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1最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL 2014神经病学与神经康复学杂志2014,11,3:31
2脑缺氧是影响严重颅脑创伤患者短期预后的独立危险因素(英文)显示文摘Background:Brain hypoxia(BH)can aggravate outcome after severe traumatic brain injury(TBI).Whether BH or reduced brain oxygen(Pbto2)is an independent outcome predictor or a marker of disease severity is not fully elucidated.Objective To analyze the relationship between Pbto2,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)and to examine whether BH correlates with worse outcome independently of ICP and CPP.Methods We studied103patientsOddo M Levine JM Mackenzie L Frangos S Feihl F Kasner SE Katsnelson M Pukenas B Macmurtrie E Maloney-Wilensky E Kofke WA Leroux PD 2011中华神经外科疾病研究杂志2011,10,5:21
3联合应用MDM2和CDK4免疫组化标记有助于鉴别低级别骨肉瘤与其它骨原发性纤维骨性病变显示文摘低级别骨肉瘤是较为少见的恶性肿瘤,依据肿瘤原发位置与骨皮质的关系可分为两种亚型,即骨旁骨肉瘤和低级别中央型骨肉瘤。两者组织学形态相似,主要由轻到中度异型的梭形细胞和分化良好的网状新生骨小梁结构组成。Dujardin F Binh M B Bouvier C 孙琦 樊祥山 2011临床与实验病理学杂志2011,27,12:19
4纳秒、皮秒和飞秒激光脉冲对材料表面的改性(英文)显示文摘对基体材料镉镍铁合金600和多层TiAlN/TiN涂层的激光表面改性在基础研究和实际应用中有着很好的前景。本文观察了由超短脉冲(fs和ns)和短脉冲(ns)激光器引起的镉镍铁合金600和TiAlN/TiN镀层的表面变化。结果显示,3种激光都能使靶面发生形态改变,超短脉冲的破坏轮廓更为清晰。与ps激光脉冲相比,fs激光脉冲能产生更严重的破坏。与产生半球体形状的ps激光束相反,fs激光脉冲产生的破坏斑是圆锥形的。另外,ns脉冲辐照时热效应占支配地位,且所有的辐照都伴随着等离子体。TRTICAM S GAKOVIC B M RADAK B B BATANI D TARASENKO V F PETROVIC S STASIC J MILOVANOVIC D KRMPOT A JELENKOVIC B 2011光学精密工程2011,19,2:18
5Epithelial toll-like receptor 9 signaling in colorectal inflammation and cancer: Clinico-pathogenic aspects显示文摘Toll-like receptors (TLRs) recognize specific motifs which are frequently present in bacteria, fungi, prokaryotes and viruses. Amongst TLRs, TLR9 can be activated by such bacterial or viral DNA fragments, immunoglobulin-DNA complexes or synthetic oligonucleotides, which all contain unmethylated cytosineguanine nucleotide sequences (CpGs). Emerging data indicate that TLR9 signaling has a role in, and may influence, colorectal carcinogenesis and colonic inflammation. CpGs are classified into three groups according to their influence on both the antigen-specific humoraland cellular immunity, and the production of type 1 interferons and proinflammatory cytokines. TLR9 activation via CpGs may serve as a new therapeutic target for several cancerous and various inflammatory conditions. Due to its probable anti-cancer effects, the application possibilities of TLR9-signaling modulation may be extremely diverse even in colorectal tumors. In this review we aimed to summarize the current knowledge about TLR-signaling in the pathogenesis and therapy of inflammatory bowel diseases and colorectal cancer. Due to the species-specific differences in TLR9 expression, however, one must be careful in translating the animal model data into the human system, because of the differences between CpG-oligodeoxynucleotide-responsive cells. TLR9 agonist DNA-based immunomodulatory sequences could also represent a promising therapeutic alternative in systemic inflammatory conditions and chronic colonic inflammations as their side effects are not significant.István Fri Ferenc Sipos Tiana M Germann Alexandra Kalmár Zsolt Tulassay Béla Molnár Gyrgyi Mzes 2013World Journal of Gastroenterology2013,19,26:14
