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皮肤癌临床诊断的准确率:来自澳大利亚的经验

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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 49-49页

作者： Moffatt C.R.M. Green A.C. Whiteman D.C. 周少娜 Clive Berghofer Cancer Research center QueenslandInstitute of Medical ResearchPO Royal Brisbane HospitalBrisbaneQLD 4029Australia

Background:Australia,with the world’s highest incidence of skin cancer,has witnessed the emergence of “open access”skin cancer clinics during the past *** clinics are becoming increasingly popular destinations for the diagnosis and treatment of skin cancers,yet little is known about the diagnostic performance of practitioners in this *** sought to measure the accuracy of clinical diagnosis in this ***:Clinical and histological data were obtained from 199 consecutive patients undergoing biopsy or excision for 287 skin *** measured the sensitivity,specificity and predictive value of the clinical diagnoses compared with histological ***:Of 287 biopsied or excised lesions,the most common were benign nevi(24%)and basal cell carcinomas(22%),followed by actinic keratoses(11%),dysplastic nevi(11%)and squamous cell carcinomas(7%).Sensitivity was highest for diagnosing BCC(0.89,95%CI 0.78-0.95)and dysplastic nevi(0.80,95%CI 0.61-0.93),and lowest for actinic keratoses andthe group of benign *** was greater than 0.93 for all diagnoses except BCC(0.76,95%CI 0.70-0.81).Treating clinicians perceived moderate to strong pressure to excise 49%of lesions overall,but in particular for benign nevi(73%).Conclusions:Australian family practitioners in open access skin cancer clinics diagnose a wide range of skin lesions with high specificity and moderate to high *** neviare accurately diagnosed and often excised because of patient pressure.

关键词：临床诊断日光性角化病组织学诊断诊断灵敏度发育不良预测价值诊断特异性家庭医生切除术

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表现为躯体幻觉的额叶非惊厥性癫痫持续状态

世界核心医学期刊文摘（神经病学分册） 2005年第11期1卷 46-46页

作者： Takaya S. Matsumoto R. Namiki C. H. Fukuyama 周永 Human Brain Research center Kyoto University Graduate School of Medicine Shogoin Sakyo-ku Kyoto 606-8507 Japan

Somatic hallucinations are subjective experience of false, strange sensations of things occurring in or to the body. They can be seen in psychotic disorders, but have not been well described as an ictal psychosis in patients with nonconvulsive status epilepticus (NCSE) of frontal origin. We reported a 69-year-old woman who had NCSE of frontal origin manifesting prolonged somatic hallucinations mimicking a psychiatric disorder and initially treated as such. Ictal EEG revealed the frontal focus and ictal single-photon emission computed tomography (SPECT) showed the activation, not only in the frontal area but also in the parietal area as the projected regions, both of which might be associated with the development of her symptoms. She also had two generalized tonic-chronic seizures out of psychosis. Her psychosis and ictal rhythmic discharges on EEG ceased with valproate and she has since remained free from the symptoms. The current case suggests that long-lasting somatic hallucinations could be an ictal psychosis in frontal NCSE and thus an EEG study is needed for an early diagnosis and treatment.

关键词：发作性精神异常阵挛发作精神疾病丙戊酸钠节律性放电主观体验叶病

对无法手术切除的结肠直肠癌转移灶行氟尿嘧啶生物调节治疗:2例存活超过10年的病例报道

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世界核心医学期刊文摘（胃肠病学分册） 2006年第9期2卷 22-22页

作者： Leonard G.D. Kemeny N.E. 廖新华 Memorial Sloan-Kettering Cancer center 1275 York AvenueNew YorkNY 10021United States Dr.

The treatment of metastatic colorectal cancer by chemotherapy alone was considered palliative and without the potential to cure patients unless patients were rendered *** report two patients with metastatic colorectal cancer involving the liver who were considered inoperable andwere treated with systemic chemotherapy using biomodulated *** patients received 5-fluorouracil and N-(phosphonoacetyl)-l-aspartic acid;one also received methotrexate,leucovorin,and triacetyluridine with the N-(phosphonoacetyl)-l-aspartic acid and *** patients had a complete remission with chemotherapy and are still alive with no evidence of cancer ten years after the diagnosis of unresectable metastatic *** patients provide evidence that prolonged survival can be achieved with systemic chemotherapy without the use of surgery or other forms of local *** patients also confirm the importance of continued investigation of fluorouracil modulating agents,which may further enhance the recent progress made with fluorouracil-based combination chemo-therapy for colorectal cancer.

