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| 1 | 极高强度他汀治疗对冠状动脉粥样硬化消退的影响——ASTEROID试验显示文摘背景:以前的血管内超声(intravascular ultrasound,IVUS)试验证实,他汀治疗可减缓或阻止动脉粥样硬化的进展,但是迄今尚无应用动脉粥样斑块体积百分比(percent atheroma volume,PAV)证实粥样硬化消退的确切证据。PAV是最严格的评价病变进展和消退的IVUS测量指标。
目标:评价极高强度他汀治疗是否能逆转IVUS确定的冠状动脉粥样硬化。
设计和地点:于美国、加拿大、欧洲和澳大利亚53个社区和3级保健中心进行前瞻性开标盲法终点试验(A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden,ASTEROID)。应用马达驱动回撤IVUS评价基线和治疗24个月时冠状动脉粥样斑块负荷。每对基线和随访IVUS测量结果均进行盲法分析。
病例:从2002年11月到2003年10月,507例患者有基线IVUS检查结果,并接受至少1个剂量的研究药物。在24个月后,349例患者具有可用于评估的系列IVUS检查结果。
干预:所有患者均接受瑞舒伐他汀40ms/d强化治疗。
主要观测指标:预先设定了两个一级疗效指标:PAV变化和基线最严重病变10min节段动脉粥样斑块体积变化。二级疗效指标为整个动脉标准化总斑块体积的变化。结果:平均(SD)LDL—C水平由基线时的130.4(34.3)ms/dL降至60.8(20.0)ms/扎,平均下降了53.2%(P〈0.001)。平均(SD)HDL-C水平从基线时的43.1(11.1)ms/dL升至49.0(12.6)ms/dL,平均增加了14.7%(P〈0.001)。整个血管PAV平均(SD)变化为-0.98%(3.15%),中位数为-0.79%(97.5%CI,-1.21%~-0.53%)(与基线比较,P〈0.001)。最严重病变10min节段斑块体积平均(SD)变化为-6.1(10.1)mm^3,中位数为-5.6mm^3(97.5%CI,-6.8~-4.0mm^3)(与基线比较,P〈0.001)。总斑块体积变化中位数降低了6.8%,平均减少了-14.7(25.7)mm^3,中位数为-12.5mm^3(95%CI,-15.1~-10.5mm^3)(与基线比较,P〈0.001)。不良事件少见,与其他他汀试验相似。
结论:应用瑞舒伐他汀40ms/d进行极高强度他汀治疗可使LDL-C平均水平达到60.8ms/dL,使HDL—C增加14.7%。这导致所有3个预先设定的IVUS斑块负荷指标均显示动脉粥样硬化消退。因此,将LDL-C降至低于目前指南规定的水平,同时显著提高HDL-C,可以使冠心病患者动脉粥样硬化斑块消退。这些变化对临床预后的影响尚需进一步研究确定。 | Steven E. Nissen Stephen J. Nicholls Ilks Sipahi Peter Libby Joel S. Raichlen Christie M. Ballantyne Jean Davignon Raimund Erbel Jean Charles Fruchart Jean-Claude Tardif Paul Schoenhagen Tim Crowe Valerie Cain Kathy Wolski Marlene Coormastic E. Murat Tuzcu 仝其广(译) 王淑敏(译) 胡大一(校) | 2006 | 美国医学会杂志(中文版)2006，25，4： | 341 |
| 2 | 肛裂临床诊治指南(第三次修订)显示文摘“美国结直肠外科医师协会(American Societyof ColonandRectal Surgeons.ASCRS)”(协会)致力于推进结直肠和肛门疾病的相关理论以及预防和诊疗水平的提高,给患者提供优质的医疗服务。“标准委员会”由协会中在结直肠外科方面有显著专长的成员组成。该委员会的建立是为了引领国际结直肠和肛门疾病诊治的发展,以建立具有循证医学证据的临床诊疗指南。指南是涵盖性的,非指令性的,目的是为临床决策提供信息,而非具体的治疗方法。指南适用于所有相关的医护人员以及希望得到相应指南中疾病的相关诊治信息的患者。 | Farshid Araghizadeh ~ Robin Boushey Sridhar Chalasani George Chang Robert Cima Gary Dunn Daniel Feingold Philip Fleshner Daniel Geisler Jill Genua Sharon Gregorcyk Daniel Herzig Andreas Kaiser Ravin Kumar David Larson Steven Mills John Monson P. Terry Phang Feza Remzi David Rivadeneira Howard Ross Peter Senatore Elin Sigurdson Thomas Stahl Scott Steele Scott Strong Charles Tement Judith Trudel Madhulika Varnna Martin Weiser 丁义江(译) 皇甫少华(译) 丁曙晴(译) | 2013 | 中华胃肠外科杂志2013，16，7： | 70 |
| 3 | The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review显示文摘使随机化的控制试用和队研究的系统的评论被进行在男性功能上为征兆的良性的 prostatic 增生(BPH ) 的处理为最低限度地侵略的过程的效果评估数据。寻找的研究是与征兆的 BPH 注册了人的试用与激光手术,经尿道的微波治疗( TUMT ),前列腺(金枪鱼)的经尿道的针脱离,前列腺( TEAP )的经尿道的乙醇脱离和高紧张的频率超声( HIFU )被对待,与前列腺( TURP )或假冒的操作的传统的经尿道的切除术比较。72 研究的一个总数被识别,哪个 33 满足了包括标准。33 研究, 21 涉及了激光手术,六与 TUMT,四与金枪鱼并且二与包含信息考虑的 TEAP 男性功能。没有学习关于为男性功能上的 BPH 的 HIFU 的效果是可得到的。我们的分析证明为 BPH 的最低限度地侵略的手术在男可勃起的功能上 TURP 有可比较的效果到那些。一起,分别地,不到 15.4% 病人或 15.2% 将在激光过程, TUMT 和金枪鱼以后可勃起的功能有减少或增加。是与 TURP 观察了,射精的机能障碍(EjD ) 的高发生在有钬, potassium-titanyl-phosphate 和铥激光治疗的 BPH 的治疗以后是普通的(>33.6%) 。TUMT,金枪鱼和 neodymium:yttrium 铝石榴石为 BPH 的视觉激光脱离或空隙的激光凝结有更少的发生 EjD,而是这些过程为 BPH 治疗被认为更少有效什么时候与 TURP 相比。 | Ryan W. Frieben Hao-Cheng Lin Peter E Hinh Francesco Berardinelli Steven E. Canfield Run Wang | 2010 | Asian Journal of Andrology2010，12，4： | 13 |
