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子宫内膜切除术与术前黄体生成激素释放激素(LH-RH)激动剂的使用:一项5年前瞻性试验

世界核心医学期刊文摘（妇产科学分册） 2005年第7期1卷 28-29页

作者： Zapico A. Grassa A. martnez e. 刘亦恒 Se.v. de.Obste.ricia Y Gine.ol. Hospital Prncipe de Asturias Universidad de Alcal' a Ctra Meco s/n Alcala de Henares 28805 Madrid Spain

Obje.tive. To e.aluate.the.be.e.its of syste.atic pre.pe.ative.tre.tme.t with LH- RH agonists prior to e.dome.rial re.e.tion (e.). Study de.ign: The.study population was made.up of 98 pre.e.opausal wome. who unde.we.t re.e.toscopic tre.tme.t for abnormal ute.ine.ble.ding (AUB) be.we.n January 1996 and De.e.be. 1997. Only patie.ts with e.dome.rial polyps or dysfunctional ble.ding we.e.include.. The.population was divide. into two groups: patie.ts who had (group B) and those.who had not (group A) re.e.ve. LH- RH be.ore.the.surgical inte.ve.tion. Re.ults: e. was carrie. out as a single.proce.ure.in 66 (67.5% ) of the.patie.ts. e. plus polype.tomy was ne.e.sary in 32 (32.5% ) patie.ts. The.e.we.e.no diffe.e.ce. be.we.n the.two groups as far as the.ope.ating time.and total volume.of diste.sion me.ium we.e.conce.ne.. No intraope.ative.complications we.e.se.n in e.the. group. A highe. ne.ative.balance.of diste.sion me.ium was achie.e. in group A (320 ± 23 mL ve.sus 187 ± 16 mL; P e.e.ce.was not modifie. whe. case. with polyps we.e.e.clude.. The.failure.rate.was similar in both groups both at 12 months [group A 6 (14.8% ) ve.sus group B 7 (14.9% ) patie.ts] and at 60 months [group A, 11 (21.6% )- ve.sus group B 10 (21.2% ) patie.ts]. Like.ise. the.ame.orrhe. and hypome.orrhe. rate. at 12 months and at 60 months we.e.also shown to be.the.same.in both groups. Whe. two dose. of LH- RH are.use. and the.failure.rate.is take. into account the.cost of an acce.table.outcome.incre.se. from e.43.37 to e.373.49 pe. patie.t, while.the.total cost of a hyste.e.tomy is e.355.42. Conclusions: e.dome.rial suppre.sion with LH- RH agonists did not guarante. be.te. re.ults of e., but the. are.strongly re.omme.de. during the.le.rning curve.to achie.e.a safe. proce.ure.

关键词：子宫内膜切除术 LH-RH 黄体生成激素激动剂膨宫介质异常子宫出血宫内膜息肉功能失调手术操作时间子宫切除术

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三级医疗中心肝病住院部的HCV院内传播

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世界核心医学期刊文摘（胃肠病学分册） 2005年第5期1卷 41-42页

作者： Forns X. martnez-Baue. e. Fe.iu A. 杨雪娟 Live. Unit Institut de Malalties Digestives Hospital Clinic Villarroel 170 Barcelona 08036 Spain Dr.

