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| 1 | Challenge and Opportunity in Improving Fertilizer-nitrogen Use Efficiency of Irrigated Rice in China显示文摘Today, about 30% of world nitrogen (N) fertilizer is consumed by China. Rice crops in China consume about 37% of the total N fertilizer used for rice production in the world. Average rate of N application for rice production in China is high and fertilizer-N use efficiency is low compared with other major rice growing countries. Research progresses have been made internationally and domestically on the application method, fertilizer-N sources, computer-based decision support systems, and real-time N management in order to reduce N losses and increase fertilizer-N use efficiency. In addition to continuous increase in N rate and lack of adoption of new knowledge and technology in N management by farmers, we hypothesize that high indigenous soil N supply, adoption of hybrid and super rice cultivars, improper timing of N application, and practice of mid-season drainage could be the causes for the low fertilizer-N use efficiency in China. Future research work on improving fertilizer-N use efficiency of rice crop in China should focus more on improving cultivar's N responsiveness, optimizing the timing and rate of N application based on crop N status, and achieving optimal soil N supply capacity. | Roland Buresh Christian Witt | 2002 | Agricultural Sciences in China2002，1，7： | 86 |
| 2 | The WRKY Gene Family in Rice (Oryza sativa)显示文摘WRKY 基因编码涉及各种各样的生物学过程的规定的抄写因素。这些锌手指蛋白质,特别调停的那些成员强调回答,特别地在植物被扩展。便于进化历史的学习和这个超级基因家庭的功能,我们用 HMMER 和明确地为米饭被训练的一个隐藏的 Markov 模型为 WRKY 基因执行了彻底的搜索。这个工作在 Oryza sativa L 导致了 WRKY 基因模型的一张全面的表。ssp。indica 和 L。ssp。装饰用的梨树。这些基因印射,导致 98 的鉴定单个染色体便于消除在装饰用的梨树的冗余的 WRKY 基因并且 102 在 indica 米饭。这些基因进一步根据他们的锌手指领域的数字和结构被分类。在相应 indica 和装饰用的梨树染色体上基于保存 WRKY 领域的一棵系统树和 WRKY loci 的图形的显示,我们识别了可能的 WRKY 在内的基因复制,和在二密切相关的米饭亚种之间的损失。另外考察了在到水杨酸和 jasmonic 酸,种子发展和萌芽的抗病性和回答的 WRKYgenes 的角色被赤霉素,包括老朽的另外的发展过程,和对不能生活的压力和 abscisic 酸的回答在大米和另外的工厂调停。发信号小径调停 WRKY 基因表示也被讨论…… | Christian A. Ross Yue Liu Qingxi J. Shen | 2007 | Journal of Integrative Plant Biology2007，49，6： | 97 |
| 3 | 欧洲新生儿呼吸窘迫综合征防治共识指南:2016版显示文摘新生儿呼吸窘迫综合征(RDS)是早产儿的重要疾病,尽管治疗手段不断成熟,低龄早产儿存活率逐渐增高,但支气管肺发育不良(BPD)发病率也随之升高,其中部分原因是减少了出生后激素的使用.2006年以来,来自欧洲许多国家的新生儿专家每3年一次回顾最新文献,就RDS或有RDS风险早产儿的防治达成共识,立志于改善欧洲新生儿的预后.欧洲RDS防治指南2007年开始发布,2010年和2013年进行了更新,期间获得了欧洲围产医学学会的大力支持.RDS是由于肺表面活性物质(PS)缺乏导致生后早期出现呼吸窘迫,典型临床表现随着防治手段的改进发生了巨大变化. | DavidG.Sweet Virgilio Carnielli Gorm Greisen Mikko Hallman Eren Ozek Richard Plavka Ola Didrik Saugstad Umberto Simeoni Christian P. Speer Maximo Vento Gerard H. A. Visser Henry L. Halliday | 2017 | 中华儿科杂志2017，55，3： | 90 |
