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药物洗脱支架与裸金属支架治疗大的冠状动脉血管

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世界核心医学期刊文摘（心脏病学分册） 2007年第11期3卷 18-19页

作者： Quizhpe A.R. Feres F. de Ribamar Costa jr. J. 赵君 Institute Dante Pazzanese of Cardiology So Paulo SP Brazil Dr.

背景:最近有证据显示,药物洗脱支架(DES)在广泛的病变和患者亚组中可显著降低再狭窄率和再次血运重建的需要。然而,其用于大血管(>3.0mm)的益处尚未确立。目的:观察DES用于大的冠状动脉血管的临床效果是否优于裸金属支架(BMS)。

关键词：药物洗脱支架冠状动脉血管金属支架矿山支架

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肥胖不影响供卵受孕患者的种植率或妊娠结局

世界核心医学期刊文摘（妇产科学分册） 2005年第10期1卷 17-18页

作者： Styne-Gross A Elkind-Hirsch K Scott jr. R.T 李跃萍 Repro ductive Medicine Associates of New Jersey 111 Madison Ave Morristown NJ 07962 United States.Dr

Objective: To independently evaluate the effect of body mass index (BMI) on implantation, pregnancy, and incidence of spontaneous miscarriage using the donor oocyte recipient model. Design: Institutional Review Board- app- roved retrospective data analyses of donor oocyte cycles from 1999 to 2004. Setting: Private assisted reproductive technology (ART) center. Patient(s): Five hundred thirty- six first cycle recipients of donor oocytes. Intervention(s): Data were collected from the first cycle of each donor oocyte recipient included in the study. The body mass index (BMI) of each recipient was calculated using the formula weight (in kilograms)/height (in meters squared). Patients were divided into four groups based on BMI: underweight, normal, overweight, and obese. Pregnancy outcomes in each group were compared. Main Outcome Measure(s): Body mass index, implantation rate, pregnancy rate (PR), miscarriage rate. Result(s): There were no statistically significant differences in the implantation rates, ongoing PRs, or spontaneous abortion rates among patients in the four BMI groups. When further divided into those patients receiving blastocyst vs. day 3 transfers, there was still no effect of BMI on implantation rate, PR, or loss rate among the blastocyst or day 3 donor oocyte recipients. Conclusion(s): Body mass index has no adverse impact on implantation or reproductive outcome in donor oocyte recipients. Therefore, obesity does not appear to exert a negative effect on endometrial receptivity.

关键词：种植率供卵妊娠结局辅助生殖技术流产率囊胚移植胚胎移植自发流产正常体重子宫内膜

良性原发性睑痉挛患者健康相关的生活质量和社会心理学特征研究

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世界核心医学期刊文摘(眼科学分册) 2006年第4期 21-22页

作者： Hall T.A. Mc Gwin jr. G. Searcey K. 石圆圆 dr.Department of Ophthalmology School of Medicine University of Alabama at Birmingham 700 S 18th St Birmingham AL 35294-0009 United States

Objective: To examine vision-targeted health-related quality of life and psychosocial characteristics in patients with benign essential blepharospasm (BEB) compared with patients with hemifacial spasm (HFS). Methods: Persons with BEB (n=159) or HFS (n=91) were identified based on International Classification of Diseases, Ninth Revision, Clinical Modifications codes with subsequent verification by record abstraction. Information regarding demographics, health characteristics, disease characteristics, and vision-targeted health-related quality of life was obtained through a telephone interview. Results: For patients with BEB and HFS, the composite scores and subscale scores on the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) were low. Compared with patients with HFS, patients with BEB reported more depressive symptoms (P=.03), met the criteria for generalized anxiety disorder (P=.007), had lower NEI-VFQ-25 composite scores (Pdriving (Pdressing psychosocial issues. Conclusions: Compared with patients with HFS, those with BEB experience a greater reduction in vision-targeted health-related quality of life and are more prone to symptoms of depression and anxiety. This underscores the inadequacy of current treatment options for BEB in light of the fact that these patients had been undergoing standard-of-care treatments for some time.

关键词：患者 BEB 原发性睑痉挛社会心理学社会学质量

临床检查可以精确定位糖尿病视网膜病变的毛细血管无灌注区

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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 32-33页

作者： Kimble J.A. Brandt B.M. McGwin jr. G. 潘佳鸿 Retina Specialists of Alabama 1201 11th Avenue South Birmingham AL 35205 United States Dr.

