Transarterial Chemoembolization vs Radioembolization for Neuroendocrine Liver Metastases: A Multi-Institutional Analysis

1. Download : Download high-res image (207KB)
2. Download : Download full-size image

     

Innovations ‘Out of Place’: Controversies Over IVF Beginnings in India Between 1978 and 2005

ABSTRACT

In 1978, the year the first in vitro fertilization (IVF) baby was born in the United Kingdom, a research team in Kolkata reported that it too had successfully produced an IVF baby in India. However, the claim was dismissed at the time, because the experiment was conducted outside authorized institutions and recognized centers of innovation—in short, because it was an innovation ‘out of place.’ Tracing controversies over the case between 1978 and 2005, I show the importance of space or place in processes of knowledge production and recognition. Further, I explain the initial repudiation and subsequent partial recognition of the claim through shifts in the landscape of legitimate spaces of innovation. By discussing this specific case of the production of science and technology in the Global South, I challenge conventional narratives of diffusion that are prevalent in studies on the worldwide proliferation of reproductive technologies.     

Sex-discrete role of depressive symptomatology on 10-year first and recurrent cardiovascular disease incidence: results from ATTICA and GREECS prospective studies

ObjectiveThe sex-specific effect of depressive symptomatology on 10-year first and recurrent cardiovascular disease (CVD) events was evaluated.MethodsThe Greek samples from ATTICA (2002-2012, n = 845 free-of-CVD subjects) and GREECS (2004-2014, n = 2,172 subjects with acute coronary syndrome (ACS)) prospective epidemiological studies with baseline psychological assessments were used for the first and the recurrent event, respectively. Depressive symptomatology was assessed at baseline, through Zung Self-Rating Depression Scale in the ATTICA study, and through the Center for Epidemiological Studies-Depression scale in the GREECS study.ResultsACS as well as free-of-CVD women scored significantly higher for depressive symptomatology. Men scored higher than women against first (19.7% vs. 11.7%) and subsequent CVD events (38.8% vs. 32.9%). In participants with depressive symptoms man-to-woman first and recurrent CVD event rate ratio was below 1, confirming that depressive women were more likely to have a CVD event than depressive men. Multiadjusted analysis revealed that depressive symptomatology had an independent aggravating effect on the first (hazard ratio (HR) = 2.72, 95% confidence interval (95% CI) 1.50, 9.12) and recurrent (HR = 1.31, 95% CI 1.01, 1.69) CVD events only in women. Mediation analysis in women revealed that 35% (23%, 44%) of excess first-CVD-event risk of depressive symptoms was attributed to conventional risk factors. The respective number for recurrent CVD events was 46% (23%, 53%); different patterns of ranking regarding the mediating effect corresponding to each adjustment factor were observed.ConclusionsThe present work augments prior evidence that psychological stressors possess important drivers of CVD onset and progression mainly in women, while it gives rise to research toward unidentified paths behind this claim.     

早期康复护理和功能锻炼在骨创伤患者术后的应用效果

目的探究早期康复护理和功能锻炼应用于骨创伤患者术后效果。方法选取2018年1月—12月本院收治的60例骨创伤手术患者,随机分成观察组与对照组,各组30例。对照组患者接受常规护理,观察组患者实施术后康复护理及功能锻炼。对比两组护理效果。结果观察组的骨折愈合时长与住院时长都短于对照组,差异有统计学意义(P<0.05)。干预6个月后的,观察组的焦虑评分、抑郁评分、疼痛评分以及总分都优于对照组,差异有统计学意义(P<0.05)。结论针对骨创伤手术患者,应用术后康复护理与功能锻炼,可以有效加快患者骨折愈合速度,减轻患者的关节疼痛,促进尽快恢复关节功能,效果突出,推动患者尽早恢复健康。     

