改良松解术式治疗耻骨直肠肌综合征的临床观察(附31例报告)

目的:观察改良松解术式治疗耻骨直肠肌综合征的临床效果。方法:2004~2005年采用肛门后横切口耻骨直肠肌全束部分切断术治疗耻骨直肠肌综合征31例。结果:手术总有效率为96·8%。平均住院时间(10·58±2·35)d,平均切口愈合时间(12·16±2·08)d。结论:采用肛门后横切口耻骨直肠肌全束部分切断术的方法疗效确切,具有并发症少、切口愈合时间快和住院时间短的优点。     

Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation

Background

Overall survival in hepatocellular carcinoma patients treated with percutaneous radiofrequency ablation is influenced by both recurrence and successive treatments. We investigated post-recurrence survival after radiofrequency ablation.

Methods

Data on 103 early/intermediate patients initially treated with radiofrequency ablation and followed for a median of 78 months (range 68–82) were retrospectively analysed. If intrahepatic disease recurrence occurred within or contiguous to the previously treated area it was defined as local, otherwise as distant; recurrence classified as Barcelona Clinic Liver Cancer stage C was defined by neoplastic portal vein thrombosis or metastases.

Results

A total of 103 patients were included (82.5% male; median age 70 years, range 39–86). During follow-up, 64 recurrences were observed. Median overall survival was 62 months (95% confidence interval: 54–78) and survival rates were 97%, 65% and 52% at 1, 4 and 5 years, respectively. Median post-recurrence survival was 22 months (95% confidence interval: 16–35). Child–Pugh score, performance status, sum of tumour diameters at recurrence and recurrence patterns were independent predictors of post-recurrence survival.

Conclusions

In patients with hepatocellular carcinoma after radiofrequency ablation, clinical and tumour parameters assessed at relapse, in particular the type of recurrence pattern, influence post-recurrence survival.     

学习障碍儿童认知特征及影响因素分析

目的了解儿童学习障碍(LD)的认知特征及影响因素。方法采用修订版儿童学习障碍筛查量表(PRS)对深圳市城区6~16岁共2162名小学及初中学生进行了测评分析。结果儿童学习障碍筛出率12.20%,其中男生为17.00%,女生为7.30%,性别差异有统计学意义(P<0.05);男生除时间和方位的判断外,PRS量表其余4个学能区得分均明显低于女生,差异有统计学意义;LD儿童在听理解及社会行为两大功能区得分明显低于正常对照组,差异有统计学意义(P<0.05);6~7岁组与8~11岁组间以及12岁以下组与12岁以上组间LD发生率差异有统计学意义(P<0.05)。结论LD的发生及其学能结构差别与性别特征有明显关系;LD儿童学能低下主要表现在听理解及社会行为两大功能区;LD的发生与随年龄增长的因素有关。因此学习障碍的预防和矫治要制定个性化措施。     

Performance of polygenic risk scores for cancer prediction in a racially diverse academic biobank

PurposeGenome-wide association studies have identified hundreds of single nucleotide variations (formerly single nucleotide polymorphisms) associated with several cancers, but the predictive ability of polygenic risk scores (PRSs) is unclear, especially among non-Whites.MethodsPRSs were derived from genome-wide significant single-nucleotide variations for 15 cancers in 20,079 individuals in an academic biobank. We evaluated the improvement in discriminatory accuracy by including cancer-specific PRS in patients of genetically-determined African and European ancestry.ResultsAmong the individuals of European genetic ancestry, PRSs for breast, colon, melanoma, and prostate were significantly associated with their respective cancers. Among the individuals of African genetic ancestry, PRSs for breast, colon, prostate, and thyroid were significantly associated with their respective cancers. The area under the curve of the model consisting of age, sex, and principal components was 0.621 to 0.710, and it increased by 1% to 4% with the inclusion of PRS in individuals of European genetic ancestry. In individuals of African genetic ancestry, area under the curve was overall higher in the model without the PRS (0.723-0.810) but increased by <1% with the inclusion of PRS for most cancers.ConclusionPRS moderately increased the ability to discriminate the cancer status in individuals of European but not African ancestry. Further large-scale studies are needed to identify ancestry-specific genetic factors in non-White populations to incorporate PRS into cancer risk assessment.     

癫痫儿童认知学习能力的研究

目的:探讨癫痫儿童的认知学习状况。方法:采用学习障碍筛查量表(PRS)测量60例癫痫儿童和60例健康对照,并用丹麦维迪Keypoint诱发电位仪检测其事件相关电位P300。结果:①癫痫儿童PRS量表总分、言语得分及非言语得分均较正常儿童降低,差异有显著性(P<0.01);②癫痫儿童P300潜伏期较正常儿童延长,差异有显著性(P<0.01);③全面性发作组与部分性发作组比较,P300与PRS量表均未见显著性差异(P>0.05)。结论:本研究表明癫痫儿童存在学习障碍,PRS量表与P300可从不同角度反映癫痫儿童的认知学习状况。     

Structural organization of NadAΔ351–405, a recombinant MenB vaccine component,by its physico-chemical characterization at drug substance level

The physico-chemical characterization of NadAΔ_351–405, a recombinant protein discovered by reverse vaccinology, component of a candidate vaccine against Neisseria meningitidis serotype B is presented. Analytical methods like mass spectrometry, electrophoresis, optical spectroscopy and SEC-MALLS have been applied to unveil the structure of NadAΔ_351–405, and to evaluate Product-Related Substances. Moreover, analysis of the protein after intentional denaturation has been applied in order to challenge the chosen methods and to determine their appropriateness and specificity. All the obtained results were inserted in a model allowing in-depth understanding of the antigen NadAΔ_351–405: it is present in solution as a homo-trimer, retaining a high percentage of α-helix secondary structure, and able to reassemble from monomeric subunits after thermal denaturation; this structural organization is consistent with that foreseen for MenB NadA (Neisseria Adhesin A).     

Pervasive loss of function in asylum-seeking children in Sweden

Presently, a couple of hundred children from traumatized asylum-seeking families in Sweden have developed severe loss of mental and physical functions without evidence of underlying disease. Of the 23 treated children treated at this clinic, 15 have recovered, three are improving and five are under initial care. Communication within the family is crucial from both pathogenic and salutogenic perspectives. A permanent residence permit, correcting the underlying situation of threat and insecurity, is a condition for good results from psychiatric treatment. In Sweden there is a lack of consensus and conflicting political and medical perspectives prevail regarding the “apathetic” children.

Conclusion: Children living under unbearable life conditions can develop life-threatening depression-withdrawal stress reactions well known as pervasive refusal syndrome (PRS). This is also true of children in traumatized asylum-seeking families. Excellent results are achieved when the family's underlying fear and hopelessness can be erased and the treatment focuses on the traumatic experiences.