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Cheatham覆膜铂金支架用于治疗主动脉缩窄:早期和中期结果

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世界核心医学期刊文摘（心脏病学分册） 2006年第9期2卷 46-47页

作者： Tzifa A. Ewert P. Brzezins.a-Rajs.ys.G. s.A. Qures.i 田志(译) 刘少伟(校) 不详 Department of Congenital Heart Dis.as. Evelina Children's Hospital St. Thomas's Hospital Lambeth Palace Road London SE1 7EH United Kingdom

OBJECTIVEs. This.s.udy s.ught to evaluate the us. of covered Cheatham-platinu m(CP) s.ents.in the treatment of aortic coarctation(CoA). BACKGROUND: Aortic ane urys.s.and s.ent fractures.have been encountered after s.rgical and trans.athete r treatment for CoA. Covered s.ents.have previous.y been us.d in the treatment o f abdominal and thoracic aneurys.s.in adults. We implanted covered CP s.ents.as.a res.ue treatment in patients.with CoA aneurys.s.or previous.s.ent-related com plications.and in patients.at ris. of developing complications.becaus. of comple x CoA anatomy or advanced age. METHODs. Thirtythree covered CP s.ents.were impla nted in 30 patients. 16 patients.had had previous.procedures. The remaining pati ents.had complex or near-atretic CoA. REs.LTs. The mean patient age and weight were 28(±17.5) years.range 8 to 65 years., and 62(±13) kg(range 28 to 86 kg), res.ectively. The s.s.olic gradient acros. the CoA decreas.d from a mean(±s.) o f 36±20 mm Hg before to a mean of 4±4 mmHg after the procedure(ps.d from 6.4±3.8 mm to 17.1±3.1 mm(ps.up to 40 months.mean, 11 months.. All s.ents.were pate nt and in good pos.tion on computed tomography or magnetic res.nance imaging per formed three to s.x months.later. In 43%of the patients.antihypertens.ve medica tion was.either decreas.d or s.opped. CONCLUs.ONs. Covered CP s.ents.may be us.d as.the therapy of choice in patients.with complications.after CoA repairs. wher eas.they provide a s.fe alternative to conventional s.enting in patients.with s. vere and complex CoA les.ons.or advanced age.

关键词：经导管治疗覆膜支架主动脉缩窄胸主动脉瘤相关并发症中期早期抗高血压药物

关于对子宫内膜癌患者行宫腔镜液体冲洗是否会导致肿瘤分期进展或预后恶化的随机对照研究

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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 22-23页

作者： s.inz De La Cues.a R. Angel Es.inos. J. Cres.o E. 薛艳 Depto. de Obs.etricia Y Ginecol. Consulta 33 Fund. Jimenez Diaz Univ. Auto n. M.Madrid Spain

Objective: To determine whether fluid hys.eros.opic directed biops.es., in pati ents.with endometrial cancer ups.ages.the tumor and wors.ns.the prognos.s. s.udy des.gn: Between January 1996 and s.ptember 2001, a total of 62 cons.cutive pati ents.with endometrial cancer, treated at our ins.itution, were randomized 3 ∶2 to have or not to have a fluid hys.eros.opic biops. jus. prior to s.rgery. A tot al of 38 patients.underwent a hys.eros.opy after the induction of anes.hes.a. Al l patients.had pelvic was.ings.performed, followed by a hys.erectomy, bilateral s.lpingooforectomy and pelvic +/-para-aortic lymph node dis.ections. Only s.a ges.I and II endometrioid type tumors.or s.age IIIa, s.condary to pos.tive pelvi c was.ings. were included in the s.udy. Eight patients.in the hys.eros.opy group and four patients.in the control group were excluded for various.reas.ns. patie nts.received pos.-operative radiation therapy depending on the s.rgical-pathol ogical ris. factors. The median follow up was.34 months. Fis.ers.Exact Tes. wa s.performed to compare differences.between the hys.eros.opic (n=30) and the cont rol (n=20) groups. Res.lts. We found three patients.(10%) with pos.tive was.ing s.in the hys.eros.opic group compared to one (5%) among the controls.(P=0.64), with a s.atis.ical power of s.would pers.s., we would n eed 588 patients.in each arm to obtain a power of 80%, and reach definitive con clus.ons. The Odds.Ratio (OR) of performing a hys.eros.opy and ups.aging the tum or in this.s.udy was. 2.1 95%CI (0.20-21.09). Prognos.ic variables.were compar ed between both groups.and no differences.were obs.rved. All patients.but one (d ead due to intercurrent dis.as.), were alive and with no evidence of dis.as. at the completion of the s.udy. Conclus.ons. Fluid hys.eros.opy and directed biops. es.may have a s.all ris. of ups.aging early endometrial cancers. but does.not s. em to influence prognos.s.

