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1AGNP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
2福林酚试剂法测定蛋白质显示文摘自1922年Wu(吴)提出用福林酚(Folin-酚)试剂测定蛋白质含量[1],已有许多采用这一试剂的改良分析操作进行血清陆”、抗原-抗体沉淀物[7-9]和胰岛素[10]中蛋白质含量测定的报道。虽然这一试剂以其灵敏度高和操作简便得到推荐,但并不适合普遍的生物化学应用。Lowry O H Rosebrough N J Farr A L Randall R J 陈祥娥 2011食品与药品2011,13,3:34
3Effects of Saccharomycesboulardiion fecal short-chain fatty acids and microflora in patients on long-term total enteral nutrition显示文摘AIM: To assess the effects of Sb on fecal flora and shortchain fatty acids (SCFA) in patients on long-term TEN.METHODS: Ten patients (3 females, 7 males, 59±5.5 years),on TEN for a median of 13 mo (1-125), and 15 healthy volunteers (4 females, 11 males, 32±2.0 years) received Sb (0.5 g bid PO) for 6 d. Two stool samples were taken before, on the last 2 d and 9-10 d after treatment, for SCFA measurement and for culture and bacterial identification.Values (mean±SE) were compared using sign tests and ANOVA.RESULTS: Fecal butyrate levels were lower in patients(10.1±2.9 mmol/kg) than in controls (19.2±3.9, P= 0.02).Treatment with Sb increased total fecal SCFA levels in patients (150.2±27.2 vs 107.5±18.2 mmol/kg, P = 0.02)but not in controls (129.0±28.6 vs 113.0±15.2 mmol/kg,NS). At the end of treatment with Sb, patients had higher fecal butyrate (16.0±4.4 vs 10.1 [2.9] mmol/kg, P = 0.004).Total SCFAs remained high 9 d after treatment was discontinued. Before the treatment, the anaerobe to aerobe ratio was lower in patients compared to controls (2.4±2.3 vs69.8±1.8, P = 0.003). There were no significant changes in the fecal flora of TEN patients.CONCLUSION: Sb-induced increase of fecal SCFA concentrations (especially butyrate) may explain the preventive effects of this yeast on TEN-induced diarrhea.Stéphane M Schneider Fernand Girard-Pipau Jér(o|^)me Filippi Xavier Hébuterne Dominique Moyse Gustavo Calle Hinojosa Anne Pompei Patrick Rampal 2005World Journal of Gastroenterology2005,11,39:26
42018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
5高级别(WHO G3)胰腺神经内分泌肿瘤分类中形态学和生物学的异质性:包括分化好和分化差的肿瘤显示文摘WHO(2010)分类推荐胰腺神经内分泌肿瘤(PanNETs)的分级建立在核分裂象和Ki-67增殖指数的基础上,2级(G2)PanNETs定义为核分裂象2~20个/10HPF或Ki-67增殖指数在3%~20%之间,3级(G3)胰腺神经内分泌癌(NEC)定义为核分裂象〉20个/10HPF或Ki-67增殖指数〉20%。Basturk O Yang Z Tang L H 魏建国 许春伟 邰艳红 2015临床与实验病理学杂志2015,31,4:25
6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
7Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury显示文摘AIM: To examine complications associated with the use of therapeutic temperature modulation(mild hypothermia and normothermia) in patients with severe traumatic brain injury(TBI). METHODS: One hundred and fourteen charts were reviewed. Inclusion criteria were: severe TBI with Glasgow Coma Scale(GCS) < 9, intensive care unit(ICU) stay > 24 h and non-penetrating TBI. Patients were divided into two cohorts: the treatment group received therapeutic temperature modulation(TTM) with continuous surface cooling and indwelling bladder temperature probes. The control group received standard treatment with intermittent acetaminophen for fever. Information regarding complications during the time in the