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| 1 | 人类血压测量方法:美国心脏协会科学声明显示文摘准确的血压测量对高血压诊断与治疗至关重要。该文是美国心脏协会关于人类血压测量的最新科学声明。业已证实,在诊室许多电子血压计可以准确测量血压,同时减少与听诊法有关的人为误差。即使没有一个观察者在场,全自动电子血压计也可以通过多次测量提供较听诊法更准确的血压测量值。研究表明诊室外所测血压与诊室血压比较存在实质性差别。目前认为动态血压监测是诊室外血压评估的参考标准,当动态血压监测不可行或患者不能耐受时,家庭血压监测则是一个替代方法。 | 赵狄(摘译) 练桂丽(审校) Muntner P Shimbo D Carey RM Charleston JB Gaillard T Misra S Myers MG Ogedegbe G Schwartz JE Townsend RR Urbina EM Viera AJ White WB Wright JT Jr | 2019 | 中华高血压杂志2019，27，6： | 16 |
| 2 | Echoplanar diffusion - weighted MRI with intravenous gadolinium - DTPA显示文摘It is occasionally necessary to repeat diffusion weighted imaging(DWI)after giving intravenous contrast medium(CM).However,the effects of CM on DWI and apparent diffusion coefficients(ADC)have not been fully ex-amined.The aim of this prospective study was to investigate whether there are any diagnostically significant dif-ferences between echo-planar imaging(EPI)-DWI before and after intravenous CM.EPI-DWI was acquiredtwice in 203 consecutive patients before and after i.v.CM.Three blinded readers rated the diagnostic | Fitzek C Mentzel HJ Fitzek S Sauner D Kaiser WA Reichenbach JR | 2003 | 中国神经肿瘤杂志2003，1，4： | 15 |
| 3 | 将卒中纳入心血管风险预测工具美国心脏协会/美国卒中协会对医疗卫生专业人员的声明显示文摘背景和目的目前美国针对心血管事件风险预测以及一级和二级预防的指南声明均使用绝对风险估计值来识别血管事件高危患者以及可从特定干预措施中获益的患者。然而,这些指南并未明确地包括卒中患者。本指南对现有证据和争论进行概述以支持:(1)将卒中(尤其是动脉粥样硬化性卒中)患者纳入心血管病绝对风险增高的患者群体;(2)将卒中纳入血管性疾病风险预测工具的转归预测因素。方法和结果写作组成员由委员会联合主席基于先前在相关领域的研究成果来提名,并得到美国心脏协会(American Heart Association,AHA)卒中委员会科学声明监督委员会以及文稿监督委员会的批准。作者采用系统文献回顾(覆盖1980年1月至2010年3月期间的文献)并参考以往公布的指南、个人资料以及专家观点,以归纳现有证据,提出当前知识的不足,并根据AHA标准对适当的问题制定推荐意见。所有写作组成员均有机会对推荐意见进行评论并批准了最终版本。经广泛的AHA内部同行评议以及卒中委员会领导阶层和科学声明监督委员会的审阅后,最终获得AHA科学咨询和协调委员会的批准。将卒中患者(尤其是动脉粥样硬化性卒中患者)纳入冠状动脉和心血管病绝对高危人群的原因如下。首先,有证据显示,缺血性卒中患者发生致死性和非致死性心肌梗死或猝死的绝对风险增高,10年绝对风险≥20%,这一风险阈值已被一些指南用于定义冠状动脉疾病风险等危症。其次,纳入动脉粥样硬化性卒中的原因与纳入糖尿病、周围血管病、慢性肾脏病以及其他动脉粥样硬化性疾病的原因相同,尽管尚缺乏在所有人群或患者中风险增高的统一证据。再次,缺血性卒中的大动脉粥样硬化性卒中亚型与其他这些疾病的病理生理学机制相同。将卒中纳入高危因素将导致高危人群的数量扩大约10%。然而,由于卒中的异质性,尚不确定其他卒中亚型,包括出血性卒中以及非动脉粥样硬化性卒中亚型,是否应被视为具有相同水平的风险,因此有待进一步研究。鉴于卒中对残疾和死亡的影响、卒中与其他血管性疾病预防措施的相似性以及卒中在某些人群中较冠状动脉疾病更高的重要性,将卒中、心肌梗死和猝死纳入心血管事件风险预测工具的转归预测因素是合适的。美国以外的指南常常将卒中患者纳入心血管高危人群,并将卒中作为心脏终点的一个相关转归事件。结论动脉粥样硬化性卒中患者应被纳入会进一步发生冠状动脉粥样硬化事件的高危患者(10年≥20%)。是否应纳入非动脉粥样硬化卒中亚型尚不确定。对于一级预防,缺血性卒中应被纳入绝对风险评估方案的心血管疾病转归事件。将动脉粥样硬化性卒中作为一个高危因素或者更宽泛地将缺血性卒中视作一种转归事件纳入,可能对心血管病的预防具有重要意义,因为被评定为高危风险的患者数量将大幅增加。 | Daniel T. Lackland Mitchell S.V. Elkind Ralph D'Agostino Sr Mandip S. Dhamoon David C. Goff Jr Randall T. Higashida Leslie A. McClure Pamela H. Mitchell Ralph L. Sacco Cathy A. Sila Sidney C. Smith Jr David Tanne David L. Tirschwell Emmanuel Touze Lawrence R. Wechsler 4:~ 尤寿江(译) 于海龙(译) 刘慧慧(译) 张霞(译) 刘春风(译) | 2012 | 国际脑血管病杂志2012，20，11： | 13 |
| 4 | Endonasal Versus Supraorbital Keyhole Removal of Craniopharynglomas and Tuberoulumsellae Meningiomas显示文摘 | Fatemi N Dusick JR de Paiva Neto MA Malkasian D Kelly DF | 2009 | 中国神经肿瘤杂志2009，7，1： | 12 |
| 5 | 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 |
| 6 | 高剂量美罗培南与多黏菌素B的联合:解决鲍曼不动杆菌碳青霉烯类耐药性问题的新策略显示文摘长期以来,多黏菌素与碳青霉烯类药物联合用于治疗碳青霉烯类耐药鲍曼不动杆菌的药效学研究较少。作者对多黏菌素B与高剂量美罗培南联合使用是否可以提高杀菌率以及抑制对碳青霉烯类耐药的产生进行了研究。 | 卞星晨 刘笑芬 Lenhard JR Bulitta JB Terry D | 2017 | 中国感染与化疗杂志2017，17，4： | 8 |
| 7 | 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 |