6高危患者目标血压与心血管病预后显示文摘指南推荐血压目标值应〈140/90 mmHg(1mmHg=0.133kPa)以减少心血管事件的发生。但与其他心血管病预后(如冠状动脉事件)相比,包括脑卒中及心力衰竭在内的心血管病预后与收缩压下降关系更密切。一些心血管事件(如冠状动脉事件)风险在收缩压低时亦增高,风险-收缩压关系呈J形曲线,而脑卒中与血压不是J形曲线关系。B?hm M Schumacher H Teo KK Lonn EM Mahfoud F Mann JF Mancia G Redon J Schmieder RE Sliwa K Weber MA Williams BYusuf S 曲浥晨 叶鹏 2017中华高血压杂志2017,25,6:14
7Polymorphisms of MTHFD,plasma homocysteine levels, and risk of gastric cancer in ahigh-risk Chinese population显示文摘Purpose:Accumulative evidence suggests that folate has a protective effect on gastric cancer. The methylenetetrahyd-rofolate dlehydrogenase(MTHFD) plays an important role in folate and homocysteine metabolisms, and polymorphisms of MTHFD may result in disturbance of the folate-mediated homocysteine pathway. The aim of this study is to test the hypothesis that genetic variants of MTHFD and plasma homocysteine levels are associated with risk of gastric cancer and modulated by genotypes of methylenetetrahydrofolate reductase(MTHFR). Experimental Design: We genotyped G1958A and T401C in MTHFD and C677T in MTHFR and detected total plasma homocysteine(tHcy) levels in a case-control study of 589 gastric cancer cases and 635 cancer-free controls in a high-risk Chinese population. Results:The variant genotypes of MTHFD 1958AA and 401CC were associated with a significantly increased risk of gastric canceradjusted odds ratio(OR), 2.05; 95% confidence interval(95% CI),1.34-3.13 for 1958AA; adjusted OR,1.43; 95% CI,1.14-1.80 for 401CC compared with 1958GG/GA and 401TT/TC genotypes, respectively. Both of the effects were more evident in the subjects carrying MTHFR 677CT/TT genotypes. The average tHcy level was significantly higher in gastric cancer cases than in controls(P < 0.01), and the upper quartile of tHcy (> 13.6 mu mol/L) was associated with an 82% significantly increased risk of gastric cancer, compared with the lowest quartile of tHcy(<= 8.0 pmol/L;adjusted OR,1.82; 95% CI,1.20-2.75). Conclusions:The strong associations between MTHFD variants and the plasma tHcy levels and gastric cancer risk suggest, for the first time, a possible gene-environment interaction between genetic variants of folate-metabolizing genes and high tHcy levels in gastric carcinogenesis.Wang, L. N Ke, Q Chen, W. S Wang, J. M Tan, Y. F Zhou, Y Hua, Z. L Ding, W. L Niu, J. Y Shen, J Zhang, Z. F Wang, X. R Xu, Y. H Shen, H. B Yi Xing 2007南京医科大学学报(自然科学版)2007,27,7:10
8人血浆硫氧化还原蛋白80随着年龄增长而增加,并在载脂蛋白E基因敲除小鼠中诱导炎症、血管生成和动脉粥样硬化显示文摘硫氧化还原蛋白(thioredoxin,TRX)1是一种普遍存在的12kD的蛋白质,可产生抗氧化和抗炎作用。由巨噬细胞产生的截断形式称为TRX80,其可诱导促炎细胞因子的上调。TRX80还促进小鼠腹膜和人巨噬细胞向促炎M1表型的分化。方法:使用特异性酶联免疫吸附试验测定血浆TRX1和TRX80水平。刘莉 叶鹏 Couchie D Vaisman B Abderrazak A Mahmood DFD Hamza MM Canesi F Diderot V El Hadri K Nègre-Salvayre AE Le Page A Fulop T Remaley AT Rouis M 2017中华高血压杂志2017,25,6:9
9三级高血压单位5100例患者低血钾症与原发性醛固酮增多症的发病率显示文摘常伴有低血钾症的原发性醛固酮增多症(原醛)被认为是一个少见病。广泛筛查高血压患者发现正常血钾的原醛发生率增加。许多研究报道原醛低血钾症的发生率,相反,低血钾症患者中原醛的发生率并不明确。在该回顾性观察研究,研究者探讨了高血压患者中低钾的发生率以及低血钾症合并高血压患者中原醛的发生率。赵狄(译) 刘莉(审校) Burrello J Monticone S Losano I Cavaglià G Buffolo F Tetti M Covella M Rabbia F Veglio F Pasini B Williams TA Mulatero P 2020中华高血压杂志2020,28,3:7