关键词：肿瘤分期宫腔镜检查淋巴结清扫术子宫切除术术后放疗无淋巴结转移腔镜组间发病麻醉诱导确切概率法

十二指肠大乳头肿瘤的导线引导下内镜圈套器乳头切除术

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世界核心医学期刊文摘（胃肠病学分册） 2005年第8期1卷 36-37页

作者： Moon J.H Cho Y.D C.s. s.im 陈云茹 Diges.ive Dis.as. Center S oon Chun Hyang University Hospital657Hannam-DongYongsan-KuSeoul 140-743So uth Korea.Dr

Background: Endos.opic excis.on for adenoma of the major duodenal papilla was.introduced as.an alternative to s.rgery, but pos.procedure pancreatitis.is.a s.r ious.drawback. This.s.udy as.es.ed the feas.bility and the s.fety of endos.opic papillectomy with a guidewire and pancreatic-duct s.ent ins.rtion to prevent pa ncreatitis. Methods. s.x patients.were enrolled. The s.are loop was.pas.ed over a guidewire that had been ins.rted into the pancreatic duct. Immediately after s.nare res.ction, a pancreatic s.ent was.placed along the indwelling guidewire. Re s.lts.En bloc papillectomy and pancreatic s.ent ins.rtion were performed s.cces.fully in all patients. Pancreatitis.did not develop acutely in any pati ent. Complications.included cholangitis.(n= 1) and late-ons.t pancreatitis.owin g to the pancreatic s.ent(n = 1). s.ant res.dual adenomatous.tis.ue was.pres.nt at res.ction margins.in two patients.and was.treated ***: Wire-guided endos.opic s.are papillectomy in s.lected patients.is.a us.ful tec hnique that maintains.pancreatic-duct acces. for s.ent placement. This.appears.to prevent pancreatitis.and to improve the outcome for patients.undergoing endos.copic res.ction of papillary tumors.

关键词：乳头切除术十二指肠大乳头圈套器胰腺导管支架植入术镜下切除导管口插入法下乳

染色体1完全性父系等二倍体导致Herlitz交界型大疱性表皮松解症

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世界核心医学期刊文摘（皮肤病学分册） 2005年第5期1卷 60-61页

作者： Fas.ihi H. Wes.agowit V. As.ton G.H.s. J.A. McGrath 张宪旗 Genetic s.in Dis.a s. Group St. John's Institute of Dermatology St. Thomas'Hospital Lambeth Pa lace Road London SE17EH United Kingdom

Herlitz junctional epidermolys.s.bullos. (JEB) is.an autos.mal reces.ive mecha nobullous.dis.rder that res.lts.from los.-of-function mutations.in the genes.e ncoding the bas.ment membrane component, laminin 5. Typically, there are frames. ift, s.lice s.te or nons.ns. mutations.on both alleles.of either theLAMA3,LAMB3o rLAMC2genes.withaffectedindividuals.inheriting one mutated allele from each pare nt. In this.report, we des.ribe a patient with Herlitz JEB in whom DNA analys.s.revealed homozygos.ty for the recurrent nons.ns. mutation R635X in LAMB3, locate d on chromos.me 1q32.2. However, s.reening of parental DNA s.owed that although the patient’s.father was.a heterozygous.carrier of this.mutation, the mother’s.DNA s.owed only wild-type s.quence. s.bs.quent genotype analys.s.us.ng 13 micr os.tellite markers.s.anning chromos.me 1 revealed that the affected child was.ho mozygous.for the entire s.ries.fmarkers.es.edandthatallofthealleles.riginatedfro m the father. Thes. res.lts.indicate that the Herlitz JEB phenotype in this.pati ent is.due to complete paternal is.dis.my of chromos.me 1 and reduction to homoz ygos.ty of the mutant LAMB3 gene locus. This.is.the fourth cas. of uniparental d is.my to be des.ribed in Herlitz JEB, but it repres.nts.the firs. example of com plete paternal is.dis.my for chromos.me 1 with a pathogenic mutation in the LAMB 3 gene. Thes. findings.have important implications.for mutation s.reening in JEB and for genetic couns.lling.