| 4 | 提高中国稻田氮肥利用率的研究策略显示文摘介绍了中国水稻生产氮肥使用及利用率概况。中国氮肥消费量占世界氮肥总量的 30 %,水稻生产所消耗的氮肥占世界水稻氮肥总消耗量的 37%。与主要产稻国相比 ,中国水稻生产氮肥施用量较高而利用率较低 ;介绍了国际上公认的氮肥利用率的概念和相应的定量方法 ;总结了国内外水稻氮肥的施用方法 ,肥料种类 ,计算机推荐施肥以及实时施氮管理模式等对降低氮素损失 ,提高氮肥利用率的研究概况和研究进展 ;从水稻品种耐肥性、土壤供肥能力、施肥技术及水分管理等多方面分析了中国水稻氮肥利用率低的可能原因 ;提出了通过改善水稻品种对氮肥的敏感反应 ,以作物氮素状况为指导适时和适量施用氮肥 ,以及合理调节土壤背景氮来降低氮素损失 ,提高水稻的氮肥利用率的研究策略。 | 彭少兵 黄见良 钟旭华 杨建昌 王光火 邹应斌 张福锁 朱庆森 Roland Buresh Christian Witt | 2002 | 中国农业科学2002，35，9： | 1029 |
| 5 | 蔬菜中铅镉铜锌含量的影响因素研究显示文摘用通过大田调查的方法,研究了影响蔬菜中Pb、Cd、Cu、Zn含量的因素。结果表明:(1)蔬菜对Pb、Cd、Cu、Zn的富集可分为高富集、中富集和低富集,针对不同的土壤污染程度,可以选择不同富集系数的蔬菜种植;(2)提高土壤pH值,有助于降低蔬菜中Pb、Cd、Cu、Zn的含量;调节土壤阳离子交换量、有机质含量和粘粒含量应注意适度,过高会导致相反的结果;(3)土壤Pb、Cd、Cu、Zn之间的相互关系较为复杂,Cu与Zn之间具有相互的拮抗作用,Cu对Pb的吸收具有促进作用。 | 祖艳群 李元 陈海燕 陈建军 Marianne Guhur Christian Schvartz | 2003 | 农业环境科学学报2003，22，3： | 94 |
| 6 | 云南瑞丽物质滥用调查与社区干预显示文摘作者在云南瑞丽的四所中学和32个自然村进行了成瘾物质使用情况调查。结果发现,中学生中18.7%吸烟,1.10%的学生平均每天摄入纯酒精75g 以上,0.99%的人曾使用过鸦片,0.94%曾使用过海洛英。村民中吸烟者占43.7%,8.39%的人平均每天摄入纯酒精75g 以上,12.3%曾使用过鸦片,7.8%曾使用过海洛英。在调查的基础上,选择4个自然村开始实施为期三年以社区为基础的药物滥用预防干预计划,一年半后中期评估的结果令人鼓舞,药物依赖者中39.4%完全戒除了海洛英。 | 李建华 朱华 万文鹏 石青 刘德全 Keith Emrich Christian J.Kroll | 1993 | 中国心理卫生杂志1993，7，6： | 80 |
| 7 | 电力系统主动解列控制方法的研究显示文摘解列是电力系统在受到大的干扰,系统完整性无法保持的情况下将系统分解成几个孤岛的控制。以在线计算、全局控制、协调动作为特点的主动解列控制是一个重要的研究方向。文中分析了主动解列控制需要回答的关键问题,介绍了一种以“搜索加校验”为基本思路的主动解列策略求解方案,提出了合理解列策略的评价指标,最后指出了在主动解列研究中应当首先开展工作的几个方向。 | 沈沉 吴佳耘 乔颖 卢强 刘前进 Christian Rehtanz | 2006 | 中国电机工程学报2006，26，13： | 66 |
| 8 | 2008中西方BNP专家共识显示文摘1.前言
2008年6月,来自中国、美国、欧洲的急诊科、心血管科、实验室及内科临床专家相聚在中国上海。 | Alan Maise Christian Mueller W. Frank Peacock Gerasimos Filippatos Hu Dayi 胡大一(主译) 刘梅颜(主译) 吴寸草(翻译) 王博雅(翻译) 黄睿(翻译) | 2009 | 中国医药导刊2009，11，10： | 76 |
| 9 | 比利时马铃薯晚疫病预警系统及其在我国的应用显示文摘利用晚疫病预测预报模型可以准确地预报晚疫病发生的时间 ,指导薯农适时适量地用药。比利时利用CARAH模型 15年来取得了很好的效果 ,消除了由晚疫病造成的损失并减少了杀菌剂的施用量。本文详细地介绍了该模型的起因、数据的收集和具体的运用 ,并根据此模型在中国的初步应用提出了利用该预测预报的建议。 | 谢开云 车兴壁 Christian Ducatillon Francois Serneels | 2001 | 中国马铃薯2001，15，2： | 75 |
| 10 | Clinical characteristics and outcome of a cohort of 101 patients with hepatocellular carcinoma显示文摘AIM To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999.METHODS AND RESULTS Data were retrospectively analyzed by chart review. In 95cases (72 males and 23 females) sufficient data were available for analysis. Twenty-five (29%)of 8.5 patients were HBsAg or anti-HBc positive,21/85 (25%) were anti-HCV positive, and 6/85(7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV-positive patients than in the other two groups.Thirty-one (34%) of 90 patients had histories of alcohol abuse, In 79/ 94 (84%) patients,cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child-Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/ 94 (20%).Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%).According to Okuda 28/94 (30%) were grouped to stage Ⅰ, 53/94 (56%) were grouped to stage Ⅱ, and 13/94 (14%) were grouped to stage Ⅲ.Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8.4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non-complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival,though patients with an AFP value greater than 100μg/L did experience shortened survival.Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of therapy on survival was most pronounced in Okuda stage Ⅱ patients. There was longer survival in those Okuda stage Ⅱpatients who were treated with percutaneous ethanol injection.CONCLUSION Even in a Iow incidence area such as Germany, the majority of HCC is caused by viral hepatitis and therefore potentially preventable. Reflecting the high proportion of advanced stage tumors in our patients, the median survival was poor. Patients who received active therapy had a longer survival. | Christian Rabe Tillmann Pilz Christoph Klostermann Marc Berna Hans H.Schild Tilman Sauerbruch Wolfgang H.Caselmann | 2001 | World Journal of Gastroenterology2001，7，2： | 60 |
| 11 | 昆明市蔬菜及其土壤中铅、镉、铜和锌含量水平及污染评价显示文摘对昆明市蔬菜及其土壤中铅、镉、铜和锌含量水平进行了初步的调查并对其土壤污染进行了评价 ,结果表明 :蔬菜土壤重金属Pb、Cd、Cu、Zn均存在一定程度的污染 ,其中Pb、Zn为轻污染 ,Cd、Cu为中污染 ,土壤重金属综合评价为中污染。蔬菜可食部分Pb、Cd、Zn的含量均超过国家食品卫生标准和绿色蔬菜标准 ,依次为Pb、Cu、Cd、Zn。 | 祖艳群 李元 陈海燕 陈建军 Marianne Guhur Christian Schvartz | 2003 | 云南环境科学2003，22，B03： | 55 |
| 12 | Surgical outcome after docetaxel-based neoadjuvant chemotherapy in locally-advanced gastric cancer显示文摘AIM:To investigate feasibility,morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer.METHODS:Patients suffering from locally-advanced(T3-4 any N M0 or any T N1-3 M0)gastric carcinoma,staged with endoscopic ultrasound,bone scan,computed tomography,and laparoscopy,were assigned to receive four 21 d/cycles of TCF(docetaxel 75 mg/m 2 day 1,cisplatin 75 mg/m 2 day 1,and fluorouracil 300 mg/m 2 per day for days 1-14),either before(Arm A)or after(Arm B)gastrectomy.Operative morbidity,overall mortality,and severe adverse events were compared by intention-to-treat analysis.RESULTS:From November 1999 to November 2005,70 patients were treated.After preoperative TCF(Arm A),thirty-two(94%)resections were performed,85% of which were R0.Pathological response was complete in 4 patients(11.7%),and partial in 18(55%).No surgical mortality and 28.5%morbidity rate were observed,similar to those of immediate surgery arm(P= 0.86).Serious chemotherapy adverse events tended to be more frequent in arm B(23%vs 11%,P=0.07),with a single death per arm.CONCLUSION:Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma. | Roberto Biffi Nicola Fazio Fabrizio Luca Antonio Chiappa Bruno Andreoni Maria Giulia Zampino Arnaud Roth Jan Christian Schuller Giancarla Fiori Franco Orsi Guido Bonomo Cristiano Crosta Olivier Huber | 2010 | World Journal of Gastroenterology2010，16，7： | 43 |
