二十二碳六烯酸增加大鼠冠状动脉平滑肌细胞大电导钙离子激活钾离子流的机制

Objective To investigate the mechanism of enhanced large conductance calciumactivated potassium channel currents (BK) in coronary smooth muscle cells (SMCs) by docosahexaenoic acid (DHA). Methods Coronary SMCs were isolated by enzyme digestion. Potassium channels in coronary SMCs were identified by applications of different potassium blockers. Effects of DHA and its metabolite 16,17-epoxydocosapentaenoic acid (16,17-EDP) on BK channels in the absence and presence of cytochrome P450 epoxygenase inhibitor SKF525A were studied by patch clamp in whole-cell configuration. Results BK channels were widely distributed in SMCs, and BK currents in normal SMCs accounted for (64.2±2.7)%of total potassium currents(n =20). DHA could activate BK channels, and its 50% effective concentration (EC50) was (0.23±0.03)μmol/L, however, the effect of DHA on BK channels was abolished after SMCs were incubated with cytochrome P450 epoxygenase inhibitor SKF525A. 16,17-EDP, a metabolite of DHA, could reproduce the effects of DHA on BK channels, and its EC50 was (19.7± 2.8) nmol/L.Conclusion DHA and metabolites can activate BK channels and dilate coronary arteries through activating cytochrome P450 epoxygenase pathway.     

Statistical Analysis of Surgical Dog-Ear Regression

BACKGROUND Several methods have been developed to prevent or correct dog-ears. Most of these methods, however, result in prolonged scars and operative times.
OBJECTIVE We observed dog-ears without correction to examine the regression of dog-ears with time.
METHODS The study was performed on 43 cases of dog-ears in 26 patients. Linear regression analysis was performed to examine the correlation between various factors and the height of the dog-ears (%). We produced a regression equation to allow prediction of the height of the dog-ears (%). In addition, we estimated the initial height of the dog-ears that should be removed during surgery.
RESULTS The height of dog-ears regressed with time, and this response was better in younger and female patients. It was predicted that the time taken for a dog-ear to reduce to 50% of its original height was 20.697 days; the median time at which dog-ears completely regressed was 132 days. The odds of regression of dog-ears with an initial height of ≤8 mm was 4.667 times greater than that of larger dog-ears.
CONCLUSIONS If the height of a dog-ear is ≤8 mm, we recommend observation rather than immediate surgical removal.     

THE RELATIVE EFFECT OF TEMPERATURE, COOLING POWER AND AIR MOVEMENT ON WARMTH SENSATIONS OF COMFORT IN WINTER.

From a statistical investigation, Bedford (1) concluded that as a measure of warmth the katathermorueter is definitely infenior to the simple dry-bulb thermometer., This finding was confirmed by the study of warmth sensation in relation to the winter indoor conditions by Lee (2). The dry-bulb temperature levels are a measure only of the sensible heat in the air., while the katathermometer readings are regarded as a measure of the rate of cooling as infiuenced by the temperature., the movement of the air, and by the radiation from the surr,oundings. All these factors affect sensations''-of"comfort in or.e way or another. It is the object of the present investigation to find out to what extent the dry-bu)J) femperature or the katathermometer measurements are rel.ated quantitatively to sensations of warmth out of doors in winter.     

A 3‐year prospective radiographic evaluation of marginal bone level around different implant systems

Summary The aim of this study was to evaluate the change of marginal bone level radiographically around three different implant systems after 3 years in function. Fifty‐four patients were included and randomly assigned to three treatment groups of rough‐surface implants (TiUnite, n = 37), hybrid of smooth and rough‐surface implants (Restore, n = 38) and rough surface with microthread implants (Hexplant, n = 45). Clinical and radiographic examinations were conducted at the time of implant loading (baseline), 1 and 3 years after loading. A three‐level mixed‐effect analysis of covariance (ancova ) was used to test the significance of the mean marginal bone change of the three implant groups. A total 120 of 135 implants completed the study. None of the implants failed to integrate. Significant differences were noted in the marginal bone loss recorded for the three groups (P < 0·0001). At 3 years, the rough surface with microthread implants had a mean crestal bone loss of 0·59 ± 0·30 mm; the rough‐surface implants, 0·95 ± 0·27 mm; and the hybrid surface implants, 1·05 ± 0·34 mm. Within the limitations of this study, rough‐surface implants with microthread at the coronal part might have a long‐term positive effect in maintaining the marginal bone level against functional loading in comparison with implants without these two features.     

