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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
2Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma.显示文摘Abrey LE Batchelor TT Ferreri A J Gospodarowicz M Pulczynski EJ Zucca E Smith JR Korfel A Soussain C DeAngelis LM Neuwelt EA O′Neill BP Thiel E Shenkier T Graus F van den Bent M Seymour JF Poortmans P Armitage JO Cavalli F 2005中国神经肿瘤杂志2005,3,3:53
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
4AGNP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
5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
6Hepatocellular carcinoma surveillance:An evidence-based approach显示文摘Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC detection.Further investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.Patrick S Harris Ross M Hansen Meagan E Gray Omar I Massoud Brendan M McGuire Mohamed G Shoreibah 2019World Journal of Gastroenterology2019,25,13:31
7突发性聋治疗的国际共识显示文摘突发性聋是耳鼻咽喉科常见急症,目前该病的治疗仍存在许多问题。虽然已有很多关于突发性聋的meta分析和治疗指南问世,其治疗方案(包括治疗药物、治疗时程和给药途径)仍未形成标准。本文对突发性聋治疗的临床研究提出方法学建议,这些建议基于2017年法国巴黎国际耳鼻喉科学联合会(International Federation of Oto-rhino-laryng ological Societies,IFOS)大会中与会专家目前使用的主要治疗方案的临床证据等级。突发性聋研究中存在的主要问题是疾病的异质性,即患者初始听力损失程度及治疗后的听力恢复程度均有很大差异。全身应用糖皮质激素治疗突发性聋的有效性,其证据水平并未达到推荐使用的程度,但仍是突发性聋的主要治疗方法,可作为目前的标准方案,为减少受试者数量,建议将纳入标准限制为中度到极重度的听力损失。鼓室内糖皮质激素治疗作为挽救性治疗在几个小样本研究中被提及,需要大规模的随机对照试验加以证实。李姝娜 李越 杨军 Marx M Younes E Chandrasekhar SS 2018听力学及言语疾病杂志2018,26,4:25
8Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: Results of a multicent显示文摘AIM: Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-nuclear associated anti-neutrophil antibodies (NANA) and antibodies to exocrine pancreas (PAB), are serological tools for discriminating Crohn’s disease (CrD) and ulcerative colitis (UC). Like CrD, coeliac disease (CoD) is an inflammatory bowel disease (IBD) associated with (auto) antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS: Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence (IIF). RESULTS: ASCA+/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION: ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.S Desplat-Jégo C Johanet A Escande J Goetz N Fabien N Olsson E Ballot J Sarles JJ Baudon JC Grimaud M Veyrac P Chamouard RL Humbel 2007World Journal of Gastroenterology2007,13,16:24
9Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases显示文摘AIM: To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation (RBL) method. METHODS: A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to September, 2006, data was retrieved from archived fi les. RBL was performed using the Mc Gown applicator on an outpatient basis. The patients were asked to return to out-patient clinic for follow up at 2 wk, 1 mo, 6 mo and through telephone call every 6 mo for 2 years). RESULTS: After RBL, 696 patients (92.8%) were cured with no difference in outcome for second or third degree hemorrhoids (P = 0.31). Symptomatic recurrence was detected in 11.04% after 2 years. A total of 52 patients (6.93%) had 77 complications from RBL which required no hospitalization. Complications were pain, rectal bleeding and vaso-vagal symptoms(4.13%, 4.13% and 1.33% of patients, respectively). At 1 mo there were a significant improvement in mean SF-36 scores over baseline in five items, while after 2 years there were improvement in all items over baseline, but not significant. No significant manometeric changes after band ligation. CONCLUSION: RBL is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an out patient procedure with signifi cant improvement in quality of life. RBL doesn't alter ano-rectal functions.Ayman M El Nakeeb Amir A Fikry Waleed H Omar Elyamani M Fouda Tito A El Metwally Hosam E Ghazy Sabry A Badr Mohmed Y Abu Elkhar Salih M Elawady Hisham H Abd Elmoniam Waiel W Khafagy Mosaad M Morshed Ramadan E El Lithy Mohamed E Farid 2008World Journal of Gastroenterology2008,14,42:24
