Characteristics and course of bone mineral densities among fast bone losers in a rural Japanese community: the Miyama Study

The aim of this study was to clarify and compare the temporal course of bone mineral density (BMD) between fast bone losers and normal residents in Miyama Village, a rural Japanese community. BMD was measured over a 10-year period in a cohort study in Miyama Village, Wakayama Prefecture, Japan, to provide information on rate of bone loss in the mature and elderly population. Subjects (n=400) were selected by sex and age stratum from the full list of residents born in 1910–1949, with 50 men and 50 women in each age decade. Baseline BMD of the lumbar spine and proximal femur was measured using dual energy X-ray absorptiometry in 1990, 1993, 1997 and 2000. In the cohort, 171 men and 189 women completed the follow-up survey performed in 1993. After calculating the rate of bone loss between 1990 and 1993, the greatest tertile from the distribution of bone loss was categorized as fast bone losers, with the remainder considered as normal subjects. Changes in BMD were compared between normal subjects and fast bone losers over the 10-year period. Mean rate of change for BMD at both lumbar spine and femoral neck in fast bone losers recovered to levels similar to those in normal subjects over 7 years of observation. By contrast, BMD at the lumbar spine and femoral neck decreased steeply over the 10-year period in both groups, and mean BMD for fast bone losers was significantly lower than that of normal subjects (P<0.05). These differences were apparent only at the lumbar spine in both men and women, even after adjusting for age. These results indicate that fast bone loss is a transient phenomenon rather than a fixed status, although individuals who have been categorized as fast bone losers at some stage continue to display low BMD in the lumbar spine.     

17β-雌二醇对子宫内膜异位症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响

目的研究17β-雌二醇(17β-E2)对子宫内膜异位症(内异症)患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响,探讨Wnt/β-catenin信号通路在介导雌激素促进内异症发生发展的作用。方法体外分离培养内异症患者在位子宫内膜间质细胞。用不同浓度17β-E2处理子宫内膜间质细胞48 h;此后选用10-10mol/L 17β-E2处理子宫内膜间质细胞12、24和48 h,逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blotting)检测17β-E2处理前后子宫内膜间质细胞β-catenin mRNA和蛋白的表达水平。同法分析雌激素受体拮抗剂ICI182,780(10-6mol/L)对17β-E2促进β-catenin mRNA和蛋白表达的影响。免疫组织化学染色观察17β-E2作用后β-catenin在子宫内膜间质细胞中的定位。结果17β-E2能明显促进内异症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白的表达,并呈剂量和时间依赖性,于10-10mol/L作用48 h最明显。雌激素受体拮抗剂ICI182,780能明显抑制17β-E2对子宫内膜间质细胞β-catenin mRNA和蛋白的表达。免疫组织化学染色发现17β-E2能促进β-catenin在子宫内膜间质细胞核内的表达。结论雌激素可能通过激活Wnt/β-catenin信号通路促进内异症在位子宫内膜的异位种植。     

树舌多糖GF对小鼠HepA瘤基因组DNA甲基化影响的实验研究

目的初步探讨树舌多糖GF对小鼠HepA瘤基因组甲基化的影响.方法提取基因组DNA,采用限制性酶切片段长度多态性分析的方法进行甲基化检测.结果 HpaII酶切结果:树舌多糖组可见3个条带,猪苓对照组可见3个条带, 阴性对照组可见4个条带,正常对照组可见2个条带.MspI酶切结果:树舌多糖组可见6个条带,猪苓对照组可见5个条带,阴性对照组可见5个条带,正常对照组可见6个条带.结论小鼠HepA瘤基因组DNA是低甲基化的,树舌多糖GF有阻碍小鼠HepA瘤基因组DNA低甲基化发生的趋势,可能还具有抗5mC的突变的作用.     

