Pharmacokinetics of procainamide and its metabolite depending on acetylator phenotype]

Procainamide (Pa) and its active metabolite--N-acetylprocainamide (NAPA)--pharmacokinetics was studied in 12 healthy volunteers in relation to acetylation phenotype. Acetylation phenotype was determined with sulphadimidine test. Blood serum levels of PA and NAPA were determined 0.5; 1.0; 1.5; 2.0; 3.0; 4.0; 8.0; and 12 hours following a single oral dose of 500 mg. Blood levels of both PA and NAPA were assayed with immunofluorescence polarization technique (FPIA), using TDx apparatus manufactured by Abbott. Pharmacokinetic parameters were calculated with the aid of pharmacokinetics independent of the model principles. All results were analysed statistically (AWOA). It was found that PA and NAPA pharmacokinetics depends on acetylation phenotype. Blood serum PA levels were higher in slow acetylators during the whole follow-up whereas NAPA levels were lower. Blood serum PA levels in rapid acetylators were decreased while NAPA levels were increased. Acetylation phenotype determined in sulphadimidine test confirmed bimodal procainamide acetylation.     

Titers of antibodies against thyroid membrane antigens in patients with Graves-Basedow disease and progressive infiltrative ophthalmopathy during treatment with glucocorticoids and retro-orbital tissue irradiation]

In 22 patients with progressive endocrine ophthalmopathy (classes 4-6 according to Werner's scale and ophthalmopathy index at least 4 and evidences of infiltrative changes in retro-ocular tissues in computerised tomography, after achievement of euthyroid state) the titers of antibodies against thyroid membrane antigens (ATMA) were determined by Gardas and all. method. Control group consisted of 26 patients with Graves-Basedow disease without clinical signs of ophthalmopathy who were investigated for ATMA before and after conventional methimazole treatment. The determinations of ATMA were performed before treatment, after 3-4 weeks and subsequently once a month. ATMA's titers exceeding 1:1000 were found in 68% of patients with progressive infiltrative ophthalmopathy and in 77% of patients with Graves-Basedow disease without ophthalmopathy. The incidence of elevated ATMA titers during treatment of ophthalmopathy with supervoltage retro-orbital tissues irradiation with high dose of prednisone, decreased markedly in 6th month of treatment with subsequent increase to average 55% at the end of treatment what suggests the influence of therapy on antibodies production. The changes in the incidence of elevated ATMA titers during conventional Graves-Basedow disease treatment were different. No relations between increased ATMA titers and intensity of infiltrative ophthalmopathy and the course of treatment in the patients with ophthalmopathy were found.     

Activity of angiotensin-converting enzyme in women with hyperthyroidism accompanying Graves-Basedow disease]

Angiotensin-converting enzyme in the blood serum was assayed with Friedland's and Silverstein's Technique in 24 female patients with untreated hyperthyroidism accompanying Graves-Basedow disease. Mean ACE activity was significantly higher in patients than that in the group of healthy individuals of the same age. Increased ACE activity noted in patients with Graves-Basedow disease may, therefore, indicated a significant role of renin-angiotensin-aldosterone system in the etiopathogenesis of hypertension in this disease.     

Diabetic dimorphism according to acetylator status.

Two groups of diabetics and 19 normal controls had their rate of acetylation of sulphadimidine measured. Among 47 patients with maturity onset diabetes the 29 fast acetylators were older at diagnosis and, at a given glucose concentration, had a higher pretreatment fasting insulin concentration than slow acetylators. They also had a larger first-phase insulin secretion in response to intravenous glucose both before and after one month''s dietary treatment. The greatest difference between fast and slow acetylators was in the first-phase secretion of insulin after a month''s treatment. The proportion of fast acetylators among the second group of diabetics, who had been admitted to improve their glucose concentrations or for treatment of tissue damage, was similar to that among the normal controls (50% and 47% respectively). The data seem to indicate that diabetics are fast acetylators unexpectedly often, but it is not clear whether the dimorphism according to acetylator status produces a differential risk of neuropathy or of any other type of diabetic tissue damage.     