10美国国立老化研究所与阿尔茨海默病协会诊断指南写作组:阿尔茨海默病临床前阶段的定义显示文摘阿尔茨海默病(AD)的病理生理过程在痴呆诊断的多年前就开始了。这一长期的AD“临床前”阶段是治疗干预的关键机会,但需进一步阐明AD的病理级联过程和临床症状出现之间的联系。美国国立老化研究所和AD协会召集了一个国际工作组对AD生物标志物、流行病学和神经心理学的证据进行综述并提出建议,以确定能够预测由“正常”认知到轻度认知功能障碍(MCI)及AD痴呆的最佳预测指标。根据目前已有的主要科学证据,我们提出了一个概念性的框架和用于操作的研究标准,以通过纵向临床研究来验证和改进这些模型。这些建议仅用于研究目的,目前不涉及临床应用。我们希望这些建议能提供一个共识,以推进临床前AD的研究,最终推动更早期治疗干预的进展,使得一些疾病减缓药物的疗效发挥最大。Sperling RA Aisen PS Beckett LA Bennett DA Craft S Fagan AM Iwatsubo T Jack CR Jr Kaye J Montine TJ Park DC Reiman EM Rowe CC Siemers E Stern Y Yaffe K Carrillo MC Thies B Morrison-Bogorad M Wagster MV Phelps CH 贾建平(译) 郭起浩(译) 黄丽(译) 陆璐(译) 张逸驰(译) 邢怡(译) 2012中华神经科杂志2012,45,5:22
11珠江、流溪河大型底栖动物分布和氮磷因子的相关分析显示文摘采用Anova、多重比较并t检验的方法来比较氮、磷因子和大型底栖动物在 3个河段 (流溪河、珠江西航道及前航道 )的显著性差异分布及它们之间的相关。结果显示 ,主要污染物均为NH+4 -N ,均高出国家地表水水质V级标准。前航道NO-3 -N和NO-2 -N含量最低 ,硝化作用和河流自净作用大大地降低。PO3-4 -P也是前航道、西航道的污染因子。NH+4 -N和PO3-4 -P不是生物分布的限制因子 ,底栖动物计数和河流底层的NO-3-N ,NO-2 -N呈显著负相关关系。必须进行氮和磷的污染控制及治理 ,才可能提高河流底栖动物多样性 ,提高生态环境质量。刘玉 VERMAAT J E RUYTER E D de KRUIJF H A M de 2003中山大学学报(自然科学版)2003,42,1:22
12脑缺氧是影响严重颅脑创伤患者短期预后的独立危险因素(英文)显示文摘Background:Brain hypoxia(BH)can aggravate outcome after severe traumatic brain injury(TBI).Whether BH or reduced brain oxygen(Pbto2)is an independent outcome predictor or a marker of disease severity is not fully elucidated.Objective To analyze the relationship between Pbto2,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)and to examine whether BH correlates with worse outcome independently of ICP and CPP.Methods We studied103patientsOddo M Levine JM Mackenzie L Frangos S Feihl F Kasner SE Katsnelson M Pukenas B Macmurtrie E Maloney-Wilensky E Kofke WA Leroux PD 2011中华神经外科疾病研究杂志2011,10,5:21
13Veno occlusive disease: Update on clinical management显示文摘Hepatic veno-occlusive disease is a clinical syndrome characterized by hepatomegaly, ascites, weight gain and jaundice, due to sinusoidal congestion which can be caused by alkaloid ingestion, but the most frequent cause is haematopoietic stem cell transplantation (STC) and is also seen after solid organ transplantation. The incidence of veno occlusive disease (VOD) after STC ranges from 0 to 70%, but is decreasing. Survival is good when VOD is a mild form, but when it is severe and associated with an increase of hepatic venous pressure gradient > 20 mmHg, and mortality is about 90%. Prevention remains the best therapeutic strategy, by using non-myeloablative conditioning regimens before STC. Prophylactic administration of ursodeoxycholic acid, being an antioxidant and antiapoptotic agent, can have some benefit in reducing overall mortality. Defibrotide, which has pro-fibrinolytic and antithrombotic properties, is the most effective therapy; decompression of the sinusoids by a transjugular intrahepatic portosystemic shunt (TIPS) can be tried, especially to treat VOD after liver transplantation and when multiorgan failure (MOF) is not present. Liver transplantation can be the last option, but can not be considered a standard rescue therapy, because usually the concomitant presence of multiorgan failure contraindicates this procedure.M Senzolo G Germani E Cholongitas P Burra AK Burroughs 2007World Journal of Gastroenterology2007,13,29:19
