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| 1 | BCLC策略:预后预测和治疗推荐2022版更新显示文摘2018版BCLC预后和治疗推荐策略发布后,肝细胞癌(简称HCC)的研究又取得了重大进展。本次更新基于肝癌各领域的研究进展结果。重点关注影响策略的重要研究进展。虽然近年的研究结果成绩斐然,但将其引入为临床医生和研究者提供行动依据的循证模型指南来说证据效力依然不够确切。本文对该问题进行分析,阐述了为HCC患者制定个体化治疗临床决策所需的批判性思维和专业知识。 | Reig M Forner A Rimola J Ferrer-Fabrega J Burrel M Garcia-Criado A Kelley RK Galle PR Mazzaferro V Salem R Sangro B Singal AG Vogel A Fuster J Ayuso C Bruix J 刘永凡(摘译) 崔笑(摘译) 耿小平(审校) | 2022 | 肝胆外科杂志2022，30，5： | 80 |
| 2 | 胱抑素C与肌酐在确定肾功能风险方面的作用显示文摘血肌酐联合胱抑素c确定估算的肾小球滤过率(estimatedglomerularfiltrationrate,eGFR),能够提高准确性,但其对不同人群慢性肾脏病检测、分期和风险分类的影响尚未确定。最近美国学者报告了一项荟萃分析,比较了胱抑素c与肌酐在确定肾功能风险方面的作用。 | Shlipak MG Matsushita K rnlv J 王建中 | 2013 | 中华肾病研究电子杂志2013，2，5： | 60 |
| 3 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 4 | 急性缺血性卒中的血管内治疗:神经介入外科学学会实践标准委员会的报告显示文摘目的总结采用血管内技术治疗急性缺血性卒中的有关证据并等级分类。方法对美国心脏协会(American Heart Association,AHA)以前发表的推荐意见进行审查并作为当前流程的基础。在此这基础上,进行系统的文献回顾以评估支持急性缺血性卒中血管内治疗的证据。根据AHA卒中委员会和牛津大学循证医学中心提出的循证医学证据分级指南进行评估。对操作安全性、技术效果以及对临床转归的影响进行特别审核。 | K A Blackham P M Meyers T A Abruzzo F C Alberquerque D Fiorella J Fraser D Frei C D Gandhi D V Heck J A Hirsch D P Hsu M Jayaraman S Narayanan C Prestigiacomo J L Sunshine 包元飞(译) 李永坤(译) 刘新峰(译) | 2012 | 国际脑血管病杂志2012，20，12： | 28 |
| 5 | Pediatric functional constipation treatment with Bifi dobacterium-containing yogurt:A crossover,double-blind,controlled trial显示文摘AIM: To evaluate the treatment of pediatric functional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. METHODS: A crossover double-blind formula-controlled trial was carried out on 59 students (age range: 5-15 years) of a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma Ⅲ criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 109 colony forming unit/mL Bifidobacterium longum (B.longum) (probiotic) daily or only the yogurt for a period of 5 wk (formula). Afterwards, the groups were intercrossed for another 5 wk. Defecation frequency, stool consistency and abdominal and defecation pain were assessed.RESULTS: Both treatment groups demonstrated improvement in defecation frequency compared to baseline. However, the group treated with probiotic showed most signif icant improvement in the f irst phase of the study. An inversion was observed after crossing over, resulting in a reduction in stool frequency when this group was treated by formula. Probiotic and formula improved stool consistency in the f irst phase of treatment, but the improvement obtained with probiotic was significantly higher (P = 0.03). In the second phase of treatment, the group initially treated with probiotic showed worseningstool consistency when using formula. However, the difference was not signif icant. A signif icant improvement in abdominal pain and defecation pain was observed with both probiotic and formula in the first phase of treatment, but again the improvement was more signif icant for the group treated with B. longum during phase I (P < 0.05). When all data of the crossover study were analyzed, significant differences were observed between probiotic yogurt and yogurt only for defecation frequency (P = 0.012), defecation pain (P = 0.046) and abdominal pain (P = 0.015). | Paula VP Guerra Luiza N Lima Tassia C Souza Vanessa Mazochi Francisco J Penna Andreia M Silva Jacques R Nicoli Elizabet V Guimares | 2011 | World Journal of Gastroenterology2011，17，34： | 25 |
| 6 | Cardiac rehabilitation and exercise therapy in the elderly: Should we invest in the aged?显示文摘冠的心疾病(CHD ) 是世界范围的死亡的领先的原因并且在病人之中变得逐渐地流行 65 岁以上。老病人在为复杂并发症的更高的风险并且在一个心血管的事件以后加速物理 deconditioning,特别与他们的更年轻的对应物相比。最后几十年是到与 CHD 在病人之中在死亡,锻练能力,心理风险因素,发炎,和肥胖上表明了心脏的康复(CR ) 和锻练治疗的有益的效果的多重研究的厕所。不幸地,这个领域里的可得到的数据的重要部分与更年轻的病人相关。可行解释是更老的病人在为以病人开始并且延长到医生的多重原因的这些节目是非常未被充分代表的。在这篇文章,我们将考察 CR 节目的好处在之中老,以及一些妨碍他们的参予的障碍。 | Arthur R Menezes Carl J Lavie Richard V Milani Ross A Arena Timothy S Church | 2012 | Journal of Geriatric Cardiology2012，9，1： | 25 |
