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| 1 | 前庭性偏头痛:诊断标准——Barany学会及国际头痛学会共识文件显示文摘本文提供了前庭性偏头痛的诊断标准,由Barany学会前庭疾患分类委员会及国际头痛学会(IHS)偏头痛分类分委员会共同制定。分类包括前庭性偏头痛及很可能的前庭性偏头痛。与IHS的常规程序相同,前庭性偏头痛作为一种新分类,将首先出现在第3版国际头痛分类(ICHD-3)的附录中。若积累了进一步的证据,很可能的前庭性偏头痛也许会纳入更晚的ICHD版本中。前庭性偏头痛的诊断建立在反复发作的前庭症状、具有偏头痛病史、前庭症状与偏头痛症状间存在时间上的相关性,并排除其他可导致前庭症状的病因。符合前庭性偏头痛诊断的症状包括不同类型的眩晕及头部活动诱发的头晕伴恶心。症状的严重程度必须为中重度。急性发作的持续时间限于5 min^72 h的时间窗内。 | 华驾略 李焰生 Lempert T Olesen J Furman J Waterston J Seemungal B Carey J Bisdorff A Versino M Evers S Newman-Toker D | 2013 | 神经病学与神经康复学杂志2013,10,3: | 60 |
| 2 | Expression of the B7 - related molecule B7 - H1 by glioma cells: a potential mechanism of immune paralysis显示文摘Human glioblastoma is a highly lethal tumor that is known for its immune inhibitory capabilities.B7-homologue l(B7-H 1),a recently identified homologue of B7.1/2(CD80/86),has been described to exert costimulatoryand immune regulatory functions.We investigated the expression and the functional activity of B7-H 1 in humanglioma cells in vitro and in vivo.Although lacking B7.1/2(CD80/86),all 12 glioma cel1 1ines constitutivelyexpressed B7-H1 mRNA and protein.Exposure to IFN-gamma strongly enhanced B7-H 1 expression.Im- | Wintterle S Schreiner B Mitsdoerffer M Schneider D Chen Meyermann R Weller M Wiendl H | 2003 | 中国神经肿瘤杂志2003,1,4: | 37 |
| 3 | AGNP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 |
| 4 | Measurement of circulating levels of VEGF-A,-C,and -D and their receptors,VEGFR-1 and -2 in gastric adenocarcinoma显示文摘AIM: To analyze the serum levels and prognostic significance of vascular endothelial growth factor (VEGF) -A,-C,and -D,and their receptors,VEGFR-1 and -2 in gastric adenocarcinomas. METHODS: The serum levels of VEGF family members were measured in 76 control subjects and 76 patients with gastric adenocarcinoma using an enzyme-linked immunosorbent assay (ELISA). These measurements were correlated with clinco-pathological features and survival rates. RESULTS: The serum levels of VEGF-A and its receptor,VEGFR-1,were signifi cantly higher in patients with gastric cancer than in healthy donors (t = 2.3,P = 0.02 and t = 4.2,P < 0.0001,respectively). In contrast,the serum levels of VEGF-D were signif icantly higher in control subjects than in patients (t = 2.9,P = 0.004). There was no significant difference in serum levels of VEGF-C and VEGFR-2 between patients and controls. VEGF-C was associated with advanced tumor stage and presence of metastasis. VEGFR-1 was associated with metastasis,advanced overall stage,tumor differentiation and survival. VEGFR-2 levels were associated with poor tumor differentiation. There was no significant prognostic value for any of the VEGF family members or their receptors except for VEGFR-1 where high levels were associated with a poor overall survival. CONCLUSION: Serum VEGF levels vary significantly in the same cohort of patients with variable clinico-pathological features and prognostic values. The simultaneous measurement of VEGF receptors levels in sera may overcome the limitations of a single biomarker assay. | Mansour S Al-Moundhri A Al-Shukaili M Al-Nabhani B Al-Bahrani IA Burney A Rizivi SS Ganguly | 2008 | World Journal of Gastroenterology2008,14,24: | 32 |
