Evaluation of the UK breast screening programmes

National breast screening programmes were set up in the UK inthe early 1990s. Although they are quality-assured and publishprocess measures of performance, there is a lack of data linkingthe screening process to breast cancer mortality. A new analysisof trends in England and Wales suggests that the effect of screeninghas been to reduce mortality by 8% over 10 years in those eligiblefor screening in 1990.     

Seven-year survivor with malignant melanoma of the anus without radical surgery

We report a case of a long-term survivor with malignant melanoma of the anus who did not undergo radical surgery. A 71-year-old woman who presented with anal bleeding and anal tumor underwent an excisional biopsy in September 1985. The biopsy specimen was a lobulated, polypoid, pigmented mass 2 cm in diameter, that had been located on the anterior wall of the anus. A satellite nodule 7 mm in diameter was found on the left wall of the anus at the level of the dentate line. Both tumors were histologically diagnosed as malignant melanoma. The primary tumor was 6 mm thick. Melanoma cells were present microscopically at the cut end of the rectum. Because of her history of ischemic heart disease, the patient rejected our recommendation that she undergo radical surgery, and received 10 courses of carboplatin 20 mg intramuscularly and OK-432 10 K.E. (Klinische Einheit) intradermally every week. A single, pigmented metastatic inguinal lymph node developed and was excised in June 1987. A recurrent tumor was detected in the rectum in October 1992, so again we recommended radical surgery. The patient rejected radical surgery again, and received 12 courses of carboplatin 10 mg intramuscularly every 2 weeks. She died of disease at home in July 1993 after surviving for 7 years and 10 months. An autopsy was not performed. This case shows that local excision of the primary lesion may be appropriate to preserve the quality of life of patients with early-stage malignant melanoma of the anus.     

Survival of colorectal cancer patients in Europe during the period 1978–1989

This study concerns the survival of European patients diagnosed between 1978 and 1989 with colorectal cancer. Variations in survival in relation to age, country and period of diagnosis were examined. Data from the EUROCARE study were supplied by population-based cancer registries in 17 countries to a common protocol. Five years after diagnosis, relative survival rates were 47 and 43% for cancers of the colon and rectum, respectively. Survival decreased with increasing age: the relative risk of dying for the oldest patients (75+) was 1.39 for rectum and 1.54 for colon compared with the youngest patients (15-44 years). In 1985-1989 survival from colorectal cancer differed significantly between different European countries: the Nordic countries (Denmark excluded), The Netherlands, Switzerland, France and Austria were characterised by high survival, whilst Eastern European countries, the U.K. and Denmark were characterised by low survival. There was a general improvement in survival over the period 1978-1989: from 40 to 48% for colon cancer and 38 to 46% for rectal cancer. For neither cancer site did between-country survival differences narrow over the study period. Intercountry and time differences in survival differences are probably related to stage at diagnosis and postoperative mortality.     

痹祺胶囊治疗类风湿关节炎远期疗效观察

[目的]观察中药痹祺胶囊治疗类风湿关节炎(RA)的远期疗效。[方法]痹祺胶囊治疗RA患者120例，随访3a，观察实验室指标及双手X线变化。[结果]痹祺胶囊治疗RA总有效率为80.83％，X线在3a内均无明显变化。[结论]中药痹祺胶囊治疗RA效果良好，能控制RA病情进展，阻止RA关节结构破坏进程，是治疗RA有效的方药。     

Impairment in short-term but enhanced long-term synaptic potentiation and ERK activation in adult hippocampal area CA1 following developmental thyroid hormone insufficiency.

Thyroid hormones are critical for the development and maturation of the central nervous system. Insufficiency of thyroid hormones during development impairs performance on tasks of learning and memory that rely upon the hippocampus and impairs synaptic function in young hypothyroid animals. The present study was designed to determine if perturbations in synaptic function persist in adult euthyroid animals exposed developmentally to insufficient levels of hormone. Pre- and postnatal thyroid hormone insufficiency was induced by administration of 3 or 10 ppm propylthiouracil (PTU) to pregnant and lactating dams via the drinking water from gestation day (GD) 6 until postnatal day (PN) 30. This regimen produced a graded level of hormonal insufficiency in the dam and the offspring. Population spike and population excitatory postsynaptic potentials (EPSP) were recorded at the pyramidal cell layer and the stratum radiatum, respectively, in area CA1 of hippocampal slices from adult male offspring. PTU exposure increased baseline synaptic transmission, reduced paired-pulse facilitation, and increased the magnitude of the population spike long-term potentiation (LTP). Phosphorylation of the extracellular signal-regulated kinases (ERK1 and ERK2) was increased as a function of LTP stimulation in slices from PTU-exposed adult animals. On the other hand, no differences in the basal levels of synaptic proteins implicated in synaptic plasticity (total ERK, synapsin, growth-associated protein-43, and neurogranin) were detected. These results reinforce previous findings of persistent changes in synaptic function and, importantly extend these observations to moderate levels of thyroid hormone insufficiency that do not induce significant toxicity to the dams or the offspring. Such alterations in hippocampal synaptic function may contribute to persistent behavioral deficits associated with developmental hypothyroidism.     

