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| 1 | 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 |
| 2 | VEGF-D expression correlates with colorectal cancer aggressiveness and is downregulated by cetuximab显示文摘AIM:To gain mechanistic insights into the role played by epidermal growth factor receptor (EGFR) in the regulation of vascular endothelial growth factors (VEGFs) in colorectal cancer (CRC). METHODS:The impact of high-level expression of the growth factor receptors EGFR and VEGF receptor (VEGFR)3 and the VEGFR3 ligands VEGF-C and VEGF-D on disease progression and prognosis in human CRC was investigated in 108 patients using immunohistochemistry. Furthermore, the expression of the lymphangiogenic factors in response to the modulation of EGFR signalling by the EGFR-targeted monoclonal antibody cetuximab was investigated at the mRNA and protein level in human SW480 and SW620 CRC cell lines and a mouse xenograft model. RESULTS: Human CRC specimens and cell lines displayed EGFR, VEGF-C and VEGF-D expression with varying intensities. VEGF-C expression was associated with histological grade. Strong expression of VEGF-D was significantly associated with lymph node metastases and linked to a trend for decreased survival in lymph node-positive patients. EGFR blockade with cetuximab resulted in a significant decrease of VEGF-D expression in vitro and in vivo. CONCLUSION:In conclusion, the expression of VEGF-D in colorectal tumours is significantly associated with lymphatic involvement in CRC patients and such expression might be blocked effectively by cetuximab. | Markus Moehler Christian Frings Annett Mueller Ines Gockel Carl C Schimanski Stefan Biesterfeld Institute of Pathology Johannes Gutenberg University Mainz 55101 Germany Peter R Galle Martin H Holtmann | 2008 | World Journal of Gastroenterology2008,14,26: | 15 |
| 3 | Parvovirus B19 induced hepatic failure in an adult requiring liver transplantation显示文摘Parvovirus B19 induced acute hepatitis and hepatic failure have been previously reported, mainly in children. Very few cases of parvovirus induced hepatic failure have been reported in adults and fewer still have required liver transplantation. We report the case of a 55-year-old immunocompetent woman who developed fulminant hepatic failure after acute infection with Parvovirus B19 who subsequently underwent orthotopic liver transplantation. This is believed to be the first reported case in the literature in which an adult patient with fulminant hepatic failure associated with acute parvovirus B19 infection and without hematologic abnormalities has been identified prior to undergoing liver transplantation. This case suggests that Parvovirus B19 induced liver disease can affect adults, can occur in the absence of hematologic abnormalities and can be severe enough to require liver transplantation. | Darin S Krygier Urs P Steinbrecher Martin Petric Siegfried R Erb Stephen W Chung Charles H Scudamore Andrzej K Buczkowski Eric M Yoshida | 2009 | World Journal of Gastroenterology2009,15,32: | 3 |
