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世界核心医学期刊文摘（妇产科学分册） 2006年第4期2卷 37-38页

作者： Hunger-Dathe W. Khn B. Kloos C. 朱国栋 klinik für innere Medizin III Universittsklinikum der Friedrich-Schiller-Universitt 07740 Jena Germany Dr.

Questions: Has the goal of the declaration of St. Vincent, a comparable delivery outcome for women with and without diabetes mellitus (DM), been achieved in the region of Thuringia in Germany? Patients and Methods: In 77 women with DM type 1 and 8 women with DM type 2 we analyzed the association of glucose metabolism (Hba1c preconceptual and on pregnancy diagnosis, mean blood sugar self monitoring for each gestational month), frequency of abortions and congenital malformations. Results: Only 43.5%of the women consulted a diabetologist before conception (1-6 months). The first consultation during pregnancy was in the 9th gestational week (3-33). The prevalence of stillbirths did not differ from that of women without diabetes (DM 1.2%vs perinatal registry of the University of Jena 0.7%, n.s.). 4.7%of all pregnancies ended with an abortion. Hba1c (normal range 4.58-5.90%)was significantly higher during organogenesis (Hba1c abortion 10.5 ±3.6 vs no abortion 7.2 ±1.5%; p < 0.001). None of the women with an abortion had consulted a diabetologist before conception. The prevalence of congenital malformations ininfants of diabetic mothers was significantly higher compared with that of women without DM (17.6 vs 3.1%; p < 0.001). Mothers of those infants with congenital malformations had a significantly higher Hba1c before conception (8.7 ±1.7 vs 7.5 ±1.7%; p < 0.03), displayed significantly higher mean blood glucose (5-8 gestational week 8.0 ±1.7 vs 6.4 ±1.4 mmol/l; p < 0.01. 9-12 gestational week: 5.8 ±1.0 vs 7.1 ±1.8 mmol/l; p < 0.01) and had their first visit to a diabetologist at a later date (17 ±9 versus 10 ±6 gestational week; p < 0.001). Conclusion: The cause of frequent infant congenital malformations and abortions of mothers with DM is hyperglycemia during conception and the 1st trimenon and the lack of special care by diabetologists during these periods. Mothers of those children without congenital malformations typical for DM had a near normoglycemic glycemic cont

关键词：新生儿先天畸形平均血糖水平新生儿畸形确诊妊娠围生期糖代谢妊娠结局先天性畸形专科医师

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特发性扩张型心肌病患者血清胆固醇水平的预后意义

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世界核心医学期刊文摘（心脏病学分册） 2006年第8期2卷 23-24页

作者： Christ M. Klima T. Grimm W. 杨海涛(译) 孙凯(校) klinik für innere Medizin Kardiologie und Intensivmedizin Philipps University Marburg Baidingerstrafie D35033 Marburg Germany 不详

Aims: Previous studies indicate that low cholesterol levels are associated with adverse prognosis in heart failure patients, because elevated lipoprotein levels may negate bacterial endotoxin load induced by gastrointestinal congestion. Methods and results: We examined the prognostic significance of lipid levels in a cohort of 422 patients with idiopathic dilated cardiomyopathy(iDCM) [50± 12 years, 342 males, 80 females, left ventricular ejection fraction(LV-EF): 31.6± 10.6% ]. During 42 months of follow-up, 86 patients(20.3% ) died or received a heart transplant. In univariate Cox regression analysis, reduced LV-EF, high New York Heart Association(NYHA) class, and increased LV end-diastolic diameter(LVEDD) were strong risk factors associated with that endpoint, whereas decreased total cholesterol, HDL-cholesterol, and apoprotein I levels were identified as weak risk predictors. After step-wise multivariable analysis, only LVEDD, NYHA class, and LV-EF emerged as parameters independently contributing to the model predicting risk for death or heart transplantation(P< 0.05). Cholesterol levels were positively associated with LV-EF and negatively associated with LVEDD(P< 0.05). Circulating sCD14 levels, a marker of endotoxin exposure, were related to cholesterol levels(P< 0.05) and LV-EF(P< 0.05). Conclusion: Decreased cholesterol levels do not independently predict adverse prognosis in patients with iDCM. Our findings indicate that low cholesterol levels are dependent on the severity of cardiac disease.

