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聚合酶链反应检查诊断迁延复发型带状疱疹病毒角膜炎

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世界核心医学期刊文摘（眼科学分册） 2005年第10期1卷 23-23页

作者： Magone M.T. Nasser R.E. Cevallos A.v. Margolis T.P. 杨秀梅 Francis I. Proctor Foundation Box 0944 University of California San Francisco San Fra ncisco CA 94143-0944 United States Dr.

PURPOSE: To report a case of chronic recurrent varicella virus epithelial kera titis in a child. DESIGN: case report. METHODS: Clinical examination and polymer ase chain reaction analysis of corneal epithelium. RESULTS: A 10-year-old heal thy child developed chronic recurrent varicella virus keratitis with pseudodendr ites after recovering from systemic varicella. Analysis of the debrided pseudode ndrites was repeatedly positive for vZv DNA and negative for HSv DNA. Treatment with oral acyclovir and topical corticosteroid drops was effective in eliminatin g the pseudodendrites; however, recurrences occurred once the medications were d iscontinued. CONCLUSIONS: varicella virus epithelial keratitis in children can b e a recurrent chronic condition requiring prolonged treatment.

关键词：带状疱疹病毒聚合酶链反应复发型上皮型树突角膜上皮清创术单纯疱疹病毒

结肠直肠黏液癌与印戒细胞癌的10年效果评价

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 11-11页

作者： O'Connell J.b. Maggard M.A. C.Y. Ko 成虹 Department of Surgery David Geffen School of Medicine at UCLA 72- 215 CHS 10833 Le Conte Avenue Los Angeles CA 90095 United StatesDr.

PURPOSE: Most studies examining mucinous or signet-ring cell colorectal cancers are single institution reports. This study used a national cancer registry to analyze the epidemiology and survival outcomes of these two subtypes of colorectal cancer compared with adenocarcinoma tumors. METHODS: All patients diagnosed with mucinous (n = 16,991), signet-ring cell (n = 1,522), or adenocarcinoma (n = 146,115) colorectal cancer in the Surveillance, Epidemiology, and End Results database (1991- 2000) were evaluated. Analyses were performed to obtain age-adjusted incidence rates, stage at presentation, tumor grade, and five-year relative survival for each subtype. RESULTS: Mucinous were slightly morin females (53.4 percent). Incidence rates per 100,000 persons were: mu-cinous, 5.5; signet-ring cell, 0.6; and adenocarcinoma 46.6. The annual percent change during ten years was stable for mucinous, increased for signet-ring cell (4.8 percent; P carcinoma (- 1.1 percent; P cated in the rectum compared with adenocarcinoma (29 percent). Signet-ring cell presented at later stage (III/Iv, 80.9 percent) more often than mucinous (52.8 percent) and adenocarcinoma (49.5 percent), and also had worse tumor grade (high grade: signet-ring cell, 73.5 percent; mucinous, 20.9 percent; adenocarcinoma, 17.5 percent). Rela-tive five-year survival was worse for signet-ring cell than mucinous or adenocarcinoma. CONCLUSIONS: We present a large population-based review of colorectal cancer subtypes by analyzing national data from the past decade. Although the incidence of colorectal adenocarcinoma is decreasing in the United States, mucinous and signet-ring cell subtypes are stable and increasing, respectively. Importantly, it seems that the signet-ring cell subtype has worse outcomes, whereas survival rates for mucinous tumors are similar to adenocarcinomas.

关键词：印戒细胞癌结肠直肠效果评价黏液癌大肠腺癌肿瘤分级肿瘤分期晚期肿瘤数据分析百分比变化

对Rho激酶的抑制可通过改变细胞骨架及结缔组织生长因子的表达,调节小肠平滑肌细胞的辐射诱发纤维化显型

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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 31-31页

作者： bourgier C. Haydont v. Milliat F. M.- C.vozenin- brotons 陈云茹 Laboratoire UPRES EA 2710 Radiosensibilite Tumeurs/Tissus S. 39 Rue Camille Desmoulins 94805 Villejuif Cedex France Dr.

