Neural network forecasts of the tropical Pacific sea surface temperatures.

A nonlinear forecast system for the sea surface temperature (SST) anomalies over the whole tropical Pacific has been developed using a multi-layer perceptron neural network approach, where sea level pressure and SST anomalies were used as predictors to predict the five leading SST principal components at lead times from 3 to 15 months. Relative to the linear regression (LR) models, the nonlinear (NL) models showed higher correlation skills and lower root mean square errors over most areas of the domain, especially over the far western Pacific (west of 155 degrees E) and the eastern equatorial Pacific off Peru at lead times longer than 3 months, with correlation skills enhanced by 0.10-0.14. Seasonal and decadal changes in the prediction skills in the NL and LR models were also studied.     

Quality of life and exercise performance in patients in sinus rhythm versus persistent atrial fibrillation: a Veterans Affairs Cooperative Studies Program Substudy.

OBJECTIVES: The purpose of this study was to determine quality of life (QOL) and exercise performance (EP) in patients with persistent atrial fibrillation (AF) converted to sinus rhythm (SR) compared with those remaining in or reverting to AF. BACKGROUND: Restoration of SR in patients with AF improving QOL and EP remains controversial. METHODS: Patients with persistent AF were randomized double-blind to amiodarone, sotalol, or placebo. Those not achieving SR at day 28 were cardioverted and classified into SR or AF groups at 8 weeks (n = 624) and 1 year (n = 556). The QOL (SF-36), symptom checklist (SCL), specific activity scale (SAS), AF severity scale (AFSS), and EP were assessed. RESULTS: Favorable changes were seen in SR patients at 8 weeks in physical functioning (p < 0.001), physical role limitations (p = 0.03), general health (p = 0.002), and vitality (p < 0.001), and at 1 year in general health (p = 0.007) and social functioning (p = 0.02). Changes in the scores for SCL severity (p = 0.01), functional capacity (p = 0.003), and AFSS symptom burden (p < 0.001) at 8 weeks and in SCL severity (p < 0.01) and AF symptom burden (p < 0.001) at 1 year showed significant improvements in SR versus AF. Symptomatic patients were more likely to have improvement. The EP in SR versus AF was greater from baseline to 8 weeks (p = 0.01) and to 1 year (p = 0.02). The EP correlated with physical functioning and functional capacity except in the AF group at 1 year. CONCLUSIONS: In patients with persistent AF, restoration and maintenance of SR was associated with improvements in QOL measures and EP. There was a strong correlation between QOL measures and EP.     

Clinical applications of mifepristone.

Mifepristone is a progesterone antagonist that has been studied for a number of clinical applications. It is a well-known abortifacient that is effective for both first- and second-trimester medical abortion when used with a prostaglandin analog. It is also an effective cervical priming agent that can be used to soften the cervix before surgical evacuation. Its clinical efficacy as an emergency contraception has been proven. Other applications including treatment for fibroids, endometriosis and various cancers have been explored. However, its association with abortion limits the applications of mifepristone in many of these areas.     

原发性干燥综合征唇腺组织Fas、Fasl、Bcl-2表达的免疫组化研究

目的　探讨 Fas、Fas配体 (Fasl)及 Bcl- 2在原发性干燥综合征 (PSS)患者唇腺组织中的表达、定位及其与 PSS组织损伤的关系。方法　采用免疫组织化学方法对 30例 PSS患者及 10例正常人组织唇腺中 Fas、Fasl及 Bcl- 2的表达进行检测和组织细胞定位。结果　 PSS患者唇腺组织腺泡上皮细胞 (AEC)和导管上皮细胞(DEC)中 ,Fas/ Fasl表达阳性细胞百分比明显增加 ,与正常对照组比较有高度显著差异 (P <0 .0 1) ;Bcl- 2表达阳性细胞百分比明显减少 ,与正常对照组比较有显著差异 (P <0 .0 5 )。 PSS组 AEC、DEC及浸润单核细胞(IMC)中 ,Fas表达阳性细胞百分比三者间比较均无显著差异 (P >0 .0 5 ) ;Fasl表达阳性细胞百分比 DEC与IMC均显著高于 AEC(P<0 .0 5 ) ;Bcl- 2阳性细胞表达百分比 :IMC显著高于 AEC和 DEC(P<0 .0 5 )。结论　PSS患者唇腺上皮细胞 Fas、Fasl表达增加及 Bcl- 2表达减少可能是 PSS患者唾液腺破坏的原因之一 ;Fas、Fasl和 Bcl- 2在 IMC中异常表达也为 PSS患者唾液腺破坏的一个重要机制     

