Usefulness of intravenous adenosine in idiopathic pulmonary arterial hypertension as a screening agent for identifying long-term responders to calcium channel blockers

Although intravenous adenosine is recommended for acute vasodilator testing in patients with pulmonary hypertension, long-term outcomes in acute responders treated with calcium channel blockers (CCBs) who are identified by adenosine remain unknown. In this study, the value of adenosine for identifying long-term responders to CCBs was investigated in patients with idiopathic pulmonary arterial hypertension (IPAH). All acute responders were subsequently treated with high-dose CCB monotherapy, and 6-minute walk distances, hemodynamic data, and World Health Organization functional classifications were followed. Nine of 104 patients exhibited an acute response with intravenous adenosine (8.7%, 95% confidence interval 3.2 to 14.2). After 12 months of follow-up, all acute responders were still alive; however, only 6 patients showed sustained hemodynamic improvement (5.8%, 95% confidence interval 2 to 13). Three patients had failed CCB monotherapy and bosentan was added to their treatment. Mean tolerated dose of intravenous adenosine was 142 ± 49 μg/kg/min. No life-threatening adverse events were observed and only 2 patients of the nonresponders exhibited a 20% decrease in mean systemic arterial pressure. In nonresponders, 1- and 3-year survival rates were 89% and 75%, respectively. In conclusion, acute vasodilator testing with intravenous adenosine was safe and able to screen responders to CCB therapy in patients with IPAH. Long-term CCB responders accounted for about 5.8% of patients with IPAH.     

CYP2E1RsaⅠ/PstⅠ位点多态性与口腔癌易感性的Meta分析

目的:运用Meta的分析方法研究CYP2E1 Rsa Ⅰ/Pst Ⅰ多态性与口腔癌易感性的相互关系.方法:检索VIP,CNKI和PubMed数据库中有关CYP2E1 Rsa Ⅰ/Pst Ⅰ多态性与口腔癌易感性关联研究的文献,以OR值和95％的可信区间为效应指标,应用Rev Man 4.2软件进行Meta分析,并使用STATA 11.0软件对发表偏倚进行检验.结果:纳入12个病例对照研究,共计1259例口腔癌患者和2262例正常对照,Meta分析结果显示,总人群中c1 /c2 vs.c1/c1(OR=1.30,95％CI=1.04～1.62),c1/c2+c2/c2 vs.c1/c1 (0R=1.32,95％CI=1.07-1.64).结论:CYP2E1突变基因型c2可能会增加口腔癌发生的风险.     

华东地区正常少年儿童舌骨位置变化与年龄及性别的相关性分析

目的:通过测量华东地区不同年龄少年儿童颌面CT上舌骨的位置,研究少年儿童生长发育期间舌骨位置的变化及性别差异.方法:从上海交通大学医学院附属第九人民医院拍摄的(拍摄日期从2009年9月至2010年8月)颌面CT中筛选出281例华东地区少年儿童的CT图像,年龄6～18岁,男141例,女140例.将研究对象根据年龄分为4组,第1组为6～9岁(66例),第2组为10～12岁(62例),第3组为13～15岁(81例),第4组为16～18岁(72例).将CT原始图像数据通过三位图形软件进行三维重建,确定正中矢状面,在正中矢状面上测量舌骨点前后、垂直及相对颅底的位置参数.应用SPSS 16.0软件包中的t检验及线性相关分析对数据进行统计学分析.结果:舌骨前后向及相对颅底的位置在各年龄组均无性别差异.第3组和第4组舌骨垂直向位置有性别差异.男性舌骨前后、垂直向及相对颅底位置和女性舌骨垂直向位置与年龄呈正相关.上、下颌骨的位置与舌骨的位置相关.结论:在儿童期,舌骨位置未表现出性别差异;少年期,男性舌骨位置更低.随着年龄变化,男性舌骨位置表现出更大的变化.上、下颌骨位置影响舌骨的位置.     

�����ڹ��Ԣ�������ϻ��μ���̶������о���չ

骨性Ⅲ类错(牙合)是临床上较为复杂的错(牙合)畸形,严重影响牙齿、颌骨及面部的发育.近年来,随着正畸材料的发展与正畸技术的不断提高,固定矫治器及其矫治技术得到蓬勃发展.本文对恒牙期骨性Ⅲ类错(牙合)畸形的固定矫治研究进展做一综述.