Primary peritoneal carcinoma in a UK cancer center: comparison with advanced ovarian carcinoma over a 5-year period

Abstract.   Jaaback KS, Ludeman L, Clayton NL, Hirschowitz L. Primary peritoneal carcinoma in a UK cancer center: comparison with advanced ovarian carcinoma over a 5-year period. Int J Gynecol Cancer 2006; 16(Suppl. 1): 123–128.
The relative incidence of primary peritoneal carcinoma (PPCa) and advanced (FIGO stage III or IV) ovarian serous carcinoma (AOSCa) was assessed over 5 years at a UK cancer center, and the sociodemographic, clinical, and survival data were compared. There were 23 women with PPCa and 55 with AOSCa. The ratio of PPCa:AOSCa was higher than previously reported. No statistical difference was found between the two groups with regard to age (mean 64.43 vs 64.07 years, P = 0.9), parity (1.6 vs 1.8, P = 1.0), personal/family history of another malignancy (although five patients with AOSCa but none with PPCa had personal histories of breast cancer), or serum CA125, CA19.9, and carcinoembryonic antigen (CEA) levels. Similar numbers in both groups had malignant ascites, although 5.8% of patients with AOSCa but none with PPCa had negative cytology. Tumor grade, stage, treatment, and survival were similar (median 586 vs 641 days, P = 0.66). This analysis of the largest published UK series of patients with PPCa does not support previous reports that patients with PPCa are older than those with AOSCa and have a worse prognosis; it suggests that both groups have similar sociodemographic characteristics, clinical profiles, and survival.     

欧芹素乙和异欧芹素乙对小鼠腹腔巨噬细胞体外释放肿瘤坏死因子的抑制作用

研究了欧芹素乙（Ｉｍｐｅｒａｔｏｒｉｎ，Ｉｍｐ）和异欧芹素乙（Ｉｓｏ－ｉｍｐｅｒａｔｏｒｉｎ，Ｉｓｉ）及对照药物维拉帕米（Ｖｅｒａｐａｍｉｌ，Ｖｅｒ）对小鼠腹腔巨噬细胞体外释放肿瘤坏死因子（Ｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒ，ＴＮＦ）的影响。结果表明：Ｉｍｐ、Ｉｓｉ及Ｖｅｒ对小鼠腹腔巨噬细胞体外释放ＴＮＦ具有显著的抑制作用。药物浓度在１０－６～１０－４ｍｏｌ／Ｌ范围内，该抑制作用呈剂量依赖性：药物浓度达１０－４ｍｏｌ／Ｌ时，则可完全抑制ＴＮＦ的释放。     

腹膜透析患者应对压力的方式与焦虑抑郁情绪的关系

目的：探讨应对压力的方式与腹膜透析患者的焦虑抑郁情绪的关系。方法：采用自填式结构问卷，对81例腹膜透析患者进行调查，了解患者的一般情况和患者应对措施，同时用综合性医院焦虑和抑郁情绪量表测量他们的焦虑与抑郁情绪。结果：控制年龄等因素后的等级回归分析表明：使用“面对”和“自我缓解”应对方式显著降低患者的焦虑情绪，采用“屈从”应对方式增加焦虑的发生；文化程度高的患者采用逃避应对方式则大大增加焦虑情绪的程度，女性和经济收入高者采用面对应对方式可以大大降低焦虑情绪的发生；“自我缓解”应对方式显著降低患者抑郁情绪发生的可能性。结论：不同的应对方式对腹膜透析患者的焦虑抑郁情绪存在差异。     

连续性血液透析滤过对MODS犬肝肾IL-6和IL-10 mRNA表达的影响

目的：探讨连续性血液透析滤过（CVVHDF）后多器官功能障碍综合征（MODS）犬肝、肾组织白细胞介素-6（IL-6）和白细胞介素-10（IL-10）mRNA表达水平的变化及意义。方法：15只雄性Beagle犬,采用失血性休克＋复苏灌注＋内毒素血症复制MODS模型,随机分为CVVHDF组（n=8）和MODS组（n=7）,CVVHDF组在内毒素注射完毕后给予CVVHDF治疗12h,MODS组不给CVVHDF治疗。测定各器官功能相关指标,同时应用半定量逆转录-聚合酶链反应（RT-PCR）测定两组肝、肾组织中IL-6、IL-10mRNA表达水平。结果：CVVHDF组治疗后肝、肾功能有关指标水平均有不同程度的改善;与MODS组相比,在内毒素注射后3h及以后各时间点,血清肌酐（Scr）、尿素氮（BUN）水平显著降低（P〈0.05）;器官衰竭发生率较MODS组明显降低（37.5%vs85.7%,P〈0.05）;MODS组肝、肾组织IL-6mRNA表达水平显著高于正常对照组和CVVHDF组（P〈0.01）,而CVVHDF组肝、肾组织IL-10 mRNA表达水平显著高于正常对照组和MODS组（P〈0.01）。结论：连续性血液透析滤过能明显改善肾功能,CVVHDF早期应用可以降低MODS肝、肾组织IL-6/IL-10mRNA比值,有助于重建机体免疫系统内稳状态。     