多发性硬化患者中IL-12和孕酮的检测及其临床意义

目的检测IL-12和孕酮在多发性硬化(MS)患者中的水平,探讨男、女性多发性硬化患者存在的发病机制,比较男、女性MS患者在临床上发病的差异。方法采用酶联免疫(ELISA)法检测60例MS患者的脑脊液和40例患者血液中IL-12的水平,应用放射免疫法测定40例MS患者血液中孕酮的含量,并与40例正常对照组比较(以上标本男女各半)。结果男、女性MS患者血液中和脑脊液IL-12的含量明显高于正常对照组(P<0.01);女性患者血液中孕酮的含量明显低于正常对照组(P<0.01),男性患者血液中孕酮的含量与正常对照组差别不明显(P>0.05);女性患者血液中孕酮对IL-12的含量存在负相相关作用(r=-0.80,P<0.01),男性相关作用不明显(r=-0.38,P>0.05)。结论IL-12参与多发性硬化的发病过程;孕酮可能是男、女性患者发病差异性的原因之一。     

老年患者不稳定性股骨转子间骨折的术式选择

目的探讨不同的内固定方式在老年患者不稳定性股骨转子间骨折治疗中的应用。方法参照Evans分型,85例老年患者股骨转子间骨折,不稳定性77例,稳定性8例,分别应用不同内固定治疗,其中Gamma钉20例、重建钉25例、动力髋部螺钉(DHS)和动力髁部螺钉(DCS)40例。结果术后随访79例,均获得骨折愈合,愈合时间4～7个月,平均5.2个月,其中大于5°髋内翻者有12例。根据患者骨折愈合、关节活动、主观感觉与生活能力恢复等因素制定疗效评定标准,优良率为84.8%(67例)。未发生因本手术所致内科合并症加重或患者死亡。结论髋内翻是老年患者不稳定性股骨转子间骨折内固定术后的主要并发症。Evans分型对选择内固定具有指导意义。结合老年患者骨质疏松情况,针对不同骨折类型选用适当的内固定器械,可以提高不稳定性转子间骨折的疗效。     

Molecular cloning and characterization of a Ca2+/calmodulin-insensitive adenylyl cyclase from rat brain.

Biochemical, immunological, and molecular cloning studies have suggested the existence of multiple forms of adenylyl cyclase (EC 4.6.1.1). An adenylyl cyclase cDNA clone (type II) was isolated from a rat brain library and found to encode a protein of 1090 amino acids that was homologous to but distinct from the previously described Ca2+/calmodulin-stimulated adenylyl cyclase from bovine brain. Expression of the type II cDNA in an insect cell line resulted in an increased level of adenylyl cyclase activity that was insensitive to Ca2+/calmodulin. Addition of activated Gs alpha protein to type II-containing membranes increased enzyme activity. The mRNA encoding the type II protein was expressed at high levels in brain tissue and at low levels in olfactory epithelium and lung. The existence of multiple adenylyl cyclase enzymes may provide for complex and distinct modes of biochemical regulation of cAMP levels in the brain.     

影响肝外伤手术死亡的危险因素分析

目的分析影响肝外伤手术死亡的危险因素,探讨其临床意义。方法根据AAST和ISS标准,回顾性分析90例肝外伤手术病例,对影响手术死亡的危险因素进行单因素比较和Logistic回归分析。结果死亡15例,其中Ⅲ级2例、Ⅳ级4例、Ⅴ级9例,总体手术死亡率17%。Ⅳ~Ⅴ级肝外伤手术方式的单因素比较提示:清创性肝切除术的相对危险度是0.73;而规则性肝切除术、肝静脉或肝后下腔静脉修补术相对危险度分别是1.32、1.52。Logistic回归分析提示:ISS分会和术中失血量是影响手术死亡率的2个独立因素。结论ISS分值、术中失出血量和手术方式是影响肝外伤手术死亡的3个重要因素,娴熟的手术技能和合理的手术方式可以减少术中出血量和降低手术死亡率。     

胶质细胞瘤复发前后Cyclin D1和P16的表达

目的　探讨CyclinD1,P16在胶质瘤复发前后表达改变及其意义。方法　采用免疫组织化学LsABC法对 4 5例复发胶质瘤瘤组织、瘤旁脑组织和 10例正常脑组织CyclinD1,P16蛋白表达进行检测 ,统计分析CyclinD1,P16表达水平与胶质瘤分级、肿瘤复发的关系。结果　正常脑组织 ,瘤旁脑组织和胶质瘤组织CyclinD1表达依次升高 ,而P16的表达依次下降 ;肿瘤复发CyclinD1表达增强 ,P16的表达减弱。结论　CyclinD1与P16的表达与胶质瘤恶性进程和复发密切相关。