摘要：Objective:To evaluate risk factors for recurrent thrombosis in pediatric patients. study design:This prospective observational cohort study enrolled 120 patients with acute venous thromboembolism from January 2003 to April 2005. Datacollection included medical and family history,radiologic and laboratory studies,therapy,and follow-up. Results:The overall prevalence of recurrent thrombosis in our cohort was 19/120(15.8%). Patients with recurrence were older,with a median age of 14.8 years (range 2 weeks-23.6 years),compared with 10.1years (range newborn 23.4 years) in patients without recurrence(P = 0.03). six of the 19 patients with recurrent thrombosis had cystic fibrosis (CF),compared with 0/101without recurrence (P< 0.001). Five of these 6 patients were colonized with Burkholderia cepacia in their sputum. Central venous catheters were associated with m.s.,but not all,of the thromboses in patients with CF. Conclusions:In this study,patients with CF had a high risk of recurrent venous thrombosis,as well as a high prevalence of colonization with B cepacia. The cause of this risk has not been defined. This observation may have important implications for thromboprophylaxis,particularly in the setting of central venous catheters.

摘要：Objective: Optimizing the cut-off level for a single serum hCG determination around day 15 after oocyte retrieval or ovulation. study design: Retrospective data analysis. Results: 204 hCG samples >5 IU/L between march and October 1999 taken on day 14, 15 or 16 after oocyte retrieval in 204 patients undergoing IVF or ICsI were analyzed. ROC-curves and optimal cut-off levels to discriminate between viable and non-viable pregnancies were calculated for each day separately. Cut-off levels were found at 76, 142 and 223 IU/L for day 14, 15 and 16, respectively, and were verified by 487 hCG samples >5 IU/L taken between January 2000 and June 2004. Conclusions: A single serum hCG determination on day 14 or 15 is sufficient to discriminate viable pregnancies accurately from non-viable pregnancies.

摘要：印度的采矿工业已有一百多年的历史。然而事实证明:这个国家只有在摆脱殖民地枷锁以后,采矿工业才有了突飞猛进的发展。现在,无论在采煤部门还是在非采煤部门,生产能力都大幅度地增长了。与此同时,在矿物开采和选别生产中采用现代化技术,也是整个印度矿业界的重要特点。尽管采矿工业已经取得了长足的进步,但对于保护环境和生态平衡的必要性仍缺乏足够的重视。不过,近年来无论是政府机关还是非政府部门都越来越认识到采矿工业对环境和生态可能造成的不利影响和采取措施减轻这类有害影响的必要性。于是,从70年代中期起,政府就颁布了有关空气、水、噪声污染的各种法规,并设置了中央级和邦级的污染防治管理局。目前,项目甲方(project proponent)要从事矿石和矿物的开采以及延长矿区租用契约期限,就必须得到邦和中央政府有关部门的许可。为此,必须提交所谓“环境管理规划”(EmP),详细说明控制环境退化的各种方案。拥有30多年采矿和冶金工业的各种工作经验的印度冶金工程咨询公司(metallurgical &amp; Engineering Consultants(India)Ltd.,简称“mECON”)及时而果断地为采取行动作好了准备,以便应付各种环境同题和生态问题对这个国家提出的挑战。该公司已建立了正式的环境工程部,配备了各个不同学科的专家,装备了公司内部的各种现代化实验室。印度冶金工程咨询公司成功地完成了有关环境和生态同题方面的工作任务。该公司在矿业环境规划方面的贡献,既包括露天开采,也包括地下开采;在其环境管理规划中,该公司特别强调(与其他方面相比)合理设计排土场几何形状、矿坑水沉淀网(sedimentation network)、防渗帷幕(barrier mounds)、在项目所在地内部和四周建立绿化带以及采后土地的复垦和恢复。本文试图简要介绍印度冶金工程咨询公司在印度采矿和矿物工业环境管理规划方面的作用。该公司热切地希望继续为今天我们大家都关心的这个工业领域服务。

摘要：Objective:This study examines the operative details and complications of colorectal resection in patients with ovarian and primary peritoneal carcinoma. study design:Patients who underwent colorectal resection for ovarian and primary peritoneal cancer were identified in our surgical database for the period 1988 through 2002. Results:Of the 125 patients who were identified,73%were undergoing primary cytoreduction; 18%were undergoing secondary cytoreduction,and 7%were undergoing interval cytoreduction. The mean length of colon that was removed was 15.7 cm. The method of anastom.s.s was stapler in 63%and hand sewn in 22%; 15%patients had no anastom.s.s performed. A protective ostomy was used in 13%of patients. Optimal cytoreduction ( < 1 cm) was achieved in 74%. Operative complications occurred in 37%of patients,with the m.s. common being hemorrhage (25%). Anastomotic leaks occurred in 2.5%of the patients,and the m.s. common postoperative complication was ileus (28%). Postoperative bowel function returned to normal in 71%of patients. Conclusion:To obtain optimal cytoreduction in patients with ovarian cancer,colorectal resection often is necessary. Colorectal resection can be performed with a low risk of anastomotic complications,and patients frequently have the return of normal bowel function.

摘要：Background: Although fibrinolysis is effective in improving outcom.s.in sT- elevation myocardial infarction(sTEmI), failure to achieve reperfusion and/or reocclusion of the infarct- related artery occur in substantial proportions of patients during their index hospitalization and are associated with a significant increase in mortality. We hypothesize that the addition of clopidogrel to standard fibrinolytic therapy in patients with acute sTEmI will improve reperfusion. study design: CLARITY- TImI 28 is a multicenter, international, randomized, double- blind, placebo- contro- lled trial designed to examine the efficacy and safety of clopidogrel when added to standard adjuvant therapy for fibrinolysis. The primary efficacy end point is the composite of an occluded infarct- related artery(defined as TImI flow grade 0 or 1) on the predischarge angiogram or death or a recurrent myocardial infarction(mI) up to the start of coronary angiography. For subjects who do not undergo angiography, occurrence of death or recurrent mI by day 8 or by hospital discharge, whichever com.s.first, is used. The primary safety assessment is TImI major bleeding. secondary end points include sT resolution at 180 minutes and the clinical composite of death, mI, or recurrent ischemia. substudies include analyses of biomarkers, DNA, continuous electrocardiogram monitoring, and initiation of treatment in the ambulance. Conclusions: CLARITY- TImI 28 will help to define the role of clopidogrel as part of the pharmacologic reperfusion regimen for acute sTEmI.