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1AGNP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
2福林酚试剂法测定蛋白质显示文摘自1922年Wu(吴)提出用福林酚(Folin-酚)试剂测定蛋白质含量[1],已有许多采用这一试剂的改良分析操作进行血清陆”、抗原-抗体沉淀物[7-9]和胰岛素[10]中蛋白质含量测定的报道。虽然这一试剂以其灵敏度高和操作简便得到推荐,但并不适合普遍的生物化学应用。Lowry O H Rosebrough N J Farr A L Randall R J 陈祥娥 2011食品与药品2011,13,3:34
3尿钠排泄、血压、心血管病与死亡率的关系:社区前瞻性流行病学队列研究显示文摘WHO建议人群钠摄人<2 g/d作为预防心血管病的措施之一,但这一目标在任何国家都没有实现。该建议主要基于短期血压试验的个体水平数据,没有来自随机试验或观察性研究的关于低钠摄入与降低心血管事件的数据。前瞻性城市农村流行病学研究目前正在21个国家进行。该文对其中18个国家的数据进行分析,其中包含了临床结果数据。Mente A O'Donnell M Rangarajan S McQueen M Dagenais G Wielgosz A Lear S Ah STL Wei L Diaz R Avezum A Lopez-Jaramillo P Lanas F Mony P Szuba A Iqbal R Yusuf R Mohammadifard N Khatib R Yusoff K Ismail N Gulec S Rosengren A Yusufali A Kruger L Tsolekile LP Chifamba J Dans A Alhabib KF Yeates K Teo K Yusuf S 刘莉 叶鹏 2018中华高血压杂志2018,26,12:29
4Effects of Saccharomycesboulardiion fecal short-chain fatty acids and microflora in patients on long-term total enteral nutrition显示文摘AIM: To assess the effects of Sb on fecal flora and shortchain fatty acids (SCFA) in patients on long-term TEN.METHODS: Ten patients (3 females, 7 males, 59±5.5 years),on TEN for a median of 13 mo (1-125), and 15 healthy volunteers (4 females, 11 males, 32±2.0 years) received Sb (0.5 g bid PO) for 6 d. Two stool samples were taken before, on the last 2 d and 9-10 d after treatment, for SCFA measurement and for culture and bacterial identification.Values (mean±SE) were compared using sign tests and ANOVA.RESULTS: Fecal butyrate levels were lower in patients(10.1±2.9 mmol/kg) than in controls (19.2±3.9, P= 0.02).Treatment with Sb increased total fecal SCFA levels in patients (150.2±27.2 vs 107.5±18.2 mmol/kg, P = 0.02)but not in controls (129.0±28.6 vs 113.0±15.2 mmol/kg,NS). At the end of treatment with Sb, patients had higher fecal butyrate (16.0±4.4 vs 10.1 [2.9] mmol/kg, P = 0.004).Total SCFAs remained high 9 d after treatment was discontinued. Before the treatment, the anaerobe to aerobe ratio was lower in patients compared to controls (2.4±2.3 vs69.8±1.8, P = 0.003). There were no significant changes in the fecal flora of TEN patients.CONCLUSION: Sb-induced increase of fecal SCFA concentrations (especially butyrate) may explain the preventive effects of this yeast on TEN-induced diarrhea.Stéphane M Schneider Fernand Girard-Pipau Jér(o|^)me Filippi Xavier Hébuterne Dominique Moyse Gustavo Calle Hinojosa Anne Pompei Patrick Rampal 2005World Journal of Gastroenterology2005,11,39:26
52018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
6OPTICAL 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
7高光谱遥感在农作物长势监测中的应用显示文摘该研究是加拿大Saskatchewan Scott农作物轮作系统(ACS)研究的一部分。研究始于1994年,历时18a,评价9个可耕种农作物产量系统的可靠性。由3种处理水平(organic,reduced,high)和3种作物多样性水平(low,diversified annual grains,diversified annual perennials)结合而产生的9个农作物产量系统,被用于监测和评价加拿大牧场不同处理和不同作物种植轮作下可耕种农作物的产量。在2003年生长季共收集了3次叶面积指数和光谱反射率的数据:生长季前期(6月)、生长季旺盛期(7月)、生长季后期(8月)。叶面积指数是由LAI-2000植物冠层分析仪监测的,光谱测量是由覆盖了350-2500 nm波长范围共2215个波段的ADS便携式高光谱仪完成的。结果显示,光学测量可以用于监测农作物生长状况的差异。从生长季的早期到中期,光谱和叶面积指数在不同处理下有显著差异。7月中期是用遥感资料监测农作物长势的最佳季节;红光波段与近红外波段反射率的比值和基于这两个波段构造的归一化植被指数,是检测农作物长势的最佳植被指数。郑有飞 Guo X Olfert O Brandt S Thomas G Weiss R Sproule L 2007气象与环境科学2007,30,1:22
8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
