KMG及微导管在部分性脾栓塞中的应用价值

目的研究KMG和微导管系统在部分性脾栓塞中的应用价值。方法应用海藻酸钠微球(KMG)和微导管系统对常规导管不能超选择的18例脾功能亢进患者行部分性脾栓塞术。结果18例脾功能亢进病人均收到良好的疗效,未发生严重并发症。结论KMG配合微导管系统操作简单、方便、超选择成功率高、疗效好、副反应少,具有十分重要的临床应用价值。     

大学生篮球运动员集训期间部分淋巴细胞亚群和Th1/Th2细胞因子mRNA表达变化分析

目的:探讨大负荷体能训练对大学生篮球运动员细胞免疫功能的影响。方法:14名男子大学生篮球运动员进行为期16周的集训,在训练期间分次对运动员外周血淋巴细胞亚群(CD3+、CD4+/CD8+淋巴细胞比值、NK细胞比例)和Th1/Th2细胞因子 mRNA表达进行检测。结果:在两次分别持续了6周的训练期后,运动员外周血CD3+淋巴细胞数于增加后出现显著下降,从第7周的峰值(59.74±7.18)下降至第16周的最低值(52.02±7.92)(P<0.001);CD8+细胞数第16周(31.15±6.25)与第3周(37.98±7.05)相比显著下降(P<0.05);NK细胞数从第7周的最高值(19.62±5.21)下降至第14周的最低值(14.41±7.93)(P<0.05);IL-4 mRNA表达训练后与基础值(6.56±0.71)相比显著增加,从第7周的7.04±0.35和第14周的7.30±0.25,直至第16周达到最大值7.36±0.45(P<0.05),其他指标的变化不具有统计学意义。结果提示,大负荷训练使运动员细胞免疫功能削弱,Th1/Th2平衡向Th2方向漂移。     

Detection of disseminated tumor cells in the lymph nodes of colorectal cancer patients using a real-time polymerase chain reaction assay

Introduction Postoperative treatment for colorectal cancer depends on tumor stage as defined by the International Union Against Cancer (UICC). Adjuvant chemotherapy is not recommended in patients without lymph node involvement (UICC stages I and II). As many as 20–30% of these patients, however, will develop recurrence. Aims and objectives We conducted this study to determine the presence of disseminated tumor cells in the lymph nodes by quantitative real-time polymerase chain reaction (QRT-PCR) for cytokeratin 20 (CK20) in an attempt to provide supplementary information compared to histopathological findings. Materials and methods Using a standard QRT-PCR assay, we examined primary tumors and 391 lymph nodes from 31 patients with completely resected colorectal cancer. Results Of the 31 primary tumors, 29 were positive for CK20 by QRT-PCR. Discussion An examination of the lymph nodes from the 29 patients with CK20-positive primary tumors revealed that 35 (92.1% sensitivity) of the 38 histopathologically positive lymph nodes and 54 (16.7%) of the 324 histopathologically negative lymph nodes were positive by molecular analysis. CK20 expression was detected in 10 (100%) of 10 patients with a histopathologically positive lymph node status (pN1). In 9 (47.4%) of 19 patients with negative histopathological results (pN0), we detected a CK20 mRNA signal in at least one lymph node. Whereas eight patients with histopathologically negative lymph nodes could be upstaged on the basis of the molecular findings, no patient would be downstaged. Conclusion Our results suggest that QRT-PCR for CK20 is a useful tool for the quantitative detection of micrometastases in the regional lymph nodes. We introduce a standardized procedure that integrates a molecular diagnostic technique in the clinical staging.     

Comparison and validation of scoring systems in a cohort of patients treated for perforated peptic ulcer

Background and aims The aim of this study is to evaluate the predictive accuracy of different scoring systems on surgery for perforated peptic ulcer referred to an academic department of general surgery in a tertiary reference center. Patients and methods Seventy-five consecutive patients (Male/female ratio = 64:11; mean age, 44 years; range, 16–85) with perforated peptic ulcer disease were investigated. Disease severity scores and mortality predictions were calculated using the collected data during admission. Discrimination and calibration characteristics of each system, namely, the acute physiology and chronic health evaluation II and III, the simplified acute physiology score II, and the mortality probability models (MPM) II, were determined by using the area under receiver operating characteristics curve and the Hosmer–Lemeshow goodness-of-fit test, respectively. Results Among the 75 patients included, there were eight (10.6%) mortalities. All systems had a reliable power of discrimination and calibration. Among the systems tested, MPM II was the best performing as far as discrimination and calibration characteristics were considered. The parameters of MPM II system that were related to systemic perfusion of the patient were significantly positive in patients who died compared to those who survived. Conclusions MPM II that predicted mortality at admission is better than the other systems in predicting mortality. Results also indicate the importance of maintenance of systemic perfusion of the patient at the early phases of peptic ulcer perforation.     

Complicated transseptal puncture during intervention catheter ablation on atrial fibrillation concomitant with straight back syndrome

Straight back syndrome (SBS) is a thoracic deformity with absence of upper thoracic spine kyphosis and heart compression. The anatomic abnormity of SBS may raise the difficulty of introcardial operation and increase the complicated risk of intervention performance. Here we report a case of SBS with complicated transseptal puncture during intervention catheter ablation of atrial fibrillation.     

Effect of early and late antibiotic treatment in experimental acute pancreatitis in rats

Background The clinical course in acute necrotizing pancreatitis is mainly determined by bacterial infection of pancreatic and peripancreatic necrosis. The effect of two antibiotic regimens for early and late treatment was investigated in the taurocholate model of necrotizing pancreatitis in the rat. Materials and methods Seventy male Wistar rats were divided into five pancreatitis groups (12 animals each) and a sham-operated group (10 animals). Pancreatitis was induced by intraductal infusion of 3% taurocholate under sterile conditions. Animals received two different antibiotic regimes (20 mg/kg imipenem or 20 mg/kg ciprofloxacin plus 20 mg/kg metronidazole) early at 2, 12, 20, and 28 h after induction of pancreatitis or late at 16 and 24 h after induction of pancreatitis or no antibiotics (control). Animals were examined after 30 h for pancreatic and extrapancreatic infection. Results Early and late antibiotic treatment with both regimes could significantly reduce pancreatic infection from 58 to 8–25%. However, extrapancreatic infection was only reduced by early antibiotic therapy. While quinolones also reduced bacterial counts in small and large bowel, imipenem did not. Conclusions In our animal model of necrotizing pancreatitis, early and late treatment with ciprofloxacin/metronidazole and imipenem reduce bacterial infection of the pancreas. Extrapancreatic infection, however, is reduced significantly only by early antibiotic treatment. The effectivity of early antibiotic treatment in the clinical setting should be subject to further investigation with improved study design and sufficient patient numbers.     

Validation of a screening questionnaire for hip and knee osteoarthritis in old people

Background  

To develop a sensitive and specific screening tool for knee and hip osteoarthritis in the general population of elderly people.