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| 1 | 面向21世纪的卒中新定义:美国心脏病学会和美国卒中学会声明显示文摘尽管脑血管病有着全球性影响且对其病理生理学的认识有了很多进步,但是'卒中'这一术语在临床实践、临床研究或公共卫生评估中的定义却不一致。传统的定义依据于临床,却没有考虑到科学技术的进步。美国心脏协会(AHA)和美国卒中协会(ASA)卒中分会组织了写作小组,为21世纪卒中新定义撰写专家共识性声明。中枢神经系统(CNS)梗死,指由缺血所导致的脑、脊髓或视网膜的细胞死亡,是基于持续性损害的神经病理学、神经影像学和(或)临床证据。CNS梗死表现为一个临床谱:缺血性卒中特指伴有明显症状的CNS梗死,而静息性梗死根据定义指未引起已知的症状的梗死。卒中也还包括脑出血和蛛网膜下腔出血。新定义的卒中结合了临床和组织学标准,可被用于实践、研究和公共卫生评估。 | 俞羚 董荃 宋叶平 江静雯 李卉 刘亮贤 苏爱萍 李焰生 Sacco RL Kasner SE Broderick JP Caplan LR Connors JJ Culebras A Elkind MS George MG Hamdan AD Higashida RT Hoh BL Janis LS Kase CS Kleindorfer DO Lee JM Moseley ME Peterson ED Turan TN Valderrama AL Vinters HV | 2013 | 神经病学与神经康复学杂志2013，10，2： | 188 |
| 2 | DNA-PKcs subunits in radiosensitization by hyperthermia on hepatocellular carcinoma hepG_2 cell line显示文摘AIM: To investigate the role of DNA-PKcs subunits inradiosensitization by hyperthermia on hepatocellularcarcinoma HepG2 cell lines.METHODS: Hep G2 cells were exposed to hyperthermiaand irradiation. Hyperthermia was given at 45.5 ℃Cellsurvival was determined by an in vitro clonogenic assay forthe cells treated with or without hyperthermia at varioustime points. DNA DSB rejoining was measured usingasymmetric field inversion gel electrophoresis (AFIGE). TheDNA-PKcs activities were measured using DNA-PKcs enzymeassay system.RESULTS: Hyperthermia can significantly enhanceirradiation-killing cells. Thermal enhancement ratio ascalculated at 10 % survival was 2.02. The difference inradiosensitivity between two treatment modes manifestedas a difference in the α components and the almost sameβ components, which α value was considerably higher inthe cells of combined radiation and hyperthermia ascompared with irradiating cells (1.07 Gy-1 versus 0.44 Gy1). Survival fraction showed 1 logarithm increase after an8-hour interval between heat and irradiation, whereas DNA-PKcs activity did not show any recovery. The cells wereexposed to heat 5 minutes only, DNA-PKcs activity wasinhibited at the nadir, even though the exposure time waslengthened. Whereas the ability of DNA DSB rejoining wasinhibited with the increase of the length of hyperthermictime. The repair kinetics of DNA DSB rejoining aftertreatment with Wortmannin is different from thehyperthermic group due to the striking high slow rejoiningcomponent.CONCLUSION: Determination with the cell extracts andthe peptide phosphorylation assay, DNA-PKcs activity wasinactivated by heat treatment at 45.5 C, and could notrestore. Cell survival is not associated with the DNA-PKcsinactivity after heat. DNA-PKcs is not a unique factor affectingthe DNA DSB repair. This suggests that DNA-PKcs do notplay a crucial role in the enhancement of cellularradiosensitivity by hyperthermia. | Walter J.Curran George Iliakis | 2002 | World Journal of Gastroenterology2002，8，5： | 87 |
| 3 | A Novel Coronavirus Genome Identified in a Cluster of Pneumonia Cases--Wuhan,China 2019−2020显示文摘Emerging and re-emerging pathogens are great challenges to the public health(1).A cluster of pneumonia cases with an unknown cause occurred in Wuhan starting on December 21,2019.As of January 20,2020,a total of 201 cases of pneumonia in China have been confirmed.A team of professionals from the National Health Commission and China CDC conducted epidemiological and etiological investigations.On January 3,2020,the first complete genome of the novelβgenus coronaviruses(2019-nCoVs)was identified in samples of bronchoalveolar lavage fluid(BALF)from a patient from Wuhan by scientists of the National Institute of Viral Disease Control and Prevention(IVDC)through a combination of Sanger sequencing,Illumina sequencing,and nanopore sequencing.Three distinct strains have been identified,the virus has been designated as 2019-nCoV,and the disease has been subsequently named novel coronavirus-infected pneumonia(NCIP). | Wenjie Tan Xiang Zhao Xuejun Ma Wenling Wang Peihua Niu Wenbo Xu George F.Gao Guizhen Wu | 2020 | China CDC weekly2020，2，4： | 95 |
