.
    背景与目标: 目的:对于长间隙食管闭锁(LGEA)或广泛的腐蚀性狭窄,对于食管置换的最佳手术方法尚无共识。本文的目的是进行一项荟萃分析,比较儿童中最广泛使用的食道置换技术:空肠置入(JI),结肠置入(CI)和胃上拉(GPU)。
    方法:对近5年来发表的有关儿童食管置换术的英语文献进行回顾。重点是术后生存率,发病率(胃肠道并发症,如吻合口狭窄/渗漏和呼吸道并发症,如气胸,肺炎和肺不张),以及长期随访(如适用)。长期胃肠道疾病包括吞咽困难,反流和倾倒。长期呼吸结果包括复发性肺炎和反复吸入导致慢性肺部疾病。数据通过综合荟萃分析软件(版本2.2.064)进行计算。
    主要结果:共鉴定了15项研究(4项比较回顾性研究,8项回顾性研究和3项前瞻性研究),包括470例患者(264 LGEA)。 344(73%)名患者接受了CI,99(21%)名GPU和27(6%)JI。在这15项研究中,有9项提供了有关长期随访的数据。
    结论:缺乏适当的前瞻性比较研究。 GPU和CI在术后死亡率,吻合并发症和移植物丢失方面具有可比性。从长远来看,GPU似乎与CI相比具有更高的呼吸系统发病率,但胃肠道并发症更少。基于本文,只有两个系列提供了有关JI的数据,并且它们显示出截然不同的结果。由经验丰富的中心执行时,JI似乎是一种有效的替换技术;但是,需要更多的数字来评估此过程的结果。
  • 【儿童和青少年肥厚型心肌病的穿透性:一项为期12年的临床筛查和预测性基因检测随访研究。】 复制标题 收藏 收藏
    DOI:10.1161/CIRCULATIONAHA.111.090514 复制DOI
    作者列表:Jensen MK,Havndrup O,Christiansen M,Andersen PS,Diness B,Axelsson A,Skovby F,Køber L,Bundgaard H
    BACKGROUND & AIMS: BACKGROUND:The penetrance of hypertrophic cardiomyopathy (HCM) during childhood and adolescence has been only sparsely described. We studied the penetrance of HCM and the short- and long-term outcomes of clinical screening and predictive genetic testing of child relatives of patients with HCM. METHODS AND RESULTS:Ninety probands and 361 relatives were included in a family screening program for HCM (1994-2001). Eleven sarcomere genes, CRYAB, α-GAL, and titin were screened. Sixty-six relatives and 4 probands were <18 years of age at inclusion. Twelve child relatives were mutation carriers (age, 12 ± 5 years), and 26 had unknown genetic status, ie, relatives from families without identified mutations (n = 21) or not tested (n = 5) (age, 11 ± 5 years). Twenty-eight noncarriers (42%; age, 10 ± 4 years) served as control subjects. Two of 38 child relatives (5%) at risk of developing HCM fulfilled diagnostic criteria for HCM at inclusion. After 12 ± 1 years of follow-up, 2 of the 36 (6%; 95% confidence interval, 2-18) at-risk child relatives who were phenotype negative at inclusion had developed the HCM phenotype at 26 and 28 years of age. During follow-up, none of the child relatives experienced serious cardiac events. Participation in the screening program had no long-term negative psychological impact. CONCLUSIONS:The penetrance of HCM in phenotype-negative child relatives at risk of developing HCM was 6% after 12 years of follow-up. The finding of phenotype conversion in the mid-20s warrants continued screening into adulthood. Forty-two percent of the child relatives were noncarriers, and repeat clinical follow-up could be safely limited to the remaining children.
    背景与目标: 背景:在儿童和青少年时期肥厚型心肌病(HCM)的渗透率仅得到了很少的描述。我们研究了HCM的渗透率以及HCM患者的儿童亲属的临床筛查和预测性基因检测的短期和长期结果。
    方法与结果:1994年至2001年,在HCM家庭筛查计划中纳入了90名先证者和361名亲属。筛选了11个肌小节基因CRYAB,α-GAL和titin。六十六名亲戚和四名先证者年龄小于18岁。十二名儿童亲属是突变携带者(年龄为12±5岁),有26名遗传状况未知,即来自未发现突变的家庭的亲属(n = 21)或未经测试(n = 5)(年龄为11±5岁) )。对照组为28名非携带者(42%;年龄为10±4岁)。 38名患HCM的儿童亲属中有2名(5%)符合入选HCM的诊断标准。经过12±1年的随访,在纳入时表现型为阴性的36名高危儿童亲戚中,有2名(6%; 95%置信区间为2-18)在26岁和28岁时出现了HCM表型。 。在随访期间,没有任何一个儿童亲属经历过严重的心脏事件。参与筛查程序不会对心理产生长期负面影响。
    结论:随访12年后,表型阴性儿童亲属中HCM的外显率为6%。在20年代中期发现表型转化的情况值得继续筛选,直至成年。 42%的儿童亲属是非携带者,重复进行的临床随访可以安全地限于其余儿童。
  • 【步态,坐立姿势转移和逐步转移的惯性传感器运动分析:将膝盖患者与健康对照区分开来。】 复制标题 收藏 收藏
    DOI:10.1088/0967-3334/33/11/1947 复制DOI
    作者列表:Bolink SA,van Laarhoven SN,Lipperts M,Heyligers IC,Grimm B
    BACKGROUND & AIMS: :Patients undergoing total knee replacement for end stage knee osteoarthritis (OA) become increasingly younger and more demanding. Consequently, outcome assessment tools need to evolve toward objective performance-based measures. We applied a novel approach toward ambulatory biomechanical assessment of physical function using a single inertial sensor located at the pelvis to derive various motion parameters during activities of daily living. We investigated the potential of a clinically feasible battery of tests to define relevant parameters of physical function. We compared preoperative measures of end stage knee OA patients to healthy subjects. Our results show that measures of time yield the highest discriminative capacity to differentiate between groups. Additionally we found disease-dependent and task-specific alterations of movement for inertial sensor-derived motion parameters with good discriminative capacity. The inertial sensor's output quantities seem to capture another clinically relevant dimension of physical function that is supplementary to time. This study demonstrates the potential of inertial sensor-based motion analysis and provides a standardized test feasible for a routine clinical application in the longitudinal follow-up.
    背景与目标: :正在接受全膝关节置换以治疗终末期膝骨关节炎(OA)的患者变得越来越年轻,要求也越来越高。因此,结果评估工具需要朝着基于绩效的客观指标发展。我们应用了一种新颖的方法,通过使用位于骨盆的单个惯性传感器来对身体功能进行动态生物力学评估,以得出日常生活活动中的各种运动参数。我们研究了临床上可行的一系列测试的潜力,以定义相关的身体机能参数。我们比较了晚期膝骨关节炎患者与健康受试者的术前措施。我们的结果表明,时间量度具有最高的区分人群的区分能力。此外,我们发现了惯性传感器衍生的运动参数具有良好的判别能力的疾病相关和任务特定的运动变化。惯性传感器的输出量似乎捕获了另一项与临床相关的物理功能,是对时间的补充。这项研究证明了基于惯性传感器的运动分析的潜力,并为纵向随访中的常规临床应用提供了可行的标准化测试方法。
  • 【在两年的随访中,缺乏管状腺瘤的自发消退。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bersentes K,Fennerty MB,Sampliner RE,Garewal HS
    BACKGROUND & AIMS: OBJECTIVE:Change in colon polyp size over time has not been well characterized. It has been inferred that some polyps will increase in size, leading to an increased risk of progressing to cancer, whereas other polyps may spontaneously regress. To develop a better understanding of the natural history of colon polyps, we prospectively investigated change in polyp size over a 2-yr period.

