促性腺激素释放激素类似物那法瑞林对人乳腺癌细胞BCaP-37生长的影响

目的：观察促性腺激素释放激素(LHRH)类似物那法瑞林对体外培养的人乳腺癌细胞BCaP-37生长的影响。方法：培养的BCaP-37细胞,经下列条件作用4 d后进行细胞计数：(1) 加入10-5-10-9mol/L的那法瑞林;(2)加入10-7-10-10mol/L的雌二醇(E2);(3)在含10-8mol/L E2的条件下,加入10-6-10-8mol/L的那法瑞林或他莫昔芬;(4)加入10ng/ml或50ng/ml的表皮生长因子(EGF);(5)在含10ng/ml EGF的条件下,加入10-5-10-7mol/L的那法瑞林。结果：那法瑞林在10-5-10-9mol/L浓度下对BCaP-37培养细胞的生长无显著抑制作用,在10-6-10-8mol/L浓度下可拮抗10-8mol/L E2对BCaP-37细胞的生长促进作用,对10ng/ml EGF抑制BCaP-37细胞生长的作用无显著影响。他莫昔芬拮抗E2促进BCaP-37生长的作用与那法瑞林相似。结论：那法瑞林对人乳腺癌细胞BCaP-37体外培养生长无显著抑制作用,但能拮抗E2对BCaP-37细胞的生长促进作用。     

Dental caries and erosion status of 12-year-old Hong Kong children

Background

We examined the association of alcohol use disorders (AUD) with adherence to and health-related quality of life (HRQOL) outcomes of antiretroviral treatment (ART) for HIV/AIDS patients.

Methods

A cross-sectional multi-site survey was conducted in 468 drug users and 648 non-drug users (age: 35.4 ± 7.0 years; 63.8% male) in 3 epicentres of Vietnam. AUD, ART adherence, and HRQOL were measured using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), the self-reported Visual Analogue Scale (VAS), and the World Health Organization Quality of Life instrument (WHOQOL-HIV BREF).

Results

35.0% of drug users were hazardous drinkers, compared to 25.9% of non-drug users. 22.3% of drug users engaged in binge drinking, and 25.9% reported suboptimal ART adherence. Adjusting for propensity scores of AUD, patients who had either at-risk or binge drinking behaviour were about twice as likely to be treatment non-adherent as those who did not have AUD. Hazardous drinkers reported small to medium decrements in the Performance, Physical, Social, Spirituality, and Environment quality of life domains. Binge drinkers had a slightly higher score in Social dimension.

Conclusion

AUD is prevalent and negatively affecting adherence to and HRQOL outcomes of ART services in injection-driven HIV epidemics. Screening and intervention are recommended for AUD, especially during the stable periods of ART. Other social and psychological interventions might also enhance patients’ responses to and outcomes of ART in Vietnam.     

"I" ministernotomy for aortic valve replacement.

BACKGROUND: Minimally invasive surgical approaches have been applied recently in the management of valvular heart disease. In this report, we reviewed our preliminary experience of minimally invasive aortic valve replacement. METHODS: Eighteen patients were operated on by means of an "I" ministernotomy, and 16 patients were operated on by means of a full median sternotomy during the same period. There was no difference between these two groups in term of age, sex, and preoperative left ventricular ejection fraction. In patients of the ministernotomy group, the operations were approached through an "I" median sternal split, from the second to the fifth intercostal space, 8 to 10 cm in length, with transverse division. Cardiopulmonary bypass was established through aorto-right atrial cannulation with aortic cross-clamping and antegrade or retrograde delivery of blood cardioplegia. RESULTS: Under direct vision, aortic valve replacement was performed successfully in patients of both groups. The duration of cardiopulmonary bypass time and aortic cross-clamp time was significantly longer in the ministernotomy group than in the full sternotomy group. However, the length of incision, duration of endotracheal intubation, intensive care unit stay, pain score, postoperative length of stay, and return to normal activity interval were significantly shorter and lower in patients of the ministernotomy group than in those of the full sternotomy group. All patients recovered from the operation rapidly. Follow-up was complete in all patients with no late complications. Echocardiographic examination showed good function of aortic prostheses. CONCLUSIONS: Our experience demonstrates that the "I" ministernotomy provides good exposure, reduced wound pain, enhanced recovery, shortened hospital stay, and good cosmetic healing. It may be a good alternative for surgical correction of aortic valve lesions.     

