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47例虹膜黑色素细胞瘤的临床特征和自然病程

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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 23-23页

作者： Demirci h. Mashayekhi A. Shields C.L. 王永强 Oncology Service Wills Eye Hospital 840 Walnut Street Philadelphia PA 19107 United States Dr.

PURPOSE: To describe the clinical features, natural course, management and his topathologic features of iris melanocytoma. DESIGN: Single-center retrospective case series. METhODS: patient population: Forty-seven consecutive patients (47 eyes) with iris melanocytoma. intervention procedure: Data regarding patient an d tumor features were analyzed for their impact on the main outcome measures usi ng univariate and multivariate regression models. Kaplan-Meier estimates were u sed to analyze the main outcomes as a function of time. main outcome measures: I ncreased intraocular pressure (IOP), tumor seeding, and tumor growth. .RESULTS: Associated findings at initial presentation included iris stromal seeds in 20 pa tients (43%), and anterior chamber angle seeds in 12 (26%). Intrinsic vascular ization and sector cataract were not seen in any eyes. The management at present ation included observation in 39 patients (83%), tumor removal by sector iridec tomy/iridocyclectomy in 7 (15%), and enucleation for blind painful eye with sec ondary increased IOP in 1 (2%). The diagnosis was confirmed by histopathologic examination in 11 patients (23%). The mean follow-up was 58 months. Using Kapl anMeier estimates, clinical evidence of growth was observed in 23%at 5 years, 4 8%at 10 years, and 74%at 15 years. New tumor seeds developed in 34%at 5 years , 63%at 10 years, and 75%at 15 years. Increased IOP was observed in 11%at 5 y ears, 11%at 10 years, and 55%at 15 years. CONCLUSIONS: Iris melanocytoma repre sented only 3%of all iris nevi. Related iris stromal and anterior chamber angle seeds were common, and secondary glaucoma occurred in 11%at 5 years. Growth wa s observed in 23%at 5 years but no malignant transformation was found.

关键词：色素细胞瘤前房角继发青光眼病理学检查结果指标病例研究眼内容物病理学特点迈耶回归模型分析

被动吸烟与冠心病和脑卒中风险的关系:通过测量cotinine的前瞻性研究

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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 4-4页

作者： Whincup P.h. Gilg J.A. Emberson J.R. 任延平 Dept. of Comm unity health Sciences St. George's Hospital Medical School London SW17 0RE United KingdomProf.

Objective: To examine the associations between a biomarker of overall p assive exposure to tobacco smoke (serum cotinine concentration) and risk of coronary he art disease and stroke. Design: Prospective population based study in general pr actice (the British regional heart study). Participants 4729 men in 18 towns who provided baseline blood samples (for cotinine assay) and a detailed smoking his tory in 1978-80. Main outcome measure: Major coronary heart disease and stroke events (fatal and non-fatal) during 20 years of follow up. Results: 2105 men wh o said they did not smoke and who had cotinine concentrations ng/ml were divided into four equal sized groups on the basis of cotinine concentrations. Re lative hazards (95%confidence intervals) for coronary heart disease in the seco nd (0.8-1.4 ng/ml), third (1.5-2.7 ng/ml), and fourth (2.8-14.0 ng/ml) quarte rs of cotinine concentration compared with the first (≤0.7 ng/ml) were 1.45 (1. 01 to 2.08), 1.49 (1.03 to 2.14), and 1.57 (1.08 to 2.28), respectively, after a djustment for established risk factors for coronary heart disease. hazard ratios (for cotinine 0.8-14.0 v ≤0.7 ng/ml) were particularly increased during the f irst (3.73, 1.32 to 10.58) and second five year follow up periods (1.95, 1.09 to 3.48) compared with later periods. There was no consistent association between cotinine concentration and risk of stroke. Conclusion: Studies based on reports of smoking in a partner alone seem to underestimate the risks of exposure to pas sive smoking. Further prospective studies relating biomarkers of passive smoking to risk of coronary heart disease are needed.

