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| 1 | XRCC1 and DNA polymerase β in cellular protection against cytotoxic DNA single-strand breaks显示文摘 | Julie K Horton Mary Watson Donna F Stefanick Daniel T Shaughnessy Jack A Taylor Samuel H Wilson | 2008 | Cell Research2008，18，1： | 17 |
| 2 | Small for size syndrome following living donor and split liver transplantation显示文摘The field of liver transplantation is limited by the availability of donor organs. The use of living donor and split cadaveric grafts is one potential method of expanding the donor pool. However, primary graft dysfunction can result from the use of partial livers despite the absence of other causes such as vascular obstruction or sepsis. This increasingly recognised phenomenon is termed 'Small-for-size syndrome' (SFSS). Studies in animal models and humans have suggested portal hyperperfusion of the graft combined with poor venous outflow and reduced arterial flow might cause sinusoidal congestion and endothelial dysfunction. Graft related factors such as graft to recipient body weight ratio < 0.8, impaired venous outflow, steatosis > 30% and pro- longed warm/cold ischemia time are positively predictive of SFSS. Donor related factors include deranged liver function tests and prolonged intensive care unit stay greater than five days. Child-Pugh grade C recipients are at relatively greater risk of developing SFSS. Surgi- cal approaches to prevent SFSS fall into two categories: those targeting portal hyperperfusion by reducing inflow to the graft, including splenic artery modulation and portacaval shunts; and those aiming to relieve paren-chymal congestion. This review aims to examine thecontroversial diagnosis of SFSS, including current strate-gies to predict and prevent its occurrence. We will also consider whether such interventions could jeopardize the graft by compromising regeneration. | Hector Daniel Gonzalez Sophia Cashman Giuseppe K Fusai | 2010 | World Journal of Gastrointestinal Surgery2010，2，12： | 13 |
| 3 | Innate immunity in inflammatory bowel disease显示文摘The human intestinal tract is home to an enormous bacterial flora.The host defense against microorganisms can be divided into innate and adaptive immunity The former is the most immediate line of response to immunologic challenges presented by bacteria viruses,and fungi.The mucosal immune system has evolved to balance the need to respond to pathogens while co-existing with commensal bacteria and food antigens.In inflammatory bowel disease(IBD),this hyporesponsiveness or tolerance breaks down and inflammation supervenes driven by the intestina microbial flora.Bacteria contain compounds and are recognized by a variety of receptors,including Toll-like receptors(TLRs)and NODs(a family of intracellula bacterial sensors)and are potent stimuli of innate immune responses.Several mutations in these receptors have been associated with development of IBD. | Jesus K Yamamoto-Furusho Daniel K Podolsky | 2007 | World Journal of Gastroenterology2007，13，42： | 13 |
| 4 | Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C显示文摘AIM To determine the sensitivity and specificity of liver stiffness measurement(LSM) and serum markers(SM) for liver fibrosis evaluation in chronic hepatitis C.METHODS Between 2012 and 2014,81 consecutive hepatitis C virus(HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography(TE) [FibroS can~/ARFI technology(Virtual Touch~)] and SM [FIB-4/aspartate aminotransferase-toplatelet ratio index(APRI)].The diagnostic performance of these tests was assessed using receiver operating characteristic curves.The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2,F ≥ 3 and F = 4.The Kappa index set the concordance analysis.RESULTS Fifty point six percent were female and the median age was 51 years(30-78).Fifty-six patients(70%) weretreatment-na?ve.The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kP a,for acoustic radiation force impulse(ARFI) 1.22 m/s,for APRI 0.75 and for FIB-4 1.47.For F ≥ 3 TE was 8.9 kP a,ARFI was 1.48 m/s,APRI was 0.75,and FIB-4 was 2.For F = 4,TE was 12.2 kP a,ARFI was 1.77 m/s,APRI was 1.46,and FIB-4 was 3.91.The APRI could not distinguish between F2 and F3,P = 0.92.The negative predictive value for F = 4 for TE and ARFI was 100%.Kappa index values for F ≥ 3 METAVIR score for TE,ARFI and FIB-4 were 0.687,0.606 and 0.654,respectively.This demonstrates strong concordance between all three screening methods,and moderate to strong concordance between them and APRI(Kappa index = 0.507).CONCLUSION Given the costs and accessibility of LSM methods,and the similarity with the outcomes of SM,we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis.This is of particular importance to developing countries. | Denise C Paranaguá-Vezozzo Adriana Andrade Daniel F C Mazo Vinicius Nunes Ana L Guedes Taisa G Ragazzo Renata Moutinho Lucas S Nacif Suzane K Ono Venancio A F Alves Flair J Carrilho | 2017 | World Journal of Hepatology2017，9，8： | 7 |