兔膝关节持续被动活动对前交叉韧带重建术后切口局部组织血氧饱和度的影响

目的 探讨膝关节持续被动活动（continuous passive motion, CPM）对兔前交叉韧带重建术后切口局部组织血氧饱和度的影响. 方法 20 只八月龄雄性新西兰大白兔右侧后肢膝关节行自体双股半腱肌腱移植重建前交叉韧带手术,术后随机分为2组：自由活动组（n＝10）和CPM组（n＝10）.自由活动组笼内自由活动;CPM组应用兔膝关节持续被动活动器运动.术后第2天,近红外光技术装置ODISseyTM 局部组织血氧监护仪测量每一来回（屈曲30°～110°）不同CPM速度（分别为2.35°/s、3.2°/s 、8°/s）时的切口局部组织血氧饱和度（tissue oxygen saturation ,StO2）变化,选择最好的CPM范围和速度.分别在术前和术后第2、4、6、8、10、14天观察膝关节CPM不同角度时切口局部组织StO2的变化. 结果 与自由活动组相比,3种速度的CPM在不同屈曲角度下均保持较高的StO2,且有显著性差异（P＜0.05）,不同CPM速度之间StO2有显著性差异（P＜0.05）.每一来回（屈曲30°～110°）运动速度为3.2°/s时保持最高的StO2.在术前和术后第2、4、6、8、10、14天等各时间点,膝关节屈曲30°、60°、90°、110°时StO2均无显著性差异（P＞0.05）,不同的时间点（术前和术后第2、4、6、8、10、14天）切口的StO2差别均有显著统计学意义（P＜0.05）.术后第2～4天最低,然后逐渐上升.术后第2周拆线后,切口愈合良好,没有感染、血肿和切口裂开. 结论 兔膝前交叉韧带重建术后第2天开始进行膝关节CPM（屈曲30°～110°）,可增加切口局部组织血氧饱和度,以3.2°/s的CPM速度最佳.     

肾衰合剂对维持性腹膜透析患者残余肾功能的影响

目的：观察肾衰舍剂对连续不卧床腹膜透析（CAPD）患者残余肾功能的影响，探讨中药治疗对CAPD患者残余肾功能的保护作用及其机制。方法：将56例脾肾气（阳）虚型的CAPD患者随机分为常规腹膜透析对照组，及加服中药肾衰合剂治疗组。治疗6个月，比较残余肾KT／V、残余肾CCr的变化及下降速率。结果：在维持总体透析效能的前提下，治疗组残余肾KT／V、残余肾CCr下降速度较对照组明显缓慢。结论：肾衰合荆能有效延缓PD患者的RRF的下降。     

Acute Renal Failure after Lung Transplantation: Incidence, Predictors and Impact on Perioperative Morbidity and Mortality

The incidence, predictors and clinical significance of acute renal failure (ARF) after lung transplantation are not well described. We retrospectively collected data on 296 patients transplanted at our center between April 1992 and December 2000; follow-up was extended until December 2002. Patients were initially divided into two groups: ARF (doubling of baseline creatinine within 2 weeks after surgery) and NoARF. The ARF group was subdivided into ARFD (dialyzed) and ARFnD (not dialyzed). The incidence of ARF was 56% (166/296), but most cases were ARFnD (n = 143). Independent predictors of ARFD (n = 23) were: baseline GFR (OR 0.98, CI 0.96-0.99, p = 0.012), pulmonary diagnosis other than COPD (OR 6.80, CI 1.5-30.89, p = 0.013), mechanical ventilation > 1 d (OR 6.16, CI 1.70-22.24, p = 0.006) and parenteral amphotericin B use (OR 3.04, CI 1.03-8.98, p = 0.045). Both ARFnD and ARFD were associated with longer duration of mechanical ventilation, increased hospital stay and increased early mortality. One-year patient survival was 92.3%, 81.8% and 21.7% in the NoARF, ARFnD and ARFD groups, respectively (p < 0.0001). After controlling for important covariates, ARFD remained associated with an increased hazard of dying (HR 6.77, CI 4.00-11.44, p < 0.0001). In conclusion, ARF occurs commonly after lung transplantation and affects important clinical outcomes, especially when dialysis is required.     

