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| 1 | GRADE指南:Ⅰ.导论--GRADE证据概要表和结果总结表显示文摘本文是GRADE(Grading of Recommendations Assessment,Development,and Evaluation)系列文章的导论。该系列文章为使用GRADE系统提供指导,介绍如何将该系统用于系统评价、卫生技术评估(HTAs)及临床实践指南中备选方案的证据质量评价和推荐强度评级。GRADE方法始于提出一个明晰的问题,包括对所有重要结果的详细说明。证据被收集和汇总后,GRADE提供了明确的标准来评价其质量,包括研究设计、偏倚风险、不精确性、不一致性、间接性及效应量大小。根据支撑证据质量及备选方案带来的预期和非预期结果间的平衡情况,推荐强度以强/弱(或表述为'有条件的'/'任意的')作为特征。GRADE建议用简洁、透明、信息量丰富的结果总结表来汇总证据(以显示证据质量及每一重要结果的相对效应量和绝对效应量),和(或)以证据概要表形式额外提供证据质量评价理由的详细信息。本系列的后续文章涉及如何采用GRADE方法明确构建问题、评价证据质量及形成推荐意见。 | Gordon Guyatt Andrew D.Oxman Elie Akl Regina Kunz Gunn Vist Jan Brozek Susan Norris Yngve Falck-Ytter Paul Glasziou Hans deBeer Roman Jaeschke David Rind Joerg Meerpohl Philipp Dahm Holger J.Schünemann GRADE工作组 李幼平 杨晓妍 蒋兰慧 沈建通 | 2011 | 中国循证医学杂志2011，11，4： | 205 |
| 2 | GRADE指南:Ⅲ.证据质量分级显示文摘本文介绍证据质量分级的GRADE方法。GRADE将证据质量分为高、中、低和极低四个级别。该分级应用于证据群,而非针对个别研究。系统评价中,质量反映了我们认为效应估计值正确的把握度。对推荐意见而言,质量反映了我们认为效应估计值足以支持某特定推荐的把握度。随机对照试验初定为高质量证据,观察性研究初定为低质量证据。GRADE中所使用的质量一词不只是意味着偏倚风险,还可能受研究结果的不精确性、不一致性和间接性,及发表偏倚的影响。此外,若干因素可增加我们对效应估计值的把握度。GRADE提供了一种系统方法来思考并报告各因素。GRADE将评估证据质量的过程与给出推荐建议的过程分开。推荐强度的判断不仅依赖于证据质量。 | Howard Balshem Mark Helfanda Holger J.Schunemann Andrew D.Oxman Regina Kunz Jan Brozek Gunn E.Vist Yngve Falck-Ytter Joerg Meerpohl Susan Norris Gordon H.Guyatt GRADE工作组 李幼平 杨晓妍 高霑 | 2011 | 中国循证医学杂志2011，11，4： | 128 |
| 3 | GRADE指南:Ⅴ.证据质量评价--发表偏倚显示文摘GRADE方法中,随机试验起评即为高质量证据,观察性研究起评即为低质量证据;但若证据本身存在高发表偏倚风险,则两者证据质量级别都应降低。即使最佳证据汇总表纳入的各项研究仅有低发表偏倚风险,发表偏倚仍会极大高估效应值。当可得证据来自小样本研究、且多数由厂商资助时,作者应怀疑存在发表偏倚。若干基于检验数据类型的方法可用于评价发表偏倚,其中最常用的为漏斗图,但这些方法都有较大局限。发表偏倚可能较常见,必须特别关注早期结果、对样本量与事件数都很小的早期试验结果尤需小心。 | Gordon H.Guyatt Andrew D.Oxman Victor Montori Gunn Vist Regina Kunz Jan Brozek Pablo Alonso-Coello Ben Djulbegovic David Atkins Yngve Falck-Ytter John W.Williams Jr. Joerg Meerpohl Susan L.Norris Elie A.Akl Holger J.Schünemann 代表GRADE工作组 李幼平 王莉 钟大可 蒋兰慧 | 2011 | 中国循证医学杂志2011，11，12： | 71 |
| 4 | GRADE指南:Ⅳ.证据质量分级--研究的局限性(偏倚风险)显示文摘在GRADE方法中,若多数相关证据来自高偏倚风险的研究,则起初被定为高质量证据的随机试验和低质量证据的观察性研究均有可能被降低质量等级。随机试验已确定的局限性包括:未进行分配隐藏、未实施盲法、未报告失访情况及未恰当考虑意向性治疗原则。最近提出的局限性包括:因明显获益而早期终止试验和基于结果选择性报告结局。观察性研究的主要局限性包括使用不合适的对照及未能充分调整预后的不平衡。偏倚风险可因不同结果而异(如全死因死亡率的失访远少于生命质量的失访),许多系统评价都容易忽略这一点。在决定是否因偏倚风险而降低质量等级时,不管是随机试验还是观察性研究,作者不应采用对各个研究取平均值的方法。相反,对任何单个结果,当同时存在高、低偏倚风险的研究时,则应考虑只纳入较低偏倚风险的研究。 | Gordon H.Guyatt Andrew D.Oxman Gunn Vist Regina Kunz Jan Brozek Pablo Alonso-Coello Victor Montori Elie A.Akl Ben Djulbegovic Yngve Falck-Ytter Susan L.Norris John W.Williams Jr. David Atkins Joerg Meerpohl Holger J.Schünemann GRADE工作组 李幼平 杨晓妍 李鸿浩 李玲 | 2011 | 中国循证医学杂志2011，11，4： | 58 |
| 5 | GRADE指南:Ⅵ.证据质量评价--不精确性(随机误差)显示文摘GRADE建议通过检查95%可信区间(CI)为决定不精确性的最佳方法。在指南实际运用中,如果CI的上、下限值代表了真实效应,而临床实际情况与之不符时,必须降低证据质量级别(即对效应估计值的把握度)。除外当效应值很大且可信区间提示效应稳健,而总样本量不大且事件数很少的情况,其他应考虑因不精确性而降低证据质量级别。作此决定时,可计算有足够检验效能的单个试验所需的病例数(定义为'最优信息样本量',即optimal information size,OIS)。对连续型变量,我们建议用类似方法,首先考虑可信区间上、下限值,再计算OIS。系统评价(SR)所需方法略有不同。如果95%CI不包括相对危险度(RR)为1,且总事件发生数或病例数超过OIS标准,则精确性良好。如果95%CI包括了明显获益或危害(我们建议以RR值<0.75或>1.25作粗标准),即使达到OIS要求,因不精确性而降低证据质量级别较恰当。 | Gordon Guyatt Andrew D.Oxman Regina Kunz Jan Brozek Pablo Alonso-Coello David Rind PJ Devereaux Victor M.Montori Bo Freyschuss Gunn Vist Roman Jaeschke John W.Williams Jr. Mohammad Hassan Murad David Sinclairk Yngve Falck-Ytter Joerg Meerpohl Craig Whittington Kristian orlund Je Andrews Holger J.Schünemann 代表GRADE工作组 李幼平 王莉 陈尹 高霑 | 2011 | 中国循证医学杂志2011，11，12： | 43 |