    METHODS:Patients were enrolled if they had an endoscopically detected proximal rectal or sigmoid polyp measuring 3-9 mm. The index polyp site was then permanently marked with an adjacent India ink tattoo to allow definitive future localization of the polyp. Patients underwent flexible sigmoidoscopy at 6-month intervals, and at each examination, the polyp size was carefully measured with open biopsy forceps. After a maximum of 2 yr, each polyp was removed and the histology determined.

    RESULTS:Thirty polyps were followed in 26 patients who completed the study. Twelve polyps were tubular adenomas (TA), one was tubulovillous, 14 were hyperplastic polyps (HP), two had no pathological diagnosis, and one was a leiomyoma. HP were more likely to decrease in size than were TA. Three polyps demonstrated fast growth rates (2-4 mm/yr), and all were TA. Two polyps were removed early because their size had reached 1 cm or more. Both of those polyps were TA. No polyps regressed completely during the 2 yr of the study; neither did we find consistent linear growth rates.

    CONCLUSIONS:In contrast to prior reports, in this study, after polyps had been definitively localized with India ink, we observed no complete polyp regressions.

    背景与目标: 目的:对结肠息肉大小随时间的变化尚无定论。已经推断出某些息肉的大小会增加,导致患癌症的风险增加,而其他息肉则可能自发地消退。为了更好地了解结肠息肉的自然病史,我们前瞻性研究了两年内息肉大小的变化。

    方法:如果患者具有内窥镜检查,则入组检出近端直肠或乙状结肠息肉,大小为3-9毫米。然后将索引息肉部位永久性地标记上相邻的印度墨水纹身,以确保将来可以明确定位息肉。患者每6个月进行一次乙状结肠镜检查,每次检查时,均应使用开放式活检钳仔细测量息肉大小。最长2年后,将每个息肉切除并确定组织学。

    结果:在完成研究的26例患者中,对30例息肉进行了随访。十二个息肉是肾小管腺瘤(TA),一个是肾小管性腺癌,十四个是增生性息肉(HP),两个没有病理诊断,一个是平滑肌瘤。与TA相比,HP更有可能减小尺寸。三个息肉显示出快速的生长速度(2-4毫米/年),并且全部为TA。由于息肉的大小已达到1厘米或更大,因此较早地将其移除。这些息肉都是TA。在研究的2年中,没有息肉完全消退。我们都没有找到一致的线性增长率。

