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Hemispheric differences in the surgical outcomes of patients with traumatic acute subdural hematoma. 外伤性急性硬膜下血肿患者手术结果的半球差异。
Pub Date : 2014-05-31 DOI: 10.1186/1477-5751-13-10
Joji Inamasu, Mitsuhiro Hasegawa, Takuro Hayashi, Yoko Kato, Yuichi Hirose

Background: Our assumption that prognosis of patients with traumatic acute subdural hematoma (ASDH) does not differ significantly according to the hemispheric laterality has never been verified.

Methods: A review of the charts/radiographic images of 61 adult traumatic ASDH patients (33 left/28 right) was conducted. Intergroup comparison was made on the demographics, autonomic/laboratory data, and outcomes (90-day mortality rate). Based on the presence of concomitant brain contusion, patients were further quadrichotomized as: left ASDH with contusion (n = 14), right ASDH with contusion (n = 16), left ASDH without contusion (n = 19), and right ASDH without contusion (n = 12). Comparisons were made on demographic and outcome variables between the left ASDH with contusion and right ASDH with contusion, and between the left ASDH without contusion and right ASDH without contusion. Multivariate regression analysis was conducted to identify clinical variables correlated with fatality.

Results: There were no significant differences in the demographic, autonomic, and laboratory data between the left and right ASDH patients. However, 90-day mortality rate was significantly higher in the left ASDH patients when concomitant contusion was present (79% vs. 25%, p = 0.009). However, there were no significant hemispheric differences in the mortality rate among those without contusion (32% vs. 33%, p = 0.77). Multivariate regression analysis showed that left ASDH was correlated with fatality among those with contusion (OR: 6.620; 95% CI: 1.219-46.249).

Conclusions: This study is probably the first to report that the left ASDH patients fared substantially worse than the right-sided counterparts. Future trials on traumatic ASDHs may benefit from considering hemispheric differences in the outcomes.

背景:我们的假设是,创伤性急性硬膜下血肿(ASDH)患者的预后并没有根据半球偏侧性而有显著差异,但这一假设尚未得到证实。方法:对61例成人外伤性ASDH患者(左33例/右28例)的影像学资料进行回顾性分析。在人口统计学、自主/实验室数据和结局(90天死亡率)方面进行组间比较。根据合并脑挫伤的情况,将患者进一步四分法分为:左侧ASDH合并挫伤(n = 14)、右侧ASDH合并挫伤(n = 16)、左侧ASDH未挫伤(n = 19)、右侧ASDH未挫伤(n = 12)。比较左ASDH有挫伤与右ASDH有挫伤、左ASDH无挫伤与右ASDH无挫伤的人口学和结局变量。多因素回归分析确定与病死率相关的临床变量。结果:左、右ASDH患者在人口学、自主神经和实验室数据方面无显著差异。然而,合并挫伤的左侧ASDH患者90天死亡率明显更高(79% vs. 25%, p = 0.009)。然而,无挫伤组的死亡率在半球上没有显著差异(32%对33%,p = 0.77)。多因素回归分析显示,挫伤患者的左ASDH与病死率相关(OR: 6.620;95% ci: 1.219-46.249)。结论:这项研究可能是第一个报道左侧ASDH患者比右侧ASDH患者表现明显更差的研究。未来对创伤性泛自闭症障碍的试验可能会受益于考虑半球差异的结果。
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引用次数: 5
Modifiable cardiovascular disease risk factors as predictors of dementia death: pooling of ten general population-based cohort studies. 可改变的心血管疾病风险因素是痴呆症死亡的预测因素:汇集十项基于普通人群的队列研究。
Pub Date : 2014-05-23 DOI: 10.1186/1477-5751-13-8
G David Batty, Tom C Russ, John M Starr, Emmanuel Stamatakis, Mika Kivimäki

Background: With drug treatment for dementia being of limited effectiveness, the role of primary prevention, in particular the predictive value of modifiable cardiovascular disease risk factors, may warrant exploration. The evidence base is, however, characterised by discordant findings and is modest in size. Accordingly, we examined the association of modifiable cardiovascular disease risk factors with dementia death.

Design and methods: We pooled raw data from 10 UK general population-based prospective cohort studies within the context of an individual participant meta-analysis.

Results: A total of 103,764 men and women were followed up for a mean of 8 years giving rise to 443 dementia-related deaths and 2612 cardiovascular disease deaths. Cardiovascular disease mortality was, as anticipated, associated with the full range of risk factors under study, including raised blood pressure, smoking, diabetes, physical inactivity. By contrast, dementia death was related to very few of the cardiovascular disease risk factors: of those classified as modifiable, only smoking was associated with a raised risk and higher levels of non-HDL with a lower risk.

