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内镜下胆囊支架置入治疗末期肝病患者的症状性胆囊疾病

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世界核心医学期刊文摘（胃肠病学分册） 2005年第6期1卷 39-39页

作者： Conway J.D. Russo m.W. Shrestha R. 赵天智 med. Director of Liver Transplant. Div. of Gastroenterol. and Hepatol.CB#7080 1105 Bioinformatics Bldg.Chapel Hill NC 27599-7080 United States Dr.

Endoscopic stent insertion into the gallbladder entails placement of a double-pigtail polyethylene stent between the gallbladder and the duodenum at ERCP. This proceduremay be an effective temporary measure in patients with severe comorbid conditions, especially end-stage liver disease, that subsequently allows more definitive therapy, including liver transplantation. The records for 29 patients who underwent attempted endoscopic gallbladder stent insertion between may 1999 and may 2004 were reviewed retrospectively. mean patient age was 47 years; 86%of the patients were listed for liver transplantation, with a mean model for end-stage liver disease score of 15; 72%had Child’s class B cirrhosis. Indications for gallbladder stent placement included recurrent biliary colic (69%), acute cholecystitis (17%), acalculous cholecystitis (7%), and gallstone pancreatitis (7%). Of the 29 patients who underwent ERCP, stent placement was successful in 26 (90%). median follow-up was 9.4 months (range 0.1-40.5 months). Of those who had a stent placed, 6 (22%) subsequently underwent liver transplantation and another 15 (56%) were alive, most awaiting liver transplantation. Only 3 patients had late a complication or recurrence of biliary symptoms after stent placement. Endoscopic stent placement in the gallbladder is a safe and an effective palliative treatment for patients with symptoms caused by gallbladder disease who are poor surgical candidates.

关键词：支架置入治疗无结石性胆囊炎急性胆囊炎肝移植胆汁反流外科手术双尾身体状况

真空负压助产中胎头枕后位增加肛门括约肌损伤风险

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世界核心医学期刊文摘（妇产科学分册） 2005年第12期1卷 18-18页

作者： Wu J.m. Williams K.S. Hundley A.F 朱晓明 Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill Chapel Hill NC United States Dr

Objective: The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. Study design: We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. Results: Within the OP group, 41.7% developed a third -or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4- 4.7). In a logistic regression model that controlled for BmI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7- 9.6) more likely to be associated with an anal sphincter injury than OA position. Conclusion: Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.

关键词：枕后位括约肌损伤真空负压胎头位置外阴切开术第二产程单胎妊娠枕前位会阴撕裂产科学

长期不对称性姿势震颤可能预示帕金森病的进展而非特发性震颤:13例临床随访研究

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世界核心医学期刊文摘（神经病学分册） 2005年第5期1卷 20-20页

作者： Chaudhuri K.R. Buxton-Thomas m. Dhawan V. 高中宝 Department of Neurology King's College Hospital Denmark Hill London SES 9RS United Kingdom Dr.

Background: Patients presenting with asymmetrical postural tremor with or wot hout mild rest tremor may be diagnosed as having essential tremor (ET), although there is considerable diagnostic uncertainty as to the long term outcome of the se patients. Abstract Objective: In this study, retrospective observations were made on 1 3 patients presenting originally with asymmetrical postural tremor, initially th ough to have ET based on tremor characteristics, alcohol responsiveness, and fam ily history but who subsequently met the criteria of Parkinson’s disease (PD). methods: The patients were observed and followed up clinically with ancillary i maging using dopamine transporter SPECT scan or levodopa challenge tests in some cases. The diagnosis at original presentation with postural tremor was made wit h retrospective case note review. Results: After a variable and long latent peri od all patients developed additional signs suggesting a clinical diagnosis of PD although picking up an initial label of ET. Conclusions: We Suggest exercising caution regarding a diagnosis of ET in patients presenting with late onset asymm etrical postural tremor even if there is no rest tremor. Alcohol sensitivity of tremor, family history of tremor, or responsiveness to β blockers may not be h elpful in diagnosing ET in these cases and some may develop PD in the longs term .

关键词：对称性姿势震颤特发性震颤帕金森病随访研究左旋多巴激发试验 β阻滞剂诊断标准转运蛋白扫描成像

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无妊娠并发症的过期妊娠与有核红细胞

世界核心医学期刊文摘（妇产科学分册） 2005年第8期1卷 43-43页

作者： Perri T. Ferber A. Digli A. m.Y. Divon 马锦琪 Dr.Department of Obstetrics Lenox Hill Hospital 100 East 77th Street New York NY 10021 United States

OBJECTIVE: Elevated counts of nucleated red blood cells (NRBCs), as well as prolongation of pregnancy, have been suggested as predictors of adverse perinatal outcome. However, the association between these 2 variables has received only minimal attention. We sought to evaluate fetal NRBCs in prolonged pregnancies. mETHODS: Umbilical cord blood was prospectively collected at delivery from 75 prolonged (at or beyond 287 days) pregnancies. One hundred and fifty term deliveries (260-286 days) served as controls. All pregnancies were accurately dated with the use of first-trimester sonography. Fetal biophysical profile testing was initiated at 40 weeks of gestation. Patients were delivered if they were in spontaneous labor or the biophysical profile was nonreassuring or by 42 weeks of gestation. Nucleated red blood cell counts were expressed per 100 white blood cells (WBC). Umbilical artery pH studies, as well as other demographic and clinical variables, were obtained. RESULTS: Prolonged pregnancy was associated with a significantly increased incidence of induction of labor and a greater birth weight. There were no other differences between the study group and controls. The median NRBCs per 100 WBCs in prolonged pregnancy was not significantly elevated over the term values (median 3, range 0-35 versus median 3, range 0-34, respectively; P = .25). Neonatal outcome was also comparable between groups. The univariate regression analysis demonstrated a significant association between elevated NRBC counts and low arterial cord blood pH (P male gender (P = .028). Stepwise regression analysis revealed that low arterial cord blood pH and male gender were the only independent variables predicting elevated NRBC counts at birth. CONCLUSION: The findings of this study suggest that elevated NRBCs counts are associated with specific pregnancy complications rather than uncomplicat

