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1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
2AGNP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
3On the Application of PCA Technique to Fault Diagnosis显示文摘In this paper, we briefly address the application of the standard principal component analysis (PCA) technique to fault detection and identification. Based on an analysis of the existing test statistic, we propose a new test statistic, which is similar to the Hawkin’s TH 2 statistic but without the numerical drawback. In comparison with the SPE index, the threshold setting associated with the new statistic is computationally simpler. Our further study is dedicated to the analysis of fault sensitivity. We consider the off-set and scaling faults, and evaluate the test statistic by viewing its sensitivity to the faults. Our final study focuses on identifying off-set and scaling faults. To this end, two algorithms are proposed. This paper also includes some critical remarks on the application of the PCA technique to fault diagnosis.DING S ZHANG P DING E YIN S Naik A DENG P GUI W 2010Tsinghua Science and Technology2010,15,2:31
4Update 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
5OPTICAL PROPERTIES OF GeO_2 AND Ge NANOCRYSTALS显示文摘he co m pound m aterial of n m size particles Ge O2 Si O2 w as synthesied through hydrolysis of Si( O C2 H4) and Ge Cl4 . A heat treatm ent w as carried out for the sa m ples at 100 ~1200 ℃in air . Its optical property w as deter mined by U V Vis spectur m . We have found that theabsorption edge of spectru m shifted progressively to longer w avelengths . The quantu m size ef fect of nanocrystals appears because crystals gro w and energy of optical band gap reduces d ueto the influence of te m perature . By the analysis of X ray diffraction w e have observed theprocess in w hich the structure of particles changed fro m disorder into order .Y.H.Zhou 1) ,Y.Y.Feng 2) and H.Y.Lu 2) 1)Department of Physics Nanjing Normal University, Nanjing 210097,China 2)Physics and Ch寁O P T I C A L P R O P E R T I E S O F Ge O2 A N D Ge N A N O C R Y S T A L S Y. H. Zhou1) , Y. Y. Feng2) 1999Acta Metallurgica Sinica(English Letters)1999,12,5:22
6Cetuximab 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 2010World Journal of Gastroenterology2010,16,25:17
7在血压控制不良的高血压患者中使用数字化干预的家庭和在线血压管理:随机对照试验显示文摘HOME BP试验(The home and online management and evaluation of blood pressure)的目的是评估在初级预防中结合自我监测和自我管理的数字化干预在高血压管理中的作用。研究者纳入英国76个治疗中心经过治疗但血压控制不好(>140/90 mm Hg, 1 mm Hg=0.133 kPa)并能上网的患者622例,进行自动确定主要终点的公开随机对照试验。McMa-nus RJ Little P Stuart B Morton K Raftery J Kelly J Bradbury K Zhang J Zhu S Murray E May CR Mair FS Michie S Smith P Band R Ogburn E AllenJ Rice C Nut-tall J Williams B Yardley L 陈嘉睿(译) 叶鹏(审校) 2021中华高血压杂志2021,29,5:15
8内脏脂肪组织通过产生骨桥蛋白调控成纤维细胞衰老促进心脏衰老显示文摘老化通过增加包括骨桥蛋白(osteopontin,OPN)在内的细胞外基质(extracellular matrix,ECM)蛋白的沉积引起心脏结构和功能改变进而导致进行性间质纤维化。虽然已知OPN参与各种病理状况,但其在心肌衰老中的作用仍不清楚。Sawaki D Czibik G Pini M Ternacle J Suffee N Mercedes R Marcelin G Surenaud M Marcos E Gual P Clément K Hue S Adnot S Hatem SN Tsuchimochi I Yoshimitsu T Hénégar C Derumeaux G 刘青 叶鹏 2018中华高血压杂志2018,26,3:14
9Renin angiotensin system in liver diseases: Friend or foe?显示文摘In the last three decades,the understanding of the renin angiotensin system(RAS)has been changed by the discoveries of functional local systems,novel biologically active peptides,additional specific receptors,alternative pathways of angiotensin(Ang)?Ⅱ?generation,and new roles for enzymes and precursor components other than those in Ang?Ⅱ?synthesis.In this regard,the discovery that Ang-(1-7)opposes the pressor,proliferative,pro-fibrotic,and pro-inflammatory effects mediated by Ang?Ⅱ?has contributed to the realization that the RAS is composed of two axes.The first axis consists of the angiotensin-converting enzyme(ACE),with Ang?