BACKGROUND: Lamivudine was approved for the treat- ment of chronic hepatitis B in China in 1999; however the long-term result has not yet been reported in detail. This clinical trial was to evaluate the long-term effi...BACKGROUND: Lamivudine was approved for the treat- ment of chronic hepatitis B in China in 1999; however the long-term result has not yet been reported in detail. This clinical trial was to evaluate the long-term efficacy and safe- ty of 3-year lamivudine treatment for chronic hepatitis B and the impact of emergence of YMDD mutation of hepa- titis B virus (HBV). METHODS: This multi-center, randomized, double-blind, placebo controlled trial began from 1996 to 1999. A total of 429 patients with serum HBsAg, HBeAg and HBV DNA positive were randomized to receive either lamivudine 100 mg daily (322 patients) or placebo (107) for the first 12 weeks. All patients were given subsequently open labelled lamivudine 100 mg/d for a total of 156 weeks. RESULTS: After 12-week lamivudine therapy, the levels of serum HBV DNA decreased rapidly. The negativity of HBV DNA (<1.6 pg/ml) at week 12 was 92.2% in the lamivudine group, whereas it was only 14.1% in the place- bo group (P<0.01). After 1-year lamivudine treatment, 72.7% of the patients showed undetectable serum HBV DNA (<1.6 pg/ml). At the end of 3 years, serum HBV DNA continued to be substantially suppressed with a me- dian level below a detectable level in patients with non-YM- DD variant HBV, which was increased to 86 mEq/ml (bD- NA method, equivalent hybridization method 10 pg/ml) in patients with YMDD mutation. At the end of 1, 2 and 3 years, the rates of HBeAg loss were 9.5%, 16.8% and 20.0% respectively and the rates of HBeAg/anti-HBe sero- conversion were 8.3%, 11.5% and 17.3%. The rates of HBeAg loss and seroconversion were correlated with the baseline level of ALT. In patients with a baseline level of alanine transaminase (ALT)>2 × upper limit of normal (ULN) and ALT >5×ULN, the rates of HBeAg loss were 42.2% and 66.7%, and the rates of seroconversion were34.4% and 61.1% respectively (P<0.01) at the end of year 3. The levels of ALT at year 3 remained normal in 58.8% of patients whose baseline level of ALT was elevated, and in 79.1% of patients whose level of ALT 展开更多
During infectious disease episodes, pathogens express distinct subsets of virulence factors which allow them to adapt to different environments. Hence, genes that are expressed or upregulated in vivo are implicated in...During infectious disease episodes, pathogens express distinct subsets of virulence factors which allow them to adapt to different environments. Hence, genes that are expressed or upregulated in vivo are implicated in pathogenesis. We used in vivo induced antigen technology (IVIAT) to identify antigens which are expressed during infection with Salmonella enterica serovar Typhi. We identified 7 in vivo induced (IVI) antigens, which included BcfD (a fimbrial structural subunit), GrxC (a glutaredoxin 3), SapB (an ABC-type transport system), T3663 (an ABC-type uncharacterized transport system), T3816 (a putative rhodanese-related sulfurtransferase), T1497 (a probable TonB-dependent receptor) and T3689 (unknown function). Of the 7 identified antigens, 5 antigens had no cross-immunoreactivity in adsorbed control sera from healthy subjects. These 5 included BcfD, GrxC, SapB, T3663 and T3689. Antigens identified in this study are potential targets for drug and vaccine development and may be utilized as diagnostic agents.展开更多
AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of re...AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.展开更多
