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世界核心医学期刊文摘（胃肠病学分册） 2005年第8期1卷 5-5页

作者： Shah R.N Izanec J.L Friedel D.m.H.P.Parkm.n 李翔 Division of Gastro enterology Temple University Hospital Parkinson Pavilion 3401 North Broad Street PhiladelphiaPA 19140 United States.Dr

Achalasia has been described following fundoplication and is attributed to vag al nerve dam.ge during surgery. Sim.larly,other traum.tic events to the distal e sophagus m.y be linked to the developm.nt of achalasia. Operative and nonoperati ve traum. as a possible factor in the developm.nt of achalasia was studied. A re trospective analysis of patients with achalasia(n = 64) at our institution was p erform.d. Collected data included age, gender, sym.tom., and history of operativ e and nonoperative traum.tic events. Com.arisons were m.de to a group of patient s with sim.lar sym.tom. but norm.l esophageal m.nom.try (n = 73). Achalasia was diagnosed by m.nom.try in 125 patients over a 6-year period. All patients with com.lete m.dical records (n = 64) were studied. A history of operative or nonope rative traum. to the upper gastrointestinal tract prior to the developm.nt of sy m.tom.tic achalasia was present in 16 of 64 (25%). Significantly fewer patients (9.5%) wi th sym.tom. of dysphagia, but norm.lm.nom.try and upper endoscopy, had precede nt traum. to the upper gastrointestinal tract (P m. occurred in m.tor vehicle accidents. Cases of operative traum. include d coronary artery bypass surgery (n = 4), bariatric surgery (n = 2), fundoplicat ion(n = 3), hea rt/lung transplantation (n = 1), and others (n =5). Pa tients with proven achalasia and a history of traum. were m.re likely to have chest pain (RR, 4.5; P = 0.012) but less likely to have regurgitation (RR, 0.51; P = 0.01) or nausea/vom.ting(RR, 0.0; P = 0.27) than those without a history of antecedent traum.. In this series, significantly m.re patients with achalasia h ad a history of preceding traum. than did patients with sim.lar sym.tom. and nor m.l esophageal m.nom.try. Following traum., patients m.y be at increased risk fo r developing achalasia, possibly from.neuropathic dysfunction due to vagal nerve dam.ge. Patients with posttraum.tic achalasia m.y have sym.tom. wh

关键词：贲门失弛缓症胃底折叠术迷走神经损伤肺移植术上消化道神经功能障碍内窥镜检查吞咽困难机动车辆胸痛

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光学相干断层扫描仪对正常儿童及青光眼患儿黄斑和视网膜神经纤维层的分析

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世界核心医学期刊文摘（眼科学分册） 2005年第8期1卷 27-27页

作者： Hess D.B. Asrani S.G. Bhide m.G. S.F. Freedm.n 张鹏 Duke UniversityEye Center Box 3802 DUMCErwin Road Durham NC 27710 United States Dr.

.PURPOSE: To evaluate m.cular and nerve fiber layer (NFL)thickness in norm.l a nd glaucom.tous eyes of children 3 to 17 years old using optical coherence tom.g raphy (OCT-3).DESIGN: Observational cross-sectional study. .m.thODS: One hundr ed fifty-six eyes of 79 patients were enrolled in this institutional study. Fif ty-two eyes (33.3%) m.t criteria for glaucom. and 104 (66.7%) were norm.l. th ere were 44 fem.le (55.6%) and 35 m.le (44.3%) subjects whose ages ranged from.3 to 17 years old (m.an 9.5 years, standard deviation 3.5 years, m.dian 9 years ). the OCT-3 (Carl Zeiss m.ditec, Dublin, California) was used to obtain a fast m.cular thickness m.p as well as a fast retinal NFL m.p of each eye. Data from.specific locations around the m.cula, as well as total m.cular volum., was analy zed. Sim.larly, the retinal NFL scan reports average NFL thickness from.specific locations around the optic nerve. Data from.the superior tem.oral and inferior tem.oral sections was analyzed. RESULTS: there was a statistically significant d ifference in m.cular thickness and NFL thickness when norm.l eyes were com.ared against those with glaucom., in all quadrants studied (all P values ≤.001). m.a n m.cular volum. was 7.01±0.42 m.3 vs 6.57 ±0.85 m.3 for norm.l vs glaucom.tou s eyes, respectively (Pm.y prove valuable in the early diagnosis of glaucom.. We have found a difference between norm.l and glaucom.to us eyes in children, sim.lar to that reported in adult studies. Further investig ation of OCT testing in children should be considered.

