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| 1 | SPIRIT 2013声明:定义临床研究方案的标准条目显示文摘临床研究方案是临床研究设计、实行、报告和评价的基础。然而,临床研究方案及现存的临床研究方案指引在内容和质量上差异很大。本文描述了《规范临床研究方案内容》(Standard Protocol Items:Recommendations for Interventional Trials 2013 ),简称SPIRIT2013声明,一个临床研究方案必须报告的条目指引的系统建立和范围。 | An-Wen Chan Jennifer M.Tetzlaff Douglas G.Altman Andreas Laupacis Peter C.GΦtzsche Karmela Krleza-Jeri AsbjΦrn Hróbjartsson Howard Mann Kay Dickersin Jesse A.Berlin Caroline J.Doré Wendy R.Parulekar William S.M.Summerskill Trish Groves Kenneth F.Schulz Harold C.Sox Frank W.Rockhold Drummond Rennie David Moher 钟丽丹 郑颂华 吴泰相 李幼平 商洪才 张伯礼 唐旭东 吕爱平 卞兆祥 | 2013 | 中国循证医学杂志2013，13，12： | 23 |
| 2 | 初中留守儿童社会支持特点与情绪行为问题的关系显示文摘目的探讨福建省初中留守儿童社会支持的特点及其与情绪行为问题的关系,为制定有效的干预措施提供依据。方法采用社会支持问卷及长处和困难问卷(学生版),对福建省乡镇中学的963名留守儿童和1 520名非留守儿童进行调查分析。结果留守儿童与非留守儿童总体社会支持得分分别为(34.98±6.01),(35.94±5.78)分,差异无统计学意义(t=3.959,P>0.05)。非留守儿童和仅父亲外出务工的留守儿童得到的社会支持高于其他类型的留守儿童(F=8.699,P<0.05)。社会支持水平与留守儿童的情绪行为呈负相关,主观支持、支持利用度对于初中留守儿童的情绪行为问题均具有负向预测作用。高社会支持水平下的留守儿童比低社会支持水平下的留守儿童具有较少的情绪行为问题,低社会支持水平的留守女生较男生存在更多的情绪问题(P值均<0.01)。结论为减少情绪行为问题的发生,在给留守儿童提供客观社会支持的同时,应特别重视其对支持的主观感受和培养利用社会支持的能力。 | 江琴 Bj?rn Albin | 2014 | 中国学校卫生2014，35，3： | 23 |
| 3 | Design of 16S rRNA gene primers for 454 pyrosequencing of the human foregut microbiome显示文摘AIM:To design and validate broad-range 16S rRNA primers for use in high throughput sequencing to classify bacteria isolated from the human foregut microbiome.METHODS:A foregut microbiome dataset was constructed using 16S rRNA gene sequences obtained from oral,esophageal,and gastric microbiomes produced by Sanger sequencing in previous studies represented by 219 bacterial species.Candidate primers evaluated were from the European rRNA database.To assess the effect of sequence length on accuracy of classification,16S rRNA genes of various lengths were created by trimming the full length sequences.Sequences spanning various hypervariable regions were selected to simulate the amplicons that would be obtained using possible primer pairs.The sequences were compared with full length 16S rRNA genes for accuracy in taxonomic classification using online software at the Ribosomal Database Project (RDP).The universality of the primer set was evaluated using the RDP 16S rRNA database which is comprised of 433 306 16S rRNA genes,represented by 36 phyla.RESULTS:Truncation to 100 nucleotides(nt)downstream from the position corresponding to base 28 in the Escherichia coli 16S rRNA gene caused misclassification of 87(39.7%)of the 219 sequences,compared with misclassification of only 29(13.2%)sequences with truncation to 350 nt.Among 350-nt sequence reads within various regions of the 16S rRNA gene,the reverse read of an amplicon generated using the 343F/798R primers had the least(8.2%)effect on classification.In comparison,truncation to 900 nt mimicking single pass Sanger reads misclassified 5.0%of the 219 sequences.The 343F/798R amplicon accurately assigned 91.8%of the 219 sequences at the species level.Weighted by abundance of the species in the esophageal dataset,the 343F/798R amplicon yielded similar classification accuracy without a significant loss in species coverage(92%).Modification of the 343F/798R primers to 347F/803R increased their universality among foregut species.Assuming that a typicalpolymerase chain reaction can tolerate 2 mismatches between a