    结论:与先前的报告相比,在本研究中,在使用印度墨水对息肉进行了明确定位之后,我们没有观察到息肉完全消失。

  • 【OP-1(rhBMP-7)替代auto外侧自体for骨移植治疗后外侧腰椎关节置换术的安全性和有效性:至少4年的随访研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.spinee.2007.03.012 复制DOI
    作者列表:Vaccaro AR,Whang PG,Patel T,Phillips FM,Anderson DG,Albert TJ,Hilibrand AS,Brower RS,Kurd MF,Appannagari A,Patel M,Fischgrund JS
    BACKGROUND & AIMS: BACKGROUND CONTEXT:Although autogenous bone is still considered to be the gold standard graft material for promoting spinal fusion, other bone graft substitutes have been developed in an attempt to improve arthrodesis rates and avoid the complications associated with the procurement of autograft. The bone morphogenetic proteins (BMPs) represent a family of osteoinductive growth factors that are known to stimulate the osteoblastic differentiation of stem cells. Osteogenic protein-1 (OP-1) Putty is a commercially available BMP preparation that is already approved for use in humans. Previous clinical studies involving patients with degenerative spondylolisthesis have reported that the efficacy and safety of OP-1 Putty is comparable to that of autograft at both 1- and 2-year follow-up. PURPOSE:The purpose of this study was to evaluate the intermediate-term efficacy and safety of OP-1 Putty as an alternative to autogenous bone by comparing the 4-year radiographic, clinical, and safety data of these same patients who underwent decompression and uninstrumented fusion with either OP-1 Putty or iliac crest autograft. STUDY DESIGN/SETTING:A prospective, randomized, controlled, multicenter clinical pilot study. PATIENT SAMPLE:Thirty-six patients undergoing decompressive laminectomy and single-level uninstrumented fusion for degenerative spondylolisthesis and symptomatic spinal stenosis were randomized in a 2:1 fashion to receive either OP-1 Putty (24 patients) or autogenous iliac crest bone graft (12 patients). OUTCOME MEASURES:Patient-reported outcome measures consisting of Oswestry Disability Index and Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) scores were used to evaluate clinical efficacy. Perioperative data including operative time, estimated blood loss, and duration of hospital stay were also recorded for each surgery. Postoperatively, a neurological examination and an assessment of donor-site pain (if applicable) were performed at every follow-up visit. Radiographic fusion success was defined as the presence of continuous bridging bone formation between the transverse processes at the level of the spondylolisthesis with minimal motion evident on dynamic lateral x-ray films. The primary efficacy endpoint was the overall success rate, a composite measure derived from both radiographic and clinical parameters. The safety of OP-1 Putty was confirmed by comparing the nature and frequency of all adverse events and complications that were prospectively observed in either of the groups. METHODS:Thirty-six patients with degenerative spondylolisthesis and symptoms of neurogenic claudication underwent decompressive laminectomy and single-level uninstrumented fusion with either OP-1 Putty or autograft. All patients were evaluated at 6 weeks and 3, 6, 9, 12, and 24 months, after which time they were instructed to return on a yearly basis. Multiple neuroradiologists blinded to the assigned treatment reviewed static and dynamic X-ray films with digital calipers to assess fusion status according to the presence of continuous bridging bone across the transverse processes as well as the amount of residual motion evident at the level of interest. Oswestry Disability Index surveys and SF-36 questionnaires were used to assess clinical outcomes. RESULTS:At the 48-month time point, complete radiographic and clinical data were available for 22 of 36 patients (16 OP-1 Putty and 6 autograft) and 25 of 36 patients (18 OP-1 Putty and 7 autograft), respectively. Radiographic evidence of a solid arthrodesis was present in 11 of 16 OP-1 Putty patients (68.8%) and 3 of 6 autograft patients (50%). Clinically successful outcomes defined as at least a 20% improvement in preoperative Oswestry scores were experienced by 14 of 19 OP-1 Putty patients (73.7%) and 4 of 7 autograft patients (57.1%); these clinical findings were corroborated by similar increases in SF-36 scores. The respective overall success rates of the OP-1 Putty and autograft group were 62.5% and 33.3%. In this study, there were no incidents