9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
10幽门螺杆菌感染处理的当前观念——MaastrichtⅢ共识报告显示文摘名词缩写欧洲幽门螺杆菌研究小组:European Helicobacter Study Group,EHSG胃食管反流病:gastro-esophageal reflux disease。P Malfertheiner F Megraud C O'Morain F Bazzoli E El-Omar D Graham R Hunt T Rokkas N Vakil EJ Kuipers 朱琦 2007胃肠病学2007,12,3:15
11Budesonide induces complete remission in autoimmune hepatitis显示文摘瞄准:泼尼松和 azathioprine 为自体免疫的肝炎(AIH ) 代表标准疗法。然而,仅仅, 65% 病人进入完全的组织学的宽恕。最近, budesonide (芽) 被报导是一种有希望的选择。在这研究,我们在 AIH 估计了芽的功效和安全。方法:十八个病人(12 个女人, 6 个男人;吝啬的年龄 45.4+/-21 年) 与芽(Budenofalk ) 与 AIH 被对待在上面三次每日、跟随的 3 mg 为至少 24 wk.Seven,病人们也有主要胆汁性肝硬变(n=5 ) 或主要致硬化的胆管炎(n=2 ) 的特征。先进的肝纤维变性或肝硬化在 6 个病人是在场的。结果:十五(83%) 病人们有完全的临床、生物化学的宽恕。十个病人,与尖锐肝炎包括五,作为首要的治疗被给芽,哪个七进入宽恕。三个病人,二与肝肝硬化,没改善。有第二线的治疗的所有病人经历了长期的宽恕。组织学的宽恕也在三个病人被看见。临床上相关的导致芽的副作用与肝肝硬化(n=4 ) 仅仅在病人被记录。结论:芽在在我们有 AIH.Side 效果的病人的多数的宽恕正式就职是有效的,治疗失败主要与肝肝硬化在病人被观察。Antal Csepregi Christoph R(o|¨)cken Gerhard Treiber Peter Malfertheiner 2006World Journal of Gastroenterology2006,12,9:14
12父母参与NICU患儿护理的优势与挑战显示文摘在围产期护理发展之前,新生儿都是在家庭出生并由其父母和助产士进行护理。自20世纪初期,医院开始为新生儿、早产儿提供医疗服务和专业护理,取代了父母的家庭护理。1979年护士出现短缺,爱沙尼亚塔林儿童医院新生儿病房开展了一个新的护理模式,该项目规定:新生儿全天24 h由父母看护,必要的时候医护人员给予帮助;尽可能的提倡母乳喂养;尽量减少医疗技术使用。李变 张欣 Warre R O'Brien K Lee SK 2015中国新生儿科杂志2015,30,6:12
13限制性与自由输血策略对心血管疾病患者非心脏手术效果的影响:系统回顾与Meta分析显示文摘目的比较采取限制性与自由输血策略的心血管疾病患者的非心脏手术结局。数据来源搜集涉及医院红细胞输注阈值的随机控制试验。检索CENTRAL、Medline、EMBase、CINAHL、PubMed、LILACS、NHSBT输血证据库、Clinical Trials.gov、WHO国际临床试验注册平台、国际标准随机对照临床试验编号登记、欧盟临床试验登记。检索时间为2015-11-02之前。试验选择选取发表与未发表的比较限制性与自由输血阈值的随机控制试验,试验均纳入心血管疾病患者。结果检索到41项试验,其中7项试验纳入心血管疾病患者。另选取4项纳入心血管疾病患者的试验。最终共搜集11项纳入心血管疾病患者(n=3 033)的试验进行Meta分析(限制性输血1 514例,自由输血1 519例)。输血阈值与30 d死亡率之间联系的汇集风险比例为1.15〔95%CI(0.88,1.50),P=0.50〕,异质性较小(I^2=14%)。限制性输血患者的急性冠脉综合征风险与自由输血患者相比更高〔9项试验;风险比例1.78,95%CI(1.18,2.70),P=0.01,I^2=0%〕。结论对急性冠脉综合征或慢性心血管疾病患者采取80 g/L以下的限制性输血阈值可能并不安全,对病死率与其他结局的影响并不确定。这些数据可暂时支持对急性或慢性心血管疾病患者使用更加自由的输血阈值(>80 g/L),但有待更具有说服力的高质量的心血管疾病患者随机试验进行验证。Docherty AB O' Donnell R Brunskill S 本刊编辑部 2016中国全科医学2016,19,15:12
14Interplay between nitric oxide and VIP in CCK-8-induced phasic contractile activity in the rabbit sphincter of Oddi显示文摘AIM: The sphincter of Oddi (SO) plays an important role in delivery of bile into the duodenum. To establish whether vasoactive intestinal polypeptide (VIP) and nitric oxide (NO) were involved in phasic contractile activity of the rabbit SO stimulated by cholecystokinin-octapeptide (CCK-8).METHODS: Isolated SO muscle rings were cleaned of fat and mounted horizontally on two small L-shaped hooksone of which was connected to a force transducer for the measurement of isometric tension. The experiments were carried out in a thermostatically controlled (37±0.2℃)organ bath (5 mL) containing Krebs solution. The organ fluid was gassed with 95% O2 and 50 mL/L CO2 to keep the pH at 7.40±0.05. Contractile responses to CCK-8 (1μmol/L) were evaluated in the presence and absence of N^G-nitro-L-arginine (LNNA), an inhibitor of NO synthase (100μmol/L), and (p-chloro-D-Phe^6-Leu^17)-VIP (VIPa,30μmol/L), a VIP receptor antagonist.RESULTS: CCK-8 stimulated the phasic activity of the SO.NO synthase inhibition increased the frequency and amplitude of contractions with a slight increase in developed tension.Pre-incubation with VIPa also attenuated this CCK-8 effect.The combined application of LNNA and VIPa abolished the phasic activity of the muscle rings with a marked increase in tension in response to CCK-8.CONCLUSION: VIP and NO together contribute to an increase in phasic activity of SO.Attila Pálv(o|¨)lgyi Réka Sári József Németh Annamária Szabolcs István Nagy Péter Hegyi János Lonovics Zoltán Szilvássy 2005World Journal of Gastroenterology2005,11,21:11
