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1乳腺癌病人家庭支持和自理行为的相关性研究显示文摘采用家庭支持问卷和自理行为问卷对61例乳腺癌术后在门诊接受放疗的病人进行了调查。结果:乳腺癌术后放疗病人得到较多的家庭支持和执行较多的自理行为;病人的家庭支持和自理行为之间存在正性相关关系(r=029,P<005)。说明护理人员指导病人家属向病人提供有效的家庭支持,可促进病人自理。张海燕 TATSANA M MARAYART N 1999护理学杂志(综合版)1999,14,4:63
2金厂沟梁-二道沟金矿田内花岗岩类侵入体锆石的离子探针U-Pb年代学及意义显示文摘金厂沟梁-二道沟金矿田内花岗岩类侵入体SHRIMP锆石U-Ph定年结果表明,该区中生代以来到少经历了三次中酸性岩浆侵入作用,它们分别以西台子二长花岗岩、娄上含辉石石英闪长岩和西对面沟花岗闪长岩及闪长玢岩脉在218±4Ma(印支期)、161±1Ma(燕山早期)和126±1Ma(燕山晚期)的侵位为标志。花岗岩类的地球化学资料表明,这些花岗岩类侵入体形成与造山作用有关,为造山后或陆内拉张作用的产物。二道沟矿区成矿前或成矿期闪长玢岩脉的年龄126±1Ma限定了该区金矿化的最大年龄;结合前人有关年代学资料,认为本区金矿化应发生在126~118Ma。这说明金厂沟梁-二道沟金矿田的金矿床与我国胶东、小秦岭和辽东等地区的金矿床是同时形成的,再次证明燕山晚期是中国最重要而广泛的金成矿期。此外,在这些主要的金矿区内,金矿化时间上均具有与各自区内最晚一次花岗质岩浆作用同时或稍晚的特征,这可能指示金矿床是造山作用或区域构造-岩浆演化最晚期的产物。苗来成 范蔚茗 翟明国 Qiu Y M McNaughton N J Groves D I 2003岩石学报2003,19,1:70
3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
4Overexpression of ADAM9 in non-small cell lung cancer correlates with brain metastasis显示文摘The 'a disintegrin and metalloprotease' (ADAM) family contributes to regulation of the cell-cell and cell-matrix interactions that are critical determinants of malignancy. To determine the relationship between metastasis and ADAM proteins, we compared the mRNA levels of ADAM9,-10,-12,-15, and-17 in sublines of an EBC-1 lung cancer cell line that were highly metastatic to either brain or bone. ADAM9 mRNA levels were significantly higher in highly brain-metastatic sublines than in the parent or highly bonemetastalic sublines. To elucidate the role ofADAM9 in brain metastasis, we stably transfected A549 and EBC-1 cells with a fulllength ADAM9 expression vector. Compared with mock-transfectants, ADAM9 overexpression resulted in increased invasive capacityShintani Y Higashiyama S Ohta M Hirabayashi H Yamamoto S Yoshimasu T Matsuda H Matsuura N 2004中国神经肿瘤杂志2004,2,2:36
5AGNP精神科治疗药物监测共识指南:2011显示文摘治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代动力学药物-药物相互作用等情况下,测定药物浓度是很有用的。在精神科,有可能明显获益于TDM的主要患者群体包括儿童、孕妇、老年患者、智力障碍患者、涉及司法的患者、已知或怀疑携带药代动力学相关基因变异的患者,以及合并躯体疾病影响药代动力学的患者。然而,只有将TDM充分整合到临床治疗过程中去,才能发挥其优化药物治疗的潜在优势。为了促进TDM的合理应用,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了精神药物治疗药物监测指南。之后,随着知识不断更新,又有许多可能需要进行TDM的新药上市。因此,本次更新将神经精神药物的种类扩展到了128种,并将其TDM必要性划分为从'强烈推荐'到'可能有用'的四个等级。经过大量细致且全面的文献检索与分门别类的汇总整理,将基于循证医学理念的'治疗参考浓度范围'和'剂量相关参考浓度范围'呈现给大家。本共识指南引入了'实验室警戒浓度'的新概念,即实验室需要马上告知治疗医生的药物浓度上限。本共识指南还给出了诸如药物作为细胞色素P450酶的底物和抑制剂的性质,代谢物与母药浓度比值的常见范围,以及与结果解释相关的内容,还提供了何时将TDM与遗传药理学检测相结合的建议。遵循本指南,有助于改善许多患者精神药物治疗的效果,特别是那些存在药代动力学异常的患者。TDM是一门交叉学科,有时针对看起来不一致的数据,需要多学科坦诚地讨论,只有这样,患者才能从这种合作中获益。Hiemke C Baumann P Bergemann N Conca A Dietmaier O Egberts K Fric M Gerlach M Greiner C Gründer G Haen E Havemann-Reinecke U Jaquenoud Sirot E Kirchherr H Laux G Lutz UC Messer T Müller MJ Pfuhlmann B Rambeck B Riederer P Schoppek B Stingl J Uhr M Ulrich S Waschgler R Zernig G 李文标(译) 果伟(译) 阮灿军(译) 贺静(译) 汤宜朗(审校) 王传跃(审校) 2016实用药物与临床2016,19,10:37
