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| 1 | GRADE指南:Ⅰ.导论--GRADE证据概要表和结果总结表显示文摘本文是GRADE(Grading of Recommendations Assessment,Development,and Evaluation)系列文章的导论。该系列文章为使用GRADE系统提供指导,介绍如何将该系统用于系统评价、卫生技术评估(HTAs)及临床实践指南中备选方案的证据质量评价和推荐强度评级。GRADE方法始于提出一个明晰的问题,包括对所有重要结果的详细说明。证据被收集和汇总后,GRADE提供了明确的标准来评价其质量,包括研究设计、偏倚风险、不精确性、不一致性、间接性及效应量大小。根据支撑证据质量及备选方案带来的预期和非预期结果间的平衡情况,推荐强度以强/弱(或表述为'有条件的'/'任意的')作为特征。GRADE建议用简洁、透明、信息量丰富的结果总结表来汇总证据(以显示证据质量及每一重要结果的相对效应量和绝对效应量),和(或)以证据概要表形式额外提供证据质量评价理由的详细信息。本系列的后续文章涉及如何采用GRADE方法明确构建问题、评价证据质量及形成推荐意见。 | Gordon Guyatt Andrew D.Oxman Elie Akl Regina Kunz Gunn Vist Jan Brozek Susan Norris Yngve Falck-Ytter Paul Glasziou Hans deBeer Roman Jaeschke David Rind Joerg Meerpohl Philipp Dahm Holger J.Schünemann GRADE工作组 李幼平 杨晓妍 蒋兰慧 沈建通 | 2011 | 中国循证医学杂志2011，11，4： | 205 |
| 2 | GRADE指南:Ⅲ.证据质量分级显示文摘本文介绍证据质量分级的GRADE方法。GRADE将证据质量分为高、中、低和极低四个级别。该分级应用于证据群,而非针对个别研究。系统评价中,质量反映了我们认为效应估计值正确的把握度。对推荐意见而言,质量反映了我们认为效应估计值足以支持某特定推荐的把握度。随机对照试验初定为高质量证据,观察性研究初定为低质量证据。GRADE中所使用的质量一词不只是意味着偏倚风险,还可能受研究结果的不精确性、不一致性和间接性,及发表偏倚的影响。此外,若干因素可增加我们对效应估计值的把握度。GRADE提供了一种系统方法来思考并报告各因素。GRADE将评估证据质量的过程与给出推荐建议的过程分开。推荐强度的判断不仅依赖于证据质量。 | Howard Balshem Mark Helfanda Holger J.Schunemann Andrew D.Oxman Regina Kunz Jan Brozek Gunn E.Vist Yngve Falck-Ytter Joerg Meerpohl Susan Norris Gordon H.Guyatt GRADE工作组 李幼平 杨晓妍 高霑 | 2011 | 中国循证医学杂志2011，11，4： | 128 |
| 3 | GRADE指南:Ⅴ.证据质量评价--发表偏倚显示文摘GRADE方法中,随机试验起评即为高质量证据,观察性研究起评即为低质量证据;但若证据本身存在高发表偏倚风险,则两者证据质量级别都应降低。即使最佳证据汇总表纳入的各项研究仅有低发表偏倚风险,发表偏倚仍会极大高估效应值。当可得证据来自小样本研究、且多数由厂商资助时,作者应怀疑存在发表偏倚。若干基于检验数据类型的方法可用于评价发表偏倚,其中最常用的为漏斗图,但这些方法都有较大局限。发表偏倚可能较常见,必须特别关注早期结果、对样本量与事件数都很小的早期试验结果尤需小心。 | Gordon H.Guyatt Andrew D.Oxman Victor Montori Gunn Vist Regina Kunz Jan Brozek Pablo Alonso-Coello Ben Djulbegovic David Atkins Yngve Falck-Ytter John W.Williams Jr. Joerg Meerpohl Susan L.Norris Elie A.Akl Holger J.Schünemann 代表GRADE工作组 李幼平 王莉 钟大可 蒋兰慧 | 2011 | 中国循证医学杂志2011，11，12： | 71 |
| 4 | GRADE:证据质量和推荐强度分级的共识显示文摘GRADE工作组致中国读者:推荐分级的评估、制定与评价(GRADE)工作组已取得长足进步。我们制定了系列指南文件,除发表文章外,该非正式组织已经发展成为一个评价证据、转化卫生保健领域知识用以指导决策者的智囊团。80余位国际专家研究和制定了该评价系统。正如其他科学一样,证据评价和指南制定科学不会停滞不前。经过十年发展,GRADE的工作将借助中国Cochrane中心的推广在中国的卫生保健领域更加广为人知。GRADE工作组的成员期待与中国的指南制定组织、方法学家、临床医生和决策者合作,实现我们的共同目标:人人享有更好的卫生保健。中国Cochrane中心翻译GRADE工作组在BMJ上发表的系列文章,是朝这个方向迈出的重要一步,也是对下一步在中国推广GRADE工作的直接贡献。感兴趣的读者可登录我们的网站www.gradeworkinggroup.org和在以下网址获取我们的软件GRADEprohttp://gffzz73f9075754ca43bbhqfn09ub9u5f9696o.ffgz.tsg.suse.edu.cn. | Gordon H Guyatt Andrew D Oxman Gunn E Vist Regina Kunz Yngve Falck-Ytter Pablo Alonso-Coello Holger J Schünemann GRADE工作组 陈佩贤 陈耀龙 李幼平 | 2009 | 中国循证医学杂志2009，9，1： | 60 |