PURPOSE: To help the ophthalmologist who wishes to know the perfusion status o f the retina outside the macula, we determined whether clinical examination can predict capillary nonperfusion in diabetic retinopathy (dr) as accurately as flu orescein angiography (FA). DESIGN: Prospective observational case series. METHOD S: setting: Clinical practice. study population: Both eyes of 20 patients with c linically significant diabetic macular edema (CSME). observation procedure: The location of capillary nonperfusion was recorded following 90-diopter lens slit -lamp biomicroscopy, and the same measurements made on FA. main outcome measure : In the nasal and temporal quadrants of each eye, the clinical results were com pared with the “gold standard”FA. RESULTS: Most patients (84%) had definite p eripheral capillary nonperfusion. Biomicroscopy results were highly correlated w ith angiography, with only a few differences of clinical importance. CONCLUSIONS : Clinical examination can determine the location of capillary nonperfusion in D R with a high degree of accuracy.

关键词：毛细血管无灌注荧光造影生物显微镜黄斑区临床实践高度相关性眼科医师灌注状态金标准样本量

肠子宫内膜异位症合并血吸虫病:1例罕见但两者可能同时出现的病例

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世界核心医学期刊文摘（妇产科学分册） 2006年第8期2卷 38-39页

作者： Abrao M.S. Dias jr. J.A. Podgaec S. 李跃萍 Gynecology University of So Paulo Rua Sao Sebastiao 550 San Paulo Sao Paulo 04710- 090 Brazil Dr.

Ombjective: To report the case of a patient submitted to laparoscopic bowel resection in whom histology revealed endometriosis and schistosomiasis. Design: Case report. Setting: Multidisciplinary group practice and teaching hospital. Patient(s): A 31- year-old patient with pelvic pain. Intervention(s): Laparoscopic bowel resection. Main Outcome Measure(s): Laparoscopic treatment of endometriosis affecting the sigmoid. Result(s): Histology performed on tissue removed at surgery revealed epithelioid granulomas with birefringent and partially calcified eggs characteristic of Schistosoma mansoni within an endometriotic lesion affecting the entire width of the sigmoid. Conclusion(s): Endometriosis and schistosomiasis may be present simultaneously in patients with bowel symptoms and pelvic pain.

关键词：子宫内膜异位症异位病灶盆腔疼痛肠道症状组织学检查肠切除术上皮性曼森氏血吸虫腔镜教学

氨基末端脑利钠肽前体、肾脏功能和急性心力衰竭的结局:是否需重新定义心肾相互作用?

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世界核心医学期刊文摘（心脏病学分册） 2007年第4期3卷 41-42页

作者： van Kimmenade R.R.J. Januzzi jr.J.L. Baggish A.L. 郭俊 Department of Cardiology Massachusetts General HospitalBostonMAUnited States Dr.

目的:本研究旨在探讨氨基末端脑利钠肽前体(NT-proBNP)及肾功能参数对心力衰竭预后的单一和综合作用。背景:NT-proBNP和肾脏损害均可预测心力衰竭患者的死亡。

关键词：脑利钠肽急性心力衰竭氨基末端心肾肾脏功能肾功能恶化功能参数最佳预测肾功能受损肾小球

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平面心肌灌注成像评价急性胸痛患者的价值

世界核心医学期刊文摘（心脏病学分册） 2005年第5期1卷 44-45页

作者： Yamada A.T. Soares jr. J. Meneghetti J.C. 郝广华 Heart Institute (InCor) Univ. of S. Paulo Medical School Av. Dr. Eneas Carvalho A. S. ao Paulo Brazil

Background: Rest single-photon emission computed tomographic(SPECT) perfusion imaging identifies acute myocardial ischemia in patients with chest pain in the emergency department; however, the costs are high and radioisotopic services are usually not available 24 h a day. Planar imaging through a portable gamma camera may be useful in this setting. However, planar imaging might be associated with less predictive values in comparison with a gated SPECT imaging. We sought to evaluate rest planar myocardial perfusion imaging for evaluation and triage of patients with suspected acute cardiac ischemia. Methods: Patients within 6 h of chest pain onset and nondiagnostic electrocardiograms(ECGs) underwent planar myocardial perfusion imaging. Studies showing perfusion defects were considered suggestive of acute coronary syndromes. The results of planar scintigraphy were compared with the clinical diagnosis and outcomes. All patients were followed up and monitored for the occurrence of major cardiac events 120 days after hospital discharge. Results: 71 patients underwent scintigraphy. Twenty-one(30%) patients had acute coronary syndromes, 15(21%) had major cardiac events(8 had myocardial infarction and 7 underwent myocardial revascularization). Planar scintigraphy demonstrated perfusion defects in 21 patients, 16 (76%) patients with acute coronary syndromes, 12(80%) patients who had major cardiac events and in 7(88%) patients with myocardial infarction. The negative predictive value of planar scintigraphy was 90%for diagnosis of acute coronary syndromes and 94%for detecting major cardiac events. Conclusion: Early planar myocardial perfusion imaging allowed rapid and accurate risk stratification of emergency departments patients with possible myocardial ischemia and nondiagnostic ECGs.

