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| 1 | 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 |
| 2 | Worldwide experiences of endoscopic submucosal dissection:Not just Eastern acrobatics显示文摘The high incidence of gastric cancer has led to the initiation of cancer screening programs.As a result,the number of early gastric cancer cases has increased and consequentially,the cancer mortality rate has decreased.Moreover,the development of minimally invasive endoscopic treatment has been introduced for these early lesions.Endoscopic submucosal dissection(ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis.We review the results of ESD including experiences in Japan and Korea,as well as western countries. | Kwang Bum Cho Won Joong Jeon Jae J Kim | 2011 | World Journal of Gastroenterology2011，17，21： | 48 |
| 3 | Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities显示文摘Aim:To clarify the mechanism of the therapeutic action of icariin on erectlile dysfunction(ED).Methods:PDE5 was isolated from the human platelet and PDE4 form the rat liver tissue using the FPLC system (Pharmacia,Milton Keynes,UK)and the Mono Q column.The inhibitory effects of icariin on PDE5 and PDE4 activities were investigated by the two-step radioisotope procedure with [^3H]-c GMP/[^3H]-cAMP.Papaverine served as the control drug.Results:Icariin and papaverine showed dose-dependent inhibitory effects on PDE5 and PDE4 activities.The IC50 of Icariin and papaverine on PDE5 were 0.432μ mol/L and 0.680μmol/L,respectively and those on PDE4,73.50μmol/L and 3.07μmol/L,respectively.The potencies of selectivity of icariin and papaverine on PDE5(PDE4/PDE5 of IC50)were 167.67 times and 4.54 times,respectively.Conclusion:Icariin is a cGMP-specific PDE5 inhibitor that may be developed into an oral effective agent for the treatment of ED. | ZC Xin EK Kim CS Lin WJ Liu L Tian YM Yuan J Fu | 2003 | Asian Journal of Andrology2003，5，1： | 38 |
| 4 | Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis显示文摘AIM: To evaluate whether Helicobacter pylori(H. pylori) eradication therapy benefits patients with functional dyspepsia(FD).METHODS: Randomized controlled trials(RCTs) investigating the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English(up to May 2015) were identified by searching Pub Med, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio(RR) or a standard mean difference(SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0.RESULTS: This systematic review included 25 RCTs with a total of 5555 patients with FD. Twenty-three of these studies were used to evaluate the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.23(95%CI: 1.12-1.36, P < 0.0001). H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at ≥ 1 year(RR = 1.24; 95%CI: 1.12-1.37, P < 0.0001) but not during short-term follow-up at < 1 year(RR = 1.26; 95%CI: 0.83-1.92, P = 0.27). Seven studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of-0.01(95%CI:-0.11 to 0.08, P = 0.80). Six studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy(RR = 0.35; 95%CI: 0.18-0.68, P = 0.002). Eight studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy(RR = 2.02; 95%CI: 1.12-3.65, P = 0.02). Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy(RR = 7.13; 95%CI: 3.68-13.81, P < 0.00001).CONCLUSION: The decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment. | Li-Jun Du Bin-Rui Chen John J Kim Sarah Kim Jin-Hua Shen Ning Dai | 2016 | World Journal of Gastroenterology2016，22，12： | 30 |
