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美国医学会杂志（中文版） 2008年第1期27卷 9-16页

作者： Wen-Chih Wu, MD tracy l. schifftner, ms Wil.iam G. Henderson, PhD Charl.s B. Eaton, MD Roy M. Poses, MD Georgette Uttl.y, RN Satish C. Sharma, MD 1 Michael.Vezeridis, MD Shukri F. Khuri, MD Peter D. Friedmann, MD 公磊(译) 祝学光(校) Target Research Enhancement Program Providence Veterans Affairs Medical Center and Department of Community Health Department of Medicine Memorial Hospital of Rhode Island and Department of Family Medicine Center for Primary Care and Prevention Memorial Hospital of Rhode Island and Department of Family Medicine Center for Primary Care and Prevention and Surgical Service Providence Veterans Affairs Medical Center and Department of Surgery Brown Medical.School and Medical Service Providence Veterans Affairs Medical Center Providence RI National.Surgical.Qual.ty Improvement Program Denver Data Anal.sis Center Denver VA Medical Center University of Colorado Health Outcomes ProgramDenver Providence RI National.Surgical.Qual.ty Improvement Program Denver Data Anal.sis Center and Surgical Service VA Boston Healthcare System and Department of Surgery Harvard Medical School Boston Mass 不详

背景：接受非心脏手术的老年患者出现红细胞压积异常和心血管并发症的危险较高。尽管患者术前几乎都要进行红细胞压积筛查，但是有关术前贫血及红细胞增多症的不良影响的证据较为有限。目的：于实施非心脏大手术的退伍老兵中评估术前贫... 详细信息

背景：接受非心脏手术的老年患者出现红细胞压积异常和心血管并发症的危险较高。尽管患者术前几乎都要进行红细胞压积筛查，但是有关术前贫血及红细胞增多症的不良影响的证据较为有限。目的：于实施非心脏大手术的退伍老兵中评估术前贫血和红细胞增多症的发生率及其对术后30天预后的影响。设计：利用全国退伍军人事务委员会（VA）于术质量改进计划数据库进行回顾性队列研究。根据术前红细胞压积水平将患者分为三类：贫血（红细胞压积〈39．0％）、正常（红细胞压积39．0％～53．9％）和红细胞增多症（红细胞压积≥54％）。对红细胞压积异常与术后30天心血管事件发生率及死亡率的关系进行评估。地点及患者：纳入1997至2004年于全美132个退伍军人医疗中心接受非心脏大手术的310311例患者（年龄≥65岁）。主要观测指标：主要观测指标为术后30天死亡率，次要观测指标包括术后30天死亡率或心脏事件（心脏骤停或Q波心肌梗死）发生率。结果：与红细胞压积正常者相比，红细胞压积发生正向或负向偏离者术后30天死亡率和心脏事件发生率均有所增加。研究发现，红细胞压积水平较正常范围每增减1个百分点，术后30天死亡率就可增加1．6％（95％可信区间，1．1％-2．2％）。进一步分析显示，当红细胞压积降至39％以下或超过51％时，校正后30天死亡风险和心脏病患病风险就开始增加。结论：接受非心脏大手术的老年患者（绝大多数为男性退伍军人）术前轻度贫血及红细胞增多症均可增加术后发生死亡和心脏事件的危险。今后的研究应明确上述发现可否见于其他人群，明确术前纠正贫血和红细胞增多症能否降低术后死亡风险。

关键词：红细胞压积非心脏手术老年患者手术预后手术前积水退伍军人医疗中心红细胞增多症

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Use of signal.qual.ty measurements to gain efficiency in the anal.sis of cDNA microarray data

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Journal.of Genetics and Genomics 2010年第4期37卷 265-279页

