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1帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh 2021中华肿瘤防治杂志2021,28,24:49
2铝、镁轻合金中的稀土显示文摘综述了稀土镁和稀土铝合金的晶体化学、热力学和相图数据,根据其应用前景特别注意了富镁、富铝稀土合金及添加稀土对合金性能的影响,报道了若干稀土镁、稀土铝及含两个不同稀土的镁、铝合金的研究结果。对富镁、富铝的二元和三元合金相的结晶化学及形成规律进行了总结和讨论,并对有确定结构的合金精细设计和可能的应用提出了建议。Ferro R, Saccone A, Borzone G( Division of General and Inorganic Chemistry and Metallurgy Department of Chemistry, University of Genova, Dodecaneso 31,I 16146 Genova, Italy ) 1997中国稀土学报1997,15,3:36
3血管瘤联盟:脑海绵状血管畸形临床管理指南2017显示文摘2017年5月,血管瘤联盟科学顾问委员会临床专家小组(Angioma Alliance Scientific Advisory Board Clinical Experts Panel)在Neurosurgery杂志上发布了《脑海绵状血管畸形临床管理指南》,现在摘录如下。1基因测定和咨询首次脑海绵状血管畸形(cerebral cavernous malformations,CCM)时,杨中华 AKERS A AL-SHAHI SALMAN R A AWAD I 2017中国卒中杂志2017,12,8:28
4吊索训练对高水平足球运动员平衡能力、踢球速度和躯干(肌肉力量)稳定性的改善显示文摘Stray Pedersen J. I Magnussen R Kuffel E. Seiler S 周瑾(译) 2007北京体育大学学报2007,30,6:26
52018加拿大心境障碍与焦虑障碍治疗协作组/国际双相障碍学会指南:双相障碍的管理显示文摘加拿大心境障碍与焦虑障碍治疗协作组(Canadian Network for Mood and Anxiety Treatments,CANMAT)曾于2005年发布了第1版双相障碍管理指南,并分别于2007、2009和2013年对该指南进行了更新,其中最近的2次更新是与国际双相障碍学会(International Society for Bipolar Disorders,ISBD)合作完成。2018版CANMAT/ISBD双相障碍治疗指南(以下简称指南)反映了自2005年首版指南发表以来本领域取得的重大进展,包括疾病诊断与疾病管理的更新以及药物治疗与心理治疗的近期研究进展。这些前沿进展中综合考虑了循证证据的级别,并基于治疗疗效、临床实践经验、安全性、耐受性和药物导致的转相风险等,对一线、二线及三线治疗方案进行了简明而清晰的推荐。本指南中新增内容涵盖了双相Ⅰ型障碍(BD-Ⅰ)的躁狂发作急性期、抑郁发作急性期和双相障碍维持期的一线及二线治疗推荐等级划分。这种对治疗推荐等级的划分综合考虑了治疗方法对双相障碍不同时相的影响,将进一步帮助临床医生做出基于循证证据的治疗决策。锂盐、喹硫平、双丙戊酸盐、阿塞那平、阿立哌唑、帕利哌酮、利培酮和卡利拉嗪单药或联合使用被推荐为躁狂发作急性期的一线治疗选择。BD-Ⅰ抑郁期的一线治疗选择包括喹硫平、鲁拉西酮、锂盐、拉莫三嗪单药,鲁拉西酮联合锂盐或双丙戊酸盐或拉莫三嗪辅助治疗。尽管急性期治疗有效的药物通常应继续用于BD-Ⅰ的维持期治疗,但也存在一些特殊情况(例如抗抑郁药)。现有数据表明,锂盐、喹硫平、双丙戊酸盐、拉莫三嗪、阿塞那平和阿立哌唑单药或联合治疗应被视为维持治疗的初始或更换治疗方案时的一线选择。除了探讨BD-Ⅰ的相关问题外,本指南中还对双相Ⅱ型障碍(BD-Ⅱ)的临床管理进行了系统回顾并给予治疗推荐,同时针对特殊人群也有相关推荐,如处于各个生殖周期的女性、儿童、青少年和老年人。此外,本指南中还讨论了特定精神疾病及共病(如物质滥用、焦虑障碍和代谢性疾病)的影响。最后,本指南中概述了安全性和药物监测的相关问题。CANMAT/ISBD工作组希望本指南能够成为全球临床医生的实用工具。Lakshmi N Yatham Sidney H Kennedy Sagar V Parikh Ayal Sehaffer David J Bond Benicio N Frey Verinder Sharma Benjamin I Goldstein Soham Rej Serge Beaulieu Martin Alda Glenda MaeQueen Roumen V Milev Arun Ravindran Claire O'Donovan Diane Mclntosh Raymond W Lam Gustavo Vazquez Flavio Kapczinski Roger S Melntyre Jan Kozicky Shigenobu Kanba Beny Lafer Trisha Suppes Joseph R Calabrese Eduard Vieta Gin Malhi Robert M Post Michael Berk 胡晨(译) 王刚(译) 2019中华精神科杂志2019,52,1:25
6OPTICAL PROPERTIES OF GeO_2 AND Ge NANOCRYSTALS显示文摘he co m pound m aterial of n m size particles Ge O2 Si O2 w as synthesied through hydrolysis of Si( O C2 H4) and Ge Cl4 . A heat treatm ent w as carried out for the sa m ples at 100 ~1200 ℃in air . Its optical property w as deter mined by U V Vis spectur m . We have found that theabsorption edge of spectru m shifted progressively to longer w avelengths . The quantu m size ef fect of nanocrystals appears because crystals gro w and energy of optical band gap reduces d ueto the influence of te m perature . By the analysis of X ray diffraction w e have observed theprocess in w hich the structure of particles changed fro m disorder into order .Y.H.Zhou 1) ,Y.Y.Feng 2) and H.Y.Lu 2) 1)Department of Physics Nanjing Normal University, Nanjing 210097,China 2)Physics and Ch寁O P T I C A L P R O P E R T I E S O F Ge O2 A N D Ge N A N O C R Y S T A L S Y. H. Zhou1) , Y. Y. Feng2) 1999Acta Metallurgica Sinica(English Letters)1999,12,5:22
