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| 1 | 面向21世纪的卒中新定义:美国心脏病学会和美国卒中学会声明显示文摘尽管脑血管病有着全球性影响且对其病理生理学的认识有了很多进步,但是'卒中'这一术语在临床实践、临床研究或公共卫生评估中的定义却不一致。传统的定义依据于临床,却没有考虑到科学技术的进步。美国心脏协会(AHA)和美国卒中协会(ASA)卒中分会组织了写作小组,为21世纪卒中新定义撰写专家共识性声明。中枢神经系统(CNS)梗死,指由缺血所导致的脑、脊髓或视网膜的细胞死亡,是基于持续性损害的神经病理学、神经影像学和(或)临床证据。CNS梗死表现为一个临床谱:缺血性卒中特指伴有明显症状的CNS梗死,而静息性梗死根据定义指未引起已知的症状的梗死。卒中也还包括脑出血和蛛网膜下腔出血。新定义的卒中结合了临床和组织学标准,可被用于实践、研究和公共卫生评估。 | 俞羚 董荃 宋叶平 江静雯 李卉 刘亮贤 苏爱萍 李焰生 Sacco RL Kasner SE Broderick JP Caplan LR Connors JJ Culebras A Elkind MS George MG Hamdan AD Higashida RT Hoh BL Janis LS Kase CS Kleindorfer DO Lee JM Moseley ME Peterson ED Turan TN Valderrama AL Vinters HV | 2013 | 神经病学与神经康复学杂志2013，10，2： | 188 |
| 2 | AHA/ASA关于卒中和短暂性脑缺血发作患者卒中预防推荐的更新显示文摘在卒中和短暂性脑缺血发作(transient ischemic attack,TIA)患者卒中预防推荐发表以后,美国心脏协会和美国卒中协会(American Heart Association/American Stroke Association,AHA/ASA)著述委员会对最近的一些试验结果进行了回顾。本文的目的是对这些新资料做简要回顾、更新某些推荐意见并说明进行这些修改的理由。在2个领域已发表了一些新的重要临床试验结果:(1)在非心源性栓塞所致缺血性卒中或TIA患者卒中二级预防中具体抗血小板药的应用;(2)他汀类药物在预防卒中复发中的应用。 | Robert J. Adams Greg Albers Mark J. Alberts Oscar Benavente Karen Furie Larry B. Goldstein Philip Gorelick Jonathan Halperin Robert Harbaugh S. Claiborne Johnston Irene Katzan Margaret Kelly-Hayes Edgar J. Kenton Michael Marks Ralph L. Sacco Lee H. Schwamm 赵洪芹 李海峰 (译) | 2008 | 国际脑血管病杂志2008，16，4： | 123 |
| 3 | 短暂性脑缺血发作的定义和评价:美国心脏协会/美国卒中协会卒中委员会、心血管外科和麻醉委员会、心血管放射学和介入委员会、心血管护理委员会和外周血管病跨学科委员会对医疗卫生专业人员发布的科学声明:美国神经病学学会确认该声明作为神经科医生继续教育工具的价值显示文摘本科学声明面向为短暂性脑缺血发作(transient ischemic attacks,TIA)患者提供医疗诊治的临床医生和相关医疗卫生人员。采用正规的证据复习方法对1990-2007年7月期间Medline数据库进行系统的文献检索,并运用证据表、汇总分析和病例资料的合并分析,对数据进行综合处理。本文支持以下基于组织学的TIA定义:局灶性脑、脊髓或视网膜缺血引起的短暂性神经功能障碍发作,且无急性脑梗死。TIA患者的近期卒中风险较高,可根据临床量表、血管影像学和磁共振弥散加权成像进行风险分层。诊断推荐包括:TIA患者应在发病24h内接受神经影像学评价,最好是应用包括弥散序列在内的MRI;应进行无创性颈部血管成像检查,最好是无创性颅内血管成像;对于未能确定血管病因的患者,TIA发病后应尽快进行心电图检查,也应考虑持续心电监测和超声心动图检查;应进行常规血液化验;对于发病72h内就诊并且ABCD^2评分≥3分(提示近期复发风险较高)或在门诊不能迅速完成诊断评价的TIA患者,应收入院治疗。 | J. Donald Easton Jeffrey L. Saver Gregory W. Albers Mark J. Alberts Seemant Chaturvedi Edward Feldmann Thomas S. Hatsukami Randall T. Higashida S. Claibome Johnston Chelsea S. Kidwell Helmi L. Lutsep Elaine Miller Ralph L. Sacco 李海峰 高翔(译) | 2009 | 国际脑血管病杂志2009，，9： | 86 |
| 4 | 卒中或短暂性脑缺血发作患者的卒中预防指南 美国心脏协会/美国卒中协会为医疗卫生专业人员制定的指南显示文摘本指南旨在为缺血性卒中或短暂性脑缺血发作存活患者的卒中预防提供全面和及时的循证推荐,包括危险因素的控制、动脉粥样硬化性疾病的于预、心源性栓塞的抗栓治疗以及非心源性栓塞性卒中的抗血小板治疗。另外,还对其他许多特殊情况下的复发性卒中预防提供了推荐意见,包括动脉夹层分离、卯圆孔未闭、高同型半胱氨酸血症、高凝状态、镰状细胞病、脑静脉窦血栓形成、女性卒中(尤其是与妊娠和绝经后雌激素替代治疗相关性卒中)、脑出血后抗凝药的使用等,以及实施本指南及其在高危人群中应用的特定方法。 | Karen L. Furie Scott E. Kasner Robert J. Adams Gregory W. Albers Ruth L. Bush Susan C. Fagan Jonathan L. Halperin S. Claiborne Johnston Irene Katzan Walter N. Kernan Pamela H. Mitchell Bruce Ovbiagele Yuko Y. Palesch Ralph L. Sacco Lee H. Schwamm Sylvia Wassertheil-Smoller Tanya N. Turan Deidre Wentworth 李海峰(译) 刘涛(译) 杨潘(译) 王鹏(译) | 2011 | 国际脑血管病杂志2011，19，1： | 391 |
