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1最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL 2014神经病学与神经康复学杂志2014,11,3:31
2Radioembolization for the treatment of unresectable hepatocellular carcinoma:A clinical review显示文摘Hepatocellular carcinoma(HCC)is the sixth most common cancer in the world.The majority of patients with HCC present with unresectable disease.These patients have historically had limited treatment options secondary to HCC demonstrating chemoresistance to the currently available systemic therapies.Additionally, normal liver parenchyma has shown intolerance to tumoricidal radiation doses,limiting the use of external beam radiation.Because of these limitations,novel percutaneous liver-directed therapies have emerged. The targeted infusion of radioactive microspheres (radioembolization)represents one such therapy. Radioembolization is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries that supply tumor. Once infused,these microspheres traverse the hepatic vascular plexus and selectively implant within the tumor arterioles.Embedded within the arterioles, the 90Y impregnated microspheres emit high energy and low penetrating radiation doses selectively to the tumor.Radioembolization has recently shown promise for the treatment of patients with unresectable HCC. The objective of this review article is to highlight twocurrently available radioembolic devices(90Y,188Rh)and provide the reader with a recent review of the literature.Saad M Ibrahim Robert J Lewandowski Kent T Sato Vanessa L Gates Laura Kulik Mary F Mulcahy Robert K Ryu Reed A Omary Riad Salem 2008World Journal of Gastroenterology2008,14,11:14
3Mental and physical symptoms associated with lower social support for patients with hepatitis C显示文摘AIM: To systematically examine the impact of the hepatitis C virus (HCV) diagnosis on patients' level of social support in a large-scale study. METHODS: Patients evaluated and treated for HCV in a tertiary referral center were enrolled in a cross-sectional study. Demographic data, functional and emotional status as measured by the Hospital Anxiety and Depression Scale (HAD) and the Sickness Impact Profile (SIP), severity of liver disease, mode of acquisition, and physical and psychiatric comorbidities were collected from patients or abstracted from the medical record. All participants completed a semi-structured interview, addressing questions of social support. RESULTS: A total of 342 patients (mean age 45.2 years; 37% women) were enrolled. Ninety-two (27%) patients described lower levels of support by family and friends. Nearly half of the participants (45%) noted the loss of at least one relationship due to the disease. Fears related to transmitting the disease (25%) were common and often associated with ignorance or even discrimination by others (19%). Nearly one fifth of the patients did not share information about their disease with others to avoid being stigmatized. Lower levels of social support were significantly associated with living alone, being unemployed, being excluded from antiviral therapy, having psychiatric comorbidities, contracting HCV through intravenous drug use, having high levels of anxiety and depression as measured by the HAD and negative mood state as measured by the SIP. Patients reporting lower levels of social support also noted more physical symptoms as measured by the SIP. CONCLUSION: Patients with hepatitis C often face significant social problems, ranging from social isolation to familial stress. The most common concerns reflect a limited insight of patients and their relatives and friends about the disease, the risk factors for its spread, and about potential consequences. Our data suggest that educational interventions targeting support persons and the stressors identified in our findings may lessen or alleviate the social strains patients with hepatitis C experience.Julie A Blasiole Laura Shinkunas Douglas R LaBrecque Robert M Arnold Susan L Zickmund 2006World Journal of Gastroenterology2006,12,29:5
4Systematic review and meta-analysis on the association of tuberculosis in Crohn's disease patients treated with tumor necrosis factor-α inhibitors(Anti-TNFα)显示文摘AIM To perform a meta-analysis on the risk of developing Mycobacterium tuberculosis(TB) infection in Crohn's disease(CD) patients treated with tumor necrosis factoralpha(TNFα) inhibitors.METHODS A meta-analysis of randomized, double-blind, placebocontrolled trials of TNFα inhibitors for treatment of CD in adults was conducted. Arcsine transformation of TB incidence was performed to estimate risk difference. A novel epidemiologically-based correction(EBC) enabling inclusions of studies reporting no TB infection cases in placebo and treatment groups was developed to