炎症性肠病易感基因与移植后不良结局相关证据不足

欧洲有研究指出携带NOD2／CARD15和IL-23R基因变异体的供体或受体与异体造血干细胞移植后不良临床结局相关。本研究验证上述研究结果并分析炎症性肠病易感基因（IRGM）与移植后临床结局的相关性。     

A remote auscultation tool for advanced home health-care

We have developed an Internet-based tool for remote realtime auscultation. The device was based on a commercially available electronic stethoscope and a PC which digitized and transmitted the signals. A voice and video channel were also available. The remote auscultation tool was evaluated between two sites in Sweden separated by a distance of 500 km. A doctor at one of the sites performed cardiac and pulmonary auscultations on patients located at the other site. Four test patients were assisted by a nurse operating the electronic stethoscope. The auscultation sessions were performed with and without video support to assess the importance of visual contact between doctor and patient. Twenty sessions were conducted (excluding technical testing to solve problems with the equipment). Audio quality was sufficient, as judged subjectively by the doctors concerned. Video support improved the doctor s confidence that the stethoscope was being operated properly and greatly simplified the interaction. Moreover, it improved all participants subjective impression of the virtual meeting. Our work demonstrates the feasibility of performing remote auscultation sessions over the Internet.     

Improved capacity of exercise electrocardiography in the detection of coronary artery disease by focusing on diagnostic variables during the early recovery phase

The temporal distribution of the diagnostic information for the detection of coronary artery disease (CAD) provided by exercise-induced electrocardiographic (ECG) ST-segment amplitude changes in different ECG leads in men and women has not been fully investigated. To shed further light in this area, 1877 electrocardiograms selected from 8322 patients undergoing a routine exercise test on a bicycle ergometer were evaluated. ST-segment amplitude and the difference between heart rate-matched recovery and exercise ST-segment amplitudes (ST/HR difference) were measured. Coronary artery disease was verified angiographically in 669 patients and excluded in 1208 patients by angiography (n = 119), by myocardial scintigraphy (n = 250), or on clinical grounds (n = 839). The diagnostic performance of the 2 ECG methods used was assessed by constructing receiver operating characteristic curves for each sampling point every 12 seconds during 10 minutes of recovery as well as the last 4 minutes of exercise for the ST-segment amplitude. ST-segment amplitude performed better after exercise than during exercise and best within the first 2 minutes of recovery. Its diagnostic ability did not differ from the ST-amplitude hysteresis assessed by the difference between recovery ST-segment amplitude and exercise ST-segment amplitude at matched heart rate. Both methods performed better in men and the diagnostic information appeared mainly in leads I, -aVR, II, V 4 , V 5 , and V 6 . The best discrimination of CAD is provided by analysis of ST-segment amplitude changes in 6 specific leads early during the recovery phase. This information should be targeted by exercise ECG diagnostic methods.     

Polymorphism in promoter region of IL10 gene is associated with rheumatoid arthritis in women

OBJECTIVE: Rheumatoid arthritis (RA) is a genetically complex disease with many possible phenotypes. We investigated IL10 and TNFA gene polymorphisms in a group of Swedish women and men with RA compared with healthy individuals to estimate combinations of alleles specific for the disease. METHODS: We analyzed 264 patients with RA and 286 healthy controls for biallelic single-nucleotide polymorphisms in the -308 position of the TNFA and in the -1087 position of the IL10 gene by polymerase chain reaction with restriction endonuclease mapping. RESULTS: The frequencies of the -308 TNFA genotypes were not different in women and men with RA in comparison to the controls. In contrast, frequencies of the GG, AG, and AA -1087 IL10 genotypes were significantly different in women in the investigated groups: 26%, 58%, and 15% for RA patients and 24%, 54%, and 28% for the controls (chi-square = 8.18, p < 0.02). We confirmed this finding in a separate dataset of female patients and controls. The frequencies of the IL10 genotypes in men were similar in the patients and controls. We found no differences in the distribution of the TNFA or IL10 genotypes in relation to rheumatoid factor in the patients. CONCLUSION: On the basis of IL10 polymorphism, female patients with RA seem to represent a separate disease subgroup.     

Effects of weaning cereals with different phytate contents on hemoglobin,iron stores,and serum zinc: a randomized intervention in infants from 6 to 12 mo of age

BACKGROUND: Weaning foods frequently contain phytate, an inhibitor of iron and zinc absorption, which may contribute to the high prevalence of iron and zinc deficiency seen in infancy. OBJECTIVE: The objective was to investigate whether either an extensive reduction in the phytate content of infant cereals or the use of milk-based, iron-fortified infant formula would improve iron and zinc status in infants. DESIGN: In a double-blind design, infants (n = 300) were randomly assigned to 3 cereal groups from 6 to 12 mo of age: commercial milk-based cereal drink (MCD) and porridge (CC group), phytate-reduced MCD and phytate-reduced porridge (PR group), or milk-based infant formula and porridge with the usual phytate content (IF group). Venous blood samples were collected at 6 and 12 mo. Dietary intake was recorded monthly. After the intervention, 267 infants remained in the analysis. RESULTS: Hemoglobin concentrations of < 110 g/L, serum ferritin concentrations of < 12 microg/L, and serum zinc concentrations of < 10.7 micromol/L had overall prevalences at baseline and 12 mo of 28% and 15%, 9% and 18%, and 22% and 27%, respectively. After the intervention, there were no significant differences in any measure of iron or zinc status between the CC and the PR groups. However, hemoglobin was significantly higher (120 g/L compared with 117 g/L; P = 0.012) and the prevalence of anemia was lower (13% compared with 23%; P = 0.06) in the PR group than in the IF group, which could be explained by differences in daily iron intake between the 2 groups. CONCLUSION: Extensive reduction in the phytate content of weaning cereals had little long-term effect on the iron and zinc status of Swedish infants.     