background: Late radiation enteritis in humans is associated with accumulatio n of extracellular matrix and increased connective tissue growth factor (CTGF) e xpression that may involve intestinal muscular layers. Aims: We investigated the molecular pathways involved in maintenance of radiation induced fibrosis by gen e profiling and postulated that alteration of the Rho pathway could be associate d with radiation induced fibrogenic signals and CTGF sustained expression. Patie nts and methods: Ileal biopsies from individuals with and without radiation ente ritis were analysed by cDNA array, and primary cultures of intestinal smooth mus cle cells were established. Then, the effect of pharmacological inhibition of p1 60 Rho kinase, using Y- 27632, was studied by real time reverse transcription- polymerase chain reaction, western blot, and electrophoretic mobility shift ass ay. Results: Molecular profile analysis of late radiation enteritis showed alter ations in expression of genes coding for the Rho proteins. To investigate furthe r the involvement of the Rho pathway in intestinal radiation induced fibrosis, p rimary intestinal smooth muscle cells were isolated from radiation enteritis. Th ey retained their fibrogenic differentiation in vitro, exhibited a typical cytos keletal network, a high constitutive CTGF level, increased collagen secretory ca pacity, and altered expression of genes coding for the Rho family. Rho kinase bl ockade induced a simultaneous decrease in the number of actin stress fibres, α smooth muscle actin, and heat shock protein 27 levels. It also decreased CTGF l evels, probably through nuclear factor κ b inhibition, and caused decreased exp ression of the type I collagen gene. Conclusion: This study is the first showing involvement of the Rho/Rho kinase pathway in radiation fibrosis and intestinal smooth muscle cell fibrogenic differentiation. It suggests that specific inhibit ion of Rho kinase may be a promising approach for the development of

关键词：肠平滑肌细胞 Rho激酶生长因子细胞骨架放射性小肠炎显型原代培养细胞外基质抑制作用 Ⅰ型胶原基因

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卵巢癌转移至乳腺

世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 40-40页

作者： J.P. Micha Goldstein b.H. Epstein H.D. 朱亮 Gynecologic Oncology Associates Hoag Cancer Center351 Hospital RoadSuite 507Newport BeachCA 92663United States

background:Metastatic ovarian cancer to the breast should be considered in the differential diagnosis for gynecologic cancer patients with a breast tumor. Despite early detection and treatment,the long-term prognosis for these patients is poor. cases:We present three ovarian cancer patients who developed metastatic ovarian cancer to the breast. All patients were heavily pre-treated prior to the development of metastatic disease. Currently,one patient is alive at 64 months following initial detection of her metastatic disease to the breast. The second and third patients are also alive for 30 and 3 months subsequent to their diagnosis of metastatic disease. Conclusion:Although metastatic ovarian cancer to the breast following treatment for ovarian cancer is rare and associated with a poor prognosis,oncology physicians should be prepared to contend with disease metastatic to the breast. Additional investigation into the efficacy of surgery and novel chemotherapy agents is warranted.

关键词：癌转移妇科肿瘤肿瘤转移前期治疗化疗药物早期检测

肩难产:传统的危险因素是否为可靠的预测指标

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世界核心医学期刊文摘（妇产科学分册） 2005年第10期1卷 10-10页

作者： Ouzounian J.G Gherman R.b Steinke R 张丽娟 Department of Obstetrics and Gynecology Kaiser Permanente Medical Center 1011 Baldwin Park Blvd Baldwin Park CA 91706 United States.Dr

Objective: Our purpose was to determine the rate of associated risk factors for shoulder dystocia from a large cohort of patients delivered within our Southern california perinatal program. Study design: A retrospective analysis was performed of patients delivered from January 1991 to June 2001. Patients with and without shoulder dystocia were identified from our computer- stored perinatal database and compared. Statistical methods used included: χ 2 test, t test, calculation of odds ratios, and Fisher exact test, as indicated. Results: Among the 267,228 vaginal births during the study period, there were 1,686 cases of shoulder dystocia (rate 0.6% ). rates for operative vaginal delivery, diabetes, epidural use, multiparity, and postdatism were similar among cases with and without shoulder dystocia. The clinical triad of oxytocin use, labor induction, and birth weight greater than 4,500 g yielded a cumulative odds ratio of 23.2 (95% CI 17.3- 31.0) for shoulder dystocia, but its sensitivity and positive predictive value were only 12.4% and 3.4% , respectively. Conclusion: Historic obstetric risk factors for shoulder dystocia are not useful predictors for the event. Furthermore, although shoulder dystocia was observed more frequently with increasing birth weight, current limitations in estimating birth weight antenatally with accuracy preclude its practical use as a reliable predictor.

