Oral brush biopsy analysis by matrix assisted laser desorption/ionisation-time of flight mass spectrometry profiling--a pilot study

Oral squamous cell carcinomas (OSCCs) often present as advanced tumours requiring aggressive local and regional therapy and result in significant functional impairment. The objective is to develop pre-symptomatic screening detection of OSCC by a brush biopsy method which is less invasive than the conventional biopsy for histology. Given the molecular heterogeneity of oral cancer, it is unlikely that even a panel of tumour markers would provide accurate diagnosis. Therefore, approaches such as the matrix-assisted-laser-desorption/ionisation-time-of-flight-mass-spectrometry (MALDI-TOF-MS) allow several biomarkers or peptide profile patterns to be simultaneously assessed. Brush biopsies from 27 patients with histology-proven OSCCs plus 40 biopsies from 10 healthy controls were collected. MALDI-TOF-MS profiling was performed and additional statistical analysis of the data was used to classify the disease status according to the biological behaviour of the lesion. For classification a support vector machine algorithm was trained using spectra of brush biopsy samples to distinguish healthy control patients from patients with histology-proven OSCC. MALDI-TOF-MS was able to distinguish between healthy patients and OSCC patients with a sensitivity of 100% and specificity of 93%. In summary, MALDI-TOF-MS in combination with sophisticated bioinformatic methods can distinguish OSCC patients from non-cancer controls with excellent sensitivity and specificity. Further improvement and validation of this approach is necessary to determine its feasibility to assist the pre-symptomatic detection of head and neck cancer screening in routine daily practice.     

Polycystic ovary syndrome (PCOS)

1. The Rotterdam classification should be used to define PCOS in the event of: menstrual cycle anomalies; amenorrhoea, oligomenorrhoea or long cycles, clinical and/or biochemical hyperandrogenism and ultrasound appearance of polycystic ovaries.2. The presence of two of these three criteria is sufficient once all other diagnoses have been ruled out.3. Diagnosis of hirsutism should not be based on the Ferriman-Gallway score.4. The ultrasound definition of PCOS contains precise criteria that must be included in the report: presence of at least 12 follicles in each ovary measuring 2-9 mm in diameter, and/or increase in ovary size > 10 ml.5. Screening for elevated plasma LH no longer necessary. Testing for GnRH serves no purpose.6. Routine screening for metabolic abnormalities should be carried out systematically based on weight, height and BMI, waist circumference, blood pressure and laboratory parameters: plasma glucose, triglycerides, HDL cholesterol.7. In the case of obesity (BMI > 30 kg/m²), oral glucose tolerance testing (OGTT) is recommended where fasting serum glucose is normal.8. Clomiphene citrate (CC) remains the first-line therapy for ovulation induction. In patients with BMI > 30, it should be preceded by improvement of metabolic status through appropriate lifestyle modifications.     

Czech socio-economic deprivation index and its correlation with mortality data

Objectives:  The aim of the study was to create an index of socio-economic deprivation (SESDI) and to analyse correlation between SESDI and mortality data. Methods:  The SESDI components were selected from the census data (2001) at enumeration district and district level. Two methods were used for creating the SESDI: 1/ a sum of Z-scores of specific components (INDEX1); and 2/ standardized score – average values of specific components were divided by a maximum value of the specific component at the corresponding geographical level (INDEX2). Pearson’s correlation coefficient was used for assessing the relationship between indices, and between indices and mortality data (SMR). Results:  The final indices were applied to districts in the Czech Republic (N = 77). The correlation of INDEX1 and INDEX2 was high (r = 0.99). Analysis of relationships between degree of deprivation and total and selected specific SMR in the Czech Republic confirmed that mortality was associated with degree of deprivation. Conclusion:  The use of socio-economic deprivation indices in analysis of routinely collected mortality data in public health might help to explain health inequalities. Submitted: 14 November 2007; revised: 06 May 2008, 12 June 2008; accepted: 17 September 2008     

GHTF建议的体外诊断医疗器械分类和评价的原则

体外诊断（IVD）医疗器械正在迅速发展,品种日益增多。文中简要介绍了GHIF（全球协医调作组）建议的关于IVD医疗器械的分类和符合性评价原则。     

Oral osmotically driven systems: 30 years of development and clinical use

The number of marketed oral osmotically driven systems (OODS) has doubled in the last 10 years. The main clinical benefits of OODS are their ability to improve treatment tolerability and patient compliance. These advantages are mainly driven by the capacity to deliver drugs in a sustained manner, independent of the drug chemical properties, of the patient’s physiological factors or concomitant food intake. However, access to these technologies has been restricted by the crowded patent landscape and manufacturing challenges. In this review article, we intend to give an overview of the OODS development in the last 30 years, detailing the technologies, specific products and their clinical use. General guidance on technology selection is described in light of the recent advances in the field. The clinical performance of these technologies is also discussed, with a focus on food effects and the in vivo-in vitro correlation. Special attention is paid to safety given the controversial case study of Osmosin^®. Overall, oral osmotically driven systems appear to be a promising technology for product life-cycle strategies.     