Clinical significance of oxidation and acetylation genetic polymorphism in patients with hyperthyreosis

INTRODUCTION: The relationship between genetically determined polymorphic oxidation and acetylation and susceptibility to some disease was aroused much interest. The aim of our study was to evaluate whether patients with hyperthyreosis differ from healthy persons in their ability to oxidize sparteine and acetylate sulphadimidine as model drugs. Oxidation and acetylation were estimated in 48 patients with hiperthyreosis. MATERIAL AND METHODS: The control group consisted of 160 healthy volunteers for comparison of oxidation phenotype and 60 healthy volunteers for comparison of acetylation phenotype. The phenotyping of oxidation revealed two distinct populations among 40 patients with hyperthyreosis: 38 persons (95%) were extensive metabolizers (EM) of sparteine and 2 persons (5%) was poor metabolizers (PM). In 160 healthy persons (91.2%) were EM and 14 persons (8.8%) were PM. The difference between frequency distribution of PM and EM in healthy persons and in patients with hyperthyreosis was not statistically significant. RESULTS: The phenotyping of acetylation showed among 48 patients with hyperthyreosis 8 persons (13%) were rapid acetylators (RA) and 40 persons (87%) were slow acetylators (SA). In 60 healthy volunteers the phenotype of rapid acetylation was observed in 31 persons (51%) and slow acetylation in 29 persons (49%). Relative risk (odds ratio) of development of thyroid diseases was 5.34 times higher for SA in comparison to RA. The prevalence of SA among patients with hyperthyreosis in comparison to healthy volunteers was statistically significant (p < 0.0002). CONCLUSIONS: The results of our study may suggest that slow acetylation phenotype is associated with increased risk of the development of hyperthyreosis.     

Metabolic Populational in vivo Construction of Tumors under Conditions of Individual Genetic Predisposition: Communication II

The results of the analysis of the literature data on the ethnic distribution of xenobiotic biotransformation phenotypes and on tumor incidence (for all organs in total) are presented from the standpoint of the concept by L.A. Piruzyan [1]. For a number of ethnic groups, a possibility is theoretically shown of the metabolic populational in vivo construction of tumors (depending on the genetically determined metabolic status of certain populations), i.e., of the ethnic dependence of tumors. In the American population, the higher incidence of the slow acetylation phenotype than in Swedes and in the Chinese was associated with the higher incidence of morbidity. In populations of the English, the Germans, the Swedes, and the Swiss, characterized by a low incidence of the slow acetylation phenotype, the tumor morbidity was higher than in the Chinese with a higher incidence of slow acetylators. Americans are more predisposed to tumors than the Swedes. Caucasoids with either the slow or the fast acetylation phenotype are more predisposed to tumors than the Chinese. The prevalence of the fast acetylation phenotype in the Chinese and Japanese populations was associated with the lower cancer morbidity: in the Chinese compared to Australians, Danes, Swedes; in the Japanese compared to Australians, Americans, the English, Danes, Canadians, the German, the Portuguese, Finns, Czechs, and Slovaks. The lower incidence of the slow acetylators in the Chinese than in Americans, English, Danes, Canadians, Germans, Finns, Czechs, Slovaks, and Swedes was associated with a lower rate of morbidity. In the Portuguese, the higher incidence of fast acetylators than in Danes and the lower incidence of slow acetylators than in Czechs, Slovaks, and Afro-Americans was associated with the lower rate of morbidity. In the Hong Kong and Singapore Chinese with the lower incidence of slow acetylators than in the Madras Negroids, the morbidity was higher. In Australians and Swedes, the greater fraction of slow acetylators was associated with a lower morbidity than in Afro-Americans. In the Russian population of St. Petersburg, the higher incidence of slow acetylators was associated with the lower morbidity compared to the Hong Kong Chinese. Among Poles, the slow acetylator incidence was higher and the morbidity was lower than in the Portuguese. The Japanese and the Chinese (fast acetylators) are less predisposed to cancer than the above-listed Caucasoids; among Caucasoids, the Portuguese (fast acetylators) were less predisposed to cancer than the Danes, Czechs, Slovaks, and Afro-Americans. The tumor predisposition of the Hong Kong and Singapore Chinese was higher than the predisposition of the Madras Negroids. Australians, Russians (St. Petersburg residents), and Poles were less predisposed to cancer than Afro-Americans, the Hong Kong Chinese, and the Portuguese. The morbidity of the Madras Negroids with the higher incidence of the slow acetylation phenotype was lower than the morbidity of the Hong Kong and Singapore Chinese. The incidence of the slow acetylation phenotype in Afro-Americans was lower than in the Australians and Swedes and higher than in the Portuguese, Chinese, and Japanese; this was associated with the higher cancer morbidity, i.e., with the increased predisposition to tumors. The lower incidence of the T1-0 phenotype of glutathione-S-transferase in the English than in the Singapore and Shanghai Chinese and in the Japanese was associated with the higher morbidity of the English. In the Singapore Chinese, the higher incidence of the M1-0 and of T1-0 phenotypes of glutathione-S-transferase than in the Japanese was associated with the increased morbidity. In some populations, different morbidities were associated with similar incidences of one or another metabolic phenotype, or different phenotype incidences in different populations were associated with similar morbidities. The morbidity under consideration did not include chemical carcinogenesis, i.e., the conversion of procarcinogens to true carcinogens or the carcinogen inactivation. Because the results presented are preliminary, this article outlines the directions of theoretical studies that are required for definite conclusions concerning the ethnic dependence of tumors.     