关键词： cotinine 被动吸烟非致死性相对风险血标本生物标记样本量

妊娠中期羊水中膜联蛋白A5水平与胎儿宫内生长受限相关

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世界核心医学期刊文摘（妇产科学分册） 2006年第9期2卷 20-20页

作者： Van Eerden P. Chazotte C. Rand J.h. 柳蕴 Pathology Montefiore Medical Center/Albert Einstein College of Medicine Bronx NY United States Dr

Objective: The purpose of this study was to determine whether amniotic fluid levels of annexinA5 (AF- AnxA5) may be associated with intrauterine growth restriction (IUGR). Study design:Amniotic fluid was obtained in a cohort of pregnant patients (n = 172) undergoing amniocentesis at 15 to 24 weeks gestation and annexin A5 (AnxA5) levels were determined with enzyme linked immunosorbent assay (ELISA). Patients who developed IUGR were compared with the remainder of the cohort. Results:AF- AnxA5 levels significantly increased through gestation (P = .003). The mean level of AF- AnxA5 in IUGR patients (n = 15) was significantly higher (P = .028) than in the remainder of the cohort (n = 130). Elevated AF- AnxA5 > 20 ng/mL was associated with a relative risk of 3.5 for the development of IUGR(P = .023). Conclusion: AnxA5 is present in amniotic fluid and increases through gestation from 15 to 24 weeks. Elevated AF-AnxA5 levels were present in patients who developed IUGR. AF- AnxA5 may be a useful marker for identifying pregnancy abnormalities.

关键词：胎儿宫内生长受限羊水标本膜联蛋白妊娠中期 ELISA检测 IUGR 正常孕妇羊膜腔穿刺

评估阴道镜检查预测妊娠期细胞学异常患者结局的准确性

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世界核心医学期刊文摘（妇产科学分册） 2006年第4期2卷 20-20页

作者： Siddiq T.S. Twigg J.P. hammond R.h. 朱磊 Department of Obstetrics and Gynaecology Queens Medical Centre Derby Road Nottingham NG7 2UH United Kingdom

Objective: To determine the accuracy of colposcopic and cytological assessment at predicting final histological diagnosis in women referred with abnormal cervical smears during pregnancy; to use this data as a basis for a follow up protocol for pregnant patients referred with abnormal cervical cytology. Study design: Retrospective analysis of women referred to Queens Medical Centre, Nottingham, UK with abnormal cytology whilst pregnant between 1994 and 2003. Results: Forty-nine patients in total were included in the study. Colposcopic assessment in the antenatal period had a concordance with final histological diagnosis in 60%of patients and a concordance of 68%when undertaken in the post-natal period. Cytological concordance was lower at 58%. In only six percent of patients was a cervical biopsy undertaken and there were no complications as a result. There was a fall in colposcopically assessed high-grade cervical intraepithelial neoplasia between the antenatal and post-natal period. No cases of invasive cancers were diagnosed antenatally. Conclusion: A policy of conservative management of pregnant patients during the antenatal period is supported by this data. A suggested protocol of one colposcopic assessment at the time of the index abnormal smear followed by a post-partum colposcopy, and appropriate treatment is suggested.

关键词：细胞学异常阴道镜检查宫颈细胞涂片宫颈上皮内瘤变浸润癌保守性治疗组织学诊断宫颈活检研究

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偏头痛治疗中头痛疗效的预测

世界核心医学期刊文摘(神经病学分册) 2006年第8期 7-7页

作者： Maas h.J. Danhof M. Della Pasqua O.E. 刘凯 Gorlaeus Laboratories Einsteinweg 55 2333CC Leiden Netherlands

Triptans are efficacious for the acute treatment of migraine attacks. Yet, defining a concentration- effect relation for these compounds is difficult as the dynamics of the migraine attack are not thoroughly understood. The objective of this investigation was to develop a disease model to predict measures of headache in randomized placebo- controlled clinical trials investigating oral sumatriptan as a paradigm compound. A hidden Markov model based on the states of response (no relief, relief, and pain free) and headache scores (observed variable) was used in conjunction with population pharmacokinetics. Model parameters were capable of predicting the course of headache relief, pain- free status and headache recurrence. It was shown that sumatriptan shortens mean transit times between states by up to 5 h. The potency of sumatriptan (EC50)was 9 ng/ml. These findings demonstrate the value of combining pharmacokinetic and efficacy information to model disease and characterize time- independent drug properties in a population of migraineurs.

