.3H13042H;

傅春桂;9-11叶与根的距离——《把出息收藏起来》赏析赵连瑞;徐彦利;这是一篇关于故乡的文章,作者用离乡——返乡——怀乡——重新审视故乡这条线索将主人公的人生经历串联起来,并发出深切的感慨。0阅读与鉴赏(高中版)Reading and Appreciation13-14G     

CHEK2基因c.1100delC与中国人遗传性乳腺癌易感性的关联研究

目的研究上海地区非BRCA1／2基因突变的遗传倾向乳腺癌中CHEK2基因c．1100delC突变的携带情况及可能的作用。方法研究对象来自114例遗传倾向性乳腺癌，包括家族性乳腺癌76例，其中8例发病年龄低于40岁；38例单纯早发性乳腺癌（发病年龄〈40岁）。对照组为121名无乳腺癌的健康女性，静脉血中提取基因组DNA，对CHEK2基因的第10～14外显子进行长片段PCR扩增，PCR产物再进行含突变的第10外显子的扩增。突变分析全部由DNA直接测序进行鉴定。结果研究人群和对照人群中都没有发现c．1100delC的突变；在3例（3／114，2．6％）家族性乳腺癌中发现邻近c．1100delC的新的错义突变位点1111C〉T（p-His371 Tyr），对照组中则无此突变发现。结论CHEK2基因c．1100delC突变可能是中国人群罕见的突变位点，在中国人乳腺癌遗传易感性中的作用非常有限；1111C〉T可能与中国上海地区遗传倾向乳腺癌低度外显的易感性有关，需要进行进一步研究确认。     

Comparison of BACTEC™ blood culture media for the detection of fungemia

The aim of the present study was to investigate whether addition of the BACTEC? Mycosis bottle to the standard BACTEC? aerobic and anaerobic bottles contributed to a higher detection rate and a faster time to detection (TTD) of fungi. This was a retrospective cohort study of all patients with a positive blood culture with Candida species delivered to the Department of Clinical Microbiology, Herlev and Gentofte Hospital, Denmark in the 8-year period 2006 through 2014. The patients had at least one BACTEC? aerobic and one Mycosis bottle sampled at the same time and at least one of the bottles yielded growth of fungi. Among 184 patients included, 173 were examined using BACTEC? aerobic, anaerobic and Mycosis bottles. The anaerobic vial generally had the lowest detection rate and the longest TTD. The detection rate of BACTEC? aerobic plus anaerobic with the BACTEC? Mycosis bottle was significantly higher than the detection rate of BACTEC? aerobic plus anaerobic without BACTEC? Mycosis bottle for all species after 1–5 days, and specially for Candida glabrata at 2, 3, 4 and 5 days. TTD for C. glabrata was significantly shorter for BACTEC? Mycosis than TTD for BACTEC? aerobic or anaerobic bottles after ½ to 4 days. When combining “first or only” detection, the BACTEC? Mycosis bottle had a significantly higher detection as compared to the aerobic bottle. Addition of the BACTEC? Mycosis bottle to the standard BACTEC? aerobic and anaerobic bottles significantly contributed to a higher detection rate and a faster TTD of fungemia.     

Hämagglutination durch Vaccinevirus. II. Erfahrungen mit der Hämagglutinationshemmung

Summary The inhibition titer of immune sera against vaccinia hemagglutination is inversely proportional to the concentration of hemagglutinin. Using the same number of hemagglutinin units, the sample of blood or hemagglutinin and the temperature of the reaction is irrelevant. Inaetivation of the sera at 56° to 62° does not influence the reaction. The serum titers are higher, when more diluted blood cell suspensions are used, as well as vice versa. A prolonged contact between serum and hemagglutinin shows little influence on the titer. The inhibition is stronger at the acid than at the alcaline range (p_H 6 to 9). The reproducibility of the method is checked. Normal animal sera do not show any non-specific inhibition.

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Ich danke den HerrenGiese, Reinsdorf undSander für ihre Mitarbeit.     

Hämagglutination durch Vaccineyirus. I. Methode

Summary The influence of various factors on the hemagglutination by vaccinia virus was investigated. The titer shows a nearly threefold increase after a one hour rotation before sedimentation of the blood cells at 37°. Temperatures above 20° yield equal, below 20° lower titers when the tubes are repeatedly reshaken. Some samples of fowl blood show a non-specific hemagglutination which is inhibited by 0.2° normal rabbit serum. The influence of different blood samples and red cell concentrations on the hemagglutinin titer is demonstrated. The results have been reproduced in control series.