| 5 | GRADE指南:Ⅳ.证据质量分级--研究的局限性(偏倚风险)显示文摘在GRADE方法中,若多数相关证据来自高偏倚风险的研究,则起初被定为高质量证据的随机试验和低质量证据的观察性研究均有可能被降低质量等级。随机试验已确定的局限性包括:未进行分配隐藏、未实施盲法、未报告失访情况及未恰当考虑意向性治疗原则。最近提出的局限性包括:因明显获益而早期终止试验和基于结果选择性报告结局。观察性研究的主要局限性包括使用不合适的对照及未能充分调整预后的不平衡。偏倚风险可因不同结果而异(如全死因死亡率的失访远少于生命质量的失访),许多系统评价都容易忽略这一点。在决定是否因偏倚风险而降低质量等级时,不管是随机试验还是观察性研究,作者不应采用对各个研究取平均值的方法。相反,对任何单个结果,当同时存在高、低偏倚风险的研究时,则应考虑只纳入较低偏倚风险的研究。 | Gordon H.Guyatt Andrew D.Oxman Gunn Vist Regina Kunz Jan Brozek Pablo Alonso-Coello Victor Montori Elie A.Akl Ben Djulbegovic Yngve Falck-Ytter Susan L.Norris John W.Williams Jr. David Atkins Joerg Meerpohl Holger J.Schünemann GRADE工作组 李幼平 杨晓妍 李鸿浩 李玲 | 2011 | 中国循证医学杂志2011，11，4： | 58 |
| 6 | GRADE指南:Ⅵ.证据质量评价--不精确性(随机误差)显示文摘GRADE建议通过检查95%可信区间(CI)为决定不精确性的最佳方法。在指南实际运用中,如果CI的上、下限值代表了真实效应,而临床实际情况与之不符时,必须降低证据质量级别(即对效应估计值的把握度)。除外当效应值很大且可信区间提示效应稳健,而总样本量不大且事件数很少的情况,其他应考虑因不精确性而降低证据质量级别。作此决定时,可计算有足够检验效能的单个试验所需的病例数(定义为'最优信息样本量',即optimal information size,OIS)。对连续型变量,我们建议用类似方法,首先考虑可信区间上、下限值,再计算OIS。系统评价(SR)所需方法略有不同。如果95%CI不包括相对危险度(RR)为1,且总事件发生数或病例数超过OIS标准,则精确性良好。如果95%CI包括了明显获益或危害(我们建议以RR值<0.75或>1.25作粗标准),即使达到OIS要求,因不精确性而降低证据质量级别较恰当。 | Gordon Guyatt Andrew D.Oxman Regina Kunz Jan Brozek Pablo Alonso-Coello David Rind PJ Devereaux Victor M.Montori Bo Freyschuss Gunn Vist Roman Jaeschke John W.Williams Jr. Mohammad Hassan Murad David Sinclairk Yngve Falck-Ytter Joerg Meerpohl Craig Whittington Kristian orlund Je Andrews Holger J.Schünemann 代表GRADE工作组 李幼平 王莉 陈尹 高霑 | 2011 | 中国循证医学杂志2011，11，12： | 43 |
| 7 | A community-derived classification for extant lycophytes and ferns显示文摘发展史长通知了蕨类植物分类。当我们推断进化的树的能力改善了,针对认出生来的组的分类变得逐渐地预兆、稳定。这里,我们为 lycophytes 和蕨纲植物提供一个现代、全面分类,在下面,利用一条基于社区的途径类水平。我们 monophyly 用作主要标准让 taxa,而且目的识别保存两个广泛地被接受的存在 taxa 和界限并且与我们蕨类植物发展史的理解一致。总共,这个分类对待一在 337 个类, 51 个家庭, 14 目,和二个班估计了 11 916 种类。这个分类没在 lycophyte 和蕨纲植物上作为最后的词被打算分类,而是当前的假设的概括陈述,源于最好的可得到的数据并且在问题由熟悉植物的那些大多数塑造了。我们希望它将在蕨类植物上为最近的文学的那些想要的参考用作一个资源发展史和分类,为指导未来调查的一个框架,和推进讲话的刺激。 | Eric Schuettpelz Harald Schneider Alan R. Smith Peter Hovenkamp Jefferson Prado Germinal Rouhan Alexandre Salino Michael Sundue Thafs Elias Almeida Barbara Parris Emily B. Sessa Ashley R. Field Andre Luis de Gasper Carl J. Rothfels Michael D. Windham Marcus Lehnert Benjamin Dauphin Atsushi Ebihara Samuli Lehtonen Pedro Bond Schwartsburd Jordan Metzgar Li-Bing Zhang Li-Yaung Kuo Patrick J. Brownsey Masahiro Kato Marcelo Daniel Arana Francine C. Assis Michael S. Barker David S. Barrington Ho-Ming Chang Yi-Han Chang Yi-Shan Chao Cheng-Wei Chen De-Kui Chen Wen-Liang Chiou Vinicius Antonio de Oliveira Dittrich Yi-Fan Duan Jean-Yves Dubuisson Donald R. Farrar Susan Fawcett Jose Maria Gabriel y Galan Luiz Armando de Araujo Goes-Neto Jason R. Grant Amanda L. Grusz Christopher Haufler Warren Hauk Hai He Sabine Hennequin Regina Yoshie Hirai Layne Huiet Michael Kessler Petra Korall Paulo H. Labiak Anders Larsson Blanca Leen