骨肉瘤患者血清TNF-α的改变

1 临床资料我院近年经病理组织学确诊的骨肉瘤住院患者20(男13,女7)例,年龄32～78(平均51)岁,并设15例健康献血员作对照. TNF-α测定试剂盒(ELISA法)购自上海贝西科技发展有限责任公司.数据以x±s表示,用t检验进行统计学处理.结果发现骨肉瘤组较健康对照组TNF-α含量明显升高 (11.73 2.45) vs (0.89 0.21) μg/L(P<0.01).     

Escape of the yolk sac: a hypothesis to explain the embryogenesis of gastroschisis

Gastroschisis is a significant birth defect that in many countries has shown an increased prevalence in recent decades, and the change has affected primarily younger mothers. Despite numerous epidemiological studies no other consistent associated risk factor has been identified. In this paper we review the five main theories related to the pathogenesis of this malformation and outline the reasons why we think none fully explains the embryogenesis of gastroschisis. We briefly present some clinical observations we have made that we consider germane to the pathogenesis and outline a hypothesis that we think can account for the origins of this malformation. Our proposal is that the determining defect in gastroschisis is failure of the yolk sac and related vitelline structures to be incorporated into the umbilical stalk. Otherwise, ventral closure of the lateral abdominal walls occurs normally, thus orphaning the vitelline duct and yolk sac outside both the main body stalk and the abdominal wall. Thus, in addition to the umbilicus, the abdominal wall has a separate perforation through which the midpoint of the gut is attached to the exteriorized vitelline structures. This connection through the ventral wall prevents normal egress of the gut into the umbilical cord during the second month of development and acts as the egress point for the gut resulting in gastroschisis.     

Fructose-1,6-bisphosphate reduces inflammatory pain-like behaviour in mice: role of adenosine acting on A1 receptors

Background and purpose:

D-Fructose-1,6-bisphosphate (FBP) is an intermediate in the glycolytic pathway, exerting pharmacological actions on inflammation by inhibiting cytokine production or interfering with adenosine production. Here, the possible antinociceptive effect of FBP and its mechanism of action in the carrageenin paw inflammation model in mice were addressed, focusing on the two mechanisms described above.

Experimental approach:

Mechanical hyperalgesia (decrease in the nociceptive threshold) was evaluated by the electronic pressure-metre test; cytokine levels were measured by elisa and adenosine was determined by high performance liquid chromatography.

Key results:

Pretreatment of mice with FBP reduced hyperalgesia induced by intraplantar injection of carrageenin (up to 54%), tumour necrosis factor α (40%), interleukin-1 β (46%), CXCL1 (33%), prostaglandin E₂ (41%) or dopamine (55%). However, FBP treatment did not alter carrageenin-induced cytokine (tumour necrosis factor α and interleukin-1 β) or chemokine (CXCL1) production. On the other hand, the antinociceptive effect of FBP was prevented by systemic and intraplantar treatment with an adenosine A₁ receptor antagonist (8-cyclopentyl-1,3-dipropylxanthine), suggesting that the FBP effect is mediated by peripheral adenosine acting on A₁ receptors. Giving FBP to mice increased adenosine levels in plasma, and adenosine treatment of paw inflammation presented a similar antinociceptive mechanism to that of FBP.

Conclusions and implications:

In addition to anti-inflammatory action, FBP also presents an antinociceptive effect upon inflammatory hyperalgesia. Its mechanism of action seems dependent on adenosine production but not on modulation of hyperalgesic cytokine/chemokine production. In turn, adenosine acts peripherally on its A₁ receptor inhibiting hyperalgesia. FBP may have possible therapeutic applications in reducing inflammatory pain.     

Integration and coordination of pain management in primary care

Pain is one of the most common symptoms reported to primary care providers and has significant implications for health care costs. The primary aim of this article is to describe and illustrate how to integrate the treatment of chronic pain in the primary care setting. First, we address the integration and coordination of care between mental health and primary care. We then present a typical case and discuss the patient's treatment, outcome, and prognosis. The article concludes with a discussion of issues that frequently arise when integrating psychological treatment for pain in primary care settings.     

