Efficacy of minor analgesics in primary dysmenorrhoea: a systematic review

Objective To quantify the efficacy and safety of naproxen, ibuprofen, mefenamic acid, aspirin and acetaminophen (paracetamol) in the treatment of primary dysmenorrhoea through a systemic overview of randomised controlled trials.
Methods MEDLINE, EMBASE and the Science Citation Index were searched for randomised controlled trials. Efficacy was assessed by measurement of pain relief, requirement for rescue analgesics, restriction of daily life and absence from work or school. The rate ratios of side effects were used to assess safety.
Results Fifty-six trials describing 55 comparisons of analgesics with placebo and 12 direct comparisons with other analgesics met our inclusion criteria. Women taking naproxen were over three times more likely to have at least moderate pain relief than those taking placebo. Ibuprofen, mefenamic acid and aspirin were also superior to placebo but acetaminophen was not. The requirement for rescue analgesics, restriction of daily life and absence from work or school were less frequent with naproxen and ibuprofen than placebo but not with aspirin or acetaminophen. Direct comparisons did not show any difference between naproxen and ibuprofen. Side effects occurred more frequently only with naproxen when compared with placebo.
Conclusion Naproxen, ibuprofen, mefenamic acid and aspirin are all effective in primary dysmenorrhoea. Ibuprofen appears to have the most favourable risk-benefit ratio. Acetaminophen appears to be less effective than nonsteroidal anti-inflammatory drugs, but there was only one trial meeting our inclusion criteria and further studies are required.     

乳腺癌的X线诊断（附186例分析）

本文搜集经手术病理证实的186例乳腺癌，分析了乳癌的发病年龄与乳腺类型的关系，讨论了乳癌的各种X线表现，着重探讨了乳腺癌几种病理类别的X线表现特点，作者将乳腺癌的X线表现归纳为四型：肿块型（又分为团块形，结节形和不规则形），浸润型，钙化型和结构紊乱型，联系其病理结构，提出诊断要点以提高诊断。     

氧化苦参碱对胆碱酯酶影响的临床研究

目的　研究氧化苦参碱 (OM)治疗病毒性肝炎过程中 ,胆碱酯酶 (ChE)的动态变化及与同期白蛋白 (ALB)、凝血酶原活动度 (PTA)及其他肝功能的关系。方法　 98例病毒性肝炎患者分成 4组 ;A组 31例 (静脉注射OM) ,B组 30例 (口服OM) ,C组 7例 (肌内注射OM) ,D组 30例 (一般护肝药物 ,不用OM)。定期检测血清ChE、ALB、PTA、肝功能、肾功能、血常规、血清补体 1型受体 (sCR1)、红细胞黏附功能 (EIIAF)指标。结果　A、B、C 3组在治疗中ChE明显下降 ,治疗前中后比较 ,差异有显著意义 (P值分别为 <0 0 0 1、<0 0 0 1、0 0 2 3) ;同时在ChE数值及异常率与对照组比较 ,差异有显著意义(P <0 0 0 1)。A、B、C 3组在治疗前中后 ,ALB、PTA随病情而变化 (P值均 >0 0 5 )。4组治疗后病情均有明显好转 ,ChE的下降并不伴随肝功能的恶化。结论　OM制剂在治疗病毒性肝炎中ChE明显下降 ,但反映肝脏实质功能的ALB、PTA等指标无改变 ,ALT、AST、TBiL好转。在OM治疗结束后 ,ChE迅速恢复正常。所以 ,ChE的下降并不表明病情的恶化 ,其机理尚待探讨。     

Tumor Vascularity Is Not a Prognostic Factor for Malignant Melanoma of the Skin

Tumor vascularity has been proposed as a prognostic indicator for a number of solid tumors. Although a correlation between microvessel number and metastatic behavior has also been suggested for cutaneous melanoma, the small number of cases studied to date allows one to draw only preliminary conclusions. In this study, we have assessed tumor vascularity in cutaneous melanoma by comparing 60 cases of metastasizing and non-metastasizing tumors matched for tumor thickness, age, sex, and anatomic site. Ulex europaeus agglutinin I appeared to be the most suitable vascular marker for this study. Our results indicate that there was no statistically significant difference between the two groups with regard to tumor vascularity. Even after identifying 15 cases of thin (<1.0 mm thick) melanoma, there was no significant difference in the number of microvessels between metastasizing and non-metastasizing tumors. Comparison of patterns of vascular microarchitecture also failed to discriminate between the two groups. Thus, our results indicate that tumor vascularity may not be an independent prognostic factor for cutaneous melanoma.     