primer and a template,the modified 347F and 803R primers should be able to anneal 98%and 99.6%of all 16S rRNA genes in the RDP database.CONCLUSION:347F/803R is the most suitable pair of primers for classification of foregut 16S rRNA genes but also possess universality suitable for analyses of other complex microbiomes. | Carlos W Nossa William E Oberdorf Jφrn A Aas Bruce J Paster Todd Z DeSantis Eoin L Brodie Daniel Malamud Michael A Poles Zhiheng Pei | 2010 | World Journal of Gastroenterology2010，16，33： | 16 |
| 4 | Upper gastrointestinal sensory-motor dysfunction in diabetes mellitus显示文摘胃肠(官方补给) 感觉马达的畸形在有糖尿病的病人是普通的并且可以包含官方补给的道的任何部分。畸形经常是无临床症状的,并且幸好,严重、威胁生活的问题仅仅很少发生。在糖尿病的反常上面的官方补给的感觉马达的功能的致病不完全地被理解并且是最可能的起源多因素。糖尿病的自治神经病以及糖尿病的尖锐非最优的控制被显示了损害官方补给的马达和感觉功能。词法并且官方补给的墙的机械改变在糖尿病的持续时间期间开发的简历,并且可以贡献马达和感觉机能障碍。在感觉的这评论和活动性,在糖尿病的上面的官方补给的道的混乱被讨论;并且与感觉马达的机能障碍有关的机械改变也是的词法变化和简历探讨了。 | Jingbo Zhao Jens Brφndum Frφkjaer Asbjφrn Mohr Drewes Niels Ejskjaer | 2006 | World Journal of Gastroenterology2006，12，18： | 15 |
| 5 | 虎斑夜鳽分布与亚群态势研究显示文摘本世纪以来对虎斑夜鳽分布地点的新发现,表明该种从滨海到内陆漫布于中国长江以南广大地区,并向北渗透直逼东洋界北限秦岭-淮河一线;作者据此将各地的虎斑夜鳽初划为11个亚群,提出目前该种存有3个相对健康而稳定的亚群,即黄山-天目山亚群、南岭亚群和广西亚群,且每个亚群的分布范围均至少不会小于5000km2,其中以黄山-天目山亚群的记录由历史至现今相对最为长久而完整,进而提出今后在上述诸亚群范围之外还会有新的发现。文中指出,尽管近期对虎斑夜分布状况有了新认识,目前仍可视该种的受胁等级为濒危。 | 何芬奇 周放 杨晓君 杨岚 邓学建 胡鸿兴 林剑声 江航东 林植 李立 朱开明 Bjrn Anderson 张浩辉 董江天 | 2007 | 动物分类学报2007，32，4： | 14 |
| 6 | 矿井瓦斯/空气预混气体爆燃的激光纹影测试系统设计显示文摘为了准确地获取矿井瓦斯/空气预混气体爆燃流场的内部微观结构信息,能够从基元反应层面认识爆燃流场的演化过程以及惰性介质阻燃剂抑制作用的机理,在已经建成的中尺度激波管道上继续搭建高速激光纹影测试系统,结合实验室几何空间约束条件,提出纹影测试系统'Z'字型光路的设计方案。以激光纹影系统代替传统的压力火焰测试系统,将爆燃流场的研究重心从宏观的单一点源信息向微观的多重结构信息转化。研究表明,在60,100,125,212ms时火焰阵面的化学反应变强,伴随着产生了冲击波,在75ms左右火焰发生断裂,该点处的压力下降,325ms火焰阵面扫过该测点以后,压力迅速下降。该结果为寻求预混气体爆燃高速摄影、压力火焰速度测试手段之外的方法提供了新的研究思路。 | 胡洋 尹尚先 ARNTZENJ.Bj?rn 朱建芳 李雪冰 | 2019 | 光学精密工程2019，27，5： | 14 |
| 7 | Validation of Fujinon intelligent chromoendoscopy with high definition endoscopes in colonoscopy显示文摘AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in colonoscopy.METHODS:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of a gold standard(0.2% indigo carmine dye) were compared.RESULTS:FICE-filter 4 [red,green,and blue(RGB) wavelengths of 520,500,and 405 nm,respectively] provided the best images for evaluating the vascular pattern compared to white light.The mucosal surface was best assessed using filter 4.However,the views obtained were not rated significantly better than those observed with white light.The 'gold standard',indigo carmine(IC) dye,was found to be superior to both white light and filter 4.Filter 6(RGB wavelengths of 580,520,and 460 nm,respectively) allowed for exploration of the IC-stained mucosa.When assessing mucosal polyps,both FICE with magnification,and magnification following dye spraying were superior to the same techniques without magnification and to white light imaging.In the presence of suboptimal bowel preparation,observation with the FICE mode was possible,and endoscopists considered it to be superior to observation with white light.CONCLUSION:FICE-filter 4 with magnification improves the image quality of the colonic vascular patterns obtained with WLE. | Adolfo Parra-Blanco Alejandro Jiménez Bjrn Rembacken Nicolás González David Nicolás-Pérez Antonio Z Gimeno-García Marta Carrillo-Palau Takahisa Matsuda Enrique Quintero | 2009 | World Journal of Gastroenterology2009，15，42： | 12 |