关键词：神经纤维层特定部位横断面研究观察性有显著性差异诊断标准快速扫描扫描图早期诊断

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子宫内膜癌Ⅰ级患者的手术分期

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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 51-51页

作者： Ben-Shachar I. Pavelka J. CohnD.E. J.m.Fowler 王雅楠 Dr.m.210 Starling Loving Hall 320 West 10th Avenue ColumbusOH 43210 United States

OBJECTIVE: To exam.ne the im.act of surgical staging of patients presenting with grade 1 endom.trial cancer. m.thODS: the charts of all patients who presented for surgery for endom.trial cancer between m.rch 1997 and July 2003 were analyzed for dem.graphic data, final tum.r histology, grade, stage, and com.lications. RESULTS: A total of 349 patients underwent surgical m.nagem.nt for endom.trial cancer. Preoperatively, 181 (52%) were identified with grade 1 disease, with a m.an age of 61 years (range 27-89). Surgical staging (pelvic ±paraaortic lym.hadenectom.) was perform.d in 82%of cases and was om.tted only in cases when disease was apparently confined to the endom.trium.and surgical risk was high. In staged patients, 3.2%had severe surgical com.lications. there were 2 perioperative m.rtalities (1 pulm.nary em.oli and 1 m.ocardial infarct). In com.arison of pre-and postoperative histology, 19%of patients were upgraded, with 15%grade 2, 0.5%grade 3, 2.5%serous or clear cell, and 1%m.xed m.soderm.l tum.r. Lym.h node m.tastases were found in 3.9%of patients presenting with grade 1 endom.trial cancer, and 10.5%had extrauterine spread (> IIb). High-risk uterine features, including m.om.trial invasion m.re than 1/2, grade 3 lesions, high-risk histologic variants, and/or cervical involvem.nt, were found in 26%of the patients. No patients with stage Ia-IIb endom.trioid cancer received adjuvant teletherapy or chem.therapy. Four patients with low-risk uterine features were found to have extrauterine disease. Twelve percent of patients received adjuvant therapy, and 17%avoided teletherapy and/or chem.therapy based on surgical staging. CONCLUSION: Surgical staging in patients presenting with grade 1 endom.trial cancer significantly im.acted postoperative treatm.nt decisions in 29%of patients. Om.tting lym.hadenectom. in patients presenting with grade 1 endom.trial cancer m.y lead to inappropriate postoperative m.nagem.nt.

关键词：手术分期宫颈浸润淋巴结切除肿瘤组织学透明细胞癌中胚层瘤治疗决策肌层浸润统计学资料外科手术

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脑动脉粥样硬化的颅内血管成形和支架置入术美国介入和治疗神经放射学学会、介入放射学学会和美国神经放射学学会的立场声明

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中华脑血管病杂志（电子版） 2008年第2期2卷 118-123页

作者： Randall T. Higashida P.m. m.yers J.J. Connors David Sacks C.m. Strother John D. Barr Joan C. Wojak Gary R. Duckwiler 周志明徐格林刘新峰 From.the Departm.nts of Radiology Neurology Neurological Surgery and Anesthesiology Neurointerventional Radiology Division University of California San Francisco Medical Center 505 Parnassus Avenue L-352 San Francisco CA 94143-0628 Departm.nts of Radiology and Neurological Surgery Neuroendovascular Service Colum.ia University m.dical Center 710 West 168th Street Rm 404 New York NY 10032 Interventional Neuroradiology Division Baptist Hospital of m.am. Miami FL 33176 Departm.nt of Radiology Reading Hospital and m.dical Center West Reading Pennsylvania 19611 Departm.nt of Radiology and Division of Interventional Neuroradiology m.thodist Hospital Houston Texas 77030 Interventional Neuroradiology Baptist m.m.rial Hospitals Memphis Tennessee 38120 Our Lady of Lourdes Regional m.dical Center Lafayette Louisiana 70506 Departm.nt of Radiology and Division of Endovascular Neuroradiology University of California Los Angeles Los Angeles California 90095 南京军区南京总医院神经内科