| 4 | Laparoscopic Colectomy for Cancer Is Not Inferior to Open Surgery Based on 5-Year Data From the COST Study Group Trial显示文摘 | James Fleshman Daniel J. Sargent Erin Green Mehran Anvari Steven J. Stryker Robert W. Beart Michael Hellinger Richard Flanagan Walter Peters Heidi Nelson | 2007 | Annals of Surgery2007，，4： | 7 |
| 5 | 氮与自然显示文摘在某种程度上,人类对全球氮循环的改变是很重要的,因为增加的氮极大地改变了许多天然生态系统的组成、生产率和其它性质。增加的氮为什么有这么大的影响力?为什么如此多的天然生态系统都处于缺氮状态?减缓氮相对于其它元素的循环过程,和控制生态系统水平的氮输入输出过程,都使氮供应成为生态系统动态的限制因子。我们讨论了可以减慢氮循环的因子陆地植物和其它有机体之间的化学计量学差异,蛋白质沉淀防御植物的多度,土壤有机质中C-N键状态。对输入来讲,氮固定的能量消耗及其后果,氮以外的养分供应,对固氮者的优先取食,所有这些都能限制生物固氮者的多度和/或活动。这些过程加在一起,推动和维持着许多天然陆地生态系统的氮限制。 | Peter M.Vitousek Stephan Htttenschwiler Lydia Olander Steven Allison 王胜 | 2002 | AMBIO-人类环境杂志2002，31，2： | 7 |
| 6 | Colorectal cancer surveillance in inflammatory bowel disease: The search continues显示文摘Patients with infl ammatory bowel disease (IBD) are at increased risk for colorectal cancer (CRC). Risk factors for the development of CRC in the setting of IBD include disease duration, anatomic extent of disease, age at time of diagnosis, severity of inflammation, family history of colon cancer, and concomitant primary sclerosing cholangitis. The current surveillance strategy of surveillance colonoscopy with multiple random biopsies most likely reduces morbidity and mortality associated with IBD-related CRC. Unfortunately, surveillance colonoscopy also has severe limitations including high cost, sampling error at time of biopsy, and interobserver disagreement in histologically grading dysplasia. Furthermore, once dysplasia is detected there is disagreement about its management. Advances in endoscopic imaging techniques are already underway, and may potentially aid in dysplasia detection and improve overall surveillance outcomes. Management of dysplasia depends predominantly on the degree and focality of dysplasia, with the mainstay of management involving either proctocolectomy or continued colonoscopic surveillance. Lastly, continued research into additional chemopreventive agents may increase our arsenal in attempting to reduce the incidence of IBD-associated CRC. | Anis Ahmadi Steven Polyak Peter V Draganov | 2009 | World Journal of Gastroenterology2009，15，1： | 7 |