7血管性认知障碍的诊断标准:国际血管性行为与认知障碍学会的申明显示文摘长期以来,脑血管病(CVD)就被认为是认知损害的一个重要原因,但是有关脑血管病后认知障碍的概念化却有着一段多变的历史。'动脉变硬'或脑的动脉粥样硬化是'老化'的原因,是存在已久的观点,在20世纪60年代受到了来自英格兰纽卡斯尔的神经病理学研究的质疑。这些研究表明,血管性痴呆(vascular dementia,Va D)与超过一定程度的多发性脑梗死有关。徐岩 郭起浩 Sachdev P Kalaria R O'Brien J Skoog I Alladi S Black SE Blacker D Blazer DG Chen C Chui H Ganguli M Jellinger K Jeste DV Pasquier F Paulsen J Prins N Rockwood K Roman G Scheltens P 2014神经病学与神经康复学杂志2014,11,3:19
8微小RNA-1和微小RNA-29b对急性心肌梗死后不良心室重塑的诊断和预后价值显示文摘已知微小RNA(microRNAs,miRs)在急性心肌梗死(acute myocardial infarction,AMI)临床前期模型中可发挥纤维化和抗纤维化作用。为了评估miR-1,miR-21,miR-29b和miR-92a能否作为患者发生AMI后不良心室重塑(adverse ventricular remodeling,AVR)的循环生物标志物,刘莉 叶鹏 Grabmaier U Clauss S Gross L Klier I Franz WM Steinbeck G Wakili R Theiss HD Brenner C 2017中华高血压杂志2017,25,7:17
9内脏脂肪组织通过产生骨桥蛋白调控成纤维细胞衰老促进心脏衰老显示文摘老化通过增加包括骨桥蛋白(osteopontin,OPN)在内的细胞外基质(extracellular matrix,ECM)蛋白的沉积引起心脏结构和功能改变进而导致进行性间质纤维化。虽然已知OPN参与各种病理状况,但其在心肌衰老中的作用仍不清楚。Sawaki D Czibik G Pini M Ternacle J Suffee N Mercedes R Marcelin G Surenaud M Marcos E Gual P Clément K Hue S Adnot S Hatem SN Tsuchimochi I Yoshimitsu T Hénégar C Derumeaux G 刘青 叶鹏 2018中华高血压杂志2018,26,3:14
10术前肌电图和脑干听觉诱发电位与面肌痉挛微血管减压术后迟发性面瘫发生的关系(英文)显示文摘Background Delayed facial palsy ( DFP) after microvascular decompression ( MVD) in patients with hemifacial spasm ( HFS) is not uncommon,but the cause remains unknown. Objectives To assess whether intraoperative electromyography ( EMG) and brainstem auditory evoked potential ( BAEP) can predict DFP after MVD. Methods Between September 2009 and February 2011 we examined 86 patients,9 of whom ( 10. 4% ) developed DFP after MVD on the same side. All patients underwent MVD and were followed - up for a median period of 13 months ( range 6-22) . We retrospectively examined intraoperative facial EMG and BAEP findings using our MVD patients' registry. We excluded secondary HFS and immediate postoperative facial palsy after MVD in this study. We assessed the prevalence and clinical characteristics of DFP and compared EMG and BAEP findings between DFP and non-DFP groups. Results: All pa- tients recovered completely,with a mean time to recovery of 37. 8 days ( range 22-57) . There were no significant differences between DFP and non - DFP patients in terms of the amplitude and latency of intraoperative EMG and BAEP. Conclusion The usefulness of intraoperative facial EMG and BAEP is limited and cannot predict DFP after MVD for HFS. We speculate that DFP after MVD is not associated with permanent nerve damage according to the EMG findings.Kim HJ Park YS Ryu JS Huh R Han I Shin DA Kim TG Cho KG Chung SS 2012中华神经外科疾病研究杂志2012,11,4:13