| 5 | 缺血性卒中的一级预防——美国心脏协会/美国卒中协会卒中委员会指南 动脉粥样硬化性周围血管病跨学科工作组、心血管护理委员会、临床心脏病学委员会、营养、体力活动和代谢委员会以及医疗质量和转归研究跨学科工作组共同倡导显示文摘背景和目的本指南提供有关各种确定和潜在的卒中危险因素证据的概述,并提供降低卒中风险的推荐。方法写作组成员由委员会主席根据每位作者先前在相关课题领域中的工作提名,并经美国心脏协会(AHA)卒中委员会科学声明监督委员会批准。写作组采用系统文献回顾(涵盖时间段为2001年最后一次回顾发表到2005年1月),参考先前已发表的指南、个人文件和专家意见来概括现有的证据,指明现有知识的差距;如果合适,则根据标准的AHA标准做出简明的推荐。写作组全体成员在撰写过程中均有很多机会对推荐进行评论并认可这份声明的最终版本。在AHA科学咨询与协调委员会批准之前,本指南已进行过广泛的同行评议。结果对评价个体首次卒中风险的流程图进行评估。根据干预的可能性(不可干预、可干预或潜在可干预)和证据的强度(证据充分或证据不太充分),对首次卒中的危险因素或风险标记物进行分类。不可干预的危险因素包括年龄、性别、出生体重低、人种/种族和遗传因素。证据充分的可干预危险因素包括高血压、主动或被动吸烟、糖尿病、心房颤动和某些其他心脏病、血脂异常、颈动脉狭窄、镰状细胞病、绝经后激素治疗、不良饮食习惯、缺乏体力活动、肥胖和体脂分布。证据不太充分或潜在的可干预危险因素包括代谢综合征、酗酒、药物滥用、口服避孕药、睡眠呼吸障碍、偏头痛、高同型半胱氨酸血症、脂蛋白(a)升高、脂蛋白相关的磷脂酶升高、高凝状态、炎症和感染。对应用阿司匹林进行卒中一级预防的资料进行回顾。结论有大量证据可以用于确定增加首次卒中风险的各种特殊因素和提供降低这种风险的策略。 | Larry B. Goldstein Robert Adams Mark J. Alberts Lawrence J. Appel Lawrence M. Brass Cheryl D. Bushnell Antonio Culebras Thomas J. DeGraba Philip B. Gorelick John R. Guyton Robert G. Hart George Howard Margaret Kelly-Hayes J.V. (Ian) Nixon Ralph L. Sacco 苏克江 高宗恩 | 2006 | 国际脑血管病杂志2006，14，8： | 28 |
| 6 | 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 |
| 7 | Vascular endothelial growth factor and tryptase changes after chemoembolization in hepatocarcinoma patients显示文摘AIM: To evaluate vascular endothelial growth factor(VEGF) and tryptase in hepatocellular cancer(HCC)before and after trans-arterial chemoembolization(TACE).METHODS: VEGF and tryptase serum concentrations were assessed from 71 unresectable HCC patients before and after hepatic TACE performed by binding DC-Beads?to doxorubicin. VEGF levels were examined for each serum sample using the Quantikine Human VEGF-enzyme-linked immuno-absorbent assay(ELISA),whereas tryptase serum concentrations were assessed for each serum sample by means of fluoro-enzyme immunoassay(FEIA) using the Uni-CAP100 tool.Differences between serum VEGF and tryptase values before and after TACE were evaluated using Student t test. Person's correlation was used to assess the degree of association between the two variables.RESULTS: VEGF levels and serum tryptase in HCCpatients before TACE had a mean value and standard deviation(SD) of 114.31 ± 79.58 pg/mL and 8.13± 3.61 μg/L, respectively. The mean levels and SD of VEGF levels and serum tryptase in HCC patients after TACE were 238.14 ± 109.41 pg/mL and 4.02 ±3.03 μg/L. The changes between the mean values of concentration of VEGF and tryptase before treatment and after treatment was statistically significant(P <0.000231 and P < 0.00124, by Wilcoxon-Mann-Whitney respectively). A significant correlation between VEGF levels before and after TACE and between tryptase levels before and after TACE was demonstrated(r =0.68, P = 0.003; r = 0.84, P = 0.000 respectively).CONCLUSION: Our pilot results suggest that the higher serum VEGF levels and the lower tryptase levels following TACE may be potential biomarkers changing in response to therapy. | Girolamo Ranieri Michele Ammendola Ilaria Marech Annamaria Laterza Ines Abbate Caroline Oakley Angelo Vacca Rosario Sacco Cosmo Damiano Gadaleta | 2015 | World Journal of Gastroenterology2015，21，19： | 13 |
