HEMO研究与MPO研究结果给我们的启示

慢性肾衰竭的发生率估计约100-360人/100万人,不同地区的发生率有所不同,中国、欧洲和美国分别为100人/100万人、170人/100万人和360人/100万人[1].随着社会发展及生活方式的改变,疾病谱也在发生变化,其发病率和患病率还将逐年增加.血液透析是终末期肾病（ESRD）患者维持生命的重要手段,     

Copenhagen Pancreatitis Study

During the past 2 decades an increasing number of patients with pancreatitis have been admitted to the Copenhagen hospitals. For this reason all departments receiving such patients from the city of Copenhagen initiated the Copenhagen Pancreatitis Study (CPS), to provide a prospective recording of all pancreatitis patients from this geographical area and to conduct yearly follow-up studies of the patients. The aims of the CPS were, first, to establish data on the incidence, prevalence, and clinical characteristics of pancreatitis, and, second, to evaluate the accuracy of diagnostic tests applied and to provide data on the natural history and the prognosis under current therapy. The present study is an interim report on 343 patients from the initial 1 1/2 years of the CPS. Pancreatitis patients are listed in four diagnostic groups: I. Possible acute pancreatitis; II. Acute pancreatitis; III. Possible chronic pancreatitis; IV. Chronic pancreatitis. The incidence rates per year per 100,000 citizens aged 20 years or more (population aged 20 years or more: 417,000) were as follows: total, 36.3; I, 6.2; II, 21.9; III, 4.2; IV, 4.0. The prevalence for the chronic types on 31 August 1979 per 100,000 citizens aged 20 years or more was as follows: total, 27.4; III, 14.4; IV, 13.0. Gallstones were found in 1/3 of the acute and 1/10 of the chronic cases. Alcohol consumption was more than 50g/day in nearly half of the patients. Acute pancreatitis was dominated by a high leukocyte count, hyperbilirubinaemia, raised aminotransferases and blood glucose levels, and low albumin and calcium levels in serum. In chronic pancreatitis 1/3 had steatorrhoea; 1/6 regularly used morphine, and 1/4 had impaired liver function. It is concluded that the incidence rates of acute and chronic pancreatitis in Copenhagen seem to be higher than those reported elsewhere; however, differences in diagnostic criteria may play a role. The clinical and laboratory findings are in agreement with other studies.     

纳米细菌研究

纳米细菌(nanobacteria,Nb)是近年来才被发现的超微细菌．纳米细菌体积极其微小,其最小直径仅50 nm,大大低于理论上细菌体积的下限．因此纳米细菌在被发现的初期,其存在的真实性就受到许多学者的质疑,并且由此引发了一场关于微生物最小体积的争论．随着研究的不断深入,纳米细菌的生物学特性不断地被揭示,纳米细菌已经成为当前研究的一个热点问题．在医学界,纳米细菌被认为与肾结石、胆囊结石、动脉粥样硬化等病理性钙化疾病的发生有关系．本文在复习大量文献的基础上,针对纳米细菌的生物学特性以及纳米细菌与人类疾病等方面作一简单的回顾与总结．     

A Case Study

Abstract. Both ⁵¹Cr-survival studies with donor platelets and allogenic skin transplantations were performed in a patient with immune unresponsiveness to platelet antigens, i.e., HLA- and platelet-specific antigens. The patient, who suffered from hypoplastic anaemia, was successfully transfused with random donor platelets during 13 months. The serum of this patient contained only granulocyte- and mononuclear-cell-reactive antibodies, but no platelet-reactive antibodies. A nearly normal survival time of the donor platelets as well as a prolonged rejection time of a skin allograft of the same donor support the serological findings. The ⁵¹Cr-platelet survival time was not influenced by a leucocyte concentrate from the same donor, which was administered at the same time. Thus, in our patient, no increased platelet destruction could be induced via the so-called innocent bystander mechanism.     

