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嗜表皮的转移胰腺癌

世界核心医学期刊文摘（皮肤病学分册） 2006年第12期2卷 45-页

作者： Ambro C.M. Humphreys T.R. Lee j.B. 李晓莉 Department of Dermatology and Cutaneous Biology Thomas Jefferson University Hospital 833 Chestnut Street Phi-ladelphia PAUnited States Dr.

We describe an epidermotropically metastatic pancreatic mucinous ductal adenocarcinoma on the scalp. Neoplastic glandular structures that varied in size and shape containing abundant mucin within the lumens and in the neoplastic cells were present within a seborrheic keratosis and adjacent normal epidermis. Similar neoplastic glandular structures were present in the dermis, some within adnexal epithelium and lymphatic vessels. The patient’s history of pancreatic mucinous ductal adenocarcinoma and immunohistochemical staining pattern of carbohydrate antigen 19-9 (CA 19-9) confirmed the diagnosis.

关键词：表皮皮肤管状腺癌腺体结构

伴发乳头状肾细胞癌的家族性多发性皮肤和子宫平滑肌瘤

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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 61-61页

作者： Chan I. Wong T. Martinez-Mir A. j.A. McGrath 张宪旗 Genetic Skin Disease Group St. John's Institute of Dermatolog y Guy's King's/St. Thomas'Med. Sch. London United Kingdom

Multiple cutaneous and uterine leiomyomas is an autosomal dominant condition t hat results in benign smooth muscle tumours of the skin and, in females, uterine fibroids. This syndrome overlaps with hereditary leiomyomatosis and renal cell cancer syndrome in which affected individuals may develop the rare type II papil lary renal cell cancer, in addition to skin leiomyomas. Recently, heterozygous m utations in the gene encoding fumarate hydratase have been found to underlie bot h conditions. Fumarate hydratase is an enzyme that catalyses the conversion of f umarate to malate in the Kreb’s cycle and may also function as a tumour suppres sor gene. We report a family with multiple leiomyomas, uterine fibroids and papi llary renal cell cancer. The proband is a 77-year-old Polish woman who develop ed multiple cutaneous leiomyomas on her right upper arm in her thirties and subs equently underwent a hysterectomy for uterine fibroids in her forties. She has f our offspring: her eldest daughter also has skin and uterine leiomyomas with a s imilar onset; her son has multiple skin leiomyomas and in addition was diagnosed with metastatic papillary renal cell cancer at the age of 50 years; the two you ngest daughters are unaffected. DNA sequencing in all the affected individuals d isclosed a heterozygous G ?úC substitution at nucleotide 173 ofthefumaratehydra tasegene,thatconvertsanarginineresidue (CGA) to proline (CCA). This missense mut ation has not been reported previously and is designated R58P. Interestingly, th e clinically asymptomatic 20-year-old son of the individual with renal cancer was also found to be heterozygous for R58P. It is likely that he will develop sk in leiomyomas in the future but the risk of renal cancer is difficult to predict . Nevertheless, detection of this mutation has important implications for screen ing and genetic counselling in this and other family members.

关键词：乳头状肾细胞癌子宫平滑肌瘤族性多发性平滑肌瘤良性平滑肌瘤延胡索酸水合酶基因杂合性抑制功能子宫切除术先证者

报告随机对照试验的CONSORT声明修订版:说明与详述(八)

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中国循证医学杂志 2006年第4期6卷 292-296页

作者： Douglas G. Altman Kenneth F. Schulz David Moher Matthias Egger Frank Davidoff Diana Elbourne Peter C. Gфtzsche thomas Lang for the CONSORT Group 杜亮黄楷森何顶秀张小利秦文霞袁文明英国健康科学研究所医学统计学中心ICRF医学统计学组美国北卡罗莱纳州研究三角园国际家庭健康定量研究组加拿大东安大略湖所儿童医院thomas C.Chalmers系统评价中心英国布里斯托尔大学MRC健康服务研究协作网美国内科医师协会<内科学年鉴> 英国热带医学伦敦公共卫生学院医学统计学单元北欧Cochrane中心 13849 Edgewater Drive