关键词：转移性结肠直肠癌姑息性治疗氟尿嘧啶生物调节癌转移灶存活时间病例报道手术切除

植入前胚胎21号染色体嵌合现象主要由二倍体受孕引起

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世界核心医学期刊文摘（妇产科学分册） 2006年第1期2卷 34-34页

作者： Katz-Jaffe M.G. Trounson A.O. Cram D.S. 张剑萍 Colorado center for Reproductive Medicine 799 E. Hampden Ave Englewood CO 80113 United StatesDr.

High rates of chromosomal mosaicism in human IVF embryos question the accuracy of preimplantation genetic diagnosis, and, with the majority of embryo transfers still resulting in no pregnancy, chromosomal mosaicism is likely to be a contributing factor to human IVF failure. The aim of this study was to investigate the origin and nature of chromosome 21 (Ch21) cell division errors in human IVF embryos. Design: Perform single cell Ch21 allelic profiling on human IVF embryos. Setting: Academic research environment. Patient(s): Women of advanced maternal age (>35 yrs) (n = 65) undergoing infertility treatment; and amniocytes/chorionic cells from trisomy 21 pregnancies (n = 28). Intervention(s): Cells were analyzed by single cell allelic profiling, Main Outcome Measure(s): The origin and nature of cell division errors. Result(s): The vast majority of Ch21 mosaic embryos (～ 80% ) originated from diploid conceptions. In contrast, all fetal trisomy 21 originated from aneuploid conceptions. Increasing maternal age was significantly associated with aneuploid conceptions, meiotic cell division error, and adverse pregnancy outcome (P < .05). The mean daily FSH dose that produced embryos with normal Ch21 cell division was significantly lower than the mean daily FSH dose that produced embryos with mitotic Ch21 cell division errors (P < .01) and embryos with meiotic cell division errors (P < .05). Conclusion(s): Chromosomal mosaicism of Ch21 in human IVF embryos predominantly originate from diploid conceptions. Further understanding of chromosomal mosaicism with respect to IVF parameters, such as daily FSH dose, may eventually lead to improvements in IVF outcomes.

关键词： 21号染色体植入前胚胎嵌合现象二倍体受孕染色体嵌合型胚胎遗传学诊断 21-三体绒毛膜细胞细胞分裂

Consensus on clinical management of tumor-induced osteomalacia

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Chinese Medical Journal 2021年第11期134卷 1264-1266页

作者： Yan Jiang Xiang Li Li Huo Yong Liu Wei Lyu Lian Zhou Wei Yu Huan-Wen Wu Xiao-Ping Xing Mei Li Ou Wang Yue Chi Rui-Zhi Jiajue Yu Pei Jian-Min Liu Jian-Ming Ba Qiao Zhang Zhi-Feng Sheng Zhen-Lin Zhang Jia-Jun Zhao Salvatore Minisola Wei-Bo Xia on behalf of Chinese Society of Osteoporosis and Bone Mineral Research and Chinese Society of Endocrinology Department of Endocrinology Key Laboratory of EndocrinologyState Key Laboratory of Complex Severe and Rare DiseasesNHCPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Nuclear Medicine Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China Department of Orthopaedic Surgery Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China Department of ENT Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China Department of Stomatology Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China Department of Radiology Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China Department of Pathology Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China Department of Endocrinology Chinese PLA General HospitalBeijing 100853China Department of Endocrine and Metabolic Diseases Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai Institute of Endocrine and Metabolic DiseasesShanghai Clinical Center for Endocrine and Metabolic DiseasesShanghai 200025China Department of Endocrinology and Metabolism Affiliated Hospital of Guiyang Medical UniversityGuiyangGuizhou 550004China Department of Metabolism and Endocrinology The Second Xiangya HospitalCentral South UniversityChangshaHunan 410011China Department of Osteoporosis and Bone Diseases Shanghai Clinical Research Center of Bone DiseaseShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghai 200233China Department of Endocrinology and Metabolism Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandong 250021China Department of Internal Medicine and Medical Disciplines Sapienza University of RomeRomeItaly 不详

Tumor-induced osteomalacia(TIO)is a rare paraneoplastic syndrome caused by excessive fibroblast growth factor 23(FGF23)production by a tumor,which often arises from a mesenchymal origin.[1-3]Most clinical symptoms of TIO are the consequences of prolonged FGF23-mediated hypophosphatemia as muscle weakness,bone pain,impaired mobility,and fractures.[4]Clinical diagnosis and management of TIO are challenging because knowledge about this condition is still restricted to a few specialized centers,leading to delay in diagnosis and appropriate *** scope of the present consensus is to provide up-to-date guidance on the assessment and treatment of TIO.

