Esophageal lipomatosis: another consequence of the use of steroids

After we incidentally found on CT extensive esophageal fat accumulations in a patient with long-term use of steroids, we prospectively evaluated during a 6-month period all CT studies of the chest for esophageal lipomatosis and related the findings to the possible use of steroids. The diagnosis of esophageal fat on CT was made by density measurements or if too small for reliable density measurements by comparison with mediastinal fat. In 21 of 1320 exclusively older male patients the diagnosis of esophageal lipomatosis was definite in 7 and likely in 14 patients. All fat accumulations were located in the upper third of the esophagus (mean length 22 ± 6 mm) and presented ring-like (n = 10), irregular (n = 3), or as a horseshoe sparing the posterior border (n = 8). In 20 patients there was an unequivocal history of steroid treatment. Associated centripetal fat infiltration was found in 11 patients. None of the patients had swallowing problems. Prolonged use of steroids, either orally or inhalationally administered, is associated with esophageal lipomatosis. The predisposition for the upper esophagus might be related to the presence of striated muscle cells in this part of the esophagus; moreover, inhalational steroid therapy may adversely affect the upper esophagus. Received: 3 April 2000; Accepted: 2 May 2000     

Smoking practices in New York City: The use of a population-based survey to guide policy-making and programming

To inform New York City’s (NYC’s) tobacco control program, we identified the neighborhoods with the highest smoking rates, estimated the burden of second-band smoke exposure, assessed the early response to state taxation, and examined cessation practices. We used a stratified random design to conduct a digit-dialed telephone survey in 2002 among 9,674 New York City adults. Our main outcome measures included prevalence of cigarette smoking, exposure to second-hand smoke, the response of smokers to state tax increases, and cessation practices. Even after controlling for sociodemographic factors (age, racelethnicity, income, education, marital status, employment status, and foreign-born status) smoking rates were highest in Central Harlem and in the South Bronx. Sixteen percent of nonsmokers reported frequent exposure to second-hand smoke at home or in a workplace. Among smokers with a child with asthma, only 33% reported having a no-smoking policy in their homes. More than one fifth of smokers reported reducing the number of cigarettes they smoked in response to the state tax increase. Of current smokers who tried to quit, 65% used no cessation aid. These data were used to inform New York City’s smoke-free legislation, taxation, public education, and a free nicotine patch give-away program. In conclusion, large, local surveys can provide essential data to effectively advocate for, plan, implement, and evaluate a comprehensive tobacco control program. Dr. Mostashari (the guarantor) made substantial contributions to the conception, design, and supervision of this paper, the analysis and interpretation of data, the drafting of the paper, critical revisions of the paper for important intellectual content, and the acquisition of data and funding for this research. Dr. Kerker made substantial contributions to the analysis and interpretation of data, the drafting of the paper and critical revisions of the paper for important intellectual content. Ms. Hajat made substantial contributions to the acquisition of data and critical revisions of the paper for important intellectual content. Dr. Miller made substantial contributions to the conception of this paper and critical revisions of the paper for important intellectual content. Dr. Frieden made substantial contributions to the conception, design, and supervision of this paper and critical revisions of the paper for important intellectual content.     

利用基因芯片技术研究乌头碱抗KBV200细胞耐药机制

目的采用基因芯片技术研究乌头碱抗KBV200细胞耐药机制。方法提取乌头碱12.5μg/mL用药组和对照组KBV200细胞的RNA,进行cDNA微阵列分析。结果整张基因芯片5504个基因克隆,其中用药前高表达基因208个,占克隆总数的3.8%,用药后高表达基因196个,占3.6%。用药前后细胞凋亡相关基因、CDKS家族、SMADS家族、MAPK信号转导系统等的基因发生变化。结论乌头碱可能通过影响细胞凋亡相关基因和影响MAPK信号转导系统等机制,最后作用于Mdr1基因的表达,从而起到抗耐药作用。     

中草药专属性对照物质的研究

目的 :建立中草药专属性对照物质 (CSPD)用于其基原鉴定。方法 :选择具有代表性的 3种中草药 ,采用规范化的程序获取其专属性CSPD ;通过对不同来源的同种中草药CSPD的¹H-NMR图谱的比较分析 ,并对各中草药CSPD化学成分的分离和结构鉴定 ,实现对其整体化学组成的表达。结果 :3种具有代表性的中草药的CSPD的¹H-NMR图谱均有高度的特征性和重现性 ,并主要显示各中草药特征性成分的共振信号 ,与各中草药的基原严格相关。结论 :按照本研究操作程序 ,可以获得对多数中草药具有鉴别意义的专属性CSPD ,作为对其基原鉴定的参考。     

The value of the number-needed-to-treat method in antiepileptic drug trials

PURPOSE: There is controversy between clinicians and statisticians on the appropriateness of the number needed to treat (NNT) as a summary statistic to report the effectiveness of a treatment. We examine the two viewpoints and make proposals concerning the reporting of clinical trial results. METHODS: In the context of antiepileptic treatments, we explain the two different viewpoints and illustrate the use of the odds ratio, relative risk, absolute difference, and NNT on the results of randomized clinical trials with topiramate (TPM). Special attention is paid to the use of these summary statistics in meta-analyses. Here, the NNT is the expected number of patients one would need to treat to achieve a single occurrence of a specified good outcome (e.g., 50% reduction in seizure rate) in comparison to no (or placebo) treatment. RESULTS: Although the NNT is readily interpretable in some instances, it exhibits undesirable statistical behavior in other cases. In particular, confidence intervals for the NNT may split into two intervals and extend to positive and negative infinity when treatment efficacy is not clearly established by the data. Meta-analyses cannot be sensibly conducted directly on the NNT scale. CONCLUSIONS: Although other measures, such as the odds ratio, have been more commonly used in the context of meta-analyses, clinicians prefer the NNT because it gives them a clearer clinical interpretation of the effectiveness of a (new) treatment. On the other hand, statisticians do not recognize the value of the NNT, as it has undesirable statistical properties. Some reconciliation between the two views could be achieved when the clinicians acknowledge the weak aspects of the NNT and when statisticians realize that statistical appropriateness is not the same as clinical relevance. It is suggested that the NNT be used as a secondary reporting tool not on an equal footing with the classic scales.     

