大肠癌组织中血管生成与凋亡、增殖的关系

目的　研究血管内皮生长因子 (VEGF)、微血管密度 (MVD)在大肠癌组织中的表达 ,并探讨血管生成与细胞增殖和凋亡的关系。方法　应用RT PCR检测 5 2例大肠癌组织 ,4 8例癌旁黏膜组织中VEGFmRNA表达 ,序列分析验证PCR扩增的正确性 ;免疫组化法检测 5 2例大肠癌组织中VEGF蛋白的表达及MVD、凋亡指数 (AI)和增殖指数 (PI)。结果　大肠癌组织中VEGFmRNA阳性表达率为 76 .9% ,癌旁组织为 5 2 .1 % (P <0 .0 1 ) ,VEGFmRNA在大肠癌远处转移组表达高于无转移组 (P <0 .0 5 ) ,DukesD期高于DukesA、B期 ,差异有显著性 (P值均 <0 .0 1 )。扩增的VEGF与人VEGF序列具有 98%的同源性。大肠癌组织中VEGF蛋白阳性表达率为 5 5 .8% (2 9/5 2 )。VEGF表达阳性组的MVD(2 1 .1± 8.2 )与阴性组 (1 3.9± 5 .0 )比较差异有显著性 (P <0 .0 1 ) ,阳性组PI(5 6 %± 2 1 % )与阴性组(4 2 %± 1 6 % )比较差异有显著性 (P <0 .0 5 ) ,阳性组AI(0 .86 %± 0 .4 2 % )与阴性组 (0 .95 %± 0 .36 % )比较差异无显著性 (P >0 .0 5 )。VEGF表达与MVD(r=0 .5 39,P <0 .0 1 )、PI(r =0 .4 0 9,P <0 .0 1 )呈正相关 ,而与AI(r=- 0 .2 6 4 ,P >0 .0 5 )无明显相关关系。结论　VEGF不仅与大肠癌的血管生成有关 ,而且在大肠癌的细胞增殖中起     

缺氧诱导因子-2α在胃癌组织中的表达及临床意义

目的:探讨缺氧诱导因子-2α(hypoxia inducible factor-2α, HIF-2α)在胃癌组织中的表达及其临床意义.方法:采用免疫组织化学和逆转录聚合酶链反应检测36例胃癌及正常胃黏膜上皮组织中HIF-2α蛋白及mRNA的表达, 并分析其表达与胃癌临床病理特征的关系.结果:HIF-2α蛋白在胃癌组织中的阳性表达率显著高于正常胃黏膜上皮(83.3% vs 8.3%,P <0.05), 并且其在胃癌组织中的阳性表达率随分化程度的降低而显著增高(P <0.05);在有淋巴结转移组中HIF-2α蛋白的阳性表达率显著高于无淋巴结转移组(91.3% vs 69.2%,P <0.05). HIF-2α mRNA在胃癌组织中的阳性表达率及表达水平均显著高于正常胃黏膜上皮(77.8% vs 5.6%, 0.755±0.238 vs 0.581±0.147, 均P <0.05);HIF-2α mRNA的表达与胃癌患者的分化程度和淋巴结转移均存在明显相关性(均P <0.05).结论:HIF-2α的表达可能与胃癌的发生发展有关, 并对判断胃癌患者的生物学行为具有一定的意义.     

神经纤毛蛋白1及神经纤毛蛋白2在胃癌组织中的表达及临床意义

目的探讨神经纤毛蛋白1(NRP1)及神经纤毛蛋白2(NRP2)在胃癌组织中的表达及临床意义。方法回顾性分析重庆医科大学附属第一医院肿瘤科及胃肠外科2015年1月至2017年10月收集83例胃癌手术切除标本,每例标本均包括胃癌组织、癌旁组织(距肿瘤边缘1.5 cm)和正常组织(距肿瘤边缘≥5 cm),免疫组化法测定各组织NRP1和NRP2表达,CD105免疫组化染色测定微血管密度(MVD)值。结果胃癌组织NRP1和NRP2阳性率显著高于癌旁组织,差异具有统计学意义(72.29%vs 18.07%,χ2=49.25,P0.0001;69.88%vs 20.48%,χ2=40.89,P0.0001)。胃癌组织MVD值显著高于癌旁组织(36.95±5.74 vs 28.78±4.62)和正常组织(36.95±5.74 vs 17.94±4.02),差异有统计学意义(t=4.73,P0.01;t=6.36,P0.01),NRP1阳性表达胃癌组织MVP值显著高于NRP1阴性表达胃癌组织(38.47±5.82 vs 30.76±5.32,t=5.47,P0.01),NRP2阳性表达胃癌组织MVD值显著高于NRP2阴性表达胃癌组织(38.22±5.71 vs 29.84±5.17,t=5.24,P0.01),NRP2阳性表达和NRP1阳性表达胃癌组织MVD值比较,差异无统计学意义(t=0.95,P0.05),高龄、肿瘤直径5 cm、高分化、有淋巴结转移、有血管受侵和高TNM分期均增加胃癌组织NRP1及NRP2阳性表达率和MVD值(P0.05)。胃癌组织NRP1评分与NRP2评分呈显著正相关(P0.01),胃癌组织NRP1评分及NRP2评分均与MVD值呈显著正相关(P0.01)。结论过表达NRP1和NRP2可能与胃癌的发展、浸润和转移密切相关。     

