台风伤害及其影响因素的现场流行病学研究

目的分析台风伤害的危险因素。方法采用现场流行病学调查方法,1:2配对的病例对照研究。对照组选伤害者邻居,按照同职业、同村庄、同性别和年龄±5岁配对。结果台风造成392人受伤住院治疗,50人死亡。伤害罹患率为27．3／10万,伤害致死率为11．3％,伤害死亡率3．1／10万。调查了209名受伤者和31名死亡者。发现伤害主要发生在台风来临前,其中台风来临前1～6小时之间有病例155例,占64．6％。209例伤害病例中,67．5％的病例曾得到过台风预警,但138名应答者中重视预警的只有47人,仅占34．0％。发现“台风来临时不在家中”[调整OR值(MH)=3．9 (95％CI:1．9～7．7)]、“台风来临前未得到预警”[调整OR值(MH)=3．3(95％CI:1．3～8．6)]和“虽得到预警但不重视”[调整OR值(MH)=17(95％CI:4．2～68)]是台风伤害的危险因素。结论外出、不重视预警是台风伤害的危险因素,应加强台风来临的预警宣传力度。     

A Novel Bayesian Method for Efficacy Assessment in Animal Oncology Studies

In pre-clinical oncology studies, the investigator often compares efficacy of two or more treatments on tumor-bearing animals over a period of time. This is accomplished either through comparison of tumor volumes at various time points or overall survival. Due to ethical concerns, animals are euthanized before the end of the study whenever their tumor volumes reach a prespecified limit, the loss of bodyweight is beyond 20% or severely ulcerated tumors are observed. The traditional cross time-point tumor-size comparisons should not be performed when animals leave the study in a nonrandom nature. Survival analysis may alternatively be carried out to compare the time-to-euthanasia or natural death across treatment groups. As a result of government regulations, however, animal survival studies are hampered by small-sample sizes, often making statistical inference of survival data difficult. For example, it may be impossible to estimate median survival for an efficacious treatment group in which the majority of animals survive to the end of the study. Such cases create challenges to investigators who wish to rank-order the treatment effects, in effect picking the “winners” for further investigation. In this aricle, we list the benefits and shortcomings of popular methods and then propose a novel hypothesis test based directly on the survival probability to rank order the efficacy of treatments. The performance of the method is illustrated using a real-life example.     

A meta-summary of case reports of non-vitamin K antagonist oral anticoagulant use in patients with left ventricular thrombus

Left ventricular (LV) thrombus is commonly seen in patients with extensive anterior ST-elevation myocardial infarction. The standard of care for LV thrombus is anticoagulation with warfarin. However, there has been an increasing trend of case reports using non-vitamin K antagonist oral anticoagulants (NOAC) for the treatment of LV thrombus. This study aimed to perform a meta-summary of the literature to characterise and evaluate the safety and feasibility of using NOAC in patients with LV thrombus. We searched for articles published in four electronic databases: PubMed, EMBASE, Scopus and Google Scholar using an appropriate keyword/MeSH term search strategy. Twenty-four studies comprising 36 patients were included in the analysis. Rivaroxaban was used in majority of patients (47.2%), whilst Apixaban and Dabigatran were prescribed in 25.0% and 27.8% of patients respectively. The most commonly associated risk factor found was post-acute myocardial infarction in 15 patients (41.7%). LV thrombus resolution was met by most patients (87.9%), and the median duration of treatment to resolution was 30.0 days (IQR?=?22.5–47.0). One non-fatal bleeding event (3.0%) and no embolic events were reported. The use of NOAC may have a role in the treatment of LV thrombus in selected patients. Further randomized controlled trials are needed to evaluate this treatment strategy.     

Evaluation of smear layer removal by bicarbonate soda,ethylenediamine tetraacetic acid with cetrimide and sodium hypochlorite with a new model

Various methods are used to evaluate irrigants. The primary aim was to develop a model for preliminary testing of potential irrigants. The second aim was to investigate the effect of bicarbonate soda on smear layer by comparing it with ethylenediamine tetraacetic acid with cetrimide (EDTAC) and sodium hypochlorite (NaOCl). Extracted human single‐canal teeth were halved, and a uniform filing method was used to create smear layer. The following solutions were then applied – distilled water (control), 1% NaOCl, 17% EDTAC and bicarbonate soda at concentrations of 1%, 5%, 10% and 15%. Some samples had multiple solutions in different sequences. Samples were examined by scanning electron microscopy. Representative images were scored based on the degree of smear layer remaining. Results were analysed with the SAS system, using the GENMOD procedure. Complete smear layer was found in samples treated with all solutions except EDTAC used alone. There were no significant differences between the sequences, EDTAC/NaOCl/EDTAC and NaOCl/EDTAC/NaOCl. There were no significant differences between groups with and without bicarbonate soda. In conclusion, the model was effective for testing chemical effects on solutions on smear layer. Bicarbonate soda did not remove smear layer and provided no additional cleaning effects after EDTAC and NaOCl.     