关键词：偏头痛脑病舒马曲坦疗效

老年性黄斑病变危险因素的14年随访研究:哥本哈根眼科研究

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世界核心医学期刊文摘（眼科学分册） 2005年第11期1卷 8-8页

作者： Buch h. Vinding T. la Cour M. 杨秀梅 Department of Ophthalmology Righospitalet National University Hospital Blegdamsvej 9 DK-2100Cop-enhagenDenmark Dr.

Purpose: To examine the association between potential risk factors and the 14 -year incidence of age-related maculopathy (ARM). Design: Population-based co hort study. Participants: At baseline, 946 volunteers participated in the study during 1986-88. These subjects were between 60 and 80 years of age and lived in the terbro district of Copenhagen. Excluding participants who had died since baseline, 359 subjects (97.3%of survivors) were reexamined 14 years later, duri ng 2000-2002. A total of 31.8%(301/946) of the original material was included in the risk factor analyses. Methods: Participants underwent an ophthalmological examination at Rigshospitalet, the National University hospital of Copenhagen. Similar standardized protocols for physical examination were used at the baselin e and follow-up examinations. Age-relatedm- aculopa-thy lesionswere determined by the same grader grading colour fundus p hotographs from both examinations using a modification of the Wisconsin Age-rel ated Maculopathy Grading System protocol. Results: Of the 359 participants, 94 h ad incident early ARM and 52 had incident late ARM at follow-up in either eye. In logistic regression, the risk factors for early ARM or worse were as follows: cataract (odds ratio [OR] 2.8, 95%confidence interval [CI] 1.2-6.2); fami ly h istory of ARM (OR 4.5, 95%CI 1.3-15.5), and alcohol consumption >250 g/week (O R 4.6, 95%CI 1.1-19.2). high levels of apolipoprotein B ( > 100 mg/1) decrease d the risk of development of early ARM or worse (OR 0.4, 95%CI 0.2-0.8), while high levels of apolipoprotein A1 (≥150 mg/1) increased the risk of late ARM (O R 2.5, 95%CI 1.2-5.3). Advanced age at baseline was also associated with the i ncidence of late ARM(OR2.0, 95%CI 1.4-2.9). Conclusions: These findings indica te a direct correlation between age, cataract, family history, alcohol consumpti on, the apolipoproteins A1 and B and the 14-year incidence of ARM.

关键词：黄斑病变随访研究眼科研究基线研究存活者队列研究眼科检查载脂蛋白随访检查基线水平

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脑白质高信号与身体残疾和运动功能降低有关

世界核心医学期刊文摘（神经病学分册） 2005年第7期1卷 22-22页

作者： Sachdev P.S. Christensen h. Jorm A.F. 袁海峰 NPI Prince o f Wales Hospital Barker StreetRandwick NSW 2031 Australia Prof.

Objective: To determine the impact of white matter hyperintensities(WMhs) on p hysical health and cognitive function in 60-64 year old individuals residing in the community. Methods:A subsample of 478 persons aged 60-64 from a larger com munity sample underwent brain magnetic resonance imaging(MRI) scans. WMhs on T2 weighted FLAIR (fluid attenuated inversion recovery) MRI scans were assessed usi ng anautomated procedure. Subjects were assessed for global cognitive function, episodic memory, working memory (digit span),information processing speed (Symbo l Digit Modalities Test;SDMT), fine motor dexterity (Purdue Pegboard), and grip strength, and completed the Physical Component Summary of the Short Form health Survey (SF-12). Regression analyses were used to examine the effect of WMhs on physical and cognitive function. Results: Deep and periventricular WMhs were pre sent in all subjects, with women having slightly more lesions than men. WMhs wer e significantly associated with poorer reported physical health on the SF-12 sc ale, after adjusting for depression, cognitive function, and brain atrophy. WMhs were also related to lower scores on the Purdue Pegboard test, grip strength, c hoice reaction time, and SDMT, but not on tests of episodic memory, working memo ry, general intellectual function,and global cognitive function. On regression a nalyses, the Purdue Pegboard test and grip strength were related to physicaldisa bility. Conclusion: WMhs are common, albeit mild, in middle adult life. They are associated with physical disability,possibly through reduced speed, fine motor coordination, and muscular strength. They are also related to slowed information processing speed but not other cognitive functions.