Conclusions: In the present individual participant meta-analysis, there was limited evidence that cardiovascular disease risk factors were related to dementia death.

背景:由于药物治疗痴呆症的效果有限,因此有必要探讨一级预防的作用,特别是可改变的心血管疾病风险因素的预测价值。然而,证据基础的特点是研究结果不一致,而且规模不大。因此,我们研究了可改变的心血管疾病风险因素与痴呆症死亡之间的关系:设计与方法:我们在个体参与者荟萃分析的背景下,汇集了英国 10 项基于普通人群的前瞻性队列研究的原始数据:共对 103,764 名男性和女性进行了平均为期 8 年的跟踪调查,结果显示与痴呆症相关的死亡人数为 443 人,心血管疾病死亡人数为 2612 人。正如预期的那样,心血管疾病死亡与研究中的所有风险因素有关,包括血压升高、吸烟、糖尿病和缺乏运动。相比之下,痴呆症的死亡与极少数心血管疾病风险因素有关:在被归类为可改变的风险因素中,只有吸烟与风险升高有关,而非高密度脂蛋白水平升高与风险降低有关:在本项个体参与者荟萃分析中,只有有限的证据表明心血管疾病风险因素与痴呆症死亡有关。
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引用次数: 0
Remembering Yoshifumi Ninomiya. 记住吉夫美二宫。
Pub Date : 2014-04-23 DOI: 10.1186/1477-5751-13-7
Bjorn R Olsen
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引用次数: 0
Pretreatment with Saccharomyces boulardii does not prevent the experimental mucositis in Swiss mice. 博氏酵母预处理不能预防瑞士小鼠的实验性粘膜炎。
Pub Date : 2014-04-11 DOI: 10.1186/1477-5751-13-6
Tatiani Uceli Maioli, Brenda de Melo Silva, Michelle Nobre Dias, Nivea Carolina Paiva, Valbert Nascimento Cardoso, Simone Odilia Fernandes, Cláudia Martins Carneiro, Flaviano Dos Santos Martins, Simone de Vasconcelos Generoso

Background: The antimetabolite chemotherapy 5-Fluorouracil is one of the most commonly prescribed drugs in clinical cancer treatment. Although this drug is not specific for cancer cells and also acts on healthy cells, it can cause mucositis, a common collateral effect. Dysbiosis has also been described in 5-fluorouracil-induced mucositis and is likely to contribute to the overall development of mucositis. In light of this theory, the use of probiotics could be a helpful strategy to alleviate mucositis. So the aim of this study was evaluate the impact of the probiotic Saccharomyces boulardii in a model of mucositis.

Results: After induced of mucositis, mice from the Mucositis groups showed a decrease in food consumption (p < 0.05) and therefore had a greater weight loss (p < 0.05). The treatment with Saccharomyces boulardii did not reverse this effect (p > 0.05). Mucositis induced an increase in intestinal permeability and intestinal inflammation (p < 0.05). There were no differences in mucosal lesions, intestinal permeability and sIgA secretion (p > 0.05) in mice pretreated with S. boulardii.

Conclusions: S. boulardii was not able to prevent the effects of experimental mucositis induced by 5- Fluorouracil.

背景:抗代谢物化疗药物5-氟尿嘧啶是临床肿瘤治疗中最常用的药物之一。虽然这种药物不是针对癌细胞的,也对健康细胞起作用,但它会引起粘膜炎,这是一种常见的附带效应。在5-氟尿嘧啶诱导的粘膜炎中也描述了生态失调,并可能导致粘膜炎的全面发展。根据这一理论,使用益生菌可能是缓解黏膜炎的有效策略。因此,本研究的目的是评估益生菌博氏酵母菌对粘膜炎模型的影响。结果:粘膜炎诱导后,各黏膜炎组小鼠食量明显减少(p < 0.05)。粘膜炎诱导博氏弓形虫预处理小鼠肠道通透性和肠道炎症增加(p 0.05)。结论:博氏弧菌对5-氟尿嘧啶诱导的实验性粘膜炎无明显的抑制作用。
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引用次数: 35
Urinary concentrations of ADAM 12 from breast cancer patients pre- and post-surgery vs. cancer-free controls: a clinical study for biomarker validation. 乳腺癌患者手术前后与无癌对照的尿液ADAM - 12浓度:一项生物标志物验证的临床研究
Pub Date : 2014-04-01 DOI: 10.1186/1477-5751-13-5
Erin K Nyren-Erickson, Michael Bouton, Mihir Raval, Jessica Totzauer, Sanku Mallik, Neville Alberto