| 8 | 诊断性试验和策略的证据质量和推荐强度的分级显示文摘GRADE系统能对诊断性试验或策略的证据质量和推荐强度进行分级。本文旨在阐释在此过程中如何考虑患者的重要结局, | Holger J Schünemann Andrew D Oxman Jan Brozek Paul Glasziou Roman Jaeschke Gunn E Vist John W Williams Jr Regina Kunz Jonathan Craig Victor M Montori Patrick Bossuyt Gordon H Guyatt 李晓 黄程 陈耀龙 李幼平 | 2009 | 中国循证医学杂志2009，9，5： | 7 |
| 9 | Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions显示文摘During the last 15 years we have witnessed an unprecedented expansion in the drugs developed to target human epidermal growth factor receptor-2(HER-2) positive breast cancer. Trastuzumab, pertuzumab, adotrastuzumab emtansine and lapatinib are currently food and drug administration(FDA)-approved for the treatment of breast cancer patients with HER-2 overexpressed. However, given the amount of information gathered from years of uninterrupted clinical research, it is essential to have periodic updates that succinctly recapitulate what we have learnt over these last years and help us to apply that information in our daily practice. This review will pursue that objective. We will summarize the most relevant and updated informationrelated to the state of the art management of HER-2 positive breast cancer in all the clinical scenarios including the adjuvant, neoadjuvant and metastatic settings. But we will also critically appraise that literature in order to highlight some key clinical concepts that should not be overlooked. Lastly, this review will also point out some of the most promising strategies that are currently being tested and may soon become available. | Gonzalo Recondo Jr Enrique Dìaz Canton Màximo de la Vega Martin Greco Gonzalo Recondo Sr Matias E Valsecchi | 2014 | World Journal of Clinical Oncology2014，5，3： | 7 |
| 10 | 非诺贝特治疗与2型糖尿病患者长期心血管病风险的关系显示文摘2型糖尿病患者心血管病风险高,部分原因在于高三酰甘油和低高密度脂蛋白胆固醇血症。而在他汀类药物治疗基础上,加强降低三酰甘油治疗,能否降低这种风险尚不清楚。该研究的目的是在使用他汀类药物治疗的2型糖尿病患者中,确定非诺贝特能否降低心血管病风险。 | 刘莉 叶鹏 Elam MB Ginsberg HN Lovato LC Corson M Largay J Leiter LA Lopez C O'Connor PJ Sweeney ME Weiss D Friedewald WT Buse JB Gerstein HC Probstfield J Grimm R Ismail-Beigi F Goff DC Jr Fleg JL Rosenberg Y Byington RP ACCORDION study investigators | 2017 | 中华高血压杂志2017，25，6： | 7 |
| 11 | 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 |
| 12 | Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections显示文摘Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompt-ing increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor. | Christopher S Kovacs Jr Christine E Koval David van Duin Amanda Guedes de Morais Blanca E Gonzalez Robin K Avery Steven D Mawhorter Kyle D Brizendine Eric D Cober Cyndee Miranda Rabin K Shrestha Lucileia Teixeira Sherif B Mossad | 2014 | World Journal of Transplantation2014，4，2： | 7 |
| 13 | Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients显示文摘AIM To describe the relationships between non-alcoholic fatty-liver disease(NAFLD) patient's disease consequences and treatment perceptions, self-efficacy, and healthy lifestyle maintenance. METHODS A cross-sectional study among 146 ultrasound diagnosed NAFLD patients who visited the fatty liver clinic at the TelAviv Medical Center. Eighty-seven of these individuals, participated in a clinical trial of physical activity and underwent fasting blood tests, analyzed at the same lab. Exclusion criteria included positivity for serum HBsA g or anti-HCV antibodies; fatty liver suspected to be secondary to hepatotoxic drugs; excessive alcohol consumption(≥ 30 g/d in men or ≥ 20 g/d in women) and positive markers of genetic or immune-mediated liver diseases. Patients were asked to complete a selfreport structured questionnaire, assembled by the Israeli Center for Disease Control. Nutrition habits were measured using six yes/no questions(0 = no, 1 = yes) adopted from the national survey questionnaire. Participants in the clinical trial completed a detailed semi-quantitative food frequency questionnaire(FFQ) reporting their habitual nutritional intake during the past year. Self-efficacy was assessed by the Self-Efficacy Scale questionnaire, emotional representation, degree of illness understanding, timeline perception, treatment perception and symptoms were measured by the Brief Illness Perception questionnaire. Illness consequences were measured by the Personal Models of Diabetes Interview questionnaire. A path analysis was performed to describe the interrelationships between the patients' illness perceptions, and assess the extent to which the data fit a prediction of nutritional habits.RESULTS The study sample included 54.1% men, with a mean age of 47.76 ± 11.68 years(range: 20-60) and mean body mass index of 31.56 ± 4.6. The average perceived nutrition habits score was 4.73 ± 1.45 on a scale between 0-6, where 6 represents the healthiest eating habits. Most of the study participants(57.2%) did not feel they fully understood what NAFLD is. Better nutritional habits were positively predicted by the degree of illness understanding(β = 0.26; P = 0.002) and selfefficacy(β = 0.25; P = 0.003). Perceptions of more severe illness consequences were related with higher emotional representation(β = 0.55; P < 0.001), which was related with lower self-efficacy(β =-0.17; P = 0.034). The perception of treatment effectiveness was positively related with self-efficacy(β = 0.32; P < 0.001). In accordance with the correlation between self-efficacy and the perceived nutrition habits score, self-efficacy was also correlated with nutrient intake evaluated by the FFQ; negatively with saturated fat(percent of saturated fat calories from total calories)(r =-0.28, P = 0.010) and positively with fiber(r = 0.22, P = 0.047) and vitamin C intake(r = 0.34, P = 0.002). In a sub analysis of the clinical trial participants, objectively measured compliance to physical activity regimen was positively correlated with the self-efficacy level(r = 0.34, P = 0.046). CONCLUSION Self-efficacy and illness understanding are major determinants of lifestyle-modification among NAFLD patients. This information can assist clinicians in improving compliance with lifestyle changes among these patients. | Shira Zelber-Sagi Shiran Bord Gali Dror-Lavi Matthew Lee Smith Samuel D Towne Jr Assaf Buch Muriel Webb Hanny Yeshua Assy Nimer Oren Shibolet | 2017 | World Journal of Gastroenterology2017，23，10： | 6 |
| 14 | Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation显示文摘BACKGROUND The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLDLT)must still be ascertained,mainly among young children.Clinical and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver transplantation.AIM To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing PLDLT.METHODS We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLDLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative complications.The receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/kg.Subsequently,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be analyzed.RESULTS High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up period.During a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the LTr.Over a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection complications.Additionally,Cox hazard regression found that high-volume RBC transfusion increased the mortality risk by 3.031-fold compared to low-volume transfusion.The Kaplan-Meier survival curves of the studied groups were compared using log-rank tests and the analysis showed significantly decreased graft survival,but with no impact in patient survival related to major complications.On the other hand,there was a significant decrease in both graft and patient survival,with high-volume RBC transfusion.CONCLUSION Transfusion of RBC volume higher than 27.5 mL/kg during the perioperative period is associated with a significant increase in short-and long-term postoperative morbidity and mortality after PLDLT. | Karina Gordon Estela Regina Ramos Figueira Joel Avancini Rocha-Filho Luiz Antonio Mondadori Eduardo Henrique Giroud Joaquim Joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla Jose Otavio Costa Auler Jr Maria Jose Carvalho Carmona Luiz Augusto Carneiro D'Alburquerque | 2021 | World Journal of Gastroenterology2021，27，12： | 6 |
| 15 | Genome resequencing and transcriptome profiling reveal structural diversity and expression patterns of constitutive disease resistance genes in Huanglongbing-tolerant Poncirus trifoliata and its hybrids显示文摘Huanglongbing(HLB)is the most destructive bacterial disease of citrus worldwide.While most citrus varieties are susceptible to HLB,Poncirus trifoliata,a close relative of Citrus,and some of its hybrids with Citrus are tolerant to HLB.No specific HLB tolerance genes have been identified in P.trifoliata but recent studies have shown that constitutive disease resistance(CDR)genes were expressed at much higher levels in HLB-tolerant Poncirus hybrids and the expression of CDR genes was modulated by Candidatus Liberibacter asiaticus(CLas),the pathogen of HLB.The current study was undertaken to mine and characterize the CDR gene family in Citrus and Poncirus and to understand its association with HLB tolerance in Poncirus.We identified 17 CDR genes in two citrus genomes,deduced their structures,and investigated their phylogenetic relationships.We revealed that the expansion of the CDR family in Citrus seems to be due to segmental and tandem duplication events.Through genome resequencing and transcriptome sequencing,we identified eight CDR genes in the Poncirus genome(PtCDR1-PtCDR8).The number of SNPs was the highest in PtCDR2 and the lowest in PtCDR7.Most of the deletion and insertion events were observed in the UTR regions of Citrus and Poncirus CDR genes.PtCDR2 and PtCDR8 were in abundance in the leaf transcriptomes of two HLB-tolerant Poncirus genotypes and were also upregulated in HLB-tolerant,Poncirus hybrids as revealed by real-time PCR analysis.These two CDR genes seem to be good candidate genes for future studies of their role in citrus-CLas interactions. | Nidhi Rawat Brajendra Kumar Ute Albrecht Dongliang Du Ming Huang Qibin Yu Yi Zhang Yong-Ping Duan Kim D Bowman Fred G Gmitter Jr Zhanao Deng | 2017 | Horticulture Research2017，4，1： | 5 |