关键词：扩张型心肌病患者胆固醇水平特发性预后意义多元逐步回归分析左心室射血分数 Cox回归分析血清心力衰竭患者预后预测

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粒细胞集落刺激因子动员骨髓细胞治疗急性心肌梗死患者

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 25-26页

作者： Kuethe F. Figulla H. R. Herzau M. 高登峰 Dr.klinik fuer innere Medizin I Friedrich-Schiller-Universitaet Jena Erlanger Allee 101 D-07740 Jena Germany

Background: This study was undertaken to evaluate the hypothesis that treatment with granulocyte colony-stimu-lating factor(G-CSF) to mobilize bone marrow cells(BMCs) is feasible and safe and promotes neovascularization and myocardial function in patients with acute myocardial infarction. Methods: Fourteen patients in the treatment group and 9 patients in the control group were enrolled in this prospective, nonrandomized, open-label study. Forty-eight hours after successful recanalization and stent implantation, the patients of the treatment group received 10 μg/kg body weight per day G-CSF subcutaneously for mean treatment duration of 7.0±1.0 days. Nine patients fulfilled the entry criteria but refused participation and served therefore as control group. In both groups, regional wall motion and perfusion was evaluated with electrocardiogram-gated sestamibi single-photon emission computed tomography imaging and ejection fraction with radionuclidventriculography before discharge and after 3 months. Results: No severe side effects of G-CSF treatment were observed. There was a significant improvement of the regional wall motion and perfusion within the treatment group(P< .0001) and between the treatment and control group(P< .05 and P< .01, respectively). Ejection fraction in the treatment group increased from 0.40±0.11 to 0.48±0.13(P< .01), whereas in the control group, ejection fraction increased from 0.40±0.13 to 0.43±0.13(P=.049). A control angiography of the treatment group after 12.4±6.6 months showed an in-stent restenosis in 1 patient. Conclusion: In patients with acute myocardial infarction, treatment with G-CSF to mobilize BMCs is feasible and safe and seems to be effective under clinical conditions. The therapeutic effect might be attributed to BMC-associated promotion of myocardial regeneration and neovasculariza-tion.

关键词：粒细胞集落刺激因子心肌梗死患者细胞治疗骨髓细胞单光子发射计算机体层摄影急性 G-CSF动员心肌功能恢复新生血管形成局部室壁运动

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ALT水平维持正常的慢性丙型肝炎患者抗病毒治疗中的病毒动力学

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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 38-39页

作者： Kronenberger B. Herrmann E. Micol F. et al. S. Zeuzem 翟惠虹 klinik für innere Medizin II Universitatsklinikum des Saarlandes Kirrberger Strasse D-66421 Homburg/Saar Germany Dr.

The aim of the present study was to compare viral kinetics between patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels and those with elevated ALT levels. Kinetic parameters were derived from nonlinear, least square fitting of serum hepatitis C virus RNA quantifications collected from patients with chronic hepatitis C and persistently normal (n = 20) and elevated (n = 19) ALT levels before and during treatment with 180 μg pegylated interferon α-2a once weekly plus daily ribavirin. Patients with chronic hepatitis C and persistently normal ALT levels showed a trend to lower pre-treatment infected cell loss (δ) (P = .13) but no differences in efficacy of blocking virus production (ε)and infected cell loss during treatment (mδ) compared with patients with elevated ALT levels. Differences were significant for ε(P = .02) and δ(P = .04) when applying updated “healthy”levels for ALT (0.75 times and 0.63 times upper limit of normal for male and female patients, respectively). A significant reduction of the kinetic parameters , δ,and mδwas observed in patients with elevated γ-glutamyltranspeptidase (GGT) levels compared with patients with normal GGT levels (P = .02, P = .005, and P = .02, respectively). In conclusion, viral kinetics are similar in patients with chronic hepatitis C and persistently normal ALT levels and those with elevated ALT levels. However, in patients with elevated GGT levels, a major association with reduced efficacy of blocking virus production and lower infected cell loss was observed. These data show that virological response in patients with chronic hepatitis C is less associated with baseline ALT than with GGT levels.