11Chemotherapy of glioblastoma in rats using doxorubicin - loaded nanoparticles显示文摘Glioblastomas belong to the most aggressive human cancers with short survival times.Due to the blood-brainbarrier,they are mostly inaccessible to traditional chemotherapy.We have recently shown that doxorubicin boundto polysorbate-coated nanoparticles crossed the intact blood-brain barrier,thus reaching therapeutic concentra-tions in the brain.Here,we investigated the therapeutic potential of this formulation of doxorubicin in vivo using ananimal model created by implantation of 101/8 glioblastoma tumor in rat brains.Groups of 5-8 glioblastoma-Steiniger SC Kreuter J Khalansky AS Skidan IN Bobruskin I Smirnova ZS Severin SE Uhl R Kock M Geiger KD Gelperina SE 2004中国神经肿瘤杂志2004,2,1:13
12高龄对男性生育力的影响显示文摘在过去的几十年里,现代社会的压力和期望使得育龄夫妇生育年龄总体推迟。已知女性在临近40岁时卵母细胞的产生将会明显减少,而高龄对男性精子生成能力的影响还知之甚少。男性生育年龄无明确限制,因而高龄对男性生育能力的影响还不完全清楚。本文将就目前已知的高龄对男性精子质量、生育能力和子代健康的影响进行综述,希望能在医生就男性推迟生育及高龄相关的风险咨询时起到一定的指导作用。Jason R Kovac Josephine Addai Ryan P Smith Robert M Coward Dolores J Lamb Larry I Lipshultz 2013Asian Journal of Andrology2013,15,6:12
13Metastatic type 1 gastric carcinoid:A real threat or just a myth?显示文摘AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological findings,the extent of the disease,as well as the use of different therapeutic modalities and the long-term outcome were recorded.Patients’data were assessed at presentation,and thereafter at 6 to 12 monthly intervals both clinically and biochemically,but also endoscopically and histopathologically.Patients were evaluated for the presence of specific symptoms;the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded.The evaluation of response to treatment was defined using established WHO criteria.RESULTS:We studied twenty consecutive patients with a mean age of 55.1 years.The mean follow-up period was 83 mo.Twelve patients had regional lymph node metastases and 8 patients had liver metastases.The primary tumor mean diameter was 20.13±10.83mm(mean±SD).The mean Ki-67 index was 6.8%±11.2%.All but one patient underwent endoscopic or surgical excision of the tumor.The disease was stable in all but 3 patients who had progressive liver disease.All patients remained alive during the follow-up period.CONCLUSION:Metastatic GCA1 carries a good overall prognosis,being related to a tumor size of≥1 cm,an elevated Ki-67 index and high serum gastrin levels.Simona Grozinsky-Glasberg Dimitrios Thomas Jonathan R Strosberg Ulrich-Frank Pape Stephan Felder Apostolos V Tsolakis Krystallenia I Alexandraki Merav Fraenkel Leonard Saiegh Petachia Reissman Gregory Kaltsas David J Gross 2013World Journal of Gastroenterology2013,19,46:11