| 4 | DNA分析发现我国湖羊和小尾寒羊存在Booroola (FecB)多胎基因显示文摘利用“forced”限制性酶切片段长度多态性PCR技术 ,检测湖羊、小尾寒羊和新疆细毛羊的DNA样本是否存在Booroola (FecB)基因。结果表明 ,12头湖羊均为纯合型Booroola基因携带者 ;12头小尾寒羊中 ,4头为Booroola基因纯合型 ,7头为杂合型 ,1头不携带Booroola基因 ;12头新疆细毛羊均不携带Booroola基因。 | 王根林 毛鑫智 George H Davis 赵宗胜 张利军 曾永庆 | 2003 | 南京农业大学学报2003，26，1： | 158 |
| 5 | Role of Kupffer cells in the pathogenesis of liver disease显示文摘Kupffer cells, the resident liver macrophages have long been considered as mostly scavenger cells responsible for removing particulate material from the portal circu- lation. However, evidence derived mostly from animal models, indicates that Kupffer cells may be implicated in the pathogenesis of various liver diseases including viral hepatitis, steatohepatitis, alcoholic liver disease, in- trahepatic cholostasis, activation or rejection of the liver during liver transplantation and liver fibrosis. There is accumulating evidence, reviewed in this paper, suggest- ing that Kupffer cells may act both as effector cells in the destruction of hepatocytes by producing harmful soluble mediators as well as antigen presenting cells during viral infections of the liver. Moreover they may represent a significant source of chemoattractant molecules for cy- totoxic CD8 and regulatory T cells. Their role in fibrosis is well established as they are one of the main sources of TGFβ1 production, which leads to the transformation of stellate cells into myofibroblasts. Whether all these variable functions in the liver are mediated by different Kupffer cell subpopulations remains to be evaluated. In this review we propose a model that demonstrates the role of Kupffer cells in the pathogenesis of liver disease. | George Kolios Vassilis Valatas Elias Kouroumalis | 2006 | World Journal of Gastroenterology2006，12，46： | 74 |
| 6 | 肛裂临床诊治指南(第三次修订)显示文摘“美国结直肠外科医师协会(American Societyof ColonandRectal Surgeons.ASCRS)”(协会)致力于推进结直肠和肛门疾病的相关理论以及预防和诊疗水平的提高,给患者提供优质的医疗服务。“标准委员会”由协会中在结直肠外科方面有显著专长的成员组成。该委员会的建立是为了引领国际结直肠和肛门疾病诊治的发展,以建立具有循证医学证据的临床诊疗指南。指南是涵盖性的,非指令性的,目的是为临床决策提供信息,而非具体的治疗方法。指南适用于所有相关的医护人员以及希望得到相应指南中疾病的相关诊治信息的患者。 | Farshid Araghizadeh ~ Robin Boushey Sridhar Chalasani George Chang Robert Cima Gary Dunn Daniel Feingold Philip Fleshner Daniel Geisler Jill Genua Sharon Gregorcyk Daniel Herzig Andreas Kaiser Ravin Kumar David Larson Steven Mills John Monson P. Terry Phang Feza Remzi David Rivadeneira Howard Ross Peter Senatore Elin Sigurdson Thomas Stahl Scott Steele Scott Strong Charles Tement Judith Trudel Madhulika Varnna Martin Weiser 丁义江(译) 皇甫少华(译) 丁曙晴(译) | 2013 | 中华胃肠外科杂志2013，16，7： | 70 |
| 7 | Clinical epidemiology and disease burden of nonalcoholic fatty liver disease显示文摘Nonalcoholic fatty liver disease(NAFLD) is defined as the presence of hepatic fat accumulation after the exclusion of other causes of hepatic steatosis, including other causes of liver disease, excessive alcohol consumption, and other conditions that may lead to hepatic steatosis. NAFLD encompasses a broad clinical spectrum ranging from nonalcoholic fatty liver to nonalcoholic steatohepatitis(NASH), advanced fibrosis, cirrhosis, and finally hepatocellular carcinoma(HCC). NAFLD is the most