关键词： diagnosis clinical impaired

Single-cell RNA sequencing reveals the transcriptomic landscape of kidneys in patients with ischemic acute kidney injury

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Chinese Medical Journal 2023年第10期136卷 1177-1187页

作者： Rong Tang Peng Jin Chanjuan Shen Wei Lin Leilin Yu Xueling Hu Ting Meng Linlin Zhang Ling Peng Xiangcheng Xiao Peter Eggenhuizen Joshua DOoi Xueqin Wu Xiang Ding Yong Zhong Department of Nephrology Xiangya HospitalCentral South UniversityChangshaHunan 410008China Key Laboratory of Biological Nanotechnology of National Health Commission Xiangya HospitalCentral South UniversityChangshaHunan 410008China Department of Organ Transplantation Xiangya HospitalCentral South UniversityChangshaHunan 410008China Department of Hematology The Affiliated Zhuzhou Hospital Xiangya Medical CollegeCentral South UniversityZhuzhouHunan 412007China Department of Pathology Xiangya HospitalCentral South UniversityChangshaHunan 410008China Department of Nephrology Jiujiang Hospital of Traditional Chinese MedicineJiujiangJiangxi 332099China Department of Medicine Centre for Inflammatory DiseasesMonash Medical CentreMonash UniversityClaytonVIC 3168Australia Department of Nephrology The Third Xiangya HospitalCentral South UniversityChangshaHunan 410013China National Clinical Research center for Geriatric Disorders Xiangya HospitalCentral South UniversityChangshaHunan 410008China

Background:Ischemic acute kidney injury(AKI)is a common syndrome associated with considerable mortality and healthcare *** to now,the underlying pathogenesis of ischemic AKI remains incompletely understood,and specific strategies for early diagnosis and treatment of ischemic AKI are still ***,this study aimed to define the transcriptomic landscape of AKI patients through single-cell RNA sequencing(scRNA-seq)analysis in ***:In this study,scRNA-seq technology was applied to kidneys from two ischemic AKI patients,and three human public scRNA-seq datasets were collected as *** expressed genes(DEGs)and cell clusters of kidneys were *** ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis,as well as the ligand-receptor interaction between cells,were *** also validated several DEGs expression in kidneys from human ischemic AKI and ischemia/reperfusion(I/R)injury induced AKI mice through immunohistochemistry ***:15 distinct cell clusters were determined in kidney from subjects of ischemic AKI and *** injured proximal tubules(PT)displayed a proapoptotic and proinflammatory *** cells of ischemic AKI had up-regulation of novel pro-apoptotic genes including USP47,RASSF4,EBAG9,IER3,SASH1,SEPTIN7,and NUB1,which have not been reported in ischemic AKI *** hub genes were validated in kidneys from human AKI and renal I/R injury mice,***,PT highly expressed DEGs enriched in endoplasmic reticulum stress,autophagy,and retinoic acid-inducible gene I(RIG-I)*** overexpressed in other tubular cells were primarily enriched in nucleotide-binding and oligomerization domain(NOD)-like receptor signaling,estrogen signaling,interleukin(IL)-12 signaling,and IL-17 *** genes in kidney-resident immune cells including macrophages,natural killer T(NKT)cells,monocytes,and dendritic cells were associated with

关键词： Ischemic acute kidney injury Single-cell RNA sequencing Proximal tubule cells Apoptosis Inflammation Cell-cell crosstalk

Application of Big Data Deep Learning in Auxiliary diagnosis of Lower Extremity Arteriosclerosis Obliterans

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Journal of Clinical and Nursing Research 2021年第5期5卷 108-112页