| 8 | Boceprevir,GC-376,and calpain inhibitors Ⅱ,Ⅻ inhibit SARS-CoV-2 viral replication by targeting the viral main protease显示文摘A new coronavirus SARS-CoV-2,also called novel coronavirus 2019(2019-nCoV),started to circulate among humans around December 2019,and it is now widespread as a global pandemic.The disease caused by SARS-CoV-2 virus is called COVID-19,which is highly contagious and has an overall mortality rate of 6.35%as of May 26,2020.There is no vaccine or antiviral available for SARS-CoV-2.In this study,we report our discovery of inhibitors targeting the SARS-CoV-2 main protease(Mpro).Using the FRET-based enzymatic assay,several inhibitors including boceprevir,GC-376,and calpain inhibitorsⅡ,andⅫwere identified to have potent activity with single-digit to submicromolar ICs0 values in the enzymatic assay.The mechanism of action of the hits was further characterized using enzyme kinetic studies,thermal shift binding assays,and native mass spectrometry.Significantly,four compounds(boceprevir,GC-376,calpain inhibitorsⅡandⅫ)inhibit SARS-CoV-2 viral replication in cell culture with EC50 values ranging from 0.49 to 3.37μM.Notably,boceprevir,calpain inhibitorsⅡandⅫrepresent novel chemotypes that are distinct from known substrate-based peptidomimetic Mpro inhibitors.A complex crystal structure of SARS-CoV-2 Mpro with GC-376,determined at 2.15(A)resolution with three protomers per asymmetric unit,revealed two unique binding configurations,shedding light on the molecular interactions and protein conformational flexibility underlying substrate and inhibitor binding by Mpro.Overall,the compounds identified herein provide promising starting points for the further development of SARS-CoV-2 therapeutics. | Chunlong Ma Michael Dominic Sacco Brett Hurst Julia Alma Townsend Yanmei Hu Tommy Szeto Xiujun Zhang Bart Tarbet Michael Thomas Marty Yu Chen Jun Wang | 2020 | Cell Research2020，30，8： | 13 |
| 9 | 多民族人群中卵圆孔未闭与缺血性卒中的发生风险显示文摘目的:拟评价北曼哈顿多民族的前瞻性队列中卵圆孔未闭(PFO)引起缺血性卒中的风险。背景:PFO被认为与缺血性卒中风险增加相关,证据主要来自病例对照研究。在普通人群中,实际的PFO相关性卒中风险仍不明确。方法:研究对象为来自北曼哈顿研究(NOMAS)中1100例年龄〉39岁(平均68.7±10.0岁)的无卒中受试者,利用造影剂注射经胸二维超声心动图检查评估基线时的PFO。同时记录房间隔动脉瘤(ASA)。受试者接受每年随访。在校正已知的卒中危险因素后,评价PFO/ASA相关的卒中风险。 | Di Tullio M.R. Sacco R.L. Sciacca R.R. 韩瑞娟 | 2007 | 世界核心医学期刊文摘(心脏病学分册)2007，3，7： | 11 |
| 10 | On the Origin of SERKs: Bioinformatics Analysis ol the Somatic Embryogenesis Receptor Kinases显示文摘 | Marije aan den Toorn Catherine Albrecht Sacco de Vdes | 2015 | Molecular Plant2015，8，5： | 10 |