Value of albumin dialysis therapy in severe liver insufficiency

Abstract A blood purification system, molecular adsorbents re-circulating system (MARS), is based on the removal of both protein-bound and water-soluble substances and toxins in the liver. We treated a total of 88 patients within 2 years. Of these patients, 45 had acute liver failure (ALF), 31 had acute decompensation of chronic liver disease, eight had graft failure and four had miscellaneous conditions. Of the patients with ALF, 80% survived; in 23 patients their own liver recovered and 13 patients underwent successful transplantation. Only 23% of patients with acute-on-chronic liver failure survived. Most of them were not considered for transplantation due to their having liver failure from alcoholism and from not abstaining from drinking. MARS is a promising therapy for ALF, allowing the patient's own liver to recover or allowing enough time to find a liver graft. Best results were achieved in patients who had been intoxicated with a lethal dose of toxin. On the other hand, we did not observe much benefit in patients with severe acute-on-chronic liver failure (AcoChr) who did not undergo liver transplantation.     

胰岛素泵在肝移植术后糖代谢异常的应用研究

目的探讨肝移植围手术期糖代谢异常的不同处理方法。方法肝移植手术后糖代谢异常患者27例，随机分为连续皮下胰岛素输注组（Continuous subcutaneous insulin infusion，CSII）与多次皮下注射胰岛素组（Multiple daily subcutaneous injection，MDSI）。对两组患者住院期间的血糖控制情况、血糖达标时间、院内感染率、伤口愈合时间、胰岛素用量、低血糖的发生率以及术后半年的糖代谢状态进行比较。结果两组患者血糖均可以达到目标值，CSII组较MDSI组每天胰岛素用量少，血糖达标时间短，切口愈合时间短，院内感染率低。两组患者术后半年的糖代谢状态无显著差异。结论对肝移植术后糖代谢异常的控制，胰岛素泵较传统的多次皮下注射胰岛素更有优势。     

Increased NoGo-anteriorisation in first-episode schizophrenia patients during Continuous Performance Test

OBJECTIVE: NoGo-stimuli during a Continuous Performance Test (CPT) activate prefrontal brain structures such as the anterior cingulate gyrus and lead to an anteriorisation of the positive electrical field of the NoGo-P300 relative to the Go-P300, so-called NoGo-anteriorisation (NGA). NGA during CPT is regarded as a neurophysiological standard index for cognitive response control. While it is known that patients with chronic schizophrenia exhibit a significant reduction in NGA, it is unclear whether this also occurs in patients undergoing their first-episode. Thus, the aim of the present study was to determine NGA in a group of patients with first-episode schizophrenia by utilizing a CPT paradigm. METHODS: Eighteen patients with first-episode schizophrenia and 18 matched healthy subjects were investigated electrophysiologically during a cued CPT, and the parameters of the Go- and NoGo-P300 were determined using microstate analysis. Low resolution tomography analysis (LORETA) was used for source determination. RESULTS: Due to a more posterior Go- and a more anterior NoGo-centroid, NGA was greater in patients than in healthy controls. LORETA indicated the same sources for both groups after Go-stimuli, but a more anterior source in patients after NoGo-stimuli. In patients P300-amplitude responses to both Go- and NoGo-stimuli were decreased, and P300-latency to NoGo-stimuli was increased. After the Go-stimuli false reactions and reaction times were increased in patients. CONCLUSIONS: Attention was reduced in patients with first-episode schizophrenia, as indicated by more false reactions, prolongation of reaction time, P300-latencies and by a decrease in P300-amplitude. Significantly however, the NGA and prefrontal LORETA-sources indicate intact prefrontal brain structures in first-episode schizophrenia patients. Previously described changes in this indicator of prefrontal function may be related to a progressive decay in chronic schizophrenia. SIGNIFICANCE: The results support the idea of a possible new biological marker of first episode psychosis, which may be a useful parameter for the longitudinal measurement of changing prefrontal brain function in a single schizophrenia patient.