| 7 | 2018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 |
| 8 | Alcoholic liver disease:Utility of animal models显示文摘Alcoholic liver disease(ALD) is a major cause of acute and chronic liver injury. Extensive evidence has been accumulated on the pathological process of ALD during the past decades. However, effective treatment options for ALD are very limited due to the lack of suitable in vivo models that recapitulate the full spectrum of ALD. Experimental animal models of ALD, particularly rodents, have been used extensively to mimic human ALD. An ideal animal model should recapitulate all aspects of the ALD process, including significant steatosis, hepatic neutrophil infiltration, and liver injury. A better strategy against ALD depends on clear diagnostic biomarkers, accurate predictor(s) of its progression and new therapeutic approaches to modulate stop or even reverse the disease. Numerous models employing rodent animals have been established in the last decades to investigate the effects of acute and chronic alcohol exposure on the initiation and progression of ALD. Although significant progress has been made in gaining better knowledge on the mechanisms and pathology of ALD, many features of ALD are unknown, and require further investigation, ideally with improved animal models that more effectively mimic human ALD. Although differences in the degree and stages of alcoholic liver injury inevitably exist between animal models and human ALD, the acquisition and translational relevance will be greatly enhanced with the development of new and improved animal models of ALD. | Arantza Lamas-Paz Fengjie Hao Leonard J Nelson Maria Teresa Vázquez Santiago Canals Manuel Gómez del Moral Eduardo Martínez-Naves Yulia A Nevzorova Francisco Javier Cubero | 2018 | World Journal of Gastroenterology2018，24，45： | 26 |
| 9 | Genotypes and viral variants in chronic hepatitis B: A review of epidemiology and clinical relevance显示文摘The Hepatitis B Virus(HBV) has a worldwide distribu-tion and is endemic in many populations. It is constantly evolving and 10 genotypic strains have been identified with varying prevalences in different geographic regions. Numerous stable mutations in the core gene and in the su-rface gene of the HBV have also been identified in untreated HBV populations. The genotypes and viral variants have been associated with certain clinical featu-res of HBV related liver disease and Hepatocellu-lar carcinoma. For example Genotype C is associated withlater hepatitis B e antigen(HBe Ag) seroconversion, and more advanced liver disease. Genotype A is associated with a greater risk of progression to chronicity in adu-lt acqu-ired HBV infections. Genotype D is particu-larly associated with the precore mu-tation and HBe Ag negative chronic hepatitis B(CHB). The genotypes prevalent in parts of West Africa, Central and Sou-th America, E, F and H respectively, are less well stu-died. Viral variants especially the Basal Core Promotor mutation is associated with increased risk of fibrosis and cancer of the liver. Althou-gh not cu-rrently part of rou-tine clinical care, evalu-ation of genotype and viral variants may provide u-sefu-l adju-nctive information in predicting risk abou-t liver related morbidity in patients with CHB. | Catherine MN Croagh Paul V Desmond Sally J Bell | 2015 | World Journal of Hepatology2015，7，3： | 24 |
