脑缺氧是影响严重颅脑创伤患者短期预后的独立危险因素(英文)

Background:Brain hypoxia(BH)can aggravate outcome after severe traumatic brain injury(TBI).Whether BH or reduced brain oxygen(Pbto2)is an independent outcome predictor or a marker of disease severity is not fully elucidated.Objective To analyze the relationship between Pbto2,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)and to examine whether BH correlates with worse outcome independently of ICP and CPP.Methods We studied103patients monitored     

多重PCR法检测金黄色葡萄球菌耐药基因及致病毒素基因

目的：了解金黄色葡萄球菌（简称金葡菌）耐药基因及所携带致病毒素基因PVL与TSST-1的特点。方法：应用多重PCR法检测mecA基因、TSST-1基因及Py￡基因。结果：84株金 葡球经多重PCR法对其mecA基因进行检测．检出率为58．3％（49／84）。PVL基因阳性菌株的分离率为23．8％（20／84）,州￡阳性的MRSA为13株（13／49,26．5％）,PyL阳性的MSSA为7株（7／35,20．O％）,差异无统计学意义（P〉0．05）;未检出TSST-1基因。结论：金葡菌的耐药性呈上升趋势,且金葡菌可产生多种毒素,在分离金葡菌的同时,应加强其耐药基因及毒素基因的检测。     

Risk factors of nasopharyngeal carcinoma in Turkey-an epidemiological survey of the Anatolian Society of Medical Oncology

Background: Nasopharyngeal carcinoma is a rare disease in most parts of the world with a multifactorial etiology involving an interaction of genetic, viral, environmental and dietary risk factors. This is the first epidemiologic study aimed to evaluate the risk factors of nasopharyngeal carcinoma in the Turkish population. Methods: We conducted a multicentric, retrospective, case-control study using a standardized questionnaire which captured age, sex, occupation, household type, blood group, dietary habits, smoking, alcohol consumption and oral hygiene. The study included 183 cases and 183 healthy controls matched by sex and age. Multiple logistic regression and univariate analysis were employed. Results: The peak age incidence was 40-50 years and the male to female ratio was 2:1. We observed significant associations between elevated nasopharyngeal carcinoma risk and low socioeconomic status, rural household type (OR:3.95, p<0.001), farming (OR:4.24, p<0.001) and smoking (OR:3.15, p<0.001). Consumption of french fries (OR:1.44, p=0.024), fried meat (OR:1.05, p=0.023) and tea (OR:5.55, p<0.001) were associated with elevated risk, while fresh fruit consumption was associated with reduced risk (OR:0.59, p=0.011). An irregular meal pattern was also a risk factor (OR:1.75, p=0.012). There were no significant associations between consumption of grain, diary products, alcohol and nasopharyngeal carcinoma risk (p>0.05); furthermore salty foods had a borderline p value (OR:2.14, p=0.053). Blood type A increased the risk (OR:2.03, p=0.002) while blood type 0 was a protective factor (OR:0.53, p=0.009). Rare habit of teeth brushing (OR:6.17, p<0.001) and ≥10 decayed teeth before diagnosis (OR:2.17, p<0.001) increased the risk. Conclusions: The nasopharyngeal carcinoma risk factors described in the literature are also applicable for the Turkish population. People with type A blood are at risk in Turkey. Salted foods have also a border risk out of the endemic regions. This is the only study showing that poor oral hygene is a serious risk factor for nasopharyngeal carcinoma.     

Weekly topotecan for recurrent small cell lung cancer - a retrospective anatolian medical oncology group study

Aim: To evaluate efficacy and tolerability of topotecan treatment for recurrent small cell lung carcinoma.Patients and Methods: A total of 62 patients were evaluated retrospectively. Statistical analysis was performedusing GraphPad Instat (version 3.05). Results: DFifty five of patients (89%) were male and 7 (11%) were female.Median age was 56.7±9.3 (34-75). Forty eight of patients (80%) were extensive stage (ES) at the time of diagnosis.Fifty of the patients (80.6 Medical Oncology Clinic) were given median 5.36 cycles of cisplatin-etoposide (2-8 cycles).Time to recurrence was 15.6±6.13 weeks in patients with limited stage (LS) and 6.3±3.82 weeks in extensivestage (ES) (p<0.0001). Overall survival was 14.0±6.08 months in ES and 17.9±6.88 months in LS. The differencebetween two groups was statistically meaningful (p=0.0447). The overall survival of the patients was 14.8±6.43months (4.5-40 months). In terms of survival, there was no difference between males and females (p=0.1171).In 17 (27%) patients who were refractory to topotecan or in whom progression occurred other chemotherapieswere used. Conclusion: Small cell lung cancer is chemosensitive, but recurrences occur in short time. Otherchemotherapy regimens are used in progression. Topotecan is one of them. Patients who were young and in whomrecurrences occur late had given better response to topotecan. Because of the retrospective nature of the study,we couldn’t reach the records exactly and consequently, rate and duration of response couldn’t be calculated.In recurrent SCLC topotecan is one of the treatment choices. But both hematological and non hematologicalside effects should be taken into consideration.     

