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1QUADAS的制定:用于系统评价中评价诊断性研究质量的工具显示文摘背景在以系统评价为基石的循证医学时代,需要有恰当的质量评价工具。对诊断性研究的评价目前尚缺乏系统开发且经过验证的评价工具。本研究的目的是采用共识决策法整合经验证据和专家意见,制定在系统评价时用于评价原始诊断性研究质量的工具。方法按照循证原则,我们在之前发表的3篇诊断性研究文献的综述的基础上,初选出一些条目形成列表,然后通过Delphi流程逐步调整列表,形成质量评价工具。参与Delphi流程的都是诊断性研究领域的专家。结果共有9位诊断学领域的专家参与Delphi流程。经过4轮Delphi流程后,专家们对哪些条目应纳入评价工具达成共识,我们把这个评价工具命名为QUADAS。纳入条目从最初的28个减少到14个,涵盖了疾病谱、金标准、疾病进展偏倚(disease progression bias)、证实偏倚(verification bias)、评价偏倚、临床评价偏倚、合并偏倚、试验的实施、病例退出以及不确定结果。QUADAS工具中的每个条目都配有评分细则。结论本研究项目开发出了用于诊断性试验系统评价的循证质量评价工具。下一步工作是确定其适用性和有效性。Penny Whiting Anne WS Rutjes Johannes B Reitsma Patrick MM Bossuyt Jos Kleijnen 刁骧(译) 艾昌林(译) 秦莉(审校) 姚巡(审校) 2007中国循证医学杂志2007,7,4:67
2QUADAS评价:一种用于诊断性研究的质量评价工具(修订版)显示文摘背景 QUADAS是一种新近发展起来的诊断性研究的质量评价工具。虽然已有系统评价采用了QUADAS,但尚未得以正式确证。本研究的目的是评价QUADAS的有效性和实用性。方法3位评价者采用QUADAS独立评价30项研究的质量。比较每位评价者的评分与最终结论之间的意见一致度。这主要是通过比较所有QUADAS条目的总分和每个单项的得分来实现的。20位曾在其系统评价中使用过QUADAS的评价者就其使用经验完成一份简短的问卷。结果就所有条目而言,每位评价者的评分与最终结论之间的意见一致度分别达到了91%、90%和85%。就单项QUADAS条目而言,一致度在50%至100%之间,中位值是90%。与难以解释的试验结果和退出病例相关的条目,评分结果差异最大。有关QUADAS内容的反馈意见普遍较好,仅少数评价者提出了有关QUADAS涵盖面、使用便利性、评分说明的清晰度及有效性方面的问题。结论QUADAS内容本身无需作大的修改。评价过程的主要困难出现在难以解释的试验结果和退出病例这2个条目的评分上。对这些条目的评分指南提出了修改意见。评价者必需根据其系统评价制定相应的评分指南,并确保所有评价者都清楚如何评分。评价者还应考虑是否所有的QUADAS条目都与其系统评价相关,以及其他质量条目是否应作为其系统评价的评价部分。Penny F Whiting Marie E Weswood Anne WS Rutjes Johannes B Reitsma Patrick NM Bossuyt Jos Kleijnen 马章淳 钱楠 2007中国循证医学杂志2007,7,7:64
3护理本科生艾滋病知识、态度与护理意愿调查分析显示文摘目的了解护理本科生艾滋病知识、态度、护理意愿及其相关性。方法采用问卷方法对 6 8名护理本科学生(护生 )进行现况调查。结果护生的艾滋病知识均分为 (13.7± 3.1)分 ,对职业感染、不可能传播HIV的途径等知识回答正确率低。态度均分为 0 .89分 ,86 .8%的护生的态度分为正分 ,表示同情和支持艾滋病病人 ,但对因静脉吸毒、性乱、同性恋染上艾滋病者持歧视态度。护理意愿均分为 (77.7± 2 5 .3)分 ,有 2 5 .0 %的护生表示不愿意为艾滋病病人提供护理。相关分析表明艾滋病知识、态度、护理意愿之间呈显著正相关关系。结论护生艾滋病知识掌握不够全面 ,对艾滋病病人护理意愿低 ;需加强对护生艾滋病知识的培训 ,改善对病人的态度 。王红红 阳爱云 Ann B Williams 2003护理学杂志(综合版)2003,18,3:48
4帕博利珠单抗治疗伴脑转移NSCLC患者的一项非随机、开放Ⅱ期试验的长期随访结果和生物标志物分析显示文摘背景与目的我们开展了一项帕博利珠单抗用于伴未治疗脑转移的非小细胞肺癌(non-small cell lung cancer,NSCLC)或黑色素瘤患者的疗效和安全性的II期试验,旨在评估程序性死亡受体1(programmed cell death 1,PD-1)抑制剂在中枢神经系统(central nervous system,CNS)中的疗效。中期结果已发表,现报道对NSCLC队列的更新分析结果。方法这是一项开放性、单中心、II期试验。纳入标准:年龄≥18岁,诊断为晚期NSCLC并伴有≥1个5 mm-20 mm脑转移病灶,既往从未治疗或之前放疗后进展,无神经系统症状,不需要激素治疗且美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)<2分。患者每2周接受一次帕博利珠单抗(10 mg/kg)治疗。队列1为程序性死亡配体1(programmed cell death ligand 1,PD-L1)≥1%的患者,队列2为PD-L1<1%或未评估的患者。主要终点是脑转移患者缓解比例。所有经治患者均纳入疗效与安全性终点的分析。该研究已结束入组,并于Clinicaltrials.gov登记注册,注册号为NCT02085070。结果2014年3月31日-2018年5月21日,共42例患者接受治疗。中位随访时间为8.3个月(IQR:4.5个月-26.2个月)。队列1的37例患者中11例有脑转移缓解[29.7%(95%CI:15.9%-47.0%)]。队列2未观察到缓解。治疗相关的3级-4级不良事件(adverse events,AEs)包括2例肺炎、1例全身症状、1例结肠炎、1例肾上腺皮质功能不全、1例高血糖症和1例低钾血症。6例(14%)患者发生了治疗相关的严重不良事件,包括肺炎、急性肾损伤、低钾血症和肾上腺皮质功能不全。没有观察到治疗相关死亡病例。结论帕博利珠单抗治疗PD-L1≥1%的NSCLC伴脑转移患者有效,且对所有纳入的未经治疗的脑转移患者安全。需要进一步探索免疫治疗用于NSCLC合并CNS转移。Sarah B GOLDBERG Kurt A SCHALPER Scott N GETTINGER Amit MAHAJAN Roy S HERBST Anne C CHANG Rogerio LILENBAUM Frederick H WILSON Sacit Bulent OMAY James B YU Lucia JILAVEANU Thuy TRAN Kira PAVLIK Elin ROWEN Heather GERRSH Annette KOMLO Richa GUPTA Hailey WYATT Matthew RIBEIRO Yuval KLUGER Geyu ZHOU Wei WEI Veronica L CHANG Harriet M KLUGER 董晓荣(翻译/校对) 2021中国肺癌杂志2021,24,9:34
5精索静脉曲张病人双侧睾丸组织学研究和减数分裂分析显示文摘50例男性在进行精索静脉曲张结扎手术时作双侧睾丸活俭。活检组织用Johnscn得分法作组织学研究,另分一部分作减数分裂分析。所有病人术后都进行随访,,平均随访时间为19.3月,并追踪他们配偶的怀孕情况。研究表明,精索静脉曲张没有特异的组织学或减数分裂异常,也没有证据表明曲张侧睾丸病变比对侧更严重。13例妻子怀孕,这些病例至少有一侧睾丸Jobnsen得分大于7.0,我们认为采用双侧睾丸活检可预测精索静脉曲张手术的效果。王益鑫 Chandley Ann C Macintyre Margaret Hargreave Timothy B 1991男性学杂志1991,5,1:12