OBJECTIVE: To study the relations among the expression of the multidrug resistance associated-protein (mrp) gene and clinicopathologic features, the influence of α-fetoprotein (AFP), and prognosis of patients who rec...OBJECTIVE: To study the relations among the expression of the multidrug resistance associated-protein (mrp) gene and clinicopathologic features, the influence of α-fetoprotein (AFP), and prognosis of patients who received adjuvant chemotherapy after resection of primary hepatocellular carcinoma (HCC). METHODS: The expression of the mrp gene encoding MRP and mRNAmrp was determined in tissues from 54 untreated patients with HCC, adjacent tissues from 24 patients with HCC and archival paraffin-embedded tissues from 12 patients with posthepatitic cirrhosis. The relationship between the mrp gene expression and the change level of AFP was analyzed in the 24 postoperative HCC patients whose AFP level was measured after 2 weeks. All of the HCC patients were followed up. RESULTS: The percentage of positive expressions of MRP and mRNAmrp in the three kinds of tissues was 57.40%, 25.00%, 16.67%, and 72.22%, 37.50%, 33.33% respectively. Significant difference was noted in the untreated HCC tissue, compared to the other two tissues (P<0.05). No difference existed between the mrp gene expression and such clinicopathologic findings, as age, sex, and tumor size (P> 0.05), but the expression was related to the degree of differentiation of HCC (P<0.05). The effective rate of AFP in the mrp gene positive expression group or postoperative chemotherapeutic patients was lower than that in the negative group (P<0.05). Although no difference was seen in the 1-, 3-, 5-year survival rates of HCC patients (P>0.05), the mean survival time of postoperative HCC patients or the negative mrp gene expression group was longer than that of the positive group (P<0.05). CONCLUSIONS: Multidrug resistance (MDR) of HCC is related to mrp gene expression and initiates the intrinsic MDR. Detection of mrp gene expression is of great significance in accessing chemotherapeutic resistance of HCC, which provides evidence for reversing MDR in HCC. The mrp gene may be a useful marker in detecting prognosis of HCC patients because its expression is correlated wi展开更多
A recently introduced nonlinear model undergoes evaluations based on two isotropic turbulent cases:a University of Wiscosion-Madison case at a moderate Reynolds number and a Johns Hopkins University case at a high Rey...A recently introduced nonlinear model undergoes evaluations based on two isotropic turbulent cases:a University of Wiscosion-Madison case at a moderate Reynolds number and a Johns Hopkins University case at a high Reynolds number.The model uses an estimation of the subgrid-scale(SGS) kinetic energy to model the magnitude of the SGS stress tensor,and uses the normalized velocity gradient tensor to model the structure of the SGS stress tensor.Testing is performed for the first case through a comparison between direct numerical simulation(DNS) results and large eddy simulation(LES) results regarding resolved kinetic energy and energy spectrum.In the second case,we examine the resolved kinetic energy,the energy spectrum,as well as other key statistics including the probability density functions of velocities and velocity gradients,the skewness factors,and the flatness factors.Simulations using the model are numerically stable,and results are satisfactorily compared with DNS results and consistent with statistical theories of turbulence.展开更多