14恶性外周神经鞘膜瘤和细胞性神经鞘瘤的形态学和免疫表型特征显示文摘细胞性神经鞘瘤较为少见,是一种公认的良性外周神经鞘膜肿瘤,可被误诊为恶性外周神经鞘膜瘤。为制定一个细胞性神经鞘瘤诊断共识标准,作者回顾性分析来自两家医学机构的115例恶性外周神经鞘膜瘤和26例细胞性神经鞘瘤的临床病理学特征。Pekmezci M Reuss D E Hirbe A C 李晓玲 王行富 2015临床与实验病理学杂志2015,31,4:19
15Treatment of meniscal tears: An evidence based approach显示文摘Treatment options for meniscal tears fall into three broad categories;non-operative,meniscectomy or meniscal repair.Selecting the most appropriate treatment for a given patient involves both patient factors(e.g.,age,co-morbidities and compliance)and tear characteristics(e.g.,location of tear/age/reducibility of tear).There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first line.Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically.Partial meniscectomy is suitable for symptomatic tears not amenable to repair,and can still preserve meniscal function especially when the peripheral meniscal rim is intact.Meniscal repair shows 80%success at 2 years and is more suitable in younger patients with reducible tears that are peripheral(e.g.,nearer the capsular attachment)and horizontal or longitudinal in nature.However,careful patient selection and repair technique is required with good compliance to post-operative rehabilitation,which often consists of bracing and non-weight bearing for 4-6 wk.Simon C Mordecai Nawfal Al-Hadithy Howard E Ware Chinmay M Gupte 2014World Journal of Orthopedics2014,5,3:18
16Evaluation 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
17Whole brain radiotherapy for the treatment of multiple brain metastases显示文摘Tsao M Lloyd N Wong R Chow E Rakovitch E Laperriere N 2006中国神经肿瘤杂志2006,4,2:17
18IDH突变的弥漫性和间变性星形细胞瘤具有相同的发病年龄和极小的生存期差异:一个WHO分级的问题显示文摘WHO(2007)中枢神经系统肿瘤分类中列出WHOⅡ级的弥漫性星形细胞瘤(A Ⅱ WHO 2007)和WHOⅢ级的间变性星形细胞瘤( AA Ⅲ WHO 2007)之间的区别。 A Ⅱ WHO (2007)的患者与AA Ⅲ WHO (2007)的患者相比显著年轻、生存期明显较长。迄今为主,分级和分类仅仅依靠形态学而未考虑IDH这一预后相关分子标记的状态。作者发现,对于IDH突变的星形细胞瘤而言,WHO(2007)的分级系统对预后的提示意义较差。检测来自3个独立的病例系列共1360例成人弥漫性星形细胞肿瘤的年龄分布和生存时间,其中包括683例Ⅱ级IDH突变型星形细胞瘤( A Ⅱ IDHmut)、562例IDH突变型的间变性星形细胞瘤( AA Ⅲ IDHmut)和115例IDH 突变的胶质母细胞瘤( GBM IDHmut )。 A ⅡIDHmut和 AA Ⅲ IDHmut的患者显示具有相同的发病年龄(36~37岁),而两级别之间的生存时间差异小于 WHO (2007)的报道(A Ⅱ IDHmut 中位生存时间为10.9年,AAⅢIDHmut为9.3年)。作者分析提示AⅡWHO2007与AAⅢ WHO2007年龄分布和生存时间的差异主要取决于 IDH非突变型肿瘤所占的比例。这些数据结果对目前实行的星形细胞瘤分级和危险分层提出了重大挑战,并可能对 IDH突变型星形细胞瘤的治疗管理产生深远的影响。David E Yasin M Daniel S 李晓玲 王行富 2015临床与实验病理学杂志2015,31,7:17
19电感耦合等离子体质谱分析通古斯大爆炸地区沉积物中超痕量铂族元素显示文摘建立了一个用酸 (HF、HCl、HNO3、HClO4)溶解通古斯地区沉积物样品 ,以Re为内标元素 ,用电感耦合等离子体质谱 (ICP -MS)测定其中铂族元素的分析方法。方法检出限为0 .0 0 1~ 0 .0 6μg/L ,回收率大于 85%。用该方法分析了 9个取自通古斯地区的沉积物样品 ,发现了Ru、Rh、Pd、Ir。谢烈文 侯泉林 阎欣 王秀丽 Kolesnikov E M 2001岩矿测试2001,20,2:16
20Short and long term prognosis in perinatal asphyxia: An update显示文摘Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy(NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy(HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. Outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and longterm outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing novel markers.Caroline E Ahearne Geraldine B Boylan Deirdre M Murray 2016World Journal of Clinical Pediatrics2016,5,1:16
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