| 5 | 帕博利珠单抗治疗伴脑转移NSCLC患者的一项非随机、开放Ⅱ期试验的长期随访结果和生物标志物分析显示文摘背景与目的我们开展了一项帕博利珠单抗用于伴未治疗脑转移的非小细胞肺癌(non-small cell lung cancer,NSCLC)或黑色素瘤患者的疗效和安全性的II期试验,旨在评估程序性死亡受体1(programmed cell death 1,PD-1)抑制剂在中枢神经系统(central nervous system,CNS)中的疗效。中期结果已发表,现报道对NSCLC队列的更新分析结果。方法这是一项开放性、单中心、II期试验。纳入标准:年龄≥18岁,诊断为晚期NSCLC并伴有≥1个5 mm-20 mm脑转移病灶,既往从未治疗或之前放疗后进展,无神经系统症状,不需要激素治疗且美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)<2分。患者每2周接受一次帕博利珠单抗(10 mg/kg)治疗。队列1为程序性死亡配体1(programmed cell death ligand 1,PD-L1)≥1%的患者,队列2为PD-L1<1%或未评估的患者。主要终点是脑转移患者缓解比例。所有经治患者均纳入疗效与安全性终点的分析。该研究已结束入组,并于Clinicaltrials.gov登记注册,注册号为NCT02085070。结果2014年3月31日-2018年5月21日,共42例患者接受治疗。中位随访时间为8.3个月(IQR:4.5个月-26.2个月)。队列1的37例患者中11例有脑转移缓解[29.7%(95%CI:15.9%-47.0%)]。队列2未观察到缓解。治疗相关的3级-4级不良事件(adverse events,AEs)包括2例肺炎、1例全身症状、1例结肠炎、1例肾上腺皮质功能不全、1例高血糖症和1例低钾血症。6例(14%)患者发生了治疗相关的严重不良事件,包括肺炎、急性肾损伤、低钾血症和肾上腺皮质功能不全。没有观察到治疗相关死亡病例。结论帕博利珠单抗治疗PD-L1≥1%的NSCLC伴脑转移患者有效,且对所有纳入的未经治疗的脑转移患者安全。需要进一步探索免疫治疗用于NSCLC合并CNS转移。 | Sarah B GOLDBERG Kurt A SCHALPER Scott N GETTINGER Amit MAHAJAN Roy S HERBST Anne C CHANG Rogerio LILENBAUM Frederick H WILSON Sacit Bulent OMAY James B YU Lucia JILAVEANU Thuy TRAN Kira PAVLIK Elin ROWEN Heather GERRSH Annette KOMLO Richa GUPTA Hailey WYATT Matthew RIBEIRO Yuval KLUGER Geyu ZHOU Wei WEI Veronica L CHANG Harriet M KLUGER 董晓荣(翻译/校对) | 2021 | 中国肺癌杂志2021,24,9: | 34 |
| 6 | 最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。 | 陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL | 2014 | 神经病学与神经康复学杂志2014,11,3: | 31 |
| 7 | 青藏东北缘早第三纪盆地充填的沉积型式及构造背景——以囊谦和下拉秀盆地为例显示文摘一系列中小型早第三纪红色盆地出露于青藏高原的东北缘 ,它们是在印度—欧亚板块碰撞过程中因陆壳变形和高原隆升产生的。典型早第三纪盆地的地质填图和详细的沉积学研究 ,及构造、沉积和岩浆热事件的综合分析表明 ,这些盆地具有两阶段构造—沉积特征 ,即早期受控于逆冲挤压背景 ,盆地接受底部冲积扇体系的粗碎屑岩段沉积 ,局部伴有岩浆活动 ;晚期受控于走滑—拉分背景 ,盆地充填湖泊—三角洲体系的含膏砂泥岩段夹薄层灰岩 ,并伴有广泛的岩浆作用。青藏东北缘早第三纪盆地在盆地构造格架、沉积层序结构、沉积物组成和岩浆活动等方面均存在明显的阶段性演化。盆地古水流统计和岩浆岩4 0 Ar/ 3 9Ar定年结果表明 ,青藏东北缘早第三纪盆地沉积物主要形成于始新世晚期—渐新世早期 (38~ 2 9Ma)。盆地沉积型式和岩浆活动受印度—欧亚板块碰撞早期逆冲挤压和走滑—拉分构造格局的控制。 | 周江羽 王江海 尹安 Spurlin M S Horton B K | 2002 | 沉积学报2002,20,1: | 30 |
| 8 | 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 |
| 9 | 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 studied103patients | Oddo 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 |
| 10 | 纳秒、皮秒和飞秒激光脉冲对材料表面的改性(英文)显示文摘对基体材料镉镍铁合金600和多层TiAlN/TiN涂层的激光表面改性在基础研究和实际应用中有着很好的前景。本文观察了由超短脉冲(fs和ns)和短脉冲(ns)激光器引起的镉镍铁合金600和TiAlN/TiN镀层的表面变化。结果显示,3种激光都能使靶面发生形态改变,超短脉冲的破坏轮廓更为清晰。与ps激光脉冲相比,fs激光脉冲能产生更严重的破坏。与产生半球体形状的ps激光束相反,fs激光脉冲产生的破坏斑是圆锥形的。另外,ns脉冲辐照时热效应占支配地位,且所有的辐照都伴随着等离子体。 | TRTICAM S GAKOVIC B M RADAK B B BATANI D TARASENKO V F PETROVIC S STASIC J MILOVANOVIC D KRMPOT A JELENKOVIC B | 2011 | 光学精密工程2011,19,2: | 18 |
| 11 | Probiotic effects on intestinal fermentation patterns in patients with irritable bowel syndrome显示文摘AIM: To determine whether Lactobacillus casei strain Shirota (Yakult ) can alter small intestinal bacterial overgrowth (SIBO), as tested by the lactulose breath test, and whether this is associated with changes in symptoms in irritable bowel syndrome (IBS). METHODS: 18 patients with IBS (Rome Ⅱ criteria), who showed an early rise in breath hydrogen with lactulose (ERBHAL), consumed 65 mL of Yakult daily for 6 wk. Lactulose breath test was repeated at the end of the treatment period. Symptoms were recorded daily using a 10 cm visual analogue scale. RESULTS: 14 patients completed the study, 9 (64%) had reversal of ERBHAL, with the median time of f irst rise in breath hydrogen increasing from 45 to 75 min (P = 0.03). There was no signifi cant improvement in the symptom score