| 5 | Endoscopic mucosal resection of early gastric cancer: Experiences in Korea显示文摘Endoscopic mucosal resection (EMR) has been established as one of the treatment options for early gastric cancer (EGC). However, there are many uncertain areas such as indications of EMR, best treatment methods, management of complications and follow-up methods after the procedure. Most studies on this topic have been carried out by researchers in Japan. In Korea, gastric cancer is the most common malignant disease, and the second leading cause of cancer death. In these days, EMR for EGC is widely performed in many centers in Korea. In this review, we will provide an overview of the techniques and outcomes of EMR in Korea. | Jun Haeng Lee Jae J Kim | 2007 | World Journal of Gastroenterology2007，13，27： | 26 |
| 6 | A Comparison of Brain Activity between Healthy Subjects and Stroke Patients on fMRI by Acupuncture Stimulation显示文摘目的将在击病人在针灸期间调查大脑活动模式,并且用功能的磁性的回声成像(fMRI ) 把结果与正常题目作比较。有马达软弱和 10 个健康题目的 11 个击病人全部的方法 A 被学习。fMRI 在点 Quchi (LI11 ) 和 Zusanli (ST36 ) 在左边上在针灸期间被执行。数据用针灸刺激导致的大脑激活的统计参量的地图被分析。结果显示出的结果 LI11 和 ST36 的刺激生产了在二之间的显著地不同的大脑激活模式,这组织。正常的组比击组显示出更大的全面激活。在正常的组,正面的脑叶的部分,顶骨脑叶,亚 lobar,小脑和中脑,区域被针灸在左 LI11 激活。在另一方面,仅仅劣等的顶骨腹片区域的右边在击病人被激活。当左 ST36 在正常的组被刺激时,正面的脑叶,顶骨脑叶,时间的脑叶,和亚 lobar 的双方,和枕骨的脑叶的左边,和小脑和中脑区域的右边被激活。为在击组的一样的刺激,仅仅劣等的顶骨腹片和小脑区域的双方被激活(P < 0.05,簇水平) 。释放模式没在两个组在任何针灸刺激期间被注意。结论大脑信号激活在一样的针灸期间是不同的在之间健康并且击病人,和效果显示出不同针灸点的关联。 | Seung-Yeon Cho Mia Kim Jong Joo Sun Geon-Ho Jahng Hengjun J Kim Seong-Uk Park Woo-Sang Jung Chang-Nam Ko Jung-Mi Park | 2013 | Chinese Journal of Integrative Medicine2013，19，4： | 25 |
| 7 | CIPK9: a calcium sensor-interacting protein kinase required for low-potassium tolerance in Arabidopsis显示文摘钾是为在植物的很多个细胞的过程的主要宏营养素必需品之一。在土壤的低钾水平为庄稼生产代表一个限制因子。最近的研究识别了涉及钾获得的钾运输 ers,并且他们中的一些为在低钾条件下面的钾营养是批评的。然而,很少在涉及低钾发信号和回答的分子的部件上被理解。我们这里在 Arabidopsis 作为低钾反应的一个批评管理者报导 calcineurin 象 B 一样交往蛋白质的 proteinkinase (CIPK9 ) 的鉴定。CIPK9 基因对不能生活的压力条件应答,并且它的抄本由钾剥夺在根和射击是可诱导的。CIPK9 功能的混乱使变异的植物变为过分敏感到低钾媒介。进一步的分析显示那 K (+) 举起和内容没在变异的植物被影响,暗示在钾利用的规定的 CIPK9 或察觉到过程。 | Girdhar K Pandey Yong Hwa Cheongx Beom-Gi Kim John J Grant Legong Li Sheng Luan | 2007 | Cell Research2007，17，5： | 23 |
| 8 | Methylation-dependent loss of RIP3 expression in cancer represses programmed necrosis in response to chemotherapeutics显示文摘交往受体的蛋白质 kinase-3 (RIP3 或 RIPK3 ) 是执行 “ 的细胞的机械的必要部分; programmed”或 “ regulated”坏死。这里,我们证明那规划坏死响应许多化学疗法的代理人被激活并且贡献导致化疗的房间死亡。然而,我们证明那 RIP3 表情经常在化学疗法的死亡期间由于它的 transcriptional 开始地点, MLKL 的这样 RIP3 依赖的激活和下游地规划的坏死附近的 genomic methylation 是在癌症房间的 silenced 大部分被镇压。不过,有 hypomethylating 代理人的治疗恢复 RIP3 表示,并且从而以一种 RIP3 依赖的方式把敏感提升到 chemotherapeutics。RIP3 表示在 85% 乳癌病人与正常织物相比在肿瘤被减少,建议那 RIP3 缺乏断然在肿瘤生长 / 发展期间被选择。因为 hypomethylating 代理人在病人是相当容忍得好的,我们建议病人们可以从收到 hypomethylating 代理人与常规 chemotherapeutics 在治疗以前导致 RIP3 表示有益于的那 RIP3 缺乏的癌症。 | Gi-Bang Koo Michael J Morgan Da-Gyum Lee Woo-Jung Kim Jung-Ho Yoon Ja Seung Koo Seung I1 Kim Soo Jung Kim Mi Kwon Son Soon Still Hong Jean M Mulcahy Levy Daniel A Pollyea Craig T Jordan Pearlly Yan David Frankhouser Deedra Nicolet Kati Maharry Guido Marcucci Kyeong Sook Choi Hyeseong Cho ndrew Thorbum You-Sun Kim | 2015 | Cell Research2015，25，6： | 20 |
