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| 1 | 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 |
| 2 | 冠状动脉内影像学临床应用专家共识(第一部分):对冠状动脉介入治疗的指导与优化显示文摘欧洲心血管介入协会(EAPCI)专家组系统总结了血管内超声(IVUS)和光学相干断层成像(OCT)这两种血管内影像学检查临床应用指征的现有证据,提供了关于IVUS和OCT指导经皮冠状动脉介入治疗(PCI)的应用价值,并明确了最可能从腔内影像学指导的介入治疗中获得临床收益的患者或病变类型,同时详细论述了PCI前如何使用IVUS或OCT优化支架尺寸(支架长度和直径)和手术策略的选择。此外,专家推荐对支架失败(支架内再狭窄或支架内血栓形成)的患者应常规进行冠状动脉内影像学检查,并首选OCT。最后,重点论述了IVUS和OCT在指导PCI和评估支架失败两个方面的优势和局限性,并对未来需要深入研究的领域进行了展望。 | Lorenz Raber Gary S Mintz Konstantinos C Koskinas Thomas W Johnson Niels R Holm Yoshinubo Onuma Maria D Radu Michael Joner Bo Yu Haibo Jia Nicolas Meneveau Jose M.de la Torre Hemandez Javier Escaned Jonathan Hill Francesco Prati Antonio Colombo Carlo di Mario Evelyn Regar Davide Capodanno William Wijns Robert A Byme Giulio Guagliumi | 2019 | 中华心血管病杂志2019,47,1: | 17 |
| 3 | Nat Biotechnol:将人星形胶质细胞重编程为多巴胺能神经元,有助治疗帕金森病显示文摘帕金森病是一种主要影响运动系统的神经退行性疾病。它的特征在于大脑中的多巴胺能神经元(dopaminergic neuron)渐进性丧失。尽管当前的疗法旨在补充多巴胺水平,但是没有一种疗法能够恢复这些丢失的细胞。如今。在一项新的研究中,来自瑞典、奥地利、西班牙和美国的研究人员开发出一种方法:将神经胶质细胞(glialcell)转化为活性的多巴胺能神经元,并且所产生的多巴胺能神经元能够部分恢复帕金森病模式小鼠的运动功能。这项概念验证研究可能为开发出一种治疗这种疾病的新方法铺平道路。 | Pia Rivetti di Val Cervo, Elisa Martín-Montañez, Enrique M Toledo, Gioele La Manno, Sara Padrell Sánchez, Sten Linnarsson Ernest Arenas Roman A Romanov, Christian Pifl Tibor Harkany Roman A Romanov, Giada Spigolon, Débora Masini, Michael Feyder, Tibor Harkany Gilberto Fisone Elisa Martín-Montañez Yi-Han Ng Marius Wernig | 2017 | 现代生物医学进展2017,17,17: | 11 |
| 4 | Expression of triggering receptor on myeloid cell 1 and histocompatibility complex molecules in sepsis and major abdominal surgery显示文摘AIM: To evaluate the surface expression of triggering receptor on myeloid cell 1 (TREM-1), class Ⅱ major histocompatibility complex molecules (HLA-DR), andthe expression of the splicing variant (svTREM-1) ofTREM-1 in septic patients and those subjected to major abdominal surgery.METHODS: Using flow cytometry, we examined the surface expression of TREM-1 and HLA-DR in peripheral blood monocytes from 11 septic patients, 7 elective gastrointestinal surgical patients, and 10 healthy volunteers. svTREM-1 levels were analyzed by RT-PCR. RESULTS: Basal expression of TREM-1 and HLA-DR in healthy volunteers was 35.91±14.75 MFI and75.8±18.3%, respectively. In septic patients, TREM-1 expression was 59.9±23.9 MFI and HLA-DR expression was 44.39±20.25%, with a significant differencebetween healthy and septic groups (P<0.05) for bothmolecules. In the surgical patients, TREM-1 and HLA-DR expressions were 56.8±20.85 MFI and 71±13.8% before surgery and 72.65±29.92 MlFI and 72.82±22.55% after surgery. TREM-1 expression was significantly different(P = 0.0087) between the samples before and aftersurgery and svTREM-1 expression was 0.8590±0.1451 MF1, 0.8820±0.1460 MF1, and 2.210±0.7873MF1 in the healthy, surgical (after surgery) and septic groups, respectively. There was a significant difference (P = 0.048) in svTREM-1 expression between the healthy and surgical groups and the septic group.CONCLUSION: TREM-1 expression is increased during systemic inflammatory conditions such as sepsis and the postoperative phase. Simultaneous low expression of HLA-DR molecules correlates with the severity of illness and increases susceptibility to infection. Additionally, TREM-1 expression is distinctly different in surgical patients at different stages of the inflammatory response before and after surgery. Thus, surface TREM-1 appears to be an endogenous signal during the course of