Purpose: To investigate the factors related to the development of cataract in patientswith non-insulin dependent diabetes mellitus(NIDDM).Methods: 792 NIDDM patients received ophthalmologic examinations including visu...Purpose: To investigate the factors related to the development of cataract in patientswith non-insulin dependent diabetes mellitus(NIDDM).Methods: 792 NIDDM patients received ophthalmologic examinations including visualacuity, external status of the eyes, slit lamp microscopy and ophthalmoscopy. Glucose,urea nitrogen (BUN), creatinine (Cr), urine acid (UA), N-acetyl-β2-D-glucosaminidase(NAG), β2-microglobulin(β2-MG) and serum albumin in blood were quantitativelytested. Glucose, pH value, protein, cells, cast and ketobodies in urine were assayed.Diagnosis of cataract was based on lens opacities classification system Ⅱ. Any patientmeeting "NⅡ", "CⅡ" or "PⅡ" level was diagnosed as cataract.Results: The incidence of cataract in this group of NIDDM was 62.37 % (494/792),which significantly related to the duration of the disease course, but not to the sex of thepatient. The occurrence rate of cataract in patients suffering from NIDDM of less thanfive years duration, from five to ten years, and more than ten years was 49.67 % (228/459), 71.84 % (125/174), and 88.68 % (141/159), respectively. The occurrence ofcataract in patients diagnosed of the disease from five to ten years and more than tenyears was much higher than that of those with the course of the disease less than fiveyears( P ＜ 0.05 and P ＜ 0. 001, respectively) . Rising concentrations of blood ureanitrogen, creatinine, glycosylated hemoglobin HbA1c(G-HbA1c), N-acetyl-β2-D-glucosaminidase(NAG) and β2-microglobulin(β2-MG) indicated malfunction of thekidneys, and the rate of cataract occurrence in these patients was higher.Conclusion: This study indicates that prolongation of the duration of non-insulindependent diabetes mellitus, renal dysfunction, as well as poor blood glucose control,may accelerate the development of cataract.展开更多
In order to confirm the anti-carcinoma effect of 10 % Brucea javanica emulsion, 68 casesof brain metastasis as a complication of lung cancer were randomly divided into 2 groups. One group wastreated with radiotherapy...In order to confirm the anti-carcinoma effect of 10 % Brucea javanica emulsion, 68 casesof brain metastasis as a complication of lung cancer were randomly divided into 2 groups. One group wastreated with radiotherapy alone, the other was treated with a combination of radiotherapy and intravenousinjection of 10 % Brucea javanica emulsion. The results showed that the median survival duration (15months in the test group, 10 months in the control group) and the quality of life of the patients in the com-bined (test) group was much better than in the radiotherapy alone (control) group. The results suggest the10 % Brucea javanica emulsion exhibits a synergic action with the radiotherapy in the treatment of brain-metastasis as a complication of lung cancer.展开更多
Purpose: To demonstrate the effects of retinal ischemia on retinal nerve fiber layer (RNFL) and the associated visual dysfunctions.Methods :52 subjects with retinal vein occlusin (RVO) were studied both in RVO eyes an...Purpose: To demonstrate the effects of retinal ischemia on retinal nerve fiber layer (RNFL) and the associated visual dysfunctions.Methods :52 subjects with retinal vein occlusin (RVO) were studied both in RVO eyes and in the contra-lateral eyes via red-free light fundus photography. The semi-quantitative analysis of RNFL defects was done,and the severity of RNFL defects of the ischemic and the non-ischemic groups were compared.Results: The RNFL defects occurred in 75.5% of the total 53 eyes with RVO. The incidences of RNFL defects were significantly higher in eyes with cotton-wool spots and capillary non-perfusion than in other RVO eyes and controls. The RNFL defects were significantly severer in ischemic eyes than in non-ischemic ones. Conclusion : Retinal ischemia can result in RNFL defects, and the severity of RNFL defects was closely related to that of ischemia. Eye Science 1997; 13 :21 - 24 .展开更多
The Development Plan is divided into four parts: current situation of the appraisal profession, opportunities for furtherdevelopment, objectives and goals, and measures to materialize objectives and goals.