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Den HerrenReinsdorf undSander danke ich für ihre Hilfe.     

CLINICAL AND EXPERIMENTAL STUDY OF KILLING EFFECT ON HELICOBACTER PYLORI

ＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＦＫＩＬＬＩＮＧＥＦＦＥＣＴＯＮＨＥＬＩＣＯＢＡＣＴＥＲＰＹＬＯＲＩＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＦＫＩＬＬＩＮＧＥＦＦＥＣＴＯＮＨＥＬＩＣＯＢＡＣＴＥＲＰＹＬＯＲ...     

The PedsQL™ in Pediatric Asthma: Reliability and Validity of the Pediatric Quality of Life Inventory™ Generic Core Scales and Asthma Module

The PedsQL is a modular instrument designed to measure health-related quality of life (HRQOL) in children and adolescents ages 2-18. The PedsQL 4.0 Generic Core Scales were developed to be integrated with the PedsQL Disease-Specific Modules. The PedsQL3.0 Asthma Module was designed to measure pediatric asthma-specific HRQOL. The PedsQL was administered to 529 families. Internal consistency reliability was demonstrated for the PedsQL 4.0 Total Score (alpha = 0.90 child, 0.91 parent report) and Asthma Module (average alpha = 0.71 child, 0.86 parent report). The PedsQL 4.0 distinguished between healthy children and children with asthma. The validity of the PedsQL Asthma Module was demonstrated through intercorrelations with a previously standardized asthma disease- specific instrument. Responsiveness was demonstrated through patient change over time as a result of clinical intervention. The results demonstrate the reliability, validity, and responsiveness of the PedsQL required for an outcome measure in pediatric asthma clinical trials and research.     

Evaluation of the Oxoid Brilliance™ CRE Agar for the detection of carbapenemase-producing Enterobacteriaceae

The adequate detection of carbapenemase-producing Enterobacteriaceae (CPE) is essential for adequate antibiotic therapy and for infection control purposes, especially in an outbreak setting. Selective agars play an important role in the detection of CPE. The Oxoid Brilliance? CRE Agar (Thermo Fisher Scientific) was evaluated for the detection of CPE using 255 non-repetitive Enterobacteriaceae isolates, including 95 CPE (36 KPC, 4 KPC plus VIM, 4 NDM, 6 GIM, 20 VIM, and 25 OXA-48-producing isolates). The sensitivity of the CRE agar for the detection of CPE was 94 % (89/95), but differed per carbapenemase gene (100 % for KPC, NDM, and GIM, 90 % for VIM, and 84 % for OXA-48-producing isolates). The specificity of the CRE agar was 71 %, due to the growth of AmpC- and/or ESBL-producing isolates. The CRE agar is a sensitive tool for the detection of KPC and metallo-carbapenemase-producing Enterobacteriaceae, although the detection of OXA-48 producers is less optimal. The relatively low specificity requires confirmation of carbapenemase production for isolates recovered from the CRE agar.     

Gravimetric wear analysis and particulate characterization of bilateral facet-augmentation system--PercuDyn™

Dynamic stabilization systems are emerging as an alternative to fusion instrumentation. However, cyclic loading and micro-motion at various interfaces may produce wear debris leading to adverse tissue reactions such as osteolysis. Ten million cycles of wear test was performed for PercuDyn? in axial rotation and the wear profile and the wear rate was mapped. A validation study was undertaken to assess the efficiency of wear debris collection which accounted for experimental errors. The mean wear debris measured at the end of 10 million cycles was 4.01 mg, based on the worst-case recovery rate of 68.2%. Approximately 40% of the particulates were less than 5 μm; 92% less than 10 μm. About 43% of particulates were spherical in shape, 27% particulates were ellipsoidal and the remaining particles were of irregular shapes. The PercuDyn? exhibited an average polymeric wear rate of 0.4 mg/million cycles; substantially less than the literature derived studies for other motion preservation devices like the Bryan disc and Charité disc. Wear debris size and shape were also similar to these devices.     