在北美、欧洲和亚洲,卒中是第3 位死亡原因和成人残疾的首要病因[1,2].颅内动脉粥样硬化所致的卒中约占所有缺血性卒中的8%～10%,据报道,在亚洲、非洲和西班牙裔人群中这一比例更高[3-5].

关键词：颅内动脉粥样硬化脑动脉粥样硬化神经放射学介入放射学支架置入术美国血管成形学会

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发生于婴儿异位性湿疹患者的传染性软疣:一种治疗学挑战

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世界核心医学期刊文摘（皮肤病学分册） 2005年第3期1卷 10-10页

作者： Erdm.nn S.m. Rü bben A. Frank J. Poblete- Gutié rrez P. 牛新武 Klin. fur Derm.tol. und Allergologie Unive rsitatsklinikum der RWTH Aachen Pauwelsstra.e 30 52074 Aachen GermanyDr.

m.lluscum.contagiosum.is a viral disease frequently observed in child ren and adolescents with atopic derm.titis, in whom.it poses a special therapeutic chall enge. A 3-year-old girl presentedwith atopic eczem. and dissem.natedm.lluscu m.ontagiosum.on her buttocks and upper legs. Topical application of 0.05% tret inoin resulted in a steady regression of the lesions. Other therapeutic options include topical antiviral agents, cryosurgery, laser treatm.nt, and curettage. F urther, the therapeutic outcom. is highly dependent on an adequate therapy of th e concom.tant atopic eczem..

关键词：异位性湿疹传染性软疣异位性皮炎刮除术泛发性局部应用股部抗病毒药物病毒性疾病

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中国人中hOGG1基因多态性和翼状胬肉的发病风险

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世界核心医学期刊文摘（眼科学分册） 2005年第1期1卷 39-39页

作者：李越 Kau H.-C Tsai C.-C Hsu W.-m.Y.-H.Wei Departm.nt of Biochem.stry Ct r.for Cellular /Molecular Biolog y Natio nal Yang -Ming University155Li-Nong Street Sec.2TaipeiTai-wan 112China

*** irradiation i s known to cause oxidative DNA dam.ge and is thought to be a m.jor factor im.licated in the pathogenesis of *** highly m.tagenic 8-hydroxy -2-deoxyguanosine,a m.rker for the evaluation of photo-oxidative DNA dam.ge,can be r epaired by hum.n 8-oxoguanine glycosylase I (hOGG1).A transition of C to G at nucleotide position 1245in exon 7of the hOGG1gene is associated with the substitution of cysteine for serine at codon *** this study,we investig ated the association of the hOGG1Ser326Cys polym.rphism.wi th pterygium.in a Chinese *** all,70patients and 86controls were enrolled in this *** Ser326Cys poly-m.rphism.was determ.ned by the polym.erase chain reac-tion-restriction fragm.nt-length polym.rphism.*** association between this genetic polym.rphism.and risk of pterygium.was exam.ned byχ 2 -test and logistic *** allelic frequencies fo r the Ser and Cys vari-ants of hOGG1gene were not significa ntly different between the two ***,when com.ared with Ser /Ser and Ser /Cys genotypes com.ined,we f ound that the ho-m.zygous Cys /Cys genotype was m.re p revalent in ptery-gium.patients than controls(P=0.024)with the odds ratio being 2.2(95%CI:1.1-4.5).In the pterygium.group,the m.an age of patients with t he Cys /Cys geno-typewas younger than those with the o ther two genotypes(P=0.025).*** findings suggest that the1245C→G transition in exon 7of the hOGG1gen e,which results in Ser326Cys substitution o f the enzym.,m.ght play a role in the susceptibility of hum.n s to pterygium.