| 11 | Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association显示文摘 | Karen L. Furie Scott E. Kasner Robert J. Adams Gregory W. Albers Ruth L. Bush Susan C. Fagan Jonathan L. Halperin S. Claiborne Johnston Irene Katzan Walter N. Kernan Pamela H. Mitchell Bruce Ovbiagele Yuko Y. Palesch Ralph L. Sacco Lee H. Schwamm Sylvia W | 2011 | Stroke2011，，1： | 8 |
| 12 | 颈部动脉夹层分离及其与颈椎推拿疗法的联系:美国心脏协会/美国卒中协会对医疗专业人员的声明显示文摘目的:颈部动脉夹层分离(cervicalarterydissection,CD)是中青年人卒中的最常见病因。本指南旨在对CD诊治的现有证据水平以及其与颈椎推拿疗法(cervical manipulative therapy, CMT)的统计学联系进行回顾。某些类型的CMT是由医疗专业人员对颈椎施加猛烈或轻柔的推力。方法写作组成员由美国心脏协会卒中委员会的科学声明监督委员会以及美国心脏协会的手稿监督委员会任命。各成员负责与其专业领域相关的主题,回顾适当的文献并参考公开发表的临床和流行病学研究、发病率和死亡率报告、临床与公共卫生指南、权威声明、个人文件以及专家意见,对现有证据进行总结并指出目前的知识空白。结果CD患者可表现为单侧头痛、后颈部痛或主要由动脉-动脉栓塞导致的脑或视网膜缺血(短暂性缺血或卒中)、CD脑神经麻痹、眼交感神经麻痹或搏动性耳鸣。CD的诊断依赖于完整的病史、体格检查和针对性的辅助检查。尽管轻微创伤的作用存在争议,但机械压力可造成椎动脉和颈内动脉内膜损伤,进而导致CD。CD患者的残疾程度存在差异,一些患者预后良好,但有些患者则会出现严重神经系统后遗症。目前尚无循证指南可用来指导CD的最佳处理策略。抗血小板和抗凝治疗均被用于局部血栓和继发性栓塞的预防。病例对照研究和其他文献提示CD[尤其是椎动脉夹层分离(vertebral artery dissection, VAD)]与CMT之间存在流行病学联系,但尚不清楚这是由于对先前存在的CD认识不足还是CMT导致的创伤。超声、CT血管造影以及磁共振血管造影都有助于CD的诊断。神经影像学随访首选无创性检查措施,但我们认为任何单一的检查方法都不能作为金标准。结论 CD是中青年患者发生缺血性卒中的重要病因。CD最好发于颈椎上段,可累及颈内动脉或椎动脉。尽管目前的生物力学证据不足以证实CMT 可导致CD,但临床报道提示机械压力在相当一部分CD中起着一定的作用,而且大多数基于人群的对照研究在年轻患者中显示CMT与VAD卒中之间存在联系。尽管对于曾经接受过CMT的患者,CMT相关性CD的发生率尚不完全清楚并且很可能较低,但当有临床症状时,医生应考虑到CD的可能性,并且在进行颈椎推拿前告知患者CD与CMT之间的统计学联系。 | José Biller Ralph L. Sacco Felipe C. Albuquerque Bart M. Demaerschalk Pierre Fayad Preston H. Long Lori D. Noorollah Peter D. Panagos Wouter I. Schievink Neil E. Schw artz Ashfaq Shuaib David E. Thaler David L. Tirschw ell 牛牧 陈进 宋艳 吴丹 王玉琴 柯开富 | 2015 | 国际脑血管病杂志2015，23，5： | 8 |
| 13 | 腔隙性卒中发病率和预后的人群研究显示文摘Objective: To evaluate incidence and prognosis of lacunar stroke in a prospective, population-based patient registry. Methods: The authors included first-ever strokes occurring between 1994 and 1998. They assessed incidence, risk factors, mortality, and recurrence in patients with lacunar stroke. Results: The authors identified 491 patients (15.3%) with lacunar stroke (252 men and 239 women) and 2,153 patients (67.3%) with nonlacunar stroke (998 men and 1,155 women). Crude annual incidence rate for a first-ever lacunar stroke was 33.0/100,000 (95%CI 30.2 to 36.0). At the univariate logistic regression analysis among patients with lacunar stroke there was a higher proportion of cigarette smoking and hypercholesterolemia and a lower proportion of chronic atrial fibrillation than in patients with nonlacunar stroke. For lacunar stroke, the 30-day case-fatality rate was 4.3%(95%CI 2.5 to 6.1) and the 1-year case-fatality rate was 13.0%(95%CI 10.0 to 16.0). During the first year of follow-up the average annual stroke recurrence rate was lower in patients with lacunar (2.83%; 95%CI 1.36 to 4.30) than in those with nonlacunar stroke (5.10%; 95%CI 4.17 to 6.03) while from the second year onward, rates were similar in both groups. Conclusion: In the short term, patients with nonlacunar stroke had more vascular events, but in the long term, the risk of death and of stroke recurrence was similar. | Sacco S. Marini C. Totaro R. A. Carolei 邱伟庆 | 2006 | 世界核心医学期刊文摘(神经病学分册)2006，2，9： | 8 |
