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    题名 作者 年代 出处 被引量
1冠状动脉内影像学临床应用专家共识(第一部分):对冠状动脉介入治疗的指导与优化显示文摘欧洲心血管介入协会(EAPCI)专家组系统总结了血管内超声(IVUS)和光学相干断层成像(OCT)这两种血管内影像学检查临床应用指征的现有证据,提供了关于IVUS和OCT指导经皮冠状动脉介入治疗(PCI)的应用价值,并明确了最可能从腔内影像学指导的介入治疗中获得临床收益的患者或病变类型,同时详细论述了PCI前如何使用IVUS或OCT优化支架尺寸(支架长度和直径)和手术策略的选择。此外,专家推荐对支架失败(支架内再狭窄或支架内血栓形成)的患者应常规进行冠状动脉内影像学检查,并首选OCT。最后,重点论述了IVUS和OCT在指导PCI和评估支架失败两个方面的优势和局限性,并对未来需要深入研究的领域进行了展望。Lorenz Raber Gary S Mintz Konstantinos C Koskinas Thomas W Johnson Niels R Holm Yoshinubo Onuma Maria D Radu Michael Joner Bo Yu Haibo Jia Nicolas Meneveau Jose M.de la Torre Hemandez Javier Escaned Jonathan Hill Francesco Prati Antonio Colombo Carlo di Mario Evelyn Regar Davide Capodanno William Wijns Robert A Byme Giulio Guagliumi 2019中华心血管病杂志2019,47,1:17
2Platelets generated from human embryonic stem cells are functional in vitro and in the microcirculation of living mice显示文摘Shi-Jiang Lu Feng Li Hong Yin Qiang Feng Erin A Kimbrel Eunsil Hahm Jonathan N Thon Wei Wang Joseph E ltaliano Jaehyung Cho Robert Lanza 2011Cell Research2011,21,3:14
3Calcium signaling and T-type calcium channels in cancer cell cycling显示文摘Regulation of intracellular calcium is an important signaling mechanism for cell proliferation in both normal and cancerous cells. In normal epithelial cells, free calcium concentration is essential for cells to enter and accomplish the S phase and the M phase of the cell cycle. In contrast, cancerous cells can pass these phases of the cell cycle with much lower cytoplasmic free calcium concentrations, indicating an alternative mechanism has developed for fulfilling the intracellular calcium requirement for an increased rate of DNA synthesis and mitosis of fast replicating cancerous cells. The detailed mechanism underlying the altered calcium loading pathway remains unclear; however, there is a growing body of evidence that suggests the T-type Ca2+ channel is abnormally expressed in cancerous cells and that blockade of these channels may reduce cell proliferation in addition to inducing apoptosis. Recent studies also show that the expression of T-type Ca2+ channels in breast cancer cells is proliferation state dependent, i.e. the channels are expressed at higher levels during the fast-replication period, and once the cells are in a non-proliferation state, expression of this channel isminimal. Therefore, selectively blocking calcium entry into cancerous cells may be a valuable approach for preventing tumor growth. Since T-type Ca2+ channels are not expressed in epithelial cells, selective T-type Ca2+ channel blockers may be useful in the treatment of certain types of cancers.James T Taylor Xiang-Bin Zeng Jonathan E Pottle Kevin Lee Alun R Wang Stephenie G Yi lennifer A S Scruggs Suresh S Sikka Ming Li 2008World Journal of Gastroenterology2008,14,32:12
4Augmenting peripheral nerve regeneration using stem cells: A review of current opinion显示文摘Outcomes following peripheral nerve injury remain frustratingly poor. The reasons for this are multifactorial, although maintaining a growth permissive environment in the distal nerve stump following repair is arguably the most important. The optimal environment for axonal regeneration relies on the synthesis and release of many biochemical mediators that are temporally and spatially regulated with a high level of incompletely understood complexity. The Schwann cell(SC) has emerged as a key player in this process. Prolonged periods of distal nerve stump denervation, characteristic of