estimate relative odds.RESULTS Twenty-three clinical trial studies were identified, including 5669 patients. Six TB infection cases were reported across 5 studies, all from patients receiving TNFα inhibitors. Eighteen studies reported no TB infection cases in placebo and TNFα inhibitor treatment arms. TB infection risk was significantly increased among patients receiving TNFα inhibitors, with a risk difference of 0.028(95%CI: 0.0011-0.055). The odds ratio was 4.85(95%CI: 1.02-22.99) with EBC and 5.85(95%CI: 1.13-30.38) without EBC.CONCLUSION The risk of TB infection is higher among CD patients receiving TNFα inhibitors. Understanding the immunopathogenesis of CD is crucial, since using TNFα inhibitors in these patients could favor mycobacterial infections, particularly Mycobacterium avium subspecies paratuberculosis, which ultimately could worsen their clinical condition.Brent L Cao Ahmad Qasem Robert C Sharp Latifa S Abdelli Saleh A Naser 2018World Journal of Gastroenterology2018,24,25:4
5Outcomes and patients' perspectives of transition from paediatric to adult care in inflammatory bowel disease显示文摘AIM: To describe the disease and psychosocialoutcomes of an inflammatory bowel disease(IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process. RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance(35%), there was a very low usage(5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority(54%) felt they were not strongly prepared. A high rate(78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex(8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices(of the options offered) was a shared clinic appointment with all key stakeholders. CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.Alice L Bennett David Moore Peter A Bampton Robert V Bryant Jane M Andrews 2016World Journal of Gastroenterology2016,22,8:3
6Sperm retrieval success and testicular histopathology in idiopathic nonobstructive azoospermia显示文摘Prior studies have investigated sperm retrieval rates in men with non obstructive azoospermia(NOA)secondary to specific etiologies,yet most cases of NOA are idiopathic.We compared sperm retrieval rates and testicular histopathology in idiopathic NOA(iNOA)and nonidiopathic NOA(niNOA).We performed a retrospective review of men with NOA who underwent microdissection testicular sperm extraction(microTESE)between 2000 and 2016.Men with no history of malignancy or cryptorchidism and negative genetic evaluation were considered idiopathic.Multivariable regression determined the association between idiopathic etiology and primary outcomes of sperm retrieval and active spermatogenesis on histopathology.Among 224 men,86(38.4%)were idiopathic,75(33.5%)were nonidiopathic,and 63(28.1%)did not undergo genetic testing.Median age and serum testosterone were higher among iNOA or no testing versus niNOA.Median follicle-stimulating hormone(FSH)was lower among iNOA or no testing versus niNOA.A higher proportion of iNOA or no testing versus niNOA had a clinical varicocele.Sperm retrieval rates were similar between iNOA,niNOA,and no testing(41.8%vs 48.0%vs 55.6%,respectively;P=0.255).Active spermatogenesis was seen in a higher proportion of iNOA or no testing versus niNOA(31.4%and 27.0%vs 16.0%,P=0.073).On multivariable analysis,iNOA was not associated with sperm retrieval or spermatogenesis(P=0.430 and P=0.078,respectively).Rates of sperm retrieval and spermatogenesis on testis pathology were similar in men with iNOA and niNOA.These data will be useful to clinicians in preoperative counseling for men with NOA and negative genetic evaluation.Arighno Das Joshua A Halpern Annie L Darves-Bornoz Mehul Patel James Wren Mary Kate Keeter Robert E Brannigan 2020Asian Journal of Andrology2020,22,6:3
7Testing for HCV Infection: An Update of Guidance for Clinicians and Laboratorians显示文摘Getchell Jane P Wroblewski Kelly E DeMaria Alfred Bean Christine L Parker Monica M Pandori Mark Dufour D Robert Busch Michael P Brecher Mark E Meyer William A Pesano Rick L Teo Chong-Gee Beckett Geoffrey A Araujo Aufra C Branson Bernard M D 2013MMWR. Morbidity and Mortality Weekly Report2013,,18:3
814-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial显示文摘E Robert Greenberg Garnet L Anderson Douglas R Morgan Javier Torres William D Chey Luis Eduardo Bravo Ricardo L Dominguez Catterina Ferreccio Rolando Herrero Eduardo C Lazcano-Ponce María Mercedes Meza-Montenegro Rodolfo Pe?a Edgar M Pe?a Eduardo Salazar- 2011The Lancet2011,,9790:2
9Thyroid hormone stimulates hepatic lipid catabolism via activation of autophagy显示文摘Sinha Rohit Anthony You Seo-Hee Zhou Jin Siddique Mobin M Bay Boon-Huat Zhu Xuguang Privalsky Martin L Cheng Sheue-Yann Stevens Robert D Summers Scott A Newgard Christopher B Lazar Mitchell A Yen Paul M 2012EN2012,,7:2