De.pite.its me.ical and le.al implications, the.e.are.no prospe.tive.studie. analyzing the.incide.ce.and me.hanisms involve. in the.nosocomial transmission of he.atitis C virus (HCV) in live. units. This study prospe.tive.y inve.tigate. the.nosocomial transmission of HCV in the.live. unit of a te.tiary care.ce.te. from August 2000 to Octobe. 2002. The.me.ian pre.ale.ce.of HCV infe.tion among hospitalize. patie.ts was 50%. Anti-HCV-ne.ative.patie.ts admitte. to the.live. unit during the.study pe.iod we.e.prospe.tive.y followe., and se.um marke.s of HCV in fe.tion we.e.re.e.te. 6 months afte. discharge. All known risk factors for HCV transmission (including the.physical allocation of HCV-infe.te. and noninfe.te. patie.ts during hospitalization) we.e.re.orde.. Comple.e.follow-up data we.e.available.in 1,301 (84.5%) of 1,540 patie.ts. Six patie.ts (0.46%) acquire. HCV infe.tion (annual incide.ce. 0.27/100 admissions). Phyloge.e.ic analyse. of re.ove.e. HCV se.ue.ce. ide.tifie. the.source.of infe.tion as an HCV infe.te. roommate.(3 case.) and a patie.t re.e.ving care.by the.same.nurse.te.m (1 case.. The.most re.e.ant risk factors associate. with HCV acquisition we.e.duration of hospitalization (>10 days; OR, 35; 95%CI, 1.96-622) and hospitalization with an HCV-infe.te. roommate.(>5 days; OR, 12; 95%CI, 1.39-103). In fact, HCV infe.tion occurre. in 1.7%of the.357 patie.ts hospitalize. longe. than 10 days. In conclusion, HCV nosocomial infe.tion appe.rs to occur via patie.t-to-patie.t transmission in live. units, particularly in individuals who re.uire.long hospitalizations. Continuous re.nforce.e.t of unive.sal pre.e.tion me.sure. and, whe. possible. isolation of patie.ts at highe. risk might furthe. re.uce.nosocomial HCV transmission.

关键词：三级医疗 HCV 丙型肝炎病毒血清标志物阴性患者传播状况法定条款种系发生感染源

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奥美拉唑引起的皮肤色素沉着类似灰色皮病

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世界核心医学期刊文摘（皮肤病学分册） 2006年第9期2卷 7-7页

作者： Ramre.-He.nnde. M martnez-e.cribano J.A martnez-Barba e. 冯义国 De.artme.t of De.matology Virgen de la Arrixaca University Hospital 30120 El Palmar Murcia Spain

Background: Ome.razole.has be.n associate. with multiple.adve.se.e.fe.ts including skin re.ctions but, to date. cutane.us hype.pigme.tation has not be.n de.cribe. as an adve.se.e.fe.t of this drug. Obse.vations: We.de.cribe.a case.of a 52-ye.r-old Caucasian woman who de.e.ope. skin hype.pigme.tation in the.uppe. trunk, mimicking ashy de.matosis, 2 months afte. initiating ome.razole.tre.tme.t. Histopathologic e.amination of a skin biopsy take. from a pigme.te.macule.showe. de.mal macropha-ge. containing golde.-brown granule., which also displaye. a sulphur pe.k on e.e.gy-dispe.sive.X-ray microanalysis. High-pe.formance.liquid chromatography (HPLC) and mass spe.trome.ry we.e.also pe.forme. on the.drug and on a biopsy spe.ime. re.e.ling the.same.chromatograms as we.l as the.same.mass spe.tra. Conclusions: According to our re.ults, ome.razole.itse.f may induce.cutane.us pigme.tation and, to our knowle.ge. this is the.first re.ort of this finding.

关键词：皮肤色素沉着奥美拉唑皮病灰色组织病理检查高效液相色谱活检标本不良反应

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早期预测基因1型慢性丙型肝炎治疗应答的两种模式的建立与验证

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世界核心医学期刊文摘（胃肠病学分册） 2006年第10期2卷 48-48页

作者： martnez-Baue. e. Cre.po J. Rome.o-Góme. M. J.M.Sánche.-Tapias 陈云茹 Live. Unit Hospital ClnicVillarroel 17008036 BarcelonaSpain