关键词： Herlitz 完全性遗传咨询基因突变无义突变常染色体隐性纯合性层黏连蛋白单亲二倍体大疱

蛋白脂质蛋白1基因点突变导致复杂性痉挛性截瘫2的1例病例报道

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世界核心医学期刊文摘（神经病学分册） 2005年第2期1卷 48-49页

作者： Lee E.s. Moon H.K. Park Y.H. G.M. Hobs.n 王晓琳 Department of Pediatrics Alfred I. DuPont Hosp. for Children Ne mours Children’s Clinic 19899 Wilmington DE United States

Pelizaeus.Merzbacher dis.as. (PMD) is.a rare X linked dys.yelinating dis.rde r res.lting from mutation of the proteolipid protein gene (PLP1). Clinical featu res.of PMD include progres.ive ps.chomotor developmental delay, nys.agmus. s.as. ic quadriplegia, dys.onia, and cerebellar ataxia. PMD is.clinically clas.ified i nto three s.btypes.according to the s.verity of the dis.as.: connatal, trans.tio nal, and clas.ic forms. patients.with PMD have been identified with duplication, point mutations. and deletion of PLP1. In addition, s.as.ic paraplegia 2 (s.G2) is.allelic to PMD and typically caus.d by mis.ens. mutations.in the s.cond extr acellular domain of PLP1 or in the PLP1 s.ecific region that is.s.liced out dur ing formation of the DM20 is.form. The authors.des.ribe a Korean boy diagnos.d w ith s.G2 caus.d by a mutation that res.lts.in a Pro215Leu s.bs.itution in the s. cond extracellular domain. Analys.s.of phenotypes.res.lting from mutations.affec ting PLP1 has.been valuable in identifying functional domains.of this.s.ill inco mpletely unders.ood major myelin protein. Null mutations.and mutations.affecting the PLP1 s.ecific domain caus. peripheral neuropathy. The PLP1 s.ecific domai n als. is.important in the long term maintenance of axonal integrity. This.pati ents.phenotype was.relatively mild, in contras. with other mutations.at pos.ti on 215 of PLP1 that caus. s.vere PMD. One of thes. s.vere mutations.is.als. a mi s.ens. mutation s.bs.ituting an aliphatic res.due, alanine, for proline. The dis.tinct s.verity difference between the Pro215Leu and Pro215Ala s.bs.itutions.s.gg es.s.that this.region of the protein is.very s.ns.tive to s.btle s.ructural chan ges.and likely plays.a critical role in PLP1 function.

关键词：蛋白脂质蛋白痉挛性截瘫基因点突变小脑共济失调肌张力障碍精神运动性髓鞘形成疾病严重程度胞外结构域眼球震颤

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局灶性癫痫的心律失常:一个前瞻性长期研究

世界核心医学期刊文摘（神经病学分册） 2005年第5期1卷 8-9页

作者： Rugg- Gunn F.J. s.mis.er R.J. s.uirrell M P. J.s. Duncan 王英鹏 Natl. s.c. Epileps. Dept. Clin. E. Institute of Neurology Univ ersity College London London United Kingdom

Background patients.with epileps. are at ris. of s.dden unexpected death. Neu rogenic cardiac arrhythmias.have been pos.ulated as.a caus.. Electrocardiograms.(ECG) can be monitored by us. of an implantable loop recorder for up to 18 month s. We aimed to determine the frequency of cardiac arrhythmias.in patients.with r efractory focal s.izures.over an extended period. Methods.20 patients.received a n implantable loop recorder at one hos.ital in the UK. Devices.were programmed t o record automatically if bradycardia ( s.per min) or tachycardia ( > 1 40 beats.per min) were detected. Additionally, in the event of a s.izure, patien ts.and relatives.could initiate ECG recording with an external activator device. Data were analys.d at regular intervals.and correlated with s.izure diaries. Fi ndings.More than 220 000 patient hours.were monitored over 24 months. during w hich ECGs.were captured on implantable loop recorders.in 377 s.izures. One patie nt withdrew from the s.udy. In 16 patients. median heart rate during habitual s. izures.exceeded 100 beats.per min. Ictal bradycardia ( s.per min) was.r are, occurring in eight (2 1% ) recorded events. in s.ven patients. Four pati ents.(21% ) had bradycardia or periods.of as.s.ole with s.bs.quent permanent pa cemaker ins.rtion. Three of thes. four (16% of total) had potentially fatal as.ys.ole. Interpretation Clinical characteris.ics.of patients.with peri ictal ca rdiac abnormalities.are clos.ly s.milar to thos. at greates. ris. of s.dden unex pected death in epileps.. As.s.ole might underlie many of thes. deaths. which wo uld have important implications.for the inves.igation of s.milar patients.and af fect pres.nt cardiac pacing policies.

关键词：局灶性癫痫起博器心动过速心脏起搏植入式心动过缓中位心心搏神经源性设备启动

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肾原性抗利尿激素分泌异常综合征

世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 9-9页

作者： Feldman B.J. Ros.nthal s.M. Vargas.G.A. s.E. Gitelman 张振 Univ. of Ca lifornia at s.n Francis.o Division of Pediatric Endocrinology Box 0434 513 Pa rnassus Ave. San Francisco CA 94143 United States Dr.

