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1CONSORT 2010说明与详述:报告平行对照随机临床试验指南的更新显示文摘大量证据显示随机对照临床试验(randomised controlled trial,RCT)的报告质量不理想。报告不透明,则读者既不能评判试验结果是否真实可靠,也不能从中提取可用于系统综述的信息。最近的方法学分析表明,报告不充分和设计不合理与对治疗效果产生评价偏倚有关。这种系统误差对RCT损害严重,而RCT正是以其能减少或避免偏倚而被视为评价干预措施的金标准。为了提高RCT的报告质量,一个由专家和编辑组成的工作组制定了临床试验报告的统一标准(Consolidated Standards of Reporting Trials,CONSORT)声明。CONSORT声明于1996年首次发表,并于2001年更新。声明由对照检查清单和流程图组成,供作者在报告RCT时使用。许多核心医学期刊和主要国际性编辑组织都已认可CONSORT声明。该声明促进了对RCT的严格评价和解释。2001年,在对CONSORT进行修订时,人们就已经清楚地认识到,解释和说明制定CONSORT声明的原理,有助于研究人员等撰写或评价临床试验报告。一篇CONSORT说明与详述文章于2001年同2001版CONSORT声明一起发表。2007年1月的专家会议之后,对CONSORT声明作了进一步修订并已发表,即'CONSORT2010声明'。这次更新对原版对照检查清单作了文字上的修改,使其更为明晰,并收入了与一些新近才认识到的主题相关的建议,如选择性报告结局产生的偏倚。说明与详述文件旨在加强人们对CONSORT声明的理解、应用和传播,这次也作了大量修订,对每一项新增或更新的清单条目的含义和增改理由进行了解释,提供了优秀的报告实例,还尽可能地提供了相关的经验性研究的参考文献。文中收入了若干流程图实例。'CONSORT2010声明'、其说明与详述文件,以及相关网站(www.consort-statement.org),对于改进随机临床试验报告必将有所裨益。David Moher Sally Hopewell Kenneth F Schulz Victor Montori Peter C Gφtzsche P J Devereaux Diana Elbourne Matthias Egger Douglas G Altman 周庆辉 卞兆祥 刘建平 2010中西医结合学报2010,8,8:318
22019新型冠状病毒基因组特征和流行病学:病毒起源和受体结合的意义显示文摘研究者对来自9例新型冠状病毒肺炎住院患者的支气管肺泡灌洗液样本和培养的分离株进行了下一代测序。从这些个体中获得了严重急性呼吸综合征-冠状病毒2(severe acute respiratory syndrome-coronavirus 2,SARS-CoV-2)的完整和部分基因组序列。利用Sanger测序连接病毒重叠群以获得全长基因组,cDNA末端快速扩增确定终端区。对这些SARSCoV-2基因组和其他冠状病毒基因组进行了系统进化分析,以确定该病毒的进化史并有助于推断其可能的起源。刘青(译) 刘莉(审校) Lu R Zhao X Li J Niu P Yang B Wu H Wang W Song H Huang B Zhu N Bi Y Ma X Zhan F Wang L Hu T Zhou H Hu Z Zhou W Zhao L Chen J Meng Y Wang J Lin Y Yuan J Xie Z Ma J Liu WJ Wang D Xu W Holmes EC Gao GF Wu G Chen W Shi W Tan W 2020中华高血压杂志2020,28,3:516
3初级保健中原发性醛固酮增多症的患病率和临床表现显示文摘原发性醛固酮增多症(primaryaldosteronism,PA)是一种异质性疾病,以高血压和相对自主于肾素血管紧张素系统产生过量醛固酮为特征。与心血管病风险相似的原发性高血压患者相比,PA患者发生心脑血管并发症的风险以及代谢综合征患病率增加,提示正确诊断PA的重要性。Monticone S Burrello J Tizzani D Bertello C Viola A Buffolo F Gabetti L Mengozzi G Williams TA Rabbia F Veglio F Mulatero P 练桂丽 叶鹏 2017中华高血压杂志2017,25,5:58
4SARS coronavirus entry into host cells through a novel clathrin- and caveolae-independent endocytic pathway显示文摘当严重急性呼吸症候群日冕病毒(SARS-CoV ) 开始被认为与质膜通过直接熔化进入房间时,更最近的证据建议那个病毒条目可以也包含 endocytosis。我们发现了那 SARS-CoV 进入房间经由 pH 依赖并且受体依赖者 endocytosis。有任何一个 SARS-CoV 尖铁蛋白质或忍受尖铁的假病毒的房间的治疗导致了变换血管收缩素的酶的 translocation 2 (ACE2 ) , SARS-CoV 的功能的受体,从房间表面到内涵体。另外,忍受尖铁的假病毒和 1 在内涵体被发现到 colocalize 的早内涵体抗原。用象 caveolin-1 colocalization 学习一样的特定的 endocytic 小径禁止者和主导否定的 Eps15 的进一步的分析建议那个病毒条目被 clathrin 独立、 caveolae 独立的机制调停。而且,在质膜的微域,它被显示出到为许多生理的发信号小径作为平台扮演的充满胆固醇、 sphingolipid 富有的类脂化合物木排,被显示涉及病毒入口。SARS-CoV 的 Endocytic 入口可以扩展这里的 SARS-CoV 感染,和我们的调查结果的细胞的范围贡献 SARS-CoV 致病的理解,为抗病毒的药研究提供新信息。Wang,H Yang,P Liu,K Guo,F Zhang,Y Zhang,G Jiang,C 2008Cell Research2008,18,2:50
5长期保护性耕种方式对农田表层土壤性质的影响显示文摘研究了不同耕种方式对澳大利亚同一地区3种土壤表层(0-5cm)理化性质的作用,以揭示保护性耕作对土壤质量恢复的影响。结果表明:免耕穴播/保留残茬(DD/SR)、多年生人工草地(PP)和自然草地(NP)表层土壤的〉2mm水稳性团聚体含量、全氮、有机碳含量、田间持水量均显著高于其相应对照传统耕作/秸秆焚烧(CC/SB)、人工草地/作物轮作(PPC)和耕作(CT)的;土壤全氮含量、田间持水量分别与有机碳含量之间有极显著的正相关关系(r=0.994**,r=0.996**,n=6),而受土壤质地等因素的影响较小;在同一类型的土壤上,土壤有机碳含量与水稳定性团聚体含量之间存在显著的相关性;在不同试验区,耕作措施对表层土壤容重和孑L隙分布的影响存在较大差异;秸秆焚烧和施用石膏对表层土壤的pH及交换性阳离子含量有较大的影响。研究表明长期保护性耕作、草田轮作或多年生草地有利于提高表层土壤有机碳含量和结构稳定性,从而改善土壤的供肥供水能力。张国盛 K Y Chan G D Li D P Heenan 2008生态学报2008,28,6:45