关键词：肩难产阴道分娩者队列研究过期妊娠分娩孕妇阴道手术催产素使用硬膜外麻醉精确检验阳性预测值

联合应用血清肿瘤标记物ca125和SM R对卵巢癌诊断及早期检测的意义

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世界核心医学期刊文摘（妇产科学分册） 2005年第2期1卷 43-43页

作者： McIntosh M.W. Drescher C. Karlan b. 张剑萍

The serum tumor marker ca 125is elevated in most clin-ically advanced ovarian *** these eleva-tions may precede clinical detectio n by a year or more,ca125is potentially useful for early d etection as part of an ovarian cancer screening program.H owever,ca 125is often not elevated in clinically detected cancer and is fre-quently elevated in women with benig n ovarian ***125may be more useful in conjunction with one or more other tumor *** could play a role if,when usedwith ca 125,they id entify some carci-nomas missed by ca 125(i.e.,they improve sensitivity),rule out false positives(i.e.,improve specificity),or are able to detect the same cancers earli *** have evaluated a composite marker(CM)that combines ca 125and a previously described soluble mesothelin related(SMR)marker in sera from 52ovarian cancer cases,43controls with benign ovarian tumors,and 220n ormal risk controls who participated in a screening program,including 25healthywomen having two serum sampl es collected 1year *** 125,SMR,and CM were evaluated for their ability to identify clinical disease and for their temporal stability,which assesses their abi lity to obtain even greater sensitivity when used in a longitudi nal screening *** has the best sensitivity,with specificity equal to ***,CM has temporal stability at least as high as ca *** CM may outperform C A 125alone in a longitudinal screening program as well as in a diagnostic setting.

关键词：卵巢癌诊断 SM R 血清肿瘤标记物早期检测良性卵巢肿瘤晚期卵巢癌早期卵巢癌早期筛查阳性病例筛查方案

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罕见卵巢浆液性沙癌1例

世界核心医学期刊文摘（妇产科学分册） 2006年第3期2卷 47-47页

作者： Rettenmaier M.A. Goldstein b.H. Epstein H.D. 杨晓梅 Gynecologic Oncology Associates Hoag Memorial Hospital Cancer Center 351 Hospital Road Newport Beach CA 92663 United States

background. Serous psammocarcinoma of the ovary is a rare and infrequently described variant of ovarian cancer, characterized histologically by the pervasive presence of psammoma bodies. The risk of recurrent disease following surgical resection is low. case history. A 70-year-old patient was admitted to the emergency room after falling at home. CT evaluation revealed a pelvic mass and free fluid in the abdomen and pelvis. Her serum ca-125 level was greatly elevated. The patient underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy. Histologic examination revealed serous psammocarcinoma of the ovary. Conclusion. Psammocarcinoma is a rare form of ovarian cancer associated with a favorable prognosis. However, the rare incidence of this disease and inconsistent biological behavior can confound the diagnosis for the treating physician.

关键词：沙癌卵巢浆液性双侧附件经腹子宫切除术组织学检查组织学特征游离液体沙瘤生物学特性

Risk factors for fracture in adult kidney transplant recipients

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World Journal of Transplantation 2016年第2期6卷 370-379页

作者： Kyla L Naylor Guangyong Zou William D Leslie Anthony b Hodsman Ngan N Lam Eric Mcarthur Lisa-Ann Fraser Gregory A Knoll Jonathan D Adachi S Joseph Kim Amit X Garg Institute for Clinical Evaluative Sciences 2nd Institute of Health Policy Management and EvaluationUniversity of Toronto Department of Epidemiology and biostatistics Western University Department of Medicine University of Manitoba Division of Nephrology Western University Division of Nephrology University of Alberta Division of Endocrinology Western University Division of Nephrology Kidney Research CentreOttawa Hospital Research InstituteUniversity of Ottawa Division of Rheumatology McMaster University Division of Nephrology University Health NetworkUniversity of Toronto