of local or systemic toxicity, ectopic bone production, or other adverse events directly related to the use of OP-1 Putty. CONCLUSION:Despite the challenges associated with obtaining a solid uninstrumented fusion in patients with degenerative spondylolisthesis, the rates of radiographic fusion, clinical improvement, and overall success associated with the use of OP-1 Putty were at least comparable to that of the autograft controls for at least 48 months after surgery. These results appear to validate the short-term results previously reported for OP-1 Putty and suggest that this material may potentially represent a viable bone graft substitute for certain fusion applications.
    背景与目标: 背景技术:尽管自体骨仍被认为是促进脊柱融合的金标准移植材料,但已开发出其他替代骨的方法,以试图提高关节固定率并避免与自体移植相关的并发症。骨形态发生蛋白(BMP)代表一类骨诱导生长因子,已知这些因子可刺激干细胞的成骨细胞分化。成骨蛋白1(OP-1)腻子是一种可商购的BMP制剂,已被批准用于人类。先前涉及退行性脊椎滑脱患者的临床研究报告,在1年和2年的随访中,OP-1油灰的功效和安全性与自体移植相当。
    目的:本研究的目的是通过比较这些接受减压和不使用仪器的相同患者的4年影像学,临床和安全性数据来评估OP-1油灰替代自体骨的中期疗效和安全性与OP-1油灰或骨自体融合。
    研究设计/设置:一项前瞻性,随机,对照,多中心临床试验研究。
    患者样本:36例行减压椎板切除术和单级非器械融合治疗退行性腰椎滑脱和症状性椎管狭窄的患者以2:1方式随机接受OP-1腻子(24例)或自体骨植骨(12例)耐心)。
    结局指标:采用Oswestry残疾指数和医学结局研究36项简表健康调查(SF-36)评分组成的患者报告结局指标,用于评估临床疗效。每次手术还记录了围手术期数据,包括手术时间,估计的失血量和住院时间。术后,每次随访均进行神经系统检查和对供体部位疼痛的评估(如果适用)。放射照相融合成功定义为在横向滑突之间在脊椎滑脱水平上存在连续桥接的骨形成,而在动态侧向X射线胶片上可见的运动极小。主要功效终点是总体成功率,这是一项从放射学和临床参数中得出的综合指标。 OP-1腻子的安全性通过比较两组中预期观察到的所有不良事件和并发症的性质和频率来确定。
    方法:36例退行性腰椎滑脱并伴有神经源性symptoms行症状的患者接受减压椎板切除术和单层非器械融合OP-1腻子或自体移植。在第6周和第3、6、9、12和24个月对所有患者进行评估,然后指示他们每年返回一次。多家神经放射科医生对指定的治疗方法视而不见,并用数字卡尺检查了静态和动态X射线胶片,以根据横断过程中连续桥接骨的存在以及感兴趣水平上明显的残余运动量来评估融合状态。 Oswestry残疾指数调查和SF-36问卷用于评估临床结局。
    结果:在48个月的时间点,分别可获得36例患者中的22例(16例OP-1腻子和6例自体移植)和36例患者中的25例(18例OP-1腻子和7例自体移植)的完整影像学和临床资料。 16例OP-1油灰患者中有11例(68.8%)和6例自体移植患者中有3例(50%)出现了牢固的关节固定的影像学证据。 19例OP-1腻子患者中的14例(73.7%)和7例自体移植患者中的4例(57.1%)经历了临床上成功的结果,即术前Oswestry评分至少提高了20%。这些临床发现被SF-36分数的类似提高所证实。 OP-1腻子和自体移植组的总体总体成功率分别为62.5%和33.3%。在这项研究中,没有发生局部或全身毒性,异位骨生成或与使用OP-1腻子直接相关的其他不良事件的事件。
    结论:尽管在退行性脊椎滑脱患者中获得牢固的非器械融合具有挑战性,但与使用OP-1腻子相关的放射成像融合率,临床改善率和总体成功率至少可与自体植骨对照用于手术后至少48个月。这些结果似乎证实了先前报道的OP-1油灰的短期结果,并表明该材料可能是某些融合应用中可行的骨移植替代品。
  • 【氯氮平在大鼠额叶皮层诱导的GLT-1下调与突触素上调相关。】 复制标题 收藏 收藏
    DOI:10.1111/j.1471-4159.2006.04030.x 复制DOI
    作者列表:Bragina L,Melone M,Fattorini G,Torres-Ramos M,Vallejo-Illarramendi A,Matute C,Conti F
    BACKGROUND & AIMS: :In rat frontal cortex, extracellular levels of glutamate are raised by the anti-psychotic drug clozapine. We have recently shown that a significant reduction in the levels of the glutamate transporter GLT-1 may be one of the mechanisms responsible for this elevation. Here we studied whether GLT-1 down-regulation induced by chronic clozapine treatment is associated with changes in the expression of synaptophysin, synaptosome-associated protein of 25 kDa (SNAP-25) and vesicular glutamate transporter 1 (VGLUT1), three major presynaptic proteins involved in neurotransmitter release. Quantitative high-resolution confocal microscopy studies in vivo showed that GLT-1 down-regulation is closely associated with a significant increase in synaptophysin, but not SNAP-25 and VGLUT1, expression. This was confirmed in vitro studies, and in western blotting studies of synaptophysin, SNAP-25 and VGLUT1. In addition, our results show that, following clozapine treatment, synaptophysin expression increases in the very cortical regions in which GLT-1 expression is down-regulated. These findings suggest that part of the effects of clozapine may be exerted via an action on the presynaptic machinery involved in neurotransmitter release.
    背景与目标: 在大鼠额叶皮层,抗精神病药物氯氮平可提高细胞外谷氨酸水平。我们最近表明,谷氨酸转运蛋白GLT-1水平的显着降低可能是造成这种升高的机制之一。在这里,我们研究了慢性氯氮平治疗引起的GLT-1下调是否与突触素,25kDa突触体相关蛋白(SNAP-25)和水泡谷氨酸转运蛋白1(VGLUT1)(三种主要的突触前蛋白)的表达变化有关。参与神经递质的释放。体内定量高分辨率共聚焦显微镜研究表明,GLT-1的下调与突触素的显着增加密切相关,而与SNAP-25和VGLUT1的表达却没有显着相关。这在体外研究以及突触素,SNAP-25和VGLUT1的蛋白质印迹研究中得到了证实。此外,我们的结果表明,在氯氮平治疗后,突触素表达在GLT-1表达下调的非常皮质的区域增加。这些发现表明,氯氮平的部分作用可能是通过对涉及神经递质释放的突触前机制的作用来发挥的。
  • 【进行性系统性硬化症的体外光化学疗法:一项后续研究。】 复制标题 收藏 收藏
    DOI:10.1046/j.1365-4362.1997.00066.x 复制DOI
    作者列表:Schwartz J,Gonzalez J,Palangio M,Klainer AS,Bisaccia E
    BACKGROUND & AIMS: BACKGROUND:Extracorporeal photochemotherapy (photopheresis), an immune-modulating therapy, has been demonstrated to elicit a therapeutic response in the treatment of several autoimmune disorders. We evaluated the use of photopheresis in the treatment of patients with progressive systemic sclerosis (PSS; scleroderma).