the inflammatory response. svTREM-1 expression is significantly increased during sepsis, appearing to be an indicator of severity of illness. Together, these data indicate that TREM-1 may play an important role in establishing and amplifying the systemic inflammatory response. TREM-1, HLA-DR, and svTREM-1 expression analysis can provide useful diagnostic and prognostic indicators during SIRS, CARS, and sepsis. | Nestor González-Roldán Eduardo Ferat-Osorio Rosalía Aduna-Vicente Isabel Wong-Baeza Noemí Esquivel-Callejas Horacio Astudillo-de la Vega Patricio Sánchez-Fernández Lourdes Arriaga-Pizano Miguel Angel Villasís-Keever Constantino López-Macías Armando Isibasi | 2005 | World Journal of Gastroenterology2005,11,47: | 9 |
| 5 | 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 |
| 6 | Leukemia:研究鉴定出与34种AML白血病亚群相关联的基因突变显示文摘针对成年急性髓细胞白血病(acute myeloid leukemia,AML)患者的一项新的大型研究将80种癌症相关基因突变与5种AML亚型相关联。这5种AML亚型可通过特异性的染色体异常加以确定。在未来,这些发现可能有助指导基因突变测试和治疗决策。 | A-K Eisfeld K Mrózek J Kohlschmidt D Nicolet S Orwick C J Walker K W Kroll J S Blachly A J Carroll J E Kolitz B L Powell E S Wang R M Stone A de la Chapelle J C Byrd C D Bloomfield | 2017 | 现代生物医学进展2017,17,15: | 7 |
| 7 | Proteomics for discovery of candidate colorectal cancer biomarkers显示文摘Colorectal cancer(CRC)is the second most common cause of cancer-related deaths in Europe and other Western countries,mainly due to the lack of wellvalidated clinically useful biomarkers with enough sensitivity and specificity to detect this disease at early stages.Although it is well known that the pathogenesis of CRC is a progressive accumulation of mutations in multiple genes,much less is known at the proteome level.Therefore,in the last years many proteomic studies have been conducted to find new candidate protein biomarkers for diagnosis,prognosis and as therapeutic targets for this malignancy,as well as to elucidate the molecular mechanisms of colorectal carcinogenesis.An important advantage of the proteomic approaches is the capacity to look for multiple differentially expressed proteins in a single study.This review provides an overview of the recent reports describing the different proteomic tools used for the discovery of new protein markers for CRC such as two-dimensional electrophoresis methods,quantitative mass spectrometry-based techniques or protein microarrays.Additionally,we will also focus on the diverse biological samples used for CRC biomarker discovery such as tissue,serum and faeces,besides cell lines and murine models,discussing their advantages and disadvantages,and summarize the most frequently identified candidate CRC markers. | Paula lvarez-Chaver Olalla Otero-Estévez María Páez de la Cadena Francisco J Rodríguez-Berrocal Vicenta S Martínez-Zorzano | 2014 | World Journal of Gastroenterology2014,20,14: | 7 |
| 8 | Aging related methylation influences the gene expression of key control genes in colorectal cancer and adenoma显示文摘AIM To analyze colorectal carcinogenesis and age-related DNA methylation alterations of gene sequences associated with epigenetic clock CpG sites. METHODS In silico DNA methylation analysis of 353 epigenetic clock Cp G sites published by Steve Horvath was performed using methylation array data for a set of 123 colonic tissue samples [64 colorectal cancer(CRC), 42 adenoma, 17 normal; GEO accession number: GSE48684]. Among the differentially methylated agerelated genes, secreted frizzled related protein 1(SFRP1) promoter methylation was further investigated in colonic tissue