金匮肾气丸临症加减治疗甲状腺功能减退临床观察

目的探究甲状腺功能减退(甲减)患者实施重要金匮肾气丸随症加减治疗的临床疗效及对甲状腺功能的影响。方法从2018年4月-2019年7月期间在本院进行治疗的甲减患者中随机抽取84例参与研究,根据数字表法随机分成观察组和对照组,每组42例患者。对照组采用常规西医疗法,观察组在西医疗法基础上采用金匮肾气丸随症加减治疗。就两组患者治疗前后的中医症状积分、甲状腺功能指标、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)进行对比分析。结果治疗后两组患者中医正装积分显著低于治疗前,且观察组患者中医症状积分显著低于对照组,差异有统计学意义(P<0.05);治疗后两组游离三碘甲状腺原氨酸(free triiodothyronine,FT3)和游离四碘甲状腺原氨酸(free tetraiodothyronine,FT4)水平高于治疗前,促甲状腺激素(thyroid stimulating hormone,TSH)水平显著低于治疗前,且观察组患者治疗后FT3和FT4水平高于对照组,TSH水平显著低于对照组,差异有统计学意义(P<0.05);治疗后两组患者的TPOAb和TGAb水平均明显低于治疗前,且观察组患者治疗后的TPOAb和TGAb水平低于对照组,差异有统计学意义(P<0.05)。结论甲减患者的临床治疗中给药金匮肾气丸能够有效改善患者的症状体征,改善其异常的甲状腺激素、TPOAb和TGAb水平,可促进患者尽快恢复。     

枸杞多糖对大鼠角膜缘干细胞体外增殖的影响研究

目的通过体外分离和培养大鼠角膜缘干细胞(Limbal Stem Cells, LSCs)，观察枸杞多糖(Lyciumbarbarum Polysaccharide, LBP)对LSCs体外增殖的影响，为中药体外培养LSCs的研究提供实验资料。 方法体外分离和培养LSCs，显微镜观察LSCs的细胞形态特征，通过免疫荧光检测转录因子p63初步鉴定大鼠LSCs；分对照组和枸杞多糖处理组，每组20例，免疫印迹检测增殖细胞核抗原(Proliferating Cell Nuclear Antigen, PCNA)，初步探讨枸杞多糖对LSCs的增殖影响。 结果镜下观察LSCs体积小，呈多边形或椭圆形，胞核较大，核质比例大，免疫荧光结果显示体外分离的LSCs可表达p63(阳性率为76.41±1.66%)；枸杞多糖处理后LSCs的PCNA蛋白的表达水平高于对照组，并且随着枸杞多糖浓度的增加，PCNA蛋白的表达升高(P<0.05)。 结论枸杞多糖对LSCs的增殖和生长具有促进和维持的作用。     

500例老年科病区药学服务的帕累托图分析

目的： 回顾分析老年科病区药学服务记录，找出需要重点关注的内容，以便优化药学服务模式。方法： 收集2018年5月-2019年7月的老年科药学服务记录，采用Excel软件绘制帕累托图，对各类药学服务内容类别和所涉及的药品类别进行统计，以区分出构成老年病区药学服务内容和药品类型的主要因素、次要因素及一般因素。结果： 帕累托图分析结果显示，用法用量指导与干预、用药依从指导、药物选择指导构成药学服务内容的主要因素；心血管系统药物、血液及造血系统药物、主要作用于中枢神经系统药物、抗感染药物、激素及其有关药物构成药物类别的主要因素。结论： 采用帕累托图进行统计和分析，可迅速直观地了解临床药师服务的重点内容及重点关注的药物，为多重用药管理切入点的选择提供数据参考，使药师更好地在老年综合评估团队中发挥作用。     

Restoration of functional network state towards more physiological condition as the correlate of clinical effects of pallidal deep brain stimulation in dystonia

BackgroundDeep brain stimulation of the internal globus pallidus (GPi DBS) is an invasive therapeutic modality intended to retune abnormal central nervous system patterns and relieve the patient of dystonic or other motor symptoms.ObjectivesThe aim of the presented research was to determine the neuroanatomical signature of GPi DBS modulation and its association with the clinical outcome.MethodsThis open-label fixed-order study with cross-sectional validation against healthy controls analysed the resting-state functional MRI activity changes induced by GPi DBS in 18 dystonia patients of heterogeneous aetiology, focusing on both global (full brain) and local connectivity (local signal homogeneity).ResultsCompared to the switched-off state, the activation of GPi DBS led to the restoration of global subcortical connectivity patterns (in both putamina, diencephalon and brainstem) towards those of healthy controls, with positive direct correlation over large-scale cortico-basal ganglia-thalamo-cortical and cerebellar networks with the clinical improvement. Nonetheless, on average, GPi DBS also seemed to bring local connectivity both in the cortical and subcortical regions farther away from the state detected in healthy controls. Interestingly, its correlation with clinical outcome showed that in better DBS responders, local connectivity defied this effect and approached healthy controls.ConclusionsAll in all, the extent of restoration of both these main metrics of interest towards the levels found in healthy controls clearly correlated with the clinical improvement, indicating that the restoration of network state towards more physiological condition may be a precondition for successful GPi DBS outcome in dystonia.