讨论第20条结果解释应考虑研究假设、潜在偏倚和不精确的原因及与分析方法和结局的重复相关的危险因素。

关键词： CONSORT声明随机对照试验修订版结果解释危险因素

与斑贴试验反应强度有关的副-苯二胺过敏患者的分析

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世界核心医学期刊文摘（皮肤病学分册） 2005年第11期1卷 35-35页

作者： Ho S.G.Y. Basketter D.A. jefferies D. j.P. Mcfadden 刘艳 Dr. Contact Dermatitis Clinic St. John's Institute of Dermatology St. Thomas'Hospital Lambeth Palace Rd London SE1 7EH United Kingdom

Background: Despite having a positive patch test reaction to para-phenylenediamine (PPD), some patients continue to dye their hair, while others are forced to give up or abandon this practice. This difference in patient behaviour could be due to the degree of sensitization. Objectives: To establish whether the ability to continue dyeing hair in PPD allergic patients is related to the strength of patch test reaction. To note differences in other clinical features in relation to the strength of patch test reaction. Methods We analysed retrospectively the patch test records of 400 sequential PPD-positive patients for the strength of patch test reaction (+, ++, +++) and different clinical features. Data were analysed using Cochran-Mantel-Haenszel χ2 tests. Results: There was a strong linear relationship between the strength of patch test reaction and continuation with hair dyeing. Patients were more likely to report a history of hair dye reaction with increasing strength of patch test reaction. There was no difference in strength of patch test reaction in relation to age, site of rash, occupation (hairdressing) or history of atopic eczema. Overall concomitant reactivity with related aromatic amine allergens (benzocaine,N-isopropyl-Nphenyl-para-phenylenediamine, para-aminobenzoic acid) was infrequent. Conclusions: Patients with stronger patch test reactions (++, +++) are more likely to have a clear history of reacting to hair dye and are less likely to still be dyeing their hair.

关键词：斑贴试验过敏患者苯二胺反应强度特应性皮炎发疹苯佐卡因 Cochran 线性关系数据分析

阿达木单抗成功治疗严重型银屑病和银屑病关节炎

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世界核心医学期刊文摘（皮肤病学分册） 2005年第2期1卷 28-28页

作者： Chew A.-L. Bennett A. Smith C.H. j.Barker 田中伟 Skin Therapy Research Unit St. John's Institute of Dermatology St. Thomas'Hospital London SE1 7EH United Kingdom Prof.

Adalimumab, a fully human-derived recombinant monoclonal antibody against tumour necrosis factor-α, has been shown to be effective for the treatment of patients with moderately to severely active rheumatoid arthritis. We report two patients with long-standing recalcitrant psoriasis and psoriatic arthritis who, after multiple treatment failures with conventional and experimental antipsoriatic medications, both responded to treatment with adalimumab. Significant clinical improvement was noted in both skin and joint disease in the two patients after several weeks of treatment with adalimumab. We are unaware of previous published reports of adalimumab therapy in patients with psoriasis and psoriatic arthritis.

关键词：银屑病关节炎严重型达木抗银屑病药物肿瘤坏死因子人源性单克隆抗体关节症状

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79&PARK住宅区

城市环境设计 2019年第2期118卷 198-209页

作者： H?gni Laksáfoss Agata Wozniczka Agne Tamasauskaite Alberto Herzog Borko Nikolic Christin Svensson Claudio Moretti Dominic Black Eva Seo-Andersen Frederik Wegener Gabrielle Nadeau jacob Lykkefold Aaen jaime Peiro Suso jan Magasanik jesper Boye Andersen jonas Aars? Larsen julian Andres Ocampo Salazar Karl johan Nyqvist Karol Bogdan Borkowski Katarina Mácková Katrine juul Kristoffer Negendahl Lucian Racovitan Maria Teresa Fernandez Rojo Max Gabriel Pinto Min Ter Lim Narisara Ladawal Schr?der Romea Muryn Ryohei Koike Sergiu Calacean Song He Taylor McNally-Anderson Terrence Chew thomas Sebastian Krall Tiago Sá Tobias Vall? S?rensen Tore Banke Laurian Ghinitoiu 朱翰林

