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1DOG1是一种敏感和特异性的胃肠道间质瘤的标记物显示文摘Espinosa I Lee C H Kim M K 黄文斌(摘译) 2008临床与实验病理学杂志2008,24,3:117
2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
32018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
4Granulocyte-macrophage colony-stimulating factor (GM-CSF) and T-cell responses: what we do and don't know显示文摘Granulocyte 巨噬细胞刺激殖民地的因素(GM-CSF ) 是一个重要造血的生长因素和有免疫力的调节的人。GM-CSF 也在各种各样的传播白血球的功能的活动有深刻效果。它被许多房间类型在收到有免疫力的刺激之上包括 T 房间,巨噬细胞, endothelial 房间和成纤维细胞生产。尽管 GM-CSF 局部地被生产,它能以一种 paracrine 方式行动到在主人防卫提高他们的功能的成员传播 neutrophils,单核白血球和淋巴细胞。最近的集中的调查为它增加树枝状的房间(DC ) 成熟和功能以及巨噬细胞活动的能力作为一个有免疫力的助手在 GM-CSF 的应用程序上被集中。在经历化疗的癌症病人对待嗜中性白血球减少症临床上被使用,在在治疗期间的爱滋病病人,并且在在骨髓移植以后的病人。有趣地, GM-CSF-deficient 老鼠的造血的系统看起来正常;最重要的变化在一些特定的 T 房间回答。尽管 GM-CSF 的分子的克隆用 T 房间的 cDNA 图书馆被执行, T 房间在激活以后生产 GM-CSF,是众所周知的,在 T 房间功能上有在由 T 房间和它的效果的生产的这 cytokine 的系统的调查的缺乏。在这篇文章,我们将在 T 房间主要集中于 GM-CSF 的免疫生物学。Yufang Shi Catherine H Liu Arthur I Roberts Jyoti Das Guangwu Xu Guangwen Ren Yingyu Zhang Liying Zhang Zeng Rong Yuan Hung Sheng William Tan Gobardhan Das Satish Devadas 2006Cell Research2006,16,2:22
5血管性认知障碍的诊断标准:国际血管性行为与认知障碍学会的申明显示文摘长期以来,脑血管病(CVD)就被认为是认知损害的一个重要原因,但是有关脑血管病后认知障碍的概念化却有着一段多变的历史。'动脉变硬'或脑的动脉粥样硬化是'老化'的原因,是存在已久的观点,在20世纪60年代受到了来自英格兰纽卡斯尔的神经病理学研究的质疑。这些研究表明,血管性痴呆(vascular dementia,Va D)与超过一定程度的多发性脑梗死有关。徐岩 郭起浩 Sachdev P Kalaria R O'Brien J Skoog I Alladi S Black SE Blacker D Blazer DG Chen C Chui H Ganguli M Jellinger K Jeste DV Pasquier F Paulsen J Prins N Rockwood K Roman G Scheltens P 2014神经病学与神经康复学杂志2014,11,3:19
6Significance of hepatitis virus infection in the oncogenicinitiation of hepatocellular carcinoma显示文摘Hepatocellular carcinoma(HCC) is one of the most common causes of cancer-related death worldwide. Chronic infection of hepatitis B virus(HBV) and/or hepatitis C virus(HCV) is a major risk factor in the development of the HCC, independently from excessive alcohol abuse and metabolic disease. Since the biology of HBV and HCV is different, their oncogenic effect may go through different mechanisms, direct and/or indirect. Viral hepatitis infection is associated with cellular inflammation, oxidative stress, DNA damage, that may lead to subsequent hepatic injuries such as chronic hepatitis, fibrosis, cirrhosis, and finally HCC. Direct oncogenic properties of these viruses are related with their genotypic characteristics and the ability of viral proteins to interact with host proteins, thus altering the molecular pathways balance of the cells. In addition, the integration of HBV DNA, especially the gene S and X, in a particular site of the host genome can disrupt chromosomal stability and may activate various oncogenic mechanisms, including those in hematopoietic cells. Recently, several studies also had demonstrated that viral hepatitis could trigger the population of hepatic cancer stem cells. This review summarize available pre-clinical and clinical data in literature regarding oncogenic properties of HBV and HCV in the early initiation of HCC.Caecilia HC Sukowati Korri E El-Khobar Susan I Ie Beatrice Anfuso David H Muljono Claudio Tiribelli 2016World Journal of Gastroenterology2016,22,4:18
7Increased secretion of pro-inflammatory cytokines by circulating polymorphonuclear neutrophills and regulation by interleukin 10 during intestinal inflammation显示文摘Increasedsecretionofproinflammatorycytokinesbycirculatingpolymorphonuclearneutrophilsandregulationbyinterleukin10duringintes...S Nikolaus 1, J Bauditz 1, P Gionchetti 2, C Witt 3, H Lochs 1 and S Schreiber 1 1Charité University Hospital, 4th Medical Department, Humboldt University, Berlin, Germany 2Clinica Media I, Policlinico S. Orsola, University of Bolog 1998World Journal of Gastroenterology1998,4,3:17