An In Vitro Study of the Hinge and Near-Field Forward Flow Dynamics of the St. Jude Medical® Regent™ Bileaflet Mechanical Heart Valve

The most widely implanted prosthetic valve is the mechanical bileaflet. Recent clinical experiences suggest that some designs are more prone to thromboembolic episodes than others. This study evaluated the hinge flow and near-field forward flow of the new St. Jude Medical^® Regent bileaflet mechanical heart valve. Laser Doppler velocimetry measurements were conducted within the hinge and near-field forward flow regions of the Regent valve. These pulsatile flow velocity measurements were animated in time to visualize the flow fields throughout the cardiac cycle. During forward flow, a recirculation region developed in the inflow pocket of the Regent hinge but was subsequently abolished by strong backflow during valve closure. Leakage velocities in the hinge region reached 0.72 m/s and Reynolds shear stresses reached 2,600 dyn/cm². Velocities in the near-field region were highest in the lateral orifice jet, reaching 2.1 m/s. Small regions of separated flow were observed adjacent to the hinge region. Leaflet motion through the Regent hinge creates a washout pattern which restricts the persistence of stagnation zones in its hinge. Based upon the results of these studies, the hematological performance of the Regent series should be at least equivalent to the performance of the Standard series. © 2000 Biomedical Engineering Society. PAC00: 8719Uv, 8780-y, 8719Hh     

Performance evaluation of the Becton Dickinson Kiestra™ IdentifA/SusceptA

ObjectivesNew automated modules are required to provide fully automated solutions in diagnostic microbiology laboratories. We evaluated the performance of a Becton Dickinson Kiestra™ IdentifA/SusceptA prototype for MALDI-TOF identification (ID) and Phoenix™ antibiotic susceptibility testing (AST).MethodsThe performance of the IdentifA/SusceptA coupled prototype was compared with manual processing for MALDI-TOF ID on 1302 clinical microbial isolates or ATCC strains and for Phoenix™ M50 AST on 484 strains, representing 61 species.ResultsOverall, the IdentifA exhibited similar ID performances than manual spotting. Higher performances were observed for Gram-negative bacteria with an ID at the species level (score >2) of 96.5% (369/382) and 86.9% (334/384), respectively. A significantly better performance was observed with the IdentifA (95.2%, 81/85) compared with manual spotting (75.2%, 64/85) from colonies on MacConkey agar. Contrariwise, the IdentifA exhibited lower ID performances at the species level than manual processing for streptococci (76.1%, 96/126 compared with 92%, 115/125), coagulase-negative staphylococci (73.3%, 44/60 compared with 90%, 54/60) and yeasts (41.3%, 19/46 compared with 78.2%, 36/46). Staphylococcus aureus and enterococci were similarly identified by the two approaches, with ID rates of 92% (65/70) for the IdentifA and 92.7%, (64/69) for manual processing and 94.8%, (55/58) for the IdentifA and 98.2%, (57/58) for manual processing, respectively. The SusceptA exhibited an AST overall essential agreement of 98.82% (6863/6945), a category agreement of 98.86% (6866/6945), 1.05% (6/570) very major errors, 0.16% (10/6290) major errors, and 0.91% (63/6945) minor errors compared to the reference AST.ConclusionsOverall, the automated IdentifA/SusceptA exhibited high ID and AST performances.     

Micro Particle Image Velocimetry Measurements of Steady Diastolic Leakage Flow in the Hinge of a St. Jude Medical® Regent™ Mechanical Heart Valve

A number of clinical, in vitro and computational studies have shown the potential for thromboembolic complications in bileaflet mechanical heart valves (BMHV), primarily due to the complex and unsteady flows in the valve hinges. These studies have focused on quantitative and qualitative parameters such as velocity magnitude, turbulent shear stresses, vortex formation, and platelet activation to identify potential for blood damage. However, experimental characterization of the whole flow fields within the valve hinges has not yet been conducted. This information can be utilized to investigate instantaneous damage to blood elements and also to validate numerical studies focusing on the hinge’s complex fluid dynamics. The objective of this study was therefore to develop a high-resolution imaging system to characterize the flow fields and global velocity maps in a BMHV hinge. In this study, the steady leakage hinge flow fields representing the diastolic phase during the cardiac cycle in a 23 mm St. Jude Medical regent BMHV in the aortic position were characterized using a two-dimensional micro particle image velocimetry system. Diastolic flow was simulated by imposing a static pressure head on the aortic side. Under these conditions, a reverse flow jet from the aortic to the ventricular side was observed with velocities in the range of 1.47–3.24 m/s, whereas low flow regions were observed on the ventricular side of the hinge with viscous shear stress magnitude up to 60 N/m². High velocities and viscous shearing may be associated with platelet activation and hemolysis, while low flow zones can cause thrombosis due to increased residence time in the hinge. Overall, this study provides a high spatial resolution experimental technique to map the fluid velocity in the BMHV hinge, which can be extended to investigate micron-scale flow domains in various prosthetic devices under different hemodynamic conditions.     