关键词：慢性丙型肝炎 ALT水平抗病毒干扰素α 丙型肝炎患者丙氨酸转氨酶拟合值感染细胞定量的转肽酶

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干扰素α-2a加利巴韦林联用或不用金刚烷胺对慢性丙型肝炎病毒基因1型感染者的治疗:一项随机、双盲、安慰剂对照研究

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世界核心医学期刊文摘（胃肠病学分册） 2006年第5期2卷 50-51页

作者： Ferenci P. Formann E. Laferl H. 刘丽娜 Univ. klinik für innere Medizin IV Medical University of Vienna AKH Waehringer Guertel 18-20 A 1090 Wien Austria

Background/Aims: Amantadine may augment virological response rates to interferon-based therapy in chronic hepatitis C patients. Using a novel design, amantadine was studied in na ve genotype 1 patients treated in combination with peginterferon alfa-2a (40KD)/ribavirin. Methods: Patients enrolled in this randomized, placeo-controlled multicenter trial were stratified by single-dose interferon sensitivity (stratum I, 24 h HCV-RNA decline >1.4log 10; II, 0.8-1.39log10; III, < 0.8log10; a reliable means of identifying nonresponders to interferon/ribavirin) and fibrosis grade (F0/1/2 vs. F3/4) at baseline. All patients received peginterferon alfa-2a (40KD) 180 μ g/week plus ribavirin 1000-1200 mg/day and were randomized to receive amantadine 100 mg twice daily (N=114) or placebo (N=95) for 48 weeks. Results: Week 24 virological response rates in strata II and III, the primary outcome, were similar in patients treated with amantadine (63.7% ) or placebo (65.7% ), as were sustained virological response rates at week 72 (46.5 and 51.6% , respectively). Adverse event profiles were similar and amantadine did not improve health-related quality of life compared with placebo. Interferon sensitivity was the only significant predictor of treatment outcome. Conclusions: Adding amantadine to peginterferon alfa-2a (40KD)/ribavirin combination therapy does not augment virological response rates in genotype 1 patients. Virological response was almost exclusively determined by interferon sensitivity at baseline.

关键词：干扰素α-2α 慢性丙型肝炎安慰剂对照金刚烷胺利巴韦林治疗基础病毒基因随机对照研究 1型

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借助电生理标测系统对房性和室性心律失常进行高频电消除治疗

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德国医学 2000年第2期17卷 105-106,114页

作者： L.Seipel 刘启功 Abteilung innere Medizin Ⅲ Medizinische Klinik und PoliklinikUniversittsklinikum TbingenGermany 同济医科大学附属同济医院

70年代末,巴黎的Fontaine G发现,通过希氏束导管发放直流电可引起完全性房室传导阻滞(CAVB)。以后将其用于药物无效的室上性心动过速(SVT),并不断尝试采用新方法,其中由直流电休克过渡到射频电流导管消融(RFCA)是一重大突破。但是,寻找... 详细信息

70年代末,巴黎的Fontaine G发现,通过希氏束导管发放直流电可引起完全性房室传导阻滞(CAVB)。以后将其用于药物无效的室上性心动过速(SVT),并不断尝试采用新方法,其中由直流电休克过渡到射频电流导管消融(RFCA)是一重大突破。但是,寻找心律失常起源点的问题仍未解决。这里采用的导管标测技术象以前手术治疗室性心律失常一样,用导管逐点标测心房和心室,直至找到心律失常起源点,不同的是前者须借助于X线。

关键词：房性心律失常室性心律失常电生理高频电

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Comprehensive review of diagnostic modalities for early chronic pancreatitis

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World Journal of Gastroenterology 2021年第27期27卷 4342-4357页

作者： Qi-Chao Ge Christoph F Dietrich Manoop S Bhutani Bao-Zhen Zhang Yue Zhang Yi-Dan Wang Jing-JingZhang Yu-Fan Wu Si-Yu Sun Jin-Tao Guo Department of Gastroenterology Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina Department Allgemeine innere Medizin Salem und PermanenceBern CH-3000Switzerland Department of Gastrointestinal Hepatology and NutritionThe University of Texas MD Anderson Cancer CenterHoustonTX 77030United States

Chronic pancreatitis(CP)is a progressive condition caused by several factors and characterised by pancreatic fibrosis and ***,CP is difficult to diagnose at an early *** advanced methods including endoscopic ultrasound based elastography and confocal laser endomicroscopy have been used to diagnose early CP,although no unified diagnostic standards have been *** the past,the diagnosis was mainly based on imaging,and no comprehensive evaluations were *** review describes and compares the advantages and limitations of the traditional and latest diagnostic modalities and suggests guidelines for the standardisation of the methods used to diagnose early CP.