10Polarization analysis of Brillouin scattering in a circularly birefringent fiber ring resonator显示文摘Kung A Thevenaz L Robert P A 1997J Lightwave Technol1997,15,6:2
11Non-steroidal anti-inflammatory drugs and risk of neoplastic progression in Barrett’s oesophagus: a prospective study显示文摘Thomas L Vaughan Linda M Dong Patricia L Blount Kamran Ayub Robert D Odze Carissa A Sanchez Peter S Rabinovitch Brian J Reid 2005Lancet Oncology2005,,12:2
12Induction of a high incidence of lung tumors in C57BL/6 mice with multiple ethyl carbamate injections显示文摘York E Miller Lori D Dwyer-Nield Robert L Keith Mysan Le Wilbur A Franklin Alvin M Malkinson 2003Cancer Letters2003,,2:2
13D-MELD risk capping improves post-transplant and overall mortality under markov microsimulation显示文摘AIM: To hypothesize that the product of calculated Model for End-Stage Liver Disease score excluding exception points and donor age(D-MELD) risk capping ± Rule 14 could improve post liver transplant and overall survival after listing.METHODS: Probabilities derived from the United Network for Organ Sharing database between 2002 and 2004 were used to simulate potential outcomes for all patients listed for transplantation. The Markov simula-tion was then modified by screening matches using a 1200 or 1600 D-MELD risk cap ± allowing transplants for Model for End-Stage Liver Disease(MELD) ≤ 14(Rule 14). The differential impact of the rule changes was assessed.RESULTS: The Markov simulation accurately reproduced overall and post transplant survival. A 1200 D-MELD risk cap improved post-transplant survival. Both the 1200 and 1600 risk caps improved overall survival for waitlisted patients. The addition of Rule 14 further improved post transplant and overall survival by redistribution of donor livers to recipients in higher MELD subgroups. The mechanism for improved overall and post-transplant survival after listing was due to shifting a larger percentage of transplants to the moderate MELD score subgroup(MELD 15-29) while also ensuring that high MELD recipients have livers of high quality to achieve excellent post transplant survival.CONCLUSION: A 1200 D-MELD risk cap + Rule 14 provided the greatest overall benefit primarily by focusing liver transplantation towards the moderate MELD recipient.Jeffrey B Halldorson Robert L Carithers Jr Renuka Bhattacharya Ramasamy Bakthavatsalam Iris W Liou Andre A Dick Jorge D Reyes James D Perkins 2014World Journal of Transplantation2014,4,3:2
14Novel technique for anastomotic salvage using transanal minimally invasive surgery:A case report显示文摘Anastomotic leak(AL)after low anterior resection(LAR)can be a highly morbid complication.The incidence of AL ranges from 5%to 20%depending on patient characteristics and the distance of the anastomosis from the anal verge.Low anastomoses and leaks pose technical challenges for endoscopic treatment.The aim of this report was to describe the use of a commercially available laparoscopic energy device through a transanal minimally invasive surgery(TAMIS)port for the management of a symptomatic leak not requiring relaparotomy(grade B)after a LAR with diverting loop ileostomy.CASE SUMMARY A TAMIS GelPOINT Path port was inserted into the anus to access the distal rectum.Pneumorectum was achieved with AirSeal insufflation and a 30 degree laparoscope was introduced through a trocar.A LigaSureTM Retractable L-Hook device was then used to perform a septotomy of the chronic sinus tract identified posterior to the coloproctostomy.The procedure was then repeated twice in three weeks intervals with ultimate resolution of the chronic leak cavity.Several months after serial TAMIS septotomies,barium enema demonstrated a patent anastomosis with no evidence of persistent leak or stricture.The patient subsequently underwent ileostomy reversal and has had no significant postoperative issues.CONCLUSION TAMIS septotomy with the LigaSureTM Retractable L-Hook is a feasible and effective,minimally invasive salvage technique for the treatment of grade B ALs.Larger studies are needed to assess the generalizability and long-term results of this technique.Oscar A Olavarria Robert L Kress Shinil K Shah Amit K Agarwal 2019World Journal of Gastrointestinal Surgery2019,11,5:2