| 13 | Regulation of hepatic blood flow:The hepatic arterial buffer response revisited显示文摘The interest in the liver dates back to ancient times when it was considered to be the seat of life processes. The liver is indeed essential to life,not only due to its complex functions in biosynthesis,metabolism and clearance,but also its dramatic role as the blood volume reservoir. Among parenchymal organs,blood flow to the liver is unique due to the dual supply from the portal vein and the hepatic artery. Knowledge of the mutual communication of both the hepatic artery and the portal vein is essential to understand hepatic physiology and pathophysiology. To distinguish the individual importance of each of these inflows in normal and abnormal states is still a challenging task and the subject of on-going research. A central mechanism that controls and allows constancy of hepatic blood flow is the hepatic arterial buffer response. The current paper reviews the relevance of this intimate hepatic blood flow regulatory system in health and disease. We exclusively focus on the endogenous interrelationship between the hepatic arterial and portal venous inflow circuits in liver resection and transplantation,as well as inflammatory and chronic liver diseases. We do not consider the hepatic microvascular anatomy,as this has been the subject of another recent review. | Christian Eipel Kerstin Abshagen Brigitte Vollmar | 2010 | World Journal of Gastroenterology2010，16，48： | 49 |
| 14 | An Update on Abscisic Acid Signaling in Plants and More显示文摘 | Aleksandra Wasilewsk.a Florina Vlad Caroline Sirichandra Yulia Redko Fabien Jammes Christiane Valon Nicolas Frei dit Frey Jeffrey Leung | 2008 | Molecular Plant2008，1，2： | 46 |
| 15 | Overlap syndromes among autoimmune liver diseases显示文摘The three major immune disorders of the liver are autoimmune hepatitis(AIH),primary biliary cirrhosis(PBC) and primary sclerosing cholangitis(PSC).Variant forms of these diseases are generally called overlap syndromes,although there has been no standardised definition.Patients with overlap syndromes present with both hepatitic and cholestatic serum liver tests and have histological features of AIH and PBC or PSC.The AIH-PBC overlap syndrome is the most common form,affecting almost 10% of adults with AIH or PBC.Single cases of AIH and autoimmune cholangitis(AMA-negative PBC) overlap syndrome have also been reported.The AIH-PSC overlap syndrome is predominantly found in children,adolescents and young adults with AIH or PSC.Interestingly,transitions from one autoimmune to another have also been reported in a minority of patients,especially transitions from PBC to AIH-PBC overlap syndrome.Overlap syndromes show a progressive course towards liver cirrhosis and liver failure without treatment.Therapy for overlap syndromes is empiric,since controlled trials are not available in these rare disorders.Anticholestatic therapy with ursodeoxycholic acid is usually combined with immunosuppressive therapy with corticosteroids and/or azathioprine in both AIH-PBC and AIH-PSC overlap syndromes.In end-stage disease,liver transplantation is the treatment of choice. | Christian Rust Ulrich Beuers | 2008 | World Journal of Gastroenterology2008，14，21： | 41 |