| 8 | Pathophysiology of chronic pancreatitis显示文摘Chronic pancreatitis(CP)is an inflammatory disease of the pancreas characterized by progressive fibrotic destruction of the pancreatic secretory parenchyma.Despite the heterogeneity in pathogenesis and involved risk factors,processes such as necrosis/apoptosis,inflammation or duct obstruction are involved.This fibrosing process ultimately leads to progressive loss of the lobular morphology and structure of the pancreas,deformation of the large ducts and severe changes in the arrangement and composition of the islets.These conditions lead to irreversible morphological and structural changes resulting in impairment of both exocrine and endocrine functions.The prevalence of the disease is largely dependent on culture and geography.The etiological risk-factors associated with CP are multiple and involve both genetic and environmental factors.Throughout this review the M-ANNHEIM classification system will be used,comprising a detailed description of risk factors such as:alcohol-consumption,nicotineconsumption,nutritional factors,hereditary factors,efferent duct factors,immunological factors and miscellaneous and rare metabolic factors.Increased knowledge of the different etiological factors may encourage the use of further advanced diagnostic tools,which potentially will help clinicians to diagnose CP at an earlier stage.However,in view of the multi factorial disease and the complex clinical picture,it is not surprising that treatment of patients with CP is challenging and often unsuccessful. | Christina Brock Lecia Mφller Nielsen Dina Lelic Asbjφrn Mohr Drewes | 2013 | World Journal of Gastroenterology2013，19，42： | 11 |
| 9 | The enhanced X-ray Timing and Polarimetry mission—eXTP显示文摘In this paper we present the enhanced X-ray Timing and Polarimetry mission—eXTP. eXTP is a space science mission designed to study fundamental physics under extreme conditions of density, gravity and magnetism. The mission aims at determining the equation of state of matter at supra-nuclear density, measuring effects of QED, and understanding the dynamics of matter in strong-field gravity. In addition to investigating fundamental physics, eXTP will be a very powerful observatory for astrophysics that will provide observations of unprecedented quality on a variety of galactic and extragalactic objects. In particular, its wide field monitoring capabilities will be highly instrumental to detect the electro-magnetic counterparts of gravitational wave sources.The paper provides a detailed description of:(1) the technological and technical aspects, and the expected performance of the instruments of the scientific payload;(2) the elements and functions of the mission, from the spacecraft to the ground segment. | ShuangNan Zhang Andrea Santangelo Marco Feroci YuPeng Xu FangJun Lu Yong Chen Hua Feng Shu Zhang Sφren Brandt Margarita Hernanz Luca Baldini Enrico Bozzo Riccardo Campana Alessandra De Rosa YongWei Dong Yuri Evangelista Vladimir Karas Norbert Meidinger Aline Meuris Kirpal Nandra Teng Pan Giovanni Pareschi Piotr Orleanski QiuShi Huang Stephane Schanne Giorgia Sironi Daniele Spiga Jiri Svoboda Gianpiero Tagliaferri Christoph Tenzer Andrea Vacchi Silvia Zane Dave Walton ZhanShan Wang Berend Winter Xin Wu Jean J.M.in't Zand Mahdi Ahangarianabhari Giovanni Ambrosi Filippo Ambrosino Marco