Nonnegligible increasing temporal trends in unprotected anal intercourse among men who have sexual relations with other men in montreal

OBJECTIVE: To determine temporal trends in unprotected anal intercourse (UAI) among men who have sex with men (MSM) participating in the Omega Cohort Study, 1997 through 2003. METHODS: The Omega Cohort Study was a longitudinal study of HIV-negative MSM aged 16 years or older and living in Montreal. Participants completed self-administered questionnaires and interviews every 6 months. Trend analysis using the generalized estimating equation was done for length of cohort membership (visits) and by calendar time for all visits per type of sexual partner. Odds ratios (ORs) were calculated to measure the odds of increasing UAI per 6-month period. RESULTS: Among subjects who were followed for at least 4 years, UAI increased with regular seroconcordant partners (OR = 1.06, 95% confidence interval [CI]: 1.04 to 1.09) and any type of partner (OR = 1.05, 95% CI: 1.03 to 1.07). There was a nonnegligible increase in UAI with casual partners (OR = 1.05, 95% CI: 1.01 to 1.09). For the analysis by calendar time, there were increases in UAI between regular seroconcordant partners (OR = 1.04, 95% CI: 1.02 to 1.05) and any type of partner (OR = 1.03, 95% CI: 1.02 to 1.04). There were nonnegligible increases in UAI with casual partners (OR = 1.03, 95% CI: 1.00 to 1.05) and with any type of partner except a regular seroconcordant partner from 15.7% to 18.8% (OR = 1.02, 95% CI: 1.00 to 1.04). CONCLUSIONS: There was a nonnegligible and consistent increase in UAI among Omega Cohort Study participants between 1997 and 2003. Continuous trend analysis is important because it allows us to follow UAI closely and to implement intervention strategies that may help to stop or reduce the present trend.     

Residency training in anatomic pathology: looking forward in the 21st century

Residency training in anatomic pathology in the United States elicits a wide range of fundamental questions and conflicting opinions. This paper reflects the author's opinion concerning 4 questions that are often integral to these discussions and impact the outlook on training in the current century. (1) What are the goals of residency training in anatomic pathology? (2) In the face of exponential growth of information in anatomic pathology, how are residents to be trained? (3) What changes are likely to occur in the practice and training of anatomic pathology? (4) Is combined training in anatomic and clinical pathology a viable program for the 21st century?     

Using magnetoencephalography to study patterns of brain magnetic activity in Alzheimer's disease

The use of magnetoencephalography to study neurophysiologic abnormalities associated with Alzheimer's disease is reviewed. The most consistent observation is that Alzheimer's disease patients exhibit an increase in focal slow-wave activity that covaried with cognitive performance. It is still unclear whether generation of focal slow-wave activity precedes or is a consequence of Alzheimer's disease-related neuropathology. Also reviewed is the use of magnetoencephalography to identify early functional changes preceding the diagnosis of dementia. Magnetoencephalography detected neurophysiologic abnormalities associated with cognitive deficits before the diagnosis of mild cognitive impairment. This is supported by evidence presented suggesting that some patients with subjective cognitive complaints, without evidence of dementia, show an increase in focal slow-wave generators. Further research is needed to determine whether the outstanding spatial and temporal resolution of the magnetoencephalography technique could complement other neuroimaging techniques in identifying neurophysiologic abnormalities preceding the diagnosis of Alzheimer's disease and mild cognitive impairment.     

The Sony Ericsson WTA Tour 10 year age eligibility and professional development review

Concerns have long existed over the participation of adolescent athletes in professional sports. In 2004, the Sony Ericsson WTA Tour (WTA Tour) commissioned a Professional Development Advisory Panel (PDAP) to evaluate the WTA Tour's age eligibility rule (AER) and professional development programmes (PDPs) for female tennis players since their inception in 1995. More than 75% of the 628 respondents supported the principles of the AER, and 90% indicated a need for PDPs. Statistical analysis of WTA Tour players' careers found that premature retirements (players leaving the Tour at or before age 21) decreased significantly from 7% before the AER to less than 1% afterward, and median career length increased by 43%. The PDAP recommends that the WTA Tour continues a phased-in, developmentally appropriate AER, enhances the PDPs, and works with other sport governing bodies to coordinate rules and programmes at earlier ages to aid the transition of adolescents into adult sports.