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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 |
| 2 | 乳腺囊内型乳头状癌显示文摘 | Collins L C Carlo V P Hwang H 魏兵(摘译) 步宏(审校) | 2006 | 临床与实验病理学杂志2006，22，5： | 38 |
| 3 | Biochemical mechanisms in drug-induced liver injury:Certainties and doubts显示文摘Drug-induced liver injury is a significant and still unresolved clinical problem.Limitations to knowledge about the mechanisms of toxicity render incomplete the detection of hepatotoxic potential during preclinical development.Several xenobiotics are lipophilic substances and their transformation into hydrophilic compounds by the cytochrome P-450 system results in production of toxic metabolites.Aging,preexisting liver disease,enzyme induction or inhibition,genetic variances,local O2 supply and,above all,the intrinsic molecular properties of the drug may affect this process.Necrotic death follows antioxidant consumption and oxidation of intracellular proteins,which determine increased permeability of mitochondrial membranes,loss of potential,decreased ATP synthesis,inhibition of Ca2+-dependent ATPase,reduced capability to sequester Ca2+ within mitochondria,and membrane bleb formation.Conversely,activation of nucleases and energetic participation of mitochondria are the main intracellular mechanisms that lead to apoptosis.Non-parenchymal hepatic cells are inducers of hepatocellular injury and targets for damage.Activation of the immune system promotes idiosyncratic reactions that result in hepatic necrosis or cholestasis,in which different HLA genotypes might play a major role.This review focuses on current knowledge of the mechanisms of drug-induced liver injury and recent advances on newly discovered mechanisms of liver damage.Future perspectives including new frontiers for research are discussed. | Ignazio Grattagliano Leonilde Bonfrate Catia V Diogo Helen H Wang David QH Wang Piero Portincasa | 2009 | World Journal of Gastroenterology2009，15，39： | 30 |
| 4 | 2018加拿大心境障碍与焦虑障碍治疗协作组/国际双相障碍学会指南:双相障碍的管理显示文摘加拿大心境障碍与焦虑障碍治疗协作组(Canadian Network for Mood and Anxiety Treatments,CANMAT)曾于2005年发布了第1版双相障碍管理指南,并分别于2007、2009和2013年对该指南进行了更新,其中最近的2次更新是与国际双相障碍学会(International Society for Bipolar Disorders,ISBD)合作完成。2018版CANMAT/ISBD双相障碍治疗指南(以下简称指南)反映了自2005年首版指南发表以来本领域取得的重大进展,包括疾病诊断与疾病管理的更新以及药物治疗与心理治疗的近期研究进展。这些前沿进展中综合考虑了循证证据的级别,并基于治疗疗效、临床实践经验、安全性、耐受性和药物导致的转相风险等,对一线、二线及三线治疗方案进行了简明而清晰的推荐。本指南中新增内容涵盖了双相Ⅰ型障碍(BD-Ⅰ)的躁狂发作急性期、抑郁发作急性期和双相障碍维持期的一线及二线治疗推荐等级划分。这种对治疗推荐等级的划分综合考虑了治疗方法对双相障碍不同时相的影响,将进一步帮助临床医生做出基于循证证据的治疗决策。锂盐、喹硫平、双丙戊酸盐、阿塞那平、阿立哌唑、帕利哌酮、利培酮和卡利拉嗪单药或联合使用被推荐为躁狂发作急性期的一线治疗选择。BD-Ⅰ抑郁期的一线治疗选择包括喹硫平、鲁拉西酮、锂盐、拉莫三嗪单药,鲁拉西酮联合锂盐或双丙戊酸盐或拉莫三嗪辅助治疗。尽管急性期治疗有效的药物通常应继续用于BD-Ⅰ的维持期治疗,但也存在一些特殊情况(例如抗抑郁药)。现有数据表明,锂盐、喹硫平、双丙戊酸盐、拉莫三嗪、阿塞那平和阿立哌唑单药或联合治疗应被视为维持治疗的初始或更换治疗方案时的一线选择。除了探讨BD-Ⅰ的相关问题外,本指南中还对双相Ⅱ型障碍(BD-Ⅱ)的临床管理进行了系统回顾并给予治疗推荐,同时针对特殊人群也有相关推荐,如处于各个生殖周期的女性、儿童、青少年和老年人。此外,本指南中还讨论了特定精神疾病及共病(如物质滥用、焦虑障碍和代谢性疾病)的影响。最后,本指南中概述了安全性和药物监测的相关问题。CANMAT/ISBD工作组希望本指南能够成为全球临床医生的实用工具。 | Lakshmi N Yatham Sidney H Kennedy Sagar V Parikh Ayal Sehaffer David J Bond Benicio N Frey Verinder Sharma Benjamin I Goldstein Soham Rej Serge Beaulieu Martin Alda Glenda MaeQueen Roumen V Milev Arun Ravindran Claire O'Donovan Diane Mclntosh Raymond W Lam Gustavo Vazquez Flavio Kapczinski Roger S Melntyre Jan Kozicky Shigenobu Kanba Beny Lafer Trisha Suppes Joseph R Calabrese Eduard Vieta Gin Malhi Robert M Post Michael Berk 胡晨(译) 王刚(译) | 2019 | 中华精神科杂志2019，52，1： | 25 |