关键词：急性胸痛灌注成像灌注缺损心脏事件急性心肌缺血急诊科阴性预测值门控检查费用风险度

腹腔镜辅助下经阴道子宫切除术与传统子宫切除术成本效益分析的比较

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 17-18页

作者： Lenihan jr. J.P. Kovanda C. Cammarano C. 张剑萍 Tacoma Women’s Specialists PC Tacoma WAUnited States Dr.

Objective The purpose of this study was to compare the costeffectiven ess of la paroscopic-assisted vaginal hysterectomy to traditional total abdominal hystere ctomy and total vaginal hysterectomy with regard not only to direct hospital cos ts but also to indirect costs. Study design This was a combined retrospective co hort study (Canadian Task Force classification II-2) that was conducted in a su burban private practice. The cases of 268 patients who underwent hysterectomies over a 27-month period were analyzed to include clinical outcomes, direct hospi tal costs, and indirect costs (time to return to normal function, time to return to work, and time away from work required by other family members). Results For all patients, length of hospital stay and time of return to normal function wer e shorter for laparoscopic-assisted vaginal hysterectomy than for total abdomin al hysterectomy and total vaginal hysterectomy. For working patients, time to re turn to work and time off for working family members were all significantly shor ter after laparoscopic-assisted vaginal hysterectomy when compared with both to tal abdominal hysterectomy and total vaginal hysterectomy. Operating times were similar for total abdominal hysterectomy and laparoscopic-assisted vaginal hyst erectomy, and complications were greater for total abdominal hysterectomy. In a comparison of all procedures, direct hospital costs were greatest for laparoscop ic-assisted vaginal hysterectomy and least for total vaginal hysterectomy. Conc lusion For most patients, laparoscopic-assisted vaginal hysterectomy provides a minimally invasive way to accomplish a hysterectomy with a lower cost to employ ers (payers) on the basis of lost work hours.

关键词：子宫切除术腔镜成本效益分析子宫全切术手术时间间接费用回顾性队列研究

140例后节疾病序贯病例经结膜25G玻切手术预后

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世界核心医学期刊文摘（眼科学分册） 2005年第9期1卷 55-56页

作者： Lakhanpal R.R. Humayun M.S. De Juan jr. E. 吴琼 Department of Ophthalmology Keck School of Medicine University of Southern California 1450 San Pablo Street LosAngeles CA90033United States Dr.

Purpose: To evaluate the safety and efficacy of 25-gauge instrumentation for a variety of vitreoretinal conditions on previously nonvitrectomized eyes. Design: Single-center, retrospective, interventional case series. Participants: One-hundred forty eyes of 140 patients were evaluated at the Doheny Retina Institute from July 2002 to July 2003. Intervention: All patients underwent surgical procedures using the Millennium 25-gauge Transconjunctival Standard Vitrectomy system. Twenty eyes (14.3%) underwent procedures without vitrectomy. Main Outcome Measures: Postoperative visual acuity (VA), intraocular pressure, surgical time, postoperative inflammation, complications, and number of sutured sites. Results: No intraoperative complications were noted. No cases required conversion to 20-gauge machines. Ten cases (7.1%) involved single-site sclerotomy suture placement due to bleb formation at the conclusion of the procedure, but 5 of these entry sites were enlarged to facilitate larger instrumentation for tissue manipulation. Median VA improved from 20/250 (logarithm of the minimum angle of resolution, 1.08±0.47) preoperatively to 20/60 (0.47±0.30)-(P< 0.0001) at final visit. Mean follow-upwas 33.8±9.7weeks, and all eyes were observed for a minimum of 12 weeks. Mean total surgical time was 17.4±6.9minutes. Intraocular pressures remained stable throughout the postoperative course. Five eyes (3.8%) presented on day 1 with shallow choroidal detachments, but all resolved by day 7, and none required volume infusion during the postoperative period. All but one of these cases was within the first 50 procedures performed. No detectable inflammation was noted in any eyes by 4 weeks postoperatively. No case of retinal detachment or endophthalmitis was recorded. Conclusions: Transconjunctival surgery using 25-gauge instrumentation may hasten postoperative recovery by decreasing overall surgical time and postoperative inflammation. Procedures requiring minimal intraocular manipulati

关键词：手术预后玻璃体手术巩膜切开滤过泡视网膜脱离术后炎症术后视力眼内炎手术模式干预性