6新媒体联盟地平线报告:2017图书馆版显示文摘地平线报告系列展示了5年内创新实践和技术对全球学术与研究型图书馆的影响。报告涉及6大关键趋势,6种重要挑战和6项技术发展,它们影响着图书馆战略、运营和服务,包括学习、创意调查、研究和信息管理。其中专家们认为大数据、数字学术技术、图书馆服务平台、网络身份、人工智能、物联网等技术具有促进学术和研究型图书馆发生真正改变的潜力。本报告为图书馆领导者、图书馆工作人员、政策制定者和技术人员提供参考和技术规划指南。S·亚当斯·贝克尔 M·卡明斯 A·戴维斯 A·弗里曼 C·霍尔·盖辛格 V·安娜塔娜额亚娟 K·兰利 N·沃尔夫森 高茜(译) 曹红岩(译) 徐路(译) 周晖(译) 谢艳秋(译) 洪长勇(译) 王丽媛(译) 鄂丽君(译) 2017开放学习研究2017,22,5:33
7帕博利珠单抗治疗伴脑转移NSCLC患者的一项非随机、开放Ⅱ期试验的长期随访结果和生物标志物分析显示文摘背景与目的我们开展了一项帕博利珠单抗用于伴未治疗脑转移的非小细胞肺癌(non-small cell lung cancer,NSCLC)或黑色素瘤患者的疗效和安全性的II期试验,旨在评估程序性死亡受体1(programmed cell death 1,PD-1)抑制剂在中枢神经系统(central nervous system,CNS)中的疗效。中期结果已发表,现报道对NSCLC队列的更新分析结果。方法这是一项开放性、单中心、II期试验。纳入标准:年龄≥18岁,诊断为晚期NSCLC并伴有≥1个5 mm-20 mm脑转移病灶,既往从未治疗或之前放疗后进展,无神经系统症状,不需要激素治疗且美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)<2分。患者每2周接受一次帕博利珠单抗(10 mg/kg)治疗。队列1为程序性死亡配体1(programmed cell death ligand 1,PD-L1)≥1%的患者,队列2为PD-L1<1%或未评估的患者。主要终点是脑转移患者缓解比例。所有经治患者均纳入疗效与安全性终点的分析。该研究已结束入组,并于Clinicaltrials.gov登记注册,注册号为NCT02085070。结果2014年3月31日-2018年5月21日,共42例患者接受治疗。中位随访时间为8.3个月(IQR:4.5个月-26.2个月)。队列1的37例患者中11例有脑转移缓解[29.7%(95%CI:15.9%-47.0%)]。队列2未观察到缓解。治疗相关的3级-4级不良事件(adverse events,AEs)包括2例肺炎、1例全身症状、1例结肠炎、1例肾上腺皮质功能不全、1例高血糖症和1例低钾血症。6例(14%)患者发生了治疗相关的严重不良事件,包括肺炎、急性肾损伤、低钾血症和肾上腺皮质功能不全。没有观察到治疗相关死亡病例。结论帕博利珠单抗治疗PD-L1≥1%的NSCLC伴脑转移患者有效,且对所有纳入的未经治疗的脑转移患者安全。需要进一步探索免疫治疗用于NSCLC合并CNS转移。Sarah B GOLDBERG Kurt A SCHALPER Scott N GETTINGER Amit MAHAJAN Roy S HERBST Anne C CHANG Rogerio LILENBAUM Frederick H WILSON Sacit Bulent OMAY James B YU Lucia JILAVEANU Thuy TRAN Kira PAVLIK Elin ROWEN Heather GERRSH Annette KOMLO Richa GUPTA Hailey WYATT Matthew RIBEIRO Yuval KLUGER Geyu ZHOU Wei WEI Veronica L CHANG Harriet M KLUGER 董晓荣(翻译/校对) 2021中国肺癌杂志2021,24,9:34
8Vitamin D improves inflammatory bowel disease outcomes:Basic science and clinical review显示文摘Vitamin D deficiency is commonly diagnosed among patients with inflammatory bowel disease(IBD).Patients with IBD are at risk of low bone density and increased fractures due to low vitamin D levels,long standing disease,and frequent steroid exposures;as a result,it is well established that vitamin D supplementation in this population is important.There is increasing support for the role of vitamin D in strengthening the innate immune system by acting as an immunomodulator and reducing inflammation in experimental and human IBD.The active form of vitamin D,1,25(OH)D3,acts on T cells to promote T helper(Th)2/regulatory T responses over Th1/Th17 responses;suppresses dendritic cell inflammatory activity;induces antibacterial activity;and regulates cytokine production in favor of an antiinflammatory response.Murine and human IBD studies support a therapeutic role of vitamin D in IBD.Risk factors for vitamin D deficiency in this population include decreased sunlight exposure,disease duration,smoking,and genetics.Vitamin D normalization is associated with reduced risk of relapse,reduced risk of IBD-related surgeries,and improvement in quality of life.Vitamin D