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盆腔淋巴结计数是FIGO分期Ⅰ期和Ⅱ期高危组织学类型子宫内膜癌患者的重要预后因子

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世界核心医学期刊文摘（妇产科学分册） 2006年第10期2卷 47-48页

作者： Lutman C.v. Havrilesky L.J. Cragun J.M. J.T. Soper 朱磊 Division of Gynecologic Oncology Department of Obstetrics and Gynecology Duke University Medical Center PO Box 3079 Durham NC 27710 United States

Objective.: To determine whether pelvic lymph node count is associated with patterns of recurrence or survival in patients with FIGO stage I and II endometrial cancer. Methods.: Single institution retrospective study of 467 patients with FIGO stage I and II endometrial cancer treated with primary surgery including lymph node dissection. Analysis included pelvic lymph node count, histology, stage, age, race, BMI, year of surgery, depth of myometrial invasion, and adjuvant radiation. Kaplan-Meier life-tables were used to calculate survival; the Cox proportional hazards model was used to identify prognostic factors independently associated with survival. Results.: Mean pelvic lymph node count was 12.6(SD±8). Distant recurrence was associated with decreased pelvic lymph node count, high-risk histology, and postoperative pelvic radiation. Pelvic lymph node countwas not associated with survival by univariate analysis, however, overall(OS) and progression-free(PFS) survival were significantly better with pelvic lymph node counts ≥12 among women with high-risk histology(Pnot among women with low-risk histology. Multivariable Cox proportional hazards regression identified increasing age, non-Caucasian race, and high-risk histology as independent negative prognostic factors for both OS and PFI. Among patients with high-risk histology, pelvic lymph node count remained an independent prognostic factor for both overall(OS) and progression-free survival(PFS) in the model, with hazard ratios of 0.28 and 0.29, respectively, when ≥12 pelvic lymph nodes were identi-fied. Pelvic lymph node count had no association with OS or PFS in women with low-risk histology. Conclusion.: Pelvic lymph node count ≥12 is an important prognostic variable in patients with FIGO stage I and II endometrial cancer who have high-risk histology. Most likely, the association of survival and lymph node count in this group is the result of improved staging among patients with higher pelvic lymph n

关键词：盆腔淋巴结 FIGO分期预后因子肌层浸润深度手术分期无进展生存期淋巴清扫术后放疗肿瘤复

应用单克隆抗体酶联免疫吸附试验双抗体法检测人体丝虫病循环抗原

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中国寄生虫学与寄生虫病杂志 1987年第1期 3-7页

作者：郑惠君,陶增厚,M.v.R.Reddy,B.C.Harinath,W.F.Piessens 贵州省寄生虫病研究所贵州省寄生虫病研究所印度Mahatma Gandhi医学科学研究所生化研究室印度Mahatma Gandhi医学科学研究所生化研究室美国哈佛大学公共卫生学院热带病学教研组

应用兔抗微丝蚴抗体及抗班氏丝虫微丝蚴代谢抗原(ES34株)或抗马来丝虫3期幼虫抗原(HC11株)单克隆抗体(McAb)酶联免疫吸附试验(ELISA)双抗体法检测人体丝虫病循环抗原时,微丝蚴血症者阳性率分别为94.5％(103/109)及89.0％(97/109),且ES3... 详细信息

应用兔抗微丝蚴抗体及抗班氏丝虫微丝蚴代谢抗原(ES34株)或抗马来丝虫3期幼虫抗原(HC11株)单克隆抗体(McAb)酶联免疫吸附试验(ELISA)双抗体法检测人体丝虫病循环抗原时,微丝蚴血症者阳性率分别为94.5％(103/109)及89.0％(97/109),且ES34株单克隆抗体ELISA检测结果显示微丝蚴密度与抗原滴度呈正相关;部分微丝蚴血症者尿液中亦可测得丝虫抗原;晚期丝虫病人阳性率分别为57.4％(31/54)及61.1％(33/54);获自美国及中国贵阳非丝虫病流行区正常人血清阳性率分别为0～4.1％及2.8～4.1％;30份肠道蠕虫感染者血清全部为阴性。血清中丝虫循环抗原的存在似与活动性感染有关。

关键词：循环抗原双抗体法血清丝虫病蠕虫病微丝单克隆抗体

慢性酒精性胰腺炎合并十二指肠壁囊性营养不良的临床特征、诊断步骤及疗效观察:一项包含23例患者的回顾性、多中心研究

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世界核心医学期刊文摘（胃肠病学分册） 2006年第11期2卷 15-16页