从儿童到成人的医疗保健系统的转变对许多患有癫痫的年轻人及其家庭来说是一个挑战。最近,加拿大安大略省卫生部和长期医疗部门成立了一个过渡工作组(Transition working group,TWG),为安大略省癫痫患者的过渡提出建议。在此对这项工作...从儿童到成人的医疗保健系统的转变对许多患有癫痫的年轻人及其家庭来说是一个挑战。最近,加拿大安大略省卫生部和长期医疗部门成立了一个过渡工作组(Transition working group,TWG),为安大略省癫痫患者的过渡提出建议。在此对这项工作做出总结。TWG包括儿科和成人癫痫病专家、精神科医生和来自学术界和社区的家庭医生,从事儿童和成人癫痫项目的社区医师、护士和社会工作者,以及青少年内科医师、律师、职业治疗师、社区癫痫机构的代表、癫痫患者和患者父母。该小组主要解决3个领域的问题:(1)癫痫的诊断和管理;(2)癫痫患者心理健康和社会心理需求;(3)癫痫患者经济、社会和法律支持。目前虽然还没有对过渡方案的结果进行系统研究,但TWG能早期识别处于过渡失败风险的青少年,在实际过渡之前即应协调儿童和成人神经科医师以及其他专家。过渡期是重新思考诊断和重复诊断检测(特别是基因检测,现有技术较多年前可发现更多病因)的理想时期。在转至成人医疗系统后部分筛查应重复。文章提出的7个步骤可以促进过渡,从而有助于为青少年癫痫患者转出儿童保健系统提供持续且合理的医疗服务。展开更多
基金This study was sponsored by GlaxoSmithKline Ltd (China)
文摘BACKGROUND: Lamivudine was approved for the treat- ment of chronic hepatitis B in China in 1999; however the long-term result has not yet been reported in detail. This clinical trial was to evaluate the long-term efficacy and safe- ty of 3-year lamivudine treatment for chronic hepatitis B and the impact of emergence of YMDD mutation of hepa- titis B virus (HBV). METHODS: This multi-center, randomized, double-blind, placebo controlled trial began from 1996 to 1999. A total of 429 patients with serum HBsAg, HBeAg and HBV DNA positive were randomized to receive either lamivudine 100 mg daily (322 patients) or placebo (107) for the first 12 weeks. All patients were given subsequently open labelled lamivudine 100 mg/d for a total of 156 weeks. RESULTS: After 12-week lamivudine therapy, the levels of serum HBV DNA decreased rapidly. The negativity of HBV DNA (<1.6 pg/ml) at week 12 was 92.2% in the lamivudine group, whereas it was only 14.1% in the place- bo group (P<0.01). After 1-year lamivudine treatment, 72.7% of the patients showed undetectable serum HBV DNA (<1.6 pg/ml). At the end of 3 years, serum HBV DNA continued to be substantially suppressed with a me- dian level below a detectable level in patients with non-YM- DD variant HBV, which was increased to 86 mEq/ml (bD- NA method, equivalent hybridization method 10 pg/ml) in patients with YMDD mutation. At the end of 1, 2 and 3 years, the rates of HBeAg loss were 9.5%, 16.8% and 20.0% respectively and the rates of HBeAg/anti-HBe sero- conversion were 8.3%, 11.5% and 17.3%. The rates of HBeAg loss and seroconversion were correlated with the baseline level of ALT. In patients with a baseline level of alanine transaminase (ALT)>2 × upper limit of normal (ULN) and ALT >5×ULN, the rates of HBeAg loss were 42.2% and 66.7%, and the rates of seroconversion were34.4% and 61.1% respectively (P<0.01) at the end of year 3. The levels of ALT at year 3 remained normal in 58.8% of patients whose baseline level of ALT was elevated, and in 79.1% of patients whose level of ALT
基金Supported by the National Natural Science Foundation of China (Grant No. 30500435)
文摘During infectious disease episodes, pathogens express distinct subsets of virulence factors which allow them to adapt to different environments. Hence, genes that are expressed or upregulated in vivo are implicated in pathogenesis. We used in vivo induced antigen technology (IVIAT) to identify antigens which are expressed during infection with Salmonella enterica serovar Typhi. We identified 7 in vivo induced (IVI) antigens, which included BcfD (a fimbrial structural subunit), GrxC (a glutaredoxin 3), SapB (an ABC-type transport system), T3663 (an ABC-type uncharacterized transport system), T3816 (a putative rhodanese-related sulfurtransferase), T1497 (a probable TonB-dependent receptor) and T3689 (unknown function). Of the 7 identified antigens, 5 antigens had no cross-immunoreactivity in adsorbed control sera from healthy subjects. These 5 included BcfD, GrxC, SapB, T3663 and T3689. Antigens identified in this study are potential targets for drug and vaccine development and may be utilized as diagnostic agents.
文摘AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.