| 9 | Yes相关蛋白通过肿瘤坏死因子受体相关因子6控制内皮活化和血管炎症显示文摘继发于异常的内皮激活的微血管炎症和内皮功能障碍在败血症和器官衰竭的病理生理学中起关键作用。抑制内皮细胞过度活化的内在信号传导机制尚未完全明了。该研究旨在确定Yes相关蛋白(Yes-associated protein,YAP)(Hippo通路的主要转录共激活剂)在调节内皮活化和血管炎症的强度和程度中的中心作用。 | 刘青 叶鹏 Lv Y Kim K Sheng Y Cho J Qain Z Zhao YY Hu G Pan D Malik AB | 2018 | 中华高血压杂志2018，26，8： | 20 |
| 10 | Approaches to functional genomics in filamentous fungi显示文摘在细丝状的真菌的基因功能的学习是在很最近的年里做了大进展的研究的一个领域。很多转变和基因操作策略被开发了并且适用于经济地重要的细丝状的真菌和 oomycetes 的一张多样、很快膨胀的表。与真菌的染色体的重要数字,定序的现在或被定序的、功能的基因组学答应揭开来年里的很多新信息。这评论讨论在在细丝状的真菌检验基因功能被做了并且描述不同途径的优点和限制的最近的进展。 | Richard J Weld Kim M Plummer Margaret A Carpenter Hayley J Ridgway | 2006 | Cell Research2006，16，1： | 19 |
| 11 | Outcomes of furazolidone-and amoxicillin-based quadruple therapy for Helicobacter pylori infection and predictors of failed eradication显示文摘AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pylori infection treated with furazolidone, amoxicillin, bismuth, and proton pump inhibitor therapy(January 2015 to December 2015) who received the ^(13)C-urea breath test > 4 wk after treatment were evaluated. Demographic and clinical data including prior H. pylori treatment attempts, medication adherence, alcohol and cigarette consumption during therapy, and treatment-related adverse events were recorded by reviewing medical records and telephone surveys. H. pylori eradication rates for overall and subgroups were evaluated. Multivariate analysis was performed to identify independent predictors of failed H. pylori eradication.RESULTS Of the 992 patients treated and retested for H. pylori infection, the overall eradication rate was 94.5% [95% confidence interval(CI): 94.1%-95.9%]. H. pylori eradication rate of primary therapy was 95.0%(95%CI: 93.5%-96.5%), while that of rescue therapy was 91.3%(95%CI: 86.8%-95.8%). Among the 859 patients who completed the study protocol, 144(17%) reported treatment-related adverse events including 24(3%) leading to premature discontinuation. On multivariate analysis, poor medication adherence [adjusted odds ratio(AOR) = 6.7, 95%CI: 2.8-15.8], two or more previous H. pylori treatments(AOR = 7.4, 95%CI: 2.2-24.9), alcohol consumption during therapy(AOR = 4.4, 95%CI: 1.5-12.3), and possibly smoking during therapy(AOR = 1.9, 95%CI: 0.9-4.3) were associated with failed H. pylori eradication. CONCLUSION Furazolidone-and amoxicillin-based quadruple therapy for H. pylori infection in an area with a high prevalence of clarithromycin resistance demonstrated high eradication rates as primary and rescue therapies with a favorable safety profile. Patient education targeting abstinence from alcohol during therapy and strict medication adherence may further optimize H. pylori eradication. | Ya-Wen Zhang Wei-Ling Hu Yuan Cai Wen-Fang Zheng Qin Du John J Kim John Y Kao Ning Dai Jian-Min Si | 2018 | World Journal of Gastroenterology2018，24，40： | 18 |
| 12 | TNFα and reactive oxygen species in necrotic cell death显示文摘 | Michael J Morgan You-Sun Kim Zheng-gang Liu | 2008 | Cell Research2008，18，3： | 13 |