is an inexpensive supplement which has been shown to improve IBD outcomes.However,further research is required to determine optimal serum vitamin D levels which will achieve beneficial immune effects,and stronger evidence is needed to support the role of vitamin D in inducing disease response and remission,as well as maintaining this improvement in patients’disease states.Krista M Reich Richard N Fedorak Karen Madsen Karen I Kroeker 2014World Journal of Gastroenterology2014,20,17:34
9An overview of animal models for investigating the pathogenesis and therapeutic strategies in acute hepatic failure显示文摘Acute hepatic failure (AHF) is a severe liver injury accompanied by hepatic encephalopathy which causes multiorgan failure with an extremely high mortality rate, even if intensive care is provided. Management of severe AHF continues to be one of the most challenging problems in clinical medicine. Liver transplantation has been shown to be the most effective therapy, but the procedure is limited by shortage of donor organs. Although a number of clinical trials testing different liver assist devices are under way, these systems alone have no significant effect on patient survival and are only regarded as a useful approach to bridge patients with AHF to liver transplantation. As a result, reproducible experimental animal models resembling the clinical conditions are still needed. The three main approaches used to create an animal model for AHF are: surgical procedures, toxic liver injury and infective procedures. Most common models are based on surgical techniques (total/partial hepatectomy, complete/transient devascularization) or the use of hepatotoxic drugs (acetaminophen, galactosamine, thioacetamide, and others), and very few satisfactory viral models are available. We have recently developed a viral model of AHF by means of the inoculation of rabbits with the virus of rabbit hemorrhagic disease. This model displays biochemical and histological characteristics, and clinical features that resemble those in human AHF. In the present article an overview is given of the most widely used animal models of AHF, and their main advantages and disadvantages are reviewed.María Jesús Tuón Marcelino Alvarez Jesús M Culebras Javier González-Gallego 2009World Journal of Gastroenterology2009,15,25:29
10尿钠排泄、血压、心血管病与死亡率的关系:社区前瞻性流行病学队列研究显示文摘WHO建议人群钠摄人<2 g/d作为预防心血管病的措施之一,但这一目标在任何国家都没有实现。该建议主要基于短期血压试验的个体水平数据,没有来自随机试验或观察性研究的关于低钠摄入与降低心血管事件的数据。前瞻性城市农村流行病学研究目前正在21个国家进行。该文对其中18个国家的数据进行分析,其中包含了临床结果数据。Mente A O'Donnell M Rangarajan S McQueen M Dagenais G Wielgosz A Lear S Ah STL Wei L Diaz R Avezum A Lopez-Jaramillo P Lanas F Mony P Szuba A Iqbal R Yusuf R Mohammadifard N Khatib R Yusoff K Ismail N Gulec S Rosengren A Yusufali A Kruger L Tsolekile LP Chifamba J Dans A Alhabib KF Yeates K Teo K Yusuf S 刘莉 叶鹏 2018中华高血压杂志2018,26,12:29