common liver disease in the world and NASH may soon become the most common indication for liver transplantation. Ongoing persistence of obesity with increasing rate of diabetes will increase the prevalence of NAFLD, and as this population ages, many will develop cirrhosis and end-stage liver disease. There has been a general increase in the prevalence of NAFLD, with Asia leading the rise, yet the United States is following closely behind with a rising prevalence from 15% in 2005 to 25% within 5 years. NAFLD is commonly associated with metabolic comorbidities, including obesity, type Ⅱ diabetes, dyslipidemia, and metabolic syndrome. Our understanding of the pathophysiology of NAFLD is constantly evolving. Based on NAFLD subtypes, it has the potential to progress into advanced fibrosis, end-stage liver disease and HCC. The increasing prevalence of NAFLD with advanced fibrosis, is concerning because patients appear toexperience higher liver-related and non-liver-related mortality than the general population. The increased morbidity and mortality, healthcare costs and declining health related quality of life associated with NAFLD makes it a formidable disease, and one that requires more in-depth analysis. | Brandon J Perumpail Muhammad Ali Khan Eric R Yoo George Cholankeril Donghee Kim Aijaz Ahmed | 2017 | World Journal of Gastroenterology2017，23，47： | 70 |
| 8 | Diabetic cardiomyopathy:Pathophysiology,diagnostic evaluation and management显示文摘Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population.Diabetes-related heart disease occurs in the form of coronary artery disease(CAD),cardiac autonomic neuropathy or diabetic cardiomyopathy(DbCM).The prevalence of cardiac failure is high in the diabetic population and DbCM is a common but underestimated cause of heart failure in diabetes.The pathogenesis of diabetic cardiomyopathy is yet to be clearly defined.Hyperglycemia,dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn implicated.The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DbCM.In the early stages of the disease diastolic dysfunction is the only abnormality,but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction.Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction,but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used recently for early detection of DbCM.The management of DbCM involves improvement in lifestyle,control of glucose and lipid abnormalities,and treatment of hypertension and CAD,if present.The role of vasoactive drugs and antioxidants is being explored.This review discusses the pathophysiology,diagnostic evaluation and management options of DbCM. | Joseph M Pappachan George I Varughese Rajagopalan Sriraman Ganesan Arunagirinathan | 2013 | World Journal of Diabetes2013，4，5： | 57 |
| 9 | Pathophysiology of pulmonary complications of acute pancreatitis显示文摘Acute pancreatitis in its severe form is complicated by multiple organ system dysfunction, most importantly by pulmonary complications which include hypoxia, acute respiratory distress syndrome, atelectasis, and pleural effusion. The pathogenesis of some of the above complications is attributed to the production of noxious cytokines. Clinically significant is the early onset of pleural effusion, which heralds a poor outcome of acute pancreatitis. The role of circulating trypsin, phospholipase A2, platelet activating factor, release of free fatty acids, chemoattractants such as tumor necrsosis factor (TNF)- alpha, interleukin (IL)-1, IL-6, IL-8, fMet-leu-phe (a bacterial wall product), nitric oxide, substance P, and macrophage inhibitor factor is currently studied. The hope is that future management of acute pancreatitis with a better understanding of the pathogenesis of lung injury will be directed against the production of noxious cytokines. | George W Browne CS Pitchumoni | 2006 | World Journal of Gastroenterology2006，12，44： | 57 |
