脾切除对结直肠癌切除术后的影响：一项多中心、嵌入式、配对队列研究

目的探讨医源性脾脏损伤脾切除对结直肠癌切除患者术后长期生存的影响。方法对1990年1月1日至1999年12月31日10年间行结直肠癌手术切除并附带脾切除患者进行病例配对回顾研究。分析患者年龄、性别、依据美国麻醉学医师协会（ASA）标准评估的身体状况、疾病分期、手术类型及预后等资料。配对病例来自同一医疗中心，性别、年龄、疾病分期及手术类型完全相同。手术附带脾切除患者为试验组，未切脾者为对照组。结果55例患者行医源性脾切除术，对照组在年龄、性别、身体状况、疾病分期及手术类型上与之匹配。随访时间（从手术开始到患者死亡或者最后一次随访1为2～205个月（中位随访时间为43个月）。Cox比例危险度模型进行Kaplan-Meier法生存分析发现两组间差异有显著性意义，不切除脾脏对患者生存有利（危险度1．8，95％可信区间为1-3．3，P=0．0399），未切脾组与切脾组5年生存率分别为70％和47％，10年生存率分别为55％和38％。结论结直肠癌患者在行结肠或直肠切除时，因医源性脾脏损伤而切除脾脏者，预后较差。     

Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy

Periodontal sites of shallow initial probing depth often seem to lose probing attachment following various types of periodontal therapy, including nonsurgical therapy. The susceptibility to this treatment-associated probing attachment loss may conceivably be related to gingival architecture as well as to the inflammatory status of the tissues. This study was designed to study the relationship of buccolingual gingival thickness and bleeding on probing in shallow buccal sites (less than or equal to 3.5 mm probing depth) to loss of probing attachment following nonsurgical therapy. 3 months following treatment consisting of oral hygiene instruction and supra- and subgingival debridement, thin (less than or equal to 1.5 mm), initially non-bleeding sites displayed a mean loss of probing attachment of 0.3 mm. Thick (greater than or equal to 2.0 mm), non-bleeding sites displayed a less noticeable mean loss of probing attachment, whereas bleeding sites of both categories of gingival thickness showed a tendency towards gains in probing attachment levels. It may be concluded that the mean loss in probing attachment levels, commonly seen for shallow sites post-therapy, may be primarily due to the changes in shallow, thin healthy areas.     

Complete FcRn dependence for intravenous Ig therapy in autoimmune skin blistering diseases

Numerous mechanisms of action have been proposed for intravenous Ig (IVIG). In this study, we used IgG passive transfer murine models of bullous pemphigoid (BP), pemphigus foliaceus (PF), and pemphigus vulgaris (PV) to test the hypothesis that the effect of IVIG in autoantibody-mediated cutaneous bullous diseases is to accelerate the degradation of pathogenic IgG by saturation of the MHC-like Fc receptor neonatal Fc receptor (FcRn). BP, PF, and PV are organ-specific antibody-mediated diseases in which autoantibodies target the hemidesmosomal antigen BP180 and desmosomal antigens Dsg1 and Dsg3, respectively. Antibodies against BP180, Dsg1, and Dsg3, when injected into neonatal mice, induce the BP, PF, and PV disease phenotypes, respectively. We found that FcRn-deficient mice were resistant to experimental BP, PF, and PV. Circulating levels of pathogenic IgG in FcRn-deficient mice were significantly reduced compared with those in WT mice. Administration of high-dose human IgG (HDIG) to WT mice also drastically reduced circulating pathogenic IgG levels and prevented blistering. In FcRn-deficient mice, no additional protective effect with HDIG was realized. These data demonstrate that the therapeutic efficacy of HDIG treatment in the pemphigus and pemphigoid models is dependent on FcRn. Thus, FcRn is a promising therapeutic target for treating such IgG-mediated autoimmune diseases.     