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
9胃癌外科治疗:荷兰全国随机D1与D2临床试验15年随访结果报告显示文摘Songun I Putter H Kranenbarg E 张信华 2010消化肿瘤杂志(电子版)2010,,01:13
10基因表达分析表明p63是骨巨细胞瘤的一种诊断用标记显示文摘Lee C H Espinosa I Jensen K C 饶秋(摘译) 2008临床与实验病理学杂志2008,24,4:13
11非胰岛素依赖型糖尿病冠状动脉疾病的危险因素:英国糖尿病前瞻性研究(UKPDS:23)显示文摘目的:评价2型糖尿病患者冠状动脉疾病的基线危险因素。设计:对2 693例资料完整的患者进行年龄和性别调整的逐步选择过程分析,以确定哪些冠状动脉疾病的危险因素应纳入 Cox 比例风险模型。对象:3 055例白人患者,平均年龄52岁,均新近诊断为2型糖尿病,且无动脉粥样硬化相关疾病的证据。平均随访期7.9年。335例患者于10年内出现冠状动脉疾病。结局评定:具有明确异常心电图的心绞痛、致死或非致死性心肌梗塞。结果:冠状动脉疾病与低密度脂蛋白胆固醇浓度升高、高密度脂蛋白胆固醇浓度降低、甘油三酯浓度升高、高血红蛋白 A_(1c)、高收缩压、高空腹血糖以及吸烟史密切相关。低密度脂蛋白胆固醇较高1/3对较低1/3区间的估计风险比为2.26(95%可信区间为1.70~3.00),高密度脂蛋白胆固醇为0.55(0.41~0.73),血红蛋白 A_(1c)为1.52(1.15~2.01),收缩压为1.82(1.34~2.47)。吸烟者的估计风险比为1.41(1.06~1.88)。结论:2型糖尿病患者中,存在冠状动脉疾病潜在的、可变的5种危险因素的交叉重叠影响。它们是低密度脂蛋白胆固醇浓度升高、高密度脂蛋白胆固醇浓度降低、高血压、高血糖和吸烟。R C Turner H Millns H A W Neil I M Stratton S E Manley D R Matthews R R Holman 赵维纲 1998英国医学杂志中文版1998,0,3:11
12蛋白酶激活受体2在载脂蛋白E缺陷小鼠的血管炎症和动脉粥样硬化中发挥关键作用显示文摘凝血系统与血管炎症密切相关,尽管其潜在机制仍不清楚。最近的研究结果表明,蛋白酶激活受体(protease-activated receptor,PAR)2——活化因子X(activated factor X,FXa)的主要受体之一——在血管细胞和白细胞中均有表达,这提示PAR-2可能参与炎症性疾病的发病机制。Hara T Phuong PT Fukuda D Yamaguchi K Murata C Nishimoto S Yagi S Kusunose K Yamada H Soeki T Wakatsuki T Imoto I Shimabukuro M Sata M 刘青 叶鹏 2018中华高血压杂志2018,26,6:11
13Use of rifaximin in gastrointestinal and liver diseases显示文摘Rifaximin is a broad spectrum oral antibiotic with antimicrobial activity against Gram-positive and Gramnegative aerobic and anaerobic bacteria. It is poorly absorbed and thus has a highly favorable safety profile. Rifaximin has been shown to be effective in the treatment of traveler's diarrhea, functional bloating and irritable bowel syndrome, small bowel bacterial overgrowth and in the prevention of recurrent overt hepatic encephalopathy. In addition, there is emerging evidence for a possible beneficial effect of rifaximin in the treatment of uncomplicated diverticular disease and in the prevention of recurrent diverticulitis. The use of rifaximin is associated with a low incidence of development, or persistence of spontaneous bacterial mutants. Moreover, the development of important drug resistance among extra-intestinal flora during rifaximin therapy is unlikely because of minimal systemic absorption and limited cross-resistance of rifaximin with other antimicrobials. This review addresses the current and emerging role of rifaximin in the treatment of gastrointestinal and liver disorders.Rani H Shayto Rachel Abou Mrad Ala I Sharara 2016World Journal of Gastroenterology2016,22,29:10
14Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index显示文摘AIM: To study the factors that may affect survival of cholangiocarcinoma in Lebanon. METHODS: A retrospective review of the medical records of 55 patients diagnosed with cholangio- carcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival. RESULTS: The median survival of all patients was 8.57 mo (0.03-105.2). Univariate analysis showed that low bilirubin level (< 10 mg/dL), radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012, 0.038 and 0.038, respectively). In subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 mo, P = 0.001). Multivariate analysis identifiedonly low bilirubin level < 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P < 0.05). CONCLUSION: Our data show that palliative and postoperative chemotherapy as well as a bilirubin level < 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.Mirna H Farhat Ali I Shamseddine Ayman N Tawil Ghina Berjawi Charif Sidani Wael Shamseddeen Kassem A Barada 2008World Journal of Gastroenterology2008,14,20:9