| 6 | The early Holocene optimum inferred from a high-resolution pollen record of Huguangyan Maar Lake in southern China显示文摘A high-resolution pollen record of the past 13000 a from Huguangyan Maar Lake reveals the vegetation and environment changes in southern China during the Holocene. It shows that (i) pollen percentage of trees and shrubs reached 56% during the early Holocene (11600―7800 cal a BP), of which the pollen percentage of tropical trees reached a maximum at 9500―8000 cal a BP, reflecting a hot and wet envi- ronment; (ii) during the mid-Holocene (7800―4200 cal a BP), the pollen percentage of montane conif- erous trees and herbs increased, while the percentage of tropical-subtropical trees decreased, indi- cating lower temperature and humidity; (iii) in the late Holocene spanning from 4200 to 350 cal a BP, the pollen percentage of herbs and montane conifer increased significantly, indicating a marked decrease of temperature and humidity. Our pollen data reveal that the time period 9500―8000 cal a BP in south- ern China represents a climatic optimum for the Holocene characterized by hot and wet conditions. This is consistent with the Holocene optimum found in lower latitude regions globally. We speculate that strong insolation might cause the northward migration of the ITCZ and subtropical summer mon- soon front, which resulted in an early Holocene optimum in the Huguangyan area. The dry tendency and climate fluctuations of the middle and late Holocene could be associated with a decrease in solar insolation and frequent ENSO event. | WANG ShuYun LUE HouYuan LIU JiaQi Joerg F. W. NEGENDANK | 2007 | Chinese Science Bulletin2007，52，20： | 36 |
| 7 | Diagnosis of biliary strictures after liver transplantation:Which is the best tool?显示文摘AIM: To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagnosis of biliary complications after liver transplantation. METHODS: In 75 patients after liver transplantation, who received ERC due to suspected biliary complications, the result of the cholangiography was compared to the results of indirect imaging methods performed prior to ERC. The cholangiography showed no biliary stenosis (NoST) in 25 patients, AST in 27 and ITBL in 23 patients. RESULTS: Biliary congestion as a result of AST was detected with a sensitivity of 68.4% in US analysis (specificity 91%), of 71% in MRI (specificity 25%) and of 40% in CT (specificity 57.1%). In ITBL, biliary congestion was detected with a sensitivity of 58.8% in the US, 88.9%in MRI and of 83.3% in CT. However, as anastomotic or ischemic stenoses were the underlying cause of biliary congestion, the