CHEK2*1100delC homozygosity in the Netherlands—prevalence and risk of breast and lung cancer

The 1100delC mutation in the CHEK2 gene has a carrier frequency of up to 1.5% in individuals from North-West Europe. Women heterozygous for 1100delC have an increased breast cancer risk (odds ratio 2.7). To explore the prevalence and clinical consequences of 1100delC homozygosity in the Netherlands, we genotyped a sporadic breast cancer hospital-based cohort, a group of non-BRCA1/2 breast cancer families, and breast tumors from a tumor tissue bank. Three 1100delC homozygous patients were found in the cohort of 1434 sporadic breast cancer patients, suggesting an increased breast cancer risk for 1100delC homozygotes (odds ratio 3.4, 95% confidence interval 0.4–32.6, P=0.3). Another 1100delC homozygote was found in 592 individuals from 108 non-BRCA1/2 breast cancer families, and two more were found after testing 1706 breast tumors and confirming homozygosity on their wild-type DNA. Follow-up data was available for five homozygous patients, and remarkably, three of them had developed contralateral breast cancer. A possible relationship between 1100delC and lung cancer risk was investigated in 457 unrelated lung cancer patients but could not be confirmed. Due to the small number of 1100delC homozygotes identified, the breast cancer risk estimate associated with this genotype had limited accuracy but is probably higher than the risk in heterozygous females. Screening for CHEK2 1100delC could be beneficial in countries with a relatively high allele frequency.     

Cytodiagnosis of benign and malignant Hürthle cell lesions of the thyroid by fine-needle aspiration biopsy.

Eighty-two Hürthle cell (HC) lesions of the thyroid with cytologic evaluation by fine-needle aspiration biopsy (FNAB) were reviewed. In 17 cases the FNAB was not diagnostic because the fine-needle aspirates (FNAs) were too scanty in cellularity. Among the remaining 65 lesions, there were 45 HC adenomas (HCAs), six non-neoplastic HC nodules (NHCNs), 10 primary HC carcinomas (HCCs), and four metastatic HCCs. Forty-four HCAs were diagnosed as HC tumor (HCT), and one HCA was wrongly diagnosed as medullary carcinoma. All six NHCNs were wrongly diagnosed as HCT. Of 10 primary HCCs, there were diagnosed as HCT and seven as suspected HCC. Four metastatic HCCs were correctly diagnosed. The FNAs from 38 HCAs and four NHCNs were predominantly composed of large monomorphic HCs with oval nuclei, inconspicuous nucleoli, and abundant, well-defined, granular cytoplasm present singly, in acinar arrangement, and in monolayered sheets of variable sizes. Nuclear pleomorphism and prominent nucleoli were noted in seven HCAs and two NHCNs. Occasional small syncytial tumor cell clusters (STCCs) were noted in six cases, and a few naked tumor cell nuclei (NTCN) were observed in 16 cases. The FNAs from 14 HCCs were hypercellular. In all cases tumor cells were relatively small and showed monomorphic or pleomorphic nuclei, prominent nucleoli, and ill-defined cytoplasm. STCCs of variable sizes were present in abundance in 10 cases, and numerous NTCN were noted in 12 cases. In two HCCs, the tumor cells with well-defined cytoplasm were present singly and in cohesive sheets, and no STCCs or NTCN were observed. Thus, the presence of small tumor cells with ill-defined cytoplasm and prominent nucleoli in syncytial clusters and abundant NTCN in the FNA of a thyroid nodule should alert the observer about the strong possibility of an HCC.