10Mycophenolate mofetil for maintenance of remission in steroid-dependent autoimmune pancreatitis显示文摘Systemic corticosteroids represent the standard treatment for autoimmune pancreatitis with IgG4-associated cholangitis.For steroid-dependent disease,azathioprine has been used for maintenance of remission.Mycophenolate mofetil has been used for transplant immunosuppression and more recently for autoimmune hepatitis;however,there are no case reports to date on the use of mycophenolate mofetil in adult patients with autoimmune pancreatitis.A patient with IgG4-mediated autoimmune pancreatitis and IgG4-associated cholangitis refractory to steroids and intolerant of azathioprine was treated with mycophenolate mofetil,which inhibits de novo guanosine synthesis and blockade of both B and T lymphocyte production.Introduction of mycophenolate mofetil and uptitration to 1000 mg by mouth twice daily over a treatment period of 4 mo was associated with improvement in the patient's energy level and blood glucose control and was not associated with any adverse events.The patient was managed without a biliary stent.However,there was a return of symptoms,jaundice,increase in transaminases,and hyperbilirubinemia when the prednisone dose reached 11 mg per day.In the first report of mycophenolate mofetil use in an adult patient with IgG4-associated autoimmune pancreatitis and IgG4-associated cholangitis,the introduction of mycophenolate mofetil was safe and well-tolerated without adverse events,but it did not enable discontinuation of the steroids.Mycophenolate mofetil and other immunomodulatory therapies should continue to be studied for maintenance of remission in the large subset of patients with refractory or recurrent autoimmune pancreatitis.Jamie B Sodikoff Steven A Keilin Sheila J Bharmal Melinda M Lewis Gottumukkala S Raju Field F Willingham 2012World Journal of Gastroenterology2012,18,18:6
11健康领域的文化能力显示文摘1背景 尽管人类对其他社会的兴趣纵贯历史的各个阶段,但是检验不同文化概念对人类健康实践的影响从20世纪才开始,当时是伴随着长期的人类学田野调查产生的,这些田野调查揭露了不同文化之间相关卫生实践的多样性、复杂性和连续性。Napier A D Ancarno C Butler B Calabrese j Chater A Chatterjee H Guesnet F Home R Jacyna S Jadhav S Macdonald A Neuendorf U Parkhurst A Reynolds R Scambler G Shamdasani S Smith S Z Stougaard-Nielsen J Thomson L Tyler N Volkmann A M Walker T Watson J Williams AC Willott C Wilson J Woolf K 2016中国卫生政策研究2016,9,2:5
12持续气道正压通气在预防阻塞性睡眠呼吸暂停患者心血管事件中的作用显示文摘阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)导致阵发性低氧血症,夜间交感神经系统激活,血压、氧化应激和炎症指标的升高以及高凝血症。较大的胸内负压波动也会给心脏和大血管施加机械应力。基于人群和睡眠诊所的队列研究显示,OSA与心脑血管事件,特别是脑卒中相关。McEvoy RD Antic NA Heeley E Luo Y Ou Q Zhang X Mediano O Chen R Drager LF Liu Z Chen G Du B McArdle N Mukherjee S Tripathi M Billot L Li Q Lorenzi-Filho G Barbe F Redline S Wang J Arima H Neal B White DP Grunstein RR Zhong N Anderson CS 练桂丽 叶鹏 2016中华高血压杂志2016,24,11:4
13Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) - Update 2008显示文摘M Claudon D Cosgrove T Albrecht L Bolondi M Bosio F Calliada J.-M Correas K Darge C Dietrich M D’Onofrio D Evans C Filice L Greiner K J?ger N Jong E Leen R Lencioni D Lindsell A Martegani S Meairs C Nols?e F Piscaglia P Ricci G Seidel B Skjoldbye L Solbia 2008Ultraschall in Med2008,,01:4