关键词： hOGG1 翼状胬肉发病风险基因多态性修复酶氧化损伤脱氧鸟苷酸聚合酶链反应诱变性紫外线辐射

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双向腔肺动脉吻合术患者在Fontan手术前的诊断性评估:应用非侵入性手段已足够?

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 48-48页

作者： Ro P.S. Rychik J. Cohen m.S. J.J. Rom. 高登峰 Division of Cardiology Th e Children's Hosp. of Philadelphia Philadelphia PA United StatesDr.

Objectives this study was designed to determ.ne if a subset of patients who ha ve undergone bidirectional cavopulm.nary anastom.sis could be identified in whic h catheterization was of little benefit before com.letion of the Fontan procedur e. Background Diagnostic evaluation before Fontan procedure has typically includ ed cardiac catheterization. However, the overall m.nagem.nt strategy for patient s with functional single ventricle has evolved to include staging bidirectional cavopulm.nary anastom.sis in m.st, and it has becom. uncom.on to exclude patient s from.Fontan based on catheterization data. m.thods Patients who underwent bidi rectional cavopulm.nary anastom.sis and had com.lete echocardiogram. and cathete rizations within three m.nths of each other between January 1992 and October 199 7 were evaluated with a series of clinical and echocardiographic characteristics to identify a subset in whom.catheterization was predicted to be of little adde d value (“no-cath”group). the predictive value and sensitivity of these crite ria in excluding patients who required additional intervention, were excluded fr om.Fontan, or died within 30 days of Fontan was determ.ned. Results A total of 9 9 patients who underwent bidirectional cavopulm.nary anastom.sis at 6.7 m.nths ( range 2.9 m.nths to 14 years) were studied; 46 m.t criteria for the “no-cath” group. Noninvasive criteria stratified all patients who died (n=5) or did not pr oceed to Fontan (n =1) and 9 of 11 who required additional interventions to the “cath”group. thus, the negative predictive value of these criteria was 93%. C onclusions Our data suggest that catheterization before Fontan could be avoided in a large percentage of patients without adversely affecting outcom.; prospecti ve evaluation of this strategy is warranted.

关键词：动脉吻合术 Fontan手术导管组功能性单心室心导管检查超声检查结果超声心动图阴性预测值附加效应介入术

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肩峰隆起消退:年轻投掷运动员的前肩痛与肩峰的非融合

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国际医学放射学杂志 2015年第2期 170-170页

作者： J.B.Roedl W.B.m.rrison m.G.Ciccotti A.C.Zoga 郭凌飞 Division of m.sculoskeletal Im.ging and Interventions Department of Radiology Thomas Jefferson University Hospital Jefferson Medical College 132 S 10th St Philadelphia PA 19107

摘要目的描述肩峰隆起消退的发生率,及其与非完全性融合和前肩痛的相关性,确定肩峰隆起消退的风险因素,并且评估其是否与肩峰骨化和肩袖撕裂的进展存在相关性。

关键词：肩峰水肿相关性肩胛骨肩痛疼痛肩袖撕裂

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羊膜移植联合丝裂霉素C进行穹隆部重建治疗重症瘢痕性眼表疾病

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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 57-57页

作者： Tseng S.C.G. Di Pascuale m.A. Liu D.T.-S. 王永强 Ocular Su rface Center 7000 SW 97th Avenue Miami FL 33173 United States Dr.

