Experimental Study of a New Operative Procedure for Nonischemic Dilated Cardiomyopathy: Overlapping Cardiac Volume Reduction Operation

Purpose: To assess a newly devised procedure for cardiac volume reduction without resecting any cardiac muscle and evaluate its effectiveness in an experimental settings. Methods: Ten beagle dogs underwent a rapid pacing leading to heart failure for 3 weeks and then underwent left ventricular reduction by a procedure called the overlapping cardiac volume reduction operation (OLCVR), which consisted of a longitudinal incision in the left ventricular (LV) free wall, sutures from the left margin to the septal wall, and the right margin to the LV free wall. A slope of the linear preload recruitable stroke work relationship (M _w), with an X-intercept (V _o) were calculated as precise indicators of the LV systolic function. The constant of isovolumic pressure decay (Tau) and the peak filling rate (PFR) were also calculated as indicators of the LV diastolic function. Results: The LV end-diastolic dimensions significantly decreased by OLCVR (43 ± 2 to 25 ± 1 mm). Fractional shortening significantly improved by OLCVR (11% ± 2% to 30% ± 4%). M _w (erg · cm⁻³ · 10³) also significantly improved (21 ± 2 to 33 ± 3 (P < 0.001)), whereas V _o, Tau, and PFR did not show any significant changes. Conclusion: The OLCVR significantly increased the early LV systolic function without any detrimental effects on the diastolic function. This procedure may therefore be a useful therapeutic option for end-stage cardiomyopathy. Received: April 8, 2002 / Accepted: September 3, 2002 Reprint requests to: Y. Matsui, Department of Cardiovascular Surgery, NTT East Corporation Sapporo Hospital, South 1 West 15, Sapporo 060-0061, Japan     

慢性乙型肝炎重叠急性戊型肝炎3种血清细胞因子表达及意义

目的分析慢性乙型肝炎重叠急性戊型肝炎患者血清γ-干扰素（IFN-γ）、白细胞介素-2（IL-2）、白细胞介素-10（IL-10）的表达及临床意义。方法采用酶联免疫吸附试验（ELISA）测定慢性乙型肝炎重叠急性戊型肝炎患者（重叠组）、急性戊型肝炎患者（AHE组）、慢性乙型肝炎患者（CHB组）和健康体检者（对照组）的血清IFN-γ、IL-2、IL-10水平;分别采用实时荧光PCR和ELISA方法测定重叠组和CHB组的乙肝病毒（HBV）基因定量（HBV DNA）和HBV血清标记物;同时检测重叠组、AHE组和CHB组的主要肝功能指标。结果 重叠组IFN-γ高于CHB组和对照组,IL-10低于CHB组和对照组,IL-2高于CHB组（P〈0.05）;CHB组IL-10高于其他3组（P〈0.05）。重叠组丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、血清总胆红素（TBIL）高于CHB组,胆碱酯酶（CHE）、白蛋白（ALB）、凝血酶原活动度（PTA）低于CHB组（P〈0.05）。重叠组乙型肝炎e抗原（HBeAg）和HBV DNA阴性率高于CHB组（P=0.00）。重叠组组中HBV-DNA阴性者IFN-γ、IL-2水平高于HBV-DNA阳性者,IL-10水平低于HBV DNA阳性者（P〈0.01）。结论 IFN-γ、IL-2、IL-10参与慢性乙型肝炎重叠急性戊型肝炎肝细胞免疫损伤过程;IFN-γ、IL-2、IL-10可作为判断重叠感染后肝细胞损伤程度的指标;重叠感染后IFN-γ、IL-2可能影响HBV的复制。     

2014 - 2016年中国大陆地区流动人口基本医疗保险参保和重复参保研究

目的 了解我国大陆地区流动人口基本医疗保险参保和重复参保现状,探究重复参保的影响因素。方法 基于国家卫生健康委2014 - 2016年流动人口动态监测调查数据,利用cochran - armitage趋势检验方法分析基本医疗保险参保率和重复参保率的变化趋势,利用logistic回归模型分析重复参保的影响因素。结果 （1）基本医疗保险参保率从84.95%上升至88.05%（P＜0.001）,其中新型农村合作医疗、城乡居民基本医疗保险参保率呈上升趋势,城镇居民基本医疗保险参保率呈下降趋势,城镇职工基本医疗保险参保率维持平稳;（2）重复参保率从4.37%下降至2.44%（P＜0.001）;（3）重复参保率存在地区性差异（P＜0.001）;（4）户口性质（OR = 5.558,农业vs.非农业, P＜0.001）和社会保障数（OR = 30.089, 社会保障数4～5种vs.社会保障数0～1种, P＜0.001）等是影响重复参保的主要因素。结论 2014 - 2016年我国大陆地区流动人口基本医疗保险覆盖率上升,重复参保率下降,户籍性质和社会保障等是影响重复参保的主要因素。     

Measures of Spatial Similarity and Response Magnitude in MEG and Scalp EEG

Sensor selection is typically used in magnetoencephalography (MEG) and scalp electroencephalography (EEG) studies, but this practice cannot differentiate between changes in the distribution of neural sources versus changes in the magnitude of neural sources. This problem is further complicated by (1) subject averaging despite sizable individual anatomical differences and (2) experimental designs that produce overlapping waveforms due to short latencies between stimuli. Using data from the entire spatial array of sensors, we present simple multivariate measures that (1) normalize against individual differences by comparison with each individual’s standard response; (2) compare the similarity of spatial patterns in different conditions (angle test) to ascertain whether the distribution of neural sources is different; and (3) compare the response magnitude between conditions which are sufficiently similar (projection test). These claims are supported by applying the reported techniques to a short-term word priming paradigm as measured with MEG, revealing more reliable results as compared to traditional sensor selection methodology. Although precise cortical localization remains intractable, these techniques are easy to calculate, relatively assumption free, and yield the important psychological measures of similarity and response magnitude.     