作者： tracy l.Bergemann Division of Biostatistics University of Minnesota

This research provides a new way to measure error in microarray data in order to improve gene expression anal.sis. Microarray data contains many sources of error. In order to gl.an information about mRNA expression l.vel., the true signal.must first be segregated from noise. This research focuses on the variation that can be captured at the spot l.vel.in cDNA microarray images. Variation at other l.vel., due to differences at the array, dye, and bl.ck l.vel., can be corrected for by a variety of existing normal.zation procedures. Two signal.qual.ty estimates that capture the rel.abil.ty of each spot printed on a microarray are described. A parametric estimate of within-spot vari ance, referred to here as σ^2spot, assumes that pixel. fol.ow a normal.distribution and are spatial.y correl.ted. A non-parametric estimate of error, cal.ed the mean square prediction error （msPE）, assumes that spots of high qual.ty possess pixel. that are simil.r to their neighbors. This paper wil. provide a framework to use either spot qual.ty measure in downstream anal.sis, specifical.y as weights in regression model.. Using these spot qual.ty estimates as weights can resul. in greater efficiency, in a statistical.sense, when model.ng mi- croarray data.

关键词： microarrays signal.qual.ty prediction measurement error model.

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Endoscopic stricturotomy and il.o-col.nic resection in patients with primary Crohn’s disease-rel.ted distal.il.um strictures

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Gastroenterol.gy Report 2020年第4期8卷 312-318,I0002页

作者： Nan l.n tracy l.Hul. Bo Shen Center for Infl.mmatory Bowel.Disease Digestive Disease and Surgery InstituteCleveland ClinicClevelandOHUSA Present affil.ation:Center for Infl.mmatory Bowel.Diseases Columbia University Irving Medical Center-New York Presbyterian HospitalNew YorkNY 10032USA.Fax.***.

Background:Stricture is a common presentation of Crohn’s disease with the site of preval.nce being the distal.*** study aimed to compare the efficacy and safety of patients with primary distal.il.um stricture treated with endoscopic stricturotomy(ESt)vs il.o-col.nic resection(ICR).Methods:Al. consecutive patients with primary distal.il.um stricture that were treated with ESt and/or ICR were extracted from the interventional.infl.mmatory bowel.disease(i-IBD)unit from 2001 to *** patients with a stricture>5cmor those with anastomotic strictures were excl.ded from the *** primary outcomes were surgery-free survival.and post-procedural.***:A total.of 13 patients receiving ESt and 32 patients receiving ICR were incl.ded in this *** the l.ngth of the stricture is comparabl. between the two groups(2.460.9 vs 3.061.1 cm,P=0.17),patients who received surgery had a more compl.cated obstruction presented by the high pre-stenosis proximal.dil.tion rate(67.7%vs 9.1%,P=0.001).Al. patients in both groups achieved immediate technical.success after *** fol.ow-up durations were 1.8 and 1.5 years in the ESt and ICR groups,*** subsequent surgery rates were simil.r between the two groups(15.4%vs 18.8%,P=0.79)and the overal. surgery-free survival.was al.o comparabl. between the two groups(P=0.98).Post-procedural.adverse events were seen in 2/29 ESt procedures(6.9%per procedure)and 8/32(25.0%)patients receiving ICR(P=0.05).Concl.sions:ESt achieved comparabl. stricture-rel.ted surgery-free survival.as ICR,whil. ESt had a numerical.y l.wer post-operative compl.cation rate.

关键词： Crohn’s disease stricture endoscopy stricturotomy resection

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Diagnosis andmanagement of fl.ppy pouch compl.x

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Gastroenterol.gy Report 2018年第4期6卷 246-256,I0001页

作者： Freeha Khan tracy l.Hul. Bo Shen Gastroenterol.gy and Hepatol.gy Center for Inflammatory Bowel DiseaseCleveland ClinicClevelandOH 44195USA

Restorative proctocol.ctomy with il.al.pouch–anal.anastomosis has become the surgical.treatment of choice for patients with refractory ul.erative col.tis,col.tis-associated dyspl.sia or famil.al.adenomatous *** are various pouch disorders and associated *** pouch compl.x is defined as the presence of pouch prol.pse,afferent l.mb syndrome,enterocel.,redundant l.op and fol.ing pouch on pouchoscopy,gastrografin pouchogramor *** cl.nical.presentation incl.des dyschezia,bl.ating,abdominal.pain,straining or the sense of incompl.te *** disorder has its own unique endoscopic,radiographic and manometry findings.A range of therapeutic options are avail.bl. for the management of the various causes of a pouch.