Analysis of the N-acetyltransferase 2 gene polymorphism in the patients with chronic obstructive pulmonary disease and in populations of the Volga-Ural region

Restriction fragment-length polymorphism of the gene coding for N-acetyltransferase 2 (NAT2) was typed in populations of the Volga-Ural region (Bashkirs, Tatars, Chuvashes, Udmurts, and Russians) as well as in patients with chronic obstructive pulmonary disease (COPD) and in healthy individuals. Rapid and slow acetylator phenotypes were determined based on the presence or absence of the KpnI, TaqI, and BamHI restriction endonuclease recognition sites. The proportion of slow acetylators in the populations examined varied from 40.00% in Bashkirs to 64.15% in Chuvashes with statistically significant difference between these two ethnic groups (chi 2 = 5.7; p = 0.02). Overall, in the Volga-Ural populations slow acetylators represented 56.25% of the subjects examined. This value was similar to those presented in other studies of Caucasoid populations. In the COPD patients a statistically significant decrease of the slow acetylator frequency to 48.28% compared to healthy individuals (62.18%) was observed (chi 2 = 4.60; p = 0.036). The data obtained suggest a possible association between the drug resistance in the COPD patients with the rapid acetylator phenotype, which can lead to the development of the chronic form of the disease.     

Urinary 1-hydroxypyrene and mutagenicity in bus drivers and mail carriers exposed to urban air pollution in Denmark