Storage temperatures of medications on an air medical helicopter

INTRODUCTION: The safety and efficacy of medications stored on air medical helicopters may be adversely affected by extreme temperatures. The purpose of this study was to determine whether temperatures inside an air medical helicopter drug box were within the U.S. Pharmacopeia recommendations for controlled room temperature. This is defined as a temperature between 15 degrees and 30 degrees C (59 degrees and 86 degrees F) with a mean kinetic temperature of less than 25 degrees C (77 degrees F). An additional goal was to determine whether time/temperature indicator labels can reliably monitor mean kinetic temperatures. METHODS: Temperatures were monitored with miniature electronic temperature recorders and color-changing time/temperature indicator labels. RESULTS: The mean kinetic temperatures for the summer and winter periods were 25.1 degrees C (77.2 degrees F) and 12.7 degrees C (54.8 degrees F), respectively. In the summer, the electronic recorders logged temperatures exceeding 25 degrees C (59 degrees F) 37% of the time and more than 30 degrees C (86 degrees F) 6% of the time. In the winter, temperatures less than 15 degrees C (59 degrees F) were recorded 83% of the time. The mean kinetic temperatures obtained from the electronic recorder and the time/temperature indicator labels differed by less than 0.7 degree C (1.3 degrees F). The results show that medications on an air medical helicopter are subject to temperatures out of the recommended range and that time/temperature indicator labels can reliably monitor mean kinetic temperatures.     

Firebird冠脉涂膜支架系统生物学安全性评价研究

依据国家标准GB/T16175-1996,选择10项试验对Firebird冠脉涂膜支架系统进行生物学安全性评价[1],结果表明该支架系统的血液相容性良好,无全身毒性和细胞毒性,无热源性、致敏性、刺激性,也无遗传毒性,组织相容性尚可,是一种生物相容性优良的Firebird冠脉涂膜支架系统.     

一次性使用输液（血）器化学分析问题与探讨

分析了某些一次性使用输液(血)器中部分化学性能测定结果重现性差并常常引起不合格的原因,提出生产工艺改进的建议.     

非甾体抗炎药与皮质类固醇抑制角膜上皮细胞增殖的实验研究

目的 探讨非甾体抗炎药对角膜上皮细胞体外增殖的抑制作用。方法 选用原代及传代兔角膜上皮细胞，实验组中加入含不同浓度双氯芬酸钠、安贺拉(酮咯酸氨丁三醇)、地塞米松及洁霉素的培养液，对照组加入等量空白培养液，采用四甲基偶氮唑蓝(MTT)比色法检测其对细胞增殖的抑制，计算出抑制率并进行比较。结果 双氯芬酸钠、安贺拉(酮咯酸氨丁三醇)、地塞米松及洁霉素对角膜上皮细胞增殖均有抑制作用。双氯芬酸钠与安贺拉3个对应浓度的比较中，24h时双氯芬酸钠抑制率分别为61．4％、42．1％及0，安贺拉组均为0；48h时双氯芬酸钠抑制率分别为81．0％、70．2％、47．6％，安贺拉抑制率分别为38．1％、31．0％和0；72h时双氯芬酸钠抑制率分别为95．0％、95．0％、54．0％，安贺拉抑制率分别为59．1％、47．2％和33．2％．在双氯芬酸钠与地塞米松及洁霉素的原液浓度比较中，24、48、72h时双氯芬酸钠抑制率分别为93．0％、94．0％、96．0％，洁霉素为24．6％、51．2％、79．1％，地塞米松为45．6％、69．0％、80．0％．在双氯芬酸钠与地塞米松及洁霉素的二分之一原液浓度比较中，24、48、72h时双氯芬酸钠抑制率分别为68．4％、91．7％、95．0％，洁霉素为12．3％、26．2％、49．0％，地塞米松为12．3％、54．6％、55．0％．结论 非甾体抗炎药双氯芬酸钠与安贺拉对角膜上皮细胞增殖均有抑制作用，以双氯芬酸钠抑制作用最强，强于传统抗增殖药地塞米松，在抑制LASIK术后上皮植入方面有广泛的应用前景。     

达那康对视网膜脱离术后视功能恢复的干预效果

目的　探讨银杏叶提取物 (达那康 )对视网膜脱离术后视网膜功能改变的干预效果。方法　采用前瞻随机对照研究的方法将 5 0例 ( 5 0眼 )视网膜脱离患者分为达那康用药组和对照组。应用视网膜电流图和光学相干断层扫描观察术后第 1、2、4和第 8周视网膜功能和形态的改变。结果　视网膜脱离术前对照组和用药组的年龄、性别和视网膜脱离病程均具有可比性。与术后第 1周的ERGb波相比较 ,用药组第 2周ERGb即有显著的改变 ,而对照组在第 8周ERGb波才有显著的改变。OCT检查黄斑部视网膜厚度的改变用药组在术后第 4周才有显著的改变 ,而对照组在术后第8周才有显著的改变。结论　达那康可能在一定程度上促进视网膜脱离术后视功能的恢复。