| 13 | 普瑞巴林治疗中枢卒中后疼痛的安全性和疗效显示文摘全文刊登在:Kim,J S,et al.Pain 2011:1-6.研究背景·研究证实普瑞巴林可有效应用于几种类型的神经病理性疼痛。 | Kim J S | 2011 | 中国新药杂志2011，20，8： | 13 |
| 14 | Wilson disease:Histopathological correlations with treatment on follow-up liver biopsies显示文摘AIM:To investigate the progression of hepatic histopathology in serial liver biopsies from Wilson disease(WD)patients.METHODS:We report a group of 12 WD patients treated with zinc and/or penicillamine who underwent multiple follow-up liver biopsies.Demographic,clinical and laboratory data were gathered and all patients underwent an initial biopsy and at least one repeat biopsy.RESULTS:Time to repeat biopsy ranged from 2 to 12 years.Six patients(non-progressors)showed stable hepatic histology or improvement.In one case,we observed improvement of fibrosis from stage 2 to 0.Six patients(progressors)had worsening of fibrosis.There was no significant correlation between the histological findings and serum aminotransferases or copper me-tabolism parameters.The hepatic copper concentration reached normal levels in only two patients:one from the non-progressors and one from the progressors group.The estimated rate of progression of hepatic fibrosis in the entire group was 0 units per year in the time frame between the first and the second liver biopsy(4 years),and 0.25 between the second and the third(3 years).In the progressors group,the rate of progression of liver fibrosis was estimated at 0.11 fibrosis units per year between the first and second biopsy and,0.6 fibrosis units between the second and third biopsy.CONCLUSION:The inability of clinical tools to detect fibrosis progression in WD suggests that a liver biopsy with hepatic copper quantification every 3 years should be considered. | Sandy Cope-Yokoyama Milton J Finegold Giacomo Carlo Sturniolo Kyoungmi Kim Claudia Mescoli Massimo Rugge Valentina Medici | 2010 | World Journal of Gastroenterology2010，16，12： | 10 |
| 15 | Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGF-mediated alternative activation of macrophage显示文摘 | Kyoung-Han Kim Yun Hye Kim Joe Eun Son Ju Hee Lee Sarah Kim Min Seon Choe Joon Ho Moon Jian Zhong Kiya Fu Florine Lenglin Jeong-Ah Yoo Philip J Bilan Amira Klip Andras Nagy Jae-Ryong Kim Jin Gyoon Park Samer MI Hussein Kyung-Oh Doh Chi-chung Hui Hoon-Ki Sung | 2017 | Cell Research2017，27，11： | 9 |
| 16 | Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome显示文摘We report a case of virus-induced acute respiratory distress syndrome(ARDS) treated with parenteral vitamin C in a patient testing positive for enterovirus/rhinovirus on viral screening. This report outlines the first use of high dose intravenous vitamin C as an interventional therapy for ARDS, resulting from enterovirus/rhinovirus respiratory infection. From very significant preclinical research performed at Virginia Commonwealth Universitywith vitamin C and with the very positive results of a previously performed phase Ⅰ safety trial infusing high dose vitamin C intravenously into patients with severe sepsis, we reasoned that infusing identical dosing to a patient with ARDS from viral infection would be therapeutic. We report here the case of a 20-year-old, previously healthy, female who contracted