6Folic acid supplementation inhibits recurrence of colorectal adenomas:A randomized chemoprevention trial显示文摘AIM: To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas, the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenomatous polyps. METHODS: In the current double-blind, placebo-controlled trial at this VA Medical Center, patients with colorectal adenomas were randomly assigned to receive either a daily 5 mg dose of folic acid or a matched identical placebo for 3 years. All polyps were removed at baseline colonoscopy and each patient had a follow up colonoscopy at 3 years. The primary endpoint was a reduction in the number of recurrent adenomas at 3 years. RESULTS: Of 137 subjects, who were eligible after confirmation of polyp histology and run-in period to conform compliance, 94 completed the study; 49 in folic acid group and 45 in placebo group. Recurrence of adenomas at 3-year was compared between the two groups. The mean number of recurrent polyps at 3-year was 0.36 (SD, 0.69) for folic acid treated patients compared to 0.82 (SD, 1.17) for placebo treated subjects, resulting in a 3-fold increase in polyp recurrence in the placebo group. Patients below 70 years of age and those with left-sided colonicadenomas or advanced adenomas responded better to folic acid supplementation. CONCLUSION: High dose folic acid supplementation is associated with a signif icant reduction in the recurrence of colonic adenomas suggesting that folic acid may be an effective chemopreventive agent for colorectal neoplasia.Richard Jaszewski Sabeena Misra Martin Tobi Nadeem Ullah Jo Ann Naumoff Omer Kucuk Edi Levi Bradley N Axelrod Bhaumik B Patel Adhip PN Majumdar 2008World Journal of Gastroenterology2008,14,28:10
7Leukocyte driven-decidual angiogenesis in early.pregnancy显示文摘成功的怀孕并且长期,出生后母亲并且后代心脏、脉管、新陈代谢的健康在怀孕期上要求关键母亲的心血管的改编。在怀孕 decidualizing 子宫以内,协调了脉管,免疫学的和 stromal 房间变化发生。可观的注意在开始蜕膜的螺线被给了房间到子宫的生来的杀手(uNK ) 的角色动脉的改变,通常完成由的一个过程在老鼠并且在人中间怀孕期。然而,白血球角色在早得多,区域特定,蜕膜的脉管的改变现在正在被定义。对免疫者的兴趣支持房间的脉管的改变被在象不孕,周期性的自发的流产, preeclampsia (PE ) 和胎儿的生长限制那样的人的 gestational 复杂并发症被报导的脉管的错误驾驶。适当母亲的心血管的回答在怀孕期间保护母亲和他们的孩子免受以后的心血管的疾病风险举起的伤害。对在有 hemochorial 胎座式的种类的怀孕的最早子宫的回答之一是 stromal 细胞 decidualization,它为 angiogenesis 和白血球招募创造唯一的壁龛。在早蜕膜 basalis,将抱发展中的胎盘并且提供主要的血容器支持成熟胎盘的功能的培植地点的方面,白血球极大地被充实并且显示专业化性质。UNK 房间,在早蜕膜 basalis 的最丰富的白血球子集,有 angiogenic 能力并且为正常早蜕膜的 angiogenesis 是必要的。在决定的 uNK 房间和他们的角色的规定母亲并且子孙在怀孕上的心血管的健康并且产后被讨论。Patricia DA Lima Jianhong Zhang Caroline Dunk Stephen J Lye B Anne Croy 2014Cellular & Molecular Immunology2014,11,6:8
8Neuroimaging the brain-gut axis in patients with irritable bowel syndrome显示文摘AIM:To summarize and synthesize current literature on neuroimaging the brain-gut axis in patients with irritable bowel syndrome(IBS).METHODS:A database search for relevant literature was conducted using Pub Med,Scopus and Embase in February 2015.Date filters were applied from the year2009 and onward,and studies were limited to those written in the English language and those performed upon human subjects.The initial search yielded 797articles,out of which 38 were pulled for full text review and 27 were included for study analysis.Investigations were reviewed to determine study design,methodology and results,and data points were placed in tabular format to facilitate analysis of study findings across disparate investigations.RESULTS:Analysis of study data resulted in the abstraction of four key themes:Neurohormonal