ICU was collected as follows: Pneumonia was identified using a combination of clinical and laboratory data. Pulmonary embolism, pneumothorax and deep venous thrombosis were identified based onimaging results. Cardiac arrhythmias and renal failure were extracted from the clinical documentation. acute respiratory distress syndrome and acute lung injury were determined based on chest imaging and arterial blood gas results. A logistic regression was conducted to predict hospital mortality and a multiple regression was used to assess number and type of clinical complications. RESULTS: One hundred and fourteen patients were included in the analysis(mean age = 41.4, SD = 19.1, 93 males), admitted to the Jackson Memorial Hospital Neuroscience ICU and Ryder Trauma Center(mean GCS = 4.67, range 3-9), were identified and included in the analysis. Method of injury included motor vehicle accident(n = 29), motor cycle crash(n = 220), blunt head trauma(n = 212), fall(n = 229), pedestrian hit by car(n = 216), and gunshot wound to the head(n = 27). Ethnicity was primarily Caucasian(n = 260), as well as Hispanic(n = 227) and African American(n = 223); four patients had unknown ethnicity. Patients received either TTM(43) or standard therapy(71). Within the TTM group eight patients were treated with normothermia after TBI and 35 patients were treated with hypothermia. A logistic regression predicting in hospital mortality with age, GCS, and TM demonstrated that GCS(Beta = 0.572, P < 0.01) and age(Beta =-0.029) but not temperature modulation(Beta = 0.797, ns) were significant predictors of in-hospital mortality [χ2(3) = 22.27, P < 0.01] A multiple regression predicting number of complications demonstrated that receiving TTM was the main contributor and was associated with a higher number of pulmonary complications(t =-3.425, P = 0.001). CONCLUSION: Exposure to TTM is associated with an increase in pulmonary complications. These findings support more attention to these complications in studies of TTM in TBI patients.Kristine H O’Phelan Amedeo Merenda Katherine G Denny Kassandra E Zaila Cynthia Gonzalez 2015World Journal of Critical Care Medicine2015,4,4:18
8Mechanisms of regulation of PFKFB expression in pancreatic and gastric cancer cells显示文摘Enzymes 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 and-4(PFKFB-3 and PFKFB-4)play a significant role in the regulation of glycolysis in cancer cells as well as its proliferation and survival.The expression of these mRNAs is increased in malignant tumors and strongly induced in different cancer cell lines by hypoxia inducible factor(HIF)through active HIF binding sites in promoter region of PFKFB-4 and PFKFB-3 genes.Moreover,the expression and hypoxia responsibility of PFKFB-4 and PFKFB-3 was also shown for pancreatic(Panc1,PSN-1,and MIA PaCa-2)as well as gastric(MKN45 and NUGC3)cancer cells.At the same time,their basal expression level and hypoxia responsiveness vary in the different cells studied:the highest level of PFKFB-4 protein expression was found in NUGC3 gastric cancer cell line and lowest in Panc1 cells,with a stronger response