| 7 | Long-term antifibrotic action of interferon-γ treatment in patients with chronic hepatitis B virus infection显示文摘BACKGROUND:The first priority in treating fibrosis is to eliminate the causes that result in liver injury,e.g.,hepatitis B and C virus.However,in many liver diseases the cause is either unknown or untreatable.The present study was designed to investigate the long-term antifibrotic effect of interferon-gamma(IFN-γ)treatment in patients chronically infected with hepatitis B virus. METHODS:A total of 42 patients,30 treated with IFN-γand 12 controls,were enrolled from an original clinical trial(Clin Gastroenterol Hepatol 2005;3:819.).Three serial liver biopsies that were obtained at the initiation and end of IFN-γtreatment as well as 4 to 6 years after treatment discontinuation were assessed according to the modified Chevallier scoring system. RESULTS:Twenty-five out of 30 IFN-γ-treated patients were followed up until 4 to 6 years after the treatment was stopped. However,all controls were excluded from follow-up due to death,loss and elevated virus level within 2 years.Twenty-five IFN-γ-treated patients had stable serum liver function and liver fibrosis indices without any further antiviral or anti-fibrotic treatment.Improved inflammatory and fibrotic scores were found after nine months of IFN-γtreatment according to the modified Chevallier scoring system(inflammation:11.8±6.5 at the beginning of IFN-γtreatment vs.9.2±4.1 after 9 months, P<0.05;fibrosis:15.0±7.3 at baseline vs.12.6±6.8 after 9 months, P<0.05).Among them,14 patients accepted a third serial liver biopsy 4 to 6 years after treatment discontinuation,and the fibrotic score was increased(14.2±8.3 vs.11.9±7.6 after 9 months, P<0.05). CONCLUSIONS:Nine-month IFN-γtreatment significantly improves the fibrosis score in patients with chronic HBV infection.The majority of patients demonstrate stable serum biochemical indices and quality of life.However,they do not show a long-term benefit according to histological criteria. Given the limited sample size,long-term IFN-γtreatment regimens should be assessed in further clinical trials. | Peter R Mertens Steven Dooley | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，2： | 6 |
| 8 | 美国国家卒中协会短暂性脑缺血发作处理指南显示文摘目的:短暂性脑缺血发作(TIA)是常见和重要的卒中先兆。其处理方法多样,大多数发表的指南在近年来均未被更新。我们试图制定一个全面的、无偏倚的、循证的TIA处理指南。方法:根据一种客观标准(可以预测在该研究领域中执业医师对专家提名的文献测量学方法)挑选出15名专家组成员。通过系统回顾检索到过去发表的指南,由专家对其中的推荐意见的质量进行独立评价。选择出质量最高的推荐意见,然后让专家组采用改良Delphi法通过多次问卷调查的方式进行修订,从而对新的修改达成共识。给专家们提供近期临床研究的系统评价,要求专家根据新的证据判断措辞修改的合理性并且根据证据等级和质量对最终的推荐意见进行评定。不允许专家在预期有可能存在任何利益冲突的专题方面提出推荐意见。结果:通过系统回顾检索到257个指南,其中有13篇文献包括的137条推荐意见符合所有纳入标准。需要6次重复的问卷调查对53条最终推荐意见的措辞达成共识。最终的推荐意见涉及TIA的初步处理、评价、内科治疗、外科治疗和危险因素控制。结论:对TIA患者医疗诊治的最终推荐意见强调了紧急评价和治疗的重要性。这种用于制定本指南的新方法是可行的,考虑到了快速更新并能减少偏倚。 | S. Claiborne Johnston Mai N. Nguyen-Huynh Miriam E. Schwarz Kate Fuller Christina Williams S. Andrew Josephsort Graeme J. Hankey Robert G. Hart Steven R. Levine Jose Biller Robert D. Brown Ralph L. Sacco L. Jaap Kappelle Peter J. Koudstaal Julien Bogousslavsky Louis R. Caplan Jan van Gijn Ale Algra Peter M. Rothwell Harold P. Adams Gregory W. Albers 李海峰(译) | 2007 | 国际脑血管病杂志2007，15，3： | 5 |