Chun-Xiang Li Fay-Wei Li Melanie Link-Perez Hong-Mei Liu Ngan Thi Lu Esteban I. Meza-Torres Xin-Yuan Miao Robbin Moran Claudine Massi Mynssens Nathalie Nagalingum Benjamin Ollgaard Alison M. Paul Jovani B. de S. Pereira Leon R. Perrie Monica Ponce Tom A. Ranker Christian Schulz Wataru Shinohara Alexander Shmakov Erin M. Sigel Filipe Soares de Souza Lana da Silva Sylvestre Weston Testo Luz Amparo Triana-Moreno Chie Tsutsumi Hanna Tuomisto IvAn A. Valdespino Alejandra Vasco Raquel Stauffer Viveros Alan Weakley Ran Wei Stina Weststrand Paul G. Wolf George Yatskievych Xiao-Gang Xu Yue-Hong Yan Liang Zhang Xian-Chun Zhang Xin-Mao Zhou | 2016 | Journal of Systematics and Evolution2016，54，6： | 44 |
| 8 | Renin-angiotensin system in the pathogenesis of liver fibrosis显示文摘Hepatic fibrosis is considered a common response to many chronic hepatic injuries.It is a multifunctional process that involves several cell types,cytokines,chemokines and growth factors leading to a disruption of homeostatic mechanisms that maintain the liver ecosystem.In spite of many studies regarding the development of fibrosis,the understanding of the pathogenesis remains obscure.The hepatic tissue remodeling process is highly complex,resulting from the balance between collagen degradation and synthesis.Among the many mediators that take part in this process,the components of the Renin angiotensin system(RAS) have progressively assumed an important role.Angiotensin(Ang)□acts as a profibrotic mediator and Ang-(1-7),the newly recognized RAS component,appears to exert a counter-regulatory role in liver tissue.We briefly review the liver fibrosis process and current aspects of the RAS.This review also aims to discuss some experimental evidence regarding the participation of RAS mediators in the pathogenesis of liver fibrosis,focusing on the putative role of the ACE2-Ang-(1-7)-Mas receptor axis. | Regina Maria Pereira Robson Augusto Souza dos Santos Filipi Leles da Costa Dias Mauro Martins Teixeira Ana Cristina Simoes e Silva | 2009 | World Journal of Gastroenterology2009，15，21： | 37 |
| 9 | GRADE指南:Ⅱ.构建问题、确定重要结果显示文摘GRADE要求明确说明相关的背景、人群、干预措施和对照,同时要求不论研究结果能否形成证据,均需详述所有重要结果。对某一特定管理问题,人群、干预措施及结果应在不同研究间足够类似,才能认为得到相似的效应量合乎情理。指南制定者在收集证据前应先详细说明各结局的相对重要性,同样地,证据总结完成时也需要详细说明这一点。考虑到替代结局的重要性,对采用替代指标描述且对患者很重要的结局,作者应评估其重要性,并进而降低这种间接结果的证据质量等级。 | Gordon H.Guyatt Andrew D.Oxman Regina Kunz David Atkins Jan Brozek Gunn Vist Philip Alderson Paul Glasziou Yngve Falck-Ytter Holger J.Schünemann GRADE工作组 李幼平 杨晓妍 陈群飞 | 2011 | 中国循证医学杂志2011，11，4： | 40 |
| 10 | Current knowledge on esophageal atresia显示文摘Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still contro-versial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA. | Paulo Fernando Martins Pinheiro Ana Cristina Simoes e Silva Regina Maria Pereira | 2012 | World Journal of Gastroenterology2012，18，28： | 35 |