作者： Jouannaud v. Coutarel P. Tossou H. J.-F. Cadranel 王顺涛 Service d'Hépato-Gastroentérologie et de Diabétologie Centre Hospitalier Laёnnec BP 72 60109 Creil Cedex

Aim of the study -The aim of this retrospective multicenter study was to collect data from patients with chronic alcoholic pancreatitis and cystic dystrophy of the duodenal wall in order to better understand the outcome after medical, endoscopic and/or surgical treatment. Patients and methods-The data from medical records of 23 patients consecutively seen in ten primary referral centers from January 1990 to July 2004 were studied. Clinical, biological, and endoscopic features as well as imaging findings were recorded. Response to treatment was noted. Results -Twenty-three patients (20 men), aged 45 years (range: 30-66),with chronic alcohol intake, cystic dystrophy of the duodenal wall, and previously known (n = 14) or simultaneously diagnosed (n = 9) chronic pancreatitis were included. Symptoms most frequently encountered were abdominal pain (n = 22) and weight loss (n = 16). An abdominal ultrasound was available for 10 patients, abdominal computed tomography for 22, upper endoscopy for 18, and endoscopic ultrasonography for 22. Endoscopic ultrasonography enabled diagnosis of cystic dystrophy of the duodenal wall in 19/22 patients. Six patients were symptom-free after alcohol withdrawal. Seven patients received octreotide 200 to 400 μg per day, 5 of whom subsequently underwent surgery (71%). Fourteen patients out of 23 were operated on (61%), 11 of whom underwent pancreaticoduodenectomy and remained symptom-free for 47 months follow-up. Mean follow-up was 56 months (range: 2-78) for non surgical patients (39%) and 47 months (range: 12-108)-for surgical patients (61%). Conclusion -Cystic dystrophy of the duodenal wall complicating chronic alcoholic pancreatitis may be the revealing sign of pancreatitis. Endoscopic ultrasongraphy is the most reliable imaging method for diagnosis. Pancreaticoduodenectomy is the most frequently employed definitive treatment.

关键词：十二指肠壁诊断步骤慢性胰腺炎超声内镜影像学结果首次就诊奥曲肽影像学诊断无症状经戒

对治疗性ERCP的v型镜系统进行的多中心比较试验

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世界核心医学期刊文摘（胃肠病学分册） 2006年第12期2卷 27-28页

作者： Joyce A.M. Ahmad n.A. Beilstein M.C. G.G.Ginsberg 宋平 Division of Gastroenterology Hospital of the University of Pennsylvania3400 Spruce StreetPhiladelphiaPA 19104United States Dr.

Background and study aims:A new duodenoscope(the v-scope) ,with a modified elevator used in combination with a dedicated short guide wire,constitutes the *** systemis intended to allow fixation of the guidewire at the elevator lever,thereby enhancing the speed and reliability of accessory exchange over a guide wire during *** aim of this study was to evaluate the extent to which the v-system provides improved efficiency in comparison with conventional duodenoscope and guide wire *** and methods:This was an industry-sponsored multicenter randomized *** undergoing endoscopic retrograde cholangiopancreatography(ERCP) procedures in which treatment was anticipated were randomly assigned to the v-system or to a conventional duodenoscope and accessories used routinely in each *** parameters recorded included the total case time,fluoroscopy time,catheter/guide wire exchange time,guide wire repositioning,loss of guide wire access,and success or failure of guide wire fixation when using the ***:Fifty patients were included,22 in the conventional group and 28 in the v-system group.A total of 135 exchanges were carried *** patients had up to six *** median exchange time was 19.4 s with the v-system and 31.7 s with the conventional systems(P ning was required less often in the v-system group(P = 0.0005) .The v-system effectively locked the guide wire in 63 of 71 exchanges(89%) .Loss of guide wire access occurred in two patients in the conventional group and four in the v-system group,attributable to failure to lock the guide wire early during the experience(no significant differences) .Conclusions:The v-system can effectively secure the guide wire during accessory exchange in ERCP and reduces the time required to exchange *** may enhance overall efficiency during ERCP.

关键词： v型镜十二指肠镜切换时间荧光镜升降装置透视检查工作效率

荷兰全国性登记筛查家族性视网膜母细胞瘤患者的临床分期和视力预后

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世界核心医学期刊文摘(眼科学分册) 2006年第12期 32-33页

作者： Imhof S.M. Moll A.C. Schouten-van Meeteren A.Y.n. 潘佳鸿 vU University Medical Centre Department of Ophthalmology De Boelelaan 1117 1081 HV Amsterdam NetherlandsDr.

