Computed tomography and radionuclide imaging in the evaluation of ischemic stroke

One hundred forty-one patients with cerebral or cerebellar infarction were examined by computed tomography (CT) as soon after the ictus as possible. The examination was repeated in 7 days, and a radionuclide brain scan was performed. The overall detection rate for ischemic infarction was approximately equal for both techniques, ranging from 58% for radionuclide scanning to 66% for the delayed CT. Almost half of the supratentorial infarcts examined by CT on the day of the ictus were demonstrated. Mass effect was observed as early as the first day and as late as the 25th day.     

Abacavir/lamivudine/zidovudine as a combined formulation tablet: bioequivalence compared with each component administered concurrently and the effect of food on absorption

A single-center, open-label, three-way crossover study was conducted in 24 healthy subjects to assess (1) the bioequivalence of a combined abacavir 300 mg/lamivudine 150 mg/zidovudine 300 mg (A/L/Z) combination tablet relative to the separate brand-name components administered simultaneously and (2) the effect of food on the bioavailability of the drugs from the combination tablet. The subjects were randomly assigned to receive each of the following three treatments, separated by a 2-day washout period: one A/L/Z combination tablet after an overnight fast, one abacavir 300 mg tablet + one lamivudine 150 mg tablet + one zidovudine 300 mg tablet sequentially after an overnight fast, or one A/L/Z combination tablet 5 minutes after completing a standardized high-fat breakfast (67 g fat, 58 g carbohydrate, and 33 g protein). Serial blood samples were collected up to 24 hours postdose for determination of abacavir, lamivudine, and zidovudine serum concentrations. Standard pharmacokinetic parameters were estimated. Treatments were considered bioequivalent if 90% confidence intervals (CI) for geometric least squares (GLS) mean ratios for abacavir, lamivudine, and zidovudine area under the serum concentration-time curve (AUC(infinity)) and maximum observed serum concentration (Cmax) fell entirely within 0.80 to 1.25 for log-transformed parameters. The combined A/L/Z tablet was bioequivalent in the extent (AUC) and rate of absorption (Cmax and time of Cmax [tmax]) to the individual brand-name drug components administered concurrently under fasted conditions. GLS ratios and 90% CI for AUC(infinity) and Cmax were 0.99 (0.96, 1.03) and 1.00 (0.90, 1.11), respectively, for abacavir; 0.95 (0.91, 0.99) and 0.90 (0.84, 0.99), respectively, for lamivudine; and 0.95 (0.89, 1.02) and 0.96 (0.80, 1.15), respectively, for zidovudine. The extent of absorption of abacavir, lamivudine, and zidovudine from the combination tablet was not altered by administration with meals, indicating that this formulation may be administered with or without food. However, food slowed the rate of absorption, delayed the tmax, and reduced the Cmax of abacavir, lamivudine, and zidovudine. These changes, which were consistent with those observed with the individual reference formulations when administered with food, were not considered clinically important. All formulations were well tolerated underfasted and fed conditions.     

活体生物萤光成像技术新进展

活体生物萤光成像技术(in vivo biolumines- cence imaging)是近年来发展起来的一项崭新的分子、基因表达的分析检测系统．与传统的检测方法相比具有巨大的优越性,堪称是分子基因检测领域的革命性技术．随着萤光成像设备的进一步完善以及转基因动物的构建开发,在欧美等发达国家活体生物萤光成像技术已被广泛地应用于感染、肿瘤免疫及治疗、自身免疫性疾病、器官移植、基因治疗、药物开发等实验领域．本文就活体生物萤光成像技术的发展和应用作如下综述．     

Luminance-modulated adaptation in the global flash mfERG: a preliminary study of early retinal functional changes in high-risk glaucoma patients

Purpose  

To investigate the association of the luminance-modulation global flash multifocal electroretinogram (mfERG) and other clinical assessments of vision in subsets of subjects at high risk of developing glaucomatous damage.     

Change in obesity‐related metabolic abnormalities associated with body mass index improvement through life‐style intervention: A meta‐regression

The reduction in body mass index standard deviation score (BMI‐SDS) associated with improvement in biomarkers relating to metabolic health in obese children is unknown. We aimed to establish the change in BMI‐SDS associated with improved inflammation, liver function, and insulin resistance to inform clinical guidelines for pediatric weight management interventions and to assess the efficacy of future trials. A large‐scale systematic review was conducted to identify relevant studies. Studies of children with a diagnosis of obesity according to defined BMI thresholds, participating in lifestyle interventions to reduce obesity, were included. Studies must have reported baseline (pre‐) and postintervention (or change of) BMI‐SDS and either fasting glucose, homeostatic model of insulin resistance (HOMA‐IR), alanine aminotransferase (ALT), C‐reactive protein (CRP), or interleukin‐6 (IL‐6). A series of meta‐regressions were conducted to establish links between BMI‐SDS change scores and change in metabolic markers of health. Sixty‐eight articles were identified. From the meta‐regression analyses, across all study subsets, greater mean falls in all four parameters, (HOMA‐IR, Glucose, ALT, and CRP) were observed with greater mean loss of BMI‐SDS, but the trends were only statistically significant for HOMA‐IR and CRP (P = .003; P = .021). However, we could not find minimum changes in BMI‐SDS that would ensure a fall in these outcomes. At this time, we are unable to recommend a definitive value of BMI‐SDS reduction needed to improve the markers of metabolic health. Future trials should aim to report additional indices of derived BMI values, which may better reflect changes in actual adiposity.     

Putting on the face: A qualitative study of power dynamics in clinical supervision

Nine master’s-level counselors (recently graduated) were interviewed about their experiences with power in clinical supervision. Using the consensual qualitative research (CQR) method (Hill, Thompson, & Nutt Williams, 1997), the authors derived five general categories: power resides in the supervisor’s expertise, supervisor error erodes his or her power, misuse of power elicits self-preservation, supervisor demonstrating trust in the supervisee’s abilities empowers the supervisee, and supervisor transparency reduces power. Power dynamics appeared to be most salient in situations where the supervisee experienced a negative supervisory event. Implications for training and research are discussed.     

IVF过程受精失败的预测

在发明和常规应用卵胞浆内单精子注射（ICSI）之前,十多年的临床体外受精（IVF）治疗实践中,受精率低下很常见,大约有20％～35％的IVF患者受精率很低（〈35％的卵子受精）和受精完全失败（所有卵子都不受精）。虽然受精失败与精子或卵子的质量有关,但相当一部分患者受精失败与精液质量或精子功能低下有很密切相关性。最常见的是严重的少精,弱精和畸形精子症患者。