医用ZT胶在肺部结节病灶胸腔镜术前定位的应用

目的探讨CT引导下肺穿刺注射医用ZT胶在肺部结节病灶胸腔镜术前定位的可行性、安全性和临床价值。方法 22例共22个肺内孤立性结节病灶,术前均行CT引导下经皮肺穿刺注射医用ZT胶定位标记,术中先行肺楔形切除术去除病灶并根据病理结果决定进一步手术方案。结果术前CT引导下经皮肺穿刺注射医用ZT胶定位成功率100%(22/22);穿刺定位后出现刺激性咳嗽10例(45.45%),无症状气胸3例(13.64%);无出血、血胸病例。术中均能准确定位后行肺楔形切除术,病理证实为原发性非小细胞肺癌16例,不典型腺瘤样增生4例,良性病变2例。均VATS下完成手术。无中转开胸病例,无术中、术后重大并发症。结论胸腔镜术前CT引导下经皮肺穿刺注射医用ZT胶定位肺部结节病灶,快速、安全、有效,特别在直径≤10 mm的肺微小结节的定位中具有较高的临床价值。     

Contingency Management Versus Psychotherapy for Prenatal Smoking Cessation: A Meta-Analysis of Randomized Controlled Trials

Objectives

Prenatal smoking is the leading preventable cause of poor obstetric outcomes, yet treatment options are limited. Past reviews of prenatal smoking cessation have often grouped all counseling into a single category, which ignores the fact that psychotherapy is distinct from brief counseling. The objective of this study was to compare the effect sizes of two intensive interventions for prenatal smoking cessation: contingency management (i.e., financial incentives for abstinence) and psychotherapy.

The association between variants in the CFTR gene and nonobstructive male infertility: A meta-analysis

The association of genetic variants and congenital bilateral absence of the vas deferens (CBAVD) has been well acknowledged. By contrast, the link between nonobstructive azoospermia (NOA) or oligospermia and alterations in the cystic fibrosis transmembrane conductive regulator (CFTR) remains inconclusive. To clarify the problem, a meta-analysis was performed out after systematically searching Pubmed, Web of Science, Embase and the Chinese national knowledge infrastructure (CNKI) database. As we know, the ∆F508 and IVS8-5T gene mutations are the most studied genetic variants in CFTR gene. We reviewed the data from male patients who underwent the aforementioned genetic test. Our study revealed that the IVS8-5T mutation may be positively associated with the risk of nonobstructive male infertility (odds ratio (OR) 1.69; 95% CI: 1.12–2.55). This association strengthened when concerning NOA (OR: 2.62; 95% CI: 1.49–4.61). However, the ∆F508 mutation seemed to be a smaller contributing factor to this risk (OR: 1.63; 95% CI: 0.86–3.08). Our study aims to clarify the association between the ∆F508 and IVS8-5T gene mutations and nonobstructive male infertility. Therefore, screening for the IVS8-5T mutation in the CFTR gene may be recommended for men with NOA or severe oligozoospermia seeking assisted reproductive technology (ART).     

Evidence for a flow-independent contribution to the phenomenon of thallium redistribution

Although thallium-201 is known to redistribute slowly into regions of ischemic myocardium after restoration of blood flow, it is not clear to what extent normalization of flow is an essential requirement for the redistribution process. In a search for a flow-independent component of thallium redistribution, 12 dogs with stenosis of the circumflex coronary artery underwent atrial pacing for either 20 minutes (group I, 6 dogs) or 2 hours (group II, 6 dogs). Radioactive thallium and radioactive microspheres, 7 to 10 μ, were injected after 10 minutes of atrial pacing in both groups. Pacing resulted in a 40 percent reduction in subendocardial blood flow to the circumflex-perfused myocardium in both groups I and II. This relative reduction in flow was maintained at a stable level over the 2 hour pacing period in group II. Thallium activity in the relatively ischemic zone was significantly greater in dogs with 2 hours of pacing (group II) than in those with 10 minutes of pacing (group I). Redistribution of thallium occurred despite the continued presence of reduced flow in circumflex-perfused endocardial tissue. These data suggest that a significant component of thallium redistribution may be flow-independent.     

Arylazopyrazole AAP1742 Inhibits CDKs and Induces Apoptosis in Multiple Myeloma Cells via Mcl‐1 Downregulation

Inhibitors of cyclin‐dependent kinases 9 have been developed as potential anticancer drugs for the treatment of multiple myeloma. We have previously prepared a library of arylazo‐3,5‐diaminopyrazole inhibitors of CDKs. Here, we describe a novel member, AAP1742 (CDK9 inhibition with IC₅₀ = 0.28 μm ), that reduces the viability of multiple myeloma cell lines in low micromolar concentrations. Consistent with inhibition of CDK9, AAP1742 decreases the phosphorylation of RNA polymerase II and inhibits mRNA synthesis of anti‐apoptotic proteins Mcl‐1, Bcl‐2, and XIAP, followed by apoptosis in the RPMI‐8226 cell line in a dose‐ and a time‐dependent manner. These results are consistent with the biochemical profile of AAP1742 and further suggest cellular inhibition of CDK9 as a possible target for anticancer drugs.     

Suicide prevention by suicide detection.

Suicide prevention is based on detection followed by intervention. Detection is accomplished by being aware of known high-risk factors when interviewing patients, and keeping these in mind as high indices for potential suicide. These high-risk factors include: history of previous treatment for emotional problems; present depressive disorder, anxiety, or alcoholism; decreased physical health with multiple ailments; presence of self-blame and guilt; loss of self-control; and lack of emotional support systems. Intervention includes the use of hospitalization, psychotropic drugs, and the doctor-patient relationship.     

A diagnostic approach to pain

Various factors involved in pain, including the causative stimulus, the affective-cognitive reaction, and the subsequent coping reaction, are explored, and a composite model is provided that may be helpful in narrowing the diagnosis and thus localizing areas where effective intervention may be possible.     

β-sitosterol as a nonabsorbable marker of dietary lipid absorption in man

β-[su14C]Sitosterol was evaluated for its usefulness as a nonabsorbable marker of lipid absorption in intubation studies. A liquid meal, including [su3H] triolein as a marker of absorbable lipid, was used. The β-sitosterol was shown to remain well mixed with triolein in the gastric antrum, validating its suitability for this type of study. In small bowel fluid, the β-sitosterol was shown to partition into the aqueous phase in proportion to triolein and its hydrolysis products. With this system, lipid absorption was shown to take place chiefly in the jejunum in normal individuals.