Neural basis of auditory expectation within temporal cortex

Predictive coding frameworks of perception propose that neural networks form predictions of expected input and generate prediction errors when the external input does not match expectation. We therefore investigated the processing of unexpected sounds and silence in the auditory cortex using fMRI. Unexpected sounds, when compared to expected sounds, evoked greater activation in large areas of the left temporal and insular cortices. Additionally the left middle temporal gyrus exhibited greater activation to unexpected events in general, whether sounds or silence, when compared to the corresponding expected events. These findings support predictive coding models of perception, which suggest that regions of the temporal cortex function to integrate sensory information with predictive signals during auditory perception.     

Pretreatment cortisol levels predict posttreatment outcomes among older adults with depression in cognitive behavioral therapy

Previous studies suggest that individuals with elevated levels of cortisol (the “stress hormone”) could be particularly resistant to treatment for depression. However, most of these studies have been conducted in the context of antidepressant medications, and no study has examined pretreatment cortisol levels as a predictor of treatment outcomes among older adults with depression in cognitive-behavioral therapy (CBT), despite the relevance of this population for such a research question. The current study includes 54 older adults with depression who provided salivary cortisol samples at baseline and completed measures of depression at pretreatment and posttreatment, following a 12-week course of CBT. Structural equation modeling results suggest that those with higher daily outputs of cortisol and flatter diurnal slopes were less likely to benefit from CBT—a finding which if replicated could have important implications for clinical practice and future research.     

Synthesis and Properties of Polyethylene‐Bound Antioxidants

Four novel well‐defined polyethylene‐bound antioxidants (PE‐bound antioxidants) with distinct secondary structures are synthesized via transesterification reactions between methyl 3‐(3,5‐di‐tert‐butyl‐4‐hydroxyphenyl)propionate and hydroxyl‐terminated polyethylenes. The results of thermal gravimetric analysis under an air atmosphere demonstrate that the thermal stabilities of PE‐bound antioxidants are higher than that of commercial antioxidant Irganox1076 and are strongly related to their chemical structures. Particularly, the most thermally stable PE‐bound antioxidant is the one bearing both primary and secondary antioxidant moieties. The antioxidant activities of the PE‐bound antioxidants are evaluated in polypropylene by their melt flow index.

     

Blood transfusions in colorectal cancer surgery: incidence,outcomes, and predictive factors: an American College of Surgeons National Surgical Quality Improvement Program analysis

Background

Data analyzing the short-term outcomes and predictors of blood transfusions (BTs) in colorectal cancer (CRC) surgery are limited.

Methods

The American College of Surgeons National Surgical Quality Improvement Program (2005 to 2010) was retrospectively reviewed for CRC cases performed with or without BT. Patient demographics, comorbidities, and operative variables were analyzed. Multivariate regression analysis was performed examining the effect of BT on outcomes. The LASSO algorithm for logistic regression was used to build a predictive model for BT taking into account preoperative and operative variables.

Results

A total of 27,120 patients underwent CRC, and 3,815 (14.07%) had BTs. Transfusions were associated with increased mortality (odds ratio [OR], 1.78), morbidity (OR, 2.38), length of stay (mean difference, 3.52 days), pneumonia (OR, 2.70), and surgical-site infection (OR, 1.45). This effect was “dose dependent,” as patients receiving ≥3 U of blood had increased morbidity (OR, 1.53), lengths of stay (mean difference, 1.82 days), pneumonia (OR, 2.52), and surgical-site infections (OR, 1.60) compared with those receiving 1 to 2 U. Predictors of BT were hematocrit <38%, open surgery, proctectomy, low platelet count, American Society of Anesthesiologists class IV or V, total colectomy, metastatic cancer, emergency, ascites, and infection. All P values were < .05.

Conclusions

BTs are associated with worse short-term outcomes after CRC surgery. Knowledge of predictive factors will help in risk stratification and counseling.     

Full-mouth profile of active MMP-8 in periodontitis patients

Kraft‐Neumärker M, Lorenz K, Koch R, Hoffmann T, Mäntylä P, Sorsa T, Netuschil L. Full‐mouth profile of active MMP‐8 in periodontitis patients. J Periodont Res 2012; 47: 121–128. © 2011 John Wiley & Sons A/S Background and Objective: MMP‐8 in gingival crevicular fluid is considered as a protease with high destructive potential because of its ability to degrade collagen in periodontitis‐affected patients. The aim of this study was to investigate whether there was a relationship between clinical diagnostic parameters and the concentration of active MMP‐8 (aMMP‐8) in gingival crevicular fluid in a site‐level full‐mouth analysis. Based on these data, the prognostic value of aMMP‐8 levels in relation to pocket depth may be evaluated. Material and Methods: Clinical measurements of pocket depth, bleeding on probing (BOP), plaque index (PlI) and gingival index (GI), as well as samples of gingival crevicular fluid, were obtained from four sites of each tooth of nine healthy female patients with chronic generalized periodontitis. The aMMP‐8 concentration in gingival crevicular fluid was quantified by ELISA using specific monoclonal antibodies. Multiple linear regression models for the single measures of aMMP‐8 and pocket depth were calculated with GI and BOP as additional variables. Results: Between 92 and 112 recordings were obtained for each parameter in each patient. Mean values of between 31.5 and 88.8% were calculated for pocket depths of ≥ 4 mm. Mean pocket depths ranged from 3.11 to 4.73 mm, the mean BOP values ranged from 34.0 to 96.7% and the mean full‐mouth gingival crevicular fluid aMMP‐8 concentration ranged from 3.2 to 23.7 ng/mL. Conclusion: In this sample of female periodontitis patients, a broad range of intra‐individual and interindividual aMMP‐8 values was found. Although the explained variance was rather weak, a statistically significant relationship between aMMP‐8 and pocket depth was proven.     