    METHODS:Five patients with early-onset, diffuse PSS were treated with photopheresis on 2 successive days monthly for an average of 59 months (range 54-89 months). We initially reported the response this group of patients had to photopheresis treatment at an average of 11 months (range 6-21 months).

    RESULTS:An improvement or stabilization was noted in most patients in skin thickening, joint mobility, pulmonary function studies, oral aperture, functional index, as well as symptoms including Raynaud's phenomenon, dyspnea, fatigue, dysphagia, arthralgias, and cutaneous ulcers. Renal function tests remained within normal range. A total of 296 monthly treatments were administered without significant toxicity.

    CONCLUSIONS:This study suggests that extended use of extracorporeal photochemotherapy in the management of early-onset, diffuse PSS is well tolerated and may provide an increasingly beneficial clinical outcome.

    背景与目标: 背景:体外光化学疗法(光透疗法)是一种免疫调节疗法,已被证明在多种自身免疫性疾病的治疗中引起治疗反应。我们评估了光采疗法在进行性系统性硬化症(PSS;硬皮病)患者中的应用。

    方法:对5例早发,弥漫性PSS患者进行了光采疗法。每月连续2天,平均59个月(范围54-89个月)。我们最初报告了该组患者平均11个月(6到21个月)对光穿刺治疗的反应。

    结果:大多数患者均出现了改善或稳定皮肤增厚,关节活动度,肺功能研究,口腔孔径,功能指数以及包括雷诺现象,呼吸困难,疲劳,吞咽困难,关节痛和皮肤溃疡在内的症状的患者。肾功能检查保持在正常范围内。总共进行了296个月的每月治疗,无明显毒性。