胆囊癌组织中血管内皮抑素表达及微血管密度检测的临床意义

目的 探讨血管内皮抑素及微血管密度(MVD)在胆囊癌发生、发展中的作用.方法 采用免疫组化SP法检测61份胆囊癌组织标本及10份正常胆囊组织中血管内皮抑素表达及MVD,分析其与胆囊癌临床病理参数的关系.结果 血管内皮抑素在正常胆囊组织、胆囊癌中的阳性表达率分别为40.00%、77.05%,P＜0.05;胆囊癌组织中血管内皮抑素表达强度与临床分期及淋巴结转移呈正相关,P＜0.05.胆囊癌与正常胆囊组织中MVD值分别为(76.66±20.15)、(29.53±5.03)个/HP,P＜0.01,MVD与Nevin分期、有无淋巴结转移及组织学分级有关.结论 血管内皮抑素及MVD在胆囊癌发生﹑发展中起重要作用;可用于判断胆囊癌恶性程度及疗效.     

胃癌组织Bmi-1蛋白、MMP-9蛋白、血管内皮生长因子表达情况和微血管密度变化及其临床意义

目的观察胃癌组织Bmi-1蛋白、MMP-9蛋白、血管内皮生长因子(VEGF)表达情况及和微血管密度(MVD)变化,探讨其临床意义。方法选取2010—2013年在邯郸市中心医院行胃癌切除术患者56例,收集其胃癌组织标本56份和残端正常胃黏膜组织标本40份。采用EliVisionTM免疫组织化学法检测Bmi-1蛋白、MMP-9蛋白、VEGF表达情况和MVD(CD34标记)。结果正常胃黏膜组织Bmi-1蛋白、MMP-9蛋白、VEGF阳性表达率分别为27.5%、35.0%、12.5%,低于胃癌组织中的76.8%、83.9%、89.3%(P0.05)。不同性别、年龄、肿瘤大小患者胃癌组织Bmi-1蛋白、MMP-9蛋白、VEGF阳性表达率比较,差异无统计学意义(P0.05);不同肿瘤分化程度、TNM分期及有无淋巴结转移患者胃癌组织Bmi-1蛋白、MMP-9蛋白、VEGF阳性表达率比较,差异有统计学意义(P0.05)。Bmi-1蛋白、MMP-9蛋白、VEGF阳性表达者MVD高于阴性表达者(P0.05)。胃癌组织中Bmi-1蛋白表达与MMP-9蛋白表达(r=0.450)、VEGF表达(r=0.493)呈正相关(P0.05)。结论 Bmi-1蛋白、MMP-9蛋白和VEGF在胃癌组织中均呈高表达,且肿瘤分化程度较低、TNM分期较晚和有淋巴结转移患者胃癌组织Bmi-1蛋白、MMP-9蛋白和VEGF阳性表达率明显升高,且与MVD密切相关。     

Toll样受体4在胰腺癌组织中的表达及其与肿瘤血管生成的关系

目的 探讨Toll样受体4(TLR4)在胰腺癌组织中的表达及其与肿瘤血管生成的关系.方法 采用免疫组化SP法检测62例经病理证实的胰腺癌手术切除标本及35例癌旁正常胰腺组织中TLR4蛋白表达,采用CD31抗体标记微血管内皮细胞,计算微血管密度(MVD).分析TLR4蛋白表达与胰腺癌临床病理特征以及MVD的相关性.结果 胰腺癌组织TLR4蛋白阳性表达率和MVD分别为74.2％ (46/62)和47.3±13.5,均显著高于正常胰腺组织的17.1％ (6/35)和12.6±4.8(P值均＜0.01).有淋巴结转移的胰腺癌组织中TLR4蛋白阳性表达率为83.8％,显著高于无淋巴结转移的60.0％(P=0.036);TNM分期为Ⅲ+Ⅳ期的胰腺癌组织中TLR4蛋白阳性表达率为85.3％,显著高于Ⅰ+Ⅱ期的60.7％(P =0.028).MVD与肿瘤的大小、淋巴结转移及TNM分期密切相关(P值分别为0.008、0.036、0.010).胰腺癌TLR4蛋白表达与MVD呈显著正相关(Υ=0.534,P＜0.01).结论 TLR4参与胰腺癌的发生、发展,其机制可能与促进肿瘤血管生成有关.     