关键词：脑白质认知功能身体残疾钉板信息处理速度 muscular 脑萎缩 FLAIR assessed 工作记忆

黄芪消尿蛋白方治疗对慢性肾炎患者免疫功能的影响

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青海医学院学报 1989年第2期10卷 22-28页

作者：罗国华白光辉刘彤王黎敏王克华崔森石韫珍青海医学院附属医院内科肾病组

本文报道应用中药(黄芪消尿蛋白方)对慢性肾炎患者免疫功能。95例慢性肾炎肾病型患者(Ccr>50ml/min)分成三组:中药组20例,中西药结合组,西药组40例。中药采用黄芪、党参加消尿蛋白方,西药系强的松、环磷酰胺。免疫观标包括 LTT、PhA 皮... 详细信息

本文报道应用中药(黄芪消尿蛋白方)对慢性肾炎患者免疫功能。95例慢性肾炎肾病型患者(Ccr>50ml/min)分成三组:中药组20例,中西药结合组,西药组40例。中药采用黄芪、党参加消尿蛋白方,西药系强的松、环磷酰胺。免疫观标包括 LTT、PhA 皮试,IgG、IgA、IgM、Ch ,、C_及 CIC。结果表明,三组患近期疗效接近,免疫功能均有改善,但中药组及中西药结合组的 LTT、PhA 皮试、IgG的增加幅度较西药组明显。其中,中药组的 LTT、PhA 皮试反应的增加尤其明显(P0.05)。作者认为,黄芪消尿蛋白方剂主要通过增强免疫功能,从慢性肾炎患者起到治疗作用。

关键词：免疫功能慢性肾炎患者尿蛋白中西药结合组慢性肾炎肾病型慢性肾小球肾炎皮试反应细胞免疫细胞转化试验 IgG

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ALS时脑脊液中轴突损伤标记物水平升高

世界核心医学期刊文摘(神经病学分册) 2006年第10期 46-46页

作者： Brettschneider J. Petzold A. Sü β muth S.D. h. Tumani 郭俊 Department of Neurology University of Ulm Oberer Eselsberg 45 89081UlmGermany Dr.

Objective: To test whether biomarkers for axonal degeneration correlated with clinical subtypes and were of use in predicting progression of ALS. Methods: Patients with ALS (n = 69), patients with Alzheimer disease (AD; n = 73), and age- matched controls (n = 33) were included in this prospective study. CSF levels of tau protein and neurofilaments (NfhSMI35) were measured using ELISA. In 49 patients with ALS, follow- up data were available (median follow- up 7 months). Results: CSF levels of NfhSMI35 were five times higher in patients with ALS (1.7 ng/mL) than in controls (0.3 ng/mL, p higher than in patients with AD (0.14 ng/mL, p hSMI35 values were also higher in patients with upper motor neuron- dominant ALS than in patients with typical ALS (upper motor neuron + lower motor neuron) at p = 0.02. Values of NfhSMI35 were higher in ALS of more rapid progression. The values of Nfh and tau did not correlate with CSF protein content. Conclusions: The authors propose that axonal damage markers in CSF may discriminate between subtypes of ALS and that they could be used as markers for therapeutic trials. CSF Nfh was superior to tau in these discriminations.

关键词：标记物轴突损伤 ALS