| 10 | 缺血性卒中患者的早期处理指南——美国卒中学会卒中委员会科学声明显示文摘1994年,美国心脏学会(AHA)卒中委员会委托一个专门研究小组撰写了急性缺血性卒中患者的处理指南[1].1996年,在静脉rtPA治疗急性缺血性卒中得到食品与药物管理局(FDA)批准后,这项指南又补充了一系列的推荐[2]. | 曲东锋 陈兴洲 李宏建 倪长江 Harold P.Adams Jr Robert J.Adams Thomas Brott Gregory J.del Zoppo Anthony Furlan Larry B.Goldstein Robert L.Grubb Randall Higashida Chelsea Kidwell Thomas G.Kwiatkowski John R.Marler George J.Hadermenos | 2003 | 国外医学(脑血管疾病分册)2003，11，5： | 57 |
| 11 | Treatment of taste and odor causing compounds 2-methyl isoborneol and geosmin in drinking water:A critical review显示文摘Problems due to the taste and odor in drinking water are common in treatment facilities around the world.Taste and odor are perceived by the public as the primary indicators of the safely and acceptability of drinking water and are mainly caused by the presence of two semi-volatile compounds-2-methyl isoborneol (MIB) and geosmin.A review of these two taste and odor causing compounds in drinking water is presented.The sources for the formation of these compounds in water are discussed alongwith the health and regulatory implications.The recent developments in the analysis of MIB/geosmin in water which have allowed for rapid measurements in the nanogram per liter concentrations are also discussed.This review focuses on the relevant treatment alternatives,that are described in detail with emphasis on their respective advantages and problems associated with their implementation in a fullscale facility.Conventional treatment processes in water treatment plants,such as coagulation,sedimentation and chlorination have been found to be ineffective for removal of MIB/geosmin.Studies have shown powdered activated carbon,ozonation and biofiltration to be effective in treatment of these two compounds.Although some of these technologies are more effective and show more promise than the others,much work remains to be done to optimize these technologies so that they can be retrofitted or installed with minimal impact on the overall operation and effectiveness of the treatment system. | Rangesh Srinivasan George A.Sorial | 2011 | Journal of Environmental Sciences2011，23，1： | 41 |
| 12 | 影响卒中死亡率下降的因素美国心脏协会/美国卒中协会的科学声明显示文摘背景和目的 美国的卒中死亡率自20世纪初以来一直呈下降趋势,尽管这种“下降”很受欢迎,但其原因尚不完全清楚.由于近年来卒中死亡率呈现出更为显著的加速下降趋势,卒中已从美国的第3位死亡原因下降至第4位.这促使人们对影响卒中发病风险和死亡率变化的相关因素进行详细评估.这份声明对有关卒中死亡率下降趋势的促进因素的研究证据进行回顾,并讨论了将来如何利用这些因素在卒中这一重大公共卫生问题的干预研究中发挥作用.方法 写作组成员由委员会主席和副主席根据其以前在相关领域的研究成果提名,并通过美国心脏协会(American Heart Association,AHA)卒中委员会的科学声明监督委员会和美国心脏协会手稿监督委员会批准.作者利用系统文献综述,参考公开发表的临床和流行病学研究、发病率和死亡率报告、临床与公共卫生指南、权威声明、个人文件以及专家意见,对相关证据进行总结并指出与当前知识水平的差距.所有写作组成员均有机会评论这份声明并批准其最终版本.这份声明经过AHA内部的广泛同行评议以及卒中委员会领导阶层和科学声明监督委员会的审查,然后获得AHA科学顾问与协调委员会的批准.结果 过去数十年间,在不同性别、所有种族/民族以及各个年龄组人群中都观察到卒中死亡率的下降,这体现出人群健康的重大进展.除了卒中对于总体寿命损失的影响减少外,在65岁以下人群中观察到的卒中死亡率显著下降体现了其所致潜在寿命损失年的减少.卒中死亡率的下降要归功于卒中发病率和病死率的降低.这些卒中转归的显著改善与心血管危险因素的控制和干预相一致.虽然很难计算出具体的归因危险度估计值,但始于20世纪70年代的血压控制措施似乎已对卒中死亡率的加速下降产生了最实质性的影响.尽管实施较晚,但糖尿病和血脂异常控制以及戒烟计划,特别是联合降压治疗,似乎同样促进了卒中死亡率的下降.远程医疗和卒中医疗体系也似乎具有强烈的潜在作用,但尚需足够长的时间来证明其对卒中死亡率下降的影响.其他因素也可能产生影响,但需要更多的研究来确定它们的作用.结论 卒中死亡率的下降是真实存在的,代表着公共卫生以及临床医学的巨大成功.卒中从第3位死亡原因下降至第4位是死亡率真实下降的结果,而并非由于慢性肺病死亡率上升所致,后者是目前在美国是第3位的死亡原因.有强烈的证据表明,卒中死亡率的下降可归功于以科学发现为基础、旨在降低卒中风险而执行的联合干预措施和项目,其中最有可能的是对高血压控制的改善.因此,对正在开展的干预项目进行的研究及其成果的应用已改善了人群健康.对一些积极的循证公共卫生项目以及临床干预措施的持续应用预期会进一步降低卒中死亡率. | Daniel T.Lackland Edward J.Roccella Anne F.Deutsch Myriam Fornage Mary G.George George Howard Brett M.Kissela Steven J.Kittner Judith H.Lichtman Lynda D. Lisabeth Lee H. Schwamm Eric E. Smith 高一鹭 陈政弘 王文志 | 2014 | 国际脑血管病杂志2014，22，5： | 41 |