Barbera Stefano Basso Jörg Bayer Ronaldo Bellazzini Pierluigi Bellutti Bruna Bertucci Giuseppe Bertuccio Giacomo Borghi XueLei Cao Franck Cadoux Francesco Ceraudo TianXiang Chen Yu Peng Chen Jerome Chevenez Marta Civitani Wei Cui WeiWei Cui Thomas Dauser Ettore Del Monte Sergio Di Cosimo Sebastian Diebold Victor Doroshenko Michal Dovciak YuanYuan Du Lorenzo Ducci QingMei Fan Yannick Favre Fabio Fuschino JoséLuis Ga'lvez Min Gao MingYu Ge Olivier Gevin Marco Grassi QuanYing Gu YuDong Gu DaWei Han Bin Hong Wei Hu Long Ji ShuMei Jia WeiChun Jiang Thomas Kennedy Ingo Kreykenbohm Irfan Kuvvetli Claudio Labanti Luca Latronico Gang Li MaoShun Li Xian Li Wei Li ZhengWei Li Olivier Limousin HongWei Liu XiaoJing Liu Bo Lu Tao Luo Daniele Macera Piero Malcovati Adrian Martindale Malgorzata Michalska Bin Meng Massimo Minuti Alfredo Morbidini Fabio Muleri Stephane Paltani Emanuele Perinati Antonino Picciotto Claudio Piemonte JinLu Qu Alexandre Rachevski Irina Rashevskaya Jerome Rodriguez Thomas Schanz ZhengXiang Shen LiZhi Sheng JiangBo Song LiMing Song Carmelo Sgro Liang Sun Ying Tan Phil Uttley Bo Wang DianLong Wang GuoFeng Wang Juan Wang LangPing Wang YuSa Wang Anna L.Watts XiangYang Wen Jörn Wilms ShaoLin Xiong JiaWei Yang Sheng Yang YanJi Yang Nian Yu WenDa Zhang Gianluigi Zampa Nicola Zampa Andrzej A.Zdziarski AiMei Zhang ChengMo Zhang Fan Zhang Long Zhang Tong Zhang Yi Zhang XiaoLi Zhang ZiLiang Zhang BaoSheng Zhao ShiJie Zheng Yu Peng Zhou Nicola Zorzi J.Frans Zwart | 2019 | Science China(Physics,Mechanics & Astronomy)2019，62，2： | 11 |
| 10 | Diagnosis and treatment of pancreatic exocrine insufficiency显示文摘Pancreatic exocrine insufficiency is an important cause of maldigestion and a major complication in chronic pancreatitis.Normal digestion requires adequate stimulation of pancreatic secretion,sufficient production of digestive enzymes by pancreatic acinar cells,a pancreatic duct system without significant outflow obstruction and adequate mixing of the pancreatic juice with ingested food.Failure in any of these steps may result in pancreatic exocrine insufficiency,which leads to steatorrhea,weight loss and malnutrition-related complications,such as osteoporosis.Methods evaluating digestion,such as fecal fat quantification and the13C-mixed triglycerides test,are the most accurate tests for pancreatic exocrine insufficiency,but the probability of the diagnosis can also be estimated based on symptoms,signs of malnutrition in blood tests,fecal elastase 1 levels and signs of morphologically severe chronic pancreatitis on imaging.Treatment for pancreatic exocrine insufficiency includes support to stop smoking and alcohol consumption,dietary consultation,enzyme replacement therapy and a structured follow-up of nutritional status and the effect of treatment.Pancreatic enzyme replacement therapy is administered in the form of enteric-coated minimicro-spheres during meals.The dose should be in proportion to the fat content of the meal,usually 40-50000 lipase units per main meal,and half the dose is required for a snack.In cases that do not respond to initial treatment,the doses can be doubled,and proton inhibitors can be added to the treatment.This review focuses on current concepts of the diagnosis and treatment of pancreatic exocrine insufficiency. | Bjrn Lindkvist | 2013 | World Journal of Gastroenterology2013，19，42： | 11 |