关键词：有核红细胞过期妊娠妊娠并发症脐动脉血孕妇分娩新生儿结局足月妊娠孕妇围生期超声检查新生儿出生体重

依贝沙坦和硫辛酸改善代谢综合征患者内皮功能并减少炎症标志物:依贝沙坦和硫辛酸对内皮功能影响的研究(ISLAND)结果

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世界核心医学期刊文摘（心脏病学分册） 2005年第6期1卷 49-49页

作者： Sola S. mir m.Q.S. Cheema F.A. B.V.Khan 宁宁 Dr. Emory Division of Cardiology 69 Jesse Hill Jr Dr. Atlanta GA 30303 United States

Background-The metabolic syndrome is associated with increased angiotensin II activity, induction of a proinflammatory and oxidative state, and endothelial dysfunction. We evaluated the ability of irbesartan, an angiotensin receptor blocker, and lipoic acid, an antioxidant, to affect endothelial function and inflammation in patients with the metabolic syndrome. methods and Results-We randomized 58 subjects with the metabolic syndrome in a double-blinded manner to irbesartan 150 mg/d(n=14), lipoic acid 300 mg/d(n=15), both irbesartan and lipoic acid(n=15), or matching placebo(n=14) for 4 weeks. Endothelium-dependent and-independent flow-mediated vasodilation was determined under standard conditions. Plasma levels of interleukin-6, plasminogen activator-1, and 8-isoprostane were measured. After 4 weeks of therapy, endothelium-dependent flow-mediated vasodilation of the brachial artery was increased by 67%, 44%, and 75%in the irbesartan, lipoic acid, and irbesartan plus lipoic acid groups, respectively, compared with the placebo group. Treatment with irbesartan and/or lipoic acid was associated with statistically significant reductions in plasma levels of interleukin-6 and plasminogen activator-1. In addition, treatment with irbesartan or irbesartan plus lipoic acid decreased 8-isoprostane levels. No significant changes in blood pressure were noted in any of the study groups. Conclusions-Administration of irbesartan and/or lipoic acid to patients with the metabolic syndrome improves endothelial function and reduces proinflammatory markers, factors that are implicated in the pathogenesis of atherosclerosis.

关键词：硫辛酸依贝沙坦 ISLAND 代谢综合征炎症标志物血管舒张血流介导血管紧张素Ⅱ 纤溶酶原激活物炎症反应

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线状汗腺错构瘤新发1例

世界核心医学期刊文摘（皮肤病学分册） 2006年第5期2卷 27-27页

作者： White J.m.L. Short K. Salisbury J.R. Fuller L.C. 刘艳 Department of Dermatology King' s College Hospital Denmark Hill London SE5 9RS United Kingdom Dr.

A 4-year-old girl presented with a linear, indurated area of dusky erythema and hyperpigmentation down the left leg, present since birth. Histology suggested syringomata. The clinical course and appearances suggest a ... 详细信息

关键词：错构瘤组织学检查暗红斑临床病程色素沉着

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玉米种植方式研究

作物学报 1963年第4期 399-409页

作者：范福仁莫惠栋秦泰辰胡雪华吴一民苏北农学院

在11个玉米种植方式试验中,研究了同等密度下,每穴株数不同、行距不同、营养面积的形状不同的效应。发现各种种植方式的产量和性状虽有一定差异,但一般多不够显著。

关键词：玉米种植窄行籽粒产量每穴株数宽窄行种植方形穴播行距六角形

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粒细胞集落刺激因子的皮肤表现

世界核心医学期刊文摘（皮肤病学分册） 2006年第5期2卷 26-26页

作者： White J.m.L. mufti G.J. Salisbury J.R. Du Vivier A.W.P. 焦婷 Department of Dermatology King' s College Hospital Denmark Hill London SE5 9RS United Kingdom Dr.

Granulocyte colony-stimulating factor (GCSF) is a recombinant human growth factor widely used in haematology. It is known to cause cutaneous vasculitis and neutrophilic dermatoses. We present three cases of Sweet’ s syndrome (SS) associated with GCSF use. Raised GCSF levels have been demonstrated in patients with SS. GCSF is the best understood mechanism by which neutrophil accumulation occurs and shows a dose-dependent effect in provoking SS.

关键词：皮肤血管炎嗜中性 Sweet 生长因子中性粒细胞

自动化全乳腺超声和乳腺X线摄影术对发生于致密型乳腺的乳腺癌检出率研究

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国际医学放射学杂志 2010年第3期 297-297页

作者：汪禾青 K. m. Kelly J. Dean W. S. Comulada S. J. Lee Huntington memorial Hospital Huntington-Hill Breast Center

摘要目的乳腺X线摄影是用于乳腺癌筛查的标准检查方法,但会漏诊许多乳腺癌,特别是对致密型乳腺的女性。本研究旨在对

关键词：乳腺X线摄影术超声乳腺癌筛查自动化