| 13 | 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 |
| 14 | Bio-Oss骨代用品同引导骨再生膜联合应用效果的观察显示文摘目的 通过组织学观察Bio Oss作为骨移植材料同引导骨再生膜技术联合应用治疗牙槽骨局部骨缺损及种植体周围骨缺损的临床效果。方法 从 6例牙槽骨局部缺损患者的 6处骨再生区取少量骨组织 ,采取Donath硬组织切片磨片技术行组织学观察。结果 组织学显示淡红色新生骨同淡黄色的Bio Oss颗粒区别明显 ,Bio Oss颗粒表面有新骨形成 ,并与之紧密结合。未见纤维结缔组织长入包裹Bio Oss颗粒及炎症细胞浸润。结论 Bio Oss骨有良好的生物相容性和骨引导作用 。 | 邱立新 林野 王兴 孙开华 Georg Watzek | 2002 | 中华口腔医学杂志2002，37，6： | 44 |
| 15 | Cold-chain transportation in the frozen food industry may have caused a recurrence of COVID-19 cases in destination:Successful isolation of SARS-CoV-2 virus from the imported frozen cod package surface显示文摘Coronavirus disease 2019(COVID-19)pandemic has spread in 220 countries/regions towreak havoc to human beings around theworld.At present,the second wave of COVID-19 has begun in many European countries.The complete control of COVID-19 is very urgent.Although China quickly brought the virus under control,there have been eight sporadic outbreaks in China since then.Both in Xinfadi of Beijing and Dalian outbreak of COVID-19,environmental swab samples related to imported cold chain food were tested nucleic acid positive for SARS-CoV-2.In this outbreak in Qingdao,we directly isolated SARS-CoV-2 from the cod outer package's surface swab samples.This is the first time worldwide,SARS-CoV-2 were isolated from the imported frozen cod outer package's surface,which showed that imported frozen food industry could import SARS-CoV-2 virus. | Peipei Liu Mengjie Yang Xiang Zhao Yuanyuan Guo Liang Wang Jing Zhang Wenwen Lei Weifang Han Fachun Jiang William J.Liu George F.Gao Guizhen Wu | 2020 | Biosafety and Health2020，2，4： | 41 |
| 16 | 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 |
| 17 | Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis显示文摘AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations(variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.METHODS: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI.RESULTS: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality(OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites(OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy. CONCLUSION: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed. | Jonathan G Stine Puja M Shah Scott L Cornella Sean R Rudnick Marwan S Ghabril George J Stukenborg Patrick G Northup | 2015 | World Journal of Hepatology2015，7，27： | 42 |
| 18 | Endoscopic and surgical resection of T1a/T1b esophageal neoplasms: A systematic review显示文摘AIM: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/ T1b esophageal neoplasms. METHODS: A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane Library, from 1997 up to January 2011 was performed. An analysis was carried out, pooling the effects of outcomes of 4241 patients enrolled in 80 retrospective studies. For comparisons across studies, each reporting on only one endoscopic method, we used a random effects meta-regression of the log-odds of the outcome of treatment in each study. 