| 9 | Borderline Resectable Pancreatic Cancer: Need for Standardization and Methods for Optimal Clinical Trial Design显示文摘 | Matthew H. G. Katz Robert Marsh Joseph M. Herman Qian Shi Eric Collison Alan P. Venook Hedy L. Kindler Steven R. Alberts Philip Philip Andrew M. Lowy Peter W. T. Pisters Mitchell C. Posner Jordan D. Berlin Syed A. Ahmad | 2013 | Annals of Surgical Oncology2013，，8： | 4 |
| 10 | Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo显示文摘 | Ralf Kiesslich Juergen Burg Michael Vieth Janina Gnaendiger Meike Enders Peter Delaney Adrian Polglase Wendy McLaren Daniela Janell Steven Thomas Bernhard Nafe Peter R. Galle Markus F. Neurath | 2004 | Gastroenterology2004，，3： | 3 |
| 11 | Hilar Cholangiocarcinoma: Patterns of Spread, the Importance of Hepatic Resection for Curative Operation, and a Presurgical Clinical Staging System显示文摘 | Edmund C. Burke William R. Jarnagin Steven N. Hochwald Peter W. T. Pisters Yuman Fong Leslie H. Blumgart | 1998 | Annals of Surgery1998，，3： | 3 |
| 12 | Graft Injury in Relation to Graft Size in Right Lobe Live Donor Liver Transplantation: A Study of Hepatic Sinusoidal Injury in Correlation With Portal Hemodynamics and Intragraft Gene Expression显示文摘 | Kwan Man Sheung-Tat Fan Chung-Mau Lo Chi-Leung Liu Peter Chin-Wan Fung Ting-Bo Liang Terence Kin-Wah Lee Steven Hung-Teng Tsui Irene Oi-Lin Ng Zhi-Wei Zhang John Wong | 2003 | Annals of Surgery2003，，2： | 3 |
| 13 | Feasibility of confocal endomicroscopy in the diagnosis of pediatric gastrointestinal disorders显示文摘AIM:To evaluate the feasibility and utility of confocal laser endomicroscopy(CLE) in the description of normal gastrointestinal(GI) mucosa and in the diagnosis of GI disorders in children,in comparison to histology.METHODS:Forty-four patients(19 female) median age 10.9 years(range 0.7-16.6 years) with suspected or known GI pathology underwent esophago-gastro-duodenoscopy(OGD)(n = 36) and/or ileocolonoscopy(IC)(n = 31) with CLE using sodium fluorescein and acriflavine as contrast agents.Histological sections were compared with same site confocal images by two experienced pediatric and GI histopathologists and endoscopists,respectively.RESULTS:Duodenum and ileum were intubated in all but one patient undergoing OGD and IC.The median procedure time was 16.4 min(range 7-25 min) for OGD and 27.9 min(range 15-45 min) for IC.A total of 4798 confocal images were compared with 153 biopsies from the upper GI tract from 36 procedures,and 4661 confocal images were compared with 188 biopsies from the ileocolon from 31 procedures.Confocal images were comparable to conventional histology both in normal and in pathological conditions such as esophagitis,Helicobacter pylori gastritis,celiac disease,inflammatory bowel disease,colonic heterotopia,and graft versus host disease.CONCLUSION:CLE offers the prospect of targeting biopsies to abnormal mucosa,thereby increasing diagnostic yield,reducing the number of biopsies,decreasing the burden on the histopathological services,and reducing costs. | Krishnappa Venkatesh Marta Cohen Clair Evans Peter Delaney Steven Thomas Christopher Taylor Ashraf Abou-Taleb Ralf Kiesslich Mike Thomson | 2009 | World Journal of Gastroenterology2009，15，18： | 2 |