| 10 | Colonoscopic polypectomy and associated techniques显示文摘Polypectomy of colonic polyps has been shown to reduce the risk of colon cancer development and is considered a fundamental skill for all endoscopists who perform colonoscopy.A variety of polypectomy techniques and devices are available,and their use can vary greatly based on local availability and preferences.In general,cold forceps and cold snare have been the polypectomy methods of choice for smaller polyps,and hot snare has been the method of choice for larger polyps.The use of hot forceps has mostly fallen out of favor.Polypectomy for difficult to remove polyps may require the use of special devices and advanced techniques and has continued to evolve.As a result,the vast majority of polyps today can be removed endoscopically.Since electrocautery is frequently used for polypectomy,endoscopists should be thoroughly familiar with the basic principles of electrosurgery as it pertains to polypectomy.Tattooing of a polypectomy site is an important adjunct to polypectomy and can greatly facilitate future surgery or endoscopic surveillance.The two most common post-polypectomy complications are bleeding and perforation.Their incidence can be decreased with the use of meticulous polypectomy techniques and the application of some prophylactic maneuvers.This review will examine the technique of polypectomy and its complications from the perspective of the practicing gastroenterologist. | Christopher J Fyock Peter V Draganov | 2010 | World Journal of Gastroenterology2010，16，29： | 19 |
| 11 | 纳秒、皮秒和飞秒激光脉冲对材料表面的改性(英文)显示文摘对基体材料镉镍铁合金600和多层TiAlN/TiN涂层的激光表面改性在基础研究和实际应用中有着很好的前景。本文观察了由超短脉冲(fs和ns)和短脉冲(ns)激光器引起的镉镍铁合金600和TiAlN/TiN镀层的表面变化。结果显示,3种激光都能使靶面发生形态改变,超短脉冲的破坏轮廓更为清晰。与ps激光脉冲相比,fs激光脉冲能产生更严重的破坏。与产生半球体形状的ps激光束相反,fs激光脉冲产生的破坏斑是圆锥形的。另外,ns脉冲辐照时热效应占支配地位,且所有的辐照都伴随着等离子体。 | TRTICAM S GAKOVIC B M RADAK B B BATANI D TARASENKO V F PETROVIC S STASIC J MILOVANOVIC D KRMPOT A JELENKOVIC B | 2011 | 光学精密工程2011，19，2： | 18 |
| 12 | 早、中更新世东亚冬季风强度的快速变化显示文摘对黄土高原中部洛川黄土堆积进行了系统的粒度和磁化率测量,以黄土-古土壤中的粗颗粒组分,即>30μm颗粒的百分含量作为冬季风强度代用指标,根据一个独立的时间标尺,发现在145~165、240~280、320~350、390~440、600~640、860~890、900~930和1330~1400kaB.P.东亚冬季风强度存在千年尺度快速变化的特征,冬季风加强事件的持续时间在1.4~7.2ka之间,变化幅度也不相同;周期分析结果表明,这些古气候变化存在1.89~4.0ka之间的周期,由于时间标尺的精度还有待于进一步提高,在这里没有把冬季风强度变化与北大西洋沉积物记录的古气候事件进行对比,但是,实验结果证明在早。 | 鹿化煜 K V Huissteden 安芷生 G Nugteren J Vandenberghe | 1999 | 海洋地质与第四纪地质1999，19，2： | 17 |
| 13 | 在没有危险因素的情况下,正常的低密度脂蛋白胆固醇水平与亚临床动脉粥样硬化相关显示文摘普遍认为缺乏心血管病危险因素(cardiovascular risk factors,CVRF)人群的动脉粥样硬化发生风险低,然而,无CVRF的个体仍然有心血管事件发生。为了确定无CVRF个体中亚临床动脉粥样硬化的预测因子, | Fernández-Friera L Fuster V López-Melgar B Oliva B García-Ruiz JM Mendiguren J Bueno H Pocock S Ibánez B Fernández-Ortiz A Sanz J 刘莉 叶鹏 | 2017 | 中华高血压杂志2017，25，12： | 17 |
| 14 | A review of the effects of dietary organic acids fed to swine显示文摘Animal production depends on nutrient utilization and if done there is an accelerated momentum towards growth with a low cost to feed ratio Public concern over the consumption of pork with antibiotic residues of the animals fed with antibiotic growth promoters(AGP) has paved the way to use other additives like herbs and their products,probiotics,prebiotics etc.Numerous feed additives are in vogue for achieving this target and one such classical example is the usage of organic acids and their salts.Usage of organic acids was in progress for over four decades.Early weaned piglets are(3-4 weeks age) exposed to stress with a reduced feed intake,little or no weight gain.This post weaning lag period is due to a limited digestive and absorptive capacity due to insufficient production of hydrochloric acid,pancreatic enzymes and sudden changes in feed consistency and intake.Lowering dietary pH by weak organic acids was found to overcome these problems.The main activity of organic acids is associated with a reduction in gastric pH converting the inactive pepsinogen to active pepsin for