应用食管窦房结电图测定健康人的窦房传导时间

本文首先为4例先天性心脏病患者同步记录心内窦房结电图(SNEi)和食管窦房结电图(SNEe),然后改用只为120例不同年龄的4组健康人记录SNEe。经以上两种途径测得的窦房传导时间(SACT)相关良好。SACT与年龄呈正相关,老年组的SACT显著长于其它年龄组。结果提示:SNEe和SNEi具有同等程度的可靠性。不同年龄组共用一个SACT诊断标准是不恰当的,应分别制定其标准。     

Myxoid solitary fibrous tumor: a clinicopathologic study of three cases

While focal myxoid areas are occasionally observed in solitary fibrous tumors, neoplasms of this type exhibiting extensive myxoid change are considered exceedingly uncommon. Due to their rarity, the biologic behavior of myxoid solitary fibrous tumor has not been determined. Three cases of myxoid solitary fibrous tumor are described in order to better characterize the clinical and pathologic features of this uncommon variant of solitary fibrous tumor. The tumors occurred in one man and two women, with ages of 37, 47, and 58 years, respectively. Sites of involvement included the retroperitoneum, pelvis, and soft tissue of the neck. Histologically, all cases were characterized predominantly by the presence of myxoid stroma comprising 70% to 100% of the tumor. The tumor cells were predominantly spindled in all cases, and arranged randomly, in loose fascicles, or in anastomosing strands imparting a microcystic/reticular appearance. The lesional cells had a bland cytologic appearance and low mitotic count. All tumors lacked necrosis and areas of increased cellularity. By immunohistochemistry, all cases were positive for CD34, CD99, and bcl-2, and negative for keratin, epithelial membrane antigen, desmin, actin, smooth muscle actin, and S-100 protein. To date, all cases have followed a benign course without evidence of recurrence or metastasis with a follow-up duration ranging from 50 to 87 months. The data suggest that myxoid solitary fibrous tumors are associated with an indolent clinical course and favorable prognosis.     

Loss of E-cadherin expression correlates with poor differentiation and invasion into adjacent organs in gastric adenocarcinomas

Perturbation in E-cadherin expression leads to loss of cellular adhesion with possible consequence of cellular transformation and tumor progression. The aims of this study were to determine E-cadherin expression in each subtype of gastric cancer classified by different classification systems, and to investigate the role of E-cadherin in cell differentiation, cancer invasion and metastasis. Expression of E-cadherin was analyzed in 84 patients with gastric adenocarcinoma by immunohistochemistry and correlated with clinicopahotlogical parameters. Our results showed loss of E-cadherin expression in 0% (0/3), 20.0% (9/45), 48% (15/31), 100% (3/3) and 100% (2/2) of papillary, tubular, poorly differentiated, signet-ring cell, and mucinous adenocarcinoma by Japanese histological classification. The reduction of E-cadherin expression was inversely correlated with the grade of differentiation. According to the histological classification of Lauren and Ming, the frequency of lost E-cadherin expression was higher in diffuse type (65%) and infiltrative type (64%) gastric cancer than in intestinal type (20%, P<0.001) and expanding type cancer (22%, P<0.001), respectively. The loss of E-cadherin expression was significantly associated with tumor invasion (P<0.05). Furthermore, there was a borderline association between the loss of E-cadherin expression and poor survival (P=0.109). These data demonstrated a striking correlation between E-cadherin expression and the differentiation of gastric carcinoma. The loss of E-cadherin expression may contribute to gastric cancer invasion to adjacent organs.     