乳腺癌脑转移预测模型的研究

目的 探讨乳腺癌患者发生脑转移的危险因素和利用Logistic回归模型预测乳腺癌脑转移概率.方法 对165例乳腺癌患者的年龄、分期、雌激素受体(ER)、孕激素受体(PR)及人类表皮生长因子受体-2(Her-2)评分、月经状态、是否进行辅助化疗、远处第一转移灶、无转移生存期进行分析,建立乳腺癌脑转移预测模型.结果 确诊年龄＜ 35岁、腋淋巴结转移数≥4个、ER阴性、Her-2阳性是乳腺癌发生脑转移的独立危险因素(P＜0.05).获得的预测模型的预测能力为0.783±0.037,预测脑转移发生的灵敏度、特异度可分别达0.786和0.765.结论 临床可利用该模型预测乳腺癌患者脑转移的概率,且预测概率≥0.75.     

支气管肺泡灌洗液中几丁质酶样蛋白YKL-40对儿童难治性肺炎支原体肺炎的预测价值

目的 探讨支气管肺泡灌洗液（bronchoalveolar lavage fluid,BALF）中几丁质酶样蛋白YKL-40对儿童难治性肺炎支原体肺炎（refractory Mycoplasma pneumoniae pneumonia,RMPP）的预测价值。方法 50例普通型肺炎支原体肺炎（Mycoplasma pneumoniae pneumonia,MPP）和22例RMPP患儿纳入研究。比较两组患儿的临床特征、实验室检查结果、影像学表现及BALF中YKL-40水平的差异;采用受试者工作特征曲线分析BALF YKL-40对RMPP的预测价值。结果 RMPP组发热、气促、肺实变及胸腔积液的发生率明显高于普通型MPP组（P < 0.05）,血清C-反应蛋白和乳酸脱氢酶水平明显高于普通型MPP组（P < 0.05）。RMPP组BALFYKL-40水平明显高于普通型MPP组（P < 0.05）。以BALF YKL-40水平绘制受试者工作特征曲线,其曲线下面积为0.750,预测RMPP的灵敏度为72.7%,特异度为64.0%。结论 RMPP患儿BALF YKL-40表达水平增高;BALF YKL-40对RMPP具有一定的预测价值。     

2型糖尿病家系一级亲属代谢综合征相关代谢指标情况分析

目的 分析比较2型糖尿病（T2DM）家系一级亲属同胞的代谢综合征（MS）相关代谢指标情况.方法 研究组（41个T2DM家系一级亲属同胞）及对照组按CDS2004年建议标准分别进一步分为：不伴MS组、伴MS组.分析比较研究组和对照组伴MS和不伴MS者空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1e）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、体重指数（BMI）、腰围、收缩压（SBP）、舒张压（DBP）等MS相关代谢指标情况.结果 2型糖尿病家系一级亲属同胞在发生MS后其MS相关代谢指标的异常程度较非T2DM家系一级亲属同胞发生MS者更严重（P＜0.05）.即使在未患MS的T2DM家系一级亲属同胞与对照组比较,MS相关代谢指标也存在统计学意义（P＜0.05）.结论 T2DM家系一级亲属同胞MS相关代谢指标存在早期紊乱倾向.2型糖尿病家系一级亲属同胞应早期随访、监测,干预体质量指数、血糖、血脂、血压等代谢指标.     

预见性护理对不稳定心绞痛患者护理满意度及临床疗效的影响

目的探究不稳定心绞痛患者引进预见性护理模式的临床效果,并为该院新的护理理念的开展提供实践指导。方法选取该院于2010年8月-2012年10月收治的76例不稳定心绞痛患者,采取随机数字表法进行分组,分别设为研究组和对照组,每组各38例。其中对照组实施常规心内科护理措施,研究组实施预见性护理方案。结果研究组临床疗效高于对照组,差异有统计学意义（P〈0．05）。研究组患者满意度高于对照组,差异有统计学意义（P〈0．05）。结论预见性护理能够促进患者预后康复,提高治疗效果,同时还可增强护患关系,提升护理满意度,实现医院与患者的双赢效益。     

脾切除治疗原发性免疫性血小板减少症70例疗效分析

目的 探索原发性免疫性血小板减少症患者行脾切除术的疗效、并发症及其影响疗效的因素.方法 选择2007年12月至2012年12月间于哈尔滨医科大学附属第二医院行脾切除术治疗的原发性免疫性血小板减少症70例（其中5例附加副脾摘除术）,分析患者术后疗效及其并发症,同时对脾切除术后的长期疗效进行随访,评估影响疗效的因素.结果 全部70例患者中,脾切除术后完全反应54例（77.1％）,有效12例（17.2％）,无效4例（5.7％）.其中年龄、病程、性别、脾脏有无肿大、有无副脾、术前有无出血无统计学意义,骨髓巨核细胞计数、术后血小板峰值具有统计学意义,术前对激素的反应及术前血小板计数具有重要的临床价值.结论 脾切除治疗原发性免疫性血小板减少症是一种安全而有效的治疗方法,术前激素的治疗效果及术前血小板计数可作为脾切除术的疗效预测指标.