| 5 | 欧洲新生儿呼吸窘迫综合征防治共识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,自然病程为出生当时或生后很快发病,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。存活者出生后2—4d病情开始改善。RDS临床表现早期出现呼吸窘迫如紫绀、呻吟、吸凹和呼吸急促,然后进一步发展为呼吸衰竭,血气分析结果可提示呼吸衰竭的严重性。胸部X线典型的毛玻璃样改变和支气管充气征可以确诊。Vermont Oxford新生儿协作网对RDS的定义为: | Sweet D Bevilacqua G Carnielli V Greisen G Plavka R Didrik Saugstad O Simeoni U Speer CP Valls-I-Soler A Halliday H 袁琳(译) 陈超(译) 杜立中(校) | 2008 | 中华儿科杂志2008，46，1： | 17 |
| 6 | 在没有危险因素的情况下,正常的低密度脂蛋白胆固醇水平与亚临床动脉粥样硬化相关显示文摘普遍认为缺乏心血管病危险因素(cardiovascular risk factors,CVRF)人群的动脉粥样硬化发生风险低,然而,无CVRF的个体仍然有心血管事件发生。为了确定无CVRF个体中亚临床动脉粥样硬化的预测因子, | Fernández-Friera L Fuster V López-Melgar B Oliva B García-Ruiz JM Mendiguren J Bueno H Pocock S Ibánez B Fernández-Ortiz A Sanz J 刘莉 叶鹏 | 2017 | 中华高血压杂志2017，25，12： | 17 |
| 7 | 烟酰胺磷酸核糖基转移酶促进肺血管重塑,是肺动脉高压的治疗靶点显示文摘肺动脉高压(pulmonary arterial hypertension,PAH)是一种严重的进行性疾病,其标志之一是肺血管重塑。烟酰胺磷酸核糖基转移酶(nicotinamide phosphoribosyl transferase,NAMPT)是调节细胞内烟酰胺腺嘌呤二核苷酸水平、细胞氧化还原状态,调节组蛋白脱乙酰酶,促进细胞增殖和抑制凋亡的一种细胞酶。研究人员假设NAMPT可促进肺血管重塑, | Chen J Sysol JR Singla S Zhao S Yamamura A Valdez-Jasso D Abbasi T Shioura KM Sahni S Reddy V Sridhar A Gao H Torres J Camp SM Tang H Ye SQ Comhair S Dweik R Hassoun P Yuan JX Garcia JG Machado RF 刘莉 叶鹏 | 2017 | 中华高血压杂志2017，25，2： | 10 |
| 8 | Near-infrared fluorescence sentinel lymph node detection in gastric cancer: A pilot study显示文摘AIM: To investigate feasibility and accuracy of nearinfrared fluorescence imaging using indocyanine green: nanocolloid for sentinel lymph node(SLN) detection in gastric cancer.METHODS: A prospective, single-institution, phaseI feasibility trial was conducted. Patients suffering from gastric cancer and planned for gastrectomy were included. During surgery, a subserosal injection of 1.6 m L ICG:Nanocoll was administered around the tumor. NIR fluorescence imaging of the abdominal cavity was performed using the Mini-FLARE? NIR fluorescence imaging system. Lymphatic pathways and SLNs were visualized. Of every detected SLN, the corresponding lymph node station, signal-to-background ratio and histopathological diagnosis was determined. Patients underwent standard-of-care gastrectomy. Detected SLNs outside the standard dissection planes were also resected and evaluated.RESULTS: Twenty-six patients were enrolled. Four patients were excluded because distant metastases were found during surgery or due to technical failure of the injection. In 21 of the remaining 22 patients, at least 1 SLN was detected by NIR Fluorescence imaging(mean 3.1 SLNs; range 1-6). In 8 of the 21 patients, tumor-positive LNs