| 11 | 硒汞相互作用及机理研究进展显示文摘硒汞相互作用研究在过去近半个世纪以来一直都是汞(硒)环境化学和毒理学及相关学科研究的重要领域之一,尤其在近10年内,对该领域的研究和认识取得了重要突破,国际上几乎每年都会出现与之相关的综述或评论。相比之下,国内期刊报道与之相关的综述文献并不多见。本文对这一领域的研究进展进行了尽可能详尽的系统介绍,并就重要问题阐述了相关观点并提出建议。内容上涵盖了'自然条件环境下硒汞相互作用及机理(包括水生生态系统和陆地生态系统)'、'哺乳动物(及人体)的硒汞相互作用及机理',以及'汞污染风险的新评估模式及相关建议'等三大部分。希望能对国内感兴趣的相关科研人员和环境管理工作者了解该领域的发展和动态起到一定的帮助。 | 张华 冯新斌 王祖光 Thorjфrn Larssen | 2013 | 地球与环境2013，41，6： | 11 |
| 12 | 福州孕妇妊娠中期中医体质辨识研究显示文摘目的了解福州孕中期孕妇体质,为其孕期保健提供指导。方法采用《中医体质分类与判定表》,以横断面分层抽样,调查1 000例孕中期孕妇。剔除逻辑错误量表,获有效量表989份。采用构成比描述孕中期孕妇体质分布。结果福州孕中期孕妇总体体质分布为:平和质200例(占20.2%),其余789例均为偏颇混杂体质(占79.8%),依次为:阳虚质28.5%(282/989),湿热质25.5%(252/989),阴虚质25.2%(249/989),气郁质23.1%(228/989),气虚质23.1%(228/989),血瘀质19.1%(189/989),痰湿质10.9%(108/989),特禀质7.0%(69/989)。20~岁组各体质分布差异有统计学意义(P<0.05);25~岁组各体质分布差异有统计学意义(P<0.05);30~岁组各体质分布差异有统计学意义(P<0.05)。初中组各体质分布差异有统计学意义(P<0.05);高中及中专组各体质分布差异有统计学意义(P<0.05);大专及以上组各体质分布差异有统计学意义(P<0.05)。结论福州孕妇孕中期体质特点为多虚、多湿热、多气郁。产前保健人员可在'治未病'思想指导下,依据孕妇体质提供更加有针对性的孕期保健,提高人口素质。 | 葛莉 张素英 陈锦秀 杨雪梅 郑晓云 姚立群 Bjrn Albin | 2013 | 中国全科医学2013，16，16： | 9 |
| 13 | Stage and size using magnetic resonance imaging and endosonography in neoadjuvantly-treated rectal cancer显示文摘AIM: To assess the stage and size of rectal tumours using 1.5 Tesla (1.5T) magnetic resonance imaging (MRI) and three-dimensional (3D) endosonography (ERUS). METHODS: In this study, patients were recruited in a phaseⅠ/Ⅱ trial of neoadjuvant chemotherapy for biopsy-proven rectal cancer planned for surgical resection with or without preoperative radiotherapy. The feasibility and accuracy of 1.5T MRI and 3D ERUS were compared with the histopathology of the fixed surgical specimen (pathology) to determine the stage and size of the rectal cancer before and after neoadjuvant chemotherapy. A Philips Intera 1.5T with a cardiac 5-channel synergy surface coil was used for the MRI, and a B-K Medical Falcon 2101 EXL 3D-Probe was used at 13 MHz for the ERUS. Our hypothesis was that the staging accuracy would be the same when using MRI, ERUS and a combination of MRI and ERUS. For the combination, MRI was chosen for the assessment of the lymph nodes, and ERUS was chosen for the assessment of perirectal tissue penetration. The stage was dichotomised into stageⅠ and stage Ⅱ or greater. The size was measured as the supero-inferior length and the maximal transaxial area of the tumour. RESULTS: The staging feasibility was 37 of 37 for the MRI and 29 of 36 for the ERUS, with stenosis as a limiting factor. Complete sets of investigations were available in 18 patients for size and 23 patients for stage. The stage accuracy by MRI, ERUS and the combination of MRI and ERUS was 0.65, 0.70 and 0.74, respectively, before chemotherapy and 0.65, 0.78 and 0.83, respectively, after chemotherapy. The improvement of the post-chemotherapy staging using the combination of MRI and ERUS compared with the staging using MRI alone was significant (P = 0.046). The post-chemotherapy understaging frequency by MRI, ERUS and the combination of MRI and ERUS was 0.18, 0.14 and 0.045, respectively, and these differences were non-significant. The measurements of the supero-inferior length by ERUS compared with MRI were within 1.96 standard deviations of the difference between the methods (18 mm) for tumours smaller than 50 mm. The agreement with pathology was within 1.96 standard deviations of the difference between