赫尔辛基心脏研究(HHS)

研究的疾病　高脂血症。目　　的　调查中年男性血脂异常但尚未发现冠心病临床症状时 ,吉非罗齐 (ｇｅｍｆｉｂｒｏｚｉｌ)对冠心病发病率的影响。设　　计　多中心、随机、双盲、安慰剂对照研究。病人资料　 40 81例年龄 40～ 5 5岁男性患者 ,非高密度脂蛋白值 (ｎｏｎ -ＨＤＬ ,ＴＣ -ＨＤＬ)≥ 5 2ｍｍｏｌ/Ｌ ,无冠心病临床症状和 (或 )心电图ＳＴ -Ｔ异常改变。存在充血性心力衰竭或其他影响试验结果的疾病者除外。随　　访　 5年。治疗方案　入选对象被随机分为吉非罗齐治疗组 (2 0 5 1例 )和安慰剂组(2 0 30例 )。吉非罗齐组患者给…     

心力衰竭研究进展

沿用几十年所谓“强心、利尿、扩血管和正性肌力药物”针对心力衰竭血流动力学的经典传统治疗 ,虽然能短期内改善血流动力学 ,减轻症状 ,但并不能降低心力衰竭病死率或反而增加病死率。研究证明 :神经体液细胞活性因子激活过度是心力衰竭核心机制。针对心力衰竭采取较全面阻滞交感神经 肾素 血管紧张素 醛固酮系统水平而副交感活性显著升高是抑制心肌重塑 ,治疗心力衰竭重要机制之一。心力衰竭标准治疗是 :ACEI/或ARB、β 肾上腺素受体拮抗剂、噻嗪类药、螺内酯、他汀类、抗血小板聚集药 (视病情用洋地黄、血管扩张剂、利尿剂等 )和心脏手术。     

International Hand Function Study Following Distal Radial Access: The RATATOUILLE Study

BackgroundDistal radial access (DRA) has been proposed to improve procedure ergonomics and favor radial artery patency. Although promising data, nothing is known on evolving hand function after DRA.ObjectivesThis study sought to comprehensively evaluate hand function in patients undergoing DRA.MethodsReal-world patients undergoing DRA undertook a thorough multimodality assessment of hand function implementing multidomain questionnaires (Disabilities of the Arm, Shoulder and Hand and Levine-Katz), and motor (pinch grip test) and sensory (Semmes-Weinstein monofilaments test) examinations of both hands. All assessments were performed at preprocedural baseline and planned at 1-, 6-, and 12-month follow-up (FU). Adverse clinical and procedural events were documented too.ResultsData of 313 patients (220 men, age 66 ± 10 years) from 9 international centers were analyzed. The Disabilities of the Arm, Shoulder and Hand and the Levine-Katz scores slightly improved from baseline to FU (P = 0.008 and P = 0.029, respectively). Pinch strength mildly improved from baseline to FU (P < 0.001 for both the left and right hands). Similarly, touch pressure threshold appeared to faintly improve in both the left and right hands (P < 0.012 for all the sites). For both motor and sensory function tests, comparable findings were found for the DRA hand and the contralateral one, with no significant differences between them. Repeated assessment of all tests over all FU time points similarly showed lack of worsening hand function. Access-related adverse events included 19 harmless bleedings and 3 forearm radial artery and 3 distal radial artery occlusions. None affected hand function at FU.ConclusionsIn a systematic multidimensional assessment, DRA was not associated with hand function impairment. Moreover, DRA emerges as a safe alternative vascular access.     

功过是非,尘埃落定——RECORD研究结果公布

罗格列酮是曾被广泛应用的噻唑烷二酮类(TZD)药物之一,几年前Steven Nissen博士的一篇关于格列酮类药物与心肌梗死相关性的荟萃分析文章,使该情况发生了很大变化、因此,RE-CORD研究引起学者们的广泛关注.该研究将4447例2型糖尿病患者随机分为3组,分别为磺脲类药物联合罗格列酮(n=1103)、二甲双胍联合罗格列酮(n=1117)治疗组以及二甲双胍联合磺脲类药物(n=2227)对照组,5.5年后观察其主要终点:首次因心血管事件入院或发生心血管死亡的时间.研究最终证实罗格列酮在心血管事件和心血管死亡的发生中无决定性作用,同时证实其增加心力衰竭和骨折发生的风险,尤其是女性患者.因此,目前不推荐将罗格列酮用于有心力衰竭病史或可能发生心功能异常的糖尿病患者,在具有较高骨折风险的女性中也应谨慎应用.