BACKGROUND: Previous studies in Denmark have shown that bus drivers and tramway employees were at an increased risk for developing several types of cancer and that bus drives from central Copenhagen have high levels of biomarkers of DNA damage.AIMS: The present study evaluates 1-hydroxypyrene concentrations and mutagenic activity in urine as biomarkers of exposure in non-smoking bus drivers in city and rural areas on a work day and a day off and in non-smoking mail carriers working outdoors (in the streets) and indoors (in the office). METHODS: Twenty-four hour urine samples were collected on a working day and a day off from 60 non-smoking bus drivers in city and rural areas and from 88 non-smoking mail carriers working outdoors (in the streets) and indoors (in the office). The concentration of 1-hydroxypyrene was measured by means of HPLC and the mutagenic activity was assessed by the Ames assay with Salmonella tester strain YG1021 and S9 mix. The N-acetyltransferase (NAT2) phenotype was used as a biomarker for susceptibility to mutagenic/carcinogenic compounds. RESULTS: Bus drivers excreted more 1-hydroxypyrene in urine than did mail carriers. The differences were slightly smaller when NAT2 phenotype, cooking at home, exposure to vehicle exhaust, and performing physical exercise after work were included. The NAT2 slow acetylators had 29% (1.29 [CI: 1.15-1.98]) higher 1-hydroxypyrene concentrations in urine than the fast acetylators. Male bus drivers had 0.92 revertants/mol creatinine [CI: 0.37-1.47] and female bus drivers 1.90 revertants/mol creatinine [CI: 1.01-2.79] higher mutagenic activity in urine than mail carriers. CONCLUSION: The present study indicates that bus drivers are more exposed to polycyclic aromatic hydrocarbons (PAH) and mutagens than mail carriers. Mail carriers who worked outdoors had higher urinary concentration of 1-hydroxypyrene, a marker of exposure to PAH, than those working indoors. The individual levels of urinary mutagenic activity were not correlated to excretion of 1-hydroxypyrene. This might be due to the fact that the most potent mutagenic compounds in diesel exhaust are not PAH but dinitro-pyrenes. Among bus drivers, fast NAT2 acetylators had higher mutagenic activity in urine than slow NAT2 acetylators and female bus drivers had higher mutagenic activity than male bus drivers.     

The association between N-acetyltransferase 2 gene polymorphisms and pancreatic cancer

Pancreatic cancer has been linked with exposure to environmental chemicals, which generally require metabolic activation to highly reactive toxic or carcinogenic intermediates. N-acetyltransferase 1 (NAT1) and N-acetyltransferase 2 (NAT2) are expressed primarily in extrahepatic and hepatic tissues, respectively. Both enzymes catalyze N- and O-acetylation of aromatic and heterocyclic amines. It is believed that these compounds are activated via O-acetylation and detoxified by N-acetylation. Several polymorphisms of these two genes have been associated with an increased risk of cancer. Twenty-seven cases of pancreatic cancer and 104 controls were included in this study. Blood was collected in EDTA-containing tubes, and genomic DNA was extracted from the white blood cells by using a high pure PCR template preparation kit. Genotyping of NAT2 polymorphisms was detected by a real time PCR instrument. There was a significant difference in the distribution of the NAT2*6A acetylators phenotype between cases and the controls. The odds ratio of pancreatic cancer for the NAT2*6A slow phenotype was 5.7 (95% CI = 1.27-25.55; p = 0.023) compared with the fast type. Our results suggest that slow acetylators have higher risk of developing pancreatic cancer than fast acetylators. NAT2 gene polymorphisms may be associated with genetic susceptibility to pancreatic cancer.     

住院糖尿病患者中甲状腺结节的流行病学研究

目的:观察住院糖尿病患者中甲状腺结节的患病率,探讨二者间潜在的关系。方法:于2008年8月~2011年12月间对上海交通大学附属第一人民医院南院因糖尿病收治入院的全部患者进行甲状腺相关病史收集、血清甲状腺激素检测及超声波检查,以筛查甲状腺结节。结果:在收治的660例糖尿病患者中,住院期间发现并诊断合并有甲状腺结节患者为221例,患病率为33.5%。进一步分析糖尿病患者临床特征与甲状腺结节关系,男性为29.8%,女性为38.4%,明显高于男性患者,二者相比差异有统计学意义(P<0.05);糖尿病患者甲状腺结节患病率有随年龄增长而升高的趋势,与≤30岁年龄组相比,年龄51岁~70岁组及≥70岁组结节患病率均明显升高,差异有统计学意义(41.1%,37.6%15.4%,均P<0.05);1型糖尿病患者甲状腺结节患病率为24.1%,2型糖尿病中为35.3%,高于1型糖尿病,差异有统计学意义(P<0.05);糖尿病患者中,不同体重指数、病程、治疗方法组中甲状腺结节患病率相互比较均无明显差异性(均P>0.05)。结论:住院糖尿病患者中甲状腺结节患病率较高,尤其是女性、较大年龄及2型糖尿病患者更为突出,临床上有必要对这些患者进行甲状腺结节的筛查。     