'Neural networks' as a data mining technique was employed in order to establish a prediction model of lymph node status in superficial submucosal esophageal carcinoma. Another data mining technique, the 'feature selection and root cause analysis', was used to identify the most impor-tant predictors of local recurrence and metachronous cancer development in endoscopically resected patients, and lymph node positivity in squamous carcinoma (SCC) and adenocarcinoma (ADC) separately in surgically resected patients. RESULTS: Endoscopically resected patients: Low grade dysplasia was observed in 4% of patients, high grade dysplasia in 14.6%, carcinoma in situ in 19%, mucosal cancer in 54%, and submucosal cancer in 16% of patients. There were no significant differences between endoscopic mucosal resection and endoscopic submucosal dissection (ESD) for the following parameters: complications, patients submitted to surgery, positive margins, lymph node positivity, local recurrence and metachronous cancer. With regard to piecemeal resection, ESD performed better since the number of cases was significantly less [coefficient: -7.709438, 95%CI: (-11.03803, -4.380844), P < 0.001]; hence local recurrence rates were significantly lower [coefficient: -4.033528, 95%CI: (-6.151498, -1.915559),P < 0.01]. A higher rate of esophageal stenosis was observed following ESD [coefficient: 7.322266, 95%CI: (3.810146, 10.83439), P < 0.001]. A significantly greater number of SCC patients were submitted to surgery (log-odds, ADC: -2.1206 ± 0.6249 vs SCC: 4.1356 ± 0.4038, P < 0.05). The odds for re-classification of tumor stage after endoscopic resection were 53% and 39% for ADC and SCC, respectively. Local tumor recurrence was best predicted by grade 3 differentiation and piecemeal resection, metachronous cancer development by the carcinoma in situ component, and lymph node positivity by lymphovascular invasion. With regard to surgically resected patients: Significant differences in patients with positive lymph nodes were observed between ADC and SCC [coefficient: 1.889569, 95%CI: (0.3945146, 3.384624), P<0.01). In contrast, lymphovascular and microvascular invasion and grade 3 patients between histologic types were comparable, the respective rank order of the predictors of lymph node positivity was: Grade 3, lymphovascular invasion (L+), microvascular invasion (V+), submucosal (Sm) 3 invasion, Sm2 invasion and Sm1 invasion. Histologic type (ADC/SCC) was not included in the model. The best predictors for SCC lymph node positivity were Sm3 invasion and (V+). For ADC, the most important predictor was (L+). CONCLUSION: Local tumor recurrence is predicted by grade 3, metachronous cancer by the carcinoma insitu component, and lymph node positivity by L+. T1b cancer should be treated with surgical resection. | George Sgourakis Ines Gockel Hauke Lang | 2013 | World Journal of Gastroenterology2013，19，9： | 40 |
| 19 | 阿尔金山早古生代岩浆活动与金成矿作用显示文摘文章通过同位素稀释热电离质谱(ID_TIMS)锆石U_Pb法、Rb_Sr等时线法和钾长石40Ar/39Ar测年与MDD模拟得到的数据,分析了阿尔金山北缘地区花岗岩浆活动的主要时期、与阿尔金北缘大平沟金矿有关的花岗岩形成年龄、大平沟金矿可能的成矿时代以及剥露作用时代等问题,探讨了早古生代岩浆活动与金成矿作用之间的关系以及金矿床的剥露历史。Rb_Sr等时线法给出大平沟金矿石英流体包裹体等时线年龄为(487±21)Ma,与阿尔金山早古生代岩浆活动的时代一致,代表了大平沟金矿床的成矿年龄。大平沟金矿的剥露作用发生在早侏罗世拉配泉断裂伸展作用时期。 | 杨屹 陈宣华 George Gehrels 王小凤 秦红 陈正乐 杨风 陈柏林 李学智 | 2004 | 矿床地质2004，23，4： | 39 |
| 20 | 减少急性冠状动脉综合征和卒中患者求医的延误——美国心脏协会心血管护理委员会和卒中委员会的科学声明显示文摘在寻求急性冠状动脉综合征和卒中症状的治疗方面,患者延误是限制提供这些疾病的确定性治疗的主要因素。尽管数十年来的研究和公众教育活动一直旨在缩短患者延误时间,但大多数患者仍然不能及时求医。在本科学声明中,我们总结了以下证据:(1)证明早期治疗的益处;(2)描述患者延误问题的程度;(3)确定与患者延误及时求医有关的因素;(4)揭示当前减少患者延误措施的不足。最后,提出临床实践和今后研究的建议。 | Debra K. Moser Laura P. Kimble Mark J. Alberts Angelo Alonzo Janet B. Croft Kathleen Dracup Kelly R. Evenson Alan S. Go Mary M. Hand Rashmi U. Kothari George A. Mensah Dexter L. Morris Arthur M. Pancioli Barbara Riegel Julie Johnson Zerwic 李宏建 曲东锋 | 2006 | 国际脑血管病杂志2006，14，10： | 39 |
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