Ⅱ?as the end product,and the angiotensin type 1(AT1)receptor as the main effector mediating the biological actions of Ang?Ⅱ.The second axis results from ACE2-mediated hydrolysis of Ang?Ⅱ,leading to the production of Ang-(1-7),with the Mas receptor as the main effector conveying the vasodilatory,antiproliferative,anti-fibrotic,and anti-inflammatory effects of Ang-(1-7).Experimental and clinical studies have shown that both axes of the RAS may take part in the pathogenesis of liver diseases.In this manuscript,we summarize the current evidence regarding the role of RAS in hepatic cirrhosis and its complications,including hemodynamic changes and hepatorenal syndrome.The therapeutic potential of the modulation of RAS molecules in liver diseases is also discussed.Ana Cristina Simoes e Silva Aline S Miranda Natália P Rocha Antonio L Teixeira 2017World Journal of Gastroenterology2017,23,19:12
10Effect of liver regeneration after partial hepatectomy and ischemia-reperfusion on expression of growth factor receptors显示文摘瞄准:在肝新生在四不同生长因素受体的表示的时间功课上调查试验性的部分肝切除术和 normothermic ischemia-reperfusion 损坏的效果。这由于在刺激肝新生的生长因素的潜在的治疗学的使用是相关的。方法:为部分肝切除术(PH ) , 80% 肝质量是在 Sprague Dawley 老鼠的 resected。局部缺血和灌注(I/R ) 被门静脉和肝的动脉的吸藏为 15 min 导致。表皮的生长因素受体,肝的生长因素受体,成纤维细胞生长因素受体和瘤坏死因素 receptor-1 被免疫组织化学在损害以后分析直到 72 h。量的 RT-PCR 在最小的受体表示(24 h ) 的时间点被执行。结果:在免疫组织化学, EGFR, HGFR, FGFR 和 TNFR1 与一座山峰在部分肝切除术以后给双性人看了局面的动力学直到 12 h,在 24 h 以后的一个天底和另一弱增加直到 72 h。在肝新生期间,在局部缺血和灌注以后,受体表示更低;在在灌注以后的 24 h 的天底是一样。评估这个天底是否被 mRNA 抄写的缺乏引起,或由于一根柱子翻译规定, RT-PCR 在 24 h 并且与放松肝相比被执行。在每根探针,为受体有特定的 mRNA。EGFR, FGFR 和 TNFR1 mRNA 表示比在放松肝相等或低,在 I/R 以后的 HGFR 表示比在控制强壮。结论:部分至少由于 post-transcriptional 处理,在分析受体的表达式有一个天底在肝损伤以后的 24 h。因此,到在损坏以后的 stimulate 肝新生 24 h 的生长因素的治疗学的使用可能不是成功的。P Baier G Wolf-Vorbeck S Hempel UT Hopt E von Dobschuetz 2006World Journal of Gastroenterology2006,12,24:8
11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
12ConservativeapproachinPeutz-JeghersSyndrome:Single-balloon enteroscopyandsmallbowelpolypectomy显示文摘AIM: To assess the usefulness of the balloon assisted enteroscopy in preventing surgical intervention in pa-tients with Peutz-Jeghers syndrome (PJS) having a small bowel large polyps. METHODS: Seven consecutive asymptomatic pts(age 15-38 years) with PJS have been collected; six under-went polypectomy using single balloon enteroscopy(Olympus SIF Q180) with antegrade approach using push and pull technique. SBE system consists of the SIF-Q180 enteroscope, an overtube balloon control unit(OBCU Olympus Balloon Control Unit) and a dispos-able silicone splinting tube with balloon(ST-SB1). All procedures were performed under general anesthesia. Previously all pts received wireless capsule endos-copy(WCE). Prophylactic polypectomy was reservedmainly in pts who had polyps > 15 mm in diameter. The balloon is inflated and deflated by a balloon control unit with a safety pressure setting range from-6.0 kPa to +5.4 kPa. Informed consent has been obtained from pts or parents for each procedure.RESULTS: Six pts underwent polypectomy of small bowel polyps; in 5 pts a large polyp > 15 mm(range 20-50 mm in diameter) was resected; in 1 patient with WCE negative, SBE was performed for previous surgi-cal resection of gastrointestinal stromal tumors. In 2 pts endoscopic clips were placed due to a polypectomy. No surgical complication have been reported. SBE with resection of small bowel large polyps in PJS pts was useful to avoid gastrointestinal bleeding and emergency laparotomy due to intestinal intussuscep-tions. No gastrointestinal tumors were found in sub-sequent enteroscopic surveillance in all seven pts. In order surveillance, all pts received WCE, upper en-doscopy, ileocolonoscopy every 2 years. No pts had extraintestinal malignant lesions. SBE was performed when WCE was positive for significant polyps(> 15 mm).CONCLUSION: The effective of prophylactic polyp-ectomy of small bowel large polyps(> 15 mm) could be the first line treatment for conservative approach in management of PJS patients.Torroni F Romeo E Rea F De Angelis P Foschia F Faraci S Federici di Abriola G Contini AC Caldaro T Dall’Oglio L 2014World Journal of Gastrointestinal Endoscopy2014,6,7:7
13Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013显示文摘Marie Ng Tom Fleming Margaret Robinson Blake Thomson Nicholas Graetz Christopher Margono Erin C Mullany Stan Biryukov Cristiana Abbafati Semaw Ferede Abera Jerry P Abraham Niveen M E Abu-Rmeileh Tom Achoki Fadia S AlBuhairan Zewdie A Alemu Rafael Alfonso 2014The Lancet2014,,:7
14Predictors of suboptimal bowel preparation in asymptomatic patients undergoing average-risk screening colonoscopy显示文摘AIM To identify risk factors for a suboptimal preparation among a population undergoing screening or surveillance colonoscopy.METHODS Retrospective review of the University of Michigan and Veteran's Administration(VA) Hospital records from 2009 to identify patients age 50 and older who underwent screening or surveillance procedure and had resection of polyps less than 1 cm in size and no more than 2 polyps. Patients with inflammatory bowel disease or a family history of colorectal cancer were excluded. Suboptimal procedures were defined as procedure preparations categorized as fair, poor or inadequate by the endoscopist. Multivariable logistic regression was used to identify predictors of suboptimal preparation.RESULTS Of 4427 colonoscopies reviewed, 2401 met our inclusion criteria and were analyzed. Of our population, 16% had a suboptimal preparation. African Americans were 70% more likely to have a suboptimal preparation(95%CI: 1.2-2.4). Univariable analysis revealed that narcotic and tricyclic antidepressants(TCA) use, diabetes, prep type, site(VA vs non-VA), and presence of a gastroenterology(GI) fellow were associated with suboptimal prep quality. In a multivariable model controlling for gender, age, ethnicity, procedure site and presence of a GI fellow, diabetes [odds ratio(OR) = 2.3; 95%CI: 1.6-3.2], TCA use(OR = 2.5; 95%CI: 1.3-4.9), narcotic use(OR = 1.7; 95%CI: 1.2-2.5) and Miralax-Gatorade prep vs 4L polyethylene glycol 3350(OR = 0.6; 95%CI: 0.4-0.9) were associated with a suboptimal prep quality. CONCLUSION Diabetes, narcotics use and TCA use were identified as predictors of poor preparation in screening colonoscopies while Miralax-Gatorade preps were associated with better bowel preparation.Shail M Govani Eric E Elliott Stacy B Menees Stephanie L Judd Sameer D Saini Constantinos P Anastassiades Annette L Urganus Suzanna J Boyce Philip S Schoenfeld 2016World Journal of Gastrointestinal Endoscopy2016,8,17:7
15美白牙膏去除牙外源性色斑的八周效果观察显示文摘目的 :评价含有 1%焦磷酸钠、7%三聚硫酸钠、0 .2 4 3 %氟化钠及 10 %高清洁二氧化硅的牙膏减少外源性牙色斑的效果。方法 :采用双盲、分层、二单位平行观察的临床研究方法。根据改良 L obene色斑指数 (L obene stain in-dex m ethod)均数、性别、吸烟习惯将 91名年龄为 18~ 5 5岁的研究对象平衡地分为两组 ,随机地分配使用试验或对照牙膏。于基线、第 4周及第 8周固定由一名检查者完成研究对象的色斑指数测定。结果 :86人完成了该研究。8周临床研究表明 ,使用美白牙膏的研究对象较对照组的牙齿色斑指数均数降低了 3 7.1% (P=0 .0 0 0 1)。结论 :与对照组牙膏相比 ,使用含有 1%焦磷酸钠、7%三聚硫酸钠、0 .2 4 3 %氟化钠及 10 %高清洁二氧化硅的牙膏可以有效地减少牙外源性色斑。胡德渝 庞若愚 佘晓晴 雷德伦 Volpe A R DeVizio W Petrone M E Zhang Y P Chaknis P Miller S Miller J 1999华西口腔医学杂志1999,17,3:7
16Combined carriership of TLR9 -1237C and CD14 -260T alleles enhances the risk of developing chronic relapsing pouchitis显示文摘AIM: To investigate the single nucleotide polymorphisms (SNPs) in genes involved in bacterial recognition and the susceptibility to pouchitis or pouchitis severity.METHODS: Analyses of CD14 -260C>T, CARD15/NOD2 3020insC, Toll-like receptor (TLR)4 +896A>G,TLR9 -1237T>C, TLR9+ 2848G>A, and IRAKM +22148G>A SNPs were performed in 157 ileal-pouch anal anastomosis (IPAA) patients (79 patients who did not develop pouchitis, 43 infrequent pouchitis patients,35 