| 4 | Fondaparinux预防老年急性内科患者发生静脉血栓形成的效果与安全性:随机安慰剂对照研究显示文摘目的:观察 Fondaparinux 对具有中高度静脉血栓发生危险的老年急性内科住院患者的抗凝效果与安全性。设计:双盲随机安慰剂对照研究。背景:8个国家的35个中心。参与者:849例≥60岁内科患者,住院原因分别为充血性心力衰竭、慢性肺病合并急性呼吸系统疾患、急性炎症性或感染性疾病,预期至少住院4天以上。干预:2.5 mg Fondaparinux 或安慰剂,每天1次皮下注射,持续6~14天。观察指标:主要指标为静脉血栓形成(治疗后15天内采用双侧静脉造影检查)及有症状的静脉血栓;次要指标为死亡与出血。患者随访时间为1个月。结果:Fondaparinux 治疗组425例患者和安慰剂组414例患者接受了安全性分析(10例未治疗)。644例患者(75.9%)可接受主要指标分析。静脉血栓检出率在 Fondaparinux 治疗组为5.6%(18/321),安慰剂组为10.5%(34/323),相对危险减少46.7%(95% CI 7.7%~69.3%)。安慰剂组5例患者发生有症状的静脉血栓,Fondaparinux治疗组无患者发生有症状的静脉血栓(P=0.029)。两组均有1例(0.2%)患者发生严重出血。随访结束时,安慰剂组、Fondaparinux 治疗组分别死亡25(6.0%)、14(3.3%)例患者。结论:Fondaparinux 可有效预防急性内科老年患者无症状性及有症状的静脉血栓。严重出血几率两组相似。 | Alexander T Cohen Bruce L Davidson Alexander S Gallus Michael R Lassen Martin H Prins Witold Tomkowski Alexander G G Turpie Jan F M Egberts Anthonie W A Lensing 石汉平(译) 王深明(校) | 2006 | 英国医学杂志中文版2006,9,5: | 3 |
| 5 | 菱面体畸变的钙钛矿结构多铁性氧化物薄膜畴界精细结构显示文摘畴是所有铁性材料的一个共同本质特性,畴及畴界的结构极大影响着材料性能。本文应用高分辨透射电子显微学和定量电子显微学,在原子尺度定量研究了钙钛矿菱面体结构多铁性薄膜BiFeO3的109°畴界的精细结构,包括畴界附近阳离子位移及局部铁电极化分布。结果表明:正是由于畴界附近原子发生微小位移,导致材料能带的变化,带隙减小,从而在绝缘BiFeO3中产生独特的导电性能。这不仅为研究铁电极化反转和磁电效应等科学问题提供关键的定量结构信息,同时也促进相关材料的设计和性能优化。 | 詹倩 于荣 CHU Y H MARTIN L W RAMESH R | 2010 | 电子显微学报2010,29,5: | 2 |
| 6 | Right Portal Vein Ligation Combined With In Situ Splitting Induces Rapid Left Lateral Liver Lobe Hypertrophy Enabling 2-Staged Extended Right Hepatic Resection in Small-for-Size Settings显示文摘 | Andreas A. Schnitzbauer Sven A. Lang Holger Goessmann Silvio Nadalin Janine Baumgart Stefan A. Farkas Stefan Fichtner-Feigl Thomas Lorf Armin Goralcyk Rüdiger H?rbelt Alexander Kroemer Martin Loss Petra Rümmele Marcus N. Scherer Winfried Padberg Alfred K? | 2012 | Annals of Surgery2012,,3: | 2 |
| 7 | 热浸镀锌超高强钢板钒微合金化技术研究显示文摘对超高强度钢板进行热处理,模拟热浸镀锌和合金化镀锌工艺的热循环,并考察获得的力学性能和微观组织。研究用钢含有适量的碳(~0.2%)、锰(1.2%)和铬(0.4%),保证钢板在奥氏体化后在镀锌前的连续退火线上进行快速冷却时能够完全转变成马氏体。采用不同的钒含量(0~0.1%)和氮含量(0.002%~0.012%),研究这些微合金化元素对回火马氏体强度的影响。尤其与高氮相配合情况下,钒有助于抵抗回火效应,因此在镀锌后大部分原始强化贡献被保留下来,使得钢的抗拉强度超过1 000 MPa。使用铝或硅进行不同脱氧试验,发现在同一碳含量下两者具有相同的强度水平,但是Si镇静钢的弯曲性能明显优异。对退火钢板进行微观组织观察,但是钒产生有益作用的原因还未完全掌握。通过研究得出这样结论:钒微合金化对耐腐蚀超高强度钢板的开发而言是一种极具前景的途径。 | Hutchinson B Martin D Karlsson O Lindberg F Thoors H Marceau R K W Taylor A S | 2016 | 钢铁钒钛2016,37,6: | 2 |
| 8 | 膜型巨噬细胞集落刺激因子对人脑胶质细胞瘤的免疫治疗作用显示文摘摘要 目的 探讨基因转染膜型巨噬细胞集落刺激因子(mM-CSF)对U251MG人脑胶质瘤细胞的免疫治疗作用。方法 用逆转录病毒载体将mM-CSF基因转入U251MG细胞,采用流式细胞术检测mM-CSF的表达;通过细胞毒性实验、兔疫组化方法以及观察转染细胞在免疫缺陷小鼠体内的生长情况研究mM-CSF对U251MG细胞的作用。结果①获得了表达mM-CSF的MG-2F11细胞;②大鼠巨噬细胞、人外周血淋巴细胞(PBL)和人单核细胞均可杀伤MG-2F11细胞,但不能杀伤U251MG母细胞;③接种瘤细胞到裸小鼠皮下18 h后,侵入MG-2F11肿瘤的巨噬细胞明显多于侵入MG-VV(仅转染病毒载体的U251MG细胞)肿瘤的巨噬细胞;④接种MG-2F11细胞的8只裸小鼠均无肿瘤生长,而接种MG-VV细胞的8只裸小鼠中的7只有肿瘤生长(P<0.01);另一免疫缺陷更严重的NIH-bg-nu-xidBR 小鼠,接种MG-2F11细胞后8只中的1只有肿瘤生长,而接种MG-VV细胞后8只中的7只有肿瘤生长(P<0.01)。结论mM-CSF转染的人脑胶质瘤细胞致瘤性降低,有进一步对其进行临床研究的必要。 | 陈义军 Cheri Lloyd Ramon Sanchez Martin R Jadus H Terry Wepsic | 2002 | 中华神经外科疾病研究杂志2002,1,3: | 2 |
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