e.rly pre.iction of re.ponse.to the.apy in ge.otype.1 chronic he.atitis C is difficult. Two pre.ictive.mode.s, a pre.re.tme.t scoring mode. (Pre.-SM) and a fourth we.k of the.apy scoring mode. (4w-SM) we.e.constructe. in a cohort of 104 patie.ts from a single.ce.te. (e.timation cohort) and validate. in a cohort of 141 patie.ts from four inde.e.de.t ce.te.s (validation cohort). Individual score. we.e.calculate. using variable. inde.e.de.tly associate. with sustaine. virological re.ponse.(SVR). Base.ine.viral load, aspartate.aminotransfe.ase.alanine.amino transfe.ase.ratio, se.um chole.te.ol, and a nume.ical score.for noninvasive.e.timation of live. fibrosis we.e.include. in the.Pre.-SM;HCV-RNA cle.rance.and Pre.-SM score. we.e.include. in the.4w-SM. Re.e.ve. ope.ating characte.istic analysis re.e.le. the.are. unde. the.curve.in the.e.timation cohort and in the.validation cohort to be. re.pe.tive.y, 0.856 and 0.847 for the.Pre.-SM and 0.908 and 0.907 for the.4w-SM. Low score. we.e.associate. with SVR, high score. with non-SVR. The.be.t cutoff score. from the.Pre.-SM (7 and 9.70) ide.tifie., re.pe.tive.y, 36%of patie.ts with SVR and 41%of those.with non-SVR from the.validation cohort, with high accuracy (≥90%positive.pre.ictive.value.[PPV] and spe.ificity). Similarly, cutoff score. of 3.20 and 5.60 from the.4w-SM ide.tifie., re.pe.tive.y, 71%of patie.ts with SVR and 53%of those.with non-SVR from the.same.cohort with high accuracy (PPV and spe.ificity > 92%). In conclusion, the.e.mode.s pre.icte. re.ponse.to the.apy be.ore.or afte. 4 we.ks of tre.tme.t in approximate.y 60%of ge.otype.1 patie.ts and may be.valuable.for the.manage.e.t of this condition.

关键词：慢性丙型肝炎治疗应答预测基因持续病毒学应答评分模型病毒载量肝纤维化预治疗应答率清除

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内镜下胃窦部注射肉毒杆菌毒素治疗肥胖症:一项先导研究结果

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世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 31-32页

作者： Garca-Compe.n D. Me.doza-Fue.te.e. martnez J.A. 王志宇 De.artme.t of Gastroe.te.ology Facultad de Medicina Hospital Universitario UANL Ave. Madero y Gonzalitos Monterrey N.L. México Mexico

Obje.tive.-The.aim of this study was to obse.ve.the.e.fe.ts of e.doscopic inje.tions of botulinum toxin (BT) in the.gastric antrum on body we.ght and gastric e.ptying in obe.e.patie.ts. Patie.ts and me.hods - Obe.e.patie.ts we.e.se.e.te. for the.study. By e.doscopy, 100 U of BT type.A was inje.te. into the.pre.yloric antral gastric wall. Be.ore.and afte. tre.tme.t body we.ght and solid gastric e.ptying we.e.e.aluate.. Re.ults - Twe.ve.patie.ts we.e.include. into this study. Four and twe.ve.we.ks afte. the.tre.tme.t me.ian value. of body we.ght and gastric e.ptying did not show significant change. compare. to base.ine.value.: body we.ght: (- 0.5 kg and - 1.0 kg re.pe.tive.y, P > 0.05) and gastric re.e.tion for solids at 90 min (+ 4.5% and + 10.5% re.pe.tive.y, P > 0.05). Abnormal gastric e.ptying (solid gastric re.e.tion at 90 min > 50% ) was obse.ve. in 22% of patie.ts afte. 4 we.ks and in 25% afte. 12 we.ks. Conclusions - BT inje.te. into the.gastric antrum doe. not se.m to significantly re.uce.body we.ght or de.ay gastric e.ptying in obe.e.patie.ts.

关键词：肉毒杆菌毒素肥胖症患者胃排空时间胃排空延迟基线值有显著性差异本项

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原发眼睑的、系统性、CD30^+和间变性淋巴瘤激酶(ALK)阴性的间变性大细胞淋巴瘤(ALCL)的皮肤表现

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世界核心医学期刊文摘（皮肤病学分册） 2006年第10期2卷 61-62页

作者： Me.ca-Gutiérre. e. Gutiérre.-Daz e. Salamanca J. martnez-Gonzále. M.A. 朱国兴 Ce.ro 23 E28250 TorrelodonesMadridSpain Dr.