文摘OBJECTIVE: To study the relations among the expression of the multidrug resistance associated-protein (mrp) gene and clinicopathologic features, the influence of α-fetoprotein (AFP), and prognosis of patients who received adjuvant chemotherapy after resection of primary hepatocellular carcinoma (HCC). METHODS: The expression of the mrp gene encoding MRP and mRNAmrp was determined in tissues from 54 untreated patients with HCC, adjacent tissues from 24 patients with HCC and archival paraffin-embedded tissues from 12 patients with posthepatitic cirrhosis. The relationship between the mrp gene expression and the change level of AFP was analyzed in the 24 postoperative HCC patients whose AFP level was measured after 2 weeks. All of the HCC patients were followed up. RESULTS: The percentage of positive expressions of MRP and mRNAmrp in the three kinds of tissues was 57.40%, 25.00%, 16.67%, and 72.22%, 37.50%, 33.33% respectively. Significant difference was noted in the untreated HCC tissue, compared to the other two tissues (P<0.05). No difference existed between the mrp gene expression and such clinicopathologic findings, as age, sex, and tumor size (P> 0.05), but the expression was related to the degree of differentiation of HCC (P<0.05). The effective rate of AFP in the mrp gene positive expression group or postoperative chemotherapeutic patients was lower than that in the negative group (P<0.05). Although no difference was seen in the 1-, 3-, 5-year survival rates of HCC patients (P>0.05), the mean survival time of postoperative HCC patients or the negative mrp gene expression group was longer than that of the positive group (P<0.05). CONCLUSIONS: Multidrug resistance (MDR) of HCC is related to mrp gene expression and initiates the intrinsic MDR. Detection of mrp gene expression is of great significance in accessing chemotherapeutic resistance of HCC, which provides evidence for reversing MDR in HCC. The mrp gene may be a useful marker in detecting prognosis of HCC patients because its expression is correlated wi
基金supported by the National Science Foundation (EAR-0537856 and ATM-0854766)NASA (NNG06GE256)+1 种基金Customers of Xcel Energy through a grant (RD3-42) from the Renewable Develop-ment Fundthe University of Minnesota Institute for Renewable Energy and the Environment
文摘A recently introduced nonlinear model undergoes evaluations based on two isotropic turbulent cases:a University of Wiscosion-Madison case at a moderate Reynolds number and a Johns Hopkins University case at a high Reynolds number.The model uses an estimation of the subgrid-scale(SGS) kinetic energy to model the magnitude of the SGS stress tensor,and uses the normalized velocity gradient tensor to model the structure of the SGS stress tensor.Testing is performed for the first case through a comparison between direct numerical simulation(DNS) results and large eddy simulation(LES) results regarding resolved kinetic energy and energy spectrum.In the second case,we examine the resolved kinetic energy,the energy spectrum,as well as other key statistics including the probability density functions of velocities and velocity gradients,the skewness factors,and the flatness factors.Simulations using the model are numerically stable,and results are satisfactorily compared with DNS results and consistent with statistical theories of turbulence.
