AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: Al...AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered.RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience.Univariate analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy.On multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for rebleeding and 6.90 for need of transfusion after the endoscopy.CONCLUSION: Endoscopist's experience is an important independent prognostic factor for non-variceal acute upper GI bleeding. Urgent endoscopy should be undertaken preferentially by a skilled endoscopist as less expert staff tends to underestimate some risk lesions with a negative influence on hemostasis.展开更多
目的探讨原发性肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达,并分析其意义。方法将154例原发性肝癌患者按中医辨证分为肝郁证(37例)、脾虚证(45例)、湿热证(18例)、血瘀证(28例)及阴虚证(26例),应用表面加强激光解析电离化飞...目的探讨原发性肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达,并分析其意义。方法将154例原发性肝癌患者按中医辨证分为肝郁证(37例)、脾虚证(45例)、湿热证(18例)、血瘀证(28例)及阴虚证(26例),应用表面加强激光解析电离化飞行时间质谱法(surface enhanced laser desorption ionization time of flight mass spectrometry,SELDI-TOF-MS)分析其血清蛋白指纹图谱,并结合中医证候特点,探讨肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达。结果介入前1周,M/Z为3392、4970、5911、6200、8575Da的血清蛋白峰在各证型间的表达比较,差异有统计学意义(P<0.05,P<0.01);上述5个差异蛋白峰同时出现于脾虚证和血瘀证中。介入后1周,阴虚证M/Z为8575Da的血清蛋白峰表达下调,差异有统计学意义(P<0.01)。结论肝癌介入治疗围手术期不同证型间出现血清差异蛋白质峰。展开更多
背景与目的:人卵巢浆液性乳头状腺癌细胞株SKOV3及其在裸鼠体内建立的淋巴结定向高转移亚克隆第二代SKOV3-pm2、第三代SKOV3-pm3细胞株,为卵巢癌转移分子机制的研究提供了细胞模型。本研究应用飞行时间质谱技术结合蛋白芯片分析筛选卵...背景与目的:人卵巢浆液性乳头状腺癌细胞株SKOV3及其在裸鼠体内建立的淋巴结定向高转移亚克隆第二代SKOV3-pm2、第三代SKOV3-pm3细胞株,为卵巢癌转移分子机制的研究提供了细胞模型。本研究应用飞行时间质谱技术结合蛋白芯片分析筛选卵巢癌淋巴结定向高转移与非定向转移细胞株之间的蛋白质表达差异。方法:采用动物实验测定SKOV3、SKOV3-pm2和SKOV3-pm3三种细胞株的淋巴结转移率。应用表面增强激光解吸离子化-飞行时间质谱(surface-enhanced laser desorption and ionization-time of flight-mass spectrometry,SELDI-TOF-MS)技术检测各细胞株提取的胞浆总蛋白和分泌蛋白,每种细胞分别采用CM-10型弱阳离子交换芯片和IMAC-3型固定金属亲和芯片检测。应用Ciphergen Protein Software3.2.0软件和Biomarker Wizard软件对采集3组细胞的蛋白峰进行比较,峰强度相差0.5倍以上者定义为差异蛋白。结果:动物实验显示,细胞株SKOV3及高转移亚克隆SKOV3-pm2、SKOV3-pm3的淋巴结转移率分别为20%、90%和100%,前者与后二者之间的差异有统计学意义(P<0.05)。获得CM-10和IMAC3两种蛋白芯片上SKOV3、SKOV3-pm2、SKOV3-pm3细胞株蛋白质谱图谱,对比发现:质荷比(m/z)为6971、7475、9089、9453、10103、11655的胞浆蛋白及质荷比(m/z)为4746的分泌蛋白在上述三种细胞株中存在不同程度差异表达。结论:应用SELDI-TOF-MS技术结合固定金属亲和芯片和弱阳离子交换芯片,可有效筛选卵巢癌淋巴结定向高转移特性细胞株中的特异性表达蛋白;寻找到的差异蛋白与淋巴结定向高转移潜能密切相关。展开更多
High-frequency S-wave seismogram envelopes of microearthquakes broaden with increasing travel distance,a phenomenon known as S-wave envelope broadening. Multiple forward scattering and diffraction for the random inhom...High-frequency S-wave seismogram envelopes of microearthquakes broaden with increasing travel distance,a phenomenon known as S-wave envelope broadening. Multiple forward scattering and diffraction for the random inhomogeneities along the seismic ray path are the main causes of S-wave envelope broadening,so the phenomenon of S-wave envelope broadening is used to study the inhomogeneity of the medium. The peak delay time of an S-wave,which is defined as the time lag from the direct S-wave onset to the maximum amplitude arrival of its envelope,is accepted to quantify S-wave envelope broadening. 204 small earthquake records in Changbaishan Tianchi volcano were analyzed by the S-wave envelope broadening algorithm. The results show that S-wave envelope broadening in the Changbaishan Tianchi volcano is obvious,and that the peak delay time of S-wave has a positive correlation with the hypocenter distance and frequency of the S-wave. The relationships between the S-wave peak delay time and the hypocenter distance for different frequency bands were obtained using the statistics method. The results are beneficial to the understanding of the S-wave envelope broadening phenomena and the quantitative research on the inhomogeneities of the crust medium in the Changbaishan Tianchi volcano region.展开更多
文摘AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered.RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience.Univariate analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy.On multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for rebleeding and 6.90 for need of transfusion after the endoscopy.CONCLUSION: Endoscopist's experience is an important independent prognostic factor for non-variceal acute upper GI bleeding. Urgent endoscopy should be undertaken preferentially by a skilled endoscopist as less expert staff tends to underestimate some risk lesions with a negative influence on hemostasis.