死亡相关蛋白激酶基因在胃癌组织中的表达及其临床意义

目的 研究死亡相关蛋白激酶(DAPK)基因在原发性胃癌组织中的表达及其与临床病理特征的关系,并探讨其在胃癌发生发展中可能的机制.方法 收集62例原发性胃癌及相对应的癌旁正常组织.应用RT-PCR法检测DAPK mRNA的表达,应用Western-blot及免疫组化方法检测DAPK蛋白的表达.结果 DAPKmRNA和蛋白表达水平在胃癌组织中明显低于癌旁正常组织(OD值分另0为0.2863±0.2027 vs 0.5736 4-0.1968,P＜0.0001;0.2616±0.0913 vs 0.6529±0.1808,P＜0.0001).免疫组化分析显示,DAPK在所有癌旁正常组织中表达均为阳性,均值为8.61 4-2.89;而在胃癌组织中表达则明显减弱或缺失,均值为2.90 4-3.38.DAPK在癌旁正常组织中的表达水平显著高于胃癌组织(P＜0.0001).DAPKmRNA及蛋白表达水平与胃癌分期和淋巴结转移显著相关.结论 在原发性胃癌组织中,DAPKmRNA和蛋白表达明显缺失或低下,且与胃癌临床分期和淋巴结转移显著相关.     

Survivin、COX-2和VEGF在胃癌中的表达及其与预后的意义

目的研究生存素(Survivin)、环氧合酶-2(COX-2)和血管内皮生长因子(VEGF)在胃癌组织中的表达,探讨它们表达的关系及其与胃癌预后的关系。方法选取淮南东方医院集团总医院1992~2002年10年间行根治性手术治疗,临床、病理和随访资料齐全的胃癌患者65例,应用免疫组化S-P技术,检测Survivin、COX-2和VEGF在胃癌组织中表达。结果早期胃癌的5年生存率为95.2%(20/21),中期胃癌的5年生存率为63.6%(7/11)。中期胃癌组Survivin阳性表达高于早期胃癌组(73.6%vs 66.7%,P<0.05),其VEGF阳性表达和微血管密度(MVD)平均值高于早期胃癌组(P<0.05)。Survivin和COX-2在慢性萎缩性胃炎中的表达明显低于不典型增生者(P<0.05),在癌组织中的表达明显高于非癌组织(P<0.05)。胃癌组中的VEGF阳性表达率和MVD平均值均明显高于非癌组,且与胃癌浸润深度有关(P<0.05)。胃癌中Survivin、VEGF阳性表达的MVD值显著高于Survivin、VEGF阴性表达者(P<0.05);Survivin、COX-2、VEGF及MVD值与胃癌淋巴结转移、血管浸润均密切相关(P<0.05);Survivin、COX-2阳性表达及VEGF阳性表达者5年生存率明显低于阴性或低表达者(P<0.05)。多因素分析显示,淋巴结转移、浸润深度、Survivin表达、VEGF表达均为胃癌独立的预后因素。结论Survivin、COX-2、VEGF与胃癌的生长和浸润转移关系密切,可以作为反映胃癌生物学行为和判断预后的有效指标。     

核转录因子/白细胞介素-8与胃癌血管生成及预后关系研究

目的　研究核转录因子 (NF κB)及白细胞介素 (IL) 8在人胃癌组织中表达与胃癌血管形成及预后的关系。方法　免疫组化法检测 4 1例胃癌组织中核转录因子NF κB、IL 8表达和微血管密度(MVD)。结果　 4 1例胃癌中NF κB和IL 8的阳性表达率分别为 6 8.3% (2 8例 )和 2 9.3% (12例 ) ,前者与MVD显著相关 (P =0 .0 0 2 ) ,但后者与MVD表达无关。NF κB和IL 8与TNM分期显著相关 (P<0 .0 5 ) ,阳性者多为进展期胃癌 ,而且表达阴性组预后均明显优于阳性组 (P <0 .0 5 )。结论　NF κB/IL 8旁路调控可能不是胃癌组织内的主要促血管生成途径 ,NF κB和IL 8阳性表达反映胃癌的恶性程度 ,并可作为判断预后的参考指标。     

应用组织芯片技术研究Delta-like 4在胃癌组织中的表达及意义

目的:研究Delta-like 4(DLL4)在胃癌中的表达及其与血管生成的关系.方法:采用免疫组化EnVision法检测胃癌组织芯片中DLL4的表达,用CD34进行微血管内皮细胞染色,计算微血管密度(MVD),分析其相关性.结果:DLL4在胃癌中的表达明显高于正常胃黏膜(85.9% vs 35.3%.P＜0.01).DLL4的高表达与胃癌的转移(r=0.612,P＜0.01)和胃壁浸润深度(r=0.482,P＜0.01)呈正相关,与胃癌的组织病理及Borrmann分型无关.胃癌组织MVD明显高于正常胃黏膜组织(66.5±18.6 vs 34.2±16.4.P＜0.01).MVD值与胃癌的组织病理分型(r=0.506,P＜0.01)和转移有关(r=0.426,P＜0.01),与胃癌胃壁浸润深度和Borrmann分型无明显相关性.DLL4表达阳性组的MVD指数明显高于DLL4表达阴性组(70.5±16.2 vs 32.5±10.4,P7＜0.01),DLL4表达与MVD呈正相关(r=0.521.P＜0.01).结论:DLL4表达促进血管分化,对胃癌的转移、浸润起重要作用.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。