from 8 healthy adults, 19 normal children, 20 adenoma and 8 CRC patients using bisulfite-specific PCR followed by methylation-specific high resolution melting(MS-HRM) analysis. m RNA expression of age-related 'epigenetic clock' genes was studied using Affymetrix HGU133 Plus2.0 whole transcriptome data of 153 colonic biopsy samples(49 healthy adult, 49 adenoma, 49 CRC, 6 healthy children)(GEO accession numbers: GSE37364, GSE10714, GSE4183, GSE37267). Whole promoter methylation analysis of genes showing inverse DNA methylationgene expression data was performed on 30 colonic samples using methyl capture sequencing.RESULTS Fifty-seven age-related Cp G sites including hypermethylated PPP1R16 B, SFRP1, SYNE1 and hypomethylated MGP, PIPOX were differentially methylated between CRC and normal tissues(P < 0.05, ?β≥ 10%). In the adenoma vs normal comparison, 70 CpG sites differed significantly, including hypermethylated DKK3, SDC2, SFRP1, SYNE1 and hypomethylated CEMIP, SPATA18(P < 0.05, ?β≥ 10%). In MS-HRM analysis, the SFRP1 promoter region was significantly hypermethylated in CRC(55.0% ± 8.4 %) and adenoma tissue samples(49.9% ± 18.1%) compared to normal adult(5.2% ± 2.7%) and young(2.2% ± 0.7%) colonic tissue(P < 0.0001). DNA methylation of SFRP1 promoter was slightly, but significantly increased in healthy adults compared to normal young samples(P < 0.02). This correlated with significantly increased SFRP1 m RNA levels in children compared to normal adult samples(P < 0.05). In CRC tissue the mR NA expression of 117 agerelated genes were changed, while in adenoma samples 102 genes showed differential expression compared with normal colonic tissue(P < 0.05, logF C > 0.5). The change of expression for several genes including SYNE1, CLEC3 B, LTBP3 and SFRP1, followed the same pattern in aging and carcinogenesis, though not for all genes(e.g., MGP). CONCLUSION Several age-related DNA methylation alterations can be observed during CRC development and progression affecting the m RNA expression of certain CRC- and adenoma-related key control genes. | Orsolya Galamb Alexandra Kalmár Barbara Kinga Barták árpád V Patai Katalin Leiszter Bálint Péterfia Barnabás Wichmann Gábor Valcz Gábor Veres Zsolt Tulassay Béla Molnár | 2016 | World Journal of Gastroenterology2016,22,47: | 7 |
| 9 | New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics显示文摘Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem. | Antonio Damián Sánchez-Capilla Paloma De La Torre-Rubio Eduardo Redondo-Cerezo | 2014 | World Journal of Gastrointestinal Pathophysiology2014,5,3: | 7 |
| 10 | Pulmonary vein stenosis:Etiology,diagnosis and management显示文摘Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS. | Pablo Pazos-López Cristina García-Rodríguez Alba Guitián-González Emilio Paredes-Galán María ángel De La Guarda álvarez-Moure Marta Rodríguez-álvarez José Antonio Baz-Alonso Elvis Teijeira-Fernández Francisco Eugenio Calvo-Iglesias Andrés íniguez-Romo | 2016 | World Journal of Cardiology2016,8,1: | 6 |