imaging and pathology for all tumours with MRI (15 mm) and for tumours that did not exceed 50 mm with ERUS (22 mm). Tumours exceeding 50 mm in length could not be reliably measured by ERUS due to the limit in the length of each recording. CONCLUSION: MRI is preferable to use when assessing the size of large or stenotic rectal tumours. However, staging accuracy is improved by combining MRI with ERUS. | Torbjrn Swartling Peter Klebo Kristoffer Derwinger Bengt Gustavsson Gran Kurlberg | 2013 | World Journal of Gastroenterology2013，19，21： | 9 |
| 14 | 用于海底电导率填图的可控源时域电磁法显示文摘对近十年来发展起来的海底电磁法作了综述,重点放在可控源时间域上。类似于航空电磁法可对陆地上的经济带进行电导率填图一样,可控源海底电磁法也可在数十米的范围内对海底进行电导率填图。海底的电导率通常远小于海水的电导率,理论研究表明可控源时域水平电偶极子及水平磁偶极子系统能用来精确地确定海底的电导率。这两种装置对两个半空间的响应会在时间轴上出现两个峰值。早期的第一个峰值在时间轴上的位置可以直接用来确定海底的电导率,代表了电磁波在海底的传播;而晚期的第二个峰值代表电磁波在海水中的传播,亦可用来确定海水的电导率。该文概述了可控源时域海底电磁法理论方面的主要研究成果,同时也讨论了海底电磁法的仪器设备,特别介绍了多伦多大学物理系研制的时域水平磁偶极子及水平电偶极子海底观测系统。 | 杨建文 Edwa.,RN | 1998 | 中国有色金属学报1998，8，4： | 9 |
| 15 | Yangtze Three Gorges Reservoir, China: A holistic assessment of organic pollution, mutagenic effects of sediments and genotoxic impacts on fish显示文摘Besides obvious benefits,the Three Gorges Dam's construction resulted in new pollution scenarios with the potentials to threaten the Three Gorges Reservoir(TGR) ecosystem.In order to record organic contamination,to find links to ecotoxicological impacts and to serve as reference for ensuing monitoring,several sites in the TGR area were screened applying the triad approach with additional lines-of-evidence as a holistic assessment method.Sediments and the benthic fish species Pelteobagrus vachellii were sampled in 2011 and 2012 to determine organic pollution levels,mutagenic potentials and genotoxic impacts.Two regional hot-spots near the cities of Chongqing and Kaixian were identified and further investigated in 2013.Only polycyclic aromatic hydrocarbons(PAHs) could be detected in sediments in 2011(165–1653 ng/g),emphasizing their roles as key pollutants of the area.Their ubiquity was confirmed at Chongqing(150–433 ng/g) and Kaixian(127–590 ng/g) in2013.Concentrations were comparable to other major Chinese and German rivers.However,the immense sediment influx suggested a deposition of 216–636 kg PAH/day(0.2–0.6 mg PAH/(m2·day)),indicating an ecotoxicological risk.PAH source analysis highlighted primary impacts of combustion sources on the more industrialized upper TGR section,whereas petrogenic sources dominated the mid-low section.Furthermore,sediment extracts from several sites exhibited significant activities of frameshift promutagens in the Ames fluctuation assay.Additionally,significant genotoxic impairments in erythrocytes of P.vachellii were detected(Chongqing/Kaixian),demonstrating the relevance of genotoxicity as animportant mode of action in the TGR's fish.PAHs,their derivatives and non-target compounds are considered as main causative agents. | Tilman Floehr Bj?rn Scholz-Starke Hongxia Xiao Josef Koch Lingling Wu Junli Hou Anja Wolf Axel Bergmann Kerstin Bluhm Xingzhong Yuan Martina Ro?-Nickoll Andreas Sch?ffer Henner Hollert | 2015 | Journal of Environmental Sciences2015，27，12： | 9 |