Pilot study on photodynamic therapy for acne using indocyanine green and diode laser

To demonstrate the efficacy of photodynamic therapy using indocyanine green (ICG) dye with a diode laser for acne treatment of Asian subjects, an analysis was performed of 16 randomly chosen Korean patients with acne vulgaris treated by photodynamic therapy for a mean follow up of 2 months. Volunteers were divided into two groups, a single- and multiple-treatment group, in which photodynamic therapy was repeated three times with 1-week intervals. Photodynamic therapy using ICG dye with a diode laser was effective for acne treatment of Korean subjects. However, multiple treatments were not superior to single treatments in controlling acne lesions. Photodynamic therapy combined with ICG dye and diode laser might be an alternative treatment modality for acne in Asian subjects.     

比较CypherTM和TaxusTM支架在冠心病合并糖尿病患者中应用的安全性和有效性

背景与裸支架相比,药物洗脱支架可以显著降低冠心病合并糖尿病患者PCI术后再狭窄率和靶病变重建率.但目前尚未见关于直接比较雷帕霉素洗脱支架(CypherTM)和紫杉醇洗脱支架(TaxusTM)在治疗冠心病合并糖尿病患者中安全性和有效性的研究.目的观察和比较两种药物洗脱支架在冠心病合并糖尿病患者中应用的安全性和有效性.方法自2002年6月～2004年2月新加坡国立大学医院心脏中心所有置入Cypher或Taxus支架冠心病合并糖尿病患者,观察术后6个月的主要不良心脏事件(包括死亡、心肌梗死、靶病变重建).结果共计122例患者(Cypher组为31例,Taxus组为91例).B2和C型病变75%.两组患者基本特征无显著差异.与Taxus组相比Cypher组有更小参照血管直径(2.4±0.6 mm和2.6±0.7 mm,P＜0.01),Cypher组和Taxus组术后急性和亚急性支架内血栓发生率(0%和1.1%)、6个月靶病变重建率(3.2%和3.3%)和主要不良心脏事件(6.4%和5.5%)都没有差异.结论两种药物洗脱支架在冠心病合并糖尿病患者中的临床应用安全、有效的,在降低6个月临床再狭窄率、靶病变重建率和主要不良心脏事件上无明显差异.     

Rates of venous thromboembolism in multiple myeloma patients undergoing immunomodulatory therapy with thalidomide or lenalidomide: a systematic review and meta‐analysis

Summary. Introduction: The incidence of venous thromboembolism (VTE) in patients with multiple myeloma (MM) treated with thalidomide‐ and lenalidomide‐based regimens is high. Recent observational studies have suggested that thromboprophylaxis might be efficacious in decreasing the risk of VTE in this population. Purpose: To determine the absolute rates of VTE with and without different thromboprophylactic agents in patients with newly diagnosed or previously treated MM receiving thalidomide‐ or lenalidomide‐based regimens. Results: Patients with newly diagnosed MM treated with thalidomide in combination with dexamethasone have a VTE risk of 4.1 (95% CI, 2.8–5.9) per 100 patient‐cycles. Therapeutic doses of anticoagulants seem to provide the largest absolute risk reduction of VTE. The rate of VTE in patients with previously treated MM receiving thalidomide in combination with dexamethasone is 0.8 (95% CI, 0.1–2.1) per 100 patient‐months. A combination of lenalidomide and dexamethasone is associated with of risk of VTE of 0.8 (95% CI, 0.07–2.0) per 100 patient‐cycles and 0.7 (95% CI, 0.4–0.9) per 100 patient‐cycles in patients with newly diagnosed and previously treated MM, respectively. Similarly, the rates of VTE in patients also receiving thromboprophylaxis with aspirin were 0.9 (95% CI, 0.5–1.5) and 0.6 (95% CI, 0.01–2.1), respectively. Conclusion: Patients with newly diagnosed or previously treated MM receiving thalidomide‐ or lenalidomide‐based regimens in combination with dexamethasone are at high risk of VTE. The benefit of various types of thromboprophylaxis is difficult to quantify in patients with MM receiving immunomodulatory therapy, especially in those receiving lenalidomide‐based therapy or who have previously treated MM. Randomized controlled trials are needed to address this important clinical need.