炎性肠病药物治疗的循证医学研究进展

目的:从循证医学的角度解析炎性肠病药物治疗的相关进展。旨在提高对临床证据的认知,帮助临床医生评估新的治疗,从批判的视角重新看待以往的治疗。方法:收集国外近期相关文献进行评价。结果及结论:炎性肠病(IBD)的发病机制尚不清楚,众多的治疗方案可供选择。因此,循证医学研究结果有非常重要的临床指导意义。IBD的研究方面取得了可喜的进步。但是,有关CD活动指数(CDAI)和临床分型系统仍有待于改进。通过循证医学的研究证据有望确定安全和易于耐受的药物,并能发现目前诊治方面存在的缺陷和问题,更好地解决患者的病痛。     

Prospective multicenter clinical trial of Uretex Sup for surgical treatment of stress urinary incontinence

AIM: To evaluate in a prospective multicenter study the efficacy and safety of the suburethral support Uretex (Sofradim, Trevoux, France) delivered by a suprapubic approach in the treatment of female stress urinary incontinence. METHODS: Between March 2002 and March 2003, 57 patients were treated for stress urinary incontinence with Uretex. Preoperative evaluation included urodynamic examination and questionnaires (symptoms and quality of life, Contilife). Forty patients had pure stress urinary incontinence and 17 mixed urinary incontinence. No associated procedure was performed. The objective cure rate was evaluated by clinical examination and pad-test, and the subjective cure rate was assessed through questionnaires at 1, 3 and 12 months. RESULTS: The mean follow-up was 13 months (range 11-24 months). During follow up, chronic urinary retention requiring a tape section occurred in one patient, and in another patient a delay of vaginal healing was followed by a sling exposure and resection at 4 months. No infection or urethral erosion was reported. The objective cure rate was 96.2%, and the subjective cure rate was 79.2%; four patients reported low leakage on stress and nine patients complained of urge incontinence (four de novo and five persistent). CONCLUSION: The suprapubic Uretex Sup procedure is a safe and effective treatment for women with stress urinary incontinence.     

Aspiration biopsy cytology of mammary myoepithelioma

A case of ultrastructurally confirmed myoepithelioma of the breast studied by fine-needle aspiration biopsy is reported. Aspirated tumor cells were spindle-shaped with well-defined cytoplasm and oval nuclei showing no remarkable nuclear pleomorphism. They were seen mainly in irregular bundles with strong cellular cohesiveness. Their cytoplasm contained S-100 protein demonstrated by the peroxidase antiperoxidase staining technique.     

用放免法测定脐血清中T_4T_3及TSH浓度筛选先天性新生儿甲低

本文用放免法测定脐血清T_4值(727例),T_3值(556例)及TSH值(700例)筛选先天性新生儿甲低。T_4值量男为9.56±4.29ug/dl,女为10.15±4.35ug/dl;T_3值量男为86.06±63.42ngldl,女为85.61±44.42ngld;TSH值男为13.77±12.69mIu/ml,女为13.94±12.51mIu/ml。三种激素男女之间均无显著差别,对24例可疑甲低复查了静脉血清T_4、T_3、TSH含量,T_4值均较脐血清高;T_3值较脐血清高出2—3倍TSH值均降到成年人水平。否定了甲低。并对早期诊断的取样问题进行了讨论。     

上海市某区警察心理健康状况和生活质量的时点调查

目的调查警察心理健康状况和生命质量的基本流行学资料。方法采用梅奥心理服务问卷,主要内容为心理健康状况和生命质量测定等。在上海市某公安分局内进行截断面时点调查。结果1共调查警员1611人,男性91.5%,女性8.5%,年龄28.8±17.5岁。2GHQ的平均得分:1.5±2.31,存在可能心理障碍倾向者比例15.3%,可能存在重度心理障碍者比例2.9%。3SCL-90总分大于160分者比例17.2%;单项分大于2分比例最高的是强迫症状因子(19.5%),睡眠饮食因子次之(12.8%),躯体化症状因子(12.6%)第3位,敌对因子(12.4%)处于第4位。4健康变化、总体健康感、心理健康和生命活力得分是相对最低的维度。结论1在警察群体中存在心理障碍者比例远高于一般市民,生活质量一些维度相对较差;2建立长效机制是维护和保证警察心理健康和生活质量的有效手段。     

A simulation study of three sequential methods for the comparison of two treatment groups when the response criterion is censored

Three recent sequential methods, group sequential analysis (GSA), the sequential probability ratio test (SPRT) and the triangular test (TT) are well suited to randomized clinical trials with a censored response criterion, as they do not require matched pairs of patients. We undertook a simulation study to investigate their statistical properties and to compare these three methods with the fixed-sample design. Our results suggest that the three methods have the expected statistical properties for size and power; they allow an important reduction of the average number of events before stopping, except with GSA when there is no treatment difference; the triangular test (closed design) appears the optimal design, as the variance of the number of events is smaller than with the sequential probability ratio test (open design) and analysis after every twenty new events does not alter the statistical properties of these sequential methods and enhances their usefulness.