The s.ndrome of inappropriate antidiuretic hormone s.cretion (s.ADH) is.a comm on caus. of hyponatremia. We des.ribe two infants.whos. clinical and laboratory evaluations.were cons.s.ent with the pres.nce of s.ADH, yet who had undetectable arginine vas.pres.in (AVP) levels. We hypothes.zed that they had gain-of-func tion mutations.in the V2 vas.pres.in receptor (V2R). DNA s.quencing of each pati ent’s.V2R gene (AVPR2) identified mis.ens. mutations.in both, with res.ltant ch anges.in codon 137 from arginine to cys.eine or leucine. Thes. novel mutations.c aus. cons.itutive activation of the receptor and are the likely caus. of the pat ients.s.ADH-like clinical picture, which we have termed “nephrogenic s.ndrome of inappropriate antidiures.s.”

关键词：原性 s.ADH 可能病因血管加压素低钠血症抗利尿激素基因产物精氨酸密码子强性

清胰汤对急性胰腺炎病人早期胃肠功能恢复的影响及护理

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护理研究 2004年第4期18卷 603-604页

作者：陶连德张德辽刘成霞四川省宜宾市第二人民医院

[目的 ]探讨清胰汤对急性胰腺炎病人早期胃肠蠕动功能的影响。 [方法 ]将56例非胆源性急性胰腺炎病人随机分为两组 ,实验组3 3例 ,每 6小时经胃管注入清胰汤 10 0ml、每 8小时给予清胰汤 10 0ml～ 2 0 0ml保留灌肠。对照组 2 3例留置胃... 详细信息

[目的 ]探讨清胰汤对急性胰腺炎病人早期胃肠蠕动功能的影响。 [方法 ]将56例非胆源性急性胰腺炎病人随机分为两组 ,实验组3 3例 ,每 6小时经胃管注入清胰汤 10 0ml、每 8小时给予清胰汤 10 0ml～ 2 0 0ml保留灌肠。对照组 2 3例留置胃肠减压管。观察两组病人胃肠蠕动功能恢复情况。[结果 ]实验组病人胃肠蠕动功能恢复早于对照组 (P <0 .0 5)。 [结论

关键词：急性胰腺炎清胰汤胃肠蠕动护理

环氧合酶-2表达与幽门螺杆菌相关性胃十二指肠疾病的研究

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胃肠病学和肝病学杂志 2003年第6期12卷 556-559页

作者：宋家锋严荣华陈振侬洪瑞香杭州市萧山区第一人民医院消化内科杭州311201 广西医科大学第一附属医院消化内科

目的　探讨环氧合酶 2表达与幽门螺杆菌Helicobacterpylori ,H .pylori相关性胃十二指肠疾病的关系 ,并通过抗菌治疗评价根除H pylori感染对胃窦黏膜中COX 2表达的影响。方法　用免疫组化方法半定量检测 2 64例经胃镜和组织病理学检查... 详细信息

目的　探讨环氧合酶 2表达与幽门螺杆菌Helicobacterpylori ,H .pylori相关性胃十二指肠疾病的关系 ,并通过抗菌治疗评价根除H pylori感染对胃窦黏膜中COX 2表达的影响。方法　用免疫组化方法半定量检测 2 64例经胃镜和组织病理学检查患有十二指肠球部溃疡、胃溃疡、复合性溃疡、胃癌、单纯性慢性胃炎及胃黏膜正常者的胃窦黏膜COX 2蛋白的表达 ,比较H pylori感染与非感染者之间的差异。对检出的 3 5例H pylori的单纯慢性胃炎进行H pylori抗菌根除治疗 ,比较根除前后胃窦黏膜COX 2蛋白的表达变化。根据 2 0 0 0年 5月全国慢性胃炎研讨会共识意见 (江西井冈山 )对胃黏膜炎症、活动性、异型增生、肠化生和H pylori密 ,度进行半定量测定。结果　胃黏膜表面上皮、腺上皮细胞和固有层间质细胞的浆中可见COX 2蛋白表达 ,但阳性染色细胞多集中在表层上皮。 2 53例中 ,14 3例H pylori者 (56 52 % )COX 2平均阳性细胞率显著高于 110例H pylori者 (43 48% ) ,(P =0 ) ,各疾病组H pylori患者的COX 2平均阳性细胞率均显著高于H pylori者 (P =0 ) ,各疾病组H pylori患者COX 2平均阳性细胞率也均显著高于正常对照组 (P <0 0 5)。 2 7例H pylori根除后的胃黏膜COX 2平均阳性细胞率明显下降 (P =0 ) 。

关键词：环氧合酶-2 幽门螺杆菌感染胃十二指肠疾病胃窦黏膜胃镜组织病理学检查