large gaps and proximal injuries, have been associated with a reduction in SC number and ability to support regenerating axons. Cell based therapy offers a potential therapy for the improvement of outcomes following peripheral nerve reconstruction. Stem cells have the potential to increase the number of SCs and prolong their ability to support regeneration. They may also have the ability to rescue and replenish populations of chromatolytic and apoptotic neurons following axotomy. Finally, they can be used in non-physiologic ways to preserve injured tissues such as denervated muscle while neuronal ingrowth has not yet occurred. Aside from stem cell type, careful consideration must be given to differentiation status, how stem cells are supported following transplantation and how they will be delivered to the site of injury. It is the aim of this article to review current opinions on the strategies of stem cell based therapy for the augmentation of peripheral nerve regeneration.Neil G Fairbairn Amanda M Meppelink Joanna Ng-Glazier Mark A Randolph Jonathan M Winograd 2015World Journal of Stem Cells2015,7,1:12
5Cardiotrophin 1 stimulates beneficial myogenic and vascular remodeling of the heart显示文摘出生后的心通过 hypertrophic 生长适应应力和超载,可能病理学或有益的一个过程(生理的肥大) 。生理的肥大改进心脏的性能在健康并且 diseased 个人,然而,宣传这有利改编的机制仍然保持糟糕定义。我们识别 cytokine cardiotrophin (CT1 ) 1 作为能够包括导致的导出 cardiomyocyte 的 angiogenic 信号的心肌层,和刺激的短暂、可逆的肥大概括心的生理的生长的特色的一个因素增加了由脉管形成。CT1 的能力从 caspase 激活的调停 CK2 的制止发源导致生理的肥大,阻止到无限制的病理学的生长的转变。外长的 CT1 蛋白质交货稀释了病理并且在正确的心失败的一个严格的模型恢复了可收缩的功能,建议为这难处理的心脏病的一种新奇处理选择。Mohammad Abdul-Ghani Colin Suen Baohua Jiang Yupu Deng Jonathan J Weldrick Charis Putinski Steve Brunette Pasan Femando Tom T Lee Peter Flynn Frans H H Leenen Patrick G Burgon Duncan J Stewar Lynn A Megeney 2017Cell Research2017,27,10:8
6Sessile serrated adenomas:Demographic,endoscopic and pathological characteristics显示文摘AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single center.METHODS:Patients with SSA were identified by review of the pathology database of Mayo Clinic Arizona from 2005 to 2007.A retrospective chart review was performed to extract data on demographics,polyp characteristics,presence of synchronous adenomatous polyps or cancer,polypectomy methods,and related complications.RESULTS:One hundred and seventy-one(2.9%) of all patients undergoing colonoscopy had a total of 226 SSAs.The mean(SE) size of the SSAs was 8.1(0.4) mm;42% of SSAs were ≤ 5 mm,and 69% were ≤ 9 mm.Fifty-one per cent of SSAs were located in the cecum or ascending colon.Approximately half of the patients had synchronous polyps of other histological types,including hyperplastic and adenomatous polyps.Synchronous adenocarcinoma was present in seven(4%) cases.Ninety-seven percent of polyps were removed by colonoscopy.CONCLUSION:Among patients with colon polyps,2.9% were found to have SSAs.Most of the SSAs were located in the right side and were safely managed by colonoscopy.Suryakanth R Gurudu Russell I Heigh Giovanni De Petris Evelyn G Heigh Jonathan A Leighton Shabana F Pasha Isaac B Malagon Ananya Das 2010World Journal of Gastroenterology2010,16,27:7
7Management of diverticular disease is changing显示文摘结肠的憩室的疾病主要是人住在的疾病西洋化并且工业化国家。人住在工业化国家中的百分之六十个将开发结肠的憩室。它以前是稀罕的它发生在幼仔的 40 的年龄,而是对复杂并发症敏感的更多。在年龄 80,超过 65% 人有结肠的憩室。原因遗体不明确,却流行病的研究把它归因于饮食的纤维缺乏。憩室炎的原因仍然保持不明确,却新观察和假设建议它由于在肠墙中的慢性炎。肠休息和抗菌素的标准医药治疗仍然是推荐处理。然而,改变概念和新治疗 indicate 职业人员生命学可以是的反煽动性的代理人象 mesalamine 那样并且可能在弄短有用功课和也许阻止的复发。为为严重急性病的穿孔的标准外科疗法发展了以便二阶段的过程被推荐。另外, laparoscopic 外科证明了安全并且可以慢慢地成为选择的技术。Martin H Floch Jonathan A White 2006World Journal of Gastroenterology2006,12,20:7