to hypoxia in the pancreatic cancer cell line.Overexpression of different PFKFB in pancreatic and gastric cancer cells under hypoxic condition is correlated with enhanced expression of vascular endothelial growth factor(VEGF)and Glut1 mRNA as well as with increased level of HIF-1αprotein.Increased expression of different PFKFB genes was also demonstrated in gastric,lung,breast,and colon cancers as compared to corresponding nonmalignant tissue counterparts from the same patients,being more robust in the breast and lung tumors.Moreover,induction of PFKFB-4 mRNA expression in the breast and lung cancers is stronger than PFKFB-3mRNA.The levels of both PFKFB-4 and PFKFB-3 proteins in non-malignant gastric and colon tissues were more pronounced than in the non-malignant breast and lung tissues.It is interesting to note that Panc1and PSN-1 cells transfected with dominant/negative PFKFB-3(dnPFKFB-3)showed a lower level of endogenous PFKFB-3,PFKFB-4,and VEGF mRNA expressions as well as a decreased proliferation rate of these cells.Moreover,a similar effect had dnPFKFB-4.In conclusion,there is strong evidence that PFKFB-4 and PFKFB-3 isoenzymes are induced under hypoxia in pancreatic and other cancer cell lines,are overexpressed in gastric,colon,lung,and breast malignant tumors and undergo changes in their metabolism that contribute to the proliferation and survival of cancer cells.Thus,targeting these PFKFB may therefore present new therapeutic opportunities.Oleksandr H Minchenko Katsuya Tsuchihara Dmytro O Minchenko Andreas Bikfalvi Hiroyasu Esumi 2014World Journal of Gastroenterology2014,20,38:17
9欧洲新生儿呼吸窘迫综合征防治共识显示文摘呼吸窘迫综合征(RDS)是由于肺表面活性物质(PS)缺乏及肺结构发育不成熟所致,多见于早产儿,自然病程为出生当时或生后很快发病,并在生后2d内进行性恶化,如不及时治疗,因进行性缺氧和呼吸衰竭而死亡。存活者出生后2—4d病情开始改善。RDS临床表现早期出现呼吸窘迫如紫绀、呻吟、吸凹和呼吸急促,然后进一步发展为呼吸衰竭,血气分析结果可提示呼吸衰竭的严重性。胸部X线典型的毛玻璃样改变和支气管充气征可以确诊。Vermont Oxford新生儿协作网对RDS的定义为:Sweet D Bevilacqua G Carnielli V Greisen G Plavka R Didrik Saugstad O Simeoni U Speer CP Valls-I-Soler A Halliday H 袁琳(译) 陈超(译) 杜立中(校) 2008中华儿科杂志2008,46,1:17
10Near-infrared fluorescence sentinel lymph node detection in gastric cancer: A pilot study显示文摘AIM: To investigate feasibility and accuracy of nearinfrared fluorescence imaging using indocyanine green: nanocolloid for sentinel lymph node(SLN) detection in gastric cancer.METHODS: A prospective, single-institution, phaseI feasibility trial was conducted. Patients suffering from gastric cancer and planned for gastrectomy were included. During surgery, a subserosal injection of 1.6 m L ICG:Nanocoll was administered around the tumor. NIR fluorescence imaging of the abdominal cavity was performed using the Mini-FLARE? NIR fluorescence imaging system. Lymphatic pathways and SLNs were visualized. Of every detected SLN, the corresponding lymph node station, signal-to-background ratio and histopathological diagnosis was determined. Patients underwent standard-of-care gastrectomy. Detected SLNs outside the standard dissection planes were also resected and evaluated.RESULTS: Twenty-six patients were enrolled. Four patients were excluded because distant metastases were found during surgery