Left ventricular function in patients with chronic kidney disease evaluated by colour tissue Doppler velocity imaging.

BACKGROUND: Cardiovascular disease is the leading cause of death in chronic kidney disease (CKD) patients. Tissue Doppler velocity imaging (TVI) is a new objective method that accurately quantifies myocardial tissue velocities, deformation, time intervals and left ventricular (LV) filling pressure. In this study, TVI was compared with conventional echocardiography for the assessment of left ventricular (LV) function in pre-dialysis patients with different stages of CKD. The results obtained by TVI were used to analyse possible relationships between LV function and clinical factors such as hyperparathyroidism and hypertension that could influence LV function. METHODS: Conventional echocardiography and TVI images were recorded in 40 patients (36 men and 4 women, mean age 60+/-14 years, range 28-80 years) and in 27 healthy controls (21 men and 6 women, mean age 58+/-17 years, range 28-82 years). Twenty-two patients had mild/moderate CKD (CCr>29 ml/min; Group 1) and 18 patients had severe CKD (CCr相似文献   

Morbidity of Urodynamic Investigation in Healthy Women

The morbidity of diagnostic catheterization in healthy women has never been described. In order to further elucidate the natural history of postcystometry bacteriuria we studied a group of healthy women without lower urinary tract symptoms. Thirty female volunteers aged 39–72 years underwent urine sampling prior to and at day 3 after invasive urodynamic evaluation. One case of asymptomatic bacteriuria was detected among pretest samples. On post-test sampling 10 of 29 cultures were positive. With a cut-off level of >10⁵ CFU/ml only 2 cases could be classified as significant bacteriuria. Only 1 was symptomatic. The remaining 29 women had no symptoms following the examination. Thus the incidence of lower urinary tract infection was 3.3% following repeated diagnostic catheterization. We concluded that although bacteriuria is common after diagnostic catheterization, it is essentially asymptomatic.     

A comparison of strengths of five core and post-and-core systems.

OBJECTIVE: In this in vitro study, the strength of several core and post-and-core systems was compared. A second aim was to compare the strength of posts and cores on root-filled teeth with that of cores on vital teeth. The failure modes of the core and post-and-core systems were also studied. METHOD AND MATERIALS: For root-filled teeth, Composipost carbon fiber dowels and gold alloy posts and cores were tested. For vital teeth, glass-ionomer cement with threaded parapulpal retention pins, resin composite with threaded parapulpal retention pins, and gold alloy with parallel parapulpal pins were tested. Specimens were tested in a Zwick universal material-testing machine. RESULTS: A significant variation in strength was found among core systems of cast gold, resin composite, and glass-ionomer cement constructed on vital teeth. The strength of the systems constructed on root-filled teeth did not vary significantly. The mode of failure varied, depending on the core or post-and-core material. CONCLUSION: Composipost posts and cores and cast gold posts and cores were equivalent in strength and did not vary significantly from gold cores constructed on vital teeth. The low strength values obtained for glass-ionomer cement in combination with threaded retention pins makes this combination a poor choice for core buildup.     

Colorectal cancer in ulcerative colitis: a cohort study of primary referrals from three centres.

A retrospective cohort of 823 patients with ulcerative colitis who resided at the time of diagnosis in one of three defined geographical areas (West Midlands region, Oxford region, England and Stockholm County, Sweden) was assembled. The patients were first seen at named hospitals in these areas and the diagnosis of ulcerative colitis established within five years of onset of symptoms between 1945-1965. All patients were 15 years of age or more at onset of disease and were followed for a minimum of 17 years and a maximum of 38 years. Ninety seven per cent completeness of follow up was achieved. Examining the colorectal cancer risk in the series relative to the risk in the general population by standardised morbidity ratios, there was an eight fold increased risk of cancer in the series as a whole. Dividing the series by extent of colitis, extensive colitis patients showed a 19 fold increase in risk. A four fold increased risk was shown in the remainder of the series (left sided colitis, proctitis and extent unknown). Life table analyses in extensive colitis gave cumulative risks of 7.2% (CI 3.6-10.8) at 20 years from onset of disease and 16.5% (CI 9.0-24.0) at 30 years from onset. No significant effect of age at onset, sex or referral centre could be detected. Examination of the data by interval from onset to cancer and by actual age at development of cancer suggests that patients who develop colorectal cancer will do so in a distribution around 50 years of age independent of duration of disease in adult onset ulcerative colitis (greater than 15 years at onset of disease). An inverse relationship was shown between age at onset of disease and interval from onset of disease to cancer. Further age specific rates for cancer increased up to 50 years and decreased thereafter. These results suggest that extensive colitis patients have a genetic predisposition to colorectal cancer and that longstanding inflammation is not of primary importance in the initiation/promotion of cancer in this disease.