ADA与EASD对2型糖尿病高血糖处理：治疗启动与评定的新共识方案

在不到一年时间由同一批专家代表ADA和EASD先后起草和发布了两次关于“2型糖尿病高血糖处理的共识声明”同时发表在2008年1月和12月的《DiabetesCare》和《Diabetologia》上。第一次共识声明内容主要围绕TZDs药物的安全性,本刊作了摘译转载（参阅《中国糖尿病杂志22008年第7期）。第二次修订的共识声明,关注点为降糖药的新分级,论据及观点比较清晰,故仍摘译供读者参考。     

Estimation of the age at onset in spinocerebellar ataxia type 2 Cuban patients by survival analysis

Almaguer‐Mederosa LE, Falcón NS, Almira YR, Zaldivar YG, Almarales DC, Góngora EM, Herrera MP, Batallán KE, Armiñán RR, Manresa MV, Cruz GS, Laffita‐Mesa J, Cyuz TM, Chang V, Auburger G, Gispert S, Pérez LV. Estimation of the age at onset in spinocerebellar ataxia type 2 Cuban patients by survival analysis. Previous studies have investigated the close association that exists between CAG repeat number and the age at onset in SCA2 = spinocerebellar ataxia type 2. These studies have focused on affected individuals. To further characterize this association and estimate the risk of a carrier developing SCA2 at a particular age as a function of a specific CAG repeat size, we have analyzed a large group of 924 individuals, including 394 presymptomatic and 530 affected individuals with a CAG repeat length of 32–79 units. Using a Kaplan–Meier survival analysis, we obtained cumulative probability curves for disease manifestation at a particular age for each CAG repeat length in the 34–45 range. These curves were significantly different (p < 0.001) and showed small overlap. All these information may be very valuable in predictive‐testing programs, in the planning of studies for the identification of other genetic and environmental factors as modifiers of age at onset, and in the design of clinical trials for people at enlarged risk for SCA2.     

多培沙明,非诺多泮和丙卡特罗对心肌缺血时电生理变化影响的比较

新型多巴胺受体激动剂多培沙明(DPX)能显著减轻缺氧和缺血豚鼠心室乳头肌静息电位,动作电位幅度和O相除极速度的降低程度及动作电位时程的缩短程度,其减轻作用明显大于非诺多泮(FODA)和丙卡特罗(PCTR)。DPX能使缺氧时缩短的有效不应期(ERP)延长,而使缺血时延长的ERP缩短,其程度明显大于FODA与PCTR。提示DPX抗缺血性心律失常的作用优于其他类型的多巴胺激动剂。     

Prevention of pneumococcal disease: an update on the Belgian Consensus Report

An ad hoc working party on pneumococcal vaccine with representatives of the Belgian Society for Infectiology and Clinical Microbiology, the Belgian Society of Pulmonology and Scientific Societies of General Practitioners reviewed new data on the epidemiology of S. pneumoniae infections in Belgium, on the efficacy and the cost-effectiveness of the 23-valent capsular polysaccharide vaccine. We discuss recent data on vaccination with a new conjugate pneumococcal vaccine, shown to be highly effective in children. The Working Group of the Belgian Scientific Societies endorses the recommendations issued by the Hoge Gezondheidsraad in 1993 and described in a consensus report in 1996.     

Plasmacytoid myoepithelioma of minor salivary glands: report of case with emphasis in the immunohistochemical findings

Extracorporeal formation of mineralized bone-like tissue is still an unsolved challenge in tissue engineering. Embryonic stem cells may open up new therapeutic options for the future and should be an interesting model for the analysis of fetal organogenesis. Here we describe a technique for culturing embryonic stem cells (ESCs) in the absence of artificial scaffolds which generated mineralized miromasses. Embryonic stem cells were harvested and osteogenic differentiation was stimulated by the addition of dexamethasone, ascorbic acid, and ß-glycerolphosphate (DAG). After three days of cultivation microspheres were formed. These spherical three-dimensional cell units showed a peripheral zone consisting of densely packed cell layers surrounded by minerals that were embedded in the extracellular matrix. Alizarine red staining confirmed evidence of mineralization after 10 days of DAG stimulation in the stimulated but not in the control group. Transmission electron microscopy demonstrated scorching crystallites and collagenous fibrils as early indication of bone formation. These extracellular structures resembled hydroxyl apatite-like crystals as demonstrated by distinct diffraction patterns using electron diffraction analysis. The micromass culture technique is an appropriate model to form three-dimensional bone-like micro-units without the need for an underlying scaffold. Further studies will have to show whether the technique is applicable also to pluripotent stem cells of different origin.