6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
7AGNP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
8利用AFLP进行“甘蔗属复合体”系统演化和亲缘关系研究显示文摘采用AFLP分子标记技术,对“甘蔗属复合体”中4个属16个种的6 9份来自中国和澳大利亚的甘蔗种质资源材料进行系统演化和亲缘关系分析。2对AFLP引物共检测到173个标记,其中172个为多态标记,多态率达99 4 % ;通过计算Jaccard相似性系数,用UPGMA和PCA法构建了分子系统树和效应图。结果表明:(1)属间亲缘关系中,甘蔗属与芒属较近,与河八王属和蔗茅属较远,而河八王属与蔗茅属较近;(2 )甘蔗属内,细茎野生种与其他种关系较远,其中,栽培品种与热带种关系较近,中国种和印度种关系较近,而大茎野生种自聚为一族,与上述4种分离;(3)蔗茅属内,除蔗茅种和滇蔗茅种外,无论是中国斑茅(云南、海南)还是印度尼西亚斑茅,都与蔗茅属其他种聚在一起,其中与E procerus的关系最近,与E bengalense和E sarpet种次之;由斑茅与这3个种构成的群体与由E elephantinus和E ravennae构成的群体相对分离,形成了明显的2个组群。再次表明斑茅应列入蔗茅属,建议我国甘蔗学者采纳国外分类命名(E arundinaceus) ,以能更好地开展斑茅的研究和杂交育种利用并与国际接轨;(4)蔗茅和滇蔗茅均没有聚类到蔗茅属类群中,而分别独立位于系统树2大枝系上。蔗茅与甘蔗属亲缘关系较近,与芒属亲缘关系次之,与蔗茅属和河八王属关系较远;滇蔗茅与河八王属亲缘关系?蔡青 范源洪 Aitken K Piperidis G McIntyre C L Jackson P 2005作物学报2005,31,5:33
9最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL 2014神经病学与神经康复学杂志2014,11,3:31
10Use of probiotics for prevention of radiation-induced diarrhea显示文摘AIM: To investigate the efficacy of a high-potency probiotic preparation on prevention of radiation-induced diarrhea in cancer patients. METHODS: This was a double-blind, placebo-controlled trial. Four hundred and ninety patients who underwent adjuvant postoperative radiation therapy after surgery for sigmoid, rectal, or cervical cancer were assigned to either the high-potency probiotic preparation VSL#3 (one sachet t.i.d.,) or placebo starting from the first day of radiation therapy. Efficacy endpoints were incidence and severity of radiation-induced diarrhea, daily number of bowel movements, and the time from the start of the study to the use of loperamide as rescue medication. RESULTS: More placebo patients had radiation-induced diarrhea than VSL#3 patients (124 of 239 patients, 51.8%, and 77 of 243 patients, 31.6%; P < 0.001) and more patients given placebo suffered grade 3 or 4 diarrhea compared with VSL#3 recipients (55.4% and 1.4%, P < 0.001). Daily bowel movements were 14.7 ± 6 and 5.1 ± 3 among placebo and VSL#3 recipients (P < 0.05), and the mean time to the use of loperamide was 86 ± 6 h for placebo patients and 122 ± 8 h for VSL#3 patients (P < 0.001). CONCLUSION: Probiotic lactic acid-producing bacteria are an easy, safe, and feasible approach to protect cancer patients against the risk of radiation-induced diarrhea.P Delia G Sansotta V Donato P Frosina G Messina C De Renzis G Famularo 2007World Journal of Gastroenterology2007,13,6:29
11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
12Systematic review of novel ablative methods in locally advanced pancreatic cancer显示文摘Unresectable locally advanced pancreatic cancer with or without metastatic disease is associated with a very poor prognosis.Current standard therapy is limited to chemotherapy or chemoradiotherapy.Few regimens have been shown to have a substantial survival advantage and novel treatment strategies are urgently needed.Thermal and laser based ablative techniques are widely used in many solid organ malignancies.Initial studies in the pancreas were associated with significant morbidity and mortality,which limited widespread adoption.Modifications to the various applications,in particular