THE EXPLORATION ON APPLIED VALUE OF BA IN DIAGNOSIS OF TIA

目的:探讨脑电地形图在短暂性脑缺血发作诊断中的应用价值.方法:在68例短暂性脑缺血发作患者中,进行了脑电地形图检查.结果:在67(98.52%)例患者中脑电地形图是异常的.40(58.82%)的患者脑电地形图在θ或δ频段显示高功率阴影,在α频段显示低功率阴影.14(20.59%)例患者在α频段显示低功率阴影.12(17.65%)例患者在θ或δ频段显示高功率阴影.1(1.47%)例患者在β频段显示低功率阴影.1(1.47%)例患者正常.结论:脑电地形图在短暂性脑缺血发作的临床诊断中具有重要意义.     

视黄酸依赖Fas/RARα融合基因转染HL-60细胞启动的凋亡效应研究

目的：检测视黄酸依赖Fas／RARα表达载体转染HL-60细胞启动的凋亡效应。方法：成功构建视黄酸依赖Fas／RARα表达载体，用脂质体转染HL-60白血病细胞，经四甲基偶氮唑盐[3-(4，5-dimethylthiaol-2-yl)-2，5-diphenyl tetrazolium bromide,MTT]、流式细胞、DNA梯形带和透射电镜等方法观测视黄酸处理后细胞凋亡效应的发生。结果：以一定剂量的视黄酸处理HL-60后，细胞增殖受抑，呈凋亡性变。结论：视黄酸及其依赖的融合基因表达可协同诱导HL-60细胞发生凋亡效应。     

Invasive pulmonary aspergillosis: high incidence of disseminated intravascular coagulation in fatal cases.

BACKGROUND AND PURPOSE: Disseminated intravascular coagulation (DIC) is a rarely described finding in invasive pulmonary aspergillosis (IPA) with unclear impact on mortality. METHODS: This study included patients with positive cultures of Aspergillus spp. from respiratory specimens, serological evidence of aspergillosis, or lung biopsy findings supporting aspergillosis treated at National Taiwan University Hospital from January 1999 to June 2005. IPA was defined based on the consensus of the European Organization for Research and Treatment of Cancer, and the Mycosis Study Group of the National Institute of Allergy and Infectious Diseases. Univariate logistic regression analysis was used to evaluate the factors associated with mortality. RESULTS: Proven or probable IPA was diagnosed in 26 patients. Hematological malignancy was found in 11 patients (42%) and immunosuppressive agents had been administered to 17 patients (65%). Among 20 culture-proven infections (77%), the most frequently encountered fungi were Aspergillus fumigatus (46%) and Aspergillus flavus (23%). The overall mortality rate was 62%. Univariate and multivariate analyses revealed that DIC was the only factor that was significantly associated with death attributable to IPA (p<0.01). CONCLUSIONS: IPA is associated with a high mortality rate, particularly for patients with DIC.     

Quantitative Correlation between Steric Defects and Thermal Behavior in Highly Syndiotactic Polystyrene: A Study Based on DSC and 13C NMR Spectroscopy

Several syndiotactic polystyrene (sPS) samples have been synthesized by using different catalytic systems. Their stereochemistry has been determined by ¹³C NMR spectra in both the aliphatic CH₂ and aromatic C₁ resonance regions. The observed peaks have been unambiguously assigned to specific hexads and heptads, respectively, and their intensities have been used to draw the percent of defects (meso dyads) in the polymer chains. On the hypothesis that chain defects are at the origin of chain folding and thus determine the thickness of crystalline lamellae, we performed differential scanning calorimetry (DSC) analysis on the same samples, and their thermal parameters were measured. A model was developed to determine the amount of steric defects from the DSC melting‐peak profiles, and the results obtained were compared with the NMR results. A satisfactory agreement was found (correlation factor 0.96) in the explored range of defect concentrations (up to 2.5% of meso dyads). The possible influence of the extraction procedure of the amorphous fraction was found to be negligible. Thus, information on stereochemistry can be obtained from DSC experiments starting from as‐prepared (not extracted) samples.

     

Lack of increase in time to blood culture positivity in a patient with persistent methicillin-resistant Staphylococcus aureus bacteremia predicts failure of antimicrobial therapy

Time to positivity is an available parameter in automated blood culture systems. We report a patient with persistent methicillin-resistant Staphylococcus aureus bacteremia who received various regimens for treatment of methicillin-resistant S. aureus, and demonstrate that monitoring of the time to positive blood culture might be helpful in the early recognition of treatment failure.