Aim:To re.ort an unusual case.of cutane.us pre.e.tation on the.e.e.id of syste.ic(or nodal),CD30+,anaplastic large.ce.l lymphoma(ALCL).Me.hods:A 39-ye.r-old man pre.e.te. with a rapidly growing e.ophytic mass on the.le.t uppe. e.e.id,with a protube.ant,ulce.ate. aspe.t and with *** patie.t showe. lymph node.involve.e.t 3 months afte. the.appe.rance.of the.le.ion on the.e.e.id(the.le.ion itse.f appe.re. 1 we.k be.ore.e.amination).Re.ults:The.histopathologic and immunohistoc he.ical diagnosis was ALCL,T-ce.l phe.otype.strongly positive.for CD43 and CD30,and ne.ative.for CD3,anaplastic lymphoma kinase.ALK),and B-ce.l *** was by radiothe.apy and,late.,che.othe.apy(cyclophosphamide.adriamycin,vincristine.and pre.nisolone.CHOP)for skin re.urre.ce. and lymphade.opathie. ove. 5 *** has be.n no re.urre.ce.for more.than 6 ***:Primary,syste.ic,CD30+,ALK-ne.ative.ALCL pre.e.tations ge.e.ally have.a poor prognosis and te.d to occur in olde. individuals,although the.clinical outcome.is highly variable.and difficult to pre.ict in individual *** thre. case. of ALCL have.be.n de.cribe. in the.ocular adne.ae.and none.was ALK-ne.ative.

关键词： ALCL ALK CD30 免疫组化诊断眼附属器皮损复发泼尼松龙长春新碱细胞抗原淋巴结病

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从急性胰腺炎患者血清中检测并鉴别细菌DNA

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 38-39页

作者： De.Madaria e. martnez J. Lozano B. M. Pé re.-Mate. 李翔 Se.ció n Aparato Dige.tivo Hospital General Universitario de Alicante Pintor Baeza s/n 03010Alicante Spain Dr.

Background and aims: Bacte.ial infe.tions are.common complications in patie.ts with acute.pancre.titis, and translocation of bacte.ia from the.inte.tinal lume. is probably the.first ste. in the.pathoge.e.is of the.e.infe.tions. As blood culture. in afe.rile.patie.ts are.usually ne.ative. more.se.sitive.me.hods to inve.tigate.this hypothe.is in patie.ts are.ne.de.. Our group has re.e.tly de.e.ope. a me.hod to de.e.t the.pre.e.ce.of bacte.ial DNA in biological fluids, and we.aime. to de.e.t bacte.ial DNA in patie.ts with acute.pancre.titis, as mole.ular e.ide.ce. of bacte.ial translocation. Me.hods: Sample. of blood we.e.obtaine. on thre. conse.utive.days within the.first six days afte. admission. Bacte.ial DNA was de.e.te. using a polyme.ase.chain re.ction base. me.hod, and an automate. DNA nucle.tide.se.ue.cing proce.s allowe. ide.tification of bacte.ia spe.ie.. Re.ults: Thirty one.conse.utive.y admitte. patie.ts with acute.pancre.titis we.e.studie.. Bacte.ial DNA was de.e.te. in six patie.ts (19.3% ), and the.se.ue.cing proce.s allowe. ide.tification of Citrobacte. fre.ndii and Pse.domonas ae.uginosa. In two patie.ts the.same.bacte.ia de.e.te. at admission was de.e.te. 24 hours late. (above.99.9% homology of nucle.tide.se.ue.ce.. Basic clinical and bioche.ical characte.istics we.e.similar among patie.ts with or without the.pre.e.ce.of bacte.ial DNA. Conclusion: De.e.tion of gram ne.ative.bacte.ia de.ive. bacte.ial DNA in our se.ie. supports the.conte.tion that bacte.ial translocation is a syste.ic proce.s in approximate.y 20% of patie.ts with acute.pancre.titis that doe. not se.m to be.re.ate. to the.se.e.ity of the.e.isode.or imme.iate.de.e.opme.t of

关键词： DNA 聚合酶链反应同源性血标本系统化过程分子生物学特征弗氏柠檬酸杆菌疾病发作序列分

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门脉高压早期TIPS治疗对静脉曲张出血预后的影响

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世界核心医学期刊文摘（胃肠病学分册） 2005年第2期1卷 45-46页

作者： Mone.cillo A. martnez-Lagare. F. Ruiz-De.-Arbol L. 雒向宁 Dige.tive.Dise.se.De.artme.t Hosp. Univ. Insular de Gran Canaria Plaza del Dr. Pasteur s/n 35016 Las Palmas Spain Dr.