Background: The ADAMs (A Disintegrin and Metalloproteinases) are a family of multi-domain, zinc-dependent metalloproteinase enzymes. ADAM 12 has been previously associated with the onset and progression of breast cancer, and elevated levels of ADAM 12 have been previously found in the urine of breast cancer patients. Aims of the current study are: 1) establish the viability of urinary ADAM 12 as a diagnostic marker for breast cancer, and 2) explore the effects of surgical tumor removal on the levels of urinary ADAM 12.

Methods: A total of 96 patients have been recruited for this study, including 50 patients diagnosed with cancer, and 46 age-matched controls. Commercially available ELISA kits for ADAM 12 were used to quantify the presence and concentration of this enzyme in the urine from cancer patients with ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC) both prior to any treatment and approximately two weeks following surgery, as well as from controls.

Results: We find no statistically significant differences between the concentrations of ADAM 12 in the urine of breast cancer patients prior to treatment and that of their age-matched controls; however the concentration of ADAM 12, both alone and as a function of urine total protein, are significantly elevated following surgery (p < 0.0001). Patients who underwent a mastectomy have significantly higher urinary ADAM 12 concentrations than those who underwent a lumpectomy (significant at p = 0.0271).

Conclusions: These findings suggest that urinary ADAM 12 may not correlate directly with the status and stage of breast cancer as previously thought; rather these increases may be a result of tissue injury and inflammation from biopsy and surgical resection. Results of this study may suggest a need for biomarkers to be evaluated carefully in the context of tissue damage.

背景:ADAMs (A Disintegrin and Metalloproteinases)是一个多结构域、锌依赖性的金属蛋白酶家族。ADAM - 12先前与乳腺癌的发病和进展有关,并且在乳腺癌患者的尿液中发现ADAM - 12水平升高。本研究的目的是:1)建立尿ADAM - 12作为乳腺癌诊断标志物的可行性;2)探讨手术切除肿瘤对尿ADAM - 12水平的影响。方法:本研究共招募了96例患者,其中50例诊断为癌症,46例年龄匹配的对照组。ADAM 12的市售ELISA试剂盒用于量化患有导管原位癌(DCIS)和浸润性乳腺癌(IBC)的癌症患者在任何治疗前和手术后约两周以及对照患者尿液中该酶的存在和浓度。结果:我们发现乳腺癌患者治疗前尿液中ADAM - 12的浓度与同龄对照组之间无统计学差异;然而,手术后,adam12的浓度,无论是单独的还是作为尿总蛋白的函数,都显著升高(p < 0.0001)。接受乳房切除术的患者尿中ADAM - 12浓度明显高于接受乳房肿瘤切除术的患者(p = 0.0271)。结论:这些发现提示尿ADAM - 12可能不像之前认为的那样与乳腺癌的状态和分期直接相关;相反,这些增加可能是组织损伤和活检和手术切除引起的炎症的结果。这项研究的结果可能表明,在组织损伤的背景下,需要仔细评估生物标志物。
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引用次数: 6
Clock gene Bmal1 is dispensable for intrinsic properties of murine hematopoietic stem cells. 时钟基因Bmal1对小鼠造血干细胞的内在特性是不可或缺的。
Pub Date : 2014-03-08 DOI: 10.1186/1477-5751-13-4
Aki Ieyasu, Yoko Tajima, Shigeki Shimba, Hiromitsu Nakauchi, Satoshi Yamazaki

Background: Circadian rhythms are known to influence a variety of biological phenomena such as cell cycle, sleep-wake rhythm, hormone release and other important physiological functions. Given that cell cycle entry of hibernating hematopoietic stem cells (HSCs) plays a critical role in controlling hematopoiesis, we asked functional significance of the clock gene Bmal1, which plays a central role in regulating circadian rhythms as a transcription factor. Here we investigated the necessity of Bmal1 for HSC functions using Bmal1 deficient (Bmal1⁻/⁻) mice.

Findings: Using colony-forming assays in vitro, we found that the frequency of mixed colony formation between Bmal1⁺/⁺ and Bmal1⁻/⁻ CD34-KSL cells does not differ significantly. Competitive bone marrow assays also revealed that Bmal1⁻/⁻ bone marrow cells competed normally with wild-type cells and displayed long-term multi-hematopoietic lineage reconstitution. In addition, there were no significant differences in the frequencies and hibernation state of bone marrow HSCs between Bmal1⁺/⁺ and Bmal1⁻/⁻ mice, suggesting that they are independent of circadian rhythms.