| 11 | Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy显示文摘Hepatic encephalopathy(HE)is a cognitive disturbance characterized by neuropsychiatric alterations.It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts.The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration.Therefore,the embolization of these shunts has been performed tocontrol HE manifestations,but the presence of portal vein thrombosis is considered a contraindication.In this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic shunt.Case report:a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma,even without precipitant factors.She had a wide portosystemic shunt and also portal vein thrombosis.The abdominal angiography confirmed the splenorenal shunt and showed other shunts.The larger shunt was embolized through placement of microcoils,and the patient had no recurrence of overt HE.There was a little increase of esophageal and gastric varices,but no endoscopic treatment was needed.Since portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients,portal vein thrombosis should be considered a relative contraindication to perform a shunt embolization.However,in particular cases with many shunts and severe HE,we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE recovery.In conclusion,we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein thrombosis.As the patient had other shunts,she was successfully treated by embolization of the larger shunt. | Letícia de Campos Franzoni Fábio Cardoso de Carvalho Rafael Gomes de Almeida Garzon Fábio da Silva Yamashiro Laís Augusti Lívia Alves Amaral Santos Mariana de Souza Dorna Júlio Pinheiro Baima Talles Bazeia Lima Carlos Antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro | 2014 | World Journal of Gastroenterology2014,20,42: | 6 |
| 12 | A clinical trial of CTLA-4 blockade with tremelimumab in patients with hepatocellular carcinoma and chronic hepatitis C显示文摘 | Bruno Sangro Carlos Gomez-Martin Manuel de la Mata Mercedes I?arrairaegui Elena Garralda Pilar Barrera Jose Ignacio Riezu-Boj Esther Larrea Carlos Alfaro Pablo Sarobe Juan José Lasarte Jose L. Pérez-Gracia Ignacio Melero Jesús Prieto | 2013 | Journal of Hepatology2013,,: | 6 |
| 13 | Reduced Exposure to Calcineurin Inhibitors Early After Liver Transplantation Prevents Recurrence of Hepatocellular Carcinoma显示文摘 | Manuel Rodríguez-Perálvarez Emmanuel Tsochatzis María Carmen Naveas Giulia Pieri Carmen García-Caparrós James O’Beirne Antonio Poyato-González Gustavo Ferrín-Sánchez Jose Luis Montero-álvarez David Patch Douglas Thorburn Javier Brice?o Manuel De la Mata A | 2013 | Journal of Hepatology2013,,: | 5 |
| 14 | 妊娠期高血压免疫因子、肿瘤坏死因子α、血管紧张素Ⅱ1型受体自身抗体对妊娠可溶性fms样酪氨酸1和可溶性Endoglin产物的影响显示文摘最近研究发现先兆子痫中血管新生因子、可溶性fms样酪氨酸激酶(sFlt-1)和可溶性Endoglin(sEn-doglin)不平衡;然而尚不清楚它们过度分泌的启动机制。方法:长期给予怀孕大鼠肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)或抗血管紧张素Ⅱ受体的自身抗体(AT1-AA),测定其循环和胎盘的sFlt-1和(或)sEndoglin以确定这些因素的免疫调节作用。 | Parrish MR Murphy SR Rutland S Wallace K Wenzel K Wallukat G Keiser S Ray LF Dechend R Martin JN Granger JP La Marca B 黄晓斌 | 2010 | 中华高血压杂志2010,18,12: | 5 |
| 15 | Potential of soluble CD26 as a serum marker for colorectal cancer detection显示文摘Colorectal cancer is characterized by a low survival rate even though the basis for colon cancer development,which involves the evolution of adenomas to carcinoma,is known.Moreover,the mortality rates continue to rise in economically transitioning countries although there is the opportunity to intervene in the natural history of the adenoma–cancer sequence through risk factors,screening,and treatment.Screening in particular accounted for most of the decline in colorectal cancer mortality achieved in the USA during the period 1975-2000.Patients show a better prognosis when the neoplasm is diagnosed early.Among the variety of screening strategies,the methods range from invasive and costly procedures such as colonoscopy to more low-cost and non-invasive tests such as the fecal occult blood test(guaiac and immunochemical).As