respiratory enterovirus/rhinovirus infection that led to acute lung injury and rapidly to ARDS. She contracted the infection in central Italy while on an 8-d spring break from college. During a return flight to the United States, she developed increasing dyspnea and hypoxemia that rapidly developed into acute lung injury that led to ARDS. When support with mechanical ventilation failed, extracorporeal membrane oxygenation(ECMO) was initiated. Twelve hours following ECMO initiation, high dose intravenous vitamin C was begun. The patient's recovery was rapid. ECMO and mechanical ventilation were discontinued by day-7 and the patient recovered with no long-term ARDS sequelae. Infusing high dose intravenous vitamin C into this patient with virus-induced ARDS was associated with rapid resolution of lung injury with no evidence of post-ARDS fibroproliferative sequelae. Intravenous vitamin C as a treatment for ARDS may open a new era of therapy for ARDS from many causes. | Alpha A Fowler Ⅲ Christin Kim Lawrence Lepler Rajiv Malhotra Orlando Debesa Ramesh Natarajan Bernard J Fisher Aamer Syed Christine DeWilde Anna Priday Vigneshwar Kasirajan | 2017 | World Journal of Critical Care Medicine2017，6，1： | 9 |
| 17 | 热处理豆粕饲喂生长猪的氨基酸消化率显示文摘为测定热处理对豆粕(SBM)表观回肠消化率和标准回肠消化率(SID)的影响,本试验将常规去壳豆粕(48.5%蛋白)分成4组,一份未经额外热处理,一份在125℃下高压蒸汽处理15 min,一份在125℃下高压蒸汽处理30 min,另一份在125℃下烘箱烘干30 min。制定四种豆粕-玉米淀粉型日粮配方,且每个配方只能使用上述四种豆粕中的一种,作为每种日粮中唯一氨基酸来源。用无氮日粮配方来估算基础内源性氨基酸损失。分别在初始体重为(25.3±2.0)kg的10头阉公猪回肠末端安装一个T-型瘘管。采用5×5拉丁方设计法,将试验猪分成5个日粮处理组,5个重复处理周期。每个处理周期持续7 d,在第6天和第7天收集回肠食糜。试验结果表明,随着高压蒸汽处理时间(0~30 min)的延长,蛋白质和所有氨基酸的表观回肠消化率和标准回肠消化率呈线性降低(P<0.01)。糠氨酸含量和豆粕样品的颜色表明高压蒸汽处理导致豆粕产生美拉德反应。然而,125℃烘箱干燥30min并未改变豆粕中蛋白和氨基酸标准回肠消化率,也没有改变SBM的糠氨酸含量(P>0.10),且烘箱处理的样品颜色表明该样品并未受到热处理破坏。总之,热蒸汽处理时间从0 min增至30 min,高压蒸汽处理豆粕的氨基酸消化率呈线性降低,降低原因很可能是由于125℃高压蒸汽处理导致豆粕产生美拉德反应。 | González-Vega J C Kim B G Htoo J K Lemme A Stein H H | 2015 | 中国饲料2015，，24： | 8 |
| 18 | 大气二氧化氮与每日总死亡率、心血管和呼吸系统疾病死亡率的短期关联:398个城市的多中心分析显示文摘目的:采用统一的分析方案,评估全球多个国家/地区的二氧化氮(NO_(2))与总死亡率、心血管和呼吸系统疾病死亡率之间的短期关联。研究设计:采用两阶段的时间序列分析方法、过度离散的广义线性模型和多水平meta分析。研究地点:22个低到高收入国家/地区的398个城市。主要结局指标:1973—2018年逐日总死亡人数(6280万人)、心血管疾病死亡人数(1970万人)和呼吸系统疾病死亡人数(550万人)。结果:平均而言,NO_(2)浓度在滞后1天(前1天)每增加10μg/m^(3),会导致总死亡率、心血管和呼吸系统疾病死亡率分别增加0.46%(95%可信区间0.36%~0.57%)、0.37%(0.22%~0.51%)、0.47%(0.21%~0.72%)。在对共污染物(PM_(10)、PM_(2.5)、臭氧、二氧化硫和一氧化碳)进行调整后,这些关联仍然很稳定。所有3种死因的暴露-反应曲线几乎是线性的,没有明显的阈值。在398个城市中,可归因于高过假定零水平的NO_(2)浓度造成的死亡比例为1.23%(95%可信区间0.96%~1.51%)。结论:这项多中心研究提供了关于NO_(2)短期暴露与总死亡率、心血管和呼吸系统死亡风险之间的独立和线性关联的关键证据,说明通过加强NO_(2)的控制和监管限制标准,可获得人群水平的健康收益。 | 孟夏 刘聪(校) 陈仁杰 郑湃(译) 阚海东(校) Francesco Sera Ana Vicedo-Cabrera Ai Milojevic Maria Guo Yuming Tong Shilu Micheline de Sousa Zanotti Stagliorio Coelh Paulo Hilario Nascimento Saldiva Eric Lavigne Patricia Matus Correa Nicolas Valdes Ortega Samuel Osorio Garcia Jan Kysely Ales Urban Hans Orru Marek Maasikmets Jouni J K Jaakkola Niilo Ryti Veronika Huber Alexandra Schneider Klea Katsouyanni Antonis Analitis Masahiro Hashizume Yasushi Honda Chris Fook Sheng Ng Baltazar Nunes João Paulo Teixeira Iulian Horia Holobaca Simona Fratianni Ho Kim Aurelio Tobias Carmeníniguez Bertil Forsberg ChristoferÅström Martina S Ragettli Yue-Liang Leon Guo Shih-Chun Pan Shanshan Li Michelle L Bell Antonella Zanobetti Joel Schwartz Tangchun Wu Antonio Gasparrini | 2021 | 英国医学杂志中文版2021，24，8： | 7 |