combining the techniques with high quality imaging such as computed tomography and intraoperative or endoscopic ultrasound has enabled real time treatment monitoring and significant improvements in safety.We conducted a systematic review of the litera-ture up to October 2013.Initial studies suggest that ablative therapies may confer an additional survival benefit over best supportive care but randomised studies are required to validate these findings.Margaret G Keane Konstantinos Bramis Stephen P Pereira Giuseppe K Fusai 2014World Journal of Gastroenterology2014,20,9:30
13Mechanical properties of the A356 aluminum alloy modified with La/Ce显示文摘The research of rare earths for the synthesis of materials with improved mechanical performance is of great interest when they are considered for potential applications in the automotive industry. In this regard, the effect on the mechanical properties and microstructure of the automotive A356 aluminum alloy reinforced with 0.2 (wt.%) Al-6Ce-3La (ACL) was investigated. The ACL was added to the melted A356 alloy in the as-received condition and processed by mechanical milling. In the second route, the effect of the ACL processed by mechanical milling and powder metallurgy techniques was investigated, and compared with the results obtained from the A356 alloy strengthened with ACL in the as-received condition. Microstructural properties were evaluated by means of X-ray diffraction in order to observe the solubility of Ce/La in the Al matrix. In addition, electron microscopy was employed in order to investigate the effect of milling time on the size and morphology of La/Ce phase under milling process. Mechanical properties of the A356 alloy modified with ACL were measured by hardness and tensile test. For comparison unmodified specimens of the A356 were characterized according to the previous procedure. The microstructural and mechanical characterization was carried out in specimens after solution and artificial aging. Observations in scanning electron microscopy indicated a homogeneous dispersion of La/Ce phases by using both routes; however, mechanical results, in the modified A356 alloy with the ACL in the as-received condition, showed an improvement in the mechanical performance of the A356 alloy over that reinforced with the ACL mechanically milled.E. Aguirre-De la Torre R. Pérez-Bustamante J. Camarillo-Cisneros C.D. Gómez-Esparza H.M. Medrano-Prieto R. Martínez-Sánchez 2013Journal of Rare Earths2013,31,8:25
14Langerin在Langerhans细胞组织细胞增生症和非Langerhans细胞组织细胞性疾病中的表达显示文摘Lan S K Chu P G Weiss L M 黄文斌(摘译) 2008临床与实验病理学杂志2008,24,5:23
15一项中断时间序列研究与集群随机试验:减少耐药细菌在重症监护室中定植和传播的干预措施显示文摘背景 重症监护室(ICU)是耐药细菌传播的高危科室,在设置标准预防措施时缺乏对"全面筛查和隔离携带或感染耐药细菌者"效果评估的对照研究,本研究评估此干预措施对减少ICU中耐药细菌的定植与传播的效果.曾翠 吴安华 Derde L P G Cooper B S Goossens H 2014中国感染控制杂志2014,13,1:23
16Association of N-terminal pro-brain natriuretic peptide with the severity of coronary artery disease in patients with normal left ventricular ejection fraction显示文摘Wu NQ Guo YL Li XL Liu J Qing P Xu RX Zhu CG Jia Y J Liu G Dong Q Jiang LX Li J J Ma FL 2014Chinese Medical Journal2014,,4:23