with probiotic therapy, except for wind (P=0.04). Patients commencing with at least moderate symptoms and who no longer had ERBHAL at the end of treatment, showed improvement in the overall symptoms scores [median fi nal score 5.3 (IQR3.9-5.9), 55% reduction; n=6] to a greater extent than those who had had persisting ERBHAL [final score 6.9 (5.0-7.0), 12% reduction; n = 5; P = 0.18]. CONCLUSION: Yakult is effective in altering fermentation patterns in the small bowel, consistent with reducing SIBO. The loss of ERBHAL was associated with reduced symptoms. The true interpretation of these fi ndings awaits a randomised, controlled trial. | Jacqueline S Barrett Kim EK Canale Richard B Gearry Peter M Irving Peter R Gibson | 2008 | World Journal of Gastroenterology2008,14,32: | 16 |
| 12 | 高危患者目标血压与心血管病预后显示文摘指南推荐血压目标值应〈140/90 mmHg(1mmHg=0.133kPa)以减少心血管事件的发生。但与其他心血管病预后(如冠状动脉事件)相比,包括脑卒中及心力衰竭在内的心血管病预后与收缩压下降关系更密切。一些心血管事件(如冠状动脉事件)风险在收缩压低时亦增高,风险-收缩压关系呈J形曲线,而脑卒中与血压不是J形曲线关系。 | B?hm M Schumacher H Teo KK Lonn EM Mahfoud F Mann JF Mancia G Redon J Schmieder RE Sliwa K Weber MA Williams BYusuf S 曲浥晨 叶鹏 | 2017 | 中华高血压杂志2017,25,6: | 14 |
| 13 | Prognostic value of increased carbohydrate antigen in patients with heart failure显示文摘AIM:To study the prognostic value of carbohydrateantigen 125(CA125) and whether it adds prognostic information to N-terminal pro-brain natriuretic peptide(NT-proBNP) in stable heart failure(HF) patients.METHODS:The predictive value of CA125 was retrospectively assessed in 156 patients with stable HF remitted to the outpatient HF unit for monitoring from 2009 to 2011.Patients were included in the study if they had a previous documented episode of HF and received HF treatment.CA125 and NT-proBNP concentrations were measured.The independent association between NT-proBNP or CA125 and mortality was assessed with Cox regression analysis,and their combined predictive ability was tested by the integrated discrimination improvement(IDI) index.RESULTS:The mean age of the 156 patients was 72 ± 12 years.During follow-up(17 ± 8 mo),27 patients died,1 received an urgent heart transplantation and 106 required hospitalization for HF.Higher CA125 values were correlated with outcomes:58 ± 85 KU/L if hospitalized vs 34 ± 61 KU/L if not(P < 0.05),and 94 ± 121 KU/L in those who died or needed urgent heart transplantation vs 45 ± 78 KU/L in survivors(P < 0.01).After adjusting for propensity scores,the highest risk was observed when both biomarkers were elevated vs not elevated(HR = 8.95,95%CI:3.11-25.73; P < 0.001) and intermediate when only NT-proBNP was elevated vs not elevated(HR = 4.15,95%CI:1.41-12.24; P < 0.01).Moreover,when CA125 was added to the clinical model with NT-proBNP,a 4%(P < 0.05) improvement in the IDI was found.CONCLUSION:CA125 > 60 KU/L identified patients in stable HF with poor survival.Circulating CA125 level adds prognostic value to NT-proBNP level in predicting HF outcomes. | Ana B Méndez Jordi Ordonez-Llanos Andreu Ferrero Mariana Noguero Teresa Mir Josefina Mora Antoni Bayes-Genis Sònia Mirabet Juan Cinca Eulàlia Roig | 2014 | World Journal of Cardiology2014,6,4: | 13 |
| 14 | 滋养细胞组织 GATA-3表达:445例免疫组化及其诊断应用分析显示文摘GATA-3主要表达在乳腺癌和尿路上皮癌,而在正常或病变滋养细胞组织中的表达报道甚少。作者选取445例正常/病变滋养细胞组织及其肿瘤进行 GATA-3免疫组化评估,根据着色强弱标记为(-~-),探讨GATA-3在下列组织中的表达意义。这些组织包括孕囊/中晚期妊娠胎盘/异位妊娠、葡萄胎、胎盘结节、正常/异常植入部位、绒毛膜癌、上皮样滋养细胞肿瘤、胎盘滋养细胞肿瘤、非典型平滑肌瘤(含平滑肌肉瘤)、子宫颈和肺的鳞状细胞癌。 | Natalie B Allen M G Ie-Ming S 许文静 余英豪 | 2015 | 临床与实验病理学杂志2015,31,9: | 11 |