differences,anatomic measurements of brain structure and connectivity,differences in functional responsiveness of the brain during rectal distention,and confounding/correlating patient factors.Studies in this review noted alterations of glutamate in the left hippocampus(HIPP),commonalities across IBS subjects in terms of brain oscillation patterns,cortical thickness/gray matter volume differences,and neuroanatomical regions withincreased activation in patients with IBS:Anterio cingulate cortex,mid cingulate cortex,amygdala anterior insula,posterior insula and prefrontal cortex.A striking finding among interventions was the substantia influence that patient variables(e.g.,sex,psychologica and disease related factors)had upon the identification of neuroanatomical differences in structure and con nectivity.CONCLUSION:The field of neuroimaging can provide insight into underlying physiological differences that distinguish patients with IBS from a healthy population.Kristen R Weaver Lee Anne B Sherwin Brian Walitt Gail D'Eramo Melkus Wendy A Henderson 2016World Journal of Gastrointestinal Pharmacology and Therapeutics2016,7,2:8
9Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry显示文摘AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National Registry.METHODS:A Prospective cohort study from 8 tertiary referral centres in the United Kingdom.Patients with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were treated.Visible lesions were removed by endoscopic mucosal resection(EMR)before RFA.Following initial RFA treatment,patients were followed up 3monthly.Residual flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or beyond.The main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse events.RESULTS:Twenty patients with squamous HGD/ESCC completed treatment protocol.Five patients(25%)had EMR before starting RFA treatment.CR-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this time.Eighty per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 year.Four patients(20%)required endoscopic dilatations for symptomatic structuring after treatment.Two of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per patient.The other 2 patients required only a single dilatation to achieve an adequate symptomatic response.One patient developed cancer during follow up after end of treatment protocol.CONCLUSION:The role of RFA in these patients re-mains unclear.In our series 50%patients responded at12 mo.These figures are lower than limited published data.Rehan J Haidry Mohammed A Butt Jason Dunn Matthew Banks Abhinav Gupta Howard Smart Pradeep Bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John Massimo Di Pietro Ian Penman Marco Novelli Laurence B Lovat 2013World Journal of Gastroenterology2013,19,36:7
10Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach: Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)显示文摘Inzucchi Silvio E Bergenstal Richard M Buse John B Diamant Michaela Ferrannini Ele Nauck Michael Peters Anne L Tsapas Apostolos Wender Richard Matthews David R 2012EN2012,,3:6
11DC-derived IL-18 drives Treg differentiation, murine Helicobacter pylori-specific immune tolerance, and asthma protection显示文摘Oertli Mathias Sundquist Malin Hitzler Iris Engler Daniela B Arnold Isabelle C Reuter Sebastian Maxeiner Joachim Hansson Malin Taube Christian Quiding-J?rbrink Marianne Müller Anne 2012EN2012,,3:5