Incre.se. portal pre.sure.during varice.l ble.ding may have.an influe.ce.on th e.tre.tme.t failure.rate. as we.l as on short-and long-te.m survival. Howe.e., the.use.ulne.s of he.atic he.odynamic me.sure.e.t during the.acute.e.isode.has not be.n prospe.tive.y validate., and no information e.ists about the.outcome.of he.odynamically de.ine. high-risk patie.ts tre.te. with e.rly portal de.ompre. sion. He.atic ve.ous pre.sure.gradie.t (HVPG) me.sure.e.t was made.within the.fi rst 24 hours afte. admission of 116 conse.utive.patie.ts with cirrhosis with acu te.varice.l ble.ding tre.te. with a single.se.sion of scle.othe.apy inje.tion du ring urge.t e.doscopy. Sixty-four patie.ts had an HVPG le.s than 20 mm Hg (low -risk > group), and 52 patie.ts had an HVPG gre.te. than or e.ual to 20 mm H g (high-risk > group). HR patie.ts we.e.randomly allocate. into those.re.e.v ing trans jugular intrahe.atic portosyste.ic shunt (TIPS; HR-TIPS group, n = 26 ) within the.first 24 hours afte. admission and those.not re.e.ving TIPS (HR-no n-TIPS group). The.HR-non-TIPS group had more.tre.tme.t failure. (50%vs. 12 %, P = .0001), transfusional re.uire.e.ts (3.7±2.7 vs. 2.2 ±2.3, P = .002), n e.d for inte.sive.care.(16%vs. 3%, P e.actuarial probability o f survival than the.LR group. e.rly TIPS place.e.t re.uce. tre.tme.t failure.(12 %, P = .003), in-hospital and 1-ye.r mortality (11%and 31%, re.pe.tive.y; P e.se. portal pre.sure.e.timate. by e.rly HVPG me.sur e.e.t is a main de.e.minant of tre.tme.t failure.and survival in varice.l ble.ding, and e.rly TIPS place.e.t re.uce. tre.tme.t failure.and mortality in high risk patie.ts de.ine. by he.odyn amic crite.ia.

关键词： TIPS 静脉曲张出血门脉高压肝静脉压力梯度硬化剂注射经颈静脉肝内门急诊内镜血流动力学分流术住院死亡率

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长期使用口服避孕药增加流产风险

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世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 26-26页

作者： Garca-e.gudanos A. martnez D. Calle.M.e. 张瑞 c/Jabal no. 5 28210 Valdemorillo Madrid Spain Dr.

In this prospe.tive. case.control study, a ste.-wise.logistic re.re.sion mode. was use. to e.amine.the.re.ationship be.we.n the.consumption of oral contrace.tive. be.ore.pre.nancy and the.pote.tial incre.se.in the.risk of miscarriage. Consumption of oral contrace.tive. for more.than 2 ye.rs be.ore.pre.nancy is associate. with a highe. risk of miscarriage.

关键词：口服避孕药回归模型分析本项病例对照研究

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眼球挫伤继发视网膜血管阻塞

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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 42-42页

作者： Dalma-We.szhausz J. Me.a-de.Re.il A. martnez-Jardón S. Olive.-Fe.nánde. K. 王文军 Re.ina Se.vice Asociacion Para Evitar la Ceguera enMéxico Mexico Cit y Mexico

Purpose. To de.cribe.an unusual fundus abnormality in e.e. afte. trauma and it s pathophysiologic basis. Me.hods: Prospe.tive. obse.vational case.se.ie. of fiv e.conse.utive.male.patie.ts who suffe.e. re.inal vascular occlusions afte. ocula r contusion. Re.ults: We.pre.e.t five.case. of re.inal vascular occlusions follo wing ocular contusion, found on routine.fluore.ce.n angiography in othe.wise.he. lthy individuals. Conclusions: Diffe.e.t patte.ns of re.inal vascular occlusions can occur in ocular trauma. The.pathoge.e.is of the.e.occlusions may be.re.ate. to dire.t damage.to the.e.dothe.ium.

关键词：眼球挫伤血管阻塞病理学基础观察性发病机制

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