14Occurrence and distribution of metals and porphyrins in Nigerian coal minerals显示文摘The metal contents of Nigerian coal minerals were analyzed using an atomic absorption spectrophotometer. Calcium, Na, and Fe occurred as the major elements with concentrations ranging from 9 782 μg/g for Ca to 432 μg/g for Na whereas K, Mg, Mn, Ni, Cr, Zn, Pb, and Cu, which occurred at trace levels ranged from 673.73 μg/g for Mg to 2.97 μg/g for Mn. The results of the quantitative analysis of porphyrins extracted from the coal minerals showed that Onyeama coal has the highest amount of porphyrins (ca~0.96 μg/g) while Okpara has the lowest (ca~0.30 μg/g). The porphyrins were qualitatively characterized by a combination of thin layer chromatography (TLC), infrared, and ultraviolet-visible spectrophotometers. The results of the mid infrared analysis (MIR) showed the presence of absorption bands at 3 440 cm~1~3 450 cm-1 and 1 640 cm-1~1 680 cm-1 , which are owing to the stretching vibrations of N ─ H and C─ C of aromatics, with C─ H out of plane (oop) bending vibrations at wavenumbers less than 900 cm-1, all of which are characteristic absorptions of porphyrin free base. The ultraviolet-visible data showed prominent peaks at ~400 nm(Soret band) and at wavelength ranges of 535 nm~550 nm(β-band) and 565 nm~ 600 nm (α-band) for the coal porphyrins analyzed. The geochemical significance of the metals and porphyrins in coal minerals are discussed.OLAJIRE A A AMEEN A B ABDUL-HAMMED M ADEKOLA F A 2007燃料化学学报2007,35,6:4
15Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) - Update 2008显示文摘M Claudon D Cosgrove T Albrecht L Bolondi M Bosio F Calliada J.-M Correas K Darge C Dietrich M D'Onofrio D Evans C Filice L Greiner K J?ger N Jong E Leen R Lencioni D Lindsell A Martegani S Meairs C Nols?e F Piscaglia P Ricci G Seidel B Skjoldbye L Solbia 2008Ultraschall in Med2008,,01:3
16烤烟,白肋烟和香料烟(Nicotiana tabacum)烟叶中镉浓度的调查显示文摘LLUGON-MOULIN N MARTIN F KRAUSS M R RAMEY P B ROSSIL 吴晓芸(译) 康婧(校) 2006中国烟草学报2006,12,6:3
17中国内地孕妇和家畜弓形虫的血清反应回顾性分析显示文摘弓形虫是一种引起弓形虫病的胞内原虫寄生虫。这种寄生虫在世界上分布广泛,可以感染多种温血动物,包括人类、宠物和家畜。在一般人群中,弓形虫感染可以保持无症状,也可引起淋巴结病和流感样症状,或导致眼疾,而最常发生的是绒毛膜炎,孕妇是其特定的风险群体。如果怀孕期间获得初级感染,可能导致胎儿流产、死产和神经发育障碍。在人群中的主要传播途径之一是食用含有T.gondii组织囊肿的生肉或未煮熟的肉类。Deng H F Devleesschauwer B Liu M 2018中国妇幼健康研究2018,29,6:3
18一种房颤风险评分系统的建立(Framingham心脏研究):基于社区的队列研究显示文摘背景房颤导致了发病率和病死率的显著上升。本研究旨在建立一种预测个体罹患房颤绝对风险的风险评分系统,并提供研究人员评价新危险因素的流程。方法作者评估了Framingham心脏研究中于1968年6月至1987年9月间进行了8044次检测的4764例参与者(55%为女性,年龄45~95岁)。此后,参与者被随访至房颤首发,随访期最长达10年。多变量Coxi回归确认出1(1年内罹患房颤的临床危险因素。次级分析纳入了常规超声心动图检测指标(5152例4参与者,7156次检测)对房颤风险进行再分层评估,并评价超声检测指标能否提高风险预测能力。结果4764例参与者中的457例4(10%)罹患房颤。年龄、性别、体重指数、收缩压、降压治疗、PR间期、有临床意义的心脏杂音及心力衰竭与房颤相关,并被纳入了风险评分模型(除体重指数P=0.08外,其余均为P〈0.05),模型的C统计量为0.78(95%CI0.76~0.80)。10年房颤风险随年龄变化:年龄〈65岁的人群中53例(1%)风险高于15%,而〉65岁的人群中为783例(27%)。为提高预测能力而纳入超声检测指标仅使模型C统计量略微增高,由0.78(95%C10.75~0.80)增至0.79(95%CI0.77~0.82:P=0.005)。超声心动图检测指标并不能改善风险再分层评估(P=0.18)。结论基于社区医疗中易得的临床因素建立的风险评分系统,有助于确认社区个体罹患房颤的风险,评估技术或标志物能否改善风险预测,以及针对高危个体采取预防措施。Renate B Schnabel Lisa M Sullivan Daniel Levy Michael J Pencina Joseph M Massaro Ralph B D'Agostino Sr Christopher Newton-Cheh Jennifer F Yamamoto Jared W Magnani Thomas M Tadros William B Kannel Thomas J Wang Patrick T Ellinor Philip A Wolf Ramachanclran S Vasan Emelia J Benjamin 黄刚(译) 2009世界临床医学2009,,9:2
19Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari 2019World Journal of Gastroenterology2019,25,38:2
20Appropriateness of systemic treatments in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors显示文摘AIM:To evaluate systemic treatment choices in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors(PNETs)and provide consensus treatment recommendations.METHODS:Systemic treatment options for pancreatic neuroendocrine tumors have expanded in recent years to include somatostatin analogs,angiogenesis inhibitors,inhibitors of mammalian target of rapamycinand cytotoxic agents.At this time,there is little data to guide treatment selection and sequence.We therefore assembled a panel of expert physicians to evaluate systemic treatment choices and provide consensus treatment recommendations.Treatment appropriateness ratings were collected using the RAND/UCLA modified Delphi process.After studying the literature,a multidisciplinary panel of 10 physicians assessed the appropriateness of various medical treatment scenarios on a 1-9 scale.Ratings were done both before and after an extended discussion of the evidence.Quantitative measurements of agreement were made and consensus statements developed from the second round ratings.RESULTS:Specialties represented were medical and surgical oncology,interventional radiology,and gastroenterology.Panelists had practiced for a mean of15.5 years(range:6-33).Among 202 rated scenarios,disagreement decreased from 13.2%(26 scenarios)before the face-to-face discussion of evidence to 1%(2)after.In the final ratings,46.5%(94 scenarios)were rated inappropriate,21.8%(44)were uncertain,and30.7%(62)were appropriate.Consensus statements from the scenarios included:(1)it is appropriate to use somatostatin analogs as first line therapy in patients with hormonally functional tumors and may be appropriate in patients who are asymptomatic;(2)it is appropriate to use everolimus,sunitinib,or cytotoxic chemotherapy therapy as first line therapy in patients with symptomatic or progressive tumors;and(3)beyond first line,these same agents can be used.In patients with uncontrolled secretory symptoms,octreotide LAR doses can be titrated up to 60 mg every4 wk or up to 40 mg every 3 or 4 wk.CONCLUSION:Using the Delphi process allowed physician experts to systematically obtain a consensus on the appropriateness of a variety of medical therapies in patients with PNETs.Jonathan R Strosberg George A Fisher Al B Benson Lowell B Anthony Bulent Arslan John F Gibbs Edward Greeno Renuka V Iyer Michelle K Kim William J Maples Philip A Philip Edward M Wolin Dasha Cherepanov Michael S Broder 2015World Journal of Gastroenterology2015,21,8:2
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