| 16 | Clinical and pathological characteristics of brain metastasis resected after failed radiosurgery显示文摘 | Jagannathan J Bourne TD Schlesinger D Yen CP Shaffrey ME Laws ER Jr Sheehan JP. | 2010 | 中国神经肿瘤杂志2010，8，1： | 4 |
| 17 | Hepatitis B infection among adults in the philippines:A national seroprevalence study显示文摘AIM:To determine the prevalence of hepatitis B surface antigen(HBsAg)seropositivity among adult Filipinos.METHODS:Testing for HBsAg was performed on serum samples from persons aged ≥ 20 years old who participated in the National Nutrition and Health Survey(NNHeS)conducted in 2003.Information on age,sex,marital status,educational attainment,employment status,and income were collected.For this study,marital status was classified as never married or otherwise(i.e.,married,divorced,separated,widowed);educational attainment was classified as high school graduate or below or at least some tertiary education;and employment status was classified as currently employed or currently unemployed.Annual income was divided into 4 quartiles in Philippine pesos(PhP):Q1,≤ PhP 53064;Q2,PhP 53065-92192;Q3,PhP 92193-173387;and Q4,≥ PhP 173388.Prevalence estimates were weighted so that they represented the general population.Social and demographic factors were correlated with HBsAg seropositivity.Multivariate analysis was used to determine independent predictors of HBsAg seropositivity.RESULTS:A total of 2150 randomly selected adults,20 years and over,out of the 4753 adult participants of NNHeS were tested for HBsAg.The HBsAg seroprevalence was 16.7%(95%CI:14.3%-19.1%),which corresponded to an estimated 7278968 persons infected with hepatitis B.There was no significant difference between males and females(17.5% vs 16.0%;P = 0.555).This corresponded to an estimated 3721775 men and 3557193 women infected with hepatitis B.The HBsAg seroprevalence peaked at age 20-39 years old,with declining prevalence in the older age groups.The only independent predictor of HBsAg seropositivity was the annual income,with persons in the highest income quartile being less likely to be HBsAg positive(age-adjusted OR = 0.51;95%CI:0.30-0.86)compared to subjects in the lowest income quartile.Sex,marital status,educational attainment,and employment status were not found to be independent predictors of HBsAg seropositivity.CONCLUSION:The high HBsAg seroprevalence among adults in the Philippines classifies the country as hyperendemic for HBV infection and appears unchanged over the last few decades. | Stephen N Wong Janus P Ong Madalinee Eternity D Labio Oscar T Cabahug Maria Lourdes O Daez Erlinda V Valdellon Jose D Sollano Jr Marilyn O Arguillas | 2013 | World Journal of Hepatology2013，5，4： | 3 |
| 18 | Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil. | Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari | 2019 | World Journal of Gastroenterology2019，25，38： | 2 |
| 19 | The endoscopic assessment of esophagitis: A progress report on observer agreement显示文摘 | D Armstrong JR Bennett AL Blum J Dent FT De Dombal JP Galmiche L Lundell M Margulies JE Richter SJ Spechler GN Tytgat L Wallin | 1996 | Gastroenterology1996，，1： | 2 |
| 20 | Structure of glycerol dehydratase reactivase:a new type of molecular chaperone显示文摘 | Liao D L Reiss L Turner Lvan Jr | 2003 | Structure2003，11，： | 2 |
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