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1欧洲新生儿呼吸窘迫综合征防治指南-2010版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,自然病程为生后当时或很快发病,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,在生后2—4d病情开始改善。胎龄越小,RDS发生率越高,2006年EuroNeoStat的数据显示:胎龄23~25周的早产儿RDS发生率为91%,Sweet DG Carnielli V Greisen G Hallman M Ozek E Plavka R Saugstad OD Simeoni U Speer CP Halliday HL 袁琳(翻译) 陈超(审校) 2011中华儿科杂志2011,49,1:137
2BCLC策略:预后预测和治疗推荐2022版更新显示文摘2018版BCLC预后和治疗推荐策略发布后,肝细胞癌(简称HCC)的研究又取得了重大进展。本次更新基于肝癌各领域的研究进展结果。重点关注影响策略的重要研究进展。虽然近年的研究结果成绩斐然,但将其引入为临床医生和研究者提供行动依据的循证模型指南来说证据效力依然不够确切。本文对该问题进行分析,阐述了为HCC患者制定个体化治疗临床决策所需的批判性思维和专业知识。Reig M Forner A Rimola J Ferrer-Fabrega J Burrel M Garcia-Criado A Kelley RK Galle PR Mazzaferro V Salem R Sangro B Singal AG Vogel A Fuster J Ayuso C Bruix J 刘永凡(摘译) 崔笑(摘译) 耿小平(审校) 2022肝胆外科杂志2022,30,5:80
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
4欧洲早产儿呼吸窘迫综合征防治共识指南(2013版)显示文摘本次指南更新包括了自2010年以来Cochrane系统评价和医学文献中的最新证据,并采纳了一种新的证据评估分级系统(GRADE)。以往关于早期肺表面活性物质和持续气道正压通气治疗的推荐目前拥有了更坚定的循证依据。对产房复苏、稳定生命体征等内容进行了较大扩充。生命体征稳定后的氧疗目前仍存在一定的争议,但是在获得更多的证据之前,血氧饱和度的目标范围不应低于90%,支持治疗对于超早早产儿仍然极为重要。指南对其他注意事项进行了缩减。Sweet D Carnielli V Greisen G Hallman M Ozek E Plavka R Saugstad OD Simeoni U Speer CP Halliday HL 王敏婕 袁琳 陈超 2014中华儿科杂志2014,52,10:34
5Pediatric 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
6Cardiac rehabilitation and exercise therapy in the elderly: Should we invest in the aged?显示文摘冠的心疾病(CHD ) 是世界范围的死亡的领先的原因并且在病人之中变得逐渐地流行 65 岁以上。老病人在为复杂并发症的更高的风险并且在一个心血管的事件以后加速物理 deconditioning,特别与他们的更年轻的对应物相比。最后几十年是到与 CHD 在病人之中在死亡,锻练能力,心理风险因素,发炎,和肥胖上表明了心脏的康复(CR ) 和锻练治疗的有益的效果的多重研究的厕所。不幸地,这个领域里的可得到的数据的重要部分与更年轻的病人相关。可行解释是更老的病人在为以病人开始并且延长到医生的多重原因的这些节目是非常未被充分代表的。在这篇文章,我们将考察 CR 节目的好处在之中老,以及一些妨碍他们的参予的障碍。Arthur R Menezes Carl J Lavie Richard V Milani Ross A Arena Timothy S Church 2012Journal of Geriatric Cardiology2012,9,1:25
72018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
8A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol显示文摘BACKGROUND: Laparoscopic pancreaticoduodenectomy(LPD)is a safe procedure. Oncological safety of LPD is still a matter for debate. This study aimed to compare the oncological outcomes,in terms of adequacy of resection and recurrence rate following LPD and open pancreaticoduodenectomy(OPD).METHODS: Between November 2005 and April 2009, 12LPDs(9 ampullary and 3 distal common bile duct tumors)were performed. A cohort of 12 OPDs were matched for age,gender, body mass index(BMI) and American Society of Anesthesiologists(ASA) score and tumor site.RESULTS: Mean tumor size LPD vs OPD(19.8 vs 19.2 mm,P=0.870). R0 resection was achieved in 9 LPD vs 8 OPD(P=1.000). The mean number of metastatic lymph nodes and total number resected for LPD vs OPD were 1.1 vs 2.1(P=0.140)and 20.7 vs 18.5(P=0.534) respectively. Clavien complications grade I/II(5 vs 8), III/IV(2 vs 6) and pancreatic leak(2 vs 1)were statistically not significant(LPD vs OPD). The mean high dependency unit(HDU) stay was longer in OPD(3.7 vs 1.4 days,P<0.001). There were 2 recurrences each in LPD and OPD(logrank,P=0.983). Overall mortality for LPD vs OPD was 3 vs 6(log-rank, P=0.283) and recurrence-related mortality was 2 vs 1.There was one death within 30 days in the OPD group secondary to severe sepsis and none in the LPD group.CONCLUSIONS: Compared to open procedure, LPD achieved a similar rate of R0 resection, lymph node harvest and longterm recurrence for tumors less than 2 cm. Though technically challenging, LPD is safe and does not compromise oncological outcome.Abdul R Hakeem Caroline S Verbeke Alison Cairns Amer Aldouri Andrew M Smith Krishna V Menon 2014Hepatobiliary & Pancreatic Diseases International2014,13,4:24