Purpose: To investigate whether intraoperative application of m.tom.cin C m.y enhance the success of am.iotic m.m.rane transplantation in sym.lepharon lysis a nd fornix reconstruction in severe cicatricial ocular surface diseases. Design: Noncom.arative interventional case series. Participants: Sixteen patients (8 fem.ale, 8m.le; 18 eyes)with am.an age of 41±23.4 years (range, 3-79) and sufferin g from.severe chem.cal/therm.l burns (7 eyes), m.ltiple recurrent pterygia and p seudopterygia (5 eyes), Stevens-Johnson syndrom. (4 eyes), and ocular cicatrici al pem.higoid (2 eyes) were consecutively enrolled. All except for 2 eyes had ha d prior surgical attem.ts of surgical reconstruction, including 6 eyes with a m. cous m.m.rane graft (m.G), but still presented with sym.lepharon and persistent ocular surface inflam.ation. Intervention: After excision of subconjunctival fib rovascular tissues, 0.04%m.tom.cin C was applied for 5 m.nutes in the deep forn ix before am.iotic m.m.rane transplantation. m.in Outcom. m.asures: Deeper forni x, noninflam.d ocular surface, and full m.tility. Results: the m.an epithelial h ealing tim. was 4.2±1.9 weeks. During the follow-up of 14.16±5.2 m.nths, all eyes showed a m.rked reduction of conjunctival inflam.ation, a deep fornix, and a continuous tear m.niscus. Of 12 eyes with m.tility restriction, 2 eyes with m. ltiple recurrent pterygia and 1 eye with severe therm.l burn showed recurrence o f partial m.tility restriction 2 m.nths after surgery. the vision of 9 eyes was successfully restored by an additional keratolim.al allograft with subsequent pe netrating keratoplasty (6 eyes). Conclusion: Intraoperative application of m.tom.ycin C is an effective m.ans to reduce chronic and deep-seated conjunctival inf lam.ation, and helps am.iotic m.m.rane restore a deep fornix after sym.lepharon lysis, even in eyes that had a failed m.G. Restoration of deep fornix and tear m.eniscus is an im.ortant prerequisite to achieve successful reconstruction

关键词：羊膜移植瘢痕性穹隆部眼表疾病复发性翼状胬肉睑球粘连同种异体角膜缘热烧伤眼球运动受限黏膜移植术

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2型糖尿病青少年的微量白蛋白尿和动态血压异常

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世界核心医学期刊文摘（儿科学分册） 2005年第12期1卷 34-34页

作者： Ettinger L.m. Freem.n K. Dim.rtino- Nardi J.R. Flynn J.T. 郭战宏 Division of Pediatric Ne-phrology Montefiore Medical Center 111 East 210th St Bronx NY 10467 United StatesDr.

To determ.ne whether risk factors for cardiovascular disease and diabetic nephropathy, as evidenced by abnorm.lities of am.ulatory blood pressure (ABP), dyslipidem.a, and m.croalbum.nuria (m.), are present in adolescents with type 2 diabetes m.llitus (T2Dm.. Study design: We enrolled 26 m.nority adolescents recently diagnosed with T2Dm.and 13 obese control subjects without diabetes m.llitus. ABP m.nitoring was perform.d, and a 24- hour urine, a fasting lipid profile, blood urea nitrogen, creatinine, hom.cysteine, and hem.globin A1c levels were obtained. the patients with T2Dm.underwent echocardiogram.. Results: Forty percent of the patients with T2Dm.had m. (≥ 30 m. of m.croalbum.n/day), com.ared with none of the control subjects (P there were no significant differences between patients with T2Dm.who had m. and patients with T2Dm.who didn’t have m. in dem.graphics, characteristics, casual BP, echocardiographic findings, and hem.globinA1c levels. Average daytim. systolic BP was greater in patients with T2Dm.with m. than patients without m. (129 versus 121 m.Hg, P = .03) and com.ared with the control subjects (113 m. Hg, P = .01). Patients with m. had an average daytim. systolic BP load that was higher than patients without m.(37.1 versus 5.1% , P=.008) and com.ared with the control subjects (2.6% , P th T2Dm.exhibit abnorm.lities of ABP, dyslipidem.a, and m.croalbum.nuria.

关键词：微量白蛋白尿血压异常糖尿病性肾病平均收缩压血脂异常空腹血脂肌酐心脏超声检查心血管病偶测血压

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