A new pyeloureteral drainage catheter

We describe a new pyeloureteral drainage catheter that can be used for both genitourinary tract stenting and drainage, as well as tamponade of bleeding from the renal parenchyma or subcutaneous tissue. Primary indications for the use of this catheter and recommendations on insertion techniques are presented. With the exception of one case of minor kinking of the catheter, we have had no complications or failures with this catheter. While insertion through an unprotected tissue track is somewhat difficult, we have had good success introducing the catheter through a 24-F or larger Teflon working sheath. The catheter has excellent patient retention properties. It can be converted from external to internal drainage or vice versa simply and quickly on the ward.     

European cervical cancer screening：experiences and results

1　ＯｖｅｒｖｉｅｗｏｆｆｅｍａｌｅｍａｌｉｇｎａｎｃｉｅｓｉｎＥｕｒｏｐｅＣａｎｃｅｒｉｎｃｉｄｅｎｃｅａｎｄｍｏｒｔａｌｉｔｙｅｓｔｉｍａｔｅｓｆｏｒ 1995ｗｅｒｅｒｅｐｏｒｔｅｄｒｅｃｅｎｔｌｙｆｏｒ 38ｃｏｕｎｔｒｉｅｓｉｎＥｕｒｏｐｅ[1] .Ｔｈｅｒｅｗｅｒｅｅｓｔｉｍａｔｅｄ 2 .6ｍｉｌｌｉｏｎｎｅｗｃａｓｅｓｏｆｃａｎｃｅｒｉｎＥｕｒｏｐｅｉｎ 1995 ,ｒｅｐｒｅｓｅｎｔｉｎｇｏｖｅｒｏｎｅ ｑｕａｒｔｅｒｏｆｔｈｅｗｏｒｌｄｂｕｒｄｅｎｏｆｃａｎｃｅｒｗｈｉｌｅＥｕｒｏｐｅ’ｓｉｎｈａｂｉ…     

Temperature-dependent effects of EDTA on the membrane glycoprotein IIb- IIIa complex and platelet aggregability

In agreement with previous studies, we observed that incubation of washed human platelets with EDTA at 37 degrees C for short periods caused an irreversible loss of their aggregation response to adenosine diphosphate and markedly diminished their capacity to bind fibrinogen. AP-2 is a monoclonal antibody that reacts with a determinant specific to the glycoprotein (GP) IIb-IIIa complex. We now report that in a direct binding assay, the number of sites for AP-2 on platelets incubated with EDTA at 37 degrees C fell to approximately 30% of those present on control platelets. This effect of EDTA was not observed at room temperature. Analysis of the treated platelets by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed normal amounts of GP IIb and GP IIIa. However, studies using crossed immunoelectrophoresis with 125I-AP-2, 125I-Tab (anti-GP IIb), or 125I- AP-3 (anti-GP IIIa) in intermediate gels showed that at 37 degrees C, EDTA was inducing an irreversible change in GP IIb-IIIa complexes. A reduction in size and probable dissociation of the GP IIb-IIIa precipitate was accompanied by the appearance of precipitates having the characteristics of those given by free GP IIb and free GP IIIa and the location of a major new cathodal precipitate, which bound Tab and AP-3 but not AP-2. Membrane modifications associated with the loss of antigenic determinants on GP IIb-IIIa may explain EDTA-induced loss of platelet aggregability at 37 degrees C.     

甲状腺相关性眼病伴眼外肌肌腱受累1例

目的：报告1例甲状腺相关性眼病的非典型CT扫描表现。方法：一位64岁的中国女性出现复视3mo,无视力模糊。14a前她曾患甲状腺功能亢进症伴多结节甲状腺肿并行甲状腺切除术。眼科检查发现双眼下斜视并向上注视受限。左眼red desaturation并Ⅰ级相对性瞳孔传入障碍。T3,T4和促甲状腺激素（thyroid stimulating hormone,TSH）正常。TSH受体、抗体水平高,与Graves＇病一致。磁共振成像（magnetic resonance imaging,MRI）显示双下直肌弥漫性增大,肌腱受累。结果：给予几周期静脉注射甲基强的松龙继之以口服强的松后视力无提高,反之继续下降。行左眼眼眶减压术,术后其左眼视力有所改善。结论：有肌腱受累的眼外肌增大不能排除甲状腺相关性眼眶病（thyroid assciated orbitopathy,TAO）的可能。     

Autologous protein solution inhibits MMP‐13 production by IL‐1β and TNFα‐stimulated human articular chondrocytes

Catabolic inflammatory cytokines are prevalent in osteoarthritis (OA). The purpose of this study was to evaluate an autologous protein solution (APS) as a potential chondroprotective agent for OA therapy. APS was prepared from platelet‐rich plasma (PRP). The APS solution contained both anabolic (bFGF, TGF‐β1, TGF‐β2, EGF, IGF‐1, PDGF‐AB, PDGF‐BB, and VEGF) and anti‐inflammatory (IL‐1ra, sTNF‐RI, sTNF‐RII, IL‐4, IL‐10, IL‐13, and IFNγ) cytokines but low concentrations of catabolic cytokines (IL‐1α, IL‐1β, TNFα, IL‐6, IL‐8, IL‐17, and IL‐18). Human articular chondrocytes were pre‐incubated with the antagonists IL‐1ra, sTNF‐RI, or APS prior to the addition of recombinant human IL‐1β or TNFα. Following exposure to inflammatory cytokines, the levels of MMP‐13 in the culture medium were evaluated by ELISA. MMP‐13 production stimulated in chondrocytes by IL‐1β or TNFα was reduced by rhIL‐1ra and sTNF‐RI to near basal levels. APS was also capable of inhibiting the production of MMP‐13 induced by both IL‐1β and TNFα. The combination of anabolic and anti‐inflammatory cytokines in the APS created from PRP may render this formulation to be a potential candidate for the treatment of inflammation in patients at early stages of OA. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29: 1320–1326, 2011     

Neonatal respiratory distress in near-term infants—consider surfactant protein B deficiency

Two infants presenting with respiratory distress in the first 24 h of life are described. Both patients underwent extensive investigation before the diagnosis of surfactant protein B-deficiency was reached. Both children died within 2 months of birth. Parental consanguinity was known to be a feature in the first case, who proved to have a previously unrecognized mutation of the surfactant protein B gene. In the second case, a history of parental consanguinity was not sought from the Caucasian family, but was later volunteered by the parents themselves. Case 2 proved to have the "common" surfactant protein B-deficient genotype. The key to diagnosis is having a high index of suspicion in any term or near-term newborn with severe respiratory distress; parental consanguinity must be excluded. Surfactant protein B-deficiency can be readily diagnosed from bronchoalveolar lavage specimens; a simple, inexpensive procedure which is well tolerated in newborns.