| 14 | Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study显示文摘AIM:To prospectively evaluate the short and long term clinical impact of selective transarterial chemoembolization (TACE) on liver function in patients with hepatocellular carcinoma (HCC).To assess side effects in relation to treatments.To analyze the overall survival and HCC progression free survival probability. METHODS:One hundred and seventeen cirrhotic patients with HCC were enrolled.Baseline liver function included Child-Pugh score and serum levels of alanineaminotransferase (ALT),prothrombin time(PT)and bilirubin.According to Cancer Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC) staging systems,71 patients were eligible for TACE; 32 had previously received treatment for HCC.No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions.While hospitalized, patient sunder went clinical,hematologicand ultrasonographic assessments.One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed'on demand'.Liver function tests were checked in all patients every four months.RESULTS:After first TACE,the mean Child-Pugh score increased from a mean baseline 5.62±1.12 to 6.11±1.57 at discharge time (P<0.0001),decreasing after four months to 5.81±0.73 (not significant).ALT,PT and bilirubin significantly (P<0.0001)increased 24 h after TACE and progressively decreased until discharge. After the second TACE,variations in Child-Pugh score,ALT,PT and bilirubin were comparable to that described after the first TACE.No major complications were observed.The mean follow-up was 14.7±6.3 mo (median:16 mo).Only one patient died.No other patient experienced important long term worsening of clinical status.The overall survival probability at twenty-four months was 98.18%with a correspondent HCC progression free survival probability of 69%. CONCLUSION:Selectiv TAC Emayproduce significant,but transitory increases in ALT values, with no major impact on liver function and Child-Pugh score.Preservation of liver function is achievable also in patients previously treated with other therapeutic modalities and in patients undergoing multiple TACE cycles.Liver function can remain stable in the long-term, with optimal medium term survival.This result can be achieved through rigorous patient selection on the basis of tumour characteristics and clinical conditions. | Rodolfo Sacco Marco Bertini Pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi Antonio Romano Antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare Claudio Vignali Alfonso Capria | 2009 | World Journal of Gastroenterology2009，15，15： | 7 |