    结论:这项研究表明,在早期发作,弥漫性PSS的管理中长期使用体外光化学疗法具有良好的耐受性,并且可能会提供越来越有益的临床结果。

  • 【TTYH2是果蝇果蝇基因tweety的人类同源物,在结肠癌中上调,并参与细胞增殖和细胞聚集。】 复制标题 收藏 收藏
    DOI:10.3748/wjg.v13.i19.2717 复制DOI
    作者列表:Toiyama Y,Mizoguchi A,Kimura K,Hiro J,Inoue Y,Tutumi T,Miki C,Kusunoki M
    BACKGROUND & AIMS: AIM:To investigate the expression patterns of TTYH2 in the human colon cancer and colon cancer cell lines and to evaluate the inhibitory effect of small interfering RNA (siRNA) on the expression of TTYH2 in colon cancer cell lines. METHODS:We investigated the expression patterns of TTYH2 in colon cancer, adjacent non-tumorous colon mucosa, and cancer cell lines (DLD-1, caco-2, and Lovo) by RT-PCR. Furthermore, a siRNA plasmid expression vector against TTYH2 was constructed and transfected into DLD-1 and Caco-2 with Lipofectamine 2000. The down regulation of TTYH2 expression was detected by RT-PCR and the role of siRNA in inducing cell proliferation and cell aggregation was evaluated by MTT and aggregation assay. RESULTS:TTYH2 gene expression in colon cancer tissue was significantly up-regulated compared with normal colonic mucosa (1.23 +/- 0.404 vs 0.655 +/- 0.373, P = 0.0103). Colon cancer derived cell lines including DLD-1, Caco-2, and Lovo also expressed high levels of TTYH2. In contrast, transfection with siRNA-TTYH2 significantly inhibited both proliferation and scattering of these cancer cell lines. CONCLUSION:The present work demonstrates, for the first time, that the TTYH2 gene expression is significantly up-regulated in colon cancer. The TTYH2 gene may play an important role in regulating both proliferating and metastatic potentials of colorectal cancer.
    背景与目标: 目的:研究TTYH2在人结肠癌和结肠癌细胞系中的表达模式,并评估小干扰RNA(siRNA)对TTYH2在结肠癌细胞系中表达的抑制作用。
    方法:我们通过RT-PCR研究了TTYH2在结肠癌,邻近的非肿瘤结肠粘膜和癌细胞系(DLD-1,caco-2和Lovo)中的表达模式。此外,构建了针对TTYH2的siRNA质粒表达载体,并用Lipofectamine 2000将其转染到DLD-1和Caco-2中。通过RT-PCR检测了TTYH2表达的下调,并且siRNA在诱导细胞增殖和细胞聚集中的作用为:通过MTT和聚集分析进行评估。
    结果:与正常结肠粘膜相比,结肠癌组织中TTYH2基因表达显着上调(1.23 /-0.404对0.655 /-0.373,P = 0.0103)。结肠癌衍生的细胞系(包括DLD-1,Caco-2和Lovo)也表达高水平的TTYH2。相反,用siRNA-TTYH2转染可显着抑制这些癌细胞系的增殖和扩散。
    结论:本研究首次证明了TTYH2基因的表达在结肠癌中显着上调。 TTYH2基因可能在调节结直肠癌的增殖和转移潜能中起重要作用。
  • 【随访5年以上对男性尿道狭窄治疗效果的评价】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Khenifar E,Guerder L,Jeldi A,Bittard H
    BACKGROUND & AIMS: :149 cases of urethral stricture were treated in the Urology Department from 1971 to 1984. All of these patients have therefore been treated with a minimal follow-up of 5 years. There were 87 cases of post-traumatic stricture, 53 of whom were lost to follow-up during the survey, 8 died and 26 patients were able to be reviewed. The remaining 62 cases consisted of post-infectious strictures, with 37 patients lost to follow-up during the survey, 1 patient who died and 24 patients who were reviewed. The patients reviewed were assessed according to the criteria of the SFU (French Urology Society) survey. Direct vision internal urethrotomy was performed in 33 cases with 18 very good or good results (54%), segmental resection was performed in 10 cases with 7 very good or good results, urethroplasty was performed in 4 cases with 2 good results and 2 urethral dilatations were performed with 2 good results. The failures were essentially treated by more complex surgery (urethroplasty).
    背景与目标: 从1971年至1984年,泌尿外科对149例尿道狭窄患者进行了治疗。因此,所有这些患者均接受了最少5年的随访。共有87例创伤后狭窄病例,其中53例在随访期间遗失随访,8例死亡,26例能够接受检查。其余62例由感染后狭窄组成,在调查期间遗失37例患者,其中1例死亡,24例接受了复查。根据SFU(法国泌尿外科学会)调查的标准对接受检查的患者进行评估。直视内尿道切开术33例,非常好或好(18%)(54%),节段性切除10例,好或好7例,行尿道成形术4例,好转2例,尿道扩张2例进行了2项良好结果。失败基本上是通过更复杂的手术(尿道成形术)来治疗的。
  • 【参加过性犯罪者治疗小组的智障男性:随访。】 复制标题 收藏 收藏
    DOI:10.1111/jar.12038 复制DOI
    作者列表:Heaton KM,Murphy GH
    BACKGROUND & AIMS: BACKGROUND:There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. METHOD:Thirty-four men (from seven treatment sites) were followed up. All had attended SOTSEC-ID groups. The mean length of follow-up, since the end of the treatment group, was 44 months (SD 28.7, range 15-106 months). RESULTS:The statistically significant improvements in sexual knowledge, empathy and cognitive distortions that occurred during treatment were maintained at follow-up. In all, 11 of the 34 (32%) men showed further sexually abusive behaviour, but only two of these men received convictions. Analyses of the variables associated with further sexually abusive behaviour indicated that a diagnosis of autism was associated with a higher likelihood of further sexually abusive behaviour. CONCLUSIONS:This study provides some evidence of the longer-term effectiveness of group CBT for men with intellectual disabilities and sexually abusive behaviour.
    背景与目标: 背景:已有许多针对智障和性虐待行为的男性的治疗研究,但随访研究很少。我们的目的是跟进曾参加过针对性虐待行为的集体认知行为治疗(CBT)的智障男性。
    方法:对34名男性(来自7个治疗部位)进行了随访。所有人都参加了SOTSEC-ID组。自治疗组结束以来,平均随访时间为44个月(SD 28.7,范围15-106个月)。
    结果:随访期间,在治疗过程中发生的性知识,同理心和认知扭曲方面的统计学显着改善得以维持。在这34名男性中,有11名(32%)表现出进一步的性虐待行为,但其中只有2名被定罪。对与进一步的性虐待行为有关的变量的分析表明,自闭症的诊断与进一步的性虐待行为的可能性更高有关。
    结论:这项研究提供了一些证据,表明集体CBT对于智力残疾和性虐待行为的长期有效性。
  • 【使用经校准的tris-acryl明胶微球体对有或无子宫平滑肌瘤的有症状子宫腺肌病的子宫动脉栓塞术:中期临床和MR影像学随访。】 复制标题 收藏 收藏
    DOI:10.1016/j.jvir.2007.04.024 复制DOI
    作者列表:Lohle PN,De Vries J,Klazen CA,Boekkooi PF,Vervest HA,Smeets AJ,Lampmann LE,Kroencke TJ