作者： Linbo Liu Yang Liu Hongjun Wang Yi Zhang Zhijie Liao Shengdong Du The Third Hospital of Mianyang Sichuan Mental Health CenterMianyang 621000Sichuan ProvinceChina Affiliated Hospital of Chengdu University of Traditional Chinese Medicine Chengdu 610072Sichuan ProvinceChina School of Computing and Artificial Intelligence Southwestjiaotong UniversityChengdu 611756Sichuan ProvinceChina

At present,the incidence rate of arteriosclerosis obliterans(LEASO)of the lower extremities is significantly increased by aging and lifestyle *** is of great importance to predict the LEASO effectively and accurately by analyzing the imaging data of the lower extremities⑴.At this stage,China has entered the era of big data and artificial *** institutions at all levels can produce a large number of lower limb vascular image data every *** big data deep learning technology to intelligently analyze a large number of image data,and then carry out auxiliary diagnosis,so as to improve the diagnosis and treatment effect of LEASO is the focus of clinical research.

关键词： Big data Deep learning Arteriosclerosis obliterans of lower limbs Auxiliary diagnosis

Reduced risk of dementia in patients with type 2 diabetes mellitus using Chinese herbal medicine:A nested case-control study

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World Journal of Diabetes 2023年第11期14卷 1632-1642页

作者： Hou-Hsun Liao Hanoch Livneh Hua-Lung Huang Jui-Yu Hung Ming-Chi Lu How-Ran Guo Tzung-Yi Tsai Department of Chinese Medicine Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Graduate Institute of Chinese Medicine School of Chinese MedicineCollege of Chinese MedicineChina Medical UniversityTaichung 404333TaiwanChina Department of Nursing Tzu Chi University of Science and TechnologyHualien 62247TaiwanChina Department of Special and Counselor Education Portland State UniversityPortlandOR 97207United States Department of Rehabilitation Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Department of Nursing Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Division of Allergy Immunology and RheumatologyDalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina Department of Environmental and Occupational Health College of MedicineNational Cheng Kung UniversityTainan 70428TaiwanChina Department of Occupational and Environmental Medicine National Cheng Kung University HospitalTainan 70428TaiwanChina Occupational Safety Healthand Medicine Research CenterNational Cheng Kung UniversityTainan 70428TaiwanChina Department of Medical Research Dalin Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationChiayi 62247TaiwanChina

BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)*** Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likelihood of dementia has not yet been fully *** To compare the risk of dementia between T2DM patients with and without CHM *** We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in ***,defined as those with dementia that occurred at least one year after the diagnosis of T2DM,were randomly matched to controls without dementia from the study cohort at a 1:1 *** applied conditional logistic regression to explore the associations between CHM treatment and *** A total of 11699 dementia cases were matched to 11699 non-dementia *** found that adding CHM to conventional care was related to a lower risk of dementia[adjusted odds ratio(OR)=0.51],and high-intensity CHM treatment was associated with an adjusted OR of *** This study shows that the cumulative CHM exposure was inversely associated with dementia risk in an exposureresponse manner,implying that CHM treatment may be embraced as a disease management approach for diabetic patients to prevent dementia.

关键词： Type 2 diabetes mellitus Dementia Chinese herbal medicine Nested case-control study Odds ratio

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卵巢癌转移至乳腺

世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 40-40页

作者： J.P. Micha Goldstein B.H. Epstein H.D. 朱亮 Gynecologic Oncology Associates Hoag Cancer Center351 Hospital RoadSuite 507Newport BeachCA 92663United States

Background:Metastatic ovarian cancer to the breast should be considered in the differential diagnosis for gynecologic cancer patients with a breast tumor. Despite early detection and treatment,the long-term prognosis for these patients is poor. Cases:We present three ovarian cancer patients who developed metastatic ovarian cancer to the breast. All patients were heavily pre-treated prior to the development of metastatic disease. Currently,one patient is alive at 64 months following initial detection of her metastatic disease to the breast. The second and third patients are also alive for 30 and 3 months subsequent to their diagnosis of metastatic disease. Conclusion:Although metastatic ovarian cancer to the breast following treatment for ovarian cancer is rare and associated with a poor prognosis,oncology physicians should be prepared to contend with disease metastatic to the breast. Additional investigation into the efficacy of surgery and novel chemotherapy agents is warranted.

关键词：癌转移妇科肿瘤肿瘤转移前期治疗化疗药物早期检测