Conclusions: This paper discusses the necessity of circadian rhythms for HSC functions. Our data clearly shows that a key circadian clock gene Bmal1 is dispensable for intrinsic functions of HSCs, such as differentiation, proliferation and repopulating ability.

背景:众所周知,昼夜节律影响多种生物现象,如细胞周期、睡眠-觉醒节律、激素释放和其他重要生理功能。鉴于冬眠造血干细胞(HSCs)的细胞周期进入在控制造血过程中起着关键作用,我们询问了作为转录因子在调节昼夜节律中起核心作用的时钟基因 Bmal1 的功能意义。在此,我们利用 Bmal1 缺失(Bmal1-/-)小鼠研究了 Bmal1 对造血干细胞功能的必要性:通过体外集落形成试验,我们发现 Bmal1⁺/⁺和 Bmal1-/- CD34-KSL 细胞形成混合集落的频率没有显著差异。骨髓竞争试验也显示,Bmal1-/-骨髓细胞与野生型细胞竞争正常,并显示出长期的多造血系重建。此外,Bmal1⁺/⁺和Bmal1-/-小鼠骨髓造血干细胞的频率和冬眠状态没有明显差异,表明它们不受昼夜节律的影响:本文讨论了昼夜节律对造血干细胞功能的必要性。我们的数据清楚地表明,一个关键的昼夜节律基因Bmal1对于造血干细胞的内在功能(如分化、增殖和再繁殖能力)是不可或缺的。
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引用次数: 9
Physical activity and the risk of postmenopausal breast cancer - the Norwegian Women and Cancer Study. 体育活动和绝经后乳腺癌的风险——挪威妇女和癌症研究。
Pub Date : 2014-03-01 DOI: 10.1186/1477-5751-13-3
Kristin Benjaminsen Borch, Eiliv Lund, Tonje Braaten, Elisabete Weiderpass

Background: The relationship between physical activity (PA) throughout life and the risk of postmenopausal breast cancer overall and by estrogen receptor (ER) and progesterone receptor (PR) status, has been reported, but without consistent results. The present study aimed to investigate PA from young age to adulthood in participants of the Norwegian Women and Cancer (NOWAC) Study, in order to determine whether changes in PA level affect the risk of postmenopausal breast cancer.

Methods: 1767 invasive breast cancer cases were identified among 80,202 postmenopausal participants of the NOWAC Study during 8.2 years of median follow-up. PA levels at age 14 years, 30 years and at cohort enrollment were obtained via a self-administered questionnaire. Multivariate Cox proportional hazard regression models were used to estimate relative risks and 95% confidence intervals of the risk of postmenopausal breast cancer overall and by ER/PR status.

Results: Risk of postmenopausal breast cancer overall and by ER/PR status was not associated with physical activity level at enrollment. Women with a low PA level at age 30 had an increased risk of ER+/PR + breast tumors (P for trend = 0.04) compared to women with a moderate physical activity level at age 30. Women with a low physical activity level at all three periods of life had a 20% significantly reduced risk of postmenopausal breast cancer, as well as a reduced risk of ER+/PR + and ER+/PR- breast tumors, compared with women who maintained a moderate physical activity level. However, when analyses were corrected for multiple tests, the result was no longer statistically significant. The findings were consistent over strata of age, body mass index and use of hormone replacement therapy.

Conclusions: The study results from this large Norwegian cohort do not support an association between physical activity at different periods of life and the risk of postmenopausal breast cancer.