Long-term survival following emergency abdominal aortic aneurysm repair

Survival following emergency surgery for ruptured abdominal aortic aneurysm remains poor and is in stark contrast to that for elective repair. We have carried out a 5-year retrospective observational study to determine the long-term (5-year) survival of patients following emergency surgery for ruptured abdominal aortic aneurysm at a district general hospital in East Anglia. A total of 99 patients presented to the operating theatre for emergency repair of ruptured abdominal aortic aneurysm in this 5-year study period. In-hospital mortality was 70% and was unchanged over the 5 years. Overall long-term survival in those patients discharged from hospital was good. The ICU cost per long-term survivor was calculated to be pound sterling 36750.     

保存时距对短期记忆之记忆量的影响

目的:通过对大学生短期记忆之记忆量的测定,探讨保存时距对短期记忆的记忆量的影响。方法:以学习材料(每组20个汉字,共5组)、电脑、大学生为研究对象(42名北大医学部2003级学员参加实验),实验中包括1 s立即回忆,2 s立即回忆,1 s延迟回忆,2 s延迟回忆4种不同的测验方式,并随机分配给42名参加实验的学员进行测量。结果:进行F检验作保存时距与短期记忆保留量之间的分析得到,在短期记忆中,时距的长短对记忆量的影响很大,而在长期记忆中,时距的长短对记忆量的影响不大;当保存时距较长时,延迟作用比较明显,而当保存时距较短时,延迟作用并不明显。     

中国HIV-1感染者病毒特异性细胞毒性T细胞定量研究

目的对8例HIV长期感染不进展(LTNP)及病程进展缓慢(SP)患者的病毒特异性细胞毒性T细胞(CTL)特征进行研究。方法设立队列研究,从中随机选出8例患者(4例LTNPs,4例SP)。通过采用重叠肽技术组建HIV-1B亚型全序列肽段,组建成三维肽库进行ELISPOT分析8例患者的HIV-1特异性细胞免疫反应。结果在大多数患者中存在较强的T细胞反应,特别对HIV-1病毒的pol、gag、nef蛋白的免疫反应比其他蛋白强。结论病毒特异性CTL免疫反应在HIV-1 LTNPs有较强并且很广泛的反应,这对于有效抑制病毒在人体内的生存有可能起到很大的作用,很可能是这些LTNPs及SP病程进展缓慢的主要原因之一。     

铝对大鼠海马ERK蛋白及mRNA表达影响

目的研究慢性铝中毒对大鼠海马细胞外信号调节蛋白激酶（ERK）蛋白及mRNA表达水平的变化，探讨铝中毒对学习记忆机制的影响。方法选择断乳后Wistar大鼠，用不同浓度AlCl3的水饲养3个月。测量大鼠海马长时程增强（LTP），用改良的Takai法测定丝裂原活化蛋白激酶（MAPK）活性的变化。蛋白印迹（Western blotting）方法检测ERK1／2的蛋白含量，RT-PCR方法检测ERK2的mRNA表达。结果（1）各染铝组MAPK活性降低且与对照组比较差异有统计学意义（P〈0．05）；（2）ERK1／2蛋白表达的比较：①ERK2在大鼠海马中的蛋白含量高于ERK1；②染铝组ERK1／2非磷酸水平与对照组比较均有所下降（P〈0．05），但染铝组之间差异无统计学意义（P〉0．05）；③染铝组ERK1／2磷酸化水平与对照组的比较均有下降（P〈0．05），染铝组之间的差异有统计学意义（P〈0．05）。（3）染铝组ERK2的mRNA表达与对照组比较明显降低，但染铝组之间差异无统计学意义（P〉0．05）。结论慢性铝中毒不仅影响大鼠海马中ERK2的mRNA表达水平，同时也影响ERK1／2的蛋白表达水平的降低，造成有丝分裂原活化蛋白激酶（MAPK）活性的下降，损害LTP的形成，从而影响学习记忆功能下降。