11世界胃肠病学组织全球指南——发展中国家幽门螺杆菌感染显示文摘世界上有一半人口感染幽门螺杆菌(H.pylori),其感染率因地理位置、种族、年龄和社会经济状况不同而存在很大差异.在发展中国家较高.发达国家较低。但总体而言,近年世界许多地区的H.pylori感染率均呈下降趋势。Hunt RH Xiao SD Megraud F Leon-Barua R Bazzoli F van der Merwe S Vaz Coelho LG Fock M Fedail S Cohen H Malfertheiner P Vakil N Hamid S Goh KL Wong BCY Krabshuis J Le Mair A 杜颖 戴宁 2011胃肠病学2011,16,7:27
12Pediatric functional constipation treatment with Bifi dobacterium-containing yogurt:A crossover,double-blind,controlled trial显示文摘AIM: To evaluate the treatment of pediatric functional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. METHODS: A crossover double-blind formula-controlled trial was carried out on 59 students (age range: 5-15 years) of a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma Ⅲ criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 109 colony forming unit/mL Bifidobacterium longum (B.longum) (probiotic) daily or only the yogurt for a period of 5 wk (formula). Afterwards, the groups were intercrossed for another 5 wk. Defecation frequency, stool consistency and abdominal and defecation pain were assessed.RESULTS: Both treatment groups demonstrated improvement in defecation frequency compared to baseline. However, the group treated with probiotic showed most signif icant improvement in the f irst phase of the study. An inversion was observed after crossing over, resulting in a reduction in stool frequency when this group was treated by formula. Probiotic and formula improved stool consistency in the f irst phase of treatment, but the improvement obtained with probiotic was significantly higher (P = 0.03). In the second phase of treatment, the group initially treated with probiotic showed worseningstool consistency when using formula. However, the difference was not signif icant. A signif icant improvement in abdominal pain and defecation pain was observed with both probiotic and formula in the first phase of treatment, but again the improvement was more signif icant for the group treated with B. longum during phase I (P < 0.05). When all data of the crossover study were analyzed, significant differences were observed between probiotic yogurt and yogurt only for defecation frequency (P = 0.012), defecation pain (P = 0.046) and abdominal pain (P = 0.015).Paula VP Guerra Luiza N Lima Tassia C Souza Vanessa Mazochi Francisco J Penna Andreia M Silva Jacques R Nicoli Elizabet V Guimares 2011World Journal of Gastroenterology2011,17,34:25
132018加拿大心境障碍与焦虑障碍治疗协作组/国际双相障碍学会指南:双相障碍的管理显示文摘加拿大心境障碍与焦虑障碍治疗协作组(Canadian Network for Mood and Anxiety Treatments,CANMAT)曾于2005年发布了第1版双相障碍管理指南,并分别于2007、2009和2013年对该指南进行了更新,其中最近的2次更新是与国际双相障碍学会(International Society for Bipolar Disorders,ISBD)合作完成。2018版CANMAT/ISBD双相障碍治疗指南(以下简称指南)反映了自2005年首版指南发表以来本领域取得的重大进展,包括疾病诊断与疾病管理的更新以及药物治疗与心理治疗的近期研究进展。这些前沿进展中综合考虑了循证证据的级别,并基于治疗疗效、临床实践经验、安全性、耐受性和药物导致的转相风险等,对一线、二线及三线治疗方案进行了简明而清晰的推荐。本指南中新增内容涵盖了双相Ⅰ型障碍(BD-Ⅰ)的躁狂发作急性期、抑郁发作急性期和双相障碍维持期的一线及二线治疗推荐等级划分。这种对治疗推荐等级的划分综合考虑了治疗方法对双相障碍不同时相的影响,将进一步帮助临床医生做出基于循证证据的治疗决策。