effective protein hydrolysis.Organic acids are both bacteriostatic and bactericidal.Lactic acid has been reported to reduce gastric pH and delay the multiplication of an enterotoxigenic E.coli.These acids are the intermediary products in Kreb's cycle and thus act as an energy source preventing the tissue breakdown resulting from gluconeogenesis and lipolysis.Excretion of supplemental minerals and nitrogen are minimized with organic acids as these form complexes with minerals and aids for their bio-availability.Short chain fatty cids like acetic,propionic and n-butyric acid produced by microbial fermentation of dietary fibre in the large intestines may increase the proliferation of epithelial cells and have stimulatory effects on both endocrine and exocrine pancreatic secretions in pigs.Organic acids also enhances apparent total tract digestibility and improves growth performance.It is concluded that organic acids and their salts increase the protein utilization especially in weaner pigs and improves production indices. | Mocherla V A N Suiryanrayna J V Ramana | 2016 | Journal of Animal Science and Biotechnology2016，7，1： | 15 |
| 15 | Effect of Helicobacter pylori on gastric epithelial cells显示文摘The gastrointestinal epithelium has cells with features that make them a powerful line of defense in innate mucosal immunity. Features that allow gastrointestinal epithelial cells to contribute in innate defense include cell barrier integrity, cell turnover, autophagy, and innate immune responses. Helicobacter pylori(H. pylori) is a spiral shape gram negative bacterium that selectively colonizes the gastric epithelium of more than half of the world's population. The infection invariably becomes persistent due to highly specialized mechanisms that facilitate H. pylori 's avoidance of this initial line of host defense as well as adaptive immune mechanisms. The host response is thus unsuccessful in clearing the infection and as a result becomes established as a persistent infection promoting chronic inflammation. In some individuals the associated inflammation contributes to ulcerogenesis or neoplasia. H. pylori has an array of different strategies to interact intimately with epithelial cells and manipulate their cellular processes and functions. Among the multiple aspects that H. pylori affects in gastric epithelial cells are their distribution of epithelial junctions, DNA damage, apoptosis, proliferation, stimulation of cytokine production, and cell transformation. Some of these processes are initiated as a result of the activation of signaling mechanisms activated on binding of H. pylori to cell surface receptors or via soluble virulence factors that gain access to the epithelium. The multiple responses by the epithelium to the infection contribute to pathogenesis associated with H. pylori. | Shatha Alzahrani Taslima T Lina Jazmin Gonzalez Irina V Pinchuk Ellen J Beswick Victor E Reyes | 2014 | World Journal of Gastroenterology2014，20，36： | 15 |
| 16 | Iron and non-alcoholic fatty liver disease显示文摘The mechanisms that promote liver injury in non-alcoholic fatty liver disease(NAFLD) are yet to be thoroughly elucidated. As such, effective treatment strategies are lacking and novel therapeutic targets are required. Iron has been widely implicated in the pathogenesis of NAFLD and represents a potential target for treatment. Relationships between serum ferritin concentration and NAFLD are noted in a majority of studies, although serum ferritin is an imprecise measure of iron loading. Numerous mechanisms for a pathogenic role of hepatic iron in NAFLD have been demonstrated in animal and cell culture models. However, the human data linking hepatic iron to liver injury in NAFLD is less clear, with