| 15 | 21世纪的卒中新定义:美国心脏协会/美国卒中协会对医疗专业人员的声明显示文摘尽管脑血管病的影响广泛且对其病理生理学的理解已取得一些进展,但“卒中”一词在临床实践、临床研究和公共卫生评价中的定义并不统一。经典的卒中定义主要是临床定义,不能反映科学技术的进步。因此,美国心脏协会卒中委员会/美国卒中协会召集了一个写作组,旨在对21世纪的卒中新定义制定一份专家共识文件。中枢神经系统(centralnervoussystem,CNS)梗死被定义为缺血导致的脑、脊髓或视网膜细胞死亡,并且具有永久性损伤的神经病理学、神经影像学和(或)临床证据。CNS梗死具有一系列临床表现:缺血性卒中特指伴有明显症状的CNS梗死,而无症状梗死则顾名思义不引起明显症状。广义的卒中还包括脑出血和蛛网膜下腔出血。卒中的新定义结合了临床和组织学标准,因此能被融入临床实践、研究和公共卫生评价。 | Ralph L. Sacco Scott E. Kasner Joseph P. Broderick Louis R. Caplan J.J. (Buddy) Connors Antonio Culebras Mitchell S.V. Elkind Mary G. George Allen D. Hamdan Randall T. Higashida Brian L. Hoh L. Scott Janis Carlos S. Kase Dawn O. Kleindorfer Jin-Moo Lee Michael E. Moseley Eric D. Peterson Tanya N. Turan Amy L. Valderrama Harry V. Vinters 王胜男(译) 吴齐恒(译) 邓镇(译) 周晓(译) 袁超(译) 潘速跃(译) | 2014 | 国际脑血管病杂志2014，22，1： | 7 |
| 16 | 美国国家卒中协会短暂性脑缺血发作处理指南显示文摘目的:短暂性脑缺血发作(TIA)是常见和重要的卒中先兆。其处理方法多样,大多数发表的指南在近年来均未被更新。我们试图制定一个全面的、无偏倚的、循证的TIA处理指南。方法:根据一种客观标准(可以预测在该研究领域中执业医师对专家提名的文献测量学方法)挑选出15名专家组成员。通过系统回顾检索到过去发表的指南,由专家对其中的推荐意见的质量进行独立评价。选择出质量最高的推荐意见,然后让专家组采用改良Delphi法通过多次问卷调查的方式进行修订,从而对新的修改达成共识。给专家们提供近期临床研究的系统评价,要求专家根据新的证据判断措辞修改的合理性并且根据证据等级和质量对最终的推荐意见进行评定。不允许专家在预期有可能存在任何利益冲突的专题方面提出推荐意见。结果:通过系统回顾检索到257个指南,其中有13篇文献包括的137条推荐意见符合所有纳入标准。需要6次重复的问卷调查对53条最终推荐意见的措辞达成共识。最终的推荐意见涉及TIA的初步处理、评价、内科治疗、外科治疗和危险因素控制。结论:对TIA患者医疗诊治的最终推荐意见强调了紧急评价和治疗的重要性。这种用于制定本指南的新方法是可行的,考虑到了快速更新并能减少偏倚。 | S. Claiborne Johnston Mai N. Nguyen-Huynh Miriam E. Schwarz Kate Fuller Christina Williams S. Andrew Josephsort Graeme J. Hankey Robert G. Hart Steven R. Levine Jose Biller Robert D. Brown Ralph L. Sacco L. Jaap Kappelle Peter J. Koudstaal Julien Bogousslavsky Louis R. Caplan Jan van Gijn Ale Algra Peter M. Rothwell Harold P. Adams Gregory W. Albers 李海峰(译) | 2007 | 国际脑血管病杂志2007，15，3： | 5 |
| 17 | Targeting mast cells in gastric cancer with special reference to bone metastases显示文摘Bone metastases from gastric cancer(GC) are considered a relatively uncommon finding; however, they are related to poorer prognosis. Both primary GC and its metastatic progression rely on angiogenesis. Several lines of evidence from GC patients strongly support the involvement of mast cells(MCs) positive to tryptase(MCPT) in primary gastric tumor angiogenesis. Recently,we analyzed infiltrating MCs and neovascularization in bone tissue metastases from primary GC patients, and observed a significant correlation between infiltrating MCPT and angiogenesis. Such a finding suggested the involvement of peritumoral MCPT by infiltrating surrounding tumor cells, and in bone metastasis angiogenesis from primary GC. Thus, an MCPT-stimulated angiogenic process could support the development of metastases in bone tissue. From this perspective, we aim to review the hypothetical involvement of tumorinfiltrating,peritumoral MCPT in angiogenesis-mediated GC cell growth in the bone microenvironment and in tumor-induced osteoclastic bone resorption. We also focus on the potential use of MCPT targeting agents,such as MCs tryptase inhibitors(gabexate mesylate,nafamostat mesylate) or c-KitR tyrosine kinase inhibitors(imatinib, masitinib), as possible new anti-angiogenic and anti-resorptive strategies for the treatment of GC patientsaffected by bone metastases. | Christian Leporini Michele Ammendola Ilaria Marech Giuseppe Sammarco Rosario Sacco Cosmo Damiano Gadaleta Caroline Oakley Emilio Russo Giovambattista De Sarro Girolamo Ranieri | 2015 | World Journal of Gastroenterology2015，21，37： | 5 |