| 5 | Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis显示文摘We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature. | Emily K Smith Edmund Ek Daniel Croagh Lavinia A Spain Stephen Farrell | 2009 | World Journal of Gastroenterology2009，15，38： | 7 |
| 6 | It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis显示文摘Background There is concern that blood pressure(BP)lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis.We assessed the effect of glyceryl trinitrate(GTN)in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)Trial.Methods ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of onset.Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days.The primary outcome was the modified Rankin Scale(mRS)at day 90.Ipsilateral carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic factors.results 2023(60.5%)ischaemic stroke participants had carotid imaging.As compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 days.Clinical outcomes did not differ across bilateral stenosis groups.Conclusions Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days.GTN appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis. | Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge Valeria Caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 6 |
| 7 | NZ8合金在360℃锂水和400℃蒸汽中腐蚀后氧化膜的拉曼光谱分析(英文)显示文摘通过拉曼光谱法研究NZ8合金在360℃锂水和400℃蒸汽的静态高压釜中腐蚀后氧化膜的晶体结构。结果表明,NZ8合金的氧化膜主要由单斜氧化锆组成,其中包括少量畸变的四方氧化锆。随着腐蚀时间的延长,氧化膜中平均四方氧化锆含量不断减少,单斜氧化锆含量不断增加,四方氧化锆在向单斜氧化锆转变。从氧化膜/基体界面到氧化膜外表面,四方氧化锆含量不断减少,界面处四方氧化锆含量最高。NZ8合金在360℃锂水中腐蚀98d后所得氧化膜/金属界面处四方氧化锆含量较其在400℃蒸汽中腐蚀70d所得氧化膜/金属界面处四方氧化锆含量高,而且在400℃蒸汽中腐蚀后氧化膜外表面没有四方氧化锆形成。四方氧化锆向单斜氧化锆的转变决定了NZ8合金的耐腐蚀性能。氧化膜中四方氧化锆含量越高,则锆合金的耐腐蚀性能越好。 | 章海霞 许并社 李中奎 Fruchart Daniel Hlil Ei Kébir 周廉 | 2012 | 稀有金属材料与工程2012，41，5： | 5 |
| 8 | Feasibility study of computed vs measured high b-value(1400 s/mm2) diffusion-weighted MR images of the prostate显示文摘AIM: To evaluate the impact of computed b = 1400 s/mm2(C-b1400) vs measured b = 1400 s/mm2(M-b1400) diffusion-weighted images(DWI) on lesion detection rate, image quality and quality of lesion demarcation using a modern 3T-MR system based on a small-field-of-view sequence(sFOV). METHODS: Thirty patients(PSA: 9.5 ± 8.7 ng/mL; 68 ± 12 years) referred for magnetic resonance imaging(MRI) of the prostate were enrolled in this study. All measurements were performed on a 3T MR system.For DWI, a single-shot EPI diffusion sequence(b = 0, 100, 400, 800 s/mm2) was utilized. C-b1400 was cal-culated voxelwise from the ADC and diffusion images. Additionally, M-b1400 was acquired for evaluation and comparison. Lesion detection rate and maximum lesion diameters were obtained and compared. Image quality and quality of lesion demarcation were rated accord-ing to a 5-point Likert-type scale. Ratios of lesion-to-bladder as well as prostate-to-bladder signal intensity(SI) were calculated to estimate the signal-to-noise-ratio(SNR). RESULTS: Twenty-four lesions were detected on M-b1400 images and compared to C-b1400 images. C-b1400 detected three additional cancer suspicious lesions. Overall image quality was rated significantly better and SI ratios were significantly higher on C-b1400(2.3 ± 0.8 vs 3.1 ± 1.0, P < 0.001; 5.6 ± 1.8 vs 2.8 ± 0.9, P < 0.001). Comparison of lesion size showed no significant differences between C- and M-b1400(P = 0.22). CONCLUSION: Combination of a high b-value extrap-olation and sFOV may contribute to increase diagnostic accuracy of DWI without an increase of acquisition time, which may be useful to guide targeted prostate biopsies and to improve quality of multiparametric MRI(mMRI) especially under economical aspects in a pri-vate practice setting. | Leonardo K Bittencourt Ulrike I Attenberger Daniel Lima Ralph Strecker Andre de Oliveira Stefan O Schoenberg Emerson L Gasparetto Daniel Hausmann | 2014 | World Journal of Radiology2014，6，6： | 5 |