| 14 | Patients undergoing infrainguinal bypass to treat atherosclerotic vascular disease are underprescribed cardioprotective medications: effect on graft patency, limb salvage, and mortality显示文摘 | Peter K Henke Susan Blackburn Mary C Proctor Jeri Stevens Debabrata Mukherjee Sanjay Rajagopalin Gilbert R Upchurch James C Stanley Kim A Eagle | 2004 | Journal of Vascular Surgery2004，，： | 2 |
| 15 | A Lethally Irradiated Allogeneic Granulocyte-Macrophage Colony Stimulating Factor-Secreting Tumor Vaccine for Pancreatic Adenocarcinoma: A Phase II Trial of Safety, Efficacy, and Immune Activation显示文摘 | Lutz Eric Charles J. Yeo Keith D. Lillemoe Barbara Biedrzycki Barry Kobrin Joseph Herman Elizabeth Sugar Steven Piantadosi John L. Cameron Sara Solt Beth Onners Irena Tartakovsky Miri Choi Rajni Sharma Peter B. Illei Hruban Ralph H. Ross A. Abrams Dung Le | 2011 | Annals of Surgery2011，，2： | 2 |
| 16 | Meta-analysis of new genome-wide association studies of colorectal cancer risk显示文摘 | Ulrike Peters Carolyn M. Hutter Li Hsu Fredrick R. Schumacher David V. Conti Christopher S. Carlson Christopher K. Edlund Robert W. Haile Steven Gallinger Brent W. Zanke Mathieu Lemire Jagadish Rangrej Raakhee Vijayaraghavan Andrew T. Chan Aditi Hazra Dav | 2012 | Human Genetics2012，，2： | 2 |
| 17 | Randomized, controlled trial of standard, large-capacity versus jumbo biopsy forceps for polypectomy of small, sessile, colorectal polyps显示文摘 | Peter V. Draganov Myron N. Chang Ahmad Alkhasawneh Lisa R. Dixon John Lieb Baharak Moshiree Steven Polyak Shahnaz Sultan Dennis Collins Amitabh Suman John F. Valentine Mihir S. Wagh Samir L. Habashi Chris E. Forsmark | 2012 | Gastrointestinal Endoscopy2012，，1： | 2 |
| 18 | Characteristics and health impacts of VOCs and carbonyls associated with residential cooking activities in Hong Kong显示文摘 | Yu Huang Steven Sai Hang Ho Kin Fai Ho Shun Cheng Lee Jian Zhen Yu Peter K.K. Louie | 2010 | Journal of Hazardous Materials2010，，1： | 2 |
| 19 | Protective effects of high-molecular weight Polyethylene Glycol (PEG) in human lung endothelial cell barrier regulation: Role of actin cytoskeletal rearrangement显示文摘 | Eddie T. Chiang Sara M. Camp Steven M. Dudek Mary E. Brown Peter V. Usatyuk Olga Zaborina John C. Alverdy Joe G.N. Garcia | 2008 | Microvascular Research2008，，2： | 2 |
| 20 | Increasing Prevalence of HCC and Cirrhosis in Patients With Chronic Hepatitis C Virus Infection显示文摘 | Fasiha Kanwal Tuyen Hoang Jennifer R. Kramer Steven M. Asch Matthew Bidwell Goetz Angelique Zeringue Peter Richardson Hashem B. El–Serag | 2011 | Gastroenterology2011，，4： | 2 |
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