速溶山楂饮料对高脂血症患者血脂、抗氧化酶和免疫功能的作用

目的　探讨速溶山楂饮料调节高脂血症患者脂质紊乱、提高抗氧化酶活力和增强免疫功能的作用。方法　 6 0名年龄 (5 7 9± 8 0 )岁高脂血症受试者 ,采用交叉试验方案 ,每名受试者参加 2次试验。半数受试者于第 1次试验补充速溶山楂饮料 (含 3g山楂干粉、相当于 30g鲜果 ,溶于 10 0ml水及饮料载体 ,1d 2次 ) ,另半数补充对照液 (0 75g瓜儿胶和少量淀粉作为饮料载体 ,1d 2次 )。持续 31d ,间隔 2 8d后 ,开始第 2次试验 ,受试者原补充速溶山楂饮料者 ,改为对照 ;原补充对照改为速溶山楂饮料。结果　补充速溶山楂饮料能显著降低血清总胆固醇 (9 6 % )、甘油三酯 (12 1% )、低密度脂蛋白 (18% ) ;而明显增加超氧化物歧化酶 (SOD)活力 (7 5 % )水平。受试者补充含瓜儿胶对照液虽然对某些血清脂质也有一定的改善作用 ,但效果不如速溶山楂饮料显著 ;而且 ,受试者仅在补充速溶山楂饮料时血清甘油三酯水平显著降低、抗氧化酶SOD水平显著提高 ,补充对照液无作用。结论　补充速溶山楂饮料能有效降低血清总胆固醇、甘油三酯、低密度脂蛋白、丙二醛水平 ,升高ApoA Ⅰ水平、SOD活性和NK细胞活力 ;综合测试表明 :补充速溶山楂饮料和对照比 ,调整血脂、提高抗氧化酶活力效果更显著。     

Genetic aberrations detected by comparative genomic hybridisation in vulvar cancers

Squamous cell carcinoma of the vulva is a disease of significant clinical importance, which arises in the presence or absence of human papillomavirus. We used comparative genomic hybridisation to document non-random chromosomal gains and losses within human papillomavirus positive and negative vulvar cancers. Gain of 3q was significantly more common in human papillomavirus-positive cancers compared to human papillomavirus-negative cancers. The smallest area of gain was 3q22-25, a chromosome region which is frequently gained in other human papillomavirus-related cancers. Chromosome 8q was more commonly gained in human papillomavirus-negative compared to human papillomavirus-positive cancers. 8q21 was the smallest region of gain, which has been identified in other, non-human papillomavirus-related cancers. Chromosome arms 3p and 11q were lost in both categories of vulvar cancer. This study has demonstrated chromosome locations important in the development of vulvar squamous cell carcinoma. Additionally, taken together with previous studies of human papillomavirus-positive cancers of other anogenital sites, the data indicate that one or more oncogenes important in the development and progression of human papillomavirus-induced carcinomas are located on 3q. The different genetic changes seen in human papillomavirus-positive and negative vulvar squamous cell carcinomas support the clinicopathological data indicating that these are different cancer types.     

Ease of access is a principal factor in the frequency of paracetamol overdose

Background  

In Ireland, 30% of non-fatal overdoses involve paracetamol.     

Infectious diseases. 6: Sexually transmitted infections: new diagnostic approaches and treatments

1. Commercially available nucleic acid amplification assays (eg, polymerase or ligase chain reaction) are now the "gold standard" tests for genital chlamydial infection and also have a role in screening for gonococcal infection. 2. Single-dose oral antibiotics are available for treatment of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis infections. 3. Strains of N. gonorrhoeae in urban Australia are often penicillin resistant, while strains from South East Asia and those in homosexually active men may show high-level resistance to quinolones. 4. Imiquimod, a novel immune-response modifier, is now available for effective, safe, self-administered treatment of genital warts. 5. The Pap smear remains the cornerstone of screening for precursor lesions of cervical cancer, but human papillomavirus genotyping may have a role in clinical decision-making for women with equivocal or early precancerous lesions. 6. Treatment of primary genital herpes changes the clinical course, and long-term suppressive therapy is effective for those with multiple recurrences. New technologies have made diagnosis and screening easier for patients and clinicians     

Use of CT Hounsfield unit density to identify ablated tumor after laparoscopic radiofrequency ablation of hepatic tumorsrid=""id=""Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Atlanta, Georgia, USA, 29 March–1 April 2000