锂盐、喹硫平、双丙戊酸盐、阿塞那平、阿立哌唑、帕利哌酮、利培酮和卡利拉嗪单药或联合使用被推荐为躁狂发作急性期的一线治疗选择。BD-Ⅰ抑郁期的一线治疗选择包括喹硫平、鲁拉西酮、锂盐、拉莫三嗪单药,鲁拉西酮联合锂盐或双丙戊酸盐或拉莫三嗪辅助治疗。尽管急性期治疗有效的药物通常应继续用于BD-Ⅰ的维持期治疗,但也存在一些特殊情况(例如抗抑郁药)。现有数据表明,锂盐、喹硫平、双丙戊酸盐、拉莫三嗪、阿塞那平和阿立哌唑单药或联合治疗应被视为维持治疗的初始或更换治疗方案时的一线选择。除了探讨BD-Ⅰ的相关问题外,本指南中还对双相Ⅱ型障碍(BD-Ⅱ)的临床管理进行了系统回顾并给予治疗推荐,同时针对特殊人群也有相关推荐,如处于各个生殖周期的女性、儿童、青少年和老年人。此外,本指南中还讨论了特定精神疾病及共病(如物质滥用、焦虑障碍和代谢性疾病)的影响。最后,本指南中概述了安全性和药物监测的相关问题。CANMAT/ISBD工作组希望本指南能够成为全球临床医生的实用工具。Lakshmi N Yatham Sidney H Kennedy Sagar V Parikh Ayal Sehaffer David J Bond Benicio N Frey Verinder Sharma Benjamin I Goldstein Soham Rej Serge Beaulieu Martin Alda Glenda MaeQueen Roumen V Milev Arun Ravindran Claire O'Donovan Diane Mclntosh Raymond W Lam Gustavo Vazquez Flavio Kapczinski Roger S Melntyre Jan Kozicky Shigenobu Kanba Beny Lafer Trisha Suppes Joseph R Calabrese Eduard Vieta Gin Malhi Robert M Post Michael Berk 胡晨(译) 王刚(译) 2019中华精神科杂志2019,52,1:25
14Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: Results of a multicent显示文摘AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD) and ulcerative colitis (UC). Like CrD, coeliac disease (CoD) is an inflammatory bowel disease (IBD) associated with (auto) antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS: Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence (IIF). RESULTS: ASCA+/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION: ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.S Desplat-Jégo C Johanet A Escande J Goetz N Fabien N Olsson E Ballot J Sarles JJ Baudon JC Grimaud M Veyrac P Chamouard RL Humbel 2007World Journal of Gastroenterology2007,13,16:24
15Perivascular nitric oxide activates notch signaling and promotes stem-like character in PDGF-induced glioma cells显示文摘Charles N Ozawa T Squatrito M Bleau AM Brennan CW Hambardzumyan D Holland EC. 2010中国神经肿瘤杂志2010,8,1:24
16Golgi protein-73:A biomarker for assessing cirrhosis and prognosis of liver disease patients显示文摘BACKGROUND Reliable biomarkers of cirrhosis,hepatocellular carcinoma(HCC),or progression of chronic liver diseases are missing.In this context,Golgi protein-73(GP73)also called Golgi phosphoprotein-2,was originally defined as a resident Golgi type II transmembrane protein expressed in epithelial cells.As a result,GP73 expression was found primarily in biliary epithelial cells,with only slight detection in hepatocytes.However,in patients with acute or chronic liver diseases and especially in HCC,the expression of GP73 is significantly up-regulated in hepatocytes.So far,few studies have assessed GP73 as a diagnostic or prognostic marker of liver fibrosis and disease progression.AIM To assess serum GP73 efficacy as a diagnostic marker of cirrhosis and/or HCC or as predictor of liver disease progression.METHODS GP73 serum levels were retrospectively determined by a novel GP73 ELISA(QUANTA Lite®GP73,Inova Diagnostics,Inc.,Research Use Only)in a large cohort of 