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| 1 | 急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议(英文)显示文摘The objective of this guideline is to outline the role of magnetic resonance imaging(MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury(SCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI.This review focused on longitudinal studies that controlled for baseline neurologic status.A multidisciplinary Guideline Development Group(GDG) used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for SCI patients.Based on GRADE(Grading of Recommendation,Assessment,Development and Evaluation),a strong recommendation is worded as ' we recommend,' whereas a weaker recommendation is indicated by 'we suggest.' Results Based on the limited available evidence and the clinical expertise of the GDG,our recommendations were:(1) 'We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention,when feasible,to facilitate improved clinical decision-making'(quality of evidence,very low) and(2) 'We suggest that MRI should be performed in adult patients in the acute period following SCI,before or after surgical intervention,to improve prediction of neurologic outcome '(quality of evidence,low).Conclusions These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI. | Fehlings MG Martin AR Tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns AS Chiba K Dettori JR Furlan JC Hawryluk G Holly LT Howley S Jeji T Kalsi-Ryan S Kotter M Kurpad S Kwon BK Marino RJ Massicotte E Merli G Middleton JW Nakashima H Nagoshi N Palmieri K Singh A Skelly AC Tsai EC Vaccaro A Wilson JR Yee A Harrop JS | 2017 | 中华神经外科疾病研究杂志2017,16,6: | 8 |
| 2 | Endoscopic retrograde cholangiography for pediatric choledocholithiasis: Assessing the need for endoscopic intervention显示文摘AIM:To assess pediatric patients for choledocholithiasis.We applied current adult guidelines to identify predictivefactors in children.METHODS:A single-center retrospective analysis was performed at a tertiary children's hospital.We evaluated 44 consecutive pediatric patients who underwent endoscopic retrograde cholangiography(ERCP) for suspected choledocholithiasis.Patients were stratified into those with common bile duct stones(CBDS) at ERCP vs those that did not using the American Society of Gastrointestinal Endoscopy(ASGE) guidelines(Very Strong and Strong criteria) for suspected CBDS.RESULTS:CBDS were identified in 84% at the time of ERCP.Abdominal ultrasound identified CBDS in 36% of patients.Conjugated bilirubin ≥ 0.5 mg/d L was an independent risk factor for CBDS(P = 0.003).The Very Strong(59.5%) and Strong(48.6%) ASGE criteria identified the majority of patients(P = 0.0001).A modified score using conjugated bilirubin had a higher sensitivity(81.2% vs 59.5%) and more likely to identify a stone than the standard criteria,odds ratio of 25.7 compared to 8.8.Alanine aminotransferase and gamma-glutamyl transferase values identified significant differences in a subset of patients with odds ratio of 4.1 and 3.25,respectively.CONCLUSION:Current adult guidelines identified the majority of pediatric patients with CBDS,but specific pediatric guidelines may improve detection,thus decreasing risks and unnecessary procedures. | Douglas S Fishman Bruno P Chumpitazi Isaac Raijman Cynthia Man-Wai Tsai E O’Brian Smith Mark V Mazziotti Mark A Gilger | 2016 | World Journal of Gastrointestinal Endoscopy2016,8,11: | 6 |
| 3 | 玉米DDGS饲粮添加木聚糖酶或β-葡聚糖酶对保育猪生产性能和养分利用率的影响显示文摘本试验开展保育猪玉米DDGS饲粮添加木聚糖酶和β-葡聚糖酶对生产性能和养分消化的影响研究。135只(起始体重7.2±0.2kg)保育猪随机分成5个处理组,每个处理组6个重复,每个重复4~5只,分别为正对照组(PC,玉米/豆粕+0%玉米DDGS)、负对照组(NC,以30%玉米DDGS替代部分玉米和豆粕,不添加酶制剂)、在负对照组基础上分别添加4000 U/kg木聚糖酶(XYL)、450 U/kgβ-葡聚糖酶(BGL)或4000 U/kg木聚糖酶+450 U/kgβ-葡聚糖酶(XB)的3个酶制剂组。试猪统一饲喂玉米豆粕型饲粮1周(阶段一)后过渡到试验饲粮,试验饲粮分两阶段(阶段二:7-21天和阶段三:21-35天),试验饲粮配制以总赖氨酸含量一致为基础,营养水平达到或超过NRC(1998),为了突出纤维降解酶的作用效果,阶段二与阶段三NC、XYL、BGL和XB四组试验饲粮的代谢能比PC组分别降低3.0%和4.7%。试验发现,NC组试猪生长速度显著低于PC组(P<0.001)。阶段三,BGL组与XB组试猪日增重比NC组分别提高7.7%和9.3%(P<0.001);试验全期,XB组试猪比NC猪日增重提高6.6%(P<0.001)。XYL与XB组干物质消化率比NC组分别提高1.6%和1.4%(P<0.001),添加酶制剂组能量消化率比NC组提高5.5%(P<0.001),同时,与NC组比较,酶制剂组饲粮粗蛋白质消化率提高5.9%,差异极显著(P<0.001)。XYL、BGL和XB三组与NC组相比,饲粮中性洗涤纤维、酸性洗涤纤维及半纤维素消化率分别提高33%、30%与34%(P<0.02)。同时,酶制剂添加组饲粮P消化率比NC组提高46%(P<0.01)。结果表明,玉米DDGS饲粮联合添加木聚糖酶和β-葡聚糖酶可以提高保育猪日增重,且β-葡聚糖酶起主导作用。虽然木聚糖酶和β-葡聚糖酶对保育猪日均采食量与增重耗料比没有影响,但至少部分降低了玉米DDGS对饲粮养分利用率及生产的负面影响。 | 陈芳 Tsai T Dove C R Cline P M | 2017 | 广东饲料2017,26,4: | 4 |
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