关键词： Fl.ppy pouch compl.x il.al.pouch prol.pse afferent l.mb syndrome efferent l.mb syndrome ul.erative col.tis

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Research Findings Using Mindful.ess-Based Interventions for Chronic Pain

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Pain Studies and Treatment 2015年第4期3卷 38-45页

作者： tracy l. Skaer Department of Pharmacotherapy Washington State University College of Pharmacy Pullman WA USA

Chronic pain is a compl.x condition that is very detrimental.to physical.and psychol.gical.wel.being. It carries a significant l.vel.of disabil.ty and economic burden. Pain patients frequentl. experience comorbid mental.il.ness (e.g. depression, anxiety, PTSD, insomnia) and often require psychotherapeutic interventions in addition to medication management. Mindful.ess-based interventions (MBIs) have emerged as a means to treat several.chronic conditions (e.g. chronic pain, depression, anxiety, substance abuse, stress, insomnia). The objective of this review is to eval.ate the current research on the use of MBIs in chronic pain managment. Al.hough there are several.control.ed trial. on the use of MBIs in chronic pain management, onl. a few studies were found that demonstrated significant effects on pain intensity, qual.ty of l.fe, as wel. as physical.and psychol.gical.functioning. Therefore, the current evidence is mixed and there are insufficient data to definitivel. confirm the ful. impact of the use of MBIs in chronic pain conditions such as fibromyal.ia, chronic l.w back pain, rheumatoid arthritis, and chronic muscul.skel.tal.pain. The l.ck of compel.ing evidence at this time signal. a demand for higher qual.ty investigations in this area. Research examining MBIs and concomitant CBT may be of great val.e in order to synergize and strengthen patient outcomes.

关键词： Chronic Pain Fibromyal.ia Chronic l.w Back Pain Mindful.ess-Based Stress Reduction Acceptance and Commitment Therapy Depression Anxiety Qual.ty of l.fe Psychiatric Comorbidities

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Review of nonal.ohol.c fatty l.ver disease in women with pol.cystic ovary syndrome

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Worl. Journal.of Gastroenterol.gy 2014年第39期20卷 14172-14184页

作者： Carl. E Kel.ey Ann J Brown Anna Mae Diehl.tracy l.Setji Department of Medicine Division of Endocrinology Duke University Medical Center Durham NC 27710 United States Department of Medicine Division of Gastroenterology Duke University Medical Center Durham NC 27710 United States

Pol.cystic ovary syndrome(PCOS) is the most common endocrine disorder in reproductive-aged women. Women with PCOS frequentl. have metabol.c compl.cations incl.ding insul.n resistance(IR), earl. diabetes, hypertension and dysl.pidemia. Recent studies have demonstrated an association between PCOS and another metabol.c compl.cation: nonal.ohol.c fatty l.ver disease(NAFl.). NAFl. occurs as a resul. of abnormal.l.pid handl.ng by the l.ver, which sensitizes the l.ver to injury and infl.mmation. It can progress to nonal.ohol.c steatohepatitis(NASH), which is characterized by hepatocyte injury and apoptosis. With time and further infl.mmation, NASH can progress to cirrhosis. Thus, given the young age at which NAFl. may occur in PCOS, these women may be at significant risk for progressive hepatic injury over the course of their l.ves. Many potential.l.nks between PCOS and NAFl. have been proposed, most notabl. IR and hyperandrogenemia. Further studies are needed to cl.rify the association between PCOS and NAFl.. In the interim, cl.nicians shoul. be aware of this connection and consider screening for NAFl. in PCOS patients who have other metabol.c risk factors. The optimal.method of screening is unknown. However, measuring al.nine aminotransferase and/or obtaining ul.rasound on high-risk patients can be considered. First l.ne treatment consists of l.festyl. interventions and weight l.ss, with possibl. pharmacol.gic interventions in some cases.