14非胰岛素依赖型糖尿病冠状动脉疾病的危险因素:英国糖尿病前瞻性研究(UKPDS:23)显示文摘目的:评价2型糖尿病患者冠状动脉疾病的基线危险因素。设计:对2 693例资料完整的患者进行年龄和性别调整的逐步选择过程分析,以确定哪些冠状动脉疾病的危险因素应纳入 Cox 比例风险模型。对象:3 055例白人患者,平均年龄52岁,均新近诊断为2型糖尿病,且无动脉粥样硬化相关疾病的证据。平均随访期7.9年。335例患者于10年内出现冠状动脉疾病。结局评定:具有明确异常心电图的心绞痛、致死或非致死性心肌梗塞。结果:冠状动脉疾病与低密度脂蛋白胆固醇浓度升高、高密度脂蛋白胆固醇浓度降低、甘油三酯浓度升高、高血红蛋白 A_(1c)、高收缩压、高空腹血糖以及吸烟史密切相关。低密度脂蛋白胆固醇较高1/3对较低1/3区间的估计风险比为2.26(95%可信区间为1.70~3.00),高密度脂蛋白胆固醇为0.55(0.41~0.73),血红蛋白 A_(1c)为1.52(1.15~2.01),收缩压为1.82(1.34~2.47)。吸烟者的估计风险比为1.41(1.06~1.88)。结论:2型糖尿病患者中,存在冠状动脉疾病潜在的、可变的5种危险因素的交叉重叠影响。它们是低密度脂蛋白胆固醇浓度升高、高密度脂蛋白胆固醇浓度降低、高血压、高血糖和吸烟。R C Turner H Millns H A W Neil I M Stratton S E Manley D R Matthews R R Holman 赵维纲 1998英国医学杂志中文版1998,0,3:11
15玉米种子大小和播深对出苗和幼苗活力的影响显示文摘林波波河省小农户主要以玉米为主粮来生产,播种时常因翻耕翻埋种子而造成植株个体生长差。本研究目的就是要确定种子大小和播种深度对玉米出苗和生长的影响。实验处理包括两种不同大小的种子(大粒种子和小粒种子)和4个播种深度(5cm、10cm、15cm、20cm)。种子大小对出苗率无显著影响,但不同播深对出苗率有显著影响。种子大小和播种深度均对幼苗高度有显著影响。种子大小对幼苗干重和叶片数没有影响。随播种深度增加,幼苗干重减少。结果显示,播深在5cm和10cm时,种子大小对出苗和幼苗活力没有影响,但播种深度在15cm和20cm时,对出苗和种子活力有不良影响。Molatudi R L Mariga I K 马志强 2010中国种业2010,,7:11
16Relationship between the exocrine and endocrine pancreas after acute pancreatitis显示文摘AIM:To determine the prevalence and time course of pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.METHODS:Relevant literature cited in three major biomedical journal databases(EMBASE,MEDLINE,and Scopus)was reviewed independently by two authors.There were no language constraints but the search was limited to human studies.Studies included were cohort studies of adult patients who were discharged after an attack of acute pancreatitis.Patients were excluded if they were under 18 years of age or had a previous diagnosis of prediabetes or diabetes mellitus,pancreatic exocrine insufficiency,or chronic pancreatitis.The main outcome measure was the prevalence of concomitant pancreatic exocrine insufficiency in patients who were diagnosed with prediabetes and diabetes mellitus after an attack of acute pancreatitis.Subgroup analysis was conducted for patients who were diagnosed with prediabetes only and those who were diagnosed withdiabetes mellitus only.Subgroup analysis looking at the time course of concomitant pancreatic exocrine and endocrine insufficiency was also conducted.Pooled prevalence and corresponding 95%confidence intervals were calculated for all outcome measures and P-values<0.05 were deemed statistically significant.RESULTS:Eight clinical studies comprising of 234patients met all eligibility criteria.The pooled prevalence of newly diagnosed prediabetes or diabetes in individuals after acute pancreatitis was 43%(95%CI:30%-56%).The pooled prevalence of pancreatic exocrine insufficiency in individuals after acute pancreatitis was 29%(95%CI:19%-39%).The prevalence of concomitant pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes was 40%(95%CI:25%-55%).The prevalence of concomitant pancreatic exocrine insufficiency among individuals with prediabetes alone and diabetes mellitus alone was 41%(95%CI:12%-75%)and 39%(95%CI:28%-51%),respectively.Further analysis showed that the prevalence of concomitant pancreatic exocrine insufficiency