12Strain rate dependency and fragmentation pattern of expanding warheads显示文摘For the characterization of the behaviors of a metal material in events like expanding warheads, it is necessary to know its strength and ductility at high strain rates, around 104e105/s. The flyer plate impact testing produces the uniform stress and strain rates but the testing is expensive. The Taylor test is relatively inexpensive but produces non-uniform stress and strain fields, and the results are not so easily inferred for material modeling. In the split-Hopkinson bar(SHB), which may be used in compression, tension and torsion testing, the strain rates never exceeds 103/s. In the present work, we use the expanding ring test where the strain rate is 104e105/s. A streak camera is used to examine the expanding ring velocity, and a water tank is used to collect the fragments. The experimental results are compared with the numerical simulations using the hydrocodes AUTODYN, IMPETUS Afea and a regularized smooth particle(RSPH) software. The number of fragments increases with the increase in the expansion velocity of the rings. The number of fragments is similar to the experimental results. The RSPH software shows much the same results as the AUTODYN where the Lagrangian solver is used for the ring. The IMPETUS Afea solver shows a somewhat different fragmentation characteristic due to the node splitting algorithm that induces pronounced tensile splitting.John F.MOXNES Anne K.PRYTZ Фyvind FR?YLAND Stian SKRIUDALEN Steinar BФRVE Gard ФDEGARDSTUEN 2015Defence Technology(防务技术)2015,11,1:5
13Brain changes in diabetes mellitus patients withgastrointestinal symptoms显示文摘Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system(CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal(GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testingmainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes,especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation.Anne M Drewes Eirik Søfteland Georg Dimcevski Adam D Farmer Christina Brock Jens B Frøkjær Klaus Krogh Asbjørn M Drewes 2016World Journal of Diabetes2016,7,2:4
14Polymorphisms in NF-κB,PXR,LXR,PPARγ and risk of inflammatory bowel disease显示文摘AIM:To investigate the contribution of polymorphisms in nuclear receptors to risk of inflammatory bowel disease(IBD) . METHODS:Genotypes of nuclear factor(NF) -κB(NFKB1) NFκB-94ins/del(rs28362491) ;peroxisome proliferatoractivated receptor(PPAR) -γ(PPARγ) PPARγPro12Ala(rs1801282) and C1431T(rs 3856806) ;pregnane X receptor(PXR) (NR1I2) PXR A-24381C(rs1523127) ,C8055T(2276707) ,and A7635G(rs 6785049) ;and liver X receptor(LXR) (NR1H2) LXR T-rs1405655-C and T-rs2695121-C were assessed in a Danish case-control study of 327 Crohn's disease patients,495 ulcerative colitis(UC) patients,and 779 healthy controls.Odds ratio(OR) and 95%CI were estimated by logistic regression models. RESULTS:The PXR A7635G variant,the PPARγPro12Ala and LXR T-rs2695121-C homozygous variant genotypes were associated with risk of UC(OR:1.31,95% CI:1.03-1.66,P=0.03,OR:2.30,95%CI:1.04-5.08,P=0.04,and OR:1.41,95%CI:1.00-1.98,P=0.05,respectively) compared to the corresponding homozygous wild-type genotypes.Among never smokers,PXR A7635G and the LXR T-rs1405655-C and T-rs2695121-C variant genotypes were associated with risk of IBD(OR:1.41,95%CI:1.05-1.91,P=0.02,OR:1.63,95%CI:1.21-2.20,P=0.001,and OR:2.02,95%CI:1.36-2.99,P=0.0005,respectively) compared to the respective homozygous variant genotypes.PXR A7635G(rs6785049) variant genotype was associated with a higher risk of UC diagnosis before the age of 40 years and with a higher risk of extensive disease(OR:1.34,95%CI:1.03-1.75 and OR:2.49,95%CI:1.24-5.03,respectively) . CONCLUSION:Common PXR and LXR polymorphisms may contribute to risk of IBD,especially among never smokers.Vibeke Andersen Jane Christensen Anja Ernst Bent A Jacobsen Anne Tjφnneland Henrik B Krarup Ulla Vogel 2011World Journal of Gastroenterology2011,17,2:4
15Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial显示文摘David N Krag Stewart J Anderson Thomas B Julian Ann M Brown Seth P Harlow Joseph P Costantino Takamaru Ashikaga Donald L Weaver Eleftherios P Mamounas Lynne M Jalovec Thomas G Frazier R Dirk Noyes André Robidoux Hugh MC Scarth Norman Wolmark 2010Lancet Oncology2010,,10:3
16Ly49 receptors activate angiogenic mouse DBA+ uterine natural killer cells显示文摘Patricia DA Lima Megan M Tu Mir Munir A Rahim Annie R Peng B Anne Croy Andrew P Makrigiannis 2014Cellular & Molecular Immunology2014,11,5:3
17Pediatric Nd:YAG laser capsulotomy in the operating room: review of 87 cases显示文摘AIM: To report a large series of children having Nd:YAG laser capsulotomy in the operating room using the lateral decubitus position. METHODS: Medical records of children who underwent Nd:YAG laser capsulotomy in the operating room at Ann & Robert H. Lurie Children's Hospital of Chicago between September 2008 and April 2017 were reviewed. Induction of general anesthesia and intubation was performed in the supine position after which the patient was placed in lateral decubitus position. The Nd:YAG laser capsulotomy was performed using a standard protocol. At the completion of the procedure, the patient was turned back into the supine position and extubated. RESULTS: This study included 87 eyes of 60 patients. Patient's age ranged from 1 to 18 y(mean 6.4±4.1 y). In most cases(84/87, 97%), the procedure was performed under general anesthesia. In all cases, good focus on the membrane was achieved, and the procedure was performed successfully. There were no intraoperative ocular or anesthesia-related complications. CONCLUSION: When performing Nd:YAG laser capsulotomy in the operating room, the lateral decubitus position allowsan easy and safe approach without the risk of potentially devastating complications that have been associated with the previously described sitting and prone positions.Michael Kinori Narasimhan Jagannathan Anne M Langguth Marjorie A Sasso Marilyn B Mets Bahram Rahmani Hawke Yoon Rebecca Mets-Halgrimson Sudhi P Kurup Janice L Zeid 2019International Journal of Ophthalmology(English edition)2019,12,5:2
18Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial显示文摘David N Krag Stewart J Anderson Thomas B Julian Ann M Brown Seth P Harlow Takamaru Ashikaga Donald L Weaver Barbara J Miller Lynne M Jalovec Thomas G Frazier R Dirk Noyes André Robidoux Hugh MC Scarth Denise M Mammolito David R McCready Eleftherios P Mamo 2007Lancet Oncology2007,,10:2
19A prospective feasibility study of sub-millisievert abdominopelvic CT using iterative reconstruction in Crohn’s disease显示文摘Siobhan B O’Neill Patrick D Mc Laughlin Lee Crush Owen J O’Connor Sebastian R Mc Williams Orla Craig Anne Marie Mc Garrigle Fiona O’Neill Jackie Bye Max F. Ryan Fergus Shanahan Michael M Maher 2013European Radiology2013,,:2
20The patch clamp technique显示文摘 Sadm ann B 1992J Sci Am1992,266,3:1
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