8轨道尺度的亚洲夏季风演变:“困惑”与探索显示文摘亚洲夏季风影响着亚洲大陆数十亿人口.半个世纪以来,亚洲夏季风研究取得了许多重要成就,但一些科学问题依然有待深入探索.这其中包括轨道时间尺度的两个难题:(1)中国黄土的磁化率序列显示亚洲夏季风变化以冰期-间冰期~100kyr周期为主,而中国石笋氧同位素(δ18O)序列则以~20kyr岁差周期为主,两者主导周期的差异成为了悬而未决的'中国的100kyr周期问题';(2)亚洲大陆石笋δ18O序列与许多海洋沉积记录在岁差波段上的显著相位差异,是争议已久的'海-陆岁差相位的困惑'.应当如何解答这些难题呢?首先,伴随着轨道尺度数值模拟的不断发展,岁差波段上降水量和风场变化在亚洲夏季风广大区域中的不均匀性及其区域模态差异逐渐明朗,不同气候记录的分歧在很大程度上可能只是这种降水和风场空间不均一性的体现.其次,不同记录载体有其固有的优势和局限,而此间差异则部分反映了这些局限性.总体而言,亚洲夏季风的黄土、海洋和石笋记录之间并不存在相互否定的关系,而是具有互补性;它们各自刻画了亚洲夏季风动力学系统的不同方面.因此,从整体季风系统的视角审视这些记录,能够基本解释亚洲季风的'中国的100kyr周期问题'和'海-陆岁差相位的困惑'这两个科学难题.程海 张海伟 蔡演军 石正国 易亮 邓成龙 郝青振 彭友兵 Ashish SINH A 李瀚瑛 赵景耀 田野 Jonathan BAK ER Carlos PEREZ-M EJIAS 2021中国科学:地球科学2021,51,4:6
9Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma显示文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed.Erik W Larson Halloran E Peterson Wayne T Lamoreaux Alexander R MacKay Robert K Fairbanks Jason A Call Jonathan D Carlson Benjamin C Ling John J Demakas Barton S Cooke Christopher M Lee 2014World Journal of Clinical Oncology2014,5,2:5
10Esophageal tissue engineering:A new approach for esophageal replacement显示文摘A number of congenital and acquired disorders require esophageal tissue replacement.Various surgical techniques,such as gastric and colonic interposition,are standards of treatment,but frequently complicated by stenosis and other problems.Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function.We review the literature of esophageal tissue engineering,discuss its implications,compare the methodologies that have been employed and suggest possible directions for the future.Medline,Embase,the Cochrane Library,National Research Register and ClinicalTrials.gov databases were searched with the following search terms:stem cell and esophagus,esophageal replacement,esophageal tissue engineering,esophageal substitution.Reference lists of papers identified were also examined and experts in this field contacted for further information.All full-text articles in English of all potentially relevant abstracts were reviewed.Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation.When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality.Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration,whilst omental wrapping to induce vascularization of the construct has an uncertain benefit.Decellularized matrices have been recently suggested as the optimal choice for scaffolds,but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution.Results in animal models that have used seeded scaffolds strongly suggest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a prerequisite for complete esophageal replacement.Novel approaches need to be designed to allow for peristalsis and vascularization in the engineered esophagus.Although esophageal tissue engineering potentially offers a real alternative to conventional treatments for severe esophageal disease,important barriers remain that need to be addressed.Giorgia Totonelli Panagiotis Maghsoudlou Jonathan M Fishman Giuseppe Orlando Tahera Ansari Paul Sibbons Martin A Birchall Agostino Pierro Simon Eaton Paolo De Coppi 2012World Journal of Gastroenterology2012,18,47:5