or due to technical failure of the injection. In 21 of the remaining 22 patients, at least 1 SLN was detected by NIR Fluorescence imaging(mean 3.1 SLNs; range 1-6). In 8 of the 21 patients, tumor-positive LNs were found. Overall accuracy of the technique was 90%(70%-99%; 95%CI), which decreased by higher p T-stage(100%, 100%, 100%, 90%, 0% for respectively Tx, T1, T2, T3, T4 tumors). All NIR-negative SLNs were completely effaced by tumor. Mean fluorescence signal-to-background ratio of SLNs was 4.4(range 1.4-19.8). In 8 of the 21 patients, SLNs outside the standard resection plane were identified, that contained malignant cells in 2 patients.CONCLUSION: This study shows successful use of ICG:Nanocoll as lymphatic tracer for SLN detection in gastric cancer. Moreover, tumor-containing LNs outside the standard dissection planes were identified.Quirijn RJG Tummers Leonora SF Boogerd Wobbe O de Steur Floris PR Verbeek Martin C Boonstra Henricus JM Handgraaf John V Frangioni Cornelis JH van de Velde Henk H Hartgrink Alexander L Vahrmeijer 2016World Journal of Gastroenterology2016,22,13:9
11Mechanical thrombectomy in patients with M1 occlusion and NIHSS score≤5:a single-centre experience显示文摘Background:The recent success of several mechanical thrombectomy trials has resulted in a significant change in management for patients presenting with stroke.However,it is still unclear how to manage patients that present with stroke and low National Institutes of Health Stroke Scale(NIHSS)≤5.We sought to review our experience of mechanical thrombectomy in patients with low NIHSS and confirmed M1 occlusion.Methods:We retrospectively analysed our prospectively maintained database of all patients undergoing mechanical thrombectomy between January 2008 and August 2016.We identified 41 patients with confirmed M1 occlusion and low NIHSS(≤5)on admission to our hospital.We collected demographic,radiological,procedural and outcome data.Results:The mean age of patients was 72±14,with 20 male patients.Associated medical conditions were common with hypertension seen in∼80%.Just over 50%presented with NIHSS 4 or 5.The average ASPECTS score on admission was 8.8(range 6–10),and the average clot length 10 mm.Angiographically Thrombolysis in Cerebral Infarction(TICI)≥2b was obtained in 87.8%of patients.7 patients had haemorrhage on follow-up,2 of which were symptomatic.Of 40 patients with 90-day follow-up,75%had modified Rankin Scale(mRS)score 0–2.There were 3 deaths at 90 days.Conclusions:Mechanical thrombectomy in patients with low NIHSS and proximal large vessel occlusion is technically possible and carries a high degree of success with good safety profile.Patients with low NIHSS and confirmed occlusion should be considered for mechanical thrombectomy.P Bhogal P Bucke O Ganslandt H Bazner H Henkes M Aguilar Perez 2016Stroke & Vascular Neurology2016,1,4:9