José Barzelatto lecture: Vision on unsafe abortion

José Barzelatto first distinguished himself as a leader with a vision in his years as a medical student. Later, principally as Director of the Reproductive Health Program at the World Health Organization and of the Ford Foundation program for women's sexual and reproductive rights, he contributed immensely toward the recognition of women's sexual and reproductive rights as part of their basic human rights. José Barzelatto's vision on abortion reflects his drive to promote social justice and respect individual rights, respect diversity, and promote a social consensus for a peaceful society. He believed that the fetus has moral value and did not accept abortion as a method of fertility control, but understood that abortion is a social phenomenon that cannot be changed with legal or moral condemnation. He accepted that condemning women who abort does not prevent abortion, is unfair, and causes great human suffering at a high social cost. José proposed nine points to form the basis for an overlapping consensus on abortion, on which to base a practical consensus that would allow societies to reduce the number of abortions and minimize their consequences. If we can agree on all or most of those points we would achieve the common objectives of: fewer women confronting the dilemma of how to deal with an unwanted pregnancy; fewer induced abortions; and fewer women suffering the consequences of unsafe abortion.     

Magnetic resonance imaging of lesions of synovial origin

Three patients with histologically differing lesions of synovial origin and two with synovial cysts, one of which was a dissecting popliteal cyst, were examined by magnetic resonance imaging (MR) and computerized tomography (CT). The three histologically proven synovial lesions were synovial sarcoma, diffuse giant cell tumor of tendon sheath, and synovial chondromatosis. In two of the five patients MR provided better anatomic and morphologic appreciation than CT, while in the others they were of equal value. CT demonstrated calcification in two of the lesions while on MR calcification could be identified in only one patient where it outlined the mass. MR did not demonstrate calcification in the substance of the diffuse giant cell tumor of tendon sheath. Coronal, transverse, and sagittal images of magnetic resonance graphically demonstrated the extent of the soft tissue masses and their relationship to bone, vessels, and soft tissue structures. Synovial sarcoma had a shorter T₁ than diffuse giant cell tumor of tendon sheath (these two lesions being of comparable size) and also had a uniformly longer T₂. The dissecting popliteal cyst showed the most intense signals on the T₁ weighted images, while the uncomplicated synovial cyst showed a long T₁. On the T₂ weighted images, each type of cyst showed a long T₂. The variance and overlap of intensity of MR signals suggest limited specificity in predicting the histologic nature of the synovial lesion.     

人类PU.1 cDNA的克隆及表达产物的生物活性

目的：重叠聚合酶链反应（Ｏｖｅｒｌａｐｐｉｎｇ Ｐｏｌｙｍｅｒａｓｅ ＣｈａｎｉＲｅａｃｔｉｏｎ ＰＣＲ）法是在上下游引物之间设计一对碱基互站的嵌套引物,第一轮ＰＣＲ分别扩增５’端和３’端片段,第二轮ＰＣＲ以第一轮ＰＣＲ的５’端和３’端片段混合物为模板,用上下游引物扩增出全长片段。该文用逆转录－Ｏｖｅｒｌａｐｐｉｎｇ ＰＣＲ法快速高效地从前骨髓干细胞中扩增到人类ＰＵ．１全长ｃＤＮＡ为４４２ｂｐ,酶切和测序证实完全与前人报道一致。构建的真核表达质粒ｐｃＤＮＡ３．１－ｈＰＵ．１可以被特异的抗体识别,体外细胞株转梁证实具有特异的激活启动子活性的功能。     

精神心理因素在肠易激综合征和功能性消化不良重叠症中的作用

目的探讨精神心理因素在肠易激综合征和功能性消化不良重叠症中的作用。方法对38例肠易激综合征（iBS）与功能性消化不良（FD）重叠症患者采用汉密尔顿焦虑量表（HAMA）14项和汉密尔顿抑郁量表（HAMD）17项版本进行心理测评,并将调查对象分为体力劳动组和非体力劳动组,比较分析各组评分的特点。结果女性FD与IBS重叠症患者焦虑抑郁障碍发病率较男性无显著性差异（68．2％vs75．0％,X2=0．21,P〉0．05）,非体力劳动者FD与IBS重叠症患者焦虑抑郁障碍发病率较体力劳动者显著升高（85．2％vs36．4％,X2=9．09,P〈0．005）。结论非体力劳动者FD与IBS重叠症患者合并精神心理压力可能通过增加内脏敏感性使FD与IBS重叠症发病率更高,提示心理治疗可能有助于治疗FD与IBS重瞢症。     

Fibromyalgia: a rheumatologic diagnosis?

Fibromyalgia (FM) is a medically unexplained or functional somatic syndrome (FSS). The two classification criteria are chronic widespread pain (CWP) and the finding of 11/18 tender points (TP). FM overlaps and co-occurs with other FSSs, and auxiliary symptoms that are not included in the criteria may be clues to other FSSs. About ten FSSs include chronic fatigue syndrome, myofascial pain syndromes and irritable bowel syndrome. TP do not reflect demonstrable pathology, and are locations where everyone is generally more tender. In FM they are more tender than normal due to lowered pain threshold. High TP counts are associated with the extent of distress or unspecific somatic symptoms in the absence of chronic pain. TP lack validity and should be excluded. CWP and distress are outside the domain of rheumatology, and abnormal mechanisms in FM relate to the central nervous system, as compared to "peripheral" mechanisms studied in rheumatology. FM should not be considered as a rheumatologic condition but rather as part of a broader spectre of FSSs. Patients with FSSs should be considered and treated together across medical specialities by general physicians in primary health care.