Skala Warszawska A–E oceny endoskopowych zmian w krtani związanych z refluksem gardłowo-krtaniowym. Korelacja ze skalą patologii refluksowej (RFS)

Introduction

Changes associated with laryngopharyngeal reflux (LPR) are usually related to the posterior part of the larynx and called “posterior laryngitis”. Pathologic reflux-induced mucosal changes within the larynx are easily detected with the use of videolaryngoscopy (VLS). To the multitude of described changes within the larynx that are associated with the existence of LPR Belafsky introduced assessment with 26 scale points describing changes in the larynx (RFS; reflux finding score).

Aim of the study

The aim of this study was to introduce our proposal of a new scale of endoscopic pharyngo-laryngeal findings associated with laryngopharyngeal reflux named Warsaw A–E scale. For that reason the new scale was compared to the RFS scale of Belafsky.

Material and method

A total of 249 patients were involved in this restospective study. The reflux disease was confirmed by gastroenetrologists. Larynx was evaluated with the use of videolaryngoscopy. Morphological changes within the larynx and pharynx were assessed using 1) the RFS scale according to Belafsky, 2) and using our proposed scale named Warsaw A–E scale. The results were compared.

Results

All patients received at least 7 points in RFS scale of Belafsky. Using Warsaw A–E scale, there were no patients found with the videolaryngoscopic image of the larynx classified as A type. In both the women's group, as well as the group of men prevailed type C. The comparison of the two scales showed correlation between them.

Conclusions

The study showed a statistically significant correlation of Warsaw A–E scale of laryngopharyngeal changes with a commonly used scale of RFS according to Belafsky. It was found that the Warsaw A–E scale is easier to use and less time consuming.     

Expression of Lewis y antigen and integrin αv, β3 in ovarian cancer and their relationship with chemotherapeutic drug resistance

Objective

This study investigates the expression of Lewis y antigen, integrin αv, β3 in epithelial ovarian cancer tissues. We further evaluate the relationship between their expression and chemotherapy resistance of ovarian cancer and its possible clinical significance.

Methods

Tissues of 92 patients with ovarian cancer meeting the inclusion criteria with complete follow-up data were enrolled and divided into chemotherapy resistant group and sensitive group. The expression and relationship of Lewis y antigen and integrin αv, β3 are assessed in paraffin sections using immunohistochemistry and double-labeling immunofluorescence method. Multivariate logistic regression analysis was used to investigate the relationship between age, clinical stage, differentiation, histologic subtype, Lewis y antigen and integrin αv, β3 expression in ovarian cancer patients.

Results

The expression rates of Lewis y antigen and integrin αv in the resistant group, significantly higher than the rates found in the sensitive group (p <0.05). Multivariate analysis showed that the expression of Lewis y antigen, integrin αv and ovarian cancer’s clinical stage were independent, drug resistance-related risk factors. The expression levels of Lewis y antigen and integrin αv, β3 were positively correlated with each other.

Conclusions

A close correlation between Lewis y antigen, integrin αv, β3 and ovarian cancer was observed. Lewis y antigen can influence the biological behavior of a tumor cell as an important composition of integrin αv, β3 by some signal pathway. And the expression of Lewis y antigen, integrin αv and ovarian cancer’s clinical stage are both independent, drug resistance-related risk factors.     

Actitudes de las personas usuarias de atención primaria ante el cribado del cáncer colorrectal

Objective

To describe the cultural, social and gender features that determine attitudes to colorectal cancer screening in a target group of patients aged 50 to 69 years old in the primary health care setting.

Methods

We performed a qualitative ethnographic study from a gender perspective. Participants consisted of men and women aged 50 to 69 years old in the Balearic Islands and Barcelona. Group discussion and a field diary were used.

Results

The key element was diagnosis at an early stage. Until recently, cancer was considered an incurable disease but is currently perceived as a serious health problem that can be cured if diagnosed promptly. The participants requested more information on cancer and felt they were at risk, mainly because of their age. Men tended to pay attention to symptoms while women tended to ignore them. Attitudes to colorectal cancer screening were generally positive, even to colonoscopy. Some barriers to screening were identified in women, such as a fear of having cancer.