chronic relapsing pouchitis patients) and 224 Italian Caucasian healthy controls.RESULTS: No significant differences were found in SNP frequencies between controls and IPAA patients.However, a significant difference in carriership frequency of the TLR9-1237C allele was found between the infrequent pouchitis and chronic relapsing pouchitis groups [P = 0.028, odd's ratio (OR) = 3.2, 95%CI = 1.2-8.6].This allele uniquely represented a 4-locus TLR9 haplotype comprising both studied TLR9 SNPs in Caucasians.Carrier trait analysis revealed an enhanced combined carriership of the alleles TLR9 -1237C and CD14 -260T in the chronic relapsing pouchitis and infrequent pouchitis group (P = 0.018, OR = 4.1, 95%CI = 1.4 -12.3).CONCLUSION: There is no evidence that the SNPs predispose to the need for IPAA surgery. The significant increase of the combined carriership of the CD14 -260T and TLR9 -1237C alleles in the chronic relapsing pouchitis group suggests that these markers identify a subgroup of IPAA patients with a risk of developing chronic or refractory pouchitis.KM Lammers S Ouburg SA Morré JBA Crusius P Gionchetti F Rizzello C Morselli E Caramelli R Conte G Poggioli M Campieri AS Pea 2005World Journal of Gastroenterology2005,11,46:7
17评估清晨或夜晚服用降压药对24h动态血压的影响:清晨或夜间服用降压药的希腊英国联合研究显示文摘观察数据显示,临床血压水平与随后的主要不良心血管事件之间存在强烈的线性关系。然而,动态血压监测显示,夜间血压水平比24h或白天血压水平更能预测主要的不良心血管事件。此外,夜间与白天的血压比值和杓型状态也是心血管结局的重要独立预测因素。这些发现可能对抗高血压药物的最佳给药时间有影响,一些研究表明,夜晚服用降压药可能较白天服药减少心血管事件。Poulter NR Savopoulos C Anjum A Apostolopoulou M Chapman N Cross M Falaschetti E Fotiadis S James RM Kanellos I Szigeti M Thom S Sever P Thompson D Hatzitolios AI 赵狄 练桂丽 2018中华高血压杂志2018,26,10:7
18Osteoprotegerin: A Novel Secreted Protein Involved in the Regulation of Bone Density显示文摘W.S Simonet D.L Lacey C.R Dunstan M Kelley M.-S Chang R Lüthy H.Q Nguyen S Wooden L Bennett T Boone G Shimamoto M DeRose R Elliott A Colombero H.-L Tan G Trail J Sullivan E Davy N Bucay L Renshaw-Gegg T.M Hughes D Hill W Pattison P Campbell S Sander G Van 1997Cell1997,,2:6
19一种miRNA标记在胶质瘤侵袭性表型的确定与预后评估中的价值(英文)显示文摘Gliomas represent a disparate group of tumours for which there are to date no cure. Thus,there is a recognized need for new diagnostic and therapeutic approaches based on increased understanding of their molecular nature. We performed the comparison of the microRNA( miRNA) profile of 8 WHO grade II gliomas and 24 higher grade tumours( 2 WHO grade III and 22 glioblastomas) by using the Affymetrix Gene Chip miRNA Array v. 1. 0. A relative quantification method( RT-q PCR) with standard curve was used to confirm the 22 miRNA signature resulted by array analysis. The prognostic performances of the confirmed miRNAs were estimated on the Tumor Cancer Genome Atlas( TCGA) datasets. We identified 22 miRNAs distinguishing grade II gliomas from higher grade tumours.RT-q PCR confirmed the differential expression in the two patients' groups for 13 out of the 22 miRNAs. The analysis of the Glioblastoma Multiforme( GBM) and Lower Grade Glioma( LGG) datasets from TCGA demonstrated the association with prognosis for 6 of those miRNAs. Moreover,in the GBM dataset miR-21 and miR-210 were predictors of worse prognosis in both univariable and multivariable Cox regression analyses( HR 1. 19,P = 0. 04,and HR 1. 18,P = 0. 029 respectively). Our results support a direct contribution of miRNAs to glioma cancerogenesis and suggest that miR-21 and miR-210 may play a role in the aggressive clinical behaviour of glioblastomas.Barbano R Palumbo O Pasculli B Galasso M Volinia S D'Angelo V Icolaro N Coco M Dimitri L Graziano P Copetti M Valori VM Maiello E Carella M Fazio VM Parrella P 2014中华神经外科疾病研究杂志2014,13,5:6
20Endoscopic 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 2016World Journal of Gastrointestinal Endoscopy2016,8,11:6
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