seemingly conflicting evidence, supporting either an effect of iron in hepatocytes or within reticulo-endothelial cells. Adipose tissue has emerged as a key site at which iron may have a pathogenic role in NAFLD. Evidence for this comes indirectly from studies that have evaluated the role of adipose tissue iron with respect to insulin resistance. Adding further complexity, multiple strands of evidence support an effect of NAFLD itself on iron metabolism. In this review, we summarise the human and basic science data that has evaluated the role of iron in NAFLD pathogenesis. | Laurence J Britton V Nathan Subramaniam Darrell HG Crawford | 2016 | World Journal of Gastroenterology2016，22，36： | 14 |
| 17 | 气象卫星云图的多分辨小波分解及人工神经网络降水估计研究显示文摘采用多分辨小波分析对卫星图象进行预处理 ,在保留其特征信息的同时 ,减小了数据量 ,改善了神经网络训练过程的收敛性能 ,提高了处理速度。采用这一方法根据 GOES- 8的红外亮温图象和气象雷达资料对巴西圣保罗州中部的降水量估计进行了试验 ,取得了良好的效果。 | 李伟钢 Maria C V Ramirez Nelson J Ferreira 石立华 Leonardo D de A Sá | 2000 | 南京气象学院学报2000，23，2： | 13 |
| 18 | 世界家庭医生组织(WONCA)研究论文摘要汇编——有氧运动缓解产后抑郁效果的系统性综述与荟萃分析显示文摘背景当前英美国家尚无运动方法治疗产后抑郁方面的专门指导,而且国际上在此方面的指导也不尽相同。目的评价有氧运动治疗产后抑郁的效果。设计与场所本研究为系统性综述及荟萃分析,无研究地点。方法使用计算机检索MEDLINE、EMBASE、Cochrane Library、Psyc INFO、Sport Discus、Scr Clinical Trials.gov以及World Health Organization International Clinical Trials Registry Platform数据库,收集评估产妇分娩后1年内抑郁状况的随机对照试验、有氧运动和常规护理或者其他护理方式改善产后抑郁效果的比较研究的摘要及全文。使用Cochrane协作组推荐使用的偏倚风险评估工具对纳入的文献进行偏倚风险评估。对纳入的文献进行荟萃分析。对纳入文献之间存在的异质性进行预设亚组分析。结果共纳入13篇文献,包括1 734例患者。整体来看,有氧运动可以显著缓解产后抑郁[SMD=-0.44,95%CI=(-0.75,-0.12)]。异质性分析发现,有氧运动干预效果在可能患有抑郁的产妇间及一般产妇间不存在统计学差异;只采用有氧运动取得的干预效果与采用有氧运动结合其他方式取得的干预效果不存在统计学差异;群体有氧运动与配置有氧运动咨询的干预效果不存在统计学差异。结论本项系统性综述为有氧运动具有缓解产后抑郁的效果提供了证据支持。群体运动、研究对象自己选择运动方式、运动结合其他干预方式均是有效缓解产后抑郁的方法。但是由于纳入文献存在显著异质性和高偏倚风险,故此研究结果应谨慎参考。 | PRITCHETT R V DALEY A J JOLLY K 本刊编辑部 | 2017 | 中国全科医学2017，20，30： | 12 |
| 19 | Metastatic type 1 gastric carcinoid:A real threat or just a myth?显示文摘AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological findings,the extent of the disease,as well as the use of different therapeutic modalities and the long-term outcome were recorded.Patients’data were assessed at presentation,and thereafter at 6 to 12 monthly intervals both clinically and biochemically,but also endoscopically and histopathologically.Patients were evaluated for the presence of specific symptoms;the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded.The evaluation of response to treatment was defined using established WHO criteria.RESULTS:We studied twenty consecutive patients with a mean age of 55.1 years.The mean follow-up period was 83 mo.Twelve patients had regional lymph node metastases and 8 patients had liver metastases.The primary tumor mean diameter was 20.13±10.83mm(mean±SD).The mean Ki-67 index was 6.8%±11.2%.All but one patient underwent endoscopic or surgical excision of the tumor.The disease was stable in all but 3 patients who had progressive liver disease.All patients remained alive during the follow-up period.CONCLUSION:Metastatic GCA1 carries a good overall prognosis,being related to a tumor size of≥1 cm,an elevated Ki-67 index and high serum gastrin levels. | Simona Grozinsky-Glasberg Dimitrios Thomas Jonathan R Strosberg Ulrich-Frank Pape Stephan Felder Apostolos V Tsolakis Krystallenia I Alexandraki Merav Fraenkel Leonard Saiegh Petachia Reissman Gregory Kaltsas David J Gross | 2013 | World Journal of Gastroenterology2013，19，46： | 11 |
| 20 | 放化疗联合局部切除在直肠癌器官保留中的应用:GRECCAR2随机对照试验的5年结果显示文摘背景:GRECCAR2是第一个对低位直肠癌局部切除(local ex-cision,LE)和全直肠系膜切除(total mesorectal excision,TME)进行比较的多中心随机试验。3年的随访发现了可喜的肿瘤学结果,但仍需要更长时间的随访来证实。在这项研究中,我们的目标是报告5年的肿瘤学结果,包括局部复发、转移性疾病和生存率。 | 佟伟华 RULLIER E VENDRELY V ASSELINEAU J | 2020 | 结直肠肛门外科2020，26，3： | 11 |
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