| 19 | 如何设计高质量针刺临床研究:基于证据的专家共识显示文摘本针刺随机对照试验(Randomised controlled trials, RCT)专家共识是基于目前针刺试验面临的最普遍、最关键问题,由临床医生、研究人员、从事针灸和外科的临床试验专家、统计专家、临床流行病学和方法学专家以及患者组成的国际临床研究小组联合制订。该共识将有助于临床试验资助者、注册者以及期刊编辑等评估针刺RCT方案及研究结果的相关性、重要性和质量。 | 张誉清 焦睿珉 Claudia M Witt 劳力行 刘建平 Lehana Thabane Karen J Sherman Mike Cummings Dawn P Richards Eun-Kyung Anna Kim Tae-Hun Kim Myeong Soo Lee Michael E Wechsler Benno Brinkhaus Jun J Mao Caroline A Smith 岗卫娟 刘保延 刘志顺 刘岩 郑晖 吴佳霓 AloBSO Carrasco-Labra Mohit Bhandari Philip J Devereaux 景向红 Gordon Guyatt | 2022 | 英国医学杂志中文版2022，25，6： | 7 |
| 20 | Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches显示文摘Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging. A vital step in treatment of such comorbidity is careful and comprehensive diagnostic assessment. We attempt to explain various psychosocial and pharmacological approaches for treatment of comorbid anxiety and depression. For the psychosocial component, we focus only on generalized anxiety disorder based on the following theoretical models:(1) 'the avoidance model';(2) 'the intolerance of uncertainty model';(3) 'the meta-cognitive model';(4) 'the emotion dysregulation model'; and(5) 'the acceptance based model'. For depression, the following theoretical models are explicated:(1) 'the cognitive model';(2) 'the behavioral activation model'; and(3) 'the interpersonal model'. Integration of these approaches is suggested. The treatment of comorbid anxiety and depression necessitates specific psychopharmacological adjustments as compared to treating either condition alone. Serotonin reuptake inhibitors are considered first-line treatment in uncomplicated depression comorbid with a spectrum of anxiety disorders. Short-acting benzodiazepines(BZDs) are an important 'bridging strategy' to address an acute anxiety component. In patients with comorbid substance abuse, avoidance of BZDs is recommended and we advise using an atypical antipsychotic in lieu of BZDs. For mixed anxiety and depression comorbid with bipolar disorder, we recommend augmentation of an antidepressant with either lamotrigine or an atypical agent. Combination and augmentation therapies in the treatment of comorbid conditions vis-à-vis monotherapy may be necessary for positive outcomes. Combination therapy with tricyclic antidepressants, gabapentin and selective serotonin/norepinephrine reuptake inhibitors(e.g., duloxetine) are specifically useful for comorbid chronic pain syndromes. Aripiprazole, quetiapine, risperidone and other novel atypical agents may be effective as augmentations. For treatment-resistant patients, we recommend a 'stacking approach' not dissimilar from treatment of hypertension In conclusion, we delineate a comprehensive approach comprising integration of various psychosocial approaches and incremental pharmacological interventions entailing bridging strategies, augmentation therapies and ultimately stacking approaches towards effectively treating comorbid anxiety and depression. | Jeremy D Coplan Cindy J Aaronson Venkatesh Panthangi Younsuk Kim | 2015 | World Journal of Psychiatry2015，5，4： | 7 |
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