关键词： Chronic pancreatitis Pancreatic fibrosis Early diagnosis Ultrasound endoscopy Endosonography Elastography Confocal laser endomicroscopy

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克隆病的长期治疗观察

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德国医学 1994年第4期11卷 204-205页

作者： J.Schlmerich 王思元 klinik und Poliklinik für innere Medizin 1 Universitt RegensburgGermany 同济医科大学附属同济医院

克隆病的治疗包括二个方面:一是急性发作的治疗,二是根据该病反复发作的特征进行长期治疗。急性发作的治疗常用类甾醇类药,近来也有应用大剂量5-氨基水杨酸治疗,约80%以上患者有效。长期治疗目的旨在维持缓解,又分为慢性活动性或顽固性... 详细信息

克隆病的治疗包括二个方面:一是急性发作的治疗,二是根据该病反复发作的特征进行长期治疗。急性发作的治疗常用类甾醇类药,近来也有应用大剂量5-氨基水杨酸治疗,约80%以上患者有效。长期治疗目的旨在维持缓解,又分为慢性活动性或顽固性克隆病的治疗和预防并发症的治疗,其疗效如何,至今尚不明确。

关键词：克隆病维持缓解期类甾醇治疗

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Prospective cohort comparison of flavonoid treatment in patients with resected colorectal cancer to prevent recurrence

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World Journal of Gastroenterology 2008年第14期14卷 2187-2193页

作者： Harald Hoensch Bertram Groh Lutz Edler Wilhelm Kirch Kreiskrankenhaus Gross-Gerau Innere AbteilungWilhelm-Seipp-StrasseGross-Gerau D64521Germany Department of Clinical Pharmacology Medical FacultyTechnical University Dresden Fiedler Strasse 27 Dresden D01307 Germany German Cancer Research Center Division of BiostatisticsIm Neuenheimer Feld 280 Heidelberg D69120 Germany

AIM: To investigate biological prevention with flavonoids the recurrence risk of neoplasia was studied in patients with resected colorectal cancer and after adenoma polypectomy. METHODS: Eighty-seven patients, 36 patients with resected colon cancer and 51 patients after polypectomy, were divided into 2 groups: one group was treated with a flavonoid mixture (daily standard dose 20 mg apigenin and 20 mg epigallocathechin-gallat, n = 31) and compared with a matched control group (n = 56). Both groups were observed for 3-4 years by surveillance colonoscopy and by questionnaire. RESULTS: Of 87 patients enrolled in this study, 36 had resected colon cancer and 29 of these patients had surveillance colonoscopy. Among the flavonoid-treated patients with resected colon cancer (n = 14), there was no cancer recurrence and one adenoma developed. In contrast the cancer recurrence rate of the 15 matched untreated controls was 20% (3 of 15) and adenomas evolved in 4 of those patients (27%). The combined recurrence rate for neoplasia was 7% (1 of 14) in the treated patients and 47% (7 of 15) in the controls (P = 0.027). CONCLUSION: Sustained long-term treatment with a flavonoid mixture could reduce the recurrence rate of colon neoplasia in patients with resected colon cancer.

关键词： Flavonoids Colorectal cancer Recurrence risk Intestinal neoplasia Colon polyps

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心力衰竭病理生理变化的现代认识

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德国医学 1994年第3期11卷 147-148页

作者： M.Bhm D.J.Beuckelmann R.H.G.Schwinger E.Erdmann 王琳 klinik Ⅲ fǜr innere Medizin der Universitt zu Kln Germany 同济医科大学附属同济医院

各种心脏病均可致心脏泵功能下降,心输出量减少,机体为满足重要器官血液供应,一方面通过神经内分泌,另一方面靠心脏本身进行代偿。近年来对移植心脏标本的研究,对其代偿机制有进一步认识。心肌收缩力的调节 1.钙内环境:心肌收缩力与心... 详细信息

各种心脏病均可致心脏泵功能下降,心输出量减少,机体为满足重要器官血液供应,一方面通过神经内分泌,另一方面靠心脏本身进行代偿。近年来对移植心脏标本的研究,对其代偿机制有进一步认识。心肌收缩力的调节 1.钙内环境:心肌收缩力与心肌细胞内钙离子(Ca2+)浓度有关,而胞浆中 Ca2+浓度变化受细胞膜通道、肌浆网及其与蛋白质结合状况的控制。

关键词：心力衰竭病理生理学

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