a non-invasive biological serum marker would be of great benefit because of the performance of the test,several biomarkers,including cytologic assays,DNA and mRNA,and soluble proteins,have been studied.We found that the soluble CD26(sCD26)concentration is diminished in serum of colorectal cancer patients compared to healthy donors,suggesting the potential utility of a sCD26 immunochemical detection test for early diagnosis.sCD26 originates from plasma membrane CD26 lacking its transmembrane and cytoplasmic domains.Some 90%–95%of sCD26 has been associated with serum dipeptidyl peptidase IV(DPPIV)activity.DPP-IV,assigned to the CD26 cluster,is a pleiotropic enzyme expressed mainly on epithelial cells and lymphocytes.Our studies intended to validate this test for population screening to detect colorectal cancer and advanced adenomas are reviewed here. | Oscar J Cordero Monica Imbernon Loretta De Chiara Vicenta S Martinez-Zorzano Daniel Ayude Maria Paez de la Cadena F Javier Rodriguez-Berrocal | 2011 | World Journal of Clinical Oncology2011,2,6: | 5 |
| 16 | Diffuse intestinal ganglioneuromatosis an uncommon manifestation of Cowden syndrome显示文摘Diffuse intestinal ganglioneuromatosis is a hamartomatous polyposis characterized by a disseminated, intramural or transmural proliferation of neural elements involving the enteric plexuses. It has been associated with MEN Ⅱ, neurofibromatosis type 1 and hamartomatous polyposis associated with phosphatase and tensin homolog mutation. We report the case of a female patient with a history of a breast and endometrial tumor who presented in a colonoscopy performed for rectal bleeding diffuse ganglioneuromatosis, which oriented the search for other characteristic findings of Cowden syndrome given the personal history of the patient. The presence of an esophagogastric polyposis was also noted. Cowden syndrome is characterized by skin lesions, but it is rarely diagnosed by these lesions, because they are usually overlooked. Intestinal polyposis is not a major diagnostic criterion but it is very useful for early diagnosis. The combination of colonic polyposis and glucogenic acanthosis should orient the diagnosis to Cowden syndrome. | Maria Teresa Herranz Bachiller Jesus Barrio Andrés Fernando Pons Noelia Alcaide Suárez Rafael Ruiz-Zorrilla Lorena Sancho del Val Sara Lorenzo Pelayo Carlos De La Serna Higuera Ramon Atienza Sánchez Manuel Perez Miranda | 2013 | World Journal of Gastrointestinal Oncology2013,5,2: | 5 |
| 17 | Endosonography-guided drainage of pancreatic fluid collections with a novel lumen-apposing stent显示文摘 | Joan B. Gornals Carlos la Serna-Higuera Andrés Sánchez-Yague Carme Loras Andrés M. Sánchez-Cantos Manolo Pérez-Miranda | 2013 | Surgical Endoscopy2013,,4: | 4 |
| 18 | Critical Review in Oral Biology & Medicine: Factors Affecting Wound Healing显示文摘 | Guo S DiPietro LA | 2010 | Journal of Dental Research2010,,3: | 4 |
| 19 | 在 esophagogastroduodenoscopy 使用 lidocaine 的实用性与 propofol 表现在镇静下面显示文摘 AIM:To determine whether topical lidocaine benefits esophagogastroduoduenoscopy(EGD) by decreasing propofol dose necessary for sedation or procedurerelated complications.METHODS:The study was designed as a prospective,single centre,double blind,randomised clinical trial and was conducted in 2012 between January and May(NCT01489891).Consecutive patients undergoing EGD were randomly assigned to receive supplemental topical lidocaine(L;50 mg in an excipient solution which was applied as a spray to the oropharynx) or