Carrier detection in hemophilia A: a cooperative international study. I. The carrier phenotype

Eight laboratories in six countries cooperated to clarify several issues concerning the phenotypes of heterozygous carriers of hemophilia "A." Plasma levels of factor VIII (F.VIII:C, formerly VIII:C) and von Willebrand factor (VWF:Ag, formerly VIIIR:Ag) of carriers and normal women were determined by various "in-house" methods; a single lyophilized plasma standard was used for all assays. Analysis of the collated data from 336 carriers (296 obligatory carriers and 40 sporadic carriers) and 137 normal women showed that there was no difference in the F.VIII:C levels of "paternal" carriers (women who had obtained the abnormal gene from their fathers) and "maternal" carriers. Neither was there a difference in the VWF:Ag levels of normal women and either type of carrier. Age was found to have a significant effect on both F.VIII:C and VWF:Ag, values being higher at very young and very old ages, the minima occurring in the 25- to 30-year range. ABO blood type had a striking effect. Women of types A, B, and AB (designated non- O in the study), both normals and carriers, had significantly higher levels of both factors than did women of type O. Analysis by laboratories showed that differences in mean levels of both factors between laboratories were highly significant. It was concluded that age, ABO blood type, and laboratory variation should be taken into account in carrier detection.     

Insulin receptors on leukemia and lymphoma cells

Tumor cells obtained from leukemia and lymphoma patients were investigated for specific insulin receptors. Using radioactive 125I- labeled insulin, specific insulin binding sites were demonstrated on most acute lymphocytic leukemia (ALL) and acute myelocytic leukemia (AML) cells, including acute promyelocytic leukemia (APL), chronic myelocytic leukemia (CML), and acute monocytic leukemia (AMoL) cells. Insulin receptors were not found on chronic lymphocytic leukemia (CLL) and malignant lymphoma (ML) cells. Specific insulin binding sites were also found on monocytes and thymocytes after treatment with phytohemagglutinin (PHA-P), but not on inactivated tonsil cells, peripheral blood lymphocytes, or thymocytes. There was no inverse correlation between the content of insulin receptors and the basal level of circulating insulin. These data suggest that the insulin receptor may be a new marker of acute leukemia and chronic myelocytic leukemia.     

Development of decellularized conjunctiva as a substrate for the ex vivo expansion of conjunctival epithelium

This study was performed to develop a method to decellularize human conjunctiva and to characterize the tissue in terms of its deoxyribose nucleic acid (DNA) content, tensile strength, collagen denaturation, basement membrane, extracellular matrix components and its potential to support conjunctival epithelial growth. Human conjunctival tissues were subjected to a decellularization process involving hypotonic detergent and nuclease buffers. Variations in sodium dodecyl sulfate concentration (0.05–0.5%, w/v) were tested to determine the appropriate concentration of detergent buffer. DNA quantification, collagen denaturation, cytotoxicity and tensile strength were investigated. Human conjunctival cell growth by explant culture on the decellularized tissue substrate was assessed after 28 days in culture. Samples were fixed and paraffin embedded for immunohistochemistry including conjunctival epithelial cell markers and extracellular matrix proteins. Conjunctival tissue from 20 eyes of 10 donors (age range 65–92 years) was used. Decellularization of human conjunctiva was achieved to 99% or greater DNA removal (p < 0.001) with absence of nuclear staining. This was reproducible at the lowest concentration of sodium dodecyl sulfate (0.05% w/v). No collagen denaturation (p = 0.74) and no difference in tensile strength parameters was demonstrated following decellularization. No significant difference was noted in the immunolocalization of collagen IV, laminin and fibronectin, or in the appearance of periodic acid–Schiff‐stained basement membranes following decellularization. The decellularized tissue did not exhibit any cytotoxicity and explant culture resulted in the growth of stratified conjunctival epithelium. Allogeneic decellularized human conjunctiva can be successfully decellularized using the described protocol. It represents a novel substrate to support the expansion of conjunctival epithelium for ocular surface cellular replacement therapies. Copyright © 2017 John Wiley & Sons, Ltd.