位于G?rdet国家公园边缘,Kullen有意识地塑造了一个尊重且适应环境的形式,并展现出与众不同的社区和壮丽的景色。为直接回应周围环境,建筑的西北和东南角高起至临近周边的高度;而距离公园最远、且本是视野最不好的东北角被拉高以使其拥... 详细信息

位于G?rdet国家公园边缘,Kullen有意识地塑造了一个尊重且适应环境的形式,并展现出与众不同的社区和壮丽的景色。为直接回应周围环境,建筑的西北和东南角高起至临近周边的高度;而距离公园最远、且本是视野最不好的东北角被拉高以使其拥有公园和港口最壮阔的景色。建筑西南角延伸至最远处的G?rdet国家公园;为了在建筑和自然之间创造一个人性化的柔和边缘,西南角被尽可能地压低,变成

关键词：住宅区

随机对照试验的CONSORT声明修订版:说明与详述(术语表)

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中国实用内科杂志 2006年第24期26卷 2001-2002页

作者： Douglas G.Altman Kenneth F.Schulz David Moher Matthias Egger Frank Davidoff Diana Elbourne Peter C.Gφtzsch thomas Lang 杜亮黄楷森何顶秀张小利秦文霞袁文明孙丁秦莉刘关键单位不详

校正分析通常指尽量控制(调整)各组间患者重要临床基线特征失衡.有时常指考虑重复检验的P值.见重复比较.不良事件试验中在受试者身上不希望观察到的反应.使用该术语时无须考虑该反应是否由干预措施引起.见副反应.

关键词：受试者基线随机试验概率试验结局变量 CONSORT 随机分配把握度检验效能样本量偏倚试验设计区组设计美国北卡罗来纳州干预组效应量试验方案中期分析声明

透皮东莨菪碱贴剂联合昂丹司琼对比单独应用昂丹司琼用于预防门诊手术后恶心呕吐的一项随机双盲多中心研究

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麻醉与镇痛 2010年第5期6卷 34-40页

作者： Tong j. Gan, MD Ashish C. Sinha, MD, PhD Anthony L. Kovac, MD R. Kevin jones, MD, CPI Stephen A.Cohen,MD,MBA jean P. Battildaa, MS jonathan S. Deutsch, MD joseph V. Pergolizzi, jr., MD] TDS Study Group 王琦(译) 李文志(校) Department of Anesthesiology Duke University Medical Center Durham North Carolina University of Pennsylvania Philadelphia Pennsylvania ＊University of Kansas Medical Center Kansas City Kansas Accurate Clinical Trials Inc./Saddleback Memorial Medical Center Laguna Hills California Beth Israel Deaconess Medical Center Boston Massachusetts Baxter Healthcare Corporation New Providence New Jersey Departrnent of Medicine Johns Hopkins University School of Medicine Baltimore Maryland The TDS Study Group consists of the following members: Gregory H. Adkisson (St. Agnes Healthcare Inc. Baltimore MD St. Agnes Healthcare Inc. Clinical Research Center Baltimore MD) I(eith Candiotti(University of Miami School of Medidne Jackson Health Systems Miami FL) Stephen & Cohen(Beth Israel Deaconess Medical Center Boston MA) Nell R. Connelly(Baystate Medical Center Springfield MA) Patricia L. Dalby(Magee Women's Hospital of UPMC Pittsburgh PA) Robert D'Angelo(Forsyth Medical Center Winston-Salem NC) Albert R. Davis(Loyola University Medical Center Chicago IL) David 1L Drover (Stanford Hospital and Clinics Stanford CA) Tong J. Gan Fernando Altermatt Dianne Scott(Duke University Medical Center Durham NC Duke Health Raleigh Hospital Raleigh NC and Duke Center for Aesthetic Services Durham NC) Joseph S. Gimbel(AZ Research Center John C. Lincoln Hospital North Mountain and John C. Lincoln Hospital Deer Valley Phoenix AZ)R.Kevin Jones (Saddleback Memorial Medical Center Laguna Hills CA) Anthony L. Kovac(University of Kansas Medical Center Kansas City Kansas KS) John B. Leslie(Mayo Clinic Hospital Phoenix AZ) Roberta McI(inney Jr. (Trinity Clinic North Park Mother Frances Hospital and Tyler Square Tyler TX) Tricia A. Meyer ( Scott and White Hospital Temple TX ) Joseph Pergolizzi (Physicians Day Surgery Center Naples FL) Beverly tC Philip (Brigham and Women's Hospital Boston MA) Martin I. Redmond(State University of New York at Stony Brook Ambulatory Surgica