15Manipulation of a VEGF-Notch signaling circuit drives formation of functional vascular endothelial progenitors from human pluripotent stem cells显示文摘人的 pluripotent 干细胞(hPSC ) 导出 endothelial 系细胞组成有希望的来源因为在这个竞技场的治疗学的 revascularization,而是进步被临床上可伸缩的区别协议和在移植之上与宿主发行量集成的一个功能的容器网络的低效的形成的缺乏妨碍了。在绿的地方,使用一根人的胚胎的干细胞记者房间线荧光灯蛋白质表示被 endothelial 驾驶房间特定的 VE-cadherin (VEC ) 倡导者,我们为 > 屏蔽了;60 bioactive 将支持 endothelial 区别,并且发现 BMP4 和 GSK-3β 的那个政府的小分子;在有 VEGF 的一个早阶段和处理的禁止者 -- 在一个以后的阶段表明小径的槽口的 A 和抑制在六天以内导致了 hPSCs 的有效区别到 endothelial 系。这条顺序的途径产生了 >到 endothelial 房间(EC ) 的 hPSCs 的50%变换,明确地 VEC + CD31 + CD34 + CD14 KDR 在 endothelial 系房间之中展出了更高的 angiogenic 和 clonogenic 增长潜力的高 endothelial 祖先( EP )。药品的抑制或基因槽口发信号击倒,在有 VEGF 的联合 -- 一个处理,经由 KDR + mesodermal 先锋和对成熟 EC 的 EP 的变换的封锁导致了 EP 的有效形成。当移植了进 immunocompromised 老鼠时,产生 EP 成功地与吻合在 vivo 形成了功能的毛状的容器到主人容器。在我们的协议表明电路的这 VEGF-A-Notch 的操作由 12- 导致导出 hPSC 的 EP 的快速的大规模生产到 20 褶层对当前的方法,它可以与与成熟 EC 相比形成能力的优异容器为再生 vascularization 用作一张吸引人的房间人口。Makoto Sahara Emil M Hansson Oliver Wemet Kathy O Lui Daniela Spater Kenneth R Chien 2014Cell Research2014,24,7:10
16Hepatic abscess induced by foreign body:Case report and literature review显示文摘Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon. Pre-operative diagnosis is difficult as patients are often unaware of the foreign body ingestion and symptoms and imagiology are usually non-specific. The authors report a case of 62-year-old woman who was admitted with fever and abdominal pain. Further investigation revealed hepatic abscess, without resolution despite antibiotic therapy. A liver abscess resulting from perforation and intra-hepatic migration of a bone coming from the pilorum was diagnosed by surgery. The literature concerning foreign body-induced perforation of the gastrointestinal tract complicated by liver abscess is reviewed.Sofia A Santos Sara CF Alberto Elsa Cruz Eduardo Pires Tomás Figueira lia Coimbra José Estevez Mário Oliveira Luís Novais Joo R Deus 2007World Journal of Gastroenterology2007,13,9:10
17结直肠癌腹膜转移高风险患者进行二次探查手术加腹腔热灌注化疗与随访的比较(PRO⁃PHYLOCHIP–PRODIGE15):一项随机的3期研究显示文摘背景:如果在结直肠癌腹膜转移出现症状之前就能够早期诊断和治疗,可以提高患者生存率。我们研究的目的是在结直肠癌腹膜转移的高风险患者中,探究进行有计划的二次探查手术加腹腔热灌注化疗(hyperthermic intraperitoneal chemo-therapy,HIPEC)是否可以给患者带来生存获益。张荣欣 GOéRé D GLEHEN O QUENET F 2020结直肠肛门外科2020,26,5:9
18Role of CARD15,DLG5 and OCTN genes polymorphisms in children with inflammatory bowel diseases显示文摘AIM: To investigate the contribution of variants of CARD15, OCTN1/2 and DLG5 genes in disease predispo- sition and phenotypes in a large Italian cohort of pediatric patients with inflammatory bowel diseases (IBD). METHODS: Two hundred patients with Crohn’s disease (CD), 186 ulcerative colitis (UC) patients, 434 par- ents (217 trios), and 347 healthy controls (HC) were studied. Polymorphisms of the three major variants of CARD15, 1672C/T and -207G/C