食管癌术后患者应用中药干预对生活质量及生存时间的影响研究

目的 观察中药干预对术后食管癌患者的生活质量及生存时间的影响.方法 选取180例经手术治疗的食管癌患者并依据知情同意的原则分为3个治疗组,分别是单纯化疗组、单纯中药组及中药+化疗组,每组各60例.采用生活质量核心问卷(QLQ-C30)和生存分析评估患者的生存质量和生存时间.结果 中药组、中药+化疗组和化疗组患者的临床症状及身体功能经干预均有一定改善,但总体而言,化疗+中药组的改善效果最佳,与另2组比较差异有统计学意义(P<0.05);化疗+中药组及单纯中药组患者经干预后,机体的免疫水平改善,而化疗组患者的免疫状况下降;化疗组患者的生存时间为(27.21±3.55)个月,中药组患者的生存时间为(28.56±4.19)个月,化疗+中药组患者的生存时间为(34.58±3.24)个月;经Log-Rank检验,3组差异有统计学意义(χ2=5.698,P=0.037).结论 食管癌患者术后服用中药,其生活质量、免疫状况、生存时间均明显改善,可在临床推广中药+化疗的综合干预方案.     

fMRI evaluation of hemispheric language dominance using various methods of laterality index calculation

Several functional MR imaging studies evaluating the lateralisation of linguistic functions in patients who underwent Wada testing have been reported. There is extensive variance in the Laterality index (LI) calculation across the studies, and the optimal calculation method remains unclear. We attempted to calculate the LI in different ways in the same subjects, in order to find the LI calculation method with the highest correlation to the Wada test. Fifteen patients (10 females, 5 males) suffering from medically intractable temporal lobe epilepsy (TLE) (12 left, 3 right) were admitted for the study. The patients underwent a standardized bilateral intracarotid short-acting barbiturate test. Language testing included spontaneous speech, oral comprehension, reading, object and picture naming, and repetition. All the tasks were scored separately in order to increase the possibility of correlation between Wada and LI. A silent phonemic verbal fluency task (VFT) was used as a language paradigm for functional measurement. Regions of interest (ROIs), with a known association with language function (Broca’s area, the lateral prefrontal cortex, etc.), were defined. First, the LIs were calculated from the ROIs using a previously reported method (simple suprathreshold count). Next, we used several new methods of LI calculation (t–weighting of voxels, methods independent of the choice of the statistical threshold, etc.) The most significant correlation with Wada was proven in the LIs that were evaluated from Broca’s area (up to R = 0.94, P = 1 × 10⁻⁷). However, the new LI calculation methods used in the present study did not produce a statistically significant benefit in comparison to previously reported methods.     

Sequential behavior in the rat: role of skill and attention

The serial reaction time task (SRTT) is a well-established experimental tool to study cognitive and neural mechanisms of sequential performance in humans. We have recently developed a rodent version of the human serial reaction time task, in which rats have to respond to visual stimuli by nose-poking into one of four spatial locations in order to obtain food reward. In this task, rats display superior performance under sequential as compared to random conditions of stimulus presentation. Specifically, the subjects are able to profit from sequential regularities in terms of faster reaction times and higher response accuracy. Here, we studied the effects of violating a single stimulus in rats, which had been intensively trained under sequential conditions, and we asked whether these subjects, when confronted with sequence violations, still attend to the actual stimulus order (that is, show correct responses), or whether their behavior has become fully automated (leading to specific incorrect responses to violated stimulus positions). In two independent experiments using partly differing instrumental set-ups, we found that the responses to non-cued violations of single stimulus positions were mostly correct, that is, the animals were apparently attending to the stimuli. Nevertheless, these reaction times were slowed, which probably reflects cognitive resources necessary to respond correctly to the unexpected irregularities. When quantifying the minority of responses, which were incorrect, we found that most of them were directed to the position, where the stimulus would have appeared if the sequence had not been violated. These responses were faster than the correct ones (to the violated stimulus), which indicates that sequential responding had become partly automated. Together, our data show that both, attention and skill play a role for sequential performance in our SRT task, and that they can be dissected by quantification of specific response types. In future work, the neural correlates underlying these functional mechanisms will have to be addressed.     