| 11 | Development of distributed time-variant gain model for nonlinear hydrological systems显示文摘In this paper, a rainfall-runoff modeling system is developed based on a nonlinear Volterra functional series and a hydrological conceptual modeling approach. Two models, i.e. the time-variant gain model (TVGM) and the distributed time-variant gain model (DTVGM) that are built on the platform of Digital Elevation Model (DEM), Remote Sensing (RS) and Unit Hydro-logical Process were proposed. The developed DTVGM model was applied to two cases in the Heihe River Basin that is located in the arid and semiarid region of northwestern China and the Chaobai River basin located in the semihumid region of northern China. The results indicate that, in addition to the classic dynamic differential approach to describe nonlinear processes in hy-drological systems, it is possible to study such complex processes through the proposed sys-tematic approach to identify prominent hydrological relations. The DTVGM, coupling the advan-tages of both nonlinear and distributed hydrological models, can simulate variant hydrological processes under different environment conditions. Satisfactory results were obtained in fore-casting the time-space variations of hydrological processes and the relationships between land use/cover change and surface runoff variation. | XIA Jun1, 2, WANG Gangsheng1, TAN Ge1, YE Aizhong2 & G. H. Huang3 1. Key Laboratory of Water Cycle & Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China 2. State Key Laboratory of Water Resources & Hydropower Engineering Sciences, Wuhan University, Wuhan 430072, China 3. Faculty of Engineering, University of Regina, 3737 Wascana Parkway, Regina, Sask., S4S 0A2, Canada Correspondence should be addressed to Xia Jun | 2005 | Science China Earth Sciences2005，48，6： | 32 |
| 12 | GRADE指南:Ⅶ.证据质量评价--不一致性显示文摘本文针对二分类变量结局指标相对(而非绝对)治疗效果的不一致性。证据本身不会因不同研究结果具有一致性而升级,但可能因不一致而降低质量级别。衡量一致性的标准包括点估计值的相似性、可信区间的重叠程度以及统计学判定标准包括异质性检验和I2。系统评价作者应提出并检验少数几个与患者、干预措施、结局指标以及方法学相关的先验假设以探寻异质性来源。当不一致性很大且无法解释时,因不一致性而降低质量级别是恰当的,特别当某些研究显示有显著益处而其他显示无益甚至有害时(而非仅是疗效大与疗效小的比较)。明显的亚组效应可能不可靠。如果亚组效应满足以下条件,其可信度将会增加:基于少数几个有具体方向的先验假设、亚组比较来自研究内而非研究间、交互检验的P值小、结果有生物学意义。 | Gordon H.Guyatt Andrew D.Oxman Regina Kunz James Woodcock Jan Brozek Mark Helfand Pablo Alonso-Coello Paul Glasziou Roman Jaeschke Elie A.Akl Susan Norris Gunn Vist Philipp Dahm Vijay K.Shukla Julian Higgins Yngve Falck-Ytter Holger J.Schünemann 代表GRADE小组 李幼平 杨晓妍 王莉 蔡羽嘉 陈群飞 | 2011 | 中国循证医学杂志2011，11，12： | 33 |