胸腺肽α1联合大剂量地塞米松治疗慢性特发性血小板减少性紫癜的疗效分析

目的探讨胸腺肽α1（Tα1）联合大剂量地塞米松（Dex）短程冲击治疗初治慢性特发性血小板减少性紫癜（ITP）的疗效及其细胞免疫机制。方法（1）66例初诊ITP患者口服Dex 40mg/d,连用4d;其中39例同时给予Tα1 1．6mg皮下注射,每周3次,连续应用4周。（2）ELISA法检测正常对照组20例及初诊ITP患者治疗前后血浆Tα1、IFNγ、IL-2、IL-4、IL-10及转化生长因子（TGF）-β1水平。结果（1）Tα1＋Dex联合治疗组与Dex单药治疗组,完全缓解（CR）率分别为76．9％（30／39）、44．4％（12／27）（P〈0．05）;长期反应率分别为61．5％（24／39）、34．6％（9／26）,复发率分别为38．5％（15／39）、65．4％（17／26）,差异均有统计学意义（P〈0．05）。（2）Tα1＋Dex治疗后Tα1水平为（1．83±1．22）μg/L较治疗前（2．43±1．47）μg／L明显降低（P〈0．05）。（3）Tα1＋Dex治疗后患者IFNγ和IL-2的血浆水平[（11．57±4．33）、（14．56±10．76）]ng／L均较治疗前[（22．71±7．98）、（28．42±11．27）]ng／L显著降低（P〈0．01）,且与正常对照组比较[（10．23±3．97）、（8．73±8．22）]ng／L,差异无统计学意义（P〉0．05）。IL-4和IL-10的血浆水平[（9．87±4．82）、（7．90±2．71）]ng／L均较治疗前[（5．93±3．85）、（3．24±1．36）]ng／L明显升高（P〈0．05）,且与正常对照组比较,差异无统计学意义（P〉0．05）。（4）Tα1＋Dex治疗后患者血浆TGF-β1水平（4．19±1．80）μg/L较治疗前（1．31±0．71）μg／L明显升高（P〈0．01）。（5）Tα1＋Dex治疗后患者Tα1水平与TGF-β1含量之间呈显著正相关（r=0．6028,P〈0．05）。结论（1）Tα1＋Dex联合治疗可以纠正ITP患者体内Th1／Th2平衡紊乱,减少血小板破坏,其CR率高、复发率较低且耐受性好,可作为ITP治疗的一种新的尝试。（2）Tα1＋Dex治疗后患者Tα1水平与作为Th3特异性标志的TGF-β1之间呈显著正相关,可能与NK细胞的生理性抑制功能上调有关。     

Antithrombotic efficacy of a novel factor Xa inhibitor, FXV673, in a canine model of coronary artery thrombolysis

We compared the antithrombotic efficacy of a potent factor Xa inhibitor, FXV673, to heparin and RPR109891, a GPIIb/IIIa antagonist, when used as adjunctive therapy in a canine model of rt-PA-induced coronary thrombolysis. Thrombus formation was induced by electrolytic injury to stenosed coronary artery. After thrombotic occlusion, a 135 min infusion of saline (n=8), FXV673 (10, 30 or 100 microg kg(-1)+1, 3, or 10 microg kg(-1) min(-1), respectively; n=8 per dose), heparin (60 u kg(-1)+0.7 u kg(-1) min(-1), n=8), or RPR109891 (30 microg kg(-1)+0.45 microg kg(-1) min(-1), n=8), was initiated. Aspirin (5 mg kg(-1), i.v.) was administered to all animals. Fifteen minutes after the start of drug infusion, rt-PA was administered (100 microg kg(-1)+20 microg kg(-1) min(-1) for 60 min). The incidence of reperfusion in the high dose FXV673 (8/8, 100%) was significantly greater than that in the heparin group (4/8, 50%), with a trend to faster reperfusion (23+/-5 min for FXV673 versus 41+/-11 min for heparin). Only 2/8 (25%) of the vessels reoccluded in the high dose FXV673 group, compared to 4/4 (100%) and 5/5 (100%) vessels in the heparin and RPR109891 groups, respectively (P<0.05). Throughout the protocol, blood flow was higher in the FXV673 treated group compared to other groups. FXV673 enhanced vessel patency in a dose-dependent manner. Compared to vehicle and heparin groups, the thrombus mass was decreased by 60% in the high dose FXV673. FXV673, heparin and RPR109891 increased the bleeding time by 2.7, 1.7 and 4 fold, and APTT by 2.8, 2.7 and 1.2 fold, respectively. In conclusion, FXV673 is more effective than heparin and at least as effective as RPR109891 when used as an adjunct during rt-PA-induced coronary thrombolysis.     