| 16 | Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses:A multicenter study显示文摘AIM:To evaluate the ability of endoscopic ultrasound(EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes.METHODS:A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass(n=121) or lymph node(n=101).The classification as benign or malignant,based on the real time elastography pattern,was compared with the classif ication based on the B-mode EUS images and with the fi nal diagnosis obtained by EUS-guided fi ne needle aspiration(EUS-FNA) and/or by surgical pathology.An interobserver study was performed.RESULTS:The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%,respectively,compared to 92.3% and 68.9%,respectively,for the conventional B-mode images.The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%,respectively,compared to 78.6% and 50.0%,respectively,for the B-mode images.The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes.CONCLUSION:EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity,specificity and accuracy.It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes. | Marc Giovannini Botelberge Thomas Bories Erwan Pesenti Christian Caillol Fabrice Esterni Benjamin Monges Geneviève Arcidiacono Paolo Deprez Pierre Yeung Robert Schimdt Walter Schrader Hanz Szymanski Carl Dietrich Christoph Eisendrath Pierre Van Laethem Jean-Luc Devière Jacques Vilmann Peter Saftoiu Andrian | 2009 | World Journal of Gastroenterology2009，15，13： | 48 |
| 17 | A community-derived classification for extant lycophytes and ferns显示文摘发展史长通知了蕨类植物分类。当我们推断进化的树的能力改善了,针对认出生来的组的分类变得逐渐地预兆、稳定。这里,我们为 lycophytes 和蕨纲植物提供一个现代、全面分类,在下面,利用一条基于社区的途径类水平。我们 monophyly 用作主要标准让 taxa,而且目的识别保存两个广泛地被接受的存在 taxa 和界限并且与我们蕨类植物发展史的理解一致。总共,这个分类对待一在 337 个类, 51 个家庭, 14 目,和二个班估计了 11 916 种类。这个分类没在 lycophyte 和蕨纲植物上作为最后的词被打算分类,而是当前的假设的概括陈述,源于最好的可得到的数据并且在问题由熟悉植物的那些大多数塑造了。我们希望它将在蕨类植物上为最近的文学的那些想要的参考用作一个资源发展史和分类,为指导未来调查的一个框架,和推进讲话的刺激。 | Eric Schuettpelz Harald Schneider Alan R. Smith Peter Hovenkamp Jefferson Prado Germinal Rouhan Alexandre Salino Michael Sundue Thafs Elias Almeida Barbara Parris Emily B. Sessa Ashley R. Field Andre Luis de Gasper Carl J. Rothfels Michael D. Windham Marcus Lehnert Benjamin Dauphin Atsushi Ebihara Samuli Lehtonen Pedro Bond Schwartsburd Jordan Metzgar Li-Bing Zhang Li-Yaung Kuo Patrick J. Brownsey Masahiro Kato Marcelo Daniel Arana Francine C. Assis Michael S. Barker David S. Barrington Ho-Ming Chang Yi-Han Chang Yi-Shan Chao Cheng-Wei Chen De-Kui Chen Wen-Liang Chiou Vinicius Antonio de Oliveira Dittrich Yi-Fan Duan Jean-Yves Dubuisson Donald R. Farrar Susan Fawcett Jose Maria Gabriel y Galan Luiz Armando de Araujo Goes-Neto Jason R. Grant Amanda L. Grusz Christopher Haufler Warren Hauk Hai He Sabine Hennequin Regina Yoshie Hirai Layne Huiet Michael Kessler Petra Korall Paulo H. Labiak Anders Larsson Blanca Leen Chun-Xiang Li Fay-Wei Li Melanie Link-Perez Hong-Mei Liu Ngan Thi Lu Esteban I. Meza-Torres Xin-Yuan Miao