Does bisphenol A induce superfeminization in Marisa cornuarietis? Part II: toxicity test results and requirements for statistical power analyses

This study presents results of the effects of bisphenol A (BPA) on adult egg production, egg hatchability, egg development rates and juvenile growth rates in the freshwater gastropod, Marisa cornuarietis. We observed no adult mortality, substantial inter-snail variability in reproductive output, and no effects of BPA on reproduction during 12 weeks of exposure to 0, 0.1, 1.0, 16, 160 or 640 μg/L BPA. We observed no effects of BPA on egg hatchability or timing of egg hatching. Juveniles showed good growth in the control and all treatments, and there were no significant effects of BPA on this endpoint. Our results do not support previous claims of enhanced reproduction in Marisa cornuarietis in response to exposure to BPA. Statistical power analysis indicated high levels of inter-snail variability in the measured endpoints and highlighted the need for sufficient replication when testing treatment effects on reproduction in M. cornuarietis with adequate power.     

小剂量红霉素治疗早产儿喂养不耐受的疗效观察

〔摘 要〕 目的：对早产儿喂养不耐受选择益生菌与小剂量红霉素治疗的临床效果进行分析及研究。 方法：纳入 2019 年 12 月至 2020 年 11 月于福建医科大学附属龙岩第一医院分娩并由新生儿科收治的 60 例喂养不耐受早产儿为研究对象,根据 床号奇偶数分为两组（奇数组为观察组,偶数组为对照组）,各 30 例。两组早产儿均接受常规治疗,确诊喂养不耐受后对 照组使用益生菌治疗,观察组使用小剂量红霉素治疗,比较两组早产儿各项临床指标评价临床治疗有效率。 结果：相比于 对照组,观察组早产儿呕吐、腹胀及胃潴留改善所需时间较短,差异具有统计学意义（P ＜ 0.05）;两组早产儿每日奶量增加、 体质量增加、达到全胃肠喂养耗时 3 项指标以及总体治疗效果组间比较,差异无统计学意义（P ＞ 0.05）;两组早产儿用 药期间,实验室指标正常,无相关不良反应发生。 结论：早产儿喂养不耐受选择小剂量红霉素及益生菌进行治疗均可实现 治疗的目的,但是两种药物效果比较,选择使用小剂量红霉素治疗,患儿腹胀、胃潴留及呕吐可得到迅速且有效的缓解。     

A prospective,multicentre phase II trial of low-dose erlotinib in non-small cell lung cancer patients with EGFR mutations pretreated with chemotherapy: Thoracic Oncology Research Group 0911

BackgroundLow-dose erlotinib may be as effective as gefitinib or erlotinib at full dose in non-small cell lung cancer (NSCLC) patients with activating mutations of the epidermal growth factor receptor (EGFR) gene.MethodsPatients with chemotherapy pretreated NSCLC harbouring EGFR mutations received erlotinib at 50 mg/d until disease progression or unacceptable toxicities. The dose was escalated to 150 mg/d in patients showing no response (i.e. without major tumour shrinkage according to Response Evaluation Criteria in Solid Tumours (RECIST)) to the initial dose during the first 4 weeks. The primary end-point was the objective response rate at the dose of 50 mg/d.ResultsThirty-four patients from seven institutes were enrolled. The study was closed early when no response was confirmed in 15 patients, excluding the possibility that the primary end-point would be met. The objective response and disease control rates at the dose of 50 mg/d as determined by an independent review committee were 54.5% and 84.8%, respectively. Four additional patients achieved partial response with increased 150 mg/d dose. Progression-free survival and median survival times during the entire period of the study were 9.5 and 28.5 months, respectively. Treatment-related toxicities were generally mild, the most common being skin disorders and diarrhoea. Only one case experienced grade 3 toxicity, which was transient increase of hepatic enzymes.ConclusionThe primary end-point was not met; low-dose erlotinib is not recommended for fit patients with NSCLC harbouring EGFR mutations. However, it may merit further evaluation for elderly or frail patients.     

Feasibility of abdominal plain film images in evaluation suspected drug smuggler

Objective

Drug smuggling in the gastrointestinal tract has soared within the last 20 years. Though illegal substances in the gastrointestinal tract can be visualized with ultrasound, MRI and CT, the abdominal radiograph has by far remained the most frequently used way of detecting smuggled drugs. The purpose of the study was to evaluate the inter-radiologist interpretation error and the reliability of the abdominal radiograph in detecting smuggled drugs.

Materials and methods

A total of 279 abdominal radiographs of suspected smugglers were classified by three radiologists as clearly positive or negative for drug smuggling. All available information about the cases was collected from the customs officers and police.

Results

Out of these cases 203 (73%) were interpreted as negative and 35 (13%) as positive by all three radiologists. In 86% of the cases there was, therefore, an inter-radiological agreement in interpreting the images. In 41 (14%) cases, however, there was an inter-radiologist disagreement. Kappa-value for inter-observer variability was 0.70.