Smoking (active and passive), N-acetyltransferase 2, and risk of breast cancer

Background: The relationship between smoking and breast cancer remains controversial. The study aim was to assess the relationship of passive and active smoking to breast cancer risk by N-acetyltransferase 2 (NAT2) phenotype, using a comprehensive assessment of both passive and active smoking. Methods: We undertook a population-based case–control study in Northeastern Ontario, Canada of 347 women diagnosed (2002–2004) with breast cancer and 775 population-based controls. The mailed study package included a questionnaire requesting information about established breast cancer risk factors, passive and active smoking, and a buccal swab for genetic analyses. Results: Among never-active smokers, a long duration of passive smoking was associated with an increased risk of breast cancer (odds ratio (OR) 1.86 (95% confidence interval (95% CI) 1.01–3.44) (test for trend (p = 0.07)); that risk was more elevated for NAT2 slow acetylators (OR 2.76, 95% CI 1.16–6.59) (and highest in extremely slow acetylators), but not elevated for NAT2 fast acetylators (OR 1.17, 95% CI 0.42–3.23). Among active smokers more than 20 pack-years of smoking was associated with an OR of 1.34 (95% CI 0.92-1.96); more elevated among NAT2 fast acetylators OR 1.93 (95% CI 1.01–3.69) but not elevated among NAT2 slow acetylators. Women who were NAT2 fast acetylators in the highest quartile for duration of active smoking had an OR of 2.74 (95% CI 1.42–5.27), with a significant test of trend (p = 0.005). Conclusions: These findings suggest that passive and active smoking may be related to breast cancer, and the effect may be differentially modified by NAT2 phenotype. Further research into the genetic modification of a breast cancer–smoking relationship may help to reconcile earlier discrepant findings.     

Comparison of thiamazole pharmacokinetics in healthy individuals and patients with hyperthyroidism]

Pharmacokinetic parameters of thiamazole in hyperthyroid patients (40 subjects with Graves-Basedow disease--32 female and 8 male patients) and in healthy individuals (8 subjects--5 women and 3 men) were compared. A one-compartment model was used for the analysis of examined pharmacokinetic parameters. Area under thiamazole concentration curve (AUC) and thiamazole peak plasma concentration (cmax) were significantly decreased in hyperthyroid patients in comparison with healthy individuals. An analysis of other pharmacokinetic parameters suggests that observed differences seem to depend upon lowered and retarded thiamazole absorption from the gut and acceleration of drug metabolism in hepatic microsomal system in hyperthyroid patients.     

Dispositional optimism and acceptance of illness among a group of individuals with Graves-Basedow's disease

INTRODUCTION: Dispositional optimism is a general tendency to positively perceive the world and one's own future. We can consider what kind of connection with ability to cope with difficulties. One situation which is very stressful for an individual is an illness, particularly a chronic one. The aim of the paper was to define the connection between dispositional optimism and acceptance of illness among the group with Graves-Basedow disease. This is autoimmunizational illness and diseases of this kind are particularly sensitive to the influence of psychological factors, as there are many connections between the immune system and the human psyche. MATERIAL AND METHODS: The study group consisted of 59 individuals with Graves-Basedow disease, 50 women and 9 men and 55 of healthy ones, 49 women and 6 men according to age, sex and a level of education. The patients filled out three psychological questionnaires: The Life Orientation Test-Revised (LOT-R), The Acceptance of Illness Scale (AIS) and The Personal Questionnaire. RESULTS: of the study in question indicate a lack of differences between individuals with Graves-Basedow disease and healthy ones concerning the level of dispositional optimism. There no differences in the level of dispositional optimism as regards of criterion of health: by the levels of hormones TSH, fT3 and fT4, complications and a time of duration of disease. Instead, if they suffer additionally from others diseases, they have a lower level of dispositional optimism. There exist a connection between intensification of level of dispositional optimism and acceptance of illness among testing group. CONCLUSIONS: The dispositional optimism as a supply of individual helps her or his in adaptation to difficulty situation, which is a chronic disease. It is a reason way it is worth to help of patients to grow it stronger.     