| 13 | GRADE指南:Ⅷ.证据质量评价--间接性显示文摘直接证据来自直接比较我们关注的干预措施用于我们关注的患者人群,并测量患者重要结局的研究。间接证据可由以下4种方式之一产生。第一,患者可能与我们关注的患者不同(适用性一词常用于这类间接性)。第二,所检验的干预措施可能与我们关注的干预措施不同。有关患者和干预措施间接性的决策取决于对生物或社会因素差异是否大到可能使效应尺度出现预期的较大差异的考虑。第三,结果可能有别于最初设定的结局指标——如替代结果本身不重要,但测量之是基于替代结果的变化反映患者重要结局变化这一假设。第四类间接性在概念上与前三类不同,发生于临床医生必须在未经直接比较的两种干预措施间做出选择时。这种情况下比较治疗方案需要特定的统计方法,并根据患者人群、联合干预措施、结局测量指标及备选干预措施试验方法的差异程度,将证据级别降低1或2级。 | Gordon Guyatt Andrew D.Oxman Regina Kunz James Woodcock Jan Brozek Mark Helfand Pablo Alonso-Coello Yngve Falck-Ytter Roman Jaeschke Gunn Vist Elie A.Akl Piet N Post Susan Norris Joerg Meerpohl Mona Nasser 代表GRADE工作组 李幼平 杨晓妍 李鸿浩 | 2011 | 中国循证医学杂志2011，11，12： | 30 |
| 14 | GRADE:从证据到推荐显示文摘GRADE系统将指南中的推荐分为强弱两级。本文旨在探索这种分级的含义及对患者、临床医生、政策制定者各自的意义。 | Gordon H Guyatt Andrew D Oxman Regina Kunz Yngve Falck-Ytter Gunn E Vist Alessandro Liberati Holger J Schünemann 谭培勇 陈耀龙 李幼平 | 2009 | 中国循证医学杂志2009，9，3： | 26 |
| 15 | High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients显示文摘AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 mo.Twenty-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before transplantation.Five patients received HIFU ablation as a bridging therapy.Another five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison.Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of cirrhosis.RESULTS:The HIFU group and TACE group showed no difference in terms of tumor size and tumor number.One patient in the HIFU group and no patient in the TACE group had gross ascites.The median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication occurred.In the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the treatment.In the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis.It may reduce the drop-out rate of liver transplant candidate. | Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai Ronnie TP Poon Chung Mau Lo | 2013 | World Journal of Gastroenterology2013，19，20： | 23 |
| 16 | 意见不一致时的策略:应用GRADE网格对临床实践指南达成共识显示文摘指南制定委员会的结构庞大和多元化使达成共识变得困难。Roman Jaeschke及其同事阐述了一种达成共识的简单方法,即当无法取得一致时,应用GRADE网格对临床实践指南达成共识。 | Roman Jaeschke Gordon H Guyatt Phil Dellinger Holger Schünemann Mitchell M Levy Regina Kunz Susan Norris Julian Bion 刘芳 陈耀龙 | 2009 | 中国循证医学杂志2009，9，7： | 22 |
| 17 | GRADE指南:Ⅸ.证据质量升级显示文摘证据质量升级的最常见原因是效应量大。当方法学严谨的观察性研究表明风险至少降低或增加2倍时,GRADE建议考虑将证据质量升高1级;当风险至少降低或增加5倍时,考虑将证据质量升高2级。当存在剂量-反应关系,或所有合理的混杂、偏倚会降低明显的治疗效应,或混杂、偏倚使得结果无效为假效应时,系统评价作者和指南制定者也可考虑升高证据质量。其他考虑因素包括起效迅速、潜在的疾病(状态)趋势以及间接证据。 | Gordon H.Guyatt Andrew D.Oxman Shahnaz Sultan Paul Glasziou Elie A.Akl Pablo Alonso-Coello David Atkins Regina Kunz Jan Brozek Victor Montori Roman Jaeschke David Rind Philipp Dahm Joerg Meerpohl Gunn Vist Elise Berliner Susan Norris Yngve Falck-Ytter M.Hassan Murad Holger J.Schünemann 代表GRADE工作组 李幼平 杨晓妍 李玲 王应强 | 2011 | 中国循证医学杂志2011，11，12： | 22 |