文摘目的探讨原发性肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达,并分析其意义。方法将154例原发性肝癌患者按中医辨证分为肝郁证(37例)、脾虚证(45例)、湿热证(18例)、血瘀证(28例)及阴虚证(26例),应用表面加强激光解析电离化飞行时间质谱法(surface enhanced laser desorption ionization time of flight mass spectrometry,SELDI-TOF-MS)分析其血清蛋白指纹图谱,并结合中医证候特点,探讨肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达。结果介入前1周,M/Z为3392、4970、5911、6200、8575Da的血清蛋白峰在各证型间的表达比较,差异有统计学意义(P<0.05,P<0.01);上述5个差异蛋白峰同时出现于脾虚证和血瘀证中。介入后1周,阴虚证M/Z为8575Da的血清蛋白峰表达下调,差异有统计学意义(P<0.01)。结论肝癌介入治疗围手术期不同证型间出现血清差异蛋白质峰。
文摘背景与目的:人卵巢浆液性乳头状腺癌细胞株SKOV3及其在裸鼠体内建立的淋巴结定向高转移亚克隆第二代SKOV3-pm2、第三代SKOV3-pm3细胞株,为卵巢癌转移分子机制的研究提供了细胞模型。本研究应用飞行时间质谱技术结合蛋白芯片分析筛选卵巢癌淋巴结定向高转移与非定向转移细胞株之间的蛋白质表达差异。方法:采用动物实验测定SKOV3、SKOV3-pm2和SKOV3-pm3三种细胞株的淋巴结转移率。应用表面增强激光解吸离子化-飞行时间质谱(surface-enhanced laser desorption and ionization-time of flight-mass spectrometry,SELDI-TOF-MS)技术检测各细胞株提取的胞浆总蛋白和分泌蛋白,每种细胞分别采用CM-10型弱阳离子交换芯片和IMAC-3型固定金属亲和芯片检测。应用Ciphergen Protein Software3.2.0软件和Biomarker Wizard软件对采集3组细胞的蛋白峰进行比较,峰强度相差0.5倍以上者定义为差异蛋白。结果:动物实验显示,细胞株SKOV3及高转移亚克隆SKOV3-pm2、SKOV3-pm3的淋巴结转移率分别为20%、90%和100%,前者与后二者之间的差异有统计学意义(P<0.05)。获得CM-10和IMAC3两种蛋白芯片上SKOV3、SKOV3-pm2、SKOV3-pm3细胞株蛋白质谱图谱,对比发现:质荷比(m/z)为6971、7475、9089、9453、10103、11655的胞浆蛋白及质荷比(m/z)为4746的分泌蛋白在上述三种细胞株中存在不同程度差异表达。结论:应用SELDI-TOF-MS技术结合固定金属亲和芯片和弱阳离子交换芯片,可有效筛选卵巢癌淋巴结定向高转移特性细胞株中的特异性表达蛋白;寻找到的差异蛋白与淋巴结定向高转移潜能密切相关。
基金sponsored by the National Key Technology R&D Program (2006BAC01B04)the Joint Earthquake Science Foundation (A08026,A07138),China
文摘High-frequency S-wave seismogram envelopes of microearthquakes broaden with increasing travel distance,a phenomenon known as S-wave envelope broadening. Multiple forward scattering and diffraction for the random inhomogeneities along the seismic ray path are the main causes of S-wave envelope broadening,so the phenomenon of S-wave envelope broadening is used to study the inhomogeneity of the medium. The peak delay time of an S-wave,which is defined as the time lag from the direct S-wave onset to the maximum amplitude arrival of its envelope,is accepted to quantify S-wave envelope broadening. 204 small earthquake records in Changbaishan Tianchi volcano were analyzed by the S-wave envelope broadening algorithm. The results show that S-wave envelope broadening in the Changbaishan Tianchi volcano is obvious,and that the peak delay time of S-wave has a positive correlation with the hypocenter distance and frequency of the S-wave. The relationships between the S-wave peak delay time and the hypocenter distance for different frequency bands were obtained using the statistics method. The results are beneficial to the understanding of the S-wave envelope broadening phenomena and the quantitative research on the inhomogeneities of the crust medium in the Changbaishan Tianchi volcano region.