| 9 | Direct generation of linearly polarized photon emission with designated orientations from site-controlled InGaN quantum dots显示文摘Semiconductor quantum dots(QDs)have been demonstrated viable for efficient light emission applications,in particular for the emission of single photons on demand.However,the preparation of QDs emitting photons with predefined and deterministic polarization vectors has proven arduous.Access to linearly polarized photons is essential for various applications.In this report,a novel concept to directly generate linearly-polarized photons is presented.This concept is based on InGaN QDs grown on top of elongated GaN hexagonal pyramids,by which the predefined elongation determines the polarization vectors of the emitted photons from the QDs.This growth scheme should allow fabrication of ultracompact arrays of photon emitters,with a controlled polarization direction for each individual emitter. | Anders Lundskog Chih-Wei Hsu K Fredrik Karlsson Supaluck Amloy Daniel Nilsson Urban Forsberg Per Olof Holtz Erik Janzen | 2014 | Light(Science & Applications)2014，3，1： | 4 |
| 10 | Diagnosing gastrointestinal illnesses using fecal headspacevolatile organic compounds显示文摘Volatile organic compounds(VOCs) emitted from stool are the components of the smell of stool representing the end products of microbial activity and metabolism that can be used to diagnose disease. Despite the abundance of hydrogen, carbon dioxide, and methane that have already been identified in human flatus, the small portion of trace gases making up the VOCs emitted from stool include organic acids, alcohols, esters, heterocyclic compounds, aldehydes, ketones, and alkanes, among others. These are the gases that vary among individuals in sickness and in health, in dietary changes, and in gut microbial activity. Electronic nose devices are analytical and pattern recognition platforms that can utilize mass spectrometry or electrochemical sensors to detect these VOCs in gas samples. When paired with machine-learning and pattern recognition algorithms, this can identify patterns of VOCs, and thus patterns of smell, that can be used to identify disease states. In this review, we provide a clinical background of VOC identification, electronic nose development, and review gastroenterology applications toward diagnosing disease by the volatile headspace analysis of stool. | Daniel K Chan Cadman L Leggett Kenneth K Wang | 2016 | World Journal of Gastroenterology2016，22，4： | 4 |
| 11 | Overweight and obesity in hip and knee arthroplasty:Evaluation of 6078 cases显示文摘AIM: To evaluate a possible association between thevarious levels of obesity and peri-operative characteristics of the procedure in patients who underwent endoprosthetic joint replacement in hip and knee joints. METHODS: We hypothesized that obese patients were treated for later stage of osteoarthritis, that more conservative implants were used, and the intraand perioperative complications increased for such patients. We evaluated all patients with body mass index(BMI) ≥ 25 who were treated in our institution from January 2011 to September 2013 for a primary total hip arthroplasty(THA) or total knee arthroplasty(TKA). Patients were split up by the levels of obesity according to the classification of the World Health Organization. Average age at the time of primary arthroplasty, preoperative Harris Hip Score(HHS), Hospital for Special Surgery score(HSS), gender, type of implanted prosthesis, and intra-and postoperative complications were evaluated.RESULTS: Six thousand and seventy-eight patients with a BMI ≥ 25 were treated with a primary THA or TKA. Age decreased significantly(P < 0.001) by increasing obesity in both the THA and TKA. HHS and HSS were at significantly lower levels at the time of treatment in the super-obese population(P < 0.001). Distribution patterns of the type of endoprostheses used changed with an increasing BMI. Peri- and postoperative complications were similar in form and quantity to those of the normal population. CONCLUSION: Higher BMI leads to endoprosthetic treatment in younger age, which is carried out at significantly lower levels of preoperative joint function. | Daniel Guenther Stefan Schmidl Till O Klatte Harald K Widhalm Mohamed Omar Christian Krettek Thorsten Gehrke Daniel Kendoff Carl Haasper | 2015 | World Journal of Orthopedics2015，6，1： | 4 |
| 12 | 面子研究的传承与嬗变显示文摘从历史演变到当下多视角的热议,面子研究呈现了历史传承性与嬗变性。本文主要从其概念衍生的历史渊源以及研究内容、手段的演变两个方面,对面子研究进行了详实的回溯。在此基础之上,本文从积极面子与消极面子划分之争、特定文化面子问题研究的不足、以及汉语文化特性面子研究的必要性三个方面进行概述,并提出未来研究的新议题、新思路。 | 周凌 Daniel Kádár | 2016 | 外语研究2016，33，3： | 4 |
