The effect on body composition and exercise performance of home parenteral nutrition when given as adjunct to chemotherapy of testicular carcinoma

This study has evaluated whether long-term and permanent total parenteral nutrition (TPN) can protect body composition and exercise capacity during iterated courses of chemotherapy (PVB) in men with testicular carcinoma. Thirty-three men were randomly allocated by means of a computer based algorithm to receive either TPN (at hospital and home) during the entire chemotherapy period or to rely on spontaneous oral intake only. Nutrition status was assessed by measurements of whole body nitrogen (neutron activation), total body potassium, body water, urine creatinine excretion, loco-regional body nutrition indexes (AMC, TSF) and biochemical plasma concentrations (albumin, thyroid hormones). Whole body respiratory gas exchanges were measured during resting, submaximal and maximal exercise. TPN was prescribed on an individual basis in all study patients to cover 150% of their measured caloric need; nitrogen was given as 0.2 g N kg-1 day. All individuals were allowed to eat freely throughout the study. TPN patients were in overall positive energy balance (+850 Kcal day-1), while the control group was in negative balance (-532 Kcal day-1). This led to weight gain in the TPN group (+2.2 +/- 1.0 kg) while the control group lost significant weight (-4.2 +/- 1.1 kg). The average spontaneous oral caloric intake was 1014 +/- 153 Kcal day-1 in the TPN group and 1484 +/- 200 Kcal day-1 in the control group; total protein intake corresponded to 1.5 g protein kg day-1 in the TPN group and 0.7 kg day-1 in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)     

结核菌素抗体对儿童结核病的诊断价值

目的评价体液结核菌素(PPD)抗体在小儿结核病中的诊断价值。方法回顾性分析126例行PPD检查的住院患儿,其中确诊结核病22例。利用临床流行病学方法分别计算体液PPD抗体检测对结核病的特异性、敏感性、似然比、预测值及不同患病率下的验后概率。结果体液PPD抗体检测对小儿结核病的敏感性和特异性分别为45．45％和 91．35％,阳性和阴性似然比分别为5．25和0．597,阳性预测值为52．63％,阴性预测值为88．79％。患病率为15％时,验后概率为48．09％。结论体液PPD检测对小儿结核病的诊断价值有限,临床医师应谨慎对待体液 PPD检测阳性结果,其诊断价值与所处医院患儿结核病患病率有关。     

Facilitation of DDD Follow-Up Using the DDT Mode

To facilitate follow-up, modern dual chamber pacemakers provide a variety of diagnostic features like ECG interpretation channels and intracardiac electrograms, For evaluation of the sensing performance at rest and during exercise, for assessment of the presence of crosstalk, and for measurement of the retrograde conduction time, dual chamber triggered pacing, particularly the DDT mode, can be used alternatively or additionally in pacemakers equipped with this option. In contrast to ECG interpretation channels, ECG documentation is riot required for evaluation of the sensing performance, because the triggered pulses serving as markers for sense events can also be seen on the monitor. Selection of the DDT mode not only as temporary but also as permanent program serves to facilitate pacemaker EGG interpretation for exercise tests and Holter recordings as well.     

简略快速法在大肠埃希菌鉴定中的应用价值研究

目的比较简略快速法与自动生化鉴定法在大肠埃希菌鉴定中的能力差异。方法使用快速简略鉴定法和自动生化鉴定法对临床标本分离的疑似大肠埃希菌进行鉴定,比较两种方法结果的一致性及检测时间。结果 492株疑似大肠埃希菌经快速鉴定法检出248株大肠埃希菌及244株非大肠埃希菌;该248株大肠埃希菌中,有231株被自动生化鉴定仪确认为大肠埃希菌,而244株非大肠埃希菌中,有7株被确认为大肠埃希菌。简略快速法阳性预测值及阴性预测值分别为93.1%(231/248)及97.1%(237/244)。使用自动生化鉴定法耗时2.5~7.0h,平均(4.12±1.08)h;使用简略快速法耗时0.5~2.0h,平均(1.08±0.45)h,差异具有统计学意义(t=-40.252,P0.001)。结论使用简略快速法鉴定疑似大肠埃希菌可以获得接近于自动生化鉴定法的结果,且更加节省时间。     

The assessment of diagnostic tests

To determine whether improvements have occurred since a survey of the 1982 literature assessing diagnostic tests, the authors evaluated all English-language articles that assessed clinical diagnostic tests in abridged Index Medicus journals in 1985, and that had the terms sensitivity and specificity in the title, abstract, or key words. The 89 articles were assessed against seven methodologic criteria, including use of a well-defined “gold standard,” clearly defined test interpretation, blinding, clear data presentation, correct use of sensitivity and specificity, calculation of predictive values, and consideration of prevalence. In comparisons of 1985 vs. 1982 articles, there were significant improvements in five of the seven criteria. For example, the proportion of articles using a well-defined “gold standard” rose from 68% to 88%. Overall, the frequency of papers demonstrating five or more of the seven criteria increased from 26% to 47%. However, predictive values were discussed in only 54% of the articles without, necessarily, consideration of the influence of prevalence as well. This study raises the concern that while the concepts of sensitivity and specificity are now accepted, predictive values remain less well understood. Although there has been an improvement in the assessment of diagnostic tests in published research, attention to accepted methodologic standards is still needed on the part of researchers, reviewers, and editors. Received from the Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Supported by a National Health Scholar Award to Dr. Schechter from the Department of National Health and Welfare of Canada.     