| 15 | Polymorphisms of MTHFD,plasma homocysteine levels, and risk of gastric cancer in ahigh-risk Chinese population显示文摘Purpose:Accumulative evidence suggests that folate has a protective effect on gastric cancer. The methylenetetrahyd-rofolate dlehydrogenase(MTHFD) plays an important role in folate and homocysteine metabolisms, and polymorphisms of MTHFD may result in disturbance of the folate-mediated homocysteine pathway. The aim of this study is to test the hypothesis that genetic variants of MTHFD and plasma homocysteine levels are associated with risk of gastric cancer and modulated by genotypes of methylenetetrahydrofolate reductase(MTHFR). Experimental Design: We genotyped G1958A and T401C in MTHFD and C677T in MTHFR and detected total plasma homocysteine(tHcy) levels in a case-control study of 589 gastric cancer cases and 635 cancer-free controls in a high-risk Chinese population. Results:The variant genotypes of MTHFD 1958AA and 401CC were associated with a significantly increased risk of gastric canceradjusted odds ratio(OR), 2.05; 95% confidence interval(95% CI),1.34-3.13 for 1958AA; adjusted OR,1.43; 95% CI,1.14-1.80 for 401CC compared with 1958GG/GA and 401TT/TC genotypes, respectively. Both of the effects were more evident in the subjects carrying MTHFR 677CT/TT genotypes. The average tHcy level was significantly higher in gastric cancer cases than in controls(P < 0.01), and the upper quartile of tHcy (> 13.6 mu mol/L) was associated with an 82% significantly increased risk of gastric cancer, compared with the lowest quartile of tHcy(<= 8.0 pmol/L;adjusted OR,1.82; 95% CI,1.20-2.75). Conclusions:The strong associations between MTHFD variants and the plasma tHcy levels and gastric cancer risk suggest, for the first time, a possible gene-environment interaction between genetic variants of folate-metabolizing genes and high tHcy levels in gastric carcinogenesis. | Wang, L. N Ke, Q Chen, W. S Wang, J. M Tan, Y. F Zhou, Y Hua, Z. L Ding, W. L Niu, J. Y Shen, J Zhang, Z. F Wang, X. R Xu, Y. H Shen, H. B Yi Xing | 2007 | 南京医科大学学报(自然科学版)2007,27,7: | 10 |
| 16 | Significant association between ABO blood group and pancreatic cancer显示文摘AIM:To evaluate whether the ABO blood group is related to pancreatic cancer risk in the general population of the United States.METHODS:Using the University of Pittsburgh's clinicalpancreatic cancer registry,the blood donor database from our local blood bank (Central Blood Bank),and the blood product recipient database from the regional transfusion service (Centralized Transfusion Service) in Pittsburgh,Pennsylvania,we identified 274 pancreatic cancer patients with previously determined serological ABO blood group information.The ABO blood group frequency was compared between these patients and 708842 individual,community-based blood donors who had made donations to Pittsburgh's Central Blood Bank between 1979 and 2009.RESULTS:The frequency of blood group A was statistically significantly higher amongst pancreatic cancer patients compared to its frequency amongst the regional blood donors [47.63% vs 39.10%,odds ratio (OR)=1.43,P=0.004].Conversely,the frequency of blood group O was significantly lower amongst pancreatic cancer patients relative to the community blood donors (32.12% vs 43.99%,OR=0.60,P=0.00007).There were limited blood group B (n=38) and AB (n=17) pancreatic cancer patients;the overall P trend value comparing patient to donor blood groups was 0.001.CONCLUSION:The ABO blood group is associated with pancreatic cancer risk.Future studies should examine the mechanism linking pancreatic cancer risk to ABO blood group. | Julia B Greer Mark H Yazer Jay S Raval M Michael Barmada Randall E Brand David C Whitcomb | 2010 | World Journal of Gastroenterology2010,16,44: | 10 |
| 17 | 脑卒中后个体化指导的有效性和安全性显示文摘防止脑卒中后长期功能衰退的干预措施是否安全有效,目前还缺乏相关证据。该研究是一项多中心、单盲、随机对照试验,目的是评估一项个体化身体活动和锻炼指导的有效性和安全性。纳入年龄≥18岁、在社区居住的、首发或复发性脑卒中后10~16周、改良Rankin量表评分〈5分且无严重合并症的成年脑卒中患者,随机分为对照组和干预组。干预组每个月定期接受身体活动和锻炼的个体化指导,连续18个月。对照组则接受标准治疗。 | 叶超毅 叶鹏 Askim T Langhammer B Ihle-Hansen H Gunnes M Lydersen S Indredavik B | 2018 | 中华高血压杂志2018,26,1: | 10 |
| 18 | Mycophenolate mofetil for drug-induced vanishing bile duct syndrome显示文摘Amoxicillin/clavulanate is associated with liver injury, mostly of a cholestatic pattern. While outcomes are usually benign, progression to cirrhosis and death has been reported. The role of immunosuppressive therapy for patients with a protracted course is unclear. We report the case of an elderly patient who developed prolonged cholestasis secondary to amoxicillin/clavulanate. Vanishing bile duct syndrome was confirmed by sequential liver biopsies. The patient responded to prednisone treatment, but could not be weaned off corticosteroids, even when azathioprine was added. Complete withdrawal of both prednisone and azathioprine was possible by using mycophenolate mofetil, an inosine monophosphate dehydrogenase inhibitor. Sustained remission has been maintained for more than 3 years with low-dose mycophenolate mofetil. | S Simona Jakab A Brian West Dennis M Meighan Robert S Brown Jr William B Hale | 2007 | World Journal of Gastroenterology2007,13,45: | 8 |
| 19 | Elevated basal intestinal mucosal cytokine levels in asymptomatic first-degree relatives of patients with Crohn's disease显示文摘AIM To determine levels of cytokines incolonic mucosa of asymptomatic first degreerelatives of Crohn’s disease patients.METHODS Cytokines(Interleukin(IL)1-Beta,IL-2,IL-5 and IL-8)were measured using ELISAin biopsy samples of normal looking colonicmucosa of first degree relatives of Crohn’sdisease patients(n = 9)and from normalcontrols(n = 10)with no family history ofCrohn’s disease.RESULTS Asymptomatic first degree relativesof patients with Crohn’s disease had significantlyhigher levels of basal intestinal mucosalcytokines(IL-2,IL-5 and IL-8)than normalcontrols.Whether these increased cytokinelevels serve as phenotypic markers for a geneticpredisposition to developing Crohns diseaselater on,or whether they indicate early(pre-clinical)damage has yet to be further defined.CONCLUSION Asymptomatic first degreerelatives of Crohn’s disease patients have higherlevels of cytokines in their normal-lookingintestinal mucosa compared to normal controls,This supports the hypothesis that increasedcytokines may be a cause or an early event inthe inflammatory cascade of Crohns disease andare not merely a result of the inflammatoryprocess. | Indaram AVK Nandi S Weissman S Lam S Bailey B Blumstein M Greenberg R Bank S | 2000 | World Journal of Gastroenterology2000,6,1: | 8 |
| 20 | 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 |