Characterization of the anticonvulsant profile of isonicotinic acid benzylamide in various experimental seizure models in mice

This study focused on the evaluation of anticonvulsant properties of isonicotinic acid benzylamide (iso-Nic-BZA) in numerous experimental seizure models (maximal electroshock [MES]-, bicuculline [BIC]-, pentylenetetrazole [PTZ]-, pilocarpine [PILO]-, alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid [AMPA]-, kainic acid [KA]- and N-methyl-d-aspartic acid [NMDA]-induced seizures). Moreover, acute adverse-effect profile of the agent with respect to impairment of motor coordination was assessed in animals subjected to the chimney test. The evaluation of time-course and dose-response relationships for iso-Nic-BZA provided evidence that the compound produced the peak to maximum antielectroshock action and acute adverse effects at 5min after its systemic (i.p.) administration. Iso-Nic-BZA exerted a clear-cut anticonvulsant action against maximal electroshock-induced seizures in mice and its ED(50) value was 70.6 (56.4-88.4)mg/kg. The assessment of acute adverse effects in the chimney test revealed that the agent produced acute neurotoxic effects and its TD(50) value was 135.6 (108.8-169.0)mg/kg. Additionally, iso-Nic-BZA showed the anticonvulsant activity in numerous chemically-induced seizures (AMPA-, BIC-, KA-, and PTZ-evoked clonic convulsions), remaining virtually ineffective (at doses up to 200mg/kg) in PILO- and NMDA-induced seizures in mice. Based on this study, one can conclude that iso-Nic-BZA due to the short time to peak of its maximum anticonvulsant effects (5min after its i.p. administration), deserves more attention as a potential antiepileptic drug for patients in status epilepticus.     

Functional analysis of congenital stationary night blindness type-2 CACNA1F mutations F742C, G1007R, and R1049W

Congenital stationary night blindess-2 (incomplete congenital stationary night blindness (iCSNB) or CSNB-2) is a nonprogressive, X-linked retinal disease which can lead to clinical symptoms such as myopia, hyperopia, nystagmus, strabismus, decreased visual acuity, and impaired scotopic vision. These clinical manifestations are linked to mutations found in the CACNA1F gene which encodes for the Ca(v)1.4 voltage-gated calcium channel. To better understand the physiological effects of these mutations, three missense mutants, F742C, G1007R and R1049W, previously shown to be mutated in patients with CSNB-2, were transiently expressed in human embryonic kidney (HEK) tsA-201 cells and characterized using whole-cell patch clamp. The G1007R mutation is located in transmembrane segment 5 (S5) of domain III and R1049W is located in the extracellular linker between S5 and the P-loop of domain III. Both mutants produced full length proteins that targeted to the membrane but did not support ionic currents. In 20 mM Ba(2+), F742C (S6 domain II) produced a approximately 21 mV hyperpolarizing shift in half activation potential (V(a[1/2])) and a approximately 23 mV hyperpolarizing shift in half inactivation potential (V(h[1/2])). Additionally, F742C displayed slower inactivation kinetics and a smaller whole cell conductance (G(max)). In physiological 2 mM Ca(2+), F742C produced a approximately 19 mV hyperpolarizing shift in V(a[1/2]). These findings suggest that the pathology of CSNB-2 in patients with these missense mutations in the Ca(v)1.4 calcium channel is the result in either a gain of function (F742C) or a loss of function (G1007R, R1049W).     

Monitoring HCV RNA viral load by locked nucleic acid molecular beacons real time PCR

Locked nucleic acids (LNA) based real time PCR was used in particular situations where there are difficulties in primer design due to sequence complexity. In this study a new real time RT-PCR assay was developed using LNA modified primers and LNA molecular beacon probes to monitor hepatitis C virus (HCV) viral load in plasma and serum samples. The technique did not suffer from an heterogeneity of the HCV genome and, in addition, an internal RNA control was amplified in the same reaction tube with different short primers and beacon probe. Due to the short consensus LNA primers length, the PCR efficiency was close to 100% with no formation of hairpin loop structures. In summary a new LNA molecular beacon based real time RT-PCR assay was used successfully to measure quantitatively the total level of HCV RNA in both experimental and clinical specimens. The high sensitivity (50 IU/ml), the wide range of genotype detection, increased specificity and robustness obtained with this test are particularly useful for screening large number of specimens and measuring viral loads to monitor the progress of the disease.     