| 16 | 影响糖尿病患者心血管危险因素集簇现象的因素显示文摘目的 分析影响糖尿病患者多种心血管危险因素集簇现象的因素。方法 调查 6 54例糖尿病患者并发症情况和血糖、胰岛素、HbA1c、胆固醇、甘油三酯、LDL 胆固醇、HDL 胆固醇、体重指数、腰围、臀围以及腰臀围比值等因素 ,采用HOMA公式计算出胰岛素抵抗指数。按照并存心血管危险因素 (高血压、全身性肥胖、中心性肥胖、高胆固醇血症、低HDL 胆固醇血症 )数量 ,进行分析。结果 并有 3种以上的心血管危险因素明显地高于随机的单一因素并存的计算预测值 ,餐后胰岛素水平和胰岛素面积随危险因素的增加而增加。采用有性别差异的全身性肥胖和中心性肥胖的诊断标准 ,女性糖尿病患者有更多的心血管危险因素。如果采用男女性别相同的诊断标准 ,这种并存多种心血管危险因素的性别差异则消失。多数患者的这些危险因素未得到良好的控制。结论 糖尿病多种心血管危险因素集簇是常见的 。 | 许樟荣 Lynda Molyneaux 敬华 王玉珍 刘彦君 Marg RN McGill 黄列军 Dennis Yue | 2001 | 中华内分泌代谢杂志2001，17，5： | 8 |
| 17 | Impaired contractility and remodeling of the upper gastrointestinal tract in diabetes mellitus type-1显示文摘AIM: To investigate that both the neuronal function of the contractile system and structural apparatus of the gastrointestinal tract are affected in patients with longstanding diabetes and auto mic neuropathy. METHODS: The evoked esophageal and duodenal contractile activity to standardized bag distension was assessed using a specialized ultrasound-based probe. Twelve type-1 diabetic patients with autonomic neuropathy and severe gastrointestinal symptoms and 12 healthy controls were studied. The geometry and biomechanical parameters (strain, tension/stress, and stiffness) were assessed. RESULTS: The diabetic patients had increased frequency of distension-induced contractions (6.0 ± 0.6 vs 3.3 ± 0.5, P < 0.001). This increased reactivity was correlated with the duration of the disease (P = 0.009). Impaired coordination of the contractile activity in diabetic patients was demonstrated as imbalance between the time required to evoke the first contraction at the distension site and proximal to it (1.5 ± 0.6 vs 0.5 ± 0.1, P = 0.03). The esophageal wall and especially the mucosa-submucosa layer had increased thickness in the patients (P < 0.001), and the longitudinal and radial compressive stretch was less in diabetics (P <0.001). The esophageal and duodenal wall stiffness and circumferential deformation induced by the distensions were not affected in the patients (all P > 0.14). CONCLUSION: The impaired contractile activity with an imbalance in the distension-induced contractions likely reflects neuronal abnormalities due to autonomic neuropathy. However, structural changes and remodeling of the gastrointestinal tract are also evident and may add to the neuronal changes. This may contribute to the pathophysiology of diabetic gut dysfunction and impact on future management of diabetic patients with gastrointestinal symptoms. | Jens BrΦndum FrΦkjΦr SΦren Due Andersen Niels EjskjΦr Peter Funch-Jensen AsbjΦrn Mohr Drewes Hans Gregersen | 2007 | World Journal of Gastroenterology2007，13，36： | 8 |
| 18 | Chronic fatigue is associated with increased disease-related worries and concerns in inflammatory bowel disease显示文摘AIM:To investigate the impact of chronic fatigue on disease-related worries in inflammatory bowel disease (IBD) and the potential multicolinearity between subjective questionnaires.METHODS:Patients in remission or with mild-tomoderate disease activity completed the fatigue questionnaire (FQ),the rating form of IBD patient concerns (RFIPC),the Short-Form 36 (SF-36),and IBD questionnaire (N-IBDQ).In addition,clinical and epidemiological data were obtained.RESULTS:In total,140 patients were included;of which 92 were diagnosed with ulcerative colitis and 48 with Crohn's disease.The mean age of patients with chronic fatigue was 44.2 years (SD=15.8) and for non-fatigued patients was 44.7 years (SD=16.0).Chronic fatigued patients had clinically significantly increased levels of disease-related