632 consecutive patients with chronic viral and non-viral liver diseases collected from two tertiary Academic centers in Larissa,Greece(n=366)and Debrecen,Hungary(n=266).Aspartate aminotransferase(AST)/Platelets(PLT)ratio index(APRI)was also calculated at the relevant time points in all patients.Two hundred and three patients had chronic hepatitis B,183 chronic hepatitis C,198 alcoholic liver disease,28 autoimmune cholestatic liver diseases,15 autoimmune hepatitis,and 5 with other liver-related disorders.The duration of follow-up was 50(57)mo[median(interquartile range)].The development of cirrhosis,liver decompensation and/or HCC during follow-up were assessed according to internationally accepted guidelines.In particular,the surveillance for the development of HCC was performed regularly with ultrasound imaging and alpha-fetoprotein(AFP)determination every 6 mo in cirrhotic and every 12 mo in non-cirrhotic patients.RESULTS Increased serum levels of GP73(>20 units)were detected at initial evaluation in 277 out of 632 patients(43.8%).GP73-seropositivity correlated at baseline with the presence of cirrhosis(96.4%vs 51.5%,P<0.001),decompensation of cirrhosis(60.3%vs 35.5%,P<0.001),presence of HCC(18.4%vs 7.9%,P<0.001)and advanced HCC stage(52.9%vs 14.8%,P=0.002).GP73 had higher diagnostic accuracy for the presence of cirrhosis compared to APRI score[Area under the curve(AUC)(95%CI):0.909(0.885-0.934)vs 0.849(0.813-0.886),P=0.003].Combination of GP73 with APRI improved further the accuracy(AUC:0.925)compared to GP73(AUC:0.909,P=0.005)or APRI alone(AUC:0.849,P<0.001).GP73 levels were significantly higher in HCC patients compared to non-HCC[22.5(29.2)vs 16(20.3)units,P<0.001)and positively associated with BCLC stage[stage 0:13.9(10.8);stage A:17.1(16.8);stage B:19.6(22.3);stage C:32.2(30.8);stage D:45.3(86.6)units,P<0.001]and tumor dimensions[very early:13.9(10.8);intermediate:19.6(18.4);advanced:29.1(33.6)units,P=0.004].However,the discriminative ability for HCC diagnosis was relatively low[AUC(95%CI):0.623(0.570-0.675)].Kaplan-Meier analysis showed that the detection of GP73 in patients with compensated cirrhosis at baseline,was prognostic of higher rates of decompensation(P=0.036),HCC development(P=0.08),and liver-related deaths(P<0.001)during follow-up.CONCLUSION GP73 alone appears efficient for detecting cirrhosis and superior to APRI determination.In combination with APRI,its diagnostic performance can be further improved.Most importantly,the simple GP73 measurement proved promising for predicting a worse outcome of patients with both viral and nonviral chronic liver diseases.Nikolaos K Gatselis Tamás Tornai Zakera Shums Kalliopi Zachou Asterios Saitis Stella Gabeta Roger Albesa Gary L Norman Mária Papp George N Dalekos 2020World Journal of Gastroenterology2020,26,34:21