背景:一生中体力活动(PA)与绝经后乳腺癌风险之间的关系,以及与雌激素受体(ER)和孕激素受体(PR)状态的关系,已经有报道,但没有一致的结果。本研究旨在调查挪威妇女与癌症研究(NOWAC)参与者从年轻到成年的PA水平,以确定PA水平的变化是否会影响绝经后乳腺癌的风险。方法:在NOWAC研究的80202名绝经后参与者中,在8.2年的中位随访中发现了1767例浸润性乳腺癌病例。在14岁、30岁和队列登记时,通过自我管理的问卷获得PA水平。采用多变量Cox比例风险回归模型估计绝经后乳腺癌总体风险和ER/PR状态的相对风险和95%置信区间。结果:绝经后乳腺癌的总体风险和ER/PR状态与入组时的身体活动水平无关。30岁时PA水平低的女性患ER+/PR +乳腺肿瘤的风险比30岁时运动水平适中的女性高(趋势P = 0.04)。与保持适度体育锻炼水平的女性相比,在所有三个生命周期中体育锻炼水平较低的女性患绝经后乳腺癌的风险显著降低20%,ER+/PR +和ER+/PR-乳腺肿瘤的风险也降低了20%。然而,当对多个测试进行修正分析时,结果不再具有统计学意义。这一发现在年龄、体重指数和激素替代疗法的使用中都是一致的。结论:这项来自挪威大型队列的研究结果不支持生命不同时期的体育活动与绝经后乳腺癌风险之间的联系。
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引用次数: 22
Opening peer-review: the democracy of science. 开放同行评议:科学的民主。
Pub Date : 2014-01-24 DOI: 10.1186/1477-5751-13-2
Daniel R Shanahan, Bjorn R Olsen
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引用次数: 16
Journal of Negative Results in BioMedicine 生物医学阴性结果杂志
Pub Date : 2014-01-20 DOI: 10.1186/1477-5751-13-1
Daniel R. Shanahan
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引用次数: 4
Prognostic limitations of the Eurotransplant-Donor Risk Index in liver transplantation. 欧洲移植供体风险指数在肝移植中的预后局限性。
Pub Date : 2013-12-24 DOI: 10.1186/1477-5751-12-18
Benedikt Reichert, Alexander Kaltenborn, Alon Goldis, Harald Schrem

Background: Liver transplantation is the only life-saving therapeutic option for end-stage liver disease. Progressive donor organ shortage and declining donor organ quality justify the evaluation of the leverage of the Donor-Risk-Index, which was recently adjusted to the Eurotransplant community's requirements (ET-DRI). We analysed the prognostic value of the ET-DRI for the prediction of outcome after liver transplantation in our center within the Eurotransplant community.

Results: 291 consecutive adult liver transplants were analysed in a single centre study with ongoing data collection. Determination of the area under the receiver operating characteristic curve (AUROC) was performed to calculate the sensitivity, specificity, and overall correctness of the Eurotransplant-Donor-Risk-Index (ET-DRI) for the prediction of 3-month and 1-year mortality, as well as 3-month and 1-year graft survival. Cut-off values were determined with the best Youden-index. The ET-DRI is unable to predict 3-month mortality (AUROC: 0.477) and 3-month graft survival (AUROC: 0.524) with acceptable sensitivity, specificity and overall correctness (54% and 56.3%, respectively). Logistic regression confirmed this finding (p = 0.573 and p = 0.163, respectively). Determined cut-off values of the ET-DRI for these predictions had no significant influence on long-term patient and graft survival (p = 0.230 and p = 0.083, respectively; Kaplan-Meier analysis with Log-Rank test).

Conclusions: The ET-DRI should not be used for donor organ allocation policies without further evaluation, e.g. in combination with relevant recipient variables. Robust and objective prognostic scores for donor organ allocation purposes are desperately needed to balance equity and utility in donor organ allocation.

背景:肝移植是终末期肝病唯一的救命治疗选择。供体器官持续短缺和供体器官质量下降证明了供体风险指数杠杆评估的合理性,该指数最近被调整为符合欧洲移植社区的要求(ET-DRI)。我们分析了ET-DRI在我们中心的欧洲移植社区中预测肝移植后预后的预后价值。结果:在一项持续收集数据的单中心研究中,分析了291例连续的成人肝移植。通过测定受者工作特征曲线(AUROC)下的面积,计算eurotransplantation - donor - risk - index (ET-DRI)预测3个月和1年死亡率以及3个月和1年移植物存活的敏感性、特异性和总体准确性。以最佳约登指数确定临界值。ET-DRI无法预测3个月死亡率(AUROC: 0.477)和3个月移植物存活率(AUROC: 0.524),敏感性、特异性和总体准确性均可接受(分别为54%和56.3%)。Logistic回归证实了这一发现(p = 0.573和p = 0.163)。这些预测的ET-DRI临界值对患者和移植物的长期生存没有显著影响(p = 0.230和p = 0.083);Kaplan-Meier分析,Log-Rank检验)。结论:ET-DRI不应在没有进一步评估的情况下用于供体器官分配政策,例如与相关受体变量相结合。为了平衡供体器官分配的公平性和实用性,迫切需要可靠和客观的供体器官分配预后评分。
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引用次数: 24
期刊
Journal of negative results in biomedicine
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