AIM: To determine the general and transplant-specific risk factors for fractures in kidney transplant ***: We conducted a cohort study of all adults who received a kidney-only transplant(n = 2723) in Ontario, canada between 2002 and 2009. We used multivariable Cox proportional hazards regression to determine general and transplant-specific risk factors for major fractures(proximal humerus, forearm, hip, and clinical vertebral). The final model was established using the backward elimination strategy, selecting risk factors with a P-value ≤ 0.2 and forcing recipient age and sex into the model. We also assessed risk factors for other fracture locations(excluding major fractures, and fractures involving the skull, hands or feet). RESULTS: There were 132 major fractures in the follow-up(8.1 fractures per 1000 person-years). General risk factors associated with a greater risk of major fracture were older recipient age [adjusted hazard ratio(a HR) per 5-year increase 1.11, 95%CI: 1.03-1.19] and female sex(a HR = 1.81, 95%CI: 1.28-2.57). Transplant-specific risk factors associated with a greater risk of fracture included older donor age(5-year increase)(a HR = 1.09, 95%CI: 1.02-1.17) and end-stage renal disease(ESRD) caused by diabetes(a HR = 1.72, 95%CI: 1.09-2.72) or cystic kidney disease(a HR = 1.73, 95%CI: 1.08-2.78)(compared to glomerulonephritis as the reference cause). Risk factors across the two fracture locations were not consistent(major fracture locations vs other). Specifically, general risk factors associated with an increased risk of other fractures were diabetes and a fall with hospitalization prior to transplantation, while length of time on dialysis, and renal vascular disease and other causes of ESRD were the transplant-specific risk factors associated with a greater risk of other ***: both general and transplant-specific risk factors were associated with a higher risk of fractures in kidney transplant recipients. Results ca

关键词： Fracture Risk factors Kidney transplant recipient Prognostication Cohort study

一项关于妊娠期和产褥期急性心肌梗死的人群研究

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世界核心医学期刊文摘（妇产科学分册） 2005年第8期1卷 50-50页

作者： Ladner H.E. Danielsen b. Gilbert W.M. 王雅楠 Dr.4860 Y Street SacramentoCA 95817 United States

ObJECTIvE: To estimate the population-based incidence and pregnancy outcomes of acute myocardial infarction (MI) in pregnancy. METHODS: Maternal and newborn hospital discharge records were linked to birth/death certificates for the 10-year period January 1, 1991, to December 30, 2000, for the majority (98%) of deliveries in california. This database was searched for the diagnosis of acute MI, demographic characteristics, and pregnancy outcomes. Patients were divided into 4 groups: antenatal diagnosis, intrapartum diagnosis, up to 6week postpartum diagnosis, and those without the diagnosis of acute MI. All groups were compared by Student t test or χ2 or both, where appropriate. RESULTS: A total of 151 women had an acute MI during the antepartum (38%), intrapartum (21%), or 6-week postpartum (41%) period, giving an incidence rate of 1 in 35,700 deliveries. The incidence rate increased over the study period. The maternal mortality rate was 7.3%, and maternal death only occurred in women with an acute MI before or at delivery (P ve an acute MI, those with one were more likely to be older (30%were older than 35 years compared with 10%), multiparous (78%compared with 61%), non-Hispanic white (40%compared with 35%) or African Americans (15%compared with 7%). All measures of maternal and neonatal morbidity were increased in the acute MI group compared with those without an acute MI. Multivariate analysis identified chronic hypertension, diabetes, advancing maternal age, eclampsia, and severe preeclampsia as independent risk factors for acute MI. CONCLUSION: Acute MI during pregnancy remains a rare event, with significant maternal, fetal, and neonatal morbidity and mortality and maternal mortality limited to the antepartum and intrapartum period.

关键词：急性心肌梗死妊娠结局新生儿发病率慢性高血压出院记录多胎妊娠产时病历卡新生儿死亡率人口统计学