worries,as measured by Cohen's d effect size.Worries about having an ostomy bag,loss of bowel control,and energy levels were most prominent in both chronic fatigued and non-chronic fatigued IBD patients.Variance inflation factor (VIF) and tolerance indicated that there were no problematic multicolinearity among the FQ,RFIPC,SF-36 and N-IBDQ responses (VIF < 5 and tolerance > 2).CONCLUSION:Chronic fatigue is associated with increased levels of disease-related worries and concerns in IBD.Increased levels of worries were also associated with impaired health-related quality of life. | Lars-Petter Jelsness-Jφrgensen Tomm Bernklev Magne Henriksen Roald Torp Bjφrn Moum | 2012 | World Journal of Gastroenterology2012，18，5： | 8 |
| 19 | Structure and evolution of the continental margin off Norway and the Barents Sea显示文摘 | Jan Inge Faleide Filippos Tsikalas AsbjФrn Breivik Rolf Mjelde Oliver Ritzmann Фyvind Engen Jonas Wilson Olav Eldholm | 2008 | Episodes2008，31，1： | 8 |
| 20 | 钠-葡萄糖共转运蛋白-2抑制剂或胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病:临床实践指南显示文摘临床问题对于存在不同心血管风险及肾脏结局的2型糖尿病患者,在原有生活方式干预和/或其他降糖药物的基础上加用钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂的获益及风险是什么?现行做法几十年来,2型糖尿病的治疗决策都以控制血糖为主导。SGLT-2抑制剂和GLP-1受体激动剂在传统观念中常被用于二甲双胍治疗后血糖仍控制不佳的患者。目前这一现状已经发生了改变,这得益于多项临床研究结果。研究显示SGLT-2抑制剂和GLP-1受体激动剂拥有独立于药物降糖作用之外的对于动脉粥样硬化性心血管病(CVD)和慢性肾脏病(CKD)的获益。建议本指南阐述了针对不同风险分层的成人2型糖尿病患者使用SGLT-2抑制剂或GLP-1受体激动剂的建议。•伴有3种或更少的心血管风险因素且不存在CVD或CKD:不建议启动SGLT-2抑制剂或GLP-1受体激动剂治疗。(推荐等级:弱)•伴有3种以上心血管风险因素且不存在CVD或CKD:建议启动SGLT-2抑制剂治疗,不建议启动GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD或CKD:建议启动SGLT-2抑制剂治疗和GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD和CKD:建议启动SGLT-2抑制剂治疗(推荐等级:强)和GLP-1受体激动剂治疗。(推荐等级:弱)•对于那些想要进一步降低CVD和CKD结局风险的患者:推荐优先启用SGLT-2抑制剂治疗而非GLP-1受体激动剂治疗。(推荐等级:弱)这项指南是如何制订的一个由患者、临床医生和方法学家共同组成的国际小组提出了这些推荐意见。这些推荐意见基于可信度较高的指南的标准,并使用GRADE分级方法进行评估。该小组采用了息者个体化的观点。证据一项关于获益与风险的系统综述和网络meta分析(764项随机对照研究,包括421346例参与者)发现SGLT-2抑制剂和GLP-1受体激动剂可以降低总体死亡率、心肌梗死发生率、终末期肾病或肾衰竭的发生率(中等至高等质量的证据)。在不同的亚组中这些药物对卒中、因心力衰竭所致住院和其他主要不良事件有不同的影响。药物绝对获益的程度因患者个体风险的不同有很大的差异。(例如,对于接受了超过5年药物治疗的1000例患者,在最低风险人群中死亡人数减少了5人,在最高风险人群中死亡人数减少了48人)。一项关于预后的综述确认了14种风险预测模型,其中一种(RECODe)在证据总结中报告了大部分基线风险评估数据,小组利用该模型以支持风险分层的建议。考虑到患者的价值观及个体差异,指南推荐的支撑证据包括一项对已发表论文的系统综述、一项患者焦点小组研究、一项临床问题总结,以及一项指南调查。指南解读我们依据不同的CVD和CKD风险水平,综合考虑获益、风险和其他因素的平衡,以及每一个风险组别的实际问题,来对推荐意见进行分层。本指南强烈建议CVD和CKD患者使用SGLT-2抑制剂治疗,这说明专家组认为其具有显著的获益。而对于其他成人2型糖尿病患者,推荐等级较弱,这说明专家组想要在获益、风险及治疗花费上取得一个更好的平衡。临床医生通过该指南可以使用可靠的风险计算模型,如RECODe,来明确其患者的个体心血管和肾脏疾病风险。医患交互式总结临床证据和制订决策有助于患者知晓治疗选择,包括进行共同决策。2型糖尿病人群(全球患病率不断增长1-2)正面临着不断增加的心血管疾病、肾脏病和其他并发症的风险3。数十年来,2型糖尿病的管理始终以控制血糖及糖化血红蛋白(HbA1c)为治疗目标4-5,但是,最近的高质量随机对照研究已经对这种以血糖为中心的治疗模式发起了挑战。研究结果显示,强化血糖控制未必会降低大血管不良事件,它还可能带来不利影响监管机构现在要求新型糖尿病药物必须证明其具有心血管和肾脏获益才能获得批准。对两类新药--钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂(见框图1)的临床试验结果显示,在现有治疗方案(常规治疗)之上加用这些药物,对死亡、心肌梗死、卒中、心力衰竭和肾脏的结局(如进展为终末期肾病)都有获益8-12。 | Sheyu Li Per Olav Vandvik Lyubov Lytvyn Gordon H Guyatt Suetonia C Palmer Rene Rodriguez-Gutierrez Farid Foroutan Thomas Agoritsas Reed A C Siemieniuk Michael Walsh Lawrie Frere David J Tunnicliffe Evi V Nagler Veena Manja Bjφrn Olav Asvold Vivekanand Jha Mieke Vermandere Karim Gariani Qian Zhao Yan Ren Emma Jane Cartwright Patrick Gee Alan Wickes Linda Fems Robin Wright Ling Li Qiukui Hao Reem A Mustafa 无 郭鹤鸣(译) | 2021 | 英国医学杂志中文版2021，24，9： | 7 |
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