15抗磷脂综合征诊疗指南显示文摘静脉血栓主要指深静脉血栓形成(deep vein thrombosis,DVT),最常见的部位为腓肠肌静脉,其次为股静脉。深静脉血栓形成相当多见,在美国人群的年发病率为0.1%,每年有超过20万人患DVT,大约10%的DVT患者发生肺栓塞。欧美国家对DVT的诊治与病因研究做了大量的工作,特别是近年来随着临床检验技术与分子生物学的发展,易栓症的各种发病机制已相继发现。约一半的易栓症患者的病因可被确定。 我国尚无DVT的统计资料,一般的印象是低于西方人群,但临床病例日益增多,有的医院已建立了专科病房。总的来讲,我国在心脑血管疾病方面做的工作较多,但对DVT的研究还处于早期阶段,在深度与广度上与国际水平还有较大的距离。另一方面,中国人易栓症发生情况与西方人似有较大的差别。因子VLeiden仅发现两例,凝血酶原G20210A变异尚未见报导。近年来我国血液学会对静脉血栓栓塞的诊断与治疗提出了一系列的指导意见,我们组织翻译了有关资料供有关医务人员参考,以期进一步提高我国DVT的诊断与防治水平,并希望对确定我国DVT诊断与治疗的原则及发展规划有一定的意义。我们将分5个专题介绍这些指导意见,本期介绍的'抗磷脂综合征诊疗指南';'有症状门诊病人深静脉血栓形成的诊断,临床评价和D-二聚体分析可能减少对影像学诊断的需要'。Greaves M Cohen H Machin SJ Mackie I 白艳艳 王兆钺 2004国外医学(输血及血液学分册)2004,27,5:9
16Ever-increasing diversity of drug-induced pancreatitis显示文摘With over 100000 hospital admissions per annum,acute pancreatitis remains the leading gastrointestinal cause of hospitalization in the United States and has farreaching impact well beyond.It has become increasingly recognized that druginduced pancreatitis(DIP),despite accounting for less than 3%of all cases,represents an important and growing though often inconspicuous cause of acute pancreatitis.Nevertheless,knowledge of DIP is often curtailed by the limited availability of evidence needed to implicate given agents,especially for nonprescription medications.Indeed,the majority of available data is derived from case reports,case series,or case control studies.Furthermore,the mechanism of injury and causality for many of these drugs remain elusive as a definitive correlation is generally not established(<10%of cases).Several classification systems have been proposed,but no single system has been widely adopted,and periodic updates are required in light of ongoing pharmacologic expansion.Moreover,infrequently prescribed medications or those available over-thecounter(including herbal and other alternative remedies)are often overlooked as a potential culprit of acute pancreatitis.Herein,we review the ever-increasing diversity of DIP and the potential mechanisms of injury with the goal of raising awareness regarding the nature and magnitude of this entity.We believe this manuscript will aid in increasing both primary and secondary prevention of DIP,thus ultimately facilitating more expedient diagnosis and a decrease in DIPrelated morbidity.Simcha Weissman Muhammad Aziz Ryan B Perumpail Tej I Mehta Rutwik Patel James H Tabibian 2020World Journal of Gastroenterology2020,26,22:8
17螺内酯与可乐定作为难治性高血压第4种治疗药物的比较:难治性高血压的最佳治疗随机研究显示文摘该研究旨在通过一个多中心随机试验对作为难治性高血压患者的第4种治疗药物的螺内酯与可乐定进行比较。采用药丸计数评估药物治疗依从性。难治性高血压患者(定义为包括1种利尿剂在内的3种药物治疗12周,诊室及动态血压监测血压仍未控制)随机给予螺内酯(12.5~50 mg/d)或可乐定(0.1~0.3mg,2次/d)继续治疗12周。Krieger EM Drager LF Giorgi DMA Pereira AC Barreto-Filho JAS Nogueira AR Mill JG Lotufo PA Amodeo C Batista MC Bodanese LC Carvalho ACC Castro I Chaves H Costa EAS Feitosa GS Franco RJS Fuchs FD Guimarāes AC Jardim PC Machado CA Magalhāes ME Mion D Jr Nascimento RM Nobre F Nóbrega AC Ribeiro ALP Rodrigues-Sobrinho CR Sanjuliani AF Teixeira MDCB Krieger JE ReHOT Investigators 赵狄 练桂丽 2018中华高血压杂志2018,26,3:7