sensitivity of detection was very low. InMRI detected the dominant stenosis at a correct localization in 22% and CT in 10%, while US failed completely. The biochemical parameters, showed no significant difference in bilirubin (median 5.7; 4,1; 2.5 mg/dL), alkaline phosphatase (median 360; 339; 527 U/L) or gamma glutamyl transferase (median 277; 220; 239 U/L) levels between NoST, AST and ITBL.CONCLUSION: Our data confirm that indirect imaging methods to date cannot replace direct cholangiography for diagnosis of post transplant biliary stenoses. However MRI may have the potential to complement or precede imaging by cholangiography. Optimized MRCP-processing might further improve the diagnostic impact of this method. | Thomas Zoepf Evelyn J. Maldonado-Lopez Philip Hilgard Alexander Dech■ne Massimo Malago Christoph E. Broelsch Joerg Schlaak Guido Gerken | 2005 | World Journal of Gastroenterology2005，11，19： | 32 |
| 8 | Combined TACE and PEI for palliative treatment of unresectable hepatocellular carcinoma显示文摘瞄准:估计是否 transarterial chemoembolization 的联合的有效性(不作声) 并且在 unresectable 肝细胞癌(HCC ) 的治疗的经皮的乙醇注射(PEI ) 是优异的独自不作声使随机化的控制试用是 performed.METHODS:长期的幸存率和住院的持续时间上的联合治疗的效果在 52 以前未经治疗的 HCC 被评估,随机分配了到 TACE-PEI (27 磅) 或独自不作声(25 磅) 。结果:TACE 组的累积幸存率在 6 瞬间是 75.8% , 62.9% 在 12 瞬间,并且 18.0% 分别地在 24 瞬间并且 TACE-PEI 组织 76.9% , 61.5% ,和 38.7% 。在两个组的全面幸存的比较统计上不出现了有效差量。关于有 HCC 的病人, Okuda 上演我(n = 26 ) , TACE-PEI 组的中部的幸存显著地更长(>24 瞬间,还没在学习时期到达的 median ) 与 TACE 组相比(18.4 瞬间[范围 11.6-21.7 瞬间] ;P = 0.04 ) 。TACE-PEI 为死亡把相对风险归结为 0.4 (95%CI 0.15-0.96 ) 独自与接待了的病人相比不作声。在有 HCC Okuda 阶段 II 或 III 的病人的中部的幸存是在 TACE 组的 5.0 瞬间(1.7 瞬间不定义) 与 10.4 相比,在 TACE-PEI 的瞬间组织。结论:联合 TACE-PEI 改进了生存时间与相比独自不作声。我们的学习在 HCC Okuda 舞台揭示了统计上重要的改进幸存我。副作用是次要的,联合治疗没更加延长住院的持续时间。 | Gerhild Becker Tarik Soezgen Manfred Olschewski Joerg Laubenberger Hubert Erich Blum Hans-Peter Allgaier | 2005 | World Journal of Gastroenterology2005，11，39： | 32 |
| 9 | GRADE指南:Ⅷ.证据质量评价--间接性显示文摘直接证据来自直接比较我们关注的干预措施用于我们关注的患者人群,并测量患者重要结局的研究。间接证据可由以下4种方式之一产生。第一,患者可能与我们关注的患者不同(适用性一词常用于这类间接性)。第二,所检验的干预措施可能与我们关注的干预措施不同。有关患者和干预措施间接性的决策取决于对生物或社会因素差异是否大到可能使效应尺度出现预期的较大差异的考虑。第三,结果可能有别于最初设定的结局指标——如替代结果本身不重要,但测量之是基于替代结果的变化反映患者重要结局变化这一假设。第四类间接性在概念上与前三类不同,发生于临床医生必须在未经直接比较的两种干预措施间做出选择时。这种情况下比较治疗方案需要特定的统计方法,并根据患者人群、联合干预措施、结局测量指标及备选干预措施试验方法的差异程度,将证据级别降低1或2级。 | Gordon Guyatt Andrew D.Oxman Regina Kunz James Woodcock Jan Brozek Mark Helfand Pablo Alonso-Coello Yngve Falck-Ytter Roman Jaeschke Gunn Vist Elie A.Akl Piet N Post Susan Norris Joerg Meerpohl Mona Nasser 代表GRADE工作组 李幼平 杨晓妍 李鸿浩 | 2011 | 中国循证医学杂志2011，11，12： | 30 |