| 13 | Keratinocytes costimulate naive human T cells via CD2: a potential target to prevent the development of proinflammatory Th1 cells in the skin显示文摘The interplay between keratinocytes and immune cells,especially T cells,plays an important role in the pathogenesis of chronic inflammatory skin diseases.During psoriasis,keratinocytes attract T cells by releasing chemokines,while skin-infiltrating selfreactive T cells secrete proinflammatory cytokines,e.g.,IFN γand IL-17A,that cause epidermal hyperplasia.Similarly,in chronic graftversus-host disease,allogenic IFN γ-producing Th1/Tc1 and IL-17-producing Th17/Tc17 cells are recruited by keratinocyte-derived chemokines and accumulate in the skin.However,whether keratinocytes act as nonprofessional antigen-presenting cells to directly activate naive human T cells in the epidermis remains unknown.Here,we demonstrate that under proinflammatory conditions,primary human keratinocytes indeed activate naive human T cells.This activation required cell contact and costimulatory signaling via CD58/CD2 and CD54/LFA-1.Naive T cells costimulated by keratinocytes selectively differentiated into Th1 and Th17 cells.In particular,keratinocyte-initiated Th1 differentiation was dependent on costimulation through CD58/CD2.The latter molecule initiated STAT1 signaling and IFN γproduction in T cells.Costimulation of T cells by keratinocytes resulting in Th1 and Th17 differentiation represents a new explanation for the local enrichment of Th1 and Th17 cells in the skin of patients with a chronic inflammatory skin disease.Consequently,local interference with T cell–keratinocyte interactions may represent a novel strategy for the treatment of Th1 and Th17 cell-driven skin diseases. | Christian Orlik Daniel Deibel Johanna Küblbeck Emre Balta Sabina Ganskih Jüri Habicht Beate Niesler Jutta Schröder-Braunstein Knut Schäkel Guido Wabnitz Yvonne Samstag | 2020 | Cellular & Molecular Immunology2020，17，4： | 4 |
| 14 | Laparoscopic vs open partial colectomy in elderly patients:Insights from the American College of Surgeons- National Surgical Quality Improvement Program database显示文摘AIM: To compare the outcomes between the laparoscopic and open approaches for partial colectomy in elderly patients aged 65 years and over using the American College of Surgeons- National Surgical Quality Improvement Program(ACS NSQIP) database. METHODS: The ACS NSQIP database for the years 2005-2011 was queried for all patients 65 years and above who underwent partial colectomy. 1:1 propensity score matching using the nearest- neighbor method was performed to ensure both groups had similar preoperative comorbidities. Outcomes including postoperative complications, length of stay and mortality were compared between the laparoscopic and open groups. χ2 and Fisher's exact test were used for discrete variables and Student's t-test for continuous variables. P < 0.05 was considered significant and odds ratios with 95%CI were reported when applicable. RESULTS: The total number of patients in the ACS NSQIP database of the years 2005-2011 was 1777035. We identified 27604 elderly patients who underwent partial colectomy with complete data sets. 12009(43%) of the cases were done laparoscopically and15595(57%) were done with open. After propensity score matching, there were 11008 patients each in the laparoscopic(LC) and open colectomy(OC) cohorts. The laparoscopic approach had lower post-operative complications(LC 15.2%, OC 23.8%, P < 0.001), shorter length of stay(LC 6.61 d, OC 9.62 d, P < 0.001) and lower mortality(LC 1.6%, OC 2.9%, P < 0.001). CONCLUSION: Even after propensity score matching, elderly patients in the ACS NSQIP database having a laparoscopic partial colectomy had better outcomes than those having open colectomies. In the absence of specific contraindications, elderly patients requiring a partial colectomy should be offered the laparoscopic approach. | Umashankkar Kannan Vemuru Sunil K Reddy Amar N Mukerji Vellore S Parithivel Ajay K Shah Brian F Gilchrist Daniel T Farkas | 2015 | World Journal of Gastroenterology2015，21，45： | 3 |
| 15 | 哮喘治疗的新进展显示文摘没有强有力的循证医学证据表明饮食方法或Buteyko技术对哮喘的临床管理有很大益处需要进一步研究确定当哮喘控制欠佳时患者应该怎么做小剂量吸入皮质激素可以和长效β2激动剂联合应用,以提供安全有效的哮喘控制静脉镁制剂和白三烯受体拮抗剂对急性哮喘可能具有一些作用,但仍需进一步评价将来哮喘治疗是否能得到炎症生物标志或患者基因型认识的帮助。 | Graeme P Currie Graham S Devereux Daniel K C Lee Jon G Ayres 刘艳(译) 代华平(校) | 2005 | 英国医学杂志中文版2005，8，4： | 3 |