in individuals with prediabetes or diabetes decreases over time after an attack of acute pancreatitis.CONCLUSION:Pancreatic exocrine insufficiency occurs in 40%of individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.Further studies are needed to investigate the pathogenesis of diabetes in this setting.Stephanie L M Das James I C Kennedy Rinki Murphy Anthony R J Phillips John A Windsor Maxim S Petrov 2014World Journal of Gastroenterology2014,20,45:9
17干扰素调节因子5通过损伤胞葬作用控制动脉粥样硬化病变中的坏死核心形成显示文摘髓系细胞是动脉粥样硬化病变发展和易损斑块形成的核心。动脉吞噬细胞吸收凋亡细胞(胞葬作用)的能力受损,可促进病变生长并建立坏死核心。干扰素调节因子(interferon regulatory factor,IRF)5是髓系细胞功能的重要调节因子。该研究试图确定IRF5是否影响动脉粥样硬化病变的形成和表型。方法:通过两种互补模型,研究IRF5在动脉粥样硬化中的作用:Seneviratne AN Edsfeldt AO Cole JE Kassiteridi C Swart M Park I Green P Khoyratty TE Saliba DG Goddard ME Sansom SN Goncalves I Krams R Udalova IA Monaco C 刘莉 叶鹏 2017中华高血压杂志2017,25,8:9
18Cranial base chordoma——long term outcome and review of the literature显示文摘BACKGROUND: The purpose of this study is to clarify the latest long-term therapeutic result for cranial base chordomas.We are seeking an improvement of long term therapeutic outcome through a review of cranial base chordomas treated inYoneoka Y Tsumanuma I Fukuda M Tamura T Morii K Tanaka R Fujii Y 2008中国神经肿瘤杂志2008,6,3:9
19Hemoglobin in- fusion augments the tumor necrosis factor response to bacterial endotoxin ( 1 ipopolysaccharide ) in mice 显示文摘Su Dong Hui Roth R I Levin J 1999Crit Care Med1999,27,4:8
20High-fidelity multimode fibre-based endoscopy for deep brain in vivo imaging显示文摘Progress in neuroscience relies on new techniques for investigating the complex dynamics of neuronal networks.An ongoing challenge is to achieve minimally invasive and high-resolution observations of neuronal activity in vivo inside deep brain areas.Recently introduced methods for holographic control of light propagation in complex media enable the use of a hair-thin multimode optical fibre as an ultranarrow imaging tool.Compared to endoscopes based on graded-index lenses or fibre bundles,this new approach offers a footprint reduction exceeding an order of magnitude,combined with a significant enhancement in resolution.We designed a compact and high-speed system for fluorescent imaging at the tip of a fibre,achieving a resolution of 1.18±0.04μm across a 50-μm field of view,yielding 7-kilopixel images at a rate of 3.5 frames/s.Furthermore,we demonstrate in vivo observations of cell bodies and processes of inhibitory neurons within deep layers of the visual cortex and hippocampus of anaesthetised mice.This study paves the way for modern microscopy to be applied deep inside tissues of living animal models while exerting a minimal impact on their structural and functional properties.Sergey Turtaev Ivo T.Leite Tristan Altwegg-Boussac Janelle M.P.Pakan Nathalie L.Rochefort Tomáš Čižmár 2018Light(Science & Applications)2018,7,1:8
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