    BACKGROUND & AIMS: PURPOSE:To evaluate clinical and magnetic resonance (MR) imaging results after uterine artery embolization (UAE) in women with symptomatic adenomyosis with or without uterine leiomyomas. MATERIALS AND METHODS:Thirty-eight women with symptomatic adenomyosis with or without uterine leiomyomas were treated with UAE with calibrated tris-acryl gelatin microspheres. Based on MR findings, women were categorized as having pure adenomyosis (group A; n = 15), adenomyosis dominance with fibroid tumors (group B; n = 14), or fibroid tumor dominance with adenomyosis (group C; n = 9). RESULTS:Heavy menstrual bleeding, pain, and bulk-related symptoms at last follow-up at a median of 16.5 months (range, 3-38 months) were compared with baseline symptoms. With follow-up MR imaging at a median of 12 months (range, 3-36 months), changes in uterine volume, leiomyoma volume, junctional zone thickness, and contrast enhancement of adenomyosis were assessed. After embolization, adenomyosis infarction could be depicted on contrast medium-enhanced MR in 44.1% of cases. Median reductions of uterine volume, fibroid tumor volume, and junctional zone thickness were 44.8%, 77.1%, and 23.9%, respectively. In group A, three patients needed additional surgery after UAE, in addition to two in group B and one in group C. In the remaining 32 patients, except for one patient in group C, all preexisting symptoms (eg, bleeding, pain, bulk-related symptoms) improved or resolved after UAE. Overall, 84.2% of women were satisfied with the results of UAE. CONCLUSION:In this study, midterm results (at a median of 16.5 months) showed that UAE in symptomatic adenomyosis with or without uterine leiomyomas is effective. Hysterectomy was avoided in the vast majority of patients. MR imaging showed reduction of uterine volume and junctional zone thickness.
    背景与目标: 目的:评估伴有或不伴子宫平滑肌瘤的有症状子宫腺肌病妇女子宫动脉栓塞(UAE)后的临床和磁共振(MR)成像结果。
    材料与方法:对38例有子宫腺肌瘤或无子宫肌瘤的有症状子宫腺肌病的妇女用经校准的tris-acryl明胶微球进行UAE治疗。根据MR结果,将女性分为纯腺肌病(A组; n = 15),腺肌病占纤维瘤的优势(B组; n = 14)或肌瘤伴腺肌病的优势(C组; n = 9)。
    结果:最后一次随访中月经大出血,疼痛和与大块相关的症状的中位数为16.5个月(范围3-38个月),与基线症状进行了比较。在中位12个月(范围3-36个月)内进行随访MR成像,评估子宫体积,平滑肌瘤体积,交界区厚度和子宫腺肌病造影剂增强情况的变化。栓塞后,在44.1%的病例中,造影剂增强型MR可以描绘出子宫腺肌梗塞。子宫体积,肌瘤体积和交界区厚度减少的中位数分别为44.8%,77.1%和23.9%。在A组中,除了B组中的两名和C组中的一名之外,三名患者需要在阿联酋手术后接受其他手术。在其余32名患者中,除了C组中的一名患者外,所有患者均已存在症状(例如,出血,疼痛,肿大相关症状)在阿联酋后得到改善或解决。总体而言,有84.2%的女性对阿联酋的成绩感到满意。
    结论:在这项研究中,中期结果(中位值为16.5个月)表明,阿联酋在有症状或无子宫平滑肌瘤的有症状子宫腺肌病中是有效的。绝大多数患者避免子宫切除术。磁共振成像显示子宫体积和交界区厚度减少。
  • 【抑郁和焦虑的儿童在成长过程中使用门诊心理健康服务。】 复制标题 收藏 收藏
    DOI:10.1176/ps.2006.57.7.966 复制DOI
    作者列表:Goldstein RB,Olfson M,Wickramaratne PJ,Wolk SI
    BACKGROUND & AIMS: OBJECTIVE:Childhood-onset psychiatric disorders can be persistent and impairing but often go untreated. Affected individuals' treatment utilization into adulthood is not well understood. A 15-year follow-up of depressed, anxious, and never mentally ill children (control group) examined need, predisposing, and enabling factors associated with use of outpatient mental health care into early adulthood. METHODS:Between 1977 and 1985, a total of 315 children and adolescents were ascertained. Their psychiatric status and treatment utilization into adulthood were reassessed between 1991 and 1997 by clinicians blind to their childhood diagnoses. RESULTS:Respondents ascertained for depression demonstrated 13-fold, and those ascertained for anxiety demonstrated six-fold, greater odds of any treatment compared with controls. Among utilizers, childhood depression conferred 14-fold, and childhood anxiety, 23-fold, increased odds of long-term treatment. Blacks were less likely than whites to obtain treatment. Utilizers older at follow-up reported longer treatment duration. Mood disorder episodes over follow-up and poorer global functioning were associated with both increased odds of any utilization and increased treatment duration among utilizers. CONCLUSIONS:This sample demonstrated high and persistent treatment utilization. Need indicated by childhood diagnosis was the strongest predictor of treatment; however, utilization also differed by race or ethnicity. Strategies to maximize the uptake of effective, culturally relevant treatment approaches should be investigated.
    背景与目标: 目的:儿童期精神病可能会持续存在并受损,但通常得不到治疗。受影响的个体成年后对治疗的利用尚不十分清楚。对抑郁,焦虑和从未患过精神疾病的儿童(对照组)进行的15年随访检查了在成年初期使用门诊精神卫生服务的需求,易感性和促成因素。
    方法:1977年至1985年期间,共确定了315名儿童和青少年。 1991年至1997年之间,对童年时期视而不见的临床医生对他们的精神状态和成年后的治疗方法进行了重新评估。
    结果:确定为抑郁的被调查者表现出13倍,而确定为焦虑的被调查者表现出6倍,与对照组相比,任何治疗的可能性更高。在利用者中,儿童抑郁症的长期治疗几率提高了14倍,而儿童焦虑症的风险提高了23倍。与白人相比,黑人获得治疗的可能性较小。随访时年龄较大的使用者报告治疗时间更长。随访中的情绪障碍发作和整体功能较差与利用者的使用几率增加和利用者的治疗时间增加有关。
    结论:该样品显示出高且持久的治疗利用率。儿童期诊断表明的需求是治疗的最强预测因子。但是,利用率也因种族或种族而异。应该研究最大程度地采用与文化相关的有效治疗方法的策略。
  • 【对比增强心肌梗死后大鼠心脏重塑和功能的超声心动图随访。】 复制标题 收藏 收藏
    DOI:10.1016/j.ultrasmedbio.2007.04.016 复制DOI
    作者列表:Rabald S,Hagendorff A,Pfeiffer D,Zimmer HG,Deten A
    BACKGROUND & AIMS: :Echocardiography is a reliable and commonly used method to examine cardiac diseases. Recent employment of modern technologies provides new opportunities to study left ventricular (LV) remodeling after myocardial infarction (MI) also in small rodents. LV volumes as most important prognostic parameters can be estimated by noncontrast enhanced echocardiography in rats from M-mode or single cross sections only. In this study, contrast enhanced echocardiography and volume measurements by the biplane method of discs (Simpson's rule) were applied in rats to monitor remodeling and function after MI. MI was induced in female Sprague-Dawley rats (n = 26 for MI, and n = 16 for sham). LV remodeling and heart function were serially studied by contrast enhanced echocardiography for 12 to 16 wk. At the end of the observation periods hemodynamic data were additionally measured by left and right heart catheterization. LV end systolic volume (LVESV) measured by biplane method of discs correlated best with LV developed pressure as indicator for severely impaired heart function. Interestingly, LV end systolic area (LVESA) from native short axis view correlated well with LVESV (R(2) = 0.93) and was the second best predictor for depressed heart function. Moreover, left atrial size was a powerful indicator of severely impaired heart function whereas ejection fraction or fractional area change were primarily related to infarct size. In conclusion, contrast enhanced echocardiography in rats is feasible and an economical method to study time-dependent LV remodeling and deterioration of contractile function after MI.
