氯吡格雷在非ST段抬高冠脉综合征患者中应用的药物经济学分析

氯吡格雷是腺苷二磷酸诱导的血小板聚集的选择性抑制剂。在严密设计的CURE(Clopidogrel in Unstable angina to prevent Recurrent Events,氯吡格雷预防不稳定型心绞痛患者复发事件)研究和在行经皮冠脉介入(PCI)的患者中进行的亚研究PCI-CURE中,急性冠脉综合征(acute coronary syndrome,sACS,不稳定型心绞痛或非ST段抬高的心肌梗死)患者氯吡格雷加阿司匹林联合使用1年以上与安慰剂和阿司匹林相比,可以显著降低心血管事件的危险。基于这些临床试验数据,采用各种模型、方法和(或)成本类型,氯吡格雷加阿司匹林治疗ACS患者(包括行PC…     

痤疮皮损中基因阵列表达谱揭示炎症和基质重建基因显著上调

痤疮的发病机制涉及多种因素,如皮脂分泌增多、炎症、毛囊角化过度以及毛囊内痤疮丙酸杆菌感染。为了明确涉及炎症性痤疮的特定基因,作者对痤疮患者进行了基因表达谱研究。在6例痤疮患者的正常皮肤和炎性丘疹部位行活检,同时对6例未患痤疮的正常个体皮肤行活检。使用Affymetrix     

Update on detection, morphology and fragility in pili annulati in three kindreds

BACKGROUND: Pili annulati is an inherited hair shaft abnormality with a wide range of clinical expression. OBJECTIVE: We have examined closely three kindreds to reveal levels and character of expression of the phenotype and supplement current literature on the threshold for detection and aspects of hair shaft fragility. PATIENTS AND METHODS: Eleven cases of pili annulati from three families were included in a clinical and morphological study. All cases were assessed clinically and by light and scanning electron microscopy (SEM) of hair shafts. In addition, transmission electron microscopy (TEM) (four patients) and amino acid analysis (three patients) were undertaken on clinically overt cases. Results Examination by light microscopy with a fluid mountant was more sensitive than clinical examination, increasing the detection rate by 120%. Microscopic examination revealed that the characteristic periodic bands become less frequent distally in the hair shaft. Microscopic features of weathering were found in two cases, adding pili annulati to the list of structural hair shaft dystrophies that may weaken hair and dispose to weathering. Amino acid analysis of the hair of three patients with pili annulati showed elevated lysine and decreased cystine content compared to 12 normal controls, consistent with the reduced threshold for weathering. CONCLUSION: Careful light microscopy with fluid-mounted hair is needed to detect subjects mildly affected by pili annulati. Expression of the phenotype varies widely between individuals, between hairs and within hairs of the same individual, where ageing of the hair diminishes detectable features.     

Obstetrical interventions and health centre coverage: a spatial analysis of routine data for evaluation

In this paper a spatial analysis of routine utilization datais used as a cheap and sensitive contribution to the overallevaluation of the health care delivery system. Routine dataon major surgical interventions for complicated labour in arural area in Eastern Zaire are analysed. Distance decay ofintervention rates is marked for the rural population, but lessso for areas covered by the health centre network. A coefficientof localization is used to assess the inter-area variation inintervention rates. It can be shown that differences betweenareas tend to diminish over the years.     

Intracranial vascular malformations: imaging of charged-particle radiosurgery. Part I. Results of therapy

Twenty-four patients with intracranial vascular malformations were examined before and after helium ion radiosurgical treatment with angiography, computed tomography (CT), and magnetic resonance (MR) imaging. Twenty patients had high-flow arteriovenous malformations (AVMs). After treatment 18 of 20 AVMs (90%) showed a significant reduction in size on angiograms or MR images. Eleven of 20 (55%) had complete resolution on angiograms or MR images, 35% had partial resolution, and 10% showed no size change. Before treatment, the size range of the AVMs was 0.86-383 cm3 (median, 21.7 cm3). Smaller AVMs (less than 8 cm3) were more likely to resolve completely than medium-sized AVMs (8-64 cm3) or larger AVMs (greater than 64 cm3). Four additional patients had slow-flow vascular malformations: One had a venous angioma; one, a probable cavernous hemangioma; and two, malformations that were not seen on angiograms. CT proved inaccurate in demonstrating the boundaries of the AVM after treatment because it showed persistent contrast enhancement even when the AVM was completely obliterated on angiograms. MR imaging and angiography were complementary in the evaluation of therapeutic results and should be the primary modalities in the examination of patients with AVMs.     

Decreased expression of E-cadherin and increased invasive capacity in EBV-LMP-transfected human epithelial and murine adenocarcinoma cells.

The EBV-encoded membrane protein LMP is one of 9 viral proteins regularly expressed in virally immortalized B lymphocytes. It is expressed in EBV-carrying lymphoblastoid cell lines of normal origin and in the majority of the poorly differentiated nasopharyngeal carcinomas, but not in Burkitt lymphomas. LMP has been reported to transform rodent fibroblasts, to inhibit epithelial differentiation and to alter morphology and cytokeratin expression in an in vitro immortalized human keratinocyte cell-line, RHEK-I. We now report that an LMP-transfected mouse mammary carcinoma line, SHG, exhibits a similar morphological change to that previously described in the LMP-transfected RHEK-I. In the LMP-transfected RHEK-I and SHG cells, we observed a decreased expression of the calcium-dependent adhesion molecule E-cadherin. The LMP-transfected RHEK-I cells were capable of invading type-I collagen gels while the control cells were not. The LMP-transfected SHG cells showed a significantly higher invasive capacity than the original cell line.     

Suppression of sleep-related prolactin secretion and enhancement of sleep-related growth hormone secretion.

Methysergide, a clinically-used blocker of serotonin receptors, was administered to 10 normal young men at a dose of 2 mg every 6 h for 48 h. After drug treatment, serum levels of growth hormone during sleep were 41.9% higher than placebo values (less than 0.001). In contrast, drug treatment was associated with a 36.4% decrease in stimulated growth hormone secretion during insulin tolerance testing (P less than 0.01). These opposite effects of methysergide suggest that different mechanisms are responsible for sleep-related and insulin-induced growth hormone secretion. Accordingly, data obtained with pharmacologic stimuli may lead to erroneous inferences regarding physiologic growth hormone control mechanisms. Administration of methysergide profoundly suppressed sleep-related prolactin secretion; overall nocturnal mean prolactin fell by 70.3% from 4.30+/-0.19 to 1.28+/-0.06 ng/ml (P less than 0.0001). It appears that serotonin may be significant modulating neurotransmitter for the control of growth hormone secretion, limiting sleep-related release, and enhancing insulin-induced release. It seems likely from these data that the role of serotonin in the control of prolactin secretion is relatively more important, since serotonin receptor blockade dramatically reduced sleep-related prolactin secretion.