17Current management of talar osteochondral lesions显示文摘Osteochondral lesions of the talus(OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation(BMS), or replacement procedures, such as autologous osteochondral transplantation(AOT). Reparative procedures are generally indicated for OLT < 150 mm^2 in area. Replacement strategies are used for large lesions or after failed primary repair procedures. Although shortand medium-term results have been reported, longterm studies on OLT treatment strategies are lacking. Biological augmentation including platelet-rich plasma and concentrated bone marrow aspirate is becoming increasingly popular for the treatment of OLT to enhance the biological environment during healing. In this review, we describe the most up-to-date clinical evidence of surgical outcomes, as well as both the mechanical and biological concerns associated with BMS and AOT. In addition, we will review the recent evidence for biological adjunct therapies that aim to improve outcomes and longevity of both BMS and AOT procedures.Arianna L Gianakos Youichi Yasui Charles P Hannon John G Kennedy 2017World Journal of Orthopedics2017,8,1:23
18Effects of octreotide on acute necrotizing pancreatitis in rabbits显示文摘AIM: To assess the role of oxygen-derived free radicals and cytokines in the pathogenesis of taurocholic acid-induced acute pancreatitis, and to evaluate the preventive effects of octreotide towards the development of acute pancreatitis. METHODS: Acute pancreatitis was induced in male New Zealand white rabbits by retrograde injection of 0.8 mL/kg·b·m, of 50 g/L sodium taurocholate(NaTC) in the pancreatic duct. Sham-operated animals served as control. Octreotide 1 mglkg·b.m.was administered subcutaneously before the induction of pancreatitis. Blood was taken from the jugular vein before and at 1, 3, 6, 12 and 24 h after pancreatitis induction.Serum activities of amylase, IL-6 and TNF-α and levels of malonyl dialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), catalase and superoxide dismutase (Mn-,Cu-,and Zn-SOD) in pancreatic tissue were measured.RESULTS: Serum TNF-α and IL-6 levels increased significantly 3 h after the onset of pancreatitis, and then returned to control level. The tissue concentration of MDA was significantly elevated at 24 h, while the GSH level and GP-x, catalase, Mn-SOD, Cu-, Zn-SOD activities were all significantly decreased in animals with pancreatitis as compared to the control. Octreotide pretreatment significantly reversed the changes in cytokines and reactive oxygen metabolites. Octreotide treatment did not alter the serum amylase activity and did not have any beneficial effects on the development of histopathological changes.CONCLUSION: Oxygen-derived free radicals and proinflammatory cytokines are generated at an early stage of NaTc-induced acute pancreatitis in rabbits. Prophylac ticoctreotide treatment can prevent release of cytokines and generation of reactive oxygen metabolites, but does not have any beneficial effects on the development of necrotizing pancreatitis.Lászl6Czakó PéterHegyi TamásTakács CsabaGóg AndrásFarkas YvetteMándy Ilona Sz.Varga LászlóTiszlavicz JánosLonovics 2004World Journal of Gastroenterology2004,10,14:21