Robbin Moran Claudine Massi Mynssens Nathalie Nagalingum Benjamin Ollgaard Alison M. Paul Jovani B. de S. Pereira Leon R. Perrie Monica Ponce Tom A. Ranker Christian Schulz Wataru Shinohara Alexander Shmakov Erin M. Sigel Filipe Soares de Souza Lana da Silva Sylvestre Weston Testo Luz Amparo Triana-Moreno Chie Tsutsumi Hanna Tuomisto IvAn A. Valdespino Alejandra Vasco Raquel Stauffer Viveros Alan Weakley Ran Wei Stina Weststrand Paul G. Wolf George Yatskievych Xiao-Gang Xu Yue-Hong Yan Liang Zhang Xian-Chun Zhang Xin-Mao Zhou | 2016 | Journal of Systematics and Evolution2016，54，6： | 44 |
| 18 | 基于Peerceptiv互评系统的英语写作同伴反馈效果研究显示文摘同伴互评作为教学手段的应用价值毋庸置疑。但是,同伴互评的效果与作者和评者的二语水平互动密切相关。文章以能力对同伴互评影响理论模型为依据,以基于Peerceptiv同伴互评系统的30篇学术写作文本一、二稿及1927条同伴反馈评语为研究语料,分析同伴互评的实施效果。结果显示,反馈评语与文本修改提高率总体呈正相关;作者和评者二语水平的非对称组合评语量最大,最有利于文本修改,是提高反馈效果的最佳组合方式。 | 高瑛 张福慧 张绍杰 Christian D.Schunn | 2018 | 外语电化教学2018，，2： | 50 |
| 19 | Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI显示文摘瞄准:与已知的额外的肝的原发性瘤对包括 CT, MRI 和临床 / 组织学的数据的联合标准答案在病人在肝转移的察觉用 SonoVue 评估提高对比的 ultrasonography (CEUS ) 。方法:它是一国际多集中学习,并且有 12 个中心和 125 个病人(64 男性, 61 女性,变老 59+/-11 年) 包含,与 102 个病人一起每协议。原发性瘤是在 35% 表面的颜色,在 27% 的胸,在 17% 胰腺并且其它在 21% 。用 SonoVue 的 CEUS 用西门子 Elegra, Philips HDI 5000 和 Acuson 红杉与一种 low-mechanical-index 技术和对比特定的软件被采用;为至少五分钟的连续扫描。结果:有 SonoVue 的 CEUS 显著地增加了检测的焦点的肝损害对 unenhanced sonography 的数字。在 31.4% 病人,更多的损害在对比改进以后被发现。检测的损害的全部的数字与 CEUS (55 ) 是可比较的,三倍阶段的螺线 CT (61 ) 和有一个肝特定的对比代理人(53 ) 的 MRI。变形疾病的察觉的精确性(即至少一变形损害) 比为 unenhanced sonography (81.4%) 为 CEUS (91.2%) 是显著地更高的并且类似于三倍阶段的螺线 CT (89.2%) 的。在其 CEUS 检查否定的 53 个病人,后续考试 3-6 瞬间以后在 50 个病人(94.4%) 证实了变形损害的缺席。结论:CEUS 被证明在在有已知的额外的肝的原发性瘤的病人的肝转移的察觉可靠并且怀疑肝损害。 | Christoph F Dietrich Wolfgang Kratzer Deike Strobel Etienne Danse Robert Fessl Alfred Bunk Udo Vossas Karlheinz Hauenstein Wilhelm Koch Wolfgang Blank Matthijs Oudkerk Dietbert Hahn Christian Greis | 2006 | World Journal of Gastroenterology2006，12，11： | 39 |
| 20 | 抗氧化剂一、二级预防随机试验中的死亡率系统回顾及汇总分析显示文摘背景:抗氧化剂正用于多种疾病的预防。
目的:评估补充抗氧化剂对一、二级预防随机临床试验参试者死亡率的影响。数据来源及试验选择:检索2005年10月前的电子数据库以及发表的文献目录。所有于成人中进行的、比较单独或联合使用β胡萝卜素、维生素A、维生素C(抗坏血酸)、维生素E及硒剂的安慰剂或空白治疗对照随机试验均纳入分析。使用随机、盲法及随访作为评估入选试验偏倚的指标。采用随机效应分析法分析抗氧化剂对全因死亡率的影响,结果以相对危险度(relative risk,RR)及其95%可信区间(confidence interval,CI)表示。采用汇总回归评估试验协变量的影响。
数据提取:共入选68项随即试验,包括232606例参试者(385篇文章)。
数据整合:将所有低和高偏倚风险抗氧化剂试验汇总后发现,抗氧化剂对死亡率无显著影响(RR,1.02;95%CI,0.98~1.06)。多变量汇总回归分析表明,低偏倚风险试验(RR,1.16;95%CI,1.05~1.29)和硒剂(RR,0.998;95%CI,0.997~0.9995)与死亡率显著相关。在包括180938例参试者在内的47项低偏倚试验中,补充抗氧化剂显著增加死亡率(RR,1.05;95%CI,1.02~1.08)。排除硒剂试验后,在低偏倚风险试验中,β胡萝卜素(RR,1.07;95%CI,1.02~1,11)、维生素A(RR,1.16;95%CI,1.10~1.24)以及维生素E(RR,1.04;95%CI,1.01~1.07)单独或联合使用均显著增加死亡率。维生素C及硒剂对死亡率无显著影响。
结论:β胡萝卜素、维生素A及维生素E治疗可能增加死亡率。维生素C和硒剂对死亡率的影响需要进一步研究。 | Goran Bjelakovic Dimitrinka Nikolova Lise Lotte Gluud Rose G. Simonetti Christian Gluud 顾佳(译) | 2007 | 美国医学会杂志(中文版)2007，26，5： | 35 |
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