Conclusions

In up to a seventh of the abdominal radiographs the interpretation can be challenging even for an experienced radiologist. False positive interpretation can lead to innocent passengers being detained in vain. As negatively interpreted images usually result in releasing of the suspect, there is no way of knowing how many false negative occur. This makes the abdominal radiograph a suboptimal examination, and low dose CT should be considered as the screening modality for gastrointestinal drug smugglers.     

Inter-scan repeatability of CT-based lung densitometry in the surveillance of emphysema in a lung cancer screening setting

Purpose

To investigate the inter-scan repeatability of CT-based lung densitometry protocols in the surveillance of emphysema in a lung cancer screening setting.

Materials and methods

Fifty-two healthy subjects who underwent low-dose chest CT and subsequent follow-up scan within a 16 month interval were retrospectively evaluated. Inter-scan repeatabilities were assessed for 9 different CT-based lung densitometry protocols with standard deviation (SD) of inter-scan differences. Susceptibility to inspiratory level was additionally assessed for each protocol, and volume adjustment (VA) was applied in order to evaluate the potential improvement of repeatability after compensating the influence of inspiratory level.

Results

A wide variation of inter-scan repeatability was observed among the evaluated protocols showing a difference of up to a factor of 9. Susceptibility of inspiratory level was found to be highly associated with the inter-scan repeatability of densitometric protocols. The application of VA could substantially reduce the influence of inspiratory level for all protocols, which results in an improvement of repeatability up to 51%.The order of repeatability among the protocols remained unchanged after VA. The resulting two best protocols in terms of inter-scan repeatability were RA970 and Perc1 which showed SD of 0.8% and 5.5 HU, respectively.

Conclusions

Lung densitometry protocols produce different levels of repeatability for an asymptomatic population, each being influenced by inspiratory level to a different degree. For surveillance of emphysema in a lung cancer screening setting, RA970 and Perc1 may be the most suitable protocols, in which the application of VA needs to be included as a critical part.     

胸腔镜术前低剂量CT引导下Hook-wire联合亚甲蓝定位肺局灶性磨玻璃样病变

目的探讨低剂量CT(low-dose CT,LDCT)引导下Hook-wire联合亚甲蓝定位在胸腔镜下肺局灶性磨玻璃样病变(focal ground-glass opacity,fGGO)切除术中的临床应用价值。方法 2010年11月～2012年4月对21例单侧fGGO(直径5～17 mm,平均11.5 mm,距壁层胸膜0～28 mm)行胸腔镜肺楔形切除术,术前皆行LDCT引导下Hook-wire定位,并辅以亚甲蓝染色。结果 LDCT引导下Hook-wire联合亚甲蓝定位成功率为100%,定位时间15～28 min,平均21 min。1例术中金属钩脱落,胸腔镜下观察肺组织表面血肿和亚甲蓝染色而成功手术切除;1例亚甲蓝染色失败,但Hook-wire锚定病灶亦成功手术切除。6例(28.6%)发生并发症,其中无症状气胸4例,无症状左上叶出血1例,无症状气胸和右下叶出血1例。VATS手术时间15～43 min,平均22 min;术中出血量23～38 ml,平均31 ml。术后住院5～12 d,平均7 d。fGGO术后病理:原位癌4例,微浸润腺癌3例,肺腺癌1例,不典型腺瘤样增生5例,错构瘤1例,间质性肺炎3例,肺内淋巴结增生2例,炎性肉芽肿2例。结论 LDCT引导下Hook-wire联合亚甲蓝定位fGGO的准确率高,并发症轻微。     

应用CT轴位扫描降低腰椎间盘病变放射辐射剂量的研究

目的探讨CT轴位扫描应用于腰椎间盘扫描以降低辐射剂量的可行性及其临床应用价值。方法随机抽取正常BMI的60例志愿者行CT腰椎间盘检查,在其他参数均相同情况下分别进行常规剂量(270 mA)和低剂量(180 mA、135 mA)扫描,比较两种不同低剂量CT扫描所得图像与常规剂量的图像质量差异,以及发现椎间盘病变的差异。结果在扫描图像质量方面,两种不同低剂量与常规剂量扫描有统计学差异(P<0.05)。但在诊断疾病方面,两种不同低剂量扫描与常规剂量扫描无统计学差异(P>0.05)。在满足诊断需要的同时,患者接受的辐射剂量分别降低36.5%及54.0%。结论轴位扫描应用于腰椎间盘CT扫描具有一定的可行性,并可大幅度降低患者辐射剂量。     

长程小剂量足叶乙甙持续治疗急非淋白血病

临床上不能耐受标准化疗治疗的急性非淋巴细胞性白血病７例，作者称为特殊性ＡＮＬＬ，并应用小剂量足叶乙甙，诱导化疗。结果ＣＲ２例。ＰＲ１例，ＮＲ４例，ＬＤ－ＶＰ１６治疗期间４例ＮＲ患者白血病无进展，病情稳定。这对用标准化疗治疗创造机会具积极意义。