Background: In the netherlands a comprehensive programme for screening just after birth for familial retinoblastoma is taking place. In this report the stage of the disease at the time of detection, by way of screening, and the long term visual outcome in these patients was evaluated. Methods: A nationwide, retrospective study. From January 1992-July 2004, patients at risk for familial retinoblastoma were screened 1-2 weeks after birth, and investigated for laterality, Reese-Ellsworth classification/International Classification of Retinoblastoma, macular involvement, age of primary retinoblastoma , initial therapy, and visual outcome. Results: 17 patients were diagnosed with familial retinoblastoma. 88.3%developed bilateral, 11.7%unilateral retinoblastoma. Of the 34 eyes, 56%were R-E group I, 16%were group II A-B, 16%were group III A-B, 9%were group Iv, 3%were group v. Using the International Classification of Retinoblastoma, 72%were group A, 19%were group B, 6%were group C, 3%were group E. The visual outcome revealed 73.5%of eyes with 20/20-20/40, 26.5%eyes with ≤20/100-no light perception; 5.9%of eyes were enucleated, all other eyes were treated with local or conservative treatment methods. Of all eyes, 59%had extramacular retinoblastoma, 98%of patients had at least one eye with extramacular retinoblastoma. Conclusion: Most familial retinoblastoma patients present as a R-E group I or group A when screened within 2 weeks after birth. nearly 90%of patients had a long term visual acuity of 20/20-20/40. Despite the common occurrence ofmacula involvement, bilateral macula involvement was infrequent, and since most eyes were salvaged, good vision was obtained in the majority of patients.

关键词：视网膜母细胞瘤视力预后临床分期筛查患者家族性荷兰

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主轴承盖框架底座制造工艺的优化

汽车与新动力 2014年第3期46卷 60-62页

作者： n.Gerth H.Sauer M.Gebauer T.Rdel 范明强

像铝铸件这样的轻型结构部件对优化发动机质量、功率和废气排放性能作出了很大的贡献。Audi公司的4.0 L-v8涡轮增压燃油分层喷射汽油机采用的主轴承盖框架底座就是实例。零件供应商DGH集团旗下的Heidenau有限公司和Frauhofer机床与成形... 详细信息

像铝铸件这样的轻型结构部件对优化发动机质量、功率和废气排放性能作出了很大的贡献。Audi公司的4.0 L-v8涡轮增压燃油分层喷射汽油机采用的主轴承盖框架底座就是实例。零件供应商DGH集团旗下的Heidenau有限公司和Frauhofer机床与成形技术研究所通过应用复杂的工艺设计和激光束熔融模具,在压铸成形中优化了高要求的主轴承盖框架底座。

关键词：涡轮增压燃油分层喷射汽油机主轴承盖框架底座激光束熔融优化

早期带状疱疹的征象:疱疹仅累及毛囊皮脂腺单位

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世界核心医学期刊文摘（皮肤病学分册） 2005年第8期1卷 43-44页

作者： Walsh n. Boutilier R. Glasgow D. Shaffelburg M. 罗素菊 Dr.Division of Anatomical Pathology D.J. Mackenzie Bldg. QEII Health Sciences Centre (VG Site) 5788 University Avenue Halifax NS B3H 1V8 Canada

The histopathological changes of herpes simplex,herpes zoster, and varicella are considered to beindistinguishable from one another. Evaluation of the clinical setting, with adjunctive studies if necessary, generally clarifies the specific diagnosis. vesicular lesions in all three conditions can involve epidermal and adnexal epithelium with characteristic cytopathic features. We describe three patients with non- vesicular eruptions on the head and neck whose biopsies revealed exclusive folliculosebaceous involvement by herpes. All three patients developed typical herpes zoster within days of the biopsy. There is compelling scientific evidence in the literature indicating that, in herpes zoster, the virus is transported from dorsal root or trigeminal ganglia via myelinated nerves to the skin. These terminate at the isthmus of hair follicles and primary infection of follicular and sebaceous epithelium occurs. Spread of infection to the epidermis follows. In contrast, data pertaining to recurrent herpes simplexindicates that axonaltran sport of the virus from sensory ganglia to the skin is directed primarily to the epidermis, via terminal non- myel- inated nerve twigs. The clinical evolution of our three cases and scientific data in the literature indicate that exclusive folliculosebaceous involvement by herpes, in the setting of a non- vesicular eruption, represents early herpes zoster.