19Upper-gastrointestinal bleeding secondary to peptic ulcer disease:Incidence and outcomes显示文摘AIM:To evaluate the incidence,surgery,mortality,and readmission of upper gastrointestinal bleeding(UGIB)secondary to peptic ulcer disease(PUD).METHODS:Administrative databases identified all hospitalizations for UGIB secondary to PUD in Alberta,Canada from 2004 to 2010(n=7079)using the International Classification of Diseases Codes(ICD-10).A subset of the data was validated using endoscopy reports.Positive predictive value and sensitivity with 95%confidence intervals(CI)were calculated.Incidence of UGIB secondary to PUD was calculated.Logistic regression was used to evaluate surgery,in-hospital mortality,and 30-d readmission to hospital with recurrent UGIB secondary to PUD.Co-variants accounted for in our logistic regression model included:age,sex,area of residence(i.e.,urban vs rural),number of Charlson comorbidities,presence of perforated PUD,undergoing upper endoscopy,year of admission,and interventional radiological attempt at controlling bleeding.A subgroup analysis(n=6356)compared outcomes of patients with gastric ulcers to those with duodenal ulcers.Adjusted estimates are presented as odds ratios(OR)with95%CI.RESULTS:The positive predictive value and sensitivity of ICD-10 coding for UGIB secondary to PUD were85.2%(95%CI:80.2%-90.2%)and 77.1%(95%CI:69.1%-85.2%),respectively.The annual incidence between 2004 and 2010 ranged from 35.4 to 41.2 per100000.Overall risk of surgery,in-hospital mortality,and 30-d readmission to hospital for UGIB secondary to PUD were 4.3%,8.5%,and 4.7%,respectively.Interventional radiology to control bleeding was performed in 0.6%of patients and 76%of these patients avoided surgical intervention.Thirty-day readmission significantly increased from 3.1%in 2004 to 5.2%in 2010(OR=1.07;95%CI:1.01-1.14).Rural residents(OR rural vs urban:2.35;95%CI:1.83-3.01)and older individuals(OR≥65 vs<65:1.57;95%CI:1.21-2.04)were at higher odds of being readmitted to hospital.Patients with duodenal ulcers had higher odds of dying(OR=1.27;95%CI:1.05-1.53),requiring surgery(OR=1.73;95%CI:1.34-2.23),and being readmitted to hospital(OR=1.54;95%CI:1.19-1.99)when compared to gastric ulcers.CONCLUSION:UGIB secondary to PUD,particularly duodenal ulcers,was associated with significant morbidity and mortality.Early readmissions increased over time and occurred more commonly in rural areas.Samuel Quan Alexandra Frolkis Kaylee Milne Natalie Molodecky Hong Yang Elijah Dixon Chad G Ball Robert P Myers Subrata Ghosh Robert Hilsden Sander Veldhuyzen van Zanten Gilaad G Kaplan 2014World Journal of Gastroenterology2014,20,46:21
20局灶节段透明变性及硬化在判断IgA肾病预后中的意义显示文摘目的 探讨IgA肾病 (IgAN)进展为慢性肾功能不全 (CRI)的病理学危险因素。方法 对 6 40例经肾活检确诊的IgAN病人进行平均 5 3个月的追踪观察。用病例对照法研究所有病人的病理学资料 ,同时还对其中 2 0 4例活检当时肾功能正常 ,5年后发展为CRI或终末期肾功能衰竭(ESRF) (n =18)以及 5年后肾功能仍保持正常 (n =186 )的病例进行了比较。结果 弥漫性系膜增生型 (DMP)为最常见的病理型 ,占 5 0 %。 / 间质纤维化 ,>40 %硬化肾小球 , / 血管病变 ,局灶节段透明变性及硬化 (FSHS)的均为预测肾功能恶化的危险因素 ,其中FSHS的意义更大 (P <0 0 0 0 1)。结论 FSHS的存在是IgAN病人正常肾功能进展恶化的显著指标。严海东 Packham D Kincaid Smith P Becker G 周希静 1999中华肾脏病杂志1999,15,5:20
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