| 18 | 利用H_2O-Nacl-CaCl_2体系水盐化合物和冰的融化温度计算NaCl/(Nacl+CaCl_2)比值和盐度的方程显示文摘The composition of fluid inclusions in the H_2O-NaCl-CaCl_2 system has been generally graphically estimated using the melting temperatures of hydrohalite(T_(m-HH))and ice(T_(m-ice)).Here we present two equations that can be used to calculate the relative proportion of NaCl(i.e.,NaCl/[NaCl+CaCl_2],or X_(NaCl))and the total salinity( i.e.,NaC1 + CaC12,wt% )for fluid inclusions with ice as the last melting phase.X_(NaCl)can be calculated from T_(m-HH)using the following equation: y=(a+bx)^(-1/c) where y is X_(NaCl),x is T_(m-HH),a=0.33124402,b=-0.031518028,and c=0.22932736.In the cases where only T_(m-ice)is measured and T_(m-HH)is not known,T_(m-ice)can be used as the maximum possible TIn.nil to calculate the maximum value of X_(NaCl)using the above equation.In these cases,the following equation can be used to calculate the maximum total salinity: y=(a+bx+cx^2)^(-1) where y is salinity,x is T_(m-HH),a=0.057184817,b=0.00078565757,and c=5.7262766E-6.Because the isothems in the field of ice are sub-parallel to the NaCl-CaCl_2 binary side in the H20-NaC1-CaC12 ternary system,the errors in salinity calculation introduced by the above approximation are small(less than 2 wt% ).A Windows program for calculation of X_(NsCl)and salinity is available at: http://gffzz48c1abc75f37476dhqfn09ub9u5f9696o.ffgz.tsg.suse.edu.cn/~chiguox. | GuoXiang CHI~(1*) Pei NI~(2**) 1.Department of Geology,University of Regina,3737 Wascana Parkway,Regina,Saskatchewan,Canada S4S 0A2 2.State Key Laboratory for Mineral Deposit Research,Institute of Geo-fluid Research,Department of Earth Science,Nanjing University,Nanjing 210093,China | 2007 | 岩石学报2007，23，1： | 18 |
| 19 | Cetuximab plus FOLFOX6 or FOLFIRI in metastatic colorectal cancer: CECOG trial显示文摘AIM: To investigate efficacy and safety of cetuximab combined with two chemotherapy regimens in patients with unresectable metastatic colorectal cancer (mCRC). METHODS: Randomized patients received cetuximab with 5-fluorouracil (5-FU), folinic acid (FA) and oxaliplatin (FOLFOX) 6 (arm A, n = 74) or 5-FU, FA and irinotecan (FOLFIRI) (arm B, n = 77). KRAS mutation status was determined retrospectively in a subset of tumors (n = 117). RESULTS: No significant difference was found between treatment arms A and B in the progression-free survival (PFS) rate at 9 mo, 45% vs 34%; median PFS, 8.6 mo vs 8.3 mo [hazard ratio (HR) = 1.06]; overall response rate (ORR) 43% vs 45% [odds ratio (OR) = 0.93] and median overall survival (OS), 17.4 mo vs 18.9 mo (HR = 0.98). Patients with KRAS wild-type tumors demonstrated improved PFS (HR = 0.55, P = 0.0051), OS, (HR = 0.62, P = 0.0296) and ORR (53% vs 36%) and in arm