Conclusions

The opportunity for early diagnosis is the key element in promoting participation in a colorectal cancer screening program. Perceptions-and hence willingness to participate in screening-differ between men and women. Factors to be taken into account in the design of population-based colorectal cancer programs are health concerns in men and fear of a cancer diagnosis in women.     

Mental Health Self-Assessment in Patients With Moderate to Severe Psoriasis: An Observational,Multicenter Study of 1164 Patients in Spain (The VACAP Study)

BackgroundPoor self-assessed mental health appears to be related to the severity of psoriasis.ObjectiveTo evaluate the impact of psoriasis severity on mood and anxiety disorders.MethodsA prospective, observational, multicenter study was conducted by 123 dermatologists in Spain. Patients (n = 164; mean [SD] age, 45.11 [13.92] years; 60.8% males) with moderate to severe psoriasis were evaluated at baseline and 4 months later. Psoriasis severity was measured using the Psoriasis Area and Severity Index (PASI), with a score range of 0 (mild) to 72 (severe); body surface area involvement (BSA); and physician global assessment (PGA) scores, with a range of 1 (mild) to 7 (severe). Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with a total possible score of 0–42 (higher scores representing worse mental health). Mean first and second visit scores were compared.ResultsMean (SD) scores improved between the first and second visit as follows: 13.24 (9.50) to 5.07 (6.03) for PASI, 12.52 (7.92) to 10.78 (7.32) for overall HADS, 7.83 (4.55) to 6.85 (4.21) for the HADS anxiety subscale, and 4.72 (4.12) to 3.95 (3.76) for the HADS depression subscale (P < .001 in all cases). Multivariate analyses showed that the main factors related to anxiety were psoriasis severity, sex, and completion of graduate studies. The independent variables included in the model for depression were psoriasis severity, sex, and psoriasis located on the head.ConclusionsReductions in disease severity improve self-assessed mood and anxiety disorders in patients with moderate to severe psoriasis.     

大鼠坐骨神经ATP受体mRNA表达的实验研究

目的：证实大鼠坐骨神经上ATP受体P2y的分布 。方法：梨状肌下缘以远5mm处切取长5mm的坐骨神经，同时切取主动脉3mm作阳性对照；组织总mPNA提取，RT-PCR cDNA第一链合成，反应所得产物于2%琼脂糖凝胶电泳，1цg/ml溴化乙啶染色（EB），观察，照相。结果：在大鼠坐骨神经上有3种ATP受体亚型表达（P2y2、P2y4和P2y6mRNA表达）。结论：大鼠坐骨神经上有3种ATP受体亚型分布，细胞我ATP可能通过此三种受体或其中之一完成轴突诱向作用，P2y受体与神经损伤修复有关。     

下腔静脉螺旋CT扫描方法初探

目的　探讨下腔静脉CT增强扫描 (CTA)方法和技巧。方法　使用PICKER60 0 0单螺旋CT扫描机 ,扫描层厚 3 .0～ 4.0mm ,螺距 1.2 5～ 1.5,间隔 1.5～ 2 .0mm ,应用Smooth功能对 12例病人进行下腔静脉CT增强扫描。结果　所有病例 10 0 %获得了满意的图像 ,经VOXEL工作站重建后 ,能够清楚显示下腔静脉正常解剖结构和阻塞的部位、范围及其阻塞程度。 12例经数字减影血管造影 (DSA)或 和手术对比证实的病例中 ,CTA显示病变的准确性是 91.67%。结论　高质量的下腔静脉CTA图像依赖于注药后扫描的时机准确性、扫描参数设置的合理性 ,正确的扫描方法以及操作者的技巧和熟练程度     

急性重症胰腺炎围手术期并发症与预后临床分析

目的探讨急性重症胰腺炎(severeacutepancreatitis,SAP)各种围手术期并发症与预后的关系。方法通过对我院近10年间行了外科手术治疗的116例SAP回顾调查,分析SAP围手术期各种并发症的发生率及其与SAP预后的关系。结果治愈85例(73.28%),死亡31例,病死率为26.72%;发生各种并发症232次,其中合并ARDS、胰性脑病、休克、腹腔出血和全身感染等并发症患者的病死率较高,分别为52%、40%、40.63%、66.67%和73.68。结论围手术期SAP并发症较多,严格掌握手术适应证特别重要;在各种并发症中ARDS、胰性脑病、休克、腹腔出血和感染等是死亡的主要原因。     