SNPs for OCTN genes, IGR2096a_1 and IGR2198a_1 SNPs for the IBD5 locus, and 113G/A variant of the DLG5 gene were evaluated. Potential correlations with clinical sub-phenotypes were investigated. RESULTS: Polymorphisms of CARD15 were significantly associated with CD, and at least one variant was found in 38% of patients (15% in HC, OR = 2.7, P < 0.001). Homozygosis for both OCTN1/2 variants was more com- mon in CD patients (1672TT 24%, -207CC 29%) than in HC (16% and 21%, respectively; P = 0.03), with an in- creased frequency of the TC haplotype (44.8% vs 38.3% in HC, P = 0.04). No association with the DLG5 variant was found. CD carriers of OCTN1/2 and DLG5 variants more frequently had penetrating disease (P = 0.04 and P = 0.01), while carriers of CARD15 more frequently had ileal localization (P = 0.03). No gene-gene interaction was found. In UC patients, the TC haplotype was morefrequent (45.4%, P = 0.03), but no genotype/phenotype correlation was observed. CONCLUSION: Polymorphisms of CARD15 and OCTN genes, but not DLG5 are associated with pediatric on- set of CD. Polymorphisms of CARD15, OCTN, and DLG5 genes exert a weak influence on CD phenotype.S Cucchiara A Latiano O Palmieri AM Staiano R D'Incà G Guariso G Vieni V Rutigliano O Borrelli MR Valvano V Annese 2007World Journal of Gastroenterology2007,13,8:9
19高通气综合征?还是惊恐障碍?显示文摘韩江娜 R Schepers K Stegen O Van den Bergh KP Van de Woestijne 2001中华结核和呼吸杂志2001,24,9:9
20在结肠和直肠的癌症的淋巴节点收获: 当前的考虑显示文摘 The prognostic significance of identifying lymph node(LN) metastases following surgical resection for colon and rectal cancer is well recognized and is reflected in accurate staging of the disease.An established body of evidence exists,demonstrating an association between a higher total LN count and improved survival,particularly for node negative colon cancer.In node positive disease,however,the lymph node ratios may represent a better prognostic indicator,although the impact of this on clinical treatment has yet to be universally established.By extension,strategies to increase surgical node harvest and/or laboratory methods to increase LN yield seem logical and might improve cancer staging.However,debate prevails as to whether or not these extrapolations are clinically relevant,particularly when very high LN counts are sought.Current guidelines recommend a minimum of 12 nodes harvested as the standard of care,yet the evidence for such is questionable as it is unclear whether an increasing the LN count results in improved survival.Findings from modern treatments,including down-staging in rectal cancer using pre-operative chemoradiotherapy,paradoxically suggest that lower LN count,or indeed complete absence of LNs,are associated with improved survival;implying that using a specific number of LNs harvested as a measure of surgical quality is not always appropriate.The pursuit of a sufficient LN harvest represents good clinical practice;however,recent evidence shows that the exhaustive searching for very high LN yields may be unnecessary and has little in? uence on modern approaches to treatment.James R McDonald Andrew G Renehan Sarah T O’Dwyer Najib Y Haboubi 2012World Journal of Gastrointestinal Surgery2012,4,1:8
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