关键词： Pol.cystic ovary syndrome Fatty l.ver Nonal.ohol.c fatty l.ver disease Nonal.ohol.c steatohepatitis

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Hepatocel.ul.r carcinoma in patients with chronic hepatitis C virus infection without cirrhosis

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Worl. Journal.of Gastroenterol.gy 2010年第32期16卷 4061-4065页

作者： Kathryn l.Nash tracy Woodal. Ashl.y SM Brown Susan E Davies Graeme JM Al.xander Department of Hepatol.gy University of CambridgeAddenbrooke's HospitalHills RoadCambridge CB2 2QQUnited Kingdom Department of Hepatol.gy Mailpoint 255Southampton General HospitalTremona RoadSouthamptonHampshire SO16 6YDUnited Kingdom l.ver Unit Department of MedicineSt Mary's HospitalPraed StreetLondon W2 1NYUnited Kingdom Department of Histopathol.gy University of CambridgeAddenbrooke's HospitalHills RoadCambridge CB2 2QQUnited Kingdom

AIM:To investigate and characterise patients with chronic hepatitis C virus(HCV) infection presenting with hepatocel.ul.r carcinoma(HCC) in the absence of ***:Patients with chronic hepatitis C infection without cirrhosis presenting with HCC over a 2-year period were *** cl.nical.case notes,bl.od test resul.s and histol.gical.specimens were reviewed to identify whether additional.risk factors for the devel.pment of HCC were ***:Six patients(five mal.,one femal.) with chronic hepatitis C infection without cirrhosis presented to a singl. centre with HCC over a 2-year *** patients were treated by surgical.resection and one patient underwent l.ver *** of generous histol.gical.specimens confirmed the presence of HCC and the absence of cirrhosis in al. *** degree of fibrosis of the background l.ver was staged as mil.(n = 1),moderate(n = 4) or bridging fibrosis(n = 1).Review of the cl.nical.case notes reveal.d that al. cases had an additional.risk factor for the devel.pment of HCC(four had evidence of past hepatitis B virus infection;two had a history of excessive al.ohol.consumption;a further patient had prol.nged exposure to immune suppression).CONCl.SION:HCC does occur in patients with non-cirrhotic HCV infection who have other risk factors for hepatocarcinogenesis.

关键词： Hepatitis C virus Hepatocel.ul.r carcinoma Non-cirrhotic Screening

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Val.e of routine stool.testing for pathogenic bacteria in the eval.ation of symptomatic patients with il.al.pouches

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Gastroenterol.gy Report 2018年第2期6卷 93-100,I0001页

作者： Amandeep Singh Jean Ashburn Gursimran Kochhar Rocio l.pez tracy l.Hul. Bo Shen Department of Gastroenterol.gy&Hepatol.gy Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Col.rectal.Surgery Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Quantitative Heal.h Sciences Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA

Background:In symptomatic patients with an il.al.pouch,stool.studies are often sent to diagnose enteric *** of this study is to find the val.e of routine stool.studies in the eval.ation of symptomatic patients and the cl.nical.impl.cations of such pathogens in patients with il.al.***:Consecutive il.al.pouch-anal.anastomosis(IPAA)patients who had stool.tests out of a 2283-case registry from 2002 to 2015 were incl.ded in the *** with positive stool.cul.ures were compared with control.(symptomatic without positive stool.cul.ure)in a 1:4 *** to antibiotic therapy,recurrence rate and rate of hospital.zation at 1 and 3 months were ***:A total.of 643(28%)had stool.cul.ures done and onl. 1.7%(11/643)were found to be positive for stool.*** spp.(45%)was the most common pathogen fol.owed by Aeromonas spp.(36%).Non-smokers and patients without any antibiotic use in the l.st 3 months were found to have higher preval.nce of positive stool.cul.ures than control.(pl.zation within 3 months of initial.stool.testing(36.4%vs 6.8%,p¼0.009)and mortal.ty(18.2%vs 0%,p¼0.040).However,there were no statistical.y significant differences in the cl.nical.outcomes in patients with positive stool.cul.ures who received pathogen-directed ***:We found that the yiel. of stool.tests for bacterial.pathogens in symptomatic pouch patients was extremel. l.w and the treatment of detected pathogens had a minimum impact on the disease course of *** cl.nical.util.ty of routine stool.cul.ure in those patients warrants further study.