| 16 | Novel susceptibility genes in inflammatory bowel disease显示文摘The inflammatory bowel disease, Crohn's disease and ulcerative colitis, are polygenic disorders with important environmental interactions. To date, the most widely adopted approach to identifying susceptibility genes in complex diseases has involved genome wide linkage studies followed by studies of positional candidate genes in loci of interest. This review encompasses data from studies into novel candidate genes implicated in the pathogenesis of inflammatory bowel disease. Novel techniques to identify candidate genes-genome wide association studies, yeast-two hybrid screening, microarray gene expression studies and proteomic profiling, are also reviewed and their potential role in unravelling the pathogenesis of inflammatory bowel disease are discussed. | Colin Noble Elaine Nimmo Daniel Gaya Richard K Russell Jack Satsangi | 2006 | World Journal of Gastroenterology2006，12，13： | 3 |
| 17 | The effects of exercise on cognition in Parkinson’s disease: a systematic review显示文摘Cognitive impairments are highly prevalent in Parkinson’s disease(PD)and can substantially affect a patient’s quality of life.These impairments remain difficult to manage with current clinical therapies,but exercise has been identified as a possible treatment.The objective of this systematic review was to accumulate and analyze evidence for the effects of exercise on cognition in both animal models of PD and human disease.This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)statement.Fourteen original reports were identified,including six pre-clinical animal studies and eight human clinical studies.These studies used various exercise interventions and evaluated many different outcome measures;therefore,only a qualitative synthesis was performed.The evidence from animal studies supports the role of exercise to improve cognition in humans through the promotion of neuronal proliferation,neuroprotection and neurogenesis.These findings warrant more research to determine what roles these neural mechanisms play in clinical populations.The reports on cognitive changes in clinical studies demonstrate that a range of exercise programs can improve cognition in humans.While each clinical study demonstrated improvements in a marker of cognition,there were limitations in each study,including non-randomized designs and risk of bias.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)system was used and the quality of the evidence for human studies were rated from“low”to“moderate”and the strength of the recommendations were rated from“weak”to“strong”.Studies that assessed executive function,compared to general cognitive abilities,received a higher GRADE rating.Overall,this systematic review found that in animal models exercise results in behavioral and corresponding neurobiological changes in the basal ganglia related to cognition.The clinical studies showed that various types of exercise,including aerobic,resistance and dance can improve cognitive function,although the optimal type,amount,mechanisms,and duration of exercise are unclear.With growing support for exercise to improve not only motor symptoms,but also cognitive impairments in PD,health care providers and policy makers should recommend exercise as part of routine management and neurorehabilitation for this disorder. | Danielle K Murray Matthew A Sacheli Janice J Eng A Jon Stoessl | 2014 | Translational Neurodegeneration2014，3，1： | 3 |
| 18 | Elderly patients and inflammatory bowel disease显示文摘The incidence and prevalence of inflammatory bowel disease(IBD) is increasing globally. Coupled with an ageing population, the number of older patients with IBD is set to increase. The clinical features and therapeutic options in young and elderly patients are comparable but there are some significant differences. The wide differential diagnosis of IBD in elderly patients may result in a delay in diagnosis. The relative dearth of data specific to elderly IBD patients often resulting from their exclusion from pivotal clinical trials and the lack of consensus guidelines have made clinical decisions somewhat challenging. In addition, age specific concerns such as co-morbidity; locomotor and cognitive function, poly-pharmacy and its consequences need to be taken into account. In applying modern treatment paradigms to the elderly, the clinician must consider the potential for more pronounced adverse effects in this vulnerable group and set appropriate boundaries maximising benefit and minimising harm. Meanwhile, clinicians need to make personalised decisions but as evidence based as possible in the holistic, considered and optimal management of IBD in elderly patients. In this review we will cover the clinical features and therapeutic options of IBD in the elderly; as well as addressing common questions and challenges posed by its management. | Danielle Nimmons Jimmy K Limdi | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，1： | 3 |