Hydralazine,antinuclear antibodies,and the lupus syndrome.

The incidence of patients with positive antinuclear antibody test results rose during three years of treatment with hydralazine. At the end of that period over half of the patients (both rapid and slow acetylators) had titres exceeding 1/20, but the rate of rise was faster in the slow acetylators than in the rapid. There was a significant relation between the cumulative dose of hydralazine and the proportion of patients found to have antinuclear factors. Fewer black patients had positive test results than white. Patients whose antinuclear antibody test results changed fron negative to positive during the study showed this change five to 26 months after beginning treatment. Some patients showed a substantial fall in antinuclear antibody titre even though hydralazine was continued. From these findings patients in whom test results for antinuclear antibody became positive during treatment with hydralazine need not have the drug stopped unless they have clinical features of the lupus syndrome.     

Genetic polymorphism and cancer susceptibility: evidence concerning acetyltransferases and cancer of the urinary bladder

Acetyltransferase enzymes expressed in hepatic and extrahepatic tissues are products of an acetyltransferase gene locus. Acetylation capacity is regulated by simple autosomal Mendelian inheritance of two codominant alleles at this locus. Human slow acetylators are predisposed to bladder cancer from arylamine chemicals. The role of the bladder in arylamine metabolism and of bladder acetyltransferases in the etiology of bladder cancer is not fully understood, but the acetylator genotype-dependent expression of arylamine N-acetyltransferase and N-hydroxyarylamine O-acetyltransferase in bladder cytosol may contribute towards the genetic predisposition of human slow acetylators to arylamine-induced bladder cancer.     

Clinical aspects and physiopathology of Brugada syndrome: review of current concepts

Brugada syndrome (BS) is an inherited cardiac disorder characterized by typical electrocardiographic patterns of ST segment elevation in the precordial leads, right bundle branch block, fast polymorphic ventricular tachycardia in patients without any structural heart disease, and a high risk of sudden cardiac death. The incidence of BS is high in male vs. female (i.e., 8-10/1: male/female). The disorder is caused by mutations in the SCN5A gene encoding Nav1.5, the cardiac sodium channel, which is the only gene in which mutations were found to cause the disease. Mutations in SCN5A associated with the BS phenotype usually result in a loss of channel function by a reduction in Na+ currents. We review the clinical aspects, risk stratification, and therapeutic management of this important syndrome.     

Risk of lymphoma in patients with dermatitis herpetiformis.

OBJECTIVE--To provide accurate estimates of the risk of lymphoma in patients with dermatitis herpetiformis. DESIGN--Comparison of observed and expected incidence of cancer in patients with dermatitis herpetiformis. SUBJECTS--976 patients aged 4 to 97 years with no clinical signs of coeliac disease who were admitted to hospital between 1963 and 1983. SETTING--Data from Swedish Cancer Registry. MAIN OUTCOME MEASURES--Incidence and type of cancer. RESULTS--106 cancers were diagnosed in 94 patients. The relative risk was 1.4 (95% confidence interval 1.1 to 1.7) in male patients and 1.2 (0.8 to 1.7) in female patients. When the individual cancer sites were analysed a significant risk was found only for malignant, non-Hodgkin''s lymphoma in male patients, with a relative risk of 5.4 (2.2 to 11.1). CONCLUSIONS--The risk of lymphoma is greater in male patients with dermatitis herpetiformis, and this calls for increased surveillance in these patients.     