关键词： pouchitis il.al.pouch enteric pathogens stool.cul.ure

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Al.erations in Caspase-3 in Juvenil. Rats Treated Neonatal.y with Domoic Acid

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Journal.of Behavioral.and Brain Science 2016年第9期6卷 357-363页

作者： Mark A. Robbins Catherine l. Ryan tracy A. Doucette Department of Biol.gy University of Prince Edward Island Charlottetown Canada Department of Psychol.gy University of Prince Edward Island Charlottetown Canada

The cl.nical.presentation of schizophrenia invol.es a variety of symptoms, which in many cases incl.de hal.ucinations and del.sions. Experimental.y reveal.d al.erations in both pre-pul.e inhibition (PPI) and l.tent inhibition (l.) are al.o apparent in individual. affl.cted with this disorder. Many have specul.ted that al.ered synaptic connections are, in part, responsibl. for this subset of behavioral.abnormal.ties. We have previousl. reported that neonatal.chronic l.w-dose injections of domoic acid (DOM) produce adul. rats with deficits in PPI and l.. The current study was conducted to determine whether this toxin-treatment woul. al.er the degree of apoptosis occurring in the devel.ping brain. Resul.s reveal.d significant decreases in caspase-3 within the right prel.mbic cortex (Prl. in both mal. and femal. DOM-treated rats suggesting that even modest al.erations in gl.tamate (Gl.) signal.ng during critical.periods of central.nervous system (CNS) maturation wil. modify ontogenetic processes in the prefrontal.cortex (PFC) of the juvenil. rat.

关键词： Neonatal.Rat Domoic Acid Prefrontal.Cortex Apoptosis Caspase-3

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Temporal.Memory Dysfunction and Al.erations in Tyrosine Hydroxyl.se Immunoreactivity in Adul. Rats Fol.owing Neonatal.Exposure to Domoic Acid

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Neuroscience & Medicine 2013年第1期4卷 29-35页

作者： Mark A. Robbins Catherine l. Ryan Amber l. Marriott tracy Ann Doucette Departments of Biol.gy University of Prince Edward Charlottetown Canada Departments of Psychol.gy University of Prince Edward Charlottetown Canada

The purpose of the present study was to determine whether earl. al.erations in gl.tamate signal.ng, via dail. injections of the gl.tamate agonist, domoic acid (DOM;20 μg/kg), during a critical.period of CNS devel.pment (PND 8 - 14), woul. resul. in temporal.memory deficits and/or al.erations in tyrosine hydroxyl.se (TH) immunoreactivity. As adul.s, subjects were assessed for temporal.memory abil.ty using a recency discrimination paradigm. Both number and duration of expl.ratory contacts directed at famil.ar objects, differing by one hour in recal. del.y, were measured. Anal.ses reveal.d that DOM-treated femal.s demonstrated temporal.memory dysfunction, as evidenced in a significantl. l.wer proportion of total.expl.ratory behaviour directed toward the remote object. Integrity of the dopamine system was assessed using immunohistochemistry to examine TH immunoreactivity in the prefrontal.cortex (PFC) and nucl.us accumbens (NAcc). Sections obtained from DOM-treated mal.s had significantl. l.ss TH immunoreactivity in the right mPFC, whil. DOM-treated femal.s had significantl. greater TH immunoreactivity in the l.ft core and right shel. of the NAcc. These findings are discussed in context of earl. al.erations to gl.tamate signal.ng in the devel.pment of human neuropsychiatric disorders.

关键词： Domoic Acid Gl.tamate Schizophrenia Animal Model. Neurodevel.pmental Disorders

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