汶川抗震救灾医疗后送调查分析及思考

目的：分析汶川地震医疗后送工作,为完善灾害救援的医疗后送提供科学依据。方法通过对汶川地震医疗后送的系统调研和相关资料的分析,总结汶川抗震救灾医疗后送流程、医疗后送工具及分级救治情况。结果汶川地震中医疗后送总体分三个层次进行,军队独立医疗后送体系未形成,缺乏专用卫生运力,分级救治原则不尽完善。结论在特大地震医疗后送中,应严格掌握分级救治原则,重点加强前方卫勤分队的机动能力、中间卫生专用运力、后方基地化医院救治水平,并形成三者相结合的快速立体医疗后送。     

The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience

The relationship between ethnicity and health is attracting increasing attention in international health research. Different measures are used to operationalise the concept of ethnicity. Presently, self-definition of ethnicity seems to gain favour. In contrast, in the Netherlands, the use of country of birth criteria have been widely accepted as a basis for the identification of ethnic groups. In this paper, we will discuss its advantages as well as its limitations and the solutions to these limitations from the Dutch perspective with a special focus on survey studies.

The country of birth indicator has the advantage of being objective and stable, allowing for comparisons over time and between studies. Inclusion of parental country of birth provides an additional advantage for identifying the second-generation ethnic groups. The main criticisms of this indicator seem to refer to its validity. The basis for this criticism is, firstly, the argument that people who are born in the same country might have a different ethnic background. In the Dutch context, this limitation can be addressed by the employment of additional indicators such as geographical origin, language, and self-identified ethnic group. Secondly, the country of birth classification has been criticised for not covering all dimensions of ethnicity, such as culture and ethnic identity. We demonstrate in this paper how this criticism can be addressed by the use of additional indicators.

In conclusion, in the Dutch context, country of birth can be considered a useful indicator for ethnicity if complemented with additional indicators to, first, compensate for the drawbacks in certain conditions, and second, shed light on the mechanisms underlying the association between ethnicity and health.     

感染人类呼吸道的病毒及其分类新进展

近年来,随着SAPS、禽流感等重大呼吸道传染病的出现,人们对呼吸道病毒感染给予了高度重视,促进了呼吸道病毒学的发展.这主要表现在三个方面,一是对相关病毒如SARS冠状病毒和高致病性禽流感病毒的致病性、基因与抗原变异、疫苗制备等取得了进展;二是发现了一些新的呼吸道病毒如冠状病毒HCoV-NL63和HCoV-HKU1、博卡病毒;三是一些被认为与呼吸道感染关系不大的"老病毒"如某些疱疹类病毒和细小病毒,现在经常出现在呼吸道感染者的样本中.鉴于目前呼吸道病毒的范围比以前有明显扩大,此文就能够感染人类呼吸道的病毒及其分类作一综述.     

血管紧张素转化酶活性与乙型病毒性肝炎患者临床分型关系的研究

目的探讨血清血管紧张素转化酶（ACE）与乙型病毒性肝炎不同临床分型的关系及临床意义。方法利用连续监测法对健康组60例、慢性病毒性乙型肝炎组43例、Child-Pugh A级组36例、Child-Pugh B级组34例、Child-Pugh C级组32例各样本进行ACE活性和胆碱酯酶（CHE）活性的测定,比较各组ACE和CHE值,判断肝细胞损伤程度与血清ACE的活性及ACE和CHE之间的关系。结果乙型病毒性肝炎不同临床分型血清中ACE活性变化的顺序由低到高为：健康组（23．47±6．03）μmol／L,慢性病毒性乙型肝炎组（51．79±8．58）μmol／L,乙肝后肝硬化中Child-Pugh A级组（60．57±6．40）μmol／L,Child-PughB级组（68．22±6．62）μmol／L,Child-PughC级组（77．30±8．30）μmol／L,各组肝病患者血清ACE活性都明显高于健康组（P〈0．01）。CHE活性〉4000 IU／L时,ACE活性为（34．71±9．43）μmol／L,CHE在2000N4000 IU／L时,ACE活性为（53．16±8．46）t．LmolfL,CHE在1000～2000 IU／L时,ACE活性为（67．67±9．52）μmol／L,CHE〈1000 IU／L时,ACE活性为（79．27±7．53）μmol／L,各组间比较,差异有统计学意义（均P〈0．01）。结论检测病毒性乙型肝炎不同临床分型中血清ACE的活性变化,对于判断肝细胞损伤程度有一定的临床意义。