文摘Purpose: To investigate the factors related to the development of cataract in patientswith non-insulin dependent diabetes mellitus(NIDDM).Methods: 792 NIDDM patients received ophthalmologic examinations including visualacuity, external status of the eyes, slit lamp microscopy and ophthalmoscopy. Glucose,urea nitrogen (BUN), creatinine (Cr), urine acid (UA), N-acetyl-β2-D-glucosaminidase(NAG), β2-microglobulin(β2-MG) and serum albumin in blood were quantitativelytested. Glucose, pH value, protein, cells, cast and ketobodies in urine were assayed.Diagnosis of cataract was based on lens opacities classification system Ⅱ. Any patientmeeting "NⅡ", "CⅡ" or "PⅡ" level was diagnosed as cataract.Results: The incidence of cataract in this group of NIDDM was 62.37 % (494/792),which significantly related to the duration of the disease course, but not to the sex of thepatient. The occurrence rate of cataract in patients suffering from NIDDM of less thanfive years duration, from five to ten years, and more than ten years was 49.67 % (228/459), 71.84 % (125/174), and 88.68 % (141/159), respectively. The occurrence ofcataract in patients diagnosed of the disease from five to ten years and more than tenyears was much higher than that of those with the course of the disease less than fiveyears( P ＜ 0.05 and P ＜ 0. 001, respectively) . Rising concentrations of blood ureanitrogen, creatinine, glycosylated hemoglobin HbA1c(G-HbA1c), N-acetyl-β2-D-glucosaminidase(NAG) and β2-microglobulin(β2-MG) indicated malfunction of thekidneys, and the rate of cataract occurrence in these patients was higher.Conclusion: This study indicates that prolongation of the duration of non-insulindependent diabetes mellitus, renal dysfunction, as well as poor blood glucose control,may accelerate the development of cataract.
文摘In order to confirm the anti-carcinoma effect of 10 % Brucea javanica emulsion, 68 casesof brain metastasis as a complication of lung cancer were randomly divided into 2 groups. One group wastreated with radiotherapy alone, the other was treated with a combination of radiotherapy and intravenousinjection of 10 % Brucea javanica emulsion. The results showed that the median survival duration (15months in the test group, 10 months in the control group) and the quality of life of the patients in the com-bined (test) group was much better than in the radiotherapy alone (control) group. The results suggest the10 % Brucea javanica emulsion exhibits a synergic action with the radiotherapy in the treatment of brain-metastasis as a complication of lung cancer.
文摘Purpose: To demonstrate the effects of retinal ischemia on retinal nerve fiber layer (RNFL) and the associated visual dysfunctions.Methods :52 subjects with retinal vein occlusin (RVO) were studied both in RVO eyes and in the contra-lateral eyes via red-free light fundus photography. The semi-quantitative analysis of RNFL defects was done,and the severity of RNFL defects of the ischemic and the non-ischemic groups were compared.Results: The RNFL defects occurred in 75.5% of the total 53 eyes with RVO. The incidences of RNFL defects were significantly higher in eyes with cotton-wool spots and capillary non-perfusion than in other RVO eyes and controls. The RNFL defects were significantly severer in ischemic eyes than in non-ischemic ones. Conclusion : Retinal ischemia can result in RNFL defects, and the severity of RNFL defects was closely related to that of ischemia. Eye Science 1997; 13 :21 - 24 .
文摘The Development Plan is divided into four parts: current situation of the appraisal profession, opportunities for furtherdevelopment, objectives and goals, and measures to materialize objectives and goals.
文摘从儿童到成人的医疗保健系统的转变对许多患有癫痫的年轻人及其家庭来说是一个挑战。最近,加拿大安大略省卫生部和长期医疗部门成立了一个过渡工作组(Transition working group,TWG),为安大略省癫痫患者的过渡提出建议。在此对这项工作做出总结。TWG包括儿科和成人癫痫病专家、精神科医生和来自学术界和社区的家庭医生,从事儿童和成人癫痫项目的社区医师、护士和社会工作者,以及青少年内科医师、律师、职业治疗师、社区癫痫机构的代表、癫痫患者和患者父母。该小组主要解决3个领域的问题:(1)癫痫的诊断和管理;(2)癫痫患者心理健康和社会心理需求;(3)癫痫患者经济、社会和法律支持。目前虽然还没有对过渡方案的结果进行系统研究,但TWG能早期识别处于过渡失败风险的青少年,在实际过渡之前即应协调儿童和成人神经科医师以及其他专家。过渡期是重新思考诊断和重复诊断检测(特别是基因检测,现有技术较多年前可发现更多病因)的理想时期。在转至成人医疗系统后部分筛查应重复。文章提出的7个步骤可以促进过渡,从而有助于为青少年癫痫患者转出儿童保健系统提供持续且合理的医疗服务。