| 19 | Prediction of delayed graft function using different scoring algorithms: A single-center experience显示文摘AIM To compare the performance of 3 published delayed graftfunction(DGF) calculators that compute the theoretical risk of DGF for each patient.METHODS This single-center,retrospective study included 247 consecutive kidney transplants from a deceased donor.These kidney transplantations were performed at our institution between January 2003 and December 2012.We compared the occurrence of observed DGF in our cohort with the predicted DGF according to three different published calculators. The accuracy of the calculators was evaluated by means of the c-index(receiver operating characteristic curve).RESULTS DGF occurred in 15.3% of the transplants under study.The c index of the Irish calculator provided an area under the curve(AUC) of 0.69 indicating an acceptable level of prediction,in contrast to the poor performance of the Jeldres nomogram(AUC = 0.54) and the Chapal nomogram(AUC = 0.51). With the Irish algorithm the predicted DGF risk and the observed DGF probabilities were close. The mean calculated DGF risk was significantly different between DGF-positive and DGF-negative subjects(P < 0.0001). However,at the level of the individual patient the calculated risk of DGF overlapped very widely with ranges from 10% to 51% for recipients with DGF and from 4% to 56% for those without DGF.The sensitivity,specificity and positive predictive value of a calculated DGF risk ≥ 30% with the Irish nomogram were 32%,91% and 38%. CONCLUSION Predictive models for DGF after kidney transplantation are performant in the population in which they were derived,but less so in external validations. | Magda Michalak Kristien Wouters Erik Fransen Rachel Hellemans Amaryllis H Van Craenenbroeck Marie M Couttenye Bart Bracke Dirk K Ysebaert Vera Hartman Kathleen De Greef Thiery Chapelle Geert Roeyen Gerda Van Beeumen Marie-Paule Emonds Daniel Abramowicz Jean-Louis Bosmans | 2017 | World Journal of Transplantation2017，7，5： | 3 |
| 20 | What do the recent American Heart Association/American College of Cardiology Foundation Clinical Practice Guidelines tell us about the evolving management of coronary heart disease in older adults?显示文摘Biological aging predisposes older adults to increased cardiovascular disease (CHD) and greater disease complexity. Given the high age-related prevalence of CHDand age-related compounding factors, the recently updatedAmerican HeartAssociation/American College of Cardiology Foundation CHD-related guidelines increased their focus on older patients. These guidelines are predominately evidence-based (using data from quality randomized clinical trials) and are organized to delineate medications and procedures that best treat particular cardiovascular diseases.While such rationale and thought work well in young and middle aged adults, they become problematic in patientswho are very old. Data pertaining to adults aged ≥80 are virtually absent from most randomized clinical trials, and even in the instances when very old patients were included, eligibility criteria typically excluded candidates with co-morbidities and complexities of customary CHD patients. While medications and interventions yielding benefit in clinical trials should theoretically produce the greatest benefits for patients with high intrinsic risk, age-related cardiovascular complexities also increase iatrogenic risks. Navigating between the potential for high benefit and high risk in “evidence-based”cardiovascular management remains a key Geriatric Cardiology challenge. In this review we consider the expanded Geriatric Cardiology content of current guidelines, acknowledging both the progress that has been made, as well as the work that still needs to be accomplished to truly address the patient-centered priorities of older CHDpatients. | Daniel Forman Nanette K Wenger | 2013 | Journal of Geriatric Cardiology2013，10，2： | 3 |
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