藏药七十味珍珠丸对阿尔茨海默病小鼠模型脑组织Aβ表达的影响

目的 观察藏药七十味珍珠丸(ratanasampil,RNSP)对阿尔茨海默病(AD)转基因鼠脑组织β-淀粉样蛋白(Aβ1-40和Aβ1-42)生成和改善认知功能的作用.方法 利用Y-迷宫明暗分辨学习和旷场实验来观察23只13～14月龄雌性阿尔茨海默病转基因鼠(Tg2576)和同龄雌性BL6×SJL非转基因鼠(NTg)的学习记忆功能和焦虑水平.治疗组选取6只Tg2576鼠和5只NTg鼠给予七十味珍珠丸用针管灌胃1 μl(0.14 mg/d),每天1次,连续用药8周;对照组选取7只Tg2576鼠和5只NTg鼠用蒸馏水和芝麻油各0.5 μl混匀后用针管灌胃1 μl,每天1次,连续用药8周.用蛋白印迹法和酶标免疫吸附测试法联合测定鼠脑组织β淀粉样蛋白(Aβ1-40和Aβ1-42)以及人鼠嵌合型跨膜蛋白淀粉样前体蛋白(β-amyloid precursor protein,APP)的蛋白含量,采用免疫组织化学法观察Aβ在鼠脑海马和大脑皮质的表达.结果 通过Y-迷宫明暗分辨学习测试,Tg2576鼠治疗组达标所需要的训练时间(34.23±9.65)s,比Tg2576鼠对照组(52.35±12.50)s显著降低;t=5.871,P＜0.01.与Tg2576鼠对照组比较,旷场实验测定结果显示Tg2576鼠治疗组在中央格停留时间明显减低[(4.70±3.56)s和(12.91±9.02)s;t=3.465,P＜0.01],跨格次数和站立次数增加[(85.33±17.64)次和(56.25±13.86)次;(57.67±17.08)次和(20.63±17.39)次;t=8.200,3.093,P＜0.01,P＜0.05],粪便排泄次数也明显减少[(1.17±0.56)次和(3.38±0.86)次;t=2.231,P＜0.05].两对照组比较,Tg2576鼠达标所需要的训练时间延长[(52.35±12.25)s和(37.03±8.98)s;t=3.131,P＜0.05],在中央格停留时间NTg较长,跨格次数和站立次数减少[(12.91±9.02)s和(5.24±5.88)s;(56.25±13.86)次和(82.75±22.54)次;(20.63±17.39)次和(53.50±13.94)次;P均＜0.05].上述训练项目NTg鼠在治疗组和对照组之间差异均无统计学意义.蛋白印迹法和酶标免疫吸附测试法联合结果显示Tg2576治疗组的脑组织内Aβ1-40和Aβ1-42含量均较对照组显著减低;通过RNSP治疗8周后Aβ42/Aβ40比率低于对照组(P＜0.05);但对Tg2576脑APP的表达未能减低.RNSP能够明显减少大脑皮质和海马周围老年淀粉样斑块的数目和面积.结论 藏药七十味珍珠丸可能通过减少Tg2576转基因鼠脑内Aβ1-40和Aβ1-42水平抑制老年斑的形成来改善转基因鼠学习空间记忆和探索运动能力,减少焦虑行为的发生.     

慢性HBV感染儿童外周全血细胞及肝功能特点分析

目的探讨慢性HBV感染儿童外周全血细胞指标、肝功能与HBV感染状态关系,为临床诊治儿童慢性HBV感染提供参考。方法回顾性调查127例慢性HBV感染（分为免疫耐受期和低复制期）儿童外周全血细胞指标、肝功能指标及HBVDNA水平。将调查对象按照年龄段分为低龄儿童组（年龄〈5岁）和大龄儿童组（年龄≥5岁）,在各自年龄段内比较上述指标在免疫耐受组和低复制组问差异,并与49例健康儿童（健康对照组）对照。结果在低龄儿童中,低复制组的RBC计数明显低于免疫耐受组和健康对照组（P均〈0．05）,但是后2组间差异无统计学意义（P〉0．05）。在大龄儿童中,免疫耐受组和低复制组的淋巴细胞绝对值显著低于健康对照组（P〈0．05）,但是前2组之间的淋巴细胞绝对值差异无统计学意义（P〉O．05）。在所有年龄段儿童中,外周全血其他指标在3组之间差异无统计学意义。在低龄儿童中,免疫耐受组和低复制组ALB低于健康对照组。所有慢性HBV感染患儿的ALT、AST都显著高于健康对照组（P均〈0．05）。结论在慢性HBV感染的低龄儿童中,低复制组外周血红细胞数降低;大龄儿童的淋巴细胞数减少;低龄患儿ALB、TP下降;所有患儿ALT、AST升高。