9Evaluation of clinical relevance of examining K-ras, p16 and p53 mutations along with allelic losses at 9p and 18q in EUS-guided fine needle aspiration samples of patients with chronic pancreatitis and pancreatic cancer显示文摘AIM: To establish an optimum combination of molecular markers resulting in best overall diagnostic sensitivity and specificity for evaluation of suspicious pancreatic mass. METHODS: Endoscopic ultrasound (EUS)-guided fine needle aspiration cytology (FNA) was performed on 101 consecutive patients (63 males, 38 females, 60 ± 12 years; 81 with subsequently diagnosed pancreatic cancer, 20 with chronic pancreatitis) with focal pancreatic mass. Samples were evaluated on-site by an experienced cytopathologist. DNA was extracted from Giemsa stained cells selected by laser microdissection and the presence of K-ras, p53 and p16 somatic mutations was tested by cycling-gradient capillary electrophoresis (CGCE) and single-strand conformation polymorphism (SSCP) techniques. In addition, allelic losses of tumor suppressor genes p16 (INK4, CDKN2A) and DPC4 (MADH4, SMAD4) were detected by monitoring the loss of heterozygosity (LOH) at 9p and 18q, respectively. RESULTS: Sensitivity and specificity of EUS-guided FNA were 75% and 85%, positive and negative predictivevalue reached 100%. The remaining 26% samples were assigned as inconclusive. Testing of molecular markers revealed sensitivity and specificity of 70% and 100% for K-ras mutations (P < 0.001), 24% and 90% for p53 mutations (NS), 13% and 100% for p16 mutations (NS), 85% and 64% for allelic losses at 9p (P < 0.001) and 78% and 57% for allelic losses at 18q (P < 0.05). When tests for different molecular markers were combined, the best results were obtained with K-ras + LOH at 9p (92% and 64%, P < 0.001), K-ras + LOH at 18q (92% and 57%, P < 0.001), and K-ras + LOH 9q + LOH 18q (96% and 43%, P < 0.001). When the molecular markers were used as complements to FNA cytology to evaluate inconclusive samples only, the overall sensitivity of cancer detection was 100% in all patients enrolled in the study. CONCLUSION: EUS-guided FNA cytology combined with screening of K-ras mutations and allelic losses of tumor suppressors p16 and DPC4 represents a very sensitive approach in screening for pancreatic malignancy. Molecular markers may find its use particularly in cases where FNA cytology has been inconclusive.C Salek L Benesova M Zavoral V Nosek L Kasperova M Ryska R Strnad E Traboulsi M Minarik 2007World Journal of Gastroenterology2007,13,27:18
10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
11Spontaneous transformation of human adult non-tumorigenic stem cells to cancer stem cells is driven by genomic instability in a human model of glioblastoma显示文摘Shims A Chettiar S Shepal V Rajendran G Prasad R Shastry P 2007中国神经肿瘤杂志2007,5,1:16