11Capsule endoscopy in suspected small bowel Crohn's disease:Economic impact of disease diagnosis and treatment显示文摘AIM: To model clinical and economic benef its of capsule endoscopy (CE) compared to ileo-colonoscopy and small bowel follow-through (SBFT) for evaluation of suspected Crohn’s disease (CD). METHODS: Using decision analytic modeling, total and yearly costs of diagnostic work-up for suspected CD were calculated, including procedure-related adverse events, hospitalizations, off ice visits, and medications. The model compared CE to SBFT following ileo-colonoscopy and secondarily compared CE to SBFT for initial evaluation. RESULTS: Aggregate charges for newly diagnosed, medically managed patients are approximately $8295. Patients requiring aggressive medical management costs are $29 508; requiring hospitalization, $49 074. At sensitivity > 98.7% and specifi city of > 86.4%, CE is less costly than SBFT. CONCLUSION: Costs of CE for diagnostic evaluationof suspected CD is comparable to SBFT and may be used immediately following ileo-colonoscopy.Jonathan A Leighton Ian M Gralnek Randel E Richner Michael J Lacey Frank J Papatheofanis 2009World Journal of Gastroenterology2009,15,45:5
12Predisposing factors for positive D-Xylose breath test for evaluation of small intestinal bacterial overgrowth:A retrospective study of 932 patients显示文摘AIM: To investigate, in the largest cohort to date, patient characteristics and associated risk factors for developing small intestinal bacterial overgrowth(SIBO) using the D-Xylose breath test(XBT).METHODS: We performed a retrospective crosssectional study to analyze patient characteristics who underwent the XBT for evaluation of SIBO. Diagnostic testing with the XBT was performed based on a clinical suspicion for SIBO in patients with symptoms of bloating, abdominal pain, abdominal distension, weight loss, diarrhea, and/or constipation. Consecutive electronicmedical records of 932 patients who completed the XBT at the University of Florida between 2005 and 2009 were reviewed. A two-way Analysis of Variance(ANOVA) was used to test for several associations including age, gender, and body mass index(BMI) with a +XBT. A two-way ANOVA was also performed to control for the differences and interaction with age and between genders. A similar analysis was repeated for BMI. Associations between medical conditions and prior surgical histories were conducted using the Mantel-Haenszel method for 2 by 2 contingency tables, stratified for gender. Reported odds ratio estimates reflect the odds of the prevalence of a condition within the +XBT group to that of the-XBT group. P values of less than 0.05(two-sided) were considered statistically significant.RESULTS: In the 932 consecutive eligible subjects studied, 513 had a positive XBT. A positive association was found between female gender and a positive XBT(P = 0.0025), and females with a positive test were, on average, greater than 5 years older than those with a negative test(P = 0.024). The mean BMI of positive XBT subjects was normal(24.5) and significantly lower than the subjects with a negative XBT(29.5)(P = 0.0050). A positive XBT was associated with gastroesophageal reflux disease(GERD)(OR = 1.35; 95%CI: 1.02-1.80, P = 0.04), peptic ulcer disease(PUD)(OR = 2.61; 95%CI: 1.48-4.59, P < 0.01), gastroparesis(GP)(OR = 2.04; 95%CI: 1.21-3.41, P < 0.01) and steroid use(OR = 1.35; 95%CI: 1.02-1.80, P = 0.01). Irritable bowel syndrome, independent protonpump inhibitor(PPI) usage, or previous abdominal surgery was not significantly associated with a positive XBT. No single subdivision by gender or PPI use was associated with a significant difference in the odds ratios between any of the subsets. CONCLUSION: Female gender, lower BMI, steroid use, PUD, GERD(independent of PPI use), and GP were more prevalent in patients with SIBO, determined by a positive XBT. Increasing age was associated with SIBO in females, but not in males.Richard A Schatz Qing Zhang Nilesh Lodhia Jonathan Shuster Phillip P Toskes Baharak Moshiree 2015World Journal of Gastroenterology2015,21,15:4