12IL28B polymorphism and cytomegalovirus predict response to treatment in Egyptian HCV type 4 patients显示文摘AIM:To test whether the status of positive cytomegalovirus(CMV) DNA detection adds to the predictive value of IL28B and to further categorize C/T allele carriers.METHODS:This study included 166 chronic hepatitis C(CHC) patients who received combined interferon and ribavirin therapy for 48 wk,84 spontaneous hepatitis C virus(HCV) resolvers who were positive for IgG anti-HCV antibody and negative for HCV RNA,and 100 healthy subjects who were negative for both HCV antibodies and RNA as controls.Genomic DNA from peripheral blood was used for IL28B rs.12979860 single nucleotide polymorphism(SNP) and CMV DNA detection.A 139 bp fragment containing IL28B SNP was amplified in all subjects by polymerase chain reaction using a specifically designed primer.Then the IL28B rs.12979860 SNP was detected by restriction fragment length polymorphism(RFLP) genotyping.The presence of CMV DNA was tested by amplification of the gB1 gene using nested polymerase chain reaction.The role of CMV and IL28B rs.12979860 SNP genotypes in determining the response rate to combined interferon therapy and clinical status of patients were statistically analyzed.RESULTS:Current data showed that 67% of patients carrying the IL28B 12979860 C/C allele had a sustained viral response(SVR) while the genotypes C/T and TT were associated with lower SVR rates,50% and 48%,respectively.SVR rates for the C/C allele were lower than other HCV genotypes and/or other populations.Genotype CC was associated with the response to interferon(P = 0.025).Genotype C/C was reduced from 48% in controls to 14% in CHC patients suggesting its protective role against progression to chronicity.The majority of spontaneously cleared subjects(86%) were C/C,confirming its protective role.The C/T allele was present in 71% of CHC patients compared with 38% of controls,so the use of IL28B SNP genotyping only in these patients may be of little value as a predictor of response.CMV reactivation occurred in 40% of CHC patients.Co-infection with CMV seriously diminished the response to interferon(IFN) therapy,with SVR rates in C/C genotypes 87.5% in CMV-negative patients and 12.5% in CMV-positive patients(P < 0.0001).SVR rates among C/T carriers were reduced to < 50% in patients with positive CMV DNA while the non-response rate doubled.These data indicate that a supplemental assay for CMV viremia adds to the prognostic value of IL28B genotyping.CONCLUSION:The results suggest that both genetic(i.e.,spontaneous) and therapeutic(IFN-based therapy) arms are complementary in the battle against HCV.CMV DNA testing may be of value to better predict the response to IFN,particularly in IL28B C/T carriers.Mostafa K El Awady Noha G Bader El Din Ashraf Tabll Yaser El Hosary Ashraf O Abdel Aziz Hesham El Khayat Mohsen Salama Tawfeek H Abdelhafez 2013World Journal of Gastroenterology2013,19,2:8
13油萝卜抗胞囊线虫基因的染色体定位及其在油菜附加系中的稳定性显示文摘【目的】油萝卜(2n=18,9条染色体分别被称作a~i)具有抗甜菜胞囊线虫的基因。探索油萝卜携带的抗甜菜胞囊线虫基因所在的染色体和外源的油萝卜染色体在油菜中的遗传稳定性。【方法】9个油菜附加系进行自花受粉,分别获得附加系的自交F2代。利用筛选的分子标记检测和原位杂交(FISH)检测附加染色体在F2代中的遗传稳定性;通过对9个油菜附加系F2代接种甜菜胞囊线虫的2龄幼虫,鉴定携带抗甜菜胞囊线虫基因所在的染色体。【结果】9个附加系自交F2代中的附加染色体遗传表现不一,5个油菜附加系的F2代中均有2条附加染色体,能稳定遗传;4个附加系的自交后代中附加染色体的遗传表现不稳定,部分后代中无附加染色体。FISH检测9个附加系自交F2代中的附加染色体表明:与分子标记检测的结果相符,并且4个不稳定的附加系中,有的自交后代虽然有附加染色体,但有1或2条。接种甜菜胞囊线虫测定结果表明,含有油萝卜染色体DD的油菜附加系对甜菜胞囊线虫的抗性水平与附加染色体的供体油萝卜相当,而其它8个附加系的自交后代未表现出抗性,与受体油菜相近。【结论】油萝卜的9条染色体分别附加到油菜中后,其遗传稳定性因附加的染色体而异,有的能稳定遗传,有的在自交后代中丢失1或2条;抗甜菜胞囊线虫的基因在d染色体上。张绍松 Peterka H Budahn H Schrader O 李成云 李进斌 2008中国农业科学2008,41,1:8