B超及血清CA125在子中肌腺症诊断中的作用探讨

目的：研究血清CA125及B超在子宫肌腺症诊断中的作用，提高子宫肌腺症的术前诊断率。方法：对经病理证实的93例子宫肌腺症及132例子宫肌瘤病人术前B超及血清CA125的情况进行比较。结果：子宫肌腺症组平均务清CA125值＞35u/ml，子宫肌瘤组平均血清值＜35u/ml，两组血清CA125检测有显著差异（P＜0．01），B直声像中子宫肌腺症表现为子宫均匀增大，后壁增厚，肌层回声不均等，子宫肌瘤表现为子宫不规则增大，瘤体回声均匀边界清晰。结论：血清CA125是来源于体腔上上细胞的表面抗原，其浓度与子宫内膜的发育密切相关，测定血清CA125＞35u/ml对诊断子宫肌腺症有重要意义，B超是示子宫均匀增大，子宫后壁较厚，实质回声紊乱分布不均等高度提示子宫肌腺症可能。两者结合可于提高子宫肌瘤症的术前诊断率，降低误诊率。     

女子田径运动员免疫细胞对不同运动负荷应答及恢复的特征

目的:观察女子田径运动员免疫细胞对不同运动负荷的应答性变化特征,探讨其可能机制。方法:在陕西省田径队女子400m跑运动员(n=9)大运动量、大强度训练前后,应用YSI-1500SPORT血乳酸自动分析仪测定全血乳酸含量及应用METBC-2000全自动血球分析仪对血液免疫指标(白细胞总数;淋巴细胞;中性粒细胞;单核-巨噬细胞)进行测定。结果:①大运动量训练后即刻,淋巴细胞显著升高(t=2.31,P<0.05),白细胞计数、中性粒细胞非常显著升高(t=7.07～7.15,P均<0.01以上),单核细胞高于运动前64%,但无显著性差异(t=1.59,P>0.05),恢复3h后,白细胞计数回降幅度不大(t=5.46,P<0.01),中性粒细胞在继续升高,达运动前的2.3倍(t=5.10,P<0.01),单核细胞、淋巴细胞已恢复到运动前水平。②比赛后即刻,白细胞计数,淋巴细胞、中性粒细胞在赛后即刻分别显著高于比赛前71%,66%,120%(t=3.04～4.84,P均<0.01),单核细胞高于赛前65%,但无显著性差异(t=2.23,P>0.05),恢复3h后,白细胞计数回降幅度不大(t=3.56,P<0.01),中性粒细胞在继续升高,达比赛前的2.2倍(t=7.59,P<0.01),单核细胞、淋巴细胞已恢复赛前水平。③两种负荷运动后24h,各指标均基本恢复。结论:免疫细胞在不同运动负荷后均会上升,但上升幅度间差异非常大,表明应答不仅影响循环池中白细胞     

Touched in sensation – moved by respiration

The aim of this theoretical article is to elaborate on the underpinning of Norwegian psychomotor physiotherapy (NPMP). With a narrative and hermeneutic point of departure, we explore the unfolding of a 10‐year‐long treatment by analysing a particular narrative from this treatment context in relation to some foundational perspectives on movement, sensation and time. A woman in her late thirties suffering from muscular tensions and pain, depression, anxiety and anorexia, came for NPMP. The investigation of her treatment experience is based on the journal written by her physiotherapist and first author of this article. We suggest that new experiences in movement and sensation as well as changes in movement patterns can contribute to retuning in sensation and restructuring of narrative time. Feeding the fictional space and narrative fantasy with new experiences in movement and sensation can help counteracting delusional ideas and assist changes, supporting embodied narrative identity. Ingrid’s experience is discussed in the light of Trygve Braatøy’s understanding of muscular functions, Knud E Løgstrup’s phenomenology of sensation and Paul Ricouer’s narrative time.