17Sirtuin 6抑制平滑肌细胞衰老,减少动脉粥样硬化显示文摘血管平滑肌细胞(vascular smooth muscle cell, VSMC)衰老促进动脉粥样硬化及斑块不稳定性,部分是通过脂质介导的DNA氧化损伤和端粒功能障碍起作用。Sirtuin 6(SIRT6)是一种核去乙酰化酶,参与DNA损伤应答信号转导、炎症反应和代谢。然而,其在调节VSMC衰老和动脉粥样硬化中的作用尚不清楚。陈嘉睿(译) 练桂丽(审校) Grootaert M Finigan A Figg N Uryga AK Bennett M 2021中华高血压杂志2021,29,3:21
18腹股沟疝复发的时间分析显示文摘目的假设不同术式疝修补术术后复发的发病过程是不同的,那么疝复发的时间也是不同的。该研究的目的是分析影响初次手术到复发后再次手术时间间隔的危险因素。方法研究数据来自瑞典疝登记注册系统。将5年随访期间的每一年的资料作为亚组分列,后合为大组。对于每个危险因素以再次手术为研究终点,运用Cox回归分析复发时间与危险因素之间的关系。结果共分析了142578例,其中7.7%是女性,年龄平均59岁。5年总体复发率为4.3%。多因素分析显示复发疝修补后再次复发的时间较早(P<0.05);第一次手术后如果发生并发症,则发生复发也较早(P<0.05);缝合修补或腹腔镜修补后的复发要早于开放式补片修补者(P<0.05)。通过单因素分析提示,所有缝合修补的早期复发的危险要高于所有补片修补早期复发的危险(P<0.05)。结论不同术式疝修补术后复发的发病过程是不同的。腹腔镜修补、传统疝修补术(不应用补片)和复发疝修补术后早期复发率高可能是由于手术技术失误率较高。Magnusson N Nordin P Hedberg M Gunnarsson U Sandblom G 2011中国实用外科杂志2011,31,4:20
19血管性认知障碍的诊断标准:国际血管性行为与认知障碍学会的申明显示文摘长期以来,脑血管病(CVD)就被认为是认知损害的一个重要原因,但是有关脑血管病后认知障碍的概念化却有着一段多变的历史。'动脉变硬'或脑的动脉粥样硬化是'老化'的原因,是存在已久的观点,在20世纪60年代受到了来自英格兰纽卡斯尔的神经病理学研究的质疑。这些研究表明,血管性痴呆(vascular dementia,Va D)与超过一定程度的多发性脑梗死有关。徐岩 郭起浩 Sachdev P Kalaria R O'Brien J Skoog I Alladi S Black SE Blacker D Blazer DG Chen C Chui H Ganguli M Jellinger K Jeste DV Pasquier F Paulsen J Prins N Rockwood K Roman G Scheltens P 2014神经病学与神经康复学杂志2014,11,3:19
20Liver diseases in pregnancy: Diseases not unique to pregnancy显示文摘Pregnancy is a special clinical state with several normal physiological changes that influence body organs including the liver.Liver disease can cause significant morbidity and mortality in both pregnant women and their infants.Few challenges arise in reaching an accurate diagnosis in light of such physiological changes.Laboratory test results should be carefully interpreted and the knowledge of what normal changes to expect is prudent to avoid clinical misjudgment.Other challenges entail the methods of treatment and their safety for both the mother and the baby.This review summarizes liver diseases that are not unique to pregnancy.We focus on viral hepatitis and its mode of transmission,diagnosis,effect on the pregnancy,the mother,the infant,treatment,and breast-feeding.Autoimmune hepatitis,primary biliary cirrhosis,primary sclerosing cholangitis,Wilson’s disease,Budd Chiari and portal vein thrombosis in pregnancy are also discussed.Pregnancy is rare in patients with cirrhosis because of the metabolic and hormonal changes associated with cirrhosis.Variceal bleeding can happen in up to 38%of cirrhotic pregnant women.Management of portal hypertension during pregnancy is discussed.Pregnancy increases the pathogenicity leading to an increase in the rate of gallstones.We discuss some of the interventions for gallstones in pregnancy if symptoms arise.Finally,we provide an overview of some of the options in managing hepatic adenomas and hepatocellular carcinoma during pregnancy.Ashraf A Almashhrawi Khulood T Ahmed Rubayat N Rahman Ghassan M Hammoud Jamal A Ibdah 2013World Journal of Gastroenterology2013,19,43:17
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