14低分化胰腺神经内分泌癌--44例临床病理分析显示文摘胰腺低分化神经内分泌癌包括小细胞癌和大细胞癌,其比较罕见。依据WHO(2010)胃肠胰腺系统肿瘤的分级、分类标准对107例原先诊断的胰腺低分化神经内分泌癌进行重新评价,并做了神经内分泌及腺泡分化的免疫组化标记。63例被重新分类,大部分为分化良好的神经内分泌肿瘤或是腺泡细胞癌。对其余44例低分化神经内分泌癌的临床病理特征及预后进行深入探讨。结果:患者平均年龄为59岁(范围21~82岁),男/女比率为1.4。27例位于胰腺头部,3例在体部,11例在尾部。Basturk O Tang L Hruban R H 徐磊 2014临床与实验病理学杂志2014,30,8:7
15Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis显示文摘BACKGROUND For palliation of malignant biliary obstruction(MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography(ERCP)with the placement of metallic stents. Endoscopic ultrasound(EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure.Recently, however, there have been robust randomized clinical trials(RCTs)comparing EUS-guided drainage and ERCP as primary approaches to MBO.AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO.METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment,Development and Evaluation criteria.RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients(112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96%n and 91.81%, respectively, with a risk difference(RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97; I^2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of-0.01%(95%CI:-0.12, 0.10; P = 0.90; I^2 =0%). The mean difference(MD) for the duration of the procedure was-0.12%(95%CI:-8.20, 7.97; P = 0.98; I^2 = 84%). In the EUS and ERCP groups, there were14 and 25 adverse events, respectively, with an RD of-0.06%(95%CI:-0.23, 0.12; P= 0.54; I^2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18; P =0.19; I^2 = 44%). The stent dysfunction rate was significantly lower in the EUS t group(MD =-0.22%; 95 CI:-0.35,-0.08; P = 0.001; I^2 = 0%).CONCLUSION EUS represents an interesting alternative to ERCP for MBO drainage,demonstrating lower stent dysfunction rates compared with ERCP. Technical and clinical success, duration, adverse events and patency rates were similar.Fernanda P Logiudice Wanderlei M Bernardo Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura 2019World Journal of Gastrointestinal Endoscopy2019,11,4:6
16埃索美拉唑能有效控制内镜阴性胃食管反流症状——6个月“按需治疗”对照试验显示文摘Talley NJ Lauritsen K Tunturi-Hihnala H Lind T Moum B Bang C Schulz T Omland TM Delle M Junghard O 钟捷 2003中华消化杂志2003,23,1:6
17巨峰和无核早红葡萄在越南谅山试种观察显示文摘[目的]观察巨峰、无核早红葡萄在越南谅山省的引种表现,为其在越南推广种植提供参考依据.[方法]2009年春从中国南宁引入巨峰、无核早红两个鲜食葡萄品种在越南谅山省试种,调查其枝蔓生长量、物候期、果实性状、产量等相关指标.[结果]至第1年抚育冬季,巨峰葡萄枝蔓总长234.5 cm,上架茎粗0.84 cm;无核早红葡萄枝蔓总长294.1 cm,上架茎粗0.86 cm.在物候期方面,巨峰葡萄从萌芽至果实成熟需141~151 d,表现中熟;无核早红从萌芽至果实成熟需142~151 d,未表现其应有的早熟特性.在果实性状方面,巨峰葡萄2010~2012年3年平均单果重8.9 g,种子数1.04粒,可溶性固形物(TSS)含量17.5%;无核早红葡萄2010~2012年3年平均单果重6.8 g,TSS含量13.9%.在产量方面,巨峰葡萄2010~2012年产量分别为13.69、17.50和16.24 t/ha;无核早红葡萄2010~2012年产量分别为10.81、16.02和20.92t/ha.[结论]巨峰葡萄在越南谅山省种植表现丰产稳产优质,具有较好的适栽性,可大面积推广种植;无核早红葡萄表现丰产稳产,但表现低糖低酸,极易裂果,着色困难,不宜在越南大面积发展.黄江流 PHAM Thi Thang 罗瑞鸿 NGUYN Thi Hà 吕荣华 LUONG Dǎng Ning CHU Vǎn DUòng NGUYN Manh Tòng 彭宏祥 Ly Ming Nguyet LU'O'NG i Thuy CHU Xun Tien VI Vǎn Dúc NGUYN Duy Dng Ly Dúc Khiêm 熊俏 2014南方农业学报2014,45,7:5