| 10 | Interferon-α response in chronic hepatitis B-transfected HepG2.2.15 cells is partially restored by lamivudine treatment显示文摘AIM: To characterize the IFN-response and its modul- ation by the antiviral compound lamivudine in HBV- transfected HepG2.2.15 cells. METHODS: HepG2.2.15 and HepG2 cells were stimulated with various concentrations of IFN-a2a in the presence or absence of lamivudine. Then, total RNA was extracted and analysed by customised cDNA arrays and northern blot for interferon-inducible genes (ISGs). In addition, cellular proteins were extracted for EMSA and western blot. HBV replication was assessed by southern blot or ELISAs for HBsAg and HBeAg. RESULTS: Two genes (MxA, Cig5) with completely abolished and 4 genes (IFITM1, -2, -3, and 6-16) with partially reduced IFN-responses were identified in HepG2.2.15 cells. In 2 genes (IFITM1, 6-16), the response to IFN-a could be restored by treatment with lamivudine. This effect could not be explained by a direct modulation of the Jak/Stat signalling pathway since EMSA and western blot experiments revealed no suppression of Stat1 activation and ISGF3 formation after stimulation with IFN-a in HepG2.2.15 compared to HepG2 cells. CONCLUSION: These results are consistent with the assumption that chronic hepatitis B may specifically modulate the cellular response to IFN by a selective blockage of some ISGs. Antiviral treatment with lamivudine may partially restore ISG expression by reducing HBV gene expression and replication. | Shi-He Guan Mengji Lu Petra Grünewald Michael Roggendorf Guido Gerken Joerg F Schlaak | 2007 | World Journal of Gastroenterology2007，13，2： | 22 |
| 11 | 健康相关生命质量测量工具SF-36第二版和第一版的比较显示文摘归纳了SF-36第二版(SF-36v2)与第一版的差异,主要有以下几点:①调整问卷布局和简化条目用词,使得问卷易懂和便于完成调查,减少缺答率;②生理职能(RP)和情感职能(RE)纬度的答案,以5级选项替代2级选项,减少天花板和地板效应;③精神健康(MH)和活力(VT)纬度的答案,以5级选项替代6级选项,简化了条目选项;④计分规则的改变,基于常模的计分规则,提高了结果的临床解释能力,并便于比较。和SF-36第一版相比,第二版的校正能够极大地提高测量的精确性,从而对健康状况的改变更加敏感。基于SF-36第二版的更新及其优点,很有必要进一步地研究建立基于第二版的中国常模数据。 | 陈天辉 李鲁 Joerg M.Single Michael M.Kochen | 2006 | 中国社会医学杂志2006，23，2： | 22 |
| 12 | GRADE指南:Ⅸ.证据质量升级显示文摘证据质量升级的最常见原因是效应量大。当方法学严谨的观察性研究表明风险至少降低或增加2倍时,GRADE建议考虑将证据质量升高1级;当风险至少降低或增加5倍时,考虑将证据质量升高2级。当存在剂量-反应关系,或所有合理的混杂、偏倚会降低明显的治疗效应,或混杂、偏倚使得结果无效为假效应时,系统评价作者和指南制定者也可考虑升高证据质量。其他考虑因素包括起效迅速、潜在的疾病(状态)趋势以及间接证据。 | Gordon H.Guyatt Andrew D.Oxman Shahnaz Sultan Paul Glasziou Elie A.Akl Pablo Alonso-Coello David Atkins Regina Kunz Jan Brozek Victor Montori Roman Jaeschke David Rind Philipp Dahm Joerg Meerpohl Gunn Vist Elise Berliner Susan Norris Yngve Falck-Ytter M.Hassan Murad Holger J.Schünemann 代表GRADE工作组 李幼平 杨晓妍 李玲 王应强 | 2011 | 中国循证医学杂志2011，11，12： | 22 |
| 13 | 新疆煤田火灾的成因、危害及综合治理显示文摘新疆是世界上煤田火灾最严重的地区,原因主要是新疆地处欧亚大陆腹地,具典型的大陆性干旱气候;新疆地区煤系为中下侏罗纪,地质活动较为剧烈;小煤窑的乱采滥挖等。新疆煤田火灾带来巨大危害:损失煤炭资源、污染环境、引发地质灾害、破坏生态平衡及危害生物健康等。对煤田火灾进行综合治理已经成为当务之急。为了有效灭火,应先对火区进行探测。探测方法有磁异常探测法、自然电场法和红外地面测温法等。然后因地制宜地选择适当的灭火技术进行灭火。灭火之后还应利用地理信息系统等方法对火区进行动态监测。 | 罗淑政 玉米提·哈力克 Joerg Schulz 王金山 | 2008 | 灾害学2008，23，3： | 21 |
| 14 | Portal vein thrombosis and arterioportal shunts:Effects on tumor response after chemoembolization of hepatocellular carcinoma显示文摘AIM: To evaluate the effect of portal vein thrombosis and arterioportal shunts on local tumor response in advanced cases of unresectable hepatocellular carcinoma treated by transarterial chemoembolization. METHODS: A retrospective study included 39 patients (mean age: 66.4 years, range: 45-79 years, SD: 7) with unresectable hepatocellular carcinoma (HCC) who were treated with repetitive transarterial chemoembolization (TACE) in the period between March 2006 and October 2009. The effect of portal vein thrombosis (PVT) (in 19 out of 39 patients), the presence of arterioportal shunt (APS) (in 7 out of 39), the underlying liver pathology,Child-Pugh score, initial tumor volume, number of tumors and tumor margin definition on imaging were correlated with the local tumor response after TACE. The initial and end therapy local tumor responses were evaluated according to the response evaluation criteria in solid tumors (RECIST) and magnetic resonance imaging volumetric measurements. RESULTS: The treatment protocols were well tolerated by all patients with no major complications. Local tumor response for all patients according to RECIST criteria were partial response in one patient (2.6%), stable disease in 34 patients (87.1%), and progressive disease in 4 patients (10.2%). The MR volumetric measurements showed that the PVT, APS, underlying liver pathology and tumor margin definition were statistically significant prognostic factors for the local tumor response (P = 0.018, P = 0.008, P = 0.034 and P = 0.001, respectively). The overall 6-, 12- and 18-mo survival rates from the initial TACE were 79.5%, 37.5% and 21%, respectively. CONCLUSION: TACE may be exploited safely for palliative tumor control in patients with advanced unresectable HCC; however, tumor response is significantly affected by the presence or absence of PVT and APS. | Thomas J Vogl Nour-Eldin Nour-Eldin Sally Emad-Eldin Nagy NN Naguib Joerg Trojan Hans Ackermann Omar Abdelaziz | 2011 | World Journal of Gastroenterology2011，17，10： | 20 |
| 15 | Transarterial chemoembolization using degradable starch microspheres and iodized oil in the treatment of advanced hepatocellular carcinoma: evaluation of tumor response, toxicity, and survival显示文摘BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DSM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODS: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DSM, and 5-30 ml Lipiodol. DSM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. RESULTS: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (SD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (<400 ng/ml) (Odds ratio=3.3) and PR as best response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major complications was 5.4% (n=6). All complications were managed conservatively. The mortality within 6 weeks after TACE was 2.1% (one patient). CONCLUSIONS: DSM and Lipiodol were combined successfully in the palliative TACE treatment of advanced HCC resulting in high rates of tumor response and survival at limited toxicity. Favourable tumor response was associated with tumor extent and vascularization. TACE using DSM and Lipiodol can be considered a suitable palliative measure in patients who might not tolerate long acting embolizing agents. | Timm D Kirchhoff Joerg S Bleck Arne Dettmer Ajay Chavan Herbert Rosenthal Sonja Merkesdal Bernd Frericks Lars Zender Nisar P Malek Tim F Greten Stefan Kubicka Michael P Manns Michael Galanski | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，3： | 15 |