Antisociality, underarousal and the validity of the Concealed Information Polygraph Test

The Concealed Information Polygraph Test has been advocated as the preferred method for the physiological detection of deception. In this study, we further examined the validity of the Concealed Information Test in antisocial individuals. Physiological responding to concealed information was assessed in 48 male prisoners, and compared with responding in 31 male community volunteers. Based upon the association between antisociality and autonomic hyporesponsivity, lower detection rates were expected in the prisoners. Participants were questioned on five personally significant items (e.g., day of birth), instructed to deny recognition of this information, and promised a financial reward when able to hide recognition. Prisoners showed reduced autonomic reactivity in comparison to the community volunteers. This hyporesponsivity had little impact on the sensitivity of the Concealed Information Test. Detection efficiency in the prisoners was significantly above chance (d=2.67; a=0.82; 79%), and did not differ significantly from that obtained in the community volunteers (d=3.04; a=0.85; 87%). The present data support the validity of the Concealed Information Test in criminal populations.     

Multi-disciplinary treatment of a rare pelvic cavity ependymoma

Ependymomas usually develop from neuroectodermal organs. Here, we present an ependymoma arising from the pelvic cavity. A 27-year-old Korean female was admitted to the hospital with a sensation of abdominal fullness. Imaging studies revealed a huge heterogeneous nodular mass in the pelvis and lower abdomen. Laparotomy showed that two large masses with multiple nodules were located between the uterus and rectum and uterus and bladder, respectively. Histologically, the tumor was characterized by compact columnar neoplastic cells divided by fibrovascular septae. The neoplastic cells formed true ependymal rosettes and perivascular pseudorosettes. Immunohistochemical staining showed a strong positive reaction for glial fibrillary acidic protein (GFAP) and vimentin and a partial positive reaction for S100 and EMA. The tumor was thus diagnosed as an ependymoma arising from the pelvic cavity. The patient was treated with a debulking operation and chemotherapy based upon the in vitro chemosensitivity test results. The patient was free of cancer for 4 years following surgery. This is a rare case of extraneural ependymoma for which an in vitro chemosensitivity test was critical in determining the multidisciplinary approach for treatment.     

Occupant Dynamics in Rollover Crashes: Influence of Roof Deformation and Seat Belt Performance on Probable Spinal Column Injury

Motor vehicle crashes are the leading cause of death in the United States for people ages 3-33, and rollover crashes have a higher fatality rate than any other crash mode. At the request and under the sponsorship of Ford Motor Company, Autoliv conducted a series of dynamic rollover tests on Ford Explorer sport utility vehicles (SUV) during 1998 and 1999. Data from those tests were made available to the public and were analyzed in this study to investigate the magnitude of and the temporal relationship between roof deformation, lap-shoulder seat belt loads, and restrained anthropometric test dummy (ATD) neck loads. During each of the three FMVSS 208 dolly rollover tests of Ford Explorer SUVs, the far-side, passenger ATDs exhibited peak neck compression and flexion loads, which indicated a probable spinal column injury in all three tests. In those same tests, the near-side, driver ATD neck loads never predicted a potential injury. In all three tests, objective roof/pillar deformation occurred prior to the occurrence of peak neck loads (F ( z ), M ( y )) for far-side, passenger ATDs, and peak neck loads were predictive of probable spinal column injury. The production lap and shoulder seat belts in the SUVs, which restrained both driver and passenger ATDs, consistently allowed ATD head contact with the roof while the roof was contacting the ground during this 1000 ms test series. Local peak neck forces and moments were noted each time the far-side, passenger ATD head contacted ("dived into") the roof while the roof was in contact with the ground; however, the magnitude of these local peaks was only 2-13% of peak neck loads in all three tests. "Diving-type" neck loads were not predictive of injury for either driver or passenger ATD in any of the three tests.