Background: When attempting to interpret CT scans after radiofrequency thermal ablation (RFA) of liver tumors, it is sometimes difficult to distinguish ablated from viable tumor tissue. Identification of the two types of tissue is specially problematic for lesions that are hypodense before ablation. The aim of this study was to determine whether quantitative Hounsfield unit (HU) density measurements can be used to document the lack of tumor perfusion and thereby identify ablated tissue. Methods: Liver spiral CT scans of 13 patients with 51 lesions undergoing laparoscopic RFA for metastatic liver tumors within a 2-year time period were reviewed. HU density of the lesions as well as normal liver were measured pre- and postoperatively in each CT phase (noncontrast, arterial, portovenous). Statistical analyses were performed using Student's paired t-test and ANOVA. Results: Normal liver parenchyma, which was used as a control, showed a similar increase with contrast injection in both pre- and postprocedure CT scans (56.4 ± 2.4 vs 57.1 ± 2.4 HU, respectively; p= 0.3). In contrast, ablated liver lesions showed a preablation increase of 45.7 ± 3.4 HU but only a minimal postablation increase of 6.6 ± 0.7 HU (p < 0.0001). This was true for highly vascular tumors (neuroendocrine) as well as hypovascular ones (adenocarcinoma). Conclusions: This is the first study to define quantitative radiological criteria using HU density for the evaluation of ablated tissues. A lack of increase in HU density with contrast injection indicates necrotic tissue, whereas perfused tissue shows an increase in HU density. This technique can be used in the evaluation of patients undergoing RFA. Received: 1 March 2000/Accepted: 4 April 2000/Online publication: 9 August 2000     

Local Recurrence After Laparoscopic Radiofrequency Thermal Ablation of Hepatic Tumors

Background: Since we first described laparoscopic radiofrequency ablation (LRFA) of liver tumors, several reports have documented technical and safety aspects of this procedure. Little is known, however, about the long-term follow-up of such patients.Methods: From January 1996 to February 1999, we performed LRFA on 250 liver tumors in 66 patients. Triphasic spiral computed tomographic scanning was obtained preoperatively and at 1 week, and every 3 months postoperatively. Lesion diameter was measured in the x- and y-axes and the volume estimated; 181 lesions in 43 patients for whom computed tomographic scans available were included in the study. The tumor types were as follows: 64 metastatic adenocarcinomas, 79 neuroendocrine metastases, 27 other metastases, and 11 primary liver tumors.Results: One week postoperatively, the ablated zone was larger than the original tumor in 178 of 181 lesions, which suggests ablation of the tumor and a margin of normal liver tissue. A progressive decline in lesion size was seen in 156 (88%) of 178 lesions, followed for at least 3 months (mean, 13.9 months; range, 4.9–37.8 months), which suggests resorption of the ablated tissue. Fourteen definite local treatment failures were apparent by increase in size and change in computed tomographic scan appearance, and eight lesions were scored as failures because of multifocal recurrence that encroached on ablated foci (22 total recurrences). Predictors of failure include lack of increased lesion size at 1 week (2 of 3 such lesions failed), adenocarcinoma or sarcoma (18 of 22 failures; P < .05), larger tumors (failures, M < 18cm³ vs. successes, M < 7cm³; P < .005) and vascular invasion on laparoscopic ultrasonography. By size criteria, 17 of 22 failures were apparent by 6 months. Energy delivered per gram of tissue was not significantly different (P < .45).Conclusions: LRFA has a 12% local failure rate, with larger adenocarcinomas and sarcomas at greatest risk. Failures occur early in follow-up, with most occurring by 6 months. LRFA seems to be a safe and effective treatment technique for patients with primary and metastatic liver malignancies.Presented at the 52nd Annual Meeting of the Society of Surgical Oncology, Orlando, Florida, March 4–7, 1999     

Induction of chromosome-specific aneuploidy and micronuclei in human lymphocytes by metabolites of 1,3-butadiene

1,3-Butadiene is a carcinogen in rodents, but its potential carcinogenicity to humans remains controversial. Numerous studies have shown that butadiene and its metabolites cause sister chromatid exchanges in vitro and in vivo. To test for other types of genotoxicity, the micronucleus assay and fluorescence in situ hybridization (FISH) have been used to detect chromosome damage in human lymphocytes caused by two reactive metabolites of butadiene, diepoxybutane (DEB) and monoepoxybutene (MEB). DEB (0.5-5.0 microM) significantly increased micronucleus formation 4- to 6-fold (P <0.01) and MEB (1-500 microM) by 2- to 4-fold (P <0.01) over control levels. The ability of DEB and MEB to induce aneuploidy of chromosomes 7, 8, 12, and X was examined using dual-color FISH in both interphase and metaphase cells. These chromosomes were chosen because of their involvement in leukemogenesis. Both DEB and MEB caused dose-dependent increases in hyperdiploidy of chromosomes 12 and X, but had no discernible effect on chromosomes 7 and 8. These results suggest that DEB and MEB cause chromosome-specific aneuploidy in human cells. If formed in sufficient amounts, DEB and MEB may produce chromosome damage of the type found in leukemia following exposure to butadiene.