12普通肉食螨对9种储粮害虫的捕食能力研究显示文摘研究了普通肉食螨(Cheyletus eruditusSchrank)幼螨、原若螨、后若螨、雌成螨4 种螨态对嗜卷书虱(Liposcelis bostrychophila Badonnel)、锈赤扁谷盗(Cryptolestes ferrugineus Stephens)等9 种常见储粮害虫的卵和1 龄幼虫(若虫)的捕食虫谱。研究发现,4 种螨态对9 种储粮害虫均有不同程度的捕食能力,普通肉食螨对嗜卷书虱的捕食能力较强,分别达3.3 粒/天d(卵)和2.4 头/d(1 龄若虫)。进一步探索普通肉食螨对嗜卷书虱的捕食功能反应,研究表明:在猎物密度为1~10 头(粒)范围内,原若螨、后若螨和雌成螨对嗜卷书虱卵的捕食量分别为:0.4~1.4、0.3~1.5、0.5~3.3 粒/d,对嗜卷书虱1 龄若虫的捕食量分别为0.1~0.6、0.2~1.2、0.4~2.4 头/d,原若螨、后若螨和雌成螨对嗜卷书虱卵和1 龄若虫的捕食功能均符合HollingⅡ型,攻击系数、捕食上限和捕食效能最高分别为0.515、8.485 和4.239 粒/d。贺培欢 张涛 伍祎 李燕羽 李志红 李福君 Stejskal V Kucerova Z Aulicky R 江亚杰 唐培安 曹阳 2016中国粮油学报2016,31,11:14
13肽酰基精氨酸脱亚氨酶4和中性粒细胞胞外诱捕网形成在实验性动脉粥样硬化和动脉损伤中的作用:浅表糜烂的影响显示文摘中性粒细胞可能促进人类动脉粥样硬化的血栓并发症的发生。特别是中性粒细胞胞外诱捕网(neutrophil extracellular traps,NETs)可加剧局部炎症,并放大和加剧动脉内膜损伤和血栓形成。肽酰基精氨酸脱亚氨酶4(peptidyl arginine deiminase 4,PAD4)参与NET的形成,但对该酶在动脉粥样硬化血栓形成中的作用的认识仍然不足。刘青 叶鹏 Franck G Mawson TL Folco EJ Molinaro R Ruvkun V Engelbertsen D Liu X Tesmenitsky Y Shvartz F Sukhova GK Michel JB Nicoletti A Lichtman AH Wagner DD Croce KJ Libby P 2018中华高血压杂志2018,26,5:13
14Intraductal biliary and pancreatic endoscopy: An expanding scope of possibility显示文摘Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts. For many years, technological challenges have made performing these procedures difficult. The 'mother-baby' system and other various miniscopes have been developed, but routine use has been hampered due to complex setup, scope fragility and the time consuming, technically demanding nature of the procedure. Recently, the SpyGlass peroral cholangiopancreatoscopy system has shown early success at providing diagnostic information and therapeutic options. The clinical utility of intraductal endoscopy is broad. It allows better differentiation between benign and malignant processes by allowing direct visualization and targeted sampling of tissue. Therapeutic interventions, such as electrohydraulic lithotripsy (EHL), laser lithotripsy, photodynamic therapy, and argon plasma coagulation (APC), may also be performed as part of intraductal endoscopy. Intraductal endoscopy significantly increases the diagnostic and therapeutic yield of standard endoscopic retrograde cholangiography (ERCP), and as technology progresses, it is likely that its utilization will only increase. In this review of intraductal endoscopy, we describe in detail the various endoscopic platforms and their diagnostic and clinical applications.Joel R Judah Peter V Draganov 2008World Journal of Gastroenterology2008,14,20:12
15世界家庭医生组织(WONCA)研究论文摘要汇编——有氧运动缓解产后抑郁效果的系统性综述与荟萃分析显示文摘背景当前英美国家尚无运动方法治疗产后抑郁方面的专门指导,而且国际上在此方面的指导也不尽相同。目的评价有氧运动治疗产后抑郁的效果。设计与场所本研究为系统性综述及荟萃分析,无研究地点。方法使用计算机检索MEDLINE、EMBASE、Cochrane Library、Psyc INFO、Sport Discus、Scr Clinical Trials.gov以及World Health Organization International Clinical Trials Registry Platform数据库,收集评估产妇分娩后1年内抑郁状况的随机对照试验、有氧运动和常规护理或者其他护理方式改善产后抑郁效果的比较研究的摘要及全文。使用Cochrane协作组推荐使用的偏倚风险评估工具对纳入的文献进行偏倚风险评估。对纳入的文献进行荟萃分析。对纳入文献之间存在的异质性进行预设亚组分析。结果共纳入13篇文献,包括1 734例患者。整体来看,有氧运动可以显著缓解产后抑郁[SMD=-0.44,95%CI=(-0.75,-0.12)]。异质性分析发现,有氧运动干预效果在可能患有抑郁的产妇间及一般产妇间不存在统计学差异;只采用有氧运动取得的干预效果与采用有氧运动结合其他方式取得的干预效果不存在统计学差异;群体有氧运动与配置有氧运动咨询的干预效果不存在统计学差异。结论本项系统性综述为有氧运动具有缓解产后抑郁的效果提供了证据支持。群体运动、研究对象自己选择运动方式、运动结合其他干预方式均是有效缓解产后抑郁的方法。但是由于纳入文献存在显著异质性和高偏倚风险,故此研究结果应谨慎参考。PRITCHETT R V DALEY A J JOLLY K 本刊编辑部 2017中国全科医学2017,20,30:12