    背景与目标: :超声心动图检查是一种可靠且常用的检查心脏疾病的方法。最近使用现代技术为小型啮齿动物心肌梗死(MI)后研究左心室(LV)重塑提供了新的机会。左室容积是最重要的预后参数,可通过M型或单个断面大鼠的非对比增强超声心动图进行评估。在这项研究中,对比增强超声心动图和双平面盘法测量体积(辛普森法则)应用于大鼠,以监测心梗后的重塑和功能。 MI在雌性Sprague-Dawley大鼠中诱发(MI = 26,假手术= 16)。左心室重塑和心脏功能通过对比增强超声心动图连续研究12至16周。在观察期结束时,通过左,右心脏导管检查另外测量血流动力学数据。通过双平面椎间盘法测量的左室收缩末期容积(LVESV)与左室发育压力最相关,后者可作为严重损害心脏功能的指标。有趣的是,从本机短轴视图来看,LV收缩末期面积(LVESA)与LVESV相关性很好(R(2)= 0.93),是心脏功能低下的第二佳预测指标。此外,左心房大小是严重损害心脏功能的有力指标,而射血分数或分数面积变化主要与梗死面积有关。总之,对比增强超声心动图在大鼠中是可行的,是一种经济的方法来研究时间依赖性左室重塑和心肌梗死后收缩功能的恶化。
  • 【Che-1的上调与成年大鼠脑外伤后的神经元凋亡有关。】 复制标题 收藏 收藏
    DOI:10.1007/s10571-012-9874-7 复制DOI
    作者列表:Xu J,Jin W,Wu X,Wu X,Li A,Ke K,Cao J,Liu X,Tan X,Fu H,Gao Y,Gao Z
    BACKGROUND & AIMS: :Che-1, a recently identified apoptosis related protein, affects the fate of various cell types when under stress. One attractive biological function of Che-1 is promoting the transcription of p53 after DNA damage; besides, it can also regulate cell cycle via interacting with retinoblastoma protein. Although previous evidence has showed its anti-apoptotic role in cancer cells, some studies point out that Che-1 might play an opposite role in central nervous system (CNS). However, the function of Che-1 in CNS is still with limited acquaintance. To investigate whether Che-1 is involved in CNS lesion, we performed a traumatic brain injury model in adult rats. Up-regulation of Che-1 was observed in the peritrauma brain cortex by performing western blotting and immunohistochemistry. Terminal deoxynucleotidyl transferase deoxy-UTP nick-end labeling and 4',6-diamidino-2-phenylindole staining suggested that Che-1 was involved in neuronal apoptosis after brain injury. We also investigated co-localization of Che-1 and active-caspase-3 in the ipsilateral brain cortex. In addition, the expression patterns of p53, Bax and PCNA were parallel with that of Che-1. Besides this, neurotrophin receptor-interacting MAGE homolog was found to be associated with Che-1 after brain trauma. Based on our data, we suggested that Che-1 might play an important role in neuronal apoptosis following TBI; and might provide a basis for the further study on its role in regulating the expression of p53 and cell cycle re-entry in traumatic brain injury.
    背景与目标: :Che-1是最近发现的凋亡相关蛋白,在压力下会影响各种细胞类型的命运。 Che-1的一种有吸引力的生物学功能是促进DNA损伤后p53的转录。此外,它还可以通过与视网膜母细胞瘤蛋白相互作用来调节细胞周期。尽管先前的证据表明其在癌细胞中具有抗凋亡作用,但一些研究指出,Che-1可能在中枢神经系统(CNS)中起相反的作用。但是,Che-1在中枢神经系统中的功能仍知之甚少。为了研究Che-1是否参与中枢神经系统病变,我们在成年大鼠中进行了脑外伤模型。通过进行蛋白质印迹和免疫组织化学观察,在创伤周围大脑皮层中观察到Che-1的上调。末端脱氧核苷酸转移酶脱氧-UTP缺口末端标记和4',6-二mid基-2-苯基吲哚染色提示Che-1参与脑损伤后的神经元凋亡。我们还研究了同侧大脑皮层中Che-1和active-caspase-3的共定位。另外,p53,Bax和PCNA的表达模式与Che-1平行。除此之外,还发现与神经营养蛋白受体相互作用的MAGE同源物与脑外伤后的Che-1有关。根据我们的数据,我们认为Che-1可能在TBI后的神经元凋亡中起重要作用。可能为进一步研究其在创伤性脑损伤中调控p53表达和细胞周期再进入的作用提供基础。
  • 【携带9号染色体的家族相互平衡易位的携带者的生殖随访,并与预期结果进行比较。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Castorina P,Rodeschini O,Nocera G,Larizza L
    BACKGROUND & AIMS: :Reproductive follow-up of carriers of familial reciprocal balanced translocations involving chromosome 9 and comparison with predicted outcome: Chromosome 9 is commonly implicated in reciprocal translocations (rcp). Twenty-seven families segregating rcp involving chromosome 9 were selected with the aim of comparing the theoretical risk of Mental Retardation with Congenital Anomalies (MCA/MR) calculated according to Human Cytogenetics Forum with the observed reproductive follow-up. The 27 families include 157 subjects. The reproductive follow-up showed that the majority of mothers underwent full-term pregnancies (88/130), and that there were 37 spontaneous and five voluntary abortions. Eighty-one subjects were karyotyped: 18 had a normal karyotype, 50 carried an rcp, ten had an unbalanced rcp-related karyotype and three an abnormal rcp-unrelated karyotype. Of the 88 live-born individuals, seven had an abnormal rcp-related karyotype with partial chromosome 9 trisomy (four cases) or partial 9p monosomy (three cases), and 48 were rcp carriers, two of whom also presented additional anomalies. The evaluation of reproductive outcomes in the 27 families studied revealed good concordance between the Human Cytogenetics Forum predictions and the observed follow-up in relation to the most probable mode of unbalance at birth, and the higher risk of MCA/MR in rcp carriers with unbalanced live-borns in comparison with those generating healthy progeny
    背景与目标: :涉及染色体9的家族相互平衡易位的携带者的生殖随访,并与预期结果进行比较:染色体9通常与相互易位(rcp)有关。选择了27个涉及9号染色体的rcp隔离家庭,目的是将根据人类细胞遗传学论坛计算的先天性精神发育迟滞的理论风险与观察到的生殖随访进行比较。 27个家庭包括157个科目。生殖随访表明,大多数母亲都进行了足月妊娠(88/130),并且有37例自然流产和5例自愿流产。八十一名受试者进行了核型分析:18名受试者具有正常的核型,五十名受试者具有rcp,十名受试者具有不平衡的rcp相关性核型,三名受试者具有异常的rcp无关性核型。在88个活产个体中,有7个具有与rcp相关的染色体核型异常,其中9号染色体三体性(4例)或9p单体性染色体3个(3例),而rcp携带者48个,其中两个还存在其他异常。对所研究的27个家庭的生殖结果进行的评估表明,人类细胞遗传学论坛的预测与观察到的关于出生时失衡的最可能模式以及在失衡的rcp携带者中MCA / MR的风险较高之间的随访之间具有良好的一致性。与产生健康后代的活产婴儿相比

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