青岛地区变应性鼻炎患者合并哮喘的流行病学调查研究

目的:调查青岛地区变应性鼻炎患者合并哮喘的患病率及相关因素。方法:设计"青岛地区变应性鼻炎问卷调查表"。采用多阶段抽样及整群抽样的方法,调查青岛地区常住(5年及5年以上)居民,年龄在5-70岁,均无高血压、糖尿病、风湿性疾病及精神障碍性疾病的居民。共调查人数为2052人:调查分三个阶段:问卷调查阶段、根据问卷结果筛选AR可疑对象、对AR可疑对象进行专科检查及变应原皮肤点刺试验以确诊。对结果进行统计学处理。结果:发放问卷总数为2400份,有效问卷为2052份,有效率为85.5%,青岛地区5-70岁居民AR患者248例,其中20例合并支气管哮喘,AR患者合并哮喘的患病率为8.06%,其中男7.14%,女9.26%,男女AR患者合并哮喘的患病率差异无统计学意义(X2=0.36 P>0.05)。结论:青岛地区变应性鼻炎患者合并哮喘的患病率为8.06%,初步了解青岛地区人群中变应性鼻炎合并哮喘的现状,为临床医生对其综合治疗并制定合理有效的治疗方案提供理论基础。     

88例女性小细胞肺癌临床特征分析

目的了解女性小细胞肺癌的临床特征分布。方法收集2006年1月至2012年11月大连医科大学附属二院收治的341例小细胞肺癌女性患者88例的临床资料,分析患者在年龄、分期、就诊症状、体重下降、吸烟、家族史、肿瘤位置、治疗方式、疗效反应等方面的特征。结果 2006-2012年该院女性小细胞肺癌住院患者数呈上升趋势;女性患者平均患病年龄为（57.8±11.2）岁,小于同期男性患者（60.4±10.3）岁;女性〈65岁患者比例高于男性患者（73.9%vs 67.5%）,两者比较差异有统计学意义（P=0.018）;女性患者吸烟只有13.6%,远远低于男性患者吸烟比例（85.5%）,两者比较差异有统计学意义（P=0.000）;女性家族史、体重下降、就诊症状、肿瘤位置、分期、疗效以及治疗方式的选择均与男性无差别。在广泛期小细胞肺癌中观察到女性最常见的远处转移是肝转移（40.0%）,男性肝转移只占22.2%,两者比较差异有统计学意义（P=0.036）。结论女性小细胞肺癌数一直呈上升趋势;女性小细胞肺癌就诊的平均年龄小于男性患者;在中青年小细胞肺癌中女性常见;女性吸烟患者较少;相对于男性患者,女性更常见于肝转移。     

The role of the model in mate‐choice copying in female zebra finches

Previous studies have shown that zebra finch females copy the mate choice of other females by choosing a mate of the same phenotype as the one chosen by another female (model). Little is known about the influence of the model female on the mate choice of the observing female. Therefore, we investigated the role of the model female in mate‐choice copying by manipulating her phenotype. Test females could choose between an unadorned male and an artificially adorned male, that is, wearing a red feather on the forehead. During a 2h observation period, test females could observe a single male in one cage and a male–female pair in another cage. In treatment one, the single male was unadorned and both the male and the female of the pair (model female) were adorned. In treatment two, the single male was adorned, the male of the pair unadorned and the model female adorned. Afterwards, test females could again choose between two new males, one adorned and one unadorned. In treatment one, test females first showed no preference for one of the two males, but avoided adorned males after the observation period. In treatment two, test females lost an initial preference for unadorned males after the observation period. In both treatments, test females did not copy the mate choice of the adorned model female. Adorned model females seemed to have a negative influence on the attractiveness of their mates' phenotype. Test females might have recognised model females as females of a different phenotype within their species which are adapted to different environmental conditions, or even have recognised model females as a female of another species. Our study demonstrates the important role of the model female in the complex public information network in zebra finches.