were found. Overall accuracy of the technique was 90%(70%-99%; 95%CI), which decreased by higher p T-stage(100%, 100%, 100%, 90%, 0% for respectively Tx, T1, T2, T3, T4 tumors). All NIR-negative SLNs were completely effaced by tumor. Mean fluorescence signal-to-background ratio of SLNs was 4.4(range 1.4-19.8). In 8 of the 21 patients, SLNs outside the standard resection plane were identified, that contained malignant cells in 2 patients.CONCLUSION: This study shows successful use of ICG:Nanocoll as lymphatic tracer for SLN detection in gastric cancer. Moreover, tumor-containing LNs outside the standard dissection planes were identified. | Quirijn RJG Tummers Leonora SF Boogerd Wobbe O de Steur Floris PR Verbeek Martin C Boonstra Henricus JM Handgraaf John V Frangioni Cornelis JH van de Velde Henk H Hartgrink Alexander L Vahrmeijer | 2016 | World Journal of Gastroenterology2016，22，13： | 9 |
| 9 | 具有低动脉粥样硬化风险特征的专业耐力运动员的亚临床冠状动脉疾病发病率显示文摘研究表明,具有冠状动脉疾病(coronary artery disease,CAD)危险因素的中老年(健将)运动员比久坐个体冠状动脉钙化(coronary artery calcium,CAC)评分更高。尚没有研究评估具有低动脉粥样硬化风险特征的专业运动员的CAD患病率。 | 刘莉 叶鹏 Merghani A Maestrini V Rosmini S Cox AT Dhutia H Bastiaenen R David S Yeo TJ Narain R Malhotra A Papadakis M Wilson MG Tome M AlFakih K Moon JC Sharma S | 2017 | 中华高血压杂志2017，25，6： | 8 |
| 10 | Pseudopolyps in inflammatory bowel diseases: Have we learned enough?显示文摘Pseudopolyps are a well described entity in the literature and even though the exact pathogenesis of their formation is not completely understood, they are considered non-neoplastic lesions originating from the mucosa after repeated periods of inflammation and ulceration associated with excessive healing processes. Their occurrence is less common in Crohn's disease than in ulcerative colitis, and their overall prevalence ranges from 4% to 74%; moreover, they are found more often in colon but have been detected in other parts of the gastrointestinal tract as well. When their size exceeds the arbitrary point of 1.5 cm, they are classified as giant pseudopolyps. Clinical evaluation should differentiate the pseudopolyps from other polypoid lesions, such as the dysplasiaassociated mass or lesion, but this situation represents an ongoing clinical challenge. Pseudopolyps can provoke complications such as bleeding or obstruction, and their management includes medical therapy, endoscopy and surgery; however, no consensus exists about the optimal treatment approach. Patients with pseudopolyps are considered at intermediate risk for colorectal cancer and regular endoscopic monitoring is recommended. Through a review of the literature, we provide here a proposed classification of the characteristics of pseudopolyps. | Dimitrios S Politis Konstantinos H Katsanos Epameinondas V Tsianos Dimitrios K Christodoulou | 2017 | World Journal of Gastroenterology2017，23，9： | 8 |