H-FABP与GPBB早期诊断AMI的价值研究

目的:探讨H-FABP(心肌型脂肪酸结合蛋白)与GPBB(糖原磷酸化酶同工酶)在临床早期诊断急性心肌梗死(AMI)的应用指标及实用价值.方法:选取48例正常人与42例急性心肌梗死病人采用用双抗体夹心ELISA法对急性胸痛的病人在0～1h、1～3h、3～6h内快速检测H- FABP与GPBB.结果:本实验研究结果表明H-...     

SA/hIL21双功能融合蛋白的表达、纯化及生物学活性检测

目的 制备链亲和素(SA)标记的人白细胞介素21融合蛋白(SA-hIL-21),检测其生物学活性.方法 构建hIL21-SA-pET21及pET24a-SA-hIL21质粒,利用大肠杆菌BL21(DE3)表达两种双功能融合蛋白,并利用镍金属螯合层析柱(Ni-NTA)纯化,之后透析复性,Western blotting进行鉴定,最后利用MTT法检测hIL21-SA及SA-hIL21融合蛋白与抗CD3单克隆抗体(anti-CD3)共刺激人外周血淋巴细胞的增殖活性,流式细胞仪分析两种融合蛋白对生物素化的MB49肿瘤细胞的锚定修饰效率.结果 hIL21-SA及SA-hIL21重组融合蛋白在大肠杆菌中实现了高效表达,约占菌体蛋白的30%,经复性后hIL21-SA及SA-hlL21具有了双重活性,即不仅可以与抗CD3单抗共刺激淋巴细胞的增殖,而且具有了SA介导的高效结合已生物素化的MB49肿瘤细胞表面的功能(表面修饰效率95.18%,96.91%).结论 本实验成功研制了具有双重活性的hIL21-SA及SA-hlL21融合蛋白,两种融合蛋白的双功能活性无显著性差异,该项研究为SA/hIL21双功能融合蛋白应用于肿瘤疫苗以及肿瘤局部治疗奠定了基础.     

New guidelines for cardiac risk assessment prior to non‐cardiac surgery

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00427.x
Pickett FA. New guidelines for cardiac risk assessment prior to non‐cardiac surgery. Abstract: The European Society of Cardiology (ESC) has established guidelines to determine the risk for non‐cardiac procedures, such as oral procedures, when individuals have experienced severe cardiac disease, including myocardial infarction. This is the first time the ESC has developed consensus guidelines to assist practitioners in managing care for cardiac patients receiving medical or dental procedures. Factors for risk assessment are described and management for oral care is discussed.     

Estimation of undernutrition and mean calorie intake in Africa: methodology, findings and implications

Background

Agricultural science can address a population's vitamin, amino acid and mineral malnutrition through biofortification - agronomy, plant breeding and biotechnology to develop crops with high nutrient contents. Biofortified crop varieties should be grown in areas with populations at risk of nutrient deficiency and in areas where the same crop is already grown and consumed. Information on the population at risk of nutrient deficiency is rarely available for sub-national administrative units, such as provinces, districts, and municipalities. Nor is this type of information commonly analyzed with data on agricultural production. This project developed a method to identify populations at risk of nutrient deficiency in zones with high crop production, places where biofortification interventions could be targeted.

Results

Nutrient deficiency risk data were combined with crop production and socioeconomic data to assess the suitability of establishing an intervention. Our analysis developed maps of candidate sites for biofortification interventions for nine countries in Latin America and the Caribbean. Results for Colombia, Nicaragua, and Bolivia are presented in this paper. Interventions in northern Colombia appear promising for all crops, while sites for bean biofortification are widely scattered throughout the country. The most promising sites in Nicaragua are found in the center-north region. Candidate sites for biofortification in Bolivia are found in the central part of the country, in the Andes Mountains. The availability and resolution of data limits the analysis. Some areas show opportunities for biofortification of several crops, taking advantage of their spatial coincidence. Results from this analysis should be confirmed by experts or through field visits.

Conclusion

This study demonstrates a method for identifying candidate sites for biofortification interventions. The method evaluates populations at risk of nutrient deficiencies for sub-national administrative regions, and provides a reasonable alternative to more costly, information-intensive approaches.