Efficacy of Trivalent Seasonal Influenza Vaccination in Reducing Mortality and Hospitalization in Chinese Nursing Home Older Adults

Objective

To examine the clinical efficacy of the trivalent seasonal influenza vaccination among Chinese older adults residing in a nursing home.

Design

A 12-month prospective cohort study. Participants were divided into 2 groups based on their own choice on vaccination of trivalent seasonal influenza vaccine: vaccinated group and unvaccinated group.

Setting

Fifty-eight nursing homes in Hong Kong.

Participants

A total of 1859 older adults residing in a nursing home.

Measurements

All-cause mortality, pneumonia-related mortality, all-cause hospitalization, and pneumonia-related hospitalization.

Results

A total of 1859 older adults residing in a nursing home were included: 1214 (65.3%) in the vaccinated group and 645 (34.7%) in the unvaccinated group. At 12 months of study, for all-cause mortality, 14.6% (177 of 1214) of the vaccinated group and 20.2% (130 of 645) of the unvaccinated group had died (P < .001). Multivariate analysis showed the hazard ratio for the vaccinated group was 0.72 (95% confidence interval [CI]: 0.54–0.95; P < .01). For pneumonia-related mortality, 9.4% (114 of 1214) of the vaccinated group and 12.7% (82 of 645) of the unvaccinated group died (P = .033). Multivariate analysis showed the hazard ratio for the vaccinated group was 0.80 (CI: 0.62–0.98; P < .05). The median number of all-cause hospitalizations per 1000 person-months was 55 (0–111) for the vaccinated group and 55 (0–167) for the unvaccinated group (P < .01). The median number of pneumonia-related hospitalizations per 1000 person-months was 0 (0–55) for the vaccinated group and 0 (0–111) for the unvaccinated group (P < .01).

Conclusions

Vaccination of trivalent seasonal influenza vaccine in Chinese nursing home older adults significantly reduced all-cause and pneumonia-related mortality and hospitalization.     

Cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal carcinoma: non-mucinous tumour associated with an improved survival

AIMS: Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy has been reported as a treatment option for patients with peritoneal carcinomatosis from colorectal carcinoma. METHODS: Thirty patients with colorectal peritoneal carcinomatosis underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy. All appendiceal cancers were excluded. All patients were followed until January 2006 or death. Univariate analysis was performed to evaluate significant prognostic factors for overall survival, defined from the time of surgery. RESULTS: There were 13 male patients. The mean age at the time of surgery was 54years. There was no hospital mortality. The mean duration of hospital stay was 27days. The overall median survival was 29months, with 1- and 2-year survival of 72% and 64%, respectively. Twenty-one patients had complete cytoreduction and their 1- and 2-year survival rates were 85% and 71%, respectively. Univariate analysis demonstrated that patients with non-mucinous colorectal adenocarcinoma, Peritoneal Cancer Index (PCI) < or =13, and complete cytoreduction were associated with an improved survival. CONCLUSIONS: This study reported on 30 patients who underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis. Patients with mucinous tumour had relatively more extensive intraperitoneal disease. Non-mucinous colorectal adenocarcinoma, PCI < or =13, and complete cytoreduction were associated with an improved survival.