| 11 | Role of genetics in the diagnosis and prognosis of Crohn's disease显示文摘Considering the epidemiological, genetic and immunological data, we can conclude that the inflammatory bowel diseases are heterogeneous disorders of multifactorial etiology in which hereditability and environment interact to produce the disease. It is probable that patients have a genetic predisposition for the development of the disease coupled with disturbances in immunoregulation. Several genes have so far been related to the diagnosis of Crohn's disease. These genes are related to innate pattern recognition receptors, to epithelial barrier homeostasis and maintenance of epithelial barrier integrity, to autophagy and to lymphocyte differentiation. So far, the strongest and most replicated associations with Crohn's disease have been demonstrated with NOD2 , IL23R and ATG16L1 genes. Many genes have so far been implicated in the prognosis of Crohn's disease and many attempts have been made for classification of genetic profiles in Crohn's disease.CARD15 seems to be not only a susceptibility gene, but also a disease-modifier gene for Crohn's disease. Enriching our understanding of Crohn's disease genetics is of value, but when combining genetic data with functional data the outcome could be of major importance to clinicians. | Epameinondas V Tsianos Konstantinos H Katantions Vasileios E Tsianos | 2011 | World Journal of Gastroenterology2011，17，48： | 8 |
| 12 | Evaluation of brain tumor metabolism with [^(11)C] choline PET and ~1H-MRS.显示文摘BACKGROUND:The signal of choline containing compounds(Cho)in proton magnetic resonance spectroscopy(1H-MRS)is elevated in brain tumors.[11C]choline uptake as assessed using positron emission tomography(PET)has also been suggested to be higher in brain tumors than in the normal brain.We examined whetherquantitative analysis of choline accumulation and content using these 1wo novel techniques would be helpful innon-invasive,preoperative evaluation of suspected brain tumors and tumor malignancy grade.METHODS:12patients with suspected brain tumor were studied using[11C]choline PET,gadolinium enhanced 3-D magneticresonance imaging and1H-MRS prior to diagnostic biopsy or resection.Eleven normal subjects served as | Utriainen M Komu M Vuorinen V Lehikoinen P Sonninen P Kurki T Utriainen T Roivainen A Kalimo H Minn H | 2003 | 中国神经肿瘤杂志2003，1，2： | 8 |
| 13 | 室内TDR试验监测石灰矿渣加固粘性土的物理化学反应过程(英文)显示文摘石灰矿渣和水泥矿渣常用于加固道路基层的粘性土。目前现场一般采用未加固土的最大干密度和最优含水率来评价加固土的压实施工质量。但是粘性土掺加了石灰后,发生了复杂的物理化学反应,使得其压实特性与未加固土有很大的不同。采用时域反射计监测石灰加固土内的物理化学反应过程。试验时将不同石灰矿渣掺和量和含水率的Orchard粘土通过标准击实试验夯实于击实筒中,用TDR监测其中的物理化学反应,针式贯入仪监测强度的增长。试验发现,电导率和介电常数的变化反应了土中的离子交换和硬化反应的过程。初始电导率(1d之内)的减小揭示了石灰矿渣的掺和量的大小,而长期电导率的减小揭示了强度的增长。试验表明,时域反射计技术可用于评价石灰加固土的施工质量。 | 陈仁朋 DAITA R K DRNEVICH V P KIM D H | 2006 | 岩土工程学报2006，28，2： | 7 |
| 14 | 汽车采用的无级变速功率分流变速器的设计显示文摘在汽车应用方面提出了无级变速功率分流变速箱的一种设想 ,该装置由两可变速带轮 (变速器 )和一行星齿轮系所谓太阳轮和内齿圈三转动构件组合而成。“功率分流”的布置特点是输入轴同时把功率传到太阳轮和主动带轮 ,并通过变速器传到行星齿轮传动的内齿圈。因为输入轴传递的输入功率一分为二 (传到太阳轮和主动带轮 ) ,变速器中仅通过输入轴总功率流的一小部分 ,行星齿轮传动的第三转动件 (转臂 )收集了由内齿圈和太阳轮传来的功率流 ,把总功率传到输出轴传到车辆。该特徵提高了发动机功率在汽车应用的许可范围 ,该特徵特别在低速 -高转矩情况下提供无级变速可变传动比的范围时还降低了与动力传动有关的功率损失。建立一个所谓“增益系数”,用它通过变速箱的可变速元件和速比间隔来确定总功率流的两个分量的大小。用一外齿轮箱可以在发动机和变速箱的最佳范围内扩展无级变速范围。提出了一个采用外啮合有级齿轮传动 (同步变速器 )实现有效传动比间隔的无级变速范围应用于汽车的设计程序 。 | V H Mucino Z Lu J E Smith M Kimcikiewicz B Cowan | 2004 | 传动技术2004，18，1： | 7 |