18Epigenetic profiles of pre-diabetes transitioning to type 2 diabetes and nephropathy显示文摘AIM: To examine DNA methylation profiles in a longitudinal comparison of pre-diabetes mellitus(Pre-DM) subjects who transitioned to type 2 diabetes mellitus(T2DM).METHODS: We performed DNA methylation study in bisulphite converted DNA from Pre-DM(n = 11) at baseline and at their transition to T2 DM using Illumina Infinium Human Methylation27 Bead Chip, that enables the query of 27578 individual cytosines at Cp G loci throughout the genome, which are focused on the promoter regions of 14495 genes.RESULTS: There were 694 Cp G sites hypomethylated and 174 Cp G sites hypermethylated in progression from Pre-DM to T2 DM, representing putative genes involved in glucose and fructose metabolism, inflammation, oxidative and mitochondrial stress, and fatty acid metabolism. These results suggest that this high throughput platform is able to identify hundreds of prospective Cp G sites associated with diverse genes that may reflect differences in Pre-DM compared with T2 DM. In addition, there were Cp G hypomethylation changes associated with a number of genes that may be associated with development of complications of diabetes, such as nephropathy. These hypomethylation changes were observed in all of the subjects.CONCLUSION: These data suggest that some epigenomic changes that may be involved in the progression of diabetes and/or the development of complications may be apparent at the Pre-DM state or during the transition to diabetes. Hypomethylation of a number of genes related to kidney function may be an early marker for developing diabetic nephropathy.Thomas A Vander Jagt Monica H Neugebauer Marilee Morgan Donald W Bowden Vallabh O Shah 2015World Journal of Diabetes2015,6,9:5
19提高母猪妊娠后期和哺乳期日粮能量浓度对其生产性能、仔猪活力和后代终生生长的影响(下)显示文摘人们对高产母猪的选育,导致每窝活产仔数显著增加,但是随之而来的仔猪活力和生长性能会因此降低。为了增强仔猪活力和提高生长性能,提高母猪哺乳期能量摄入越来越重要。研究旨在探索提高哺乳期母猪日粮能量(DE)浓度对母猪体重、背膘厚、乳成分及其后代仔猪活力和生长的影响。在妊娠108 d时将妊娠母猪(N=100;大白×长白)随机分配饲喂4种能量浓度日粮(消化能,DE,MJ/kg)直到再次配种:13.8(LL)、14.5(L)、15.2(H)、15.9(HH)。所有日粮均含有1.2%总赖氨酸。妊娠108 d和断奶(哺乳期第26天)时采集血样,哺乳期采集初乳(0 d)和常乳(14 d)。每天记录母猪哺乳期采食量。仔猪出生时记录每窝(总活)产仔数、仔猪初生重、宫内生长受限(IUGR)特征和肌张力。在出生时和出生后24 h记录仔猪鼓膜耳温(TEMP)。在后代猪第1、6、14、26、33、40、54、75和141日龄时称重。后代猪于断奶后(PW)饲喂标准谷物基础日粮。后代猪屠宰时(141日龄)记录胴体数据。HH母猪的哺乳期消化能摄入高于其他处理组(P<0.01)。初乳和常乳成分以及哺乳期采食量不受日粮处理影响。各处理组间的每窝产仔猪数和仔猪初生重相近。与其他处理组相比,LL母猪的后代表现出更多的IUGR特征(P<0.01),而HH母猪的后代表现出更好的肌张力(P<0.01)。与HH母猪的后代仔猪相比,LL母猪(P<0.01)和H母猪(P<0.01)的后代具有更高的24 h TEMP。H母猪断奶仔猪数高于L母猪(P<0.05)和HH母猪(P<0.01),而L母猪断奶仔猪窝重低于H母猪(P<0.05)和LL母猪(P<0.05)。断奶后仔猪生长不受日粮各处理影响。高DE日粮提高母猪能量摄入水平,但并不抑制食欲。饲喂HH日粮提高了仔猪出生时肌张力,而饲喂H日粮提高每窝断奶仔猪数。此次研究观察到仔猪活力的其他特征和断奶前窝生长性能结果互相矛盾。何颖(编译) Rooney H B O’driscoll Keelin O’doherty John V 2020猪业科学2020,37,9:5
20金刚石中的冰-Ⅶ相包裹体:来自地球深部地幔的含水流体证据显示文摘水在地球内部不同圈层的存在形态、分布、含量以及全球水循环一直以来都是固体地球科学研究的前沿热点问题之一。冰-Ⅶ相作为水的一种高压相,目前已经被国际矿物学会认定为一种新矿物。Tschauner O Huang S Greenberg E Prakapenka V B Rossman G R Shen A H Zhang D Newville M Lanzirotti A Tait K 张宝华 2018矿物岩石地球化学通报2018,37,6:4
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