背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊... 详细信息

背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊腹腔镜或隆胸手术的PONV高危女性患者，进入手术室前2小时分别给患者贴上TDS贴剂或外观相同的空白贴剂。在全麻诱导前2—5分钟给所有患者静脉注射OND4mg。手术后24~48小时评估止吐是否完善（彻底止吐标准为无呕吐或干呕，且没有追加止吐药）。同时记录发生呕吐、干呕、恶心以及追加止吐药的患者比例，记录手术后首次发生PONV的时间及离院时间，记录呕吐、干呕、恶心的发作次数与严重程度及患者对于止吐治疗的满意度。结果TDS＋OND组与OND组相比，手术后24小时恶心、呕吐的发生率显著降低，但手术后48小时两者差异无显著性。TDS＋OND组没有呕吐、干呕且未追加过止吐药的患者占48％，而OND组占39％（P〈0．02）。TDS＋OND组的彻底止吐（无恶心、呕吐或干呕，且未追加止吐药）率显著高于OND组（分别为35％和25％，P〈0．01）。TDS＋OND组手术后首次发生恶心、呕吐、干呕及追加止吐药的时间明显晚于OND组（P〈0．05）。前者不良反应的总发生率也低于后者（分别为36．7％和49％，P〈0．01）。结论与单独应用OND相比。TDS＋OND能更大程度地减少PONV，主要是通过减少不良反应而获得。

关键词：手术后恶心呕吐东莨菪碱贴剂多中心研究昂丹司琼门诊手术随机双盲应用单独

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麻醉信息管理系统的使用：一项实践指南

麻醉与镇痛 2010年第2期6卷 90-99页

作者： Stanley Muravchick, MD, PhD james E. Caldwell, MB, ChB Richard H. Epstein, MD Maria Galati, MBA Warren j. Levy, MD Michael O'Reilly, MD jeffrey S. Plagenhoef, MD Mohamed Rehman, MD David L. Reich, MD Michael M. Vigoda, MD, MBA 任思宏(译) 刘兴奎(校) 喻田(校) Department of Anesthesiology and Critical Care University of Pennsylvania School of Medidne Philadelphia Pennsylvania Department of Anesthesia and Perioperative Care University of California San Frandsoo California Department of Anesthesiology Thomas Jefferson University School of Medicine Philadelphia Pennsylvania Deparunent of Anesthesiology Mount Sinai School of Medidne New York New York ii Department of Anesthesiology University of Michigan Ann Arbor Michigan Department of Anesthesiology Southeast Alabama Medical Center Dothan Alabama Department of Anesthesiology and Critical Care Children's Hospital of Philadelphia Pennsylvania Department of Anesthesiology University of Miami School of Medidne Miami Florida 不详

麻醉信息管理系（AnesthesiaInformationMangementsysterns，AIMS）显示和储存围手术期的生理学数据和患者信息。虽然目前应用有限，但是在提高患者安全、改进临床效果和质量、简便收费和明细医疗费用、规范执行以及研究麻醉转归等方面... 详细信息

麻醉信息管理系（AnesthesiaInformationMangementsysterns，AIMS）显示和储存围手术期的生理学数据和患者信息。虽然目前应用有限，但是在提高患者安全、改进临床效果和质量、简便收费和明细医疗费用、规范执行以及研究麻醉转归等方面都有巨大的优势。虽然关于AIMS选择、安装和应用的程序和注意事项比较复杂，但是这些都可以通过不断摸索而明确。本文总结介绍了AIMS成功使用的基本要素，包括产品评估、信息技术需求评价、资源获得、领导的作用以及培训等。

关键词：麻醉信息管理系统实践指南 AIMS 围手术期临床效果医疗费用产品评估需求评价