| 18 | Endotics system vs colonoscopy for the detection of polyps显示文摘AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation. | Emanuele Tumino Rodolfo Sacco Marco Bertini Michele Bertoni Giuseppe Parisi Alfonso Capria | 2010 | World Journal of Gastroenterology2010，16，43： | 5 |
| 19 | Transarterial radioembolization for hepatocellular carcinoma:An update and perspectives显示文摘In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma(HCC),both in terms of disease control and tolerability profile.This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound(usually Yttrium90),and exerts its therapeutic effect through the radiation carried by these microspheres.A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications.Radioembolization is a technically complex and expensive technique,which has only recently entered clinical practice and is supported by scant results from phase Ⅲ clinical trials.Nevertheless,it may represent a valid alternative to transarterial chemoembolization(TACE) in the treatment of intermediate-stage HCC patients,as shown by a comparative retrospective assessment that reported a longer time to progression,but not of overall survival,and a more favorable safety profile for radioembolization.In addition,this treatment has reported a higher percentage of tumor shrinkage,if compared to TACE,for pre-transplant downsizing and it represents a promising therapeutic option in patients with large extent of disease and insufficient residual liver volume who are not immediately eligible for surgery.Radioembolization might also be a suitable companion to sorafenib in advanced HCC or it can be used as a potential alternative to this treatment in patients who are not responding or do not tolerate sorafenib. | Rodolfo Sacco Valeria Mismas Sara Marceglia Antonio Romano Luca Giacomelli Marco Bertini Graziana Federici Salvatore Metrangolo Giuseppe Parisi Emanuele Tumino Giampaolo Bresci Ambra Corti Manuel Tredici Michele Piccinno Luigi Giorgi Carlo Bartolozzi Irene Bargellini | 2015 | World Journal of Gastroenterology2015，21，21： | 4 |
| 20 | 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society显示文摘 | Craig T. January L. Samuel Wann Joseph S. Alpert Hugh Calkins Joaquin E. Cigarroa Joseph C. Cleveland Jamie B. Conti Patrick T. Ellinor Michael D. Ezekowitz Michael E. Field Katherine T. Murray Ralph L. Sacco William G. Stevenson Patrick J. Tchou Cynthia | 2014 | Circulation2014，，23： | 4 |
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