关键词：毛囊皮脂腺单位带状疱疹复发性单纯疱疹三叉神经节附属器腺上皮组织病理学改变感觉神经节细胞病理有髓神经

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由多个团体通过的新的儿童躯体虐待筛选指标

世界核心医学期刊文摘（儿科学分册） 2005年第6期1卷 42-43页

作者： Chang D. C. Knight v. M. Ziegfeld S. C. Paidas 宁亮 Pediatric Surgery University of South Florida Tampa General Hospital Tampa FL 33601 United States

There is currently no evidence-based screening instrument to assist in the detection of physical child abuse patients. The screening index for physical child abuse (SIPCA) was previously developed as a potentially new tool for this need. It is a scale that assigns point values, on the basis of variable weights from logistic regression models, to age and patterns of injuries (including fracture of base or vault of skull, contusion of eye, rib fracture, intracranial bleeding, multiple burns), with higher scores indicating greater suspicion for abuse. The purpose of this study is to validate this new tool in another independent data set. A cross-sectional hospital discharge database from 1961 hospitals in 17 states is used (n = 58558). Children aged 14 years or younger with International Classification of Diseases, ninth Revision, Clinical Modification codes 800 to 959 are included for analysis. Child abuse cases are identified by E codes and certain International Classification of Diseases, ninth Revision, Clinical Modification codes in the 995.5x range. Screening index for physical child abuse performance is evaluated by discrimination (receiver operating characteristic) and goodness of fit (pseudo r2). A total of 447 abused patients (0.76%) was identified. The receiver operating characteristic of SIPCA in this data set is 0.89 as compared with 0.86 in the development data set. The pseudo r2 of SIPCA in this data set is 0.26 as compared with 0.28 in the development data set. A SIPCA score of 3 has a sensitivity of 86.6%and a specificity of 80.5%for detecting physical abuse; raising the threshold to a score of 4 improves the specificity to 93.1%but at a loss of sensitivity to 71.8%. The validity of the new SIPCA instrument is supported by its performance in an independently derived data set. A score of 3 on SIPCA represents a balanced trade off in the sensitivity and specificity of the instrument in detecting physical abuse and is an optimal threshold above which to b

关键词：儿童躯体虐待筛选指标国际疾病分类法筛选工具筛查指标穹窿部肋骨骨折颅内出血数据资料编码区

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伴有和不伴有脑梗死的阿尔茨海默病

世界核心医学期刊文摘（神经病学分册） 2005年第8期1卷 44-45页

作者： Del Ser T. Hachinski v. Merskey H. Munoz D.G. 张玉龙 Sección de neurologa Hospital Severo Ochoa Avda.Orellana s/n Leganés 28911 Madrid Spain

Objective: To compare the clinical and pathological features of Alzheimer’s d isease (AD) patients with and without associated cerebral infarcts (CI). Methods : The consecutive records of 57 prospectively studied demented patients fulfilli ng the CERAD criteria for the pathological diagnosis of AD were *** w ith cortical Lewy bodies were excluded. CI were found in 22 cases (39%) (AD+CI group): large infarcts (5), lacunes(13) and/or hip pocampal sclerosis (4), and were absent in 35cases (AD group). Microscopic inf arcts, cribiform change,amyloid angiopathy, and white matter rarefaction were no t considered in this classification, but were quantified. Corticalatrophy, neuro fibrillary tangle and senile plaque (diffuse and neuritic) load were also measur ed. Pathological evaluation was independent of clinical information. Clinical an d pathological data were compared between both groups. Results: AD+CI cases wer e significantly older, more commonly female, less educated, and more often had b lue collar occupations, sleep disturbances, frontal release signs, and EEG spike s than AD cases. Other differences found (acute/subacute onset, behavioral distu rbances, and leukoaraiosis on CT scan) disappeared after controlling for age. Th e frequency of known vascular risk factors and focal motor and sensory signs did not differ between the groups, which showed remarkable clinical similarity over all. The only significant differences on pathological exam were hippocampal micr oinfarcts and white matter lesions,although there was a trend for lower neurodeg enerative lesion load in the AD+CI group. The ischemic lesions were located in temporal lobe in 50%of AD+CI patients; these cases had a significantly lower n eocortical neurodegenerative lesion load than those with CI in other sites. Conc lusions: The presence of CI in AD increases significantly with age, but has scar ce influence on the clinical features, and cannot be predicted from common vascu lar risk factors.

关键词：阿尔茨海默病神经纤维缠结淀粉样血管病血管危险因素皮质萎缩大面积梗死白质病变神经变性海马硬化脑白质疏松症