| 15 | 钠-葡萄糖共转运蛋白-2抑制剂或胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病:临床实践指南显示文摘临床问题对于存在不同心血管风险及肾脏结局的2型糖尿病患者,在原有生活方式干预和/或其他降糖药物的基础上加用钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂的获益及风险是什么?现行做法几十年来,2型糖尿病的治疗决策都以控制血糖为主导。SGLT-2抑制剂和GLP-1受体激动剂在传统观念中常被用于二甲双胍治疗后血糖仍控制不佳的患者。目前这一现状已经发生了改变,这得益于多项临床研究结果。研究显示SGLT-2抑制剂和GLP-1受体激动剂拥有独立于药物降糖作用之外的对于动脉粥样硬化性心血管病(CVD)和慢性肾脏病(CKD)的获益。建议本指南阐述了针对不同风险分层的成人2型糖尿病患者使用SGLT-2抑制剂或GLP-1受体激动剂的建议。•伴有3种或更少的心血管风险因素且不存在CVD或CKD:不建议启动SGLT-2抑制剂或GLP-1受体激动剂治疗。(推荐等级:弱)•伴有3种以上心血管风险因素且不存在CVD或CKD:建议启动SGLT-2抑制剂治疗,不建议启动GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD或CKD:建议启动SGLT-2抑制剂治疗和GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD和CKD:建议启动SGLT-2抑制剂治疗(推荐等级:强)和GLP-1受体激动剂治疗。(推荐等级:弱)•对于那些想要进一步降低CVD和CKD结局风险的患者:推荐优先启用SGLT-2抑制剂治疗而非GLP-1受体激动剂治疗。(推荐等级:弱)这项指南是如何制订的一个由患者、临床医生和方法学家共同组成的国际小组提出了这些推荐意见。这些推荐意见基于可信度较高的指南的标准,并使用GRADE分级方法进行评估。该小组采用了息者个体化的观点。证据一项关于获益与风险的系统综述和网络meta分析(764项随机对照研究,包括421346例参与者)发现SGLT-2抑制剂和GLP-1受体激动剂可以降低总体死亡率、心肌梗死发生率、终末期肾病或肾衰竭的发生率(中等至高等质量的证据)。在不同的亚组中这些药物对卒中、因心力衰竭所致住院和其他主要不良事件有不同的影响。药物绝对获益的程度因患者个体风险的不同有很大的差异。(例如,对于接受了超过5年药物治疗的1000例患者,在最低风险人群中死亡人数减少了5人,在最高风险人群中死亡人数减少了48人)。一项关于预后的综述确认了14种风险预测模型,其中一种(RECODe)在证据总结中报告了大部分基线风险评估数据,小组利用该模型以支持风险分层的建议。考虑到患者的价值观及个体差异,指南推荐的支撑证据包括一项对已发表论文的系统综述、一项患者焦点小组研究、一项临床问题总结,以及一项指南调查。指南解读我们依据不同的CVD和CKD风险水平,综合考虑获益、风险和其他因素的平衡,以及每一个风险组别的实际问题,来对推荐意见进行分层。本指南强烈建议CVD和CKD患者使用SGLT-2抑制剂治疗,这说明专家组认为其具有显著的获益。而对于其他成人2型糖尿病患者,推荐等级较弱,这说明专家组想要在获益、风险及治疗花费上取得一个更好的平衡。临床医生通过该指南可以使用可靠的风险计算模型,如RECODe,来明确其患者的个体心血管和肾脏疾病风险。医患交互式总结临床证据和制订决策有助于患者知晓治疗选择,包括进行共同决策。2型糖尿病人群(全球患病率不断增长1-2)正面临着不断增加的心血管疾病、肾脏病和其他并发症的风险3。数十年来,2型糖尿病的管理始终以控制血糖及糖化血红蛋白(HbA1c)为治疗目标4-5,但是,最近的高质量随机对照研究已经对这种以血糖为中心的治疗模式发起了挑战。研究结果显示,强化血糖控制未必会降低大血管不良事件,它还可能带来不利影响监管机构现在要求新型糖尿病药物必须证明其具有心血管和肾脏获益才能获得批准。对两类新药--钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂(见框图1)的临床试验结果显示,在现有治疗方案(常规治疗)之上加用这些药物,对死亡、心肌梗死、卒中、心力衰竭和肾脏的结局(如进展为终末期肾病)都有获益8-12。 | Sheyu Li Per Olav Vandvik Lyubov Lytvyn Gordon H Guyatt Suetonia C Palmer Rene Rodriguez-Gutierrez Farid Foroutan Thomas Agoritsas Reed A C Siemieniuk Michael Walsh Lawrie Frere David J Tunnicliffe Evi V Nagler Veena Manja Bjφrn Olav Asvold Vivekanand Jha Mieke Vermandere Karim Gariani Qian Zhao Yan Ren Emma Jane Cartwright Patrick Gee Alan Wickes Linda Fems Robin Wright Ling Li Qiukui Hao Reem A Mustafa 无 郭鹤鸣(译) | 2021 | 英国医学杂志中文版2021，24，9： | 7 |
| 16 | Innate and adaptive immune responses in male and female reproductive tracts in homeostasis and following HIV infection显示文摘男、女的繁殖的道是有多样的功能的要求的复杂微型环境。当同时对潜在的病原体授与保护时,在繁殖的道的免疫系统举办为胎儿的 allograft 提供保护的环境的费力的任务。因此,它发展了改编的一个唯一的集合,首先在性荷尔蒙的影响下面,它从另外的 mucosal 地点使它不同。这里,我们讨论在男性和女繁殖的道是在场的免疫系统的各种各样的部件,包括在 homeostatic 条件下面的天生的可溶的因素和房间和体液、调停房间的适应免疫。我们考察在从全身的豁免展出区分并且讨论这些特征怎么被性荷尔蒙影响的男、女的繁殖的道显示出唯一的 phenotypic 和有免疫力的房间和回答的功能的特征的证据。我们也在跟随 HIV-1 感染的繁殖的道,性荷尔蒙和有免疫力的回答之中检验相互作用。男、女的繁殖的道的唯一的特征的改进理解将提供卓见进为性播送的感染的预防改进不孕的免疫学的原因和预防干预的设计的临床的处理。 | Philip V Nguyen Jessica K Kafka Victor H Ferreira Kristy Roth Charu Kaushic | 2014 | Cellular & Molecular Immunology2014，11，5： | 7 |