15Human enamel thickness and ENAM polymorphism显示文摘The tooth enamel development gene, enamelin(ENAM), showed evidence of positive selection during a genome-wide scan of human and primate DNA for signs of adaptive evolution. The current study examined the hypothesis that a single-nucleotide polymorphism(SNP) C14625T(rs7671281) in the ENAM gene identified in the genome-wide scan is associated with a change in enamel phenotype. African Americans were selected as the target population, as they have been reported to have a target SNP frequency of approximately 50%, whereas non-Africans are predicted to have a 96% SNP frequency. Digital radiographs and DNA samples from 244 teeth in 133 subjects were analysed, and enamel thickness was assessed in relation to SNP status,controlling for age, sex, tooth number and crown length. Crown length was found to increase with molar number, and females were found to have thicker enamel. Teeth with larger crowns also had thicker enamel, and older subjects had thinner enamel.Linear regression and generalized estimating equations were used to investigate the relationship between enamel thickness of the mandibular molars and ENAM SNP status; enamel in subjects with the derived allele was significantly thinner(P = 0.040)when the results were controlled for sex, age, tooth number and crown length. The derived allele demonstrated a recessive effect on the phenotype. The data indicate that thinner dental enamel is associated with the derived ENAM genotype. This is the first direct evidence of a dental gene implicated in human adaptive evolution as having a phenotypic effect on an oral structure.Diane M Daubert Joanna L Kelley Yuriy G Udod Carolina Habor Chris G Kleist Ilona K Furman Igor N Tikonov Willie J Swanson Frank A Roberts 2016International Journal of Oral Science2016,8,2:2
16Targeting vectors for intracellular immunization显示文摘Persic L Righi M Roberts A 1997Gene1997,187,:2
17Factors associated with 5-year survival of combined hepatocellular and cholangiocarcinoma显示文摘BACKGROUND Combined hepatocellular and cholangiocarcinoma(HCC/CC)is a rare primary hepatic malignancy which carries a poor prognosis due to its aggressive nature.Few centers have enough cases to draw definitive conclusions and there is limited understanding of prognosis.Given the rarity of HCC/CC,an analysis of large national cancer database was needed to obtain larger number of HCC/CC cases.AIM To identify associated factors for 5-year survival of HCC/CC.METHODS We conducted a retrospective study of The Surveillance,Epidemiology,and End Results(SEER)database obtained from SEER*Stat 8.3.6 software.Previously defined histology code 8180 for the International Classification of Disease for Oncology,3rd edition was used to identify HCC/CC cases from 2004 to 2015.We collected demographics,American Joint Committee on Cancer(AJCC)stage,treatment,tumor size,and survival data.These data were converted to categorical variables.The Shapiro-Wilk normality test was used to assess normal distribution.Mann-Whitney U test was used to compare continuous variables without normal distribution,and t-test was used to compare continuous variables with a normal distribution.The Kaplan-Meier survival curve analyzed 5-year survival.Univariate and multivariate logistic regression model was used to analyze factors associated with 5-year survival.Multivariate Cox proportional hazard regression was done on 5-year survival.We defined P<0.05 was statistically significant.RESULTS We identified 497 patients with the following characteristics:Mean age 62.4 years(SD:11.3),149(30.0%)were female,racial distribution was:276(55.5%)white,53(10.7%)black,84(16.9%)Asian and Pacific Islander(API),77(15.5%)Hispanic,and 7(1.4%)others or unknown.Stage I/II disease occurred in 41.5%and tumor size<50 mm was seen in 35.6%of patients.Twenty-four(4.8%)received locoregional therapy(LRT),119(23.9%)underwent resection,and 50(10.1%)underwent liver transplantation.The overall median survival was 6 mo[Interquartile range(IQR):1-22].After multivariate logistic regression,tumor size<50 mm[Odds ratios(OR):2.415,P=0.05],resection(OR:12.849,P<0.01),and transplant(OR:27.129,P<0.01)showed significance for 5-year survival.Age>60,sex,race,AJCC stages,metastasis,and LRT were not significant.However,API vs white showed significant OR of 2.793(CI:1.120-6.967).Cox proportional hazard regression showed AJCC stages,tumor size<50 mm,LRT,resection,and transplant showed significant hazard ratio.CONCLUSION HCC/CC patients with tumor size<50 mm,resection,and transplant were associated with an increase in 5-year survival.API showed advantageous OR and hazard ratios over white,black.Tomoki Sempokuya Eric A Wien Robert J Pattison Jihyun Ma Linda L Wong 2020World Journal of Hepatology2020,12,11:2
18Temperature Compensation of Total Power Radiometers显示文摘David A Thompson Robert L Rogers 2003IEEE Transactions on Microwave and Techniques2003,51,10:1
19Extended spectrum β-lactamases:a clinical update显示文摘David L Paterson Robert A etal 2005Clin Microbiol Rev2005,18,4:1
20Reaction of 1, 1, 1- trichloroethane with zero-valent metals and bimetallic reductauts 显示文摘Fennelly J P Roberts A L 1998Environmental Science & Technology1998,32,:1
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