犬骨髓间质干细胞体外诱导及非诱导培养后向心肌细胞的分化

目的：骨髓间质干细胞体外诱导和非诱导培养向心肌细胞分化的结果的对比。方法：实验于2003-03／2004-12在阜外心血管病医院中心实验室完成。①分离犬骨髓间质干细胞。②于体外培养，应用不同浓度（0，6，8，10，12，14，20μmol／L）的5-氮胞苷定向诱导并连续传代培养4周，未诱导的细胞培养8周。③进行细胞形态学、细胞免疫组织化学、透射电镜鉴定。结果：（D骨髓间质于细胞于5-氮胞苷诱导培养2周时，α-肌动蛋白、TroponinI染色阴性；4周时，α-肌动蛋白染色阳性，Troponin I阴性；电镜下可见肌丝结构，其中8mmol／L 5-氮胞苷诱导的间质干细胞肌丝结构排列较规则。②骨髓间质干细胞非诱导培养8周时，α-肌动蛋白染色阳性，Troponin I阴性，电镜下亦可见肌丝结构形成；而培养4周时全部为阴性。结论：骨髓间质干细胞经5-氮胞苷诱导培养4周及未诱导连续培养8周均可定向转化为具有肌丝结构的肌样细胞，而非心肌样细胞。     

Outcomes in real-world practice are different than cooperative trial for elderly patients with early breast cancer treated with adjuvant radiation therapy

Background

The Cancer and Leukemia Group B 9,343 demonstrated that postoperative radiation can be safely omitted in women ≥70 years who underwent breast-conserving therapy for clinical stage I (T1N0M0) estrogen receptor positive breast cancer treated with antihormonal therapy. Whether such results are observed in real-world population is unknown. In this hospital-based data, we report the survival outcomes of patients who received adjuvant radiation therapy versus those who did not.

A Systematic Review and Framework for the Use of Hormone Therapy with Salvage Radiation Therapy for Recurrent Prostate Cancer

Context

Salvage radiotherapy (SRT) is a standard of care for men who recur postprostatectomy, and recent randomized trials have assessed the benefit and toxicity of adding hormone therapy (HT) to SRT with differing results.

Impact of Trauma System Structure on Injury Outcomes: A Systematic Review and Meta-Analysis

Background

The effectiveness of trauma systems in decreasing injury mortality and morbidity has been well demonstrated. However, little is known about which components contribute to their effectiveness. We aimed to systematically review the evidence of the impact of trauma system components on clinically important injury outcomes.

Methods

We searched MEDLINE, EMBASE, Cochrane CENTRAL, and BIOSIS/Web of Knowledge, gray literature and trauma association Web sites to identify studies evaluating the association between at least one trauma system component and injury outcome. We calculated pooled effect estimates using inverse-variance random-effects models. We evaluated quality of evidence using GRADE criteria.

Results

We screened 15,974 records, retaining 41 studies for qualitative synthesis and 19 for meta-analysis. Two recommended trauma system components were associated with reduced odds of mortality: inclusive design (odds ratio [OR] = 0.72 [0.65–0.80]) and helicopter transport (OR = 0.70 [0.55–0.88]). Pre-Hospital Advanced Trauma Life Support was associated with a significant reduction in hospital days (mean difference [MD] = 5.7 [4.4–7.0]) but a nonsignificant reduction in mortality (OR = 0.78 [0.44–1.39]). Population density of surgeons was associated with a nonsignificant decrease in mortality (MD = 0.58 [?0.22 to 1.39]). Trauma system maturity was associated with a significant reduction in mortality (OR = 0.76 [0.68–0.85]). Quality of evidence was low or very low for mortality and healthcare utilization.

Conclusions

This review offers low-quality evidence for the effectiveness of an inclusive design and trauma system maturity and very-low-quality evidence for helicopter transport in reducing injury mortality. Further research should evaluate other recommended components of trauma systems and non-fatal outcomes and explore the impact of system component interactions.