placebo(P;taste excipients solution without active substance,similarly delivered) prior to the standard propofol sedation procedure.The propofol was administered as a bolus intravenous(iv) dose,with patients in the L and P groups receiving initial doses based on the patient’s American Society of Anaesthesiologists(ASA) classification(ASAⅠ-Ⅱ:0.50-0.60 mg/kg;ASA Ⅲ-Ⅳ:0.25-0.35 mg/kg),followed by 10-20 mg iv dose every 30-60 s at the anaesthetist’s discretion.Vital signs,anthropometric measurements,amount of propofol administered,sedation level reached,examination time,and the subjective assessments of the endoscopist’s and anaesthetist’s satisfaction(based upon a four point Likert scale) were recorded.All statistical tests were performed by the Stata statistical software suite(Release 11,2009;StataCorp,LP,College Station,TX,United States).RESULTS:No significant differences were found between the groups treated with lidocaine or placebo in terms of total propofol dose(310.7 ± 139.2 mg/kg per minute vs 280.1 ± 87.7 mg/kg per minute,P = 0.15) or intraprocedural propofol dose(135.3 ± 151.7 mg/kg per minute vs 122.7 ± 96.5 mg/kg per minute,P = 0.58).Only when the L and P groups were analysed with the particular subgroups of female,< 65-year-old,and lower anaesthetic risk level(ASA Ⅰ-Ⅱ) was a statistically significant difference found(L:336.5 ± 141.2 mg/kg per minute vs P:284.6 ± 91.2 mg/kg per minute,P = 0.03) for greater total propofol requirements).The total incidence of complications was also similar between the two groups,with the L group showing a complication rate of 32.2%(95%CI:21.6-45.0) and the P group showing a complication rate of 26.7%(95%CI:17.0-39.0).In addition,the use of lidocaine had no effect on the anaesthetist’s or endoscopist’s satisfaction with the procedure.Thus,the endoscopist’s satisfaction Likert assessments were equally distributed among the L and P groups:unsatisfactory,[L:6.8%(95%CI:2.2-15.5) vs P:0%(95%CI:0-4.8);neutral,L:10.1%(95%CI:4.2-19.9) vs P:15%(95%CI:7.6-25.7)];satisfactory,[L:25.4%(95%CI:10-29.6) vs P:18.3%(95%CI:15.5-37.6);and very satisfactory,L:57.6%(95%CI:54-77.7) vs P:66.6%(95%CI:44.8-69.7)].Likewise,the anaesthetist’s satisfaction Likert assessments regarding the ease of maintaining a patient at an optimum sedation level without agitation or modification of the projected sedation protocol were not affected by the application of lidocaine,as evidenced by the lack of significant differences between the scores for the placebo group:unsatisfactory,L:5.8%(95%CI:1.3-13.2) vs P:0%(95%CI:0-4.8);neutral,L:16.9%(95%CI:8.9-28.4) vs P:16.7%(95%CI:8.8-27.7);satisfactory,L:15.2%(95%CI:7.7-26.1) vs P:20.3%(95%CI:11.3-31.6);and very satisfactory,L:62.7%(95%CI:49.9-74.3) vs P:63.3%(95%CI:50.6-74.7).CONCLUSION:Topical pharyngeal anaesthesia is safe in EGD but does not reduce the necessary dose of propofol or improve the anaesthetist’s or endoscopist’s satisfaction with the procedure. | Felipe de la Morena Cecilio Santander Carlos Esteban Beatriz de Cuenca Juan Antonio García Javier Sánchez Ricardo Moreno | 2013 | World Journal of Gastrointestinal Endoscopy2013,5,5: | 3 |
| 20 | 经皮经导管射频消融去肾交感神经术与螺内酯对难治性高血压昼夜节律和血压变异性的影响显示文摘经皮经导管射频消融去肾交感神经术(sympathetic renal denervation,SRD)可作为药物控制不佳的难治性高血压患者的一种替代治疗方法,SRD对减少短期血压变异性(blood pressure variability,BPV)有效。然而,这个作用尚未在随机对照试验中证实。本研究旨在比较螺内酯和SRD对昼夜血压和BPV的影响。方法:对一项随机试验进行析因分析, | de la Sierra A Pareja J Armario P Barrera Yun S Vázquez S Sans L Pascual J Oliveras A 陈云 叶鹏 | 2017 | 中华高血压杂志2017,25,8: | 3 |