A, improved PFS (HR = 0.49, P = 0.0196), OS (HR = 0.48, P = 0.0201) and ORR (56%vs 30%), compared with patients with KRAS mutated tumors. In arm B no significant differences were found in efficacy by KRAS mutation status. Treatment in arms A and B was generally well tolerated. CONCLUSION: This study confirms that combinations of cetuximab with FOLFOX6 or FOLFIRI are effective and significantly improve clinical outcome in KRAS wild-type compared with KRAS mutated mCRC. | Janja Ocvirk Thomas Brodowicz Fritz Wrba Tudor E Ciuleanu Galina Kurteva Semir Beslija Ivan Koza Zsuzsanna Pápai Diethelm Messinger Ugur Yilmaz Zsolt Faluhelyi Suayib Yalcin Demetris Papamichael Miklós Wenczl Zrinka Mrsic-Krmpotic Einat Shacham-Shmueli Damir Vrbanec Regina Esser Werner Scheithauer Christoph C Zie-linski | 2010 | World Journal of Gastroenterology2010，16，25： | 17 |
| 20 | Cirrhotic cardiomyopathy显示文摘During the course of cirrhosis, there is a progressive deterioration of cardiac function manifested by the disappearance of the hyperdynamic circulation due to afailure in heart function with decreased cardiac output. This is due to a deterioration in inotropic and chronotropic function which takes place in parallel with a diastolic dysfunction and cardiac hypertrophy in the absence of other known cardiac disease. Other findings of this specific cardiomyopathy include impaired contractile responsiveness to stress stimuli and electrophysiological abnormalities with prolonged QT interval. The pathogenic mechanisms of cirrhotic cardiomyopathy include impairment of the b-adrenergic receptor signalling, abnormal cardiomyocyte membrane lipid composition and biophysical properties, ion channel defects and overactivity of humoral cardiodepressant factors. Cirrhotic cardiomyopathy may be difficult to determine due to the lack of a specific diagnosis test. However, an echocardiogram allows the detection of the diastolic dysfunction and the E/e′ ratio may be used in the followup progression of the illness. Cirrhotic cardiomyopathy plays an important role in the pathogenesis of the impairment of effective arterial blood volume and correlates with the degree of liver failure. A clinical consequence of cardiac dysfunction is an inadequate cardiac response in the setting of vascular stress that may result in renal hypoperfusion leading to renal failure. The prognosis is difficult to establish but the severity of diastolic dysfunction may be a marker of mortality risk. Treatment is non-specific and liver transplantation may normalize the cardiac function. | Luís Ruíz-del-árbol Regina Serradilla | 2015 | World Journal of Gastroenterology2015，21，41： | 14 |
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