13Nat Genet:单基因突变导致过敏性皮炎的发生显示文摘最近,研究者们鉴定出了一类导致神经性皮炎发生的关键基因突变:CARDll。来自美国NIH过敏与传染病研究所的研究者们通过对四个没有血缘关系的患病家庭进行分析,发现了这一导致疾病产生的基因、Chi A Ma, Yuan Zhang, Michael A Weinreich, Jonathan J Lyons, Celeste G Nelson, Thomas DiMaggio, Kelly D Stone, Joshua D Milner Jeffrey R Stinson, Elisa Ruffo, Batsukh Dorjbal, Swadhinya Arjunaraja, Kelsey Voss, Andrew L Snow Jordan K Abbott, Pia J Hauk, Paul R Reynolds, Erwin W Gelfand Elisa Ruffo Salomé Glauzy, Natsuko Yamakawa, Eric Meffre Jennifer Stoddard, Julie Niemela, Sergio D Rosenzweig Yu Zhang, Helen F Matthews Joshua J McElwee Nina Jones Alejandro Palma, Matías Oleastro, Emma Prieto, Andrea R Bernasconi, Geronimo Dubra, Silvia Danielian, Jonathan Zaiat, Marcelo A Marti Brian Kim Megan A Cooper Neil Romberg 2017现代生物医学进展2017,17,27:3
14Chronic myeloid leukemia-from the Philadelphia chromosome to specific target drugs:A literature review显示文摘Chronic myeloid leukemia(CML)is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly―the presence of the Philadelphia chromosome.The advances in cytogenetic and molecular assays are of great importance to the diagnosis,prognosis,treatment,and monitoring of CML.The discovery of the breakpoint cluster region(BCR)-Abelson murine leukemia(ABL)1 fusion oncogene has revolutionized the treatment of CML patients by allowing the development of targeted drugs that inhibit the tyrosine kinase activity of the BCR-ABL oncoprotein.Tyrosine kinase inhibitors(known as TKIs)are the standard therapy for CML and greatly increase the survival rates,despite adverse effects and the odds of residual disease after discontinuation of treatment.As therapeutic alternatives,the subsequent TKIs lead to faster and deeper molecular remissions;however,with the emergence of resistance to these drugs,immunotherapy appears as an alternative,which may have a cure potential in these patients.Against this background,this article aims at providing an overview on CML clinical management and a summary on the main targeted drugs available in that context.Mariana Miranda Sampaio Maria Luísa Cordeiro Santos Hanna Santos Marques Vinícius Lima de Souza Gonçalves Glauber Rocha Lima Araújo Luana Weber Lopes Jonathan Santos Apolonio Camilo Santana Silva Luana Kauany de SáSantos Beatriz Rocha Cuzzuol Quézia Estéfani Silva Guimarães Mariana Novaes Santos Breno Bittencourt de Brito Filipe Antônio França da Silva Márcio Vasconcelos Oliveira Cláudio Lima Souza Fabrício Freire de Melo 2021World Journal of Clinical Oncology2021,12,2:3
15Dysfunctional stem and progenitor cells impair fracture healing with age显示文摘Successful fracture healing requires the simultaneous regeneration of both the bone and vasculature;mesenchymal stem cells (MSCs) are directed to replace the bone tissue, while endothelial progenitor cells (EPCs) form the new vasculature that supplies blood to the fracture site. In the elderly, the healing process is slowed, partly due to decreased regenerative function of these stem and progenitor cells. MSCs from older individuals are impaired with regard to cell number, proliferative capacity, ability to migrate, and osteochondrogenic differentiation potential. The proliferation, migration and function of EPCs are also