16Metastatic type 1 gastric carcinoid:A real threat or just a myth?显示文摘AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological findings,the extent of the disease,as well as the use of different therapeutic modalities and the long-term outcome were recorded.Patients’data were assessed at presentation,and thereafter at 6 to 12 monthly intervals both clinically and biochemically,but also endoscopically and histopathologically.Patients were evaluated for the presence of specific symptoms;the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded.The evaluation of response to treatment was defined using established WHO criteria.RESULTS:We studied twenty consecutive patients with a mean age of 55.1 years.The mean follow-up period was 83 mo.Twelve patients had regional lymph node metastases and 8 patients had liver metastases.The primary tumor mean diameter was 20.13±10.83mm(mean±SD).The mean Ki-67 index was 6.8%±11.2%.All but one patient underwent endoscopic or surgical excision of the tumor.The disease was stable in all but 3 patients who had progressive liver disease.All patients remained alive during the follow-up period.CONCLUSION:Metastatic GCA1 carries a good overall prognosis,being related to a tumor size of≥1 cm,an elevated Ki-67 index and high serum gastrin levels.Simona Grozinsky-Glasberg Dimitrios Thomas Jonathan R Strosberg Ulrich-Frank Pape Stephan Felder Apostolos V Tsolakis Krystallenia I Alexandraki Merav Fraenkel Leonard Saiegh Petachia Reissman Gregory Kaltsas David J Gross 2013World Journal of Gastroenterology2013,19,46:11
17Endoscopic therapy of benign biliary strictures显示文摘Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of post- liver transplant anastomotic strictures and distal (Bismuth Ⅰand Ⅱ) post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat, and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.Joel R Judah Peter V Draganov 2007World Journal of Gastroenterology2007,13,26:11
18小麦水不溶性戊聚糖对面筋形成及品质影响的研究显示文摘采用改进的面筋测定仪系统地研究小麦水不溶性戊聚糖对面筋形成及品质的影响。结果表明 :小麦水不溶性戊聚糖不仅降低面筋产率 ,而且影响面筋成分及品质。延长和面时间及增加和面加水量在很大程度上克服其对面筋产率的负作用 ,但不能完全消除其负作用。添加木聚糖酶可增加面筋产率 。王明伟 Hamer R J Vliet T V 2002粮食与饲料工业2002,,6:11
19烟酰胺磷酸核糖基转移酶促进肺血管重塑,是肺动脉高压的治疗靶点显示文摘肺动脉高压(pulmonary arterial hypertension,PAH)是一种严重的进行性疾病,其标志之一是肺血管重塑。烟酰胺磷酸核糖基转移酶(nicotinamide phosphoribosyl transferase,NAMPT)是调节细胞内烟酰胺腺嘌呤二核苷酸水平、细胞氧化还原状态,调节组蛋白脱乙酰酶,促进细胞增殖和抑制凋亡的一种细胞酶。研究人员假设NAMPT可促进肺血管重塑,Chen J Sysol JR Singla S Zhao S Yamamura A Valdez-Jasso D Abbasi T Shioura KM Sahni S Reddy V Sridhar A Gao H Torres J Camp SM Tang H Ye SQ Comhair S Dweik R Hassoun P Yuan JX Garcia JG Machado RF 刘莉 叶鹏 2017中华高血压杂志2017,25,2:10
20老年人不同年龄段脊柱椎体外周骨定量CT测定研究显示文摘目的 研究老年人各年龄段 T3~ L5椎体骨密度及椎体横断面面积。方法 用外周骨定量 CT(p QCT)仪测量 40具老年尸体中 60 0个椎体的总骨密度、松质骨密度、皮质下骨密度、皮质骨密度、椎体横断面总面积、松质骨面积、皮质下骨面积及皮质骨面积 ,分别统计 60~ 69岁 (A组 )、70~ 79岁 (B组 )、80~ 89岁 (C组 )、90~ 98岁 (D组 )椎体骨密度值。结果 T3~ L5椎体总骨密度 (mg/ cm3)为 1 88.2 5~ 1 91 .60 ,松质骨密度为1 2 8.0 1~ 1 30 .66,皮质下骨密度为 454.90~ 461 .87,皮质骨密度为 764.1 3~ 769.55。结论 60~ 79岁椎体总骨密度值保持在相对稳定水平 ,80岁以后该值下降较明显。沈宁江 Kuhn V Eckstein F Putz R 2003中国老年学杂志2003,23,1:10
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