| 16 | Combination of repeated single-session percutaneous ethanol injection and transarterial chemoembolisation compared to repeated single-session percutaneous ethanol injection in patients with non-resectable hepatocellular carcinoma显示文摘瞄准:为病人评估经皮的乙醇注射(PEI ) 的治疗效果与先进, non-resectable HCC 与 transarterial chemoembolisation 的联合相比(不作声) 并且重复单个会议的 PEI,独自重复了单个会议的 PEI,重复不作声独自一个,或最好的支持的照顾。方法:在学习时期期间接受了 PEI 治疗的所有病人根据物理地位和肿瘤程度被包括并且成层到下列治疗形式之一:联合不作声并且重复单个会议的 PEI,独自重复了单个会议的 PEI,重复不作声独自一个,或最好的支持的照顾。包括Okuda分类,门静脉血栓的存在,腹水的存在,肿瘤的数字,最大的肿瘤直径,和假胆硷酯酶( CHE )的临床的参数的预示的价值,以及孩子呸上演, alpha-fetoprotein (法新社),发烧,复杂并发症的发生在这些组之间被估计并且比较。幸存用 Kaplan-Meier 被决定,多,变量回归分析。结果:所有病人的 1 年、 3 年的幸存是 73% 和 47% 。在亚群分析,联合不作声, PEI (1 ) 与更长的幸存被联系(1- , 3- , 5 年的幸存:90% , 52% ,和 43%) 与 PEI 治疗相比独自一个(2 )(1- , 3- , 5 年的幸存:65% , 50% ,和 37%) 。(3 ) 在起始的层化以后的第二等的 PEI 产出可比较的结果不作声(1- , 3- , 5 年的幸存:91% , 40% ,和 30%) 当在到最好的支持的照顾(4 ) 的层化以后的 PEI 与减少的幸存被联系时(1- , 3- , 5 年的幸存:50% , 23% , 12%) 。除了选择治疗形式,为更好的幸存的预言者是肿瘤数字(n <
5 ) ,肿瘤尺寸(<
5 厘米) ,在 PEI 前的没有腹水,和在 PEI 以后的稳定的假胆硷酯酶(P <
0.05 ) 。在在 PEI 以后的 2 wk 以内的死亡是 2.8%(n = 3 ) 。有 24 (8.9%) 主修在包括部分肝梗塞,焦点的肝坏死,和肝脓肿的 PEI 以后的复杂并发症。所有复杂并发症能非通过手术被管理。结论:重复单个会议的 PEI 在有以可接受、可管理的复杂并发症率的先进 HCC 的病人是有效的。病人们成层到联合不作声, PEI 能比那些独自成层到重复 PEI 期望更长的幸存。而且,有在好临床的地位的大或多重的肿瘤的病人可以也从联合获利不作声并且为第二等的 PEI 的再考虑。 | Arne Dettmer Timm D Kirchhoff Michael Gebel Lars Zender Nisar P Malek Bernhard Panning Ajay Chavan Herbert Rosenthal Stefan Kubicka Susanne Krusche Sonja Merkesdal Michael Galanski Michael P Manns Joerg S Bleck | 2006 | World Journal of Gastroenterology2006，12，23： | 14 |
| 17 | Anti-angiogenesis in hepatocellular carcinoma treatment: Current evidence and future perspectives显示文摘Hepatocellular carcinoma(HCC) is among the most common cancer diseases worldwide.Arterial hypervascularisation is an essential step for HCC tumorigenesis and can be targeted by transarterial chemoembolization(TACE).This interventional method is the standard treatment for patients with intermediate stage HCC,but is also applied as 'bridging' therapy for patients awaiting liver transplantation in many centers worldwide.Usually the devascularization effect induced by TACE is transient,consequently resulting in repeated cycles of TACE every 4-8 wk.Despite documented survival benefits,TACE can also induce the up-regulation of proangiogenic and growth factors,which might contribute to accelerated progression in patients with incomplete response.In 2007,sorafenib,a multi-tyrosine kinase and angiogenesis inhibitor,was approved as the first systemic treatment for advanced stage HCC.Other active targeted compounds,either inhibitors of angiogenesis and/or growth factors,are currently being investigated in numerous clinical trials.To overcome revascularisation or tumor progression under TACE treatment it seems therefore attractive to combine TACE with systemic targeted