Shear bond strengths of three different resin luting cements to bovine teeth

This study evaluated the shear bond strengths of dentin/porcelain and enamel/ porcelain specimens bonded with three different dual-cure cements. The specimens were prepared using the heat-pressed ceramic technique. Three different dual-cure cements were used to bond samples to previously prepared bovine enamel and dentin surfaces. The specimens were thermocycled and tested in shear until failure. The shearbond data was subjected to one-way ANOVA, followed by Duncan's multiple range test at a significance level of p < 0.05. The shear bond strengths of Variolink II were significantly higher than those of Rely-X ARC and Panavia F for enamel and dentin (p < 0.05). Bond strenghts in enamel were higher than those of dentin in all materials (p < 0.05).     

成釉细胞瘤及牙源性角化囊肿中ICAM-1和VCAM-1的表达

目的探讨细胞间黏附分子-1(ICAM-1)和血管细胞黏附分子-1(VCAM-1)在成釉细胞瘤(AB)及牙源性角化囊肿(OKC)中的表达及其与AB、OKC病理学特征的关系。方法对38例AB、10例OKC、7例正常口腔黏膜(NOM)组织进行免疫组织化学SP法检测,结合病例病理特征进行分析。结果ICAM-1和VCAM-1在AB、OKC和NOM3组表达组间比较,具有显著统计学差异(P<0.05)。ICAM-1在AB中的阳性率达65.2%,显著高于NOM(14.3%),OKC(60.0%)与NOM未见显著统计学差异。VCAM-1在AB中的阳性血管数也显著高于OKC和NOM。ICAM-1和VCAM-1表达与AB的组织病理分型、年龄、性别和发生部位无明显相关性(P>0.05)。结论细胞黏附分子ICAM-1和VCAM-1与AB及OKC的发生、发展及细胞分化与增殖有关。     

NEWER CONCEPTS AND MANAGEMENT OF NEONATAL SEPSIS

Despite extensive research into its patho-physiology, investigations and treatment, sepsis remains an important cause of neonatal morbidity and mortality. The incidence in developing countries is 10 times that in the developed world. A large number of pro-and anti-inflammatory cytokines (interleukins, eicosanoids, tumour necrosis factor-alpha, nitric oxide) have been identified, the interplay of which leads to the Systemic Inflammatory Response Syndrome (SIRS) which can have devastating consequences on all systems of the body. In India the common organisms include Staphylococcus, E coli, Klebsiella and Candida. A number of maternal and neonatal risk factors have been identified. The initial signs and symptoms are subtle and can easily be missed. Early investigations and screening tests are important and a promising number of new tests are being studied. The gold standard for diagnosis is a positive culture from a body fluid or local source in the presence of SIRS. The threshold for starting antibiotics should be low in high-risk neonates and broad spectrum antibiotics covering the likely organisms should be given intravenously in all suspected cases in a hospital setting. This should be continued for at least 24-48 hours (till negative reports are available) in suspected cases and for 2-3 weeks in proven cases. Prophylaxis is aimed at preventing nosocomial and cross infections. Strict hand-washing, meticulous asepsis protocols, identification of high risk groups and prompt and better screening tests are essential in controlling this problem.KEY WORDS: Neonate, Sepsis, Systemic inflammatory response syndrome     

Digital colposcopy: ready for use? An overview of literature

The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.     

肥胖与青少年多囊卵巢综合征

多囊卵巢综合征（PCOS）是育龄妇女常见生殖内分泌疾病。近年发现,随着儿童肥胖患病率增加,青少年PCOS发病率也逐年提高。肥胖可通过增加外周循环胰岛素水平影响PCOS发病机制,PCOS患者高雄激素血症也会增加内脏脂肪沉积。肥胖会增加与PCOS相关的代谢和心血管方面的并发症的患病风险,如胰岛素抵抗（IR）、高脂血症、高血压以及临床症状不明显的动脉粥样硬化等。早期识别青春期PCOS,有利于及时纠正、阻断其内分泌紊乱,防止近期及远期并发症发生。