| 17 | Incidence and risk factors for the development of anemia following gastric bypass surgery显示文摘AIM:To evaluate the incidence and risk factors for the development of anemia after RouxenY gastric bypass (RYGB).METHODS: A retrospective analysis of patients undergoing RYGB from January 2003 to November 2007 was performed. All patients had a preoperative body mass index > 40 kg/m2. A total of 206 patients were evaluated. All patients were given daily supplements of ferrous sulfate tablets for 2 wk following their operation. Hematological and metabolic indices were routinely evaluated following surgery. Patients were followed for a minimum of 86 wk.RESULTS: There were 41 males and 165 females with an average age of 40.8 years. 21 patients (10.2%) developed postoperative anemia and 185 patients (89.8%) did not. Anemia was due to iron deficiency in all cases. The groups had similar demographics, surgical procedure and comorbidities. Menstruation (P = 0.02) and peptic ulcer disease (P = 0.01) were risk factors for the development of postoperative anemia.CONCLUSION: Iron deficiency anemia is frequent. RYGB surgery compounds occult blood loss. Increased ferrous sulfate supplementation may prevent iron depletion in populations at increased risk. | Dimitrios V Avgerinos Omar H Llaguna Matthew Seigerman Amanda J Lefkowitz I Michael Leitman | 2010 | World Journal of Gastroenterology2010，16，15： | 6 |
| 18 | Transcranial direct current stimulation in psychiatric disorders显示文摘The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation(t DCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally,we provide an overview of t DCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding t DCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding t DCS efficacy in psychiatry. | Gabriel Tortella Roberta Casati Luana V M Aparicio Antonio Mantovani Natasha Senco Giordano D’Urso Jerome Brunelin Fabiana Guarienti Priscila Mara Lorencini Selingardi Débora Muszkat Bernardo de Sampaio Pereira Junior Leandro Valiengo Adriano H Moffa Marcel Simis Lucas Borrione André R Brunoni | 2015 | World Journal of Psychiatry2015，5，1： | 6 |
| 19 | 猪霉菌毒素中毒的新概念显示文摘霉菌毒素是真菌的次级代谢产物,可以降低畜禽生产性能和改变新陈代谢(wannemacher等,1991)。动物采食被霉菌毒素污染的饲料而引发的病理状态称为霉菌毒素中毒。猪霉菌毒素中毒会对养猪生产造成严重的不良影响。本文综述了各种霉菌毒素对猪生长性能、繁殖性能和免疫功能的影响,各种霉菌毒素间的协同作用以及猪霉菌毒素中毒的最新研究成果。 | Trevor K Smith Gabriel Diaz Swamy H V LN 苗朝华(摘译) | 2007 | 养猪2007，，5： | 6 |
| 20 | 血管紧张素Ⅱ2型受体的基因多态性(+1675G/A)对已接受治疗高血压患者的左心室肥大和左心室构型的作用显示文摘已有报道显示血管紧张素Ⅱ2型受体的基因多态性(AGTR2+1675G/A)与左心室肥大(left ventric-ular hypertrophy,LVH)相关。研究者检验这种基因多态性是否影响已按高血压治疗指南治疗的原发性高血压和心血管疾病患者的LVH和左心室构型参数。 | 张玲玉 叶鹏 Huber M V ller H Jakob S Reibis R Do V Bol-brinker J Zergibel I Schmieder RE Treszl A Wegscheider K Kreutz R | 2010 | 中华高血压杂志2010，18，12： | 6 |
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