18Chronic stress sensitizes rats to pancreatitis induced by cerulein:Role of TNF-α显示文摘AIM:To investigate chronic stress as a susceptibility factor for developing pancreatitis,as well as tumor necrosis factor-α (TNF-α) as a putative sensitizer.METHODS:Rat pancreatic acini were used to analyze the influence of TNF-α on submaximal (50 pmol/L) cholecystokinin (CCK) stimulation.Chronic restraint (4 h every day for 21 d) was used to evaluate the effects of submaximal (0.2 μg/kg per hour) cerulein stimulation on chronically stressed rats.RESULTS:In vitro exposure of pancreatic acini toTNF-α disorganized the actin cytoskeleton.This was further increased by TNF-α/CCK treatment,which additionally reduced amylase secretion,and increased trypsin and nuclear factor-κB activities in a protein-kinase-C δ and ε-dependent manner.TNF-α/CCK also enhanced caspases' activity and lactate dehydrogenase release,induced ATP loss,and augmented the ADP/ATP ratio.In vivo,rats under chronic restraint exhibited elevated serum and pancreatic TNF-α levels.Serum,pancreatic,and lung inflammatory parameters,as well as caspases' activity in pancreatic and lung tissue,were substantially enhanced in stressed/cerulein-treated rats,which also experienced tissues' ATP loss and greater ADP/ATP ratios.Histological examination revealed that stressed/cerulein-treated animals developed abundant pancreatic and lung edema,hemorrhage and leukocyte infiltrate,and pancreatic necrosis.Pancreatitis severity was greatly decreased by treating animals with an anti-TNF-αantibody,which diminished all inflammatory parameters,histopathological scores,and apoptotic/necrotic markers in stressed/cerulein-treated rats.CONCLUSION:In rats,chronic stress increases susceptibility for developing pancreatitis,which involves TNF-α sensitization of pancreatic acinar cells to undergo injury by physiological cerulein stimulation.Marcelo G Binker Andres A Binker-Cosen Daniel Richards Herbert Y Gaisano Rodica H de Cosen Laura I Cosen-Binker 2010World Journal of Gastroenterology2010,16,44:7
19Establishing the presence or absence of chronic kidney disease:Uses and limitations of formulas estimating the glomerular filtration rate显示文摘The development of formulas estimating glomerular filtration rate(eG FR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease(CKD),which is based on e GFR values and albuminuria.This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based e GFR values and between e GFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all e GFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and,particularly, biomarkers of early renal tissue injury.Ahmed Alaini Deepak Malhotra Helbert Rondon-Berrios Christos P Argyropoulos Zeid J Khitan Dominic SC Raj Mark Rohrscheib Joseph I Shapiro Antonios H Tzamaloukas 2017World Journal of Methodology2017,7,3:7
20Recurrence of inflammatory pseudotumor in the distal bile duct: Lessons learned from a single case and reported cases显示文摘煽动性的 myofibroblastic 肿瘤(IMT ) 或煽动性的假肿瘤(IP ) 广泛地在文学被讨论了。他们通常在肺和上面的呼吸道被发现。然而,包含 biliopancreatic 区域的案例报导在最近的年增加了。限制到胰腺的头或远侧的胆汁管的这些损害的 Immunohistochemical 学习似乎与那些在称为自体免疫的胰腺炎的一个新实体观察了兼容,但是通常强烈的纤维变性反应(带状配列) 支配生产一个团。当这个条件限于胰腺的头时,胆总管可能被煽动性的过程包含,黄疸可以经常发生类似于胰的腺癌。我们以前报导了从与是一个极其稀罕的实体的自体免疫的胰腺炎联系的胆汁管产生的 IMT 的一个案例。在 Kaush-Whipple 切除术以后的四年,平淡的后续上的放射学的检查揭示了一个肿瘤团,建议本地复发。指导超声的 FNA 证实了我们的可疑诊断。作为其它,这个现在的案例建议坚持的后续是必要的以便在这个特定的地点阻止不可逆的肝损坏。EM López-Tomassetti Fernández H Díaz Luis A Martín Malagón I Arteaga González A Carrillo Pallarés 2006World Journal of Gastroenterology2006,12,24:7
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