agents,which might theoretically block the effects of proangiogenic and growth factors.Over the last 12 mo,several retrospec-tive or prospective cohort studies combining TACE and sorafenib have been published.Nevertheless,robust results of the efficacy and tolerability of such combination strategies as proven by randomized,controlled trials are awaited in the next two years. | Martin-Walter Welker Joerg Trojan | 2011 | World Journal of Gastroenterology2011，17，26： | 14 |
| 18 | MicroRNAs:Promising chemoresistance biomarkers in gastric cancer with diagnostic and therapeutic potential显示文摘Gastric cancer(GC) is the fourth most common cancer worldwide and ranks second in global cancer mortality statistics. Perioperative chemotherapy plays an important role in the management and treatment of advanced stage disease. However,response to chemotherapy varies widely,with some patients presenting no or only minor response to treatment. Hence,chemotherapy resistance is a major clinical problem that impacts on outcome. Unfortunately,to date there are no reliable biomarkers available that predict response to chemotherapy before the start of the treatment,or that allow modification of chemotherapy resistance. MicroRNAs(miRNAs) could provide an answer to this problem. miRNAs are involved in the initiation and progression of a variety of cancer types,and there is evidence that miRNAs impact on resistance towards chemotherapeutic drugs as well. This current review aims to provide an overview about the potential clinical applicability of miRNAs as biomarkers for chemoresistance in GC.The authors focus in this context on the potential of miRNAs to predict sensitivity towards different chemotherapeutics,and on the potential of miRNAs to modulate sensitivity and resistance towards chemotherapy in GC. | Christiane Matuszcak Joerg Haier Richard Hummel Kirsten Lindner | 2014 | World Journal of Gastroenterology2014，20，38： | 11 |
| 19 | 青藏高原中东部第四纪冰碛物暴露年龄的测定及其意义显示文摘青藏高原上大面积的冰盖通常会对亚洲乃至全球气候产生深远的影响。青藏高原第四纪冰川形成的时间和范围成为人们关注的热点。本研究利用就地成因的宇宙核素暴露年龄测定方法,对唐古拉山和理塘地区的第四纪冰碛物进行了^10Be、^28Al和^21Ne暴露年龄测定,首次获得了青藏高原的第四纪冰川核素暴露年龄。三种核素暴露年龄的一致性显示每期冰碛物沉积有一个确定的暴露时期,测试结果表明唐古拉山和理塘地区出现了两期第四纪冰期,一期形成于距今1.6~8万年,另一期形成于距今16-18万年。 | 赵志中 乔彦松 Joerg SCHFER 王燕 王敏 Christian SCHLüCHTER | 2006 | 地学前缘2006，13，5： | 9 |
| 20 | 新型低密度cDNA Macroarray的建立及其应用于干扰素抗HBV的研究显示文摘目的了解人肝胚瘤细胞株HepG2和稳定转染HBV全基因组细胞株HepG2.2.15的干扰素(IFN)抗病毒基因表达谱。方法选择与IFN抗病毒及其信号转导途径相关的288个IMAGE克隆,经聚合酶链反应(PCR)扩增相应的基因片段,将扩增的DNA片段纯化后点样于阳离子尼龙膜上以制备成人工芯片。HepG2和HepG2.2.15细胞经IFN处理后,分离细胞总RNA,进行逆转录并且同时以32P标记;将标记的cDNA靶基因与尼龙膜上的探针进行分子杂交。经Cyclone扫描系统和OptiQuantTM软件处理,将图像信号转换成数据信息;再经Excel软件分析、处理形成Macroarray数据值。结果Macroarray分析提示,在HepG2和HepG2.2.15细胞仅有部分IFN诱导基因表达,多数IFN诱导基因呈低表达或不表达。通过比较HepG2和HepG2.2.15细胞,发现两者表达IFN诱导基因有差异,即对IFN应答有差异。进一步分析还发现,尽管与HepG2细胞存在差异的IFN应答,HepG2.2.15细胞的IFN信号转导途径(JakSTAT途径)却是开放的、未受损伤的。结论HepG2和HepG2.2.15细胞具有差异的IFN抗病毒基因表达谱。 | 管世鹤 刘华平 杨东亮 陆蒙吉 Michael Roggendorf Joerg F.Schlaak | 2005 | 中华实验和临床病毒学杂志2005，19，3： | 9 |
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