compromised with advanced age. Although the reasons for cellular dysfunction with age are complex and multidimensional, reduced expression of growth factors, accumulation of oxidative damage from reactive oxygen species, and altered signaling of the Sirtuin-1 pathway are contributing factors to aging at the cellular level of both MSCs and EPCs. Because of these geriatric-specific issues, effective treatment for fracture repair may require new therapeutic techniques to restore cellular function. Some suggested directions for potential treatments include cellular therapies, pharmacological agents, treatments targeting age-related molecular mechanisms, and physical therapeutics. Advanced age is the primary risk factor for a fracture, due to the low bone mass and inferior bone quality associated with aging;a better understanding of the dysfunctional behavior of the aging cell will provide a foundation for new treatments to decrease healing time and reduce the development of complications during the extended recovery from fracture healing in the elderly.Diane R Wagner Sonali Karnik Zachary J Gunderson Jeffery J Nielsen Alanna Fennimore Hunter J Promer Jonathan W Lowery M Terry Loghmani Philip S Low Todd O McKinley Melissa A Kacena Matthias Clauss Jiliang Li 2019World Journal of Stem Cells2019,11,6:3
16扁桃体鳞癌中HPV感染与EGFR、VEGF表达的相关性研究显示文摘目的:研究扁桃体鳞癌(squamous cell carcinomas of the tonsil tonsillar,SCCs)中人乳头瘤病毒(human papillomavirus,HPV)感染与血管内皮生长因子(vascular endothelial growth factor,VEGF)和表皮生长因子受体(epidermal growth factor,EGFR)表达的关系,探讨HPV与EGFR和VEGF在扁桃体鳞癌发生中的交互效应。方法:采用多重实时荧光定量聚合酶链反应(multiplex real-time polymerase chain reaction,MT-PCR)检测85例扁桃体鳞癌HPV DNA及型别,通过HPV DNA分析进行HPV感染状况的测定;同时采用半定量免疫组化检测HPV(+)组和HPV(-)组中VEGF、EGFR蛋白表达情况。结果:扁桃体鳞癌中HPV感染率为49.4%(42/85),HPV-16型占所有感染者的比例为90.5%(38/42),明显高于其他型别;HPV(+)组EGFR蛋白表达明显低于HPV(-)组(P值均<0.01);HPV(+)组与HPV(-)组VEGF蛋白表达无明显差异;此外,VEGF表达与EGFR、患者的年龄、性别、TNM分期、组织学分级均无明显相关性。结论:HPV感染与扁桃体鳞癌的发生存在相关性,HPV相关的扁桃体鳞癌中,HPV基因可能通过改变EGFR表达致癌,为HPV致癌机理进一步研究提供一个新的视角,具有重要的理论意义。费继敏 Timothy A Dobbins Deanna Jones C Soon Lee Christine Loo Jonathan Clark Barbara Rose 2015现代肿瘤医学2015,23,4:3
17Acute aortic dissection显示文摘Jonathan Golledge Kim A Eagle 2008The Lancet2008,,9632:2
18Appropriateness 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
19Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial显示文摘Ronald P DeMatteo Karla V Ballman Cristina R Antonescu Robert G Maki Peter WT Pisters George D Demetri Martin E Blackstein Charles D Blanke Margaret von Mehren Murray F Brennan Shreyaskumar Patel Martin D McCarter Jonathan A Polikoff Benjamin R Tan Kouros 2009The Lancet2009,,9669:2
20用心脏的磁性的回声成像部分 1: 的心肌症的调查普通显型显示文摘 Cardiac magnetic resonance imaging(CMRI) has emerged as a useful tertiary imaging tool in the investigation of patients suspected of many different types of cardiomyopathies,CMRI sequences are now of a sufficiently robust quality to enable high spatial and temporal resolution image acquisition.This has led to CMRI becoming an effective non-invasive imaging gold standard for many cardiomyopathies.In this 2-part review,we outline the typical sequences used to image cardiomyopathy,and present the imaging spectrum of cardiomyopathy.Part 1 focuses on the current classification of cardiomyopathy,basic CMRI sequences used in evaluating cardiomyopathy and the imaging spectrum of common phenotypes.Shaunagh McDermott Ailbhe C O’Neill Carole A Ridge Jonathan D Dodd 2012World Journal of Cardiology2012,4,4:2
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