This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied mali...This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites展开更多
为了提高系统综述和荟萃分析文章报告的质量,2009年由国际著名专家组成的系统综述和荟萃分析优先报告的条目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)小组在国际重要医学期刊包括《英国医学杂志》...为了提高系统综述和荟萃分析文章报告的质量,2009年由国际著名专家组成的系统综述和荟萃分析优先报告的条目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)小组在国际重要医学期刊包括《英国医学杂志》、《临床流行病学杂志》、《内科学年鉴》和美国《公共科学图书馆医学杂志》等同步发表了《系统综述与荟萃分析优先报告条目:PRISMA声明》。该标准的制定对于改进和提高系统综述和荟萃分析的报告质量将起到重要作用。该声明较以往制定的《随机对照试验荟萃分析报告质量》(Quality of Reporting of Meta-Analyses),即《QUOROM声明》更加全面、完善。由于近年采国内外对系统综述的高度重视,发表的文章数量也越来越多,因此,有必要规范报告的标准,提高报告的质量。这份声明对系统综述和荟萃分析类文章报告的27个条目及流程图进行了定义和介绍,对相关条目进行了详细的解释和说明。及时向国内读者和临床试验研究人员介绍该声明具有重要的现实意义和学术价值。北京中医药大学循证医学中心刘建平等在第一时间内翻译了该声明,本刊希望通过介绍中文版《系统综述与荟萃分析优先报告的条目:PRISMA声明》,以进一步提高国内系统综述文章撰写和报告的质量,同时也有助于改进研究设计的方法学质量。本文的英文原文"Preferred reporring items for systematic reviews and meta-analyses:the PRISMAstatement"发表于PLoS Med.2009;6(7):e1000097.doi:10.1371/journal.pmed.1000097。该文中文版本由北京中医药大学循证医学中心李迅、曹卉娟翻译,刘建平审校(Tel:010-64286760;E-mail:jianping_l@hotmail.com)。中文译文的翻译出版由国家重点基础研究发展计划(973计划)项目资助(No.200608504602)。展开更多
Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologica...Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologically. Risk factors determining independently the outcome of SAP are early multi-organ failure, infection of necrosis and extended necrosis (> 50%). Up to one third of patients with necrotizing pancreatitis develop in the late course infection of necroses. Morbidity of SAP is biphasic, in the first week strongly related to early and persistence of organ or multi-organ dysfunction. Clinical sepsis caused by infected necrosis leading to multi-organ failure syndrome (MOFS) occurs in the later course after the first week. To predict sepsis, MOFS or deaths in the first 48-72 h, the highest predictive accuracy has been objectified for procalcitonin and IL-8; the Sepsis- Related Organ Failure Assessment (SOFA)-score predicts the outcome in the first 48 h, and provides a daily assessment of treatment response with a high positive predictive value. Contrast-enhanced CT provides the highest diagnostic accuracy for necrotizing pancreatitis when performed after the first week of disease. Patients who suffer early organ dysfunctions or at risk of developing a severe disease require early intensive care treatment. Early vigorous intravenous fluid replacement is of foremost importance. The goal is to decrease the hematocrit or restore normal cardiocirculatory functions. Antibiotic prophylaxis has not been shown as an effective preventive treatment. Early enteral feeding is based on a high level of evidence, resulting in a reduction of local and systemic infection. Patients suffering infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. Hospital mortality of SAP after interventional or surgical debridement has decreased in high volume centers to below 20%.展开更多
This special issue of Acta Mathematica Scientia is dedicated to the celebration of the 70th birthday of Constantine M. Dafermos. Costas is the Alumni-Alumnae University Professor of Brown University, a Fellow of the A...This special issue of Acta Mathematica Scientia is dedicated to the celebration of the 70th birthday of Constantine M. Dafermos. Costas is the Alumni-Alumnae University Professor of Brown University, a Fellow of the American Academy of Arts and Sciences, a Correspondent Member of the Academy of Athens, a Foreign Member of the Academia Nazionale dei Lincei, a SIAM Fellow, and an Honorary Professor of the Chinese Academy of Sciences. He is also an Editor-in-Chief of this journal.展开更多
Death-mediating proteases such as caspases and caspase-3 in particular, have been implicated in neurodegenerative processes, aging and Alzheimer＇s disease. However, emerging evidence suggests that in addition to thei...Death-mediating proteases such as caspases and caspase-3 in particular, have been implicated in neurodegenerative processes, aging and Alzheimer＇s disease. However, emerging evidence suggests that in addition to their classical role in cell death, caspases play a key role in modulating synaptic function. It is remarkable that active caspases-3, which can trigger widespread damage and degeneration, aggregates in structures as delicate as synapses and persists in neurons without causing acute cell death. Here, we evaluate this dichotomy, and discuss the hypothesis that caspase-3 may be a bifurcation point in cellular signaling, able to orient the neuronal response to stress down either pathological/apoptotic pathways or towards physiological cellular remodeling. We propose that temporal, spatial and other regulators of caspase activity are key determinants of the ultimate effect of caspase-3 activation in neurons. This concept has implications for differential roles of caspase-3 activation across the lifespan. Specifically, we propose that limited caspase-3 activation is critical for synaptic function in the healthy adult brain while chronic activation is involved in degenerative processes in the aging brain.展开更多
Mo silicides Mo_5Si_3 with high quality were prepared using ion beamdeposition equipment with two Filter Metal Vacuum Are Deposition (FMEVAD). When the number ofalternant deposition times was 198, total thickness of t...Mo silicides Mo_5Si_3 with high quality were prepared using ion beamdeposition equipment with two Filter Metal Vacuum Are Deposition (FMEVAD). When the number ofalternant deposition times was 198, total thickness of the coating is 40nm. The coatings withdroplet free can be readily obtained, so the surface is smooth. TEM observation shows that Mo and Sialternant deposition coating is compact structure. The fine Mo silicide grains densely distributedin the coating. The coating adherence on silicon is excellent.展开更多
文摘This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites
文摘为了提高系统综述和荟萃分析文章报告的质量,2009年由国际著名专家组成的系统综述和荟萃分析优先报告的条目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)小组在国际重要医学期刊包括《英国医学杂志》、《临床流行病学杂志》、《内科学年鉴》和美国《公共科学图书馆医学杂志》等同步发表了《系统综述与荟萃分析优先报告条目:PRISMA声明》。该标准的制定对于改进和提高系统综述和荟萃分析的报告质量将起到重要作用。该声明较以往制定的《随机对照试验荟萃分析报告质量》(Quality of Reporting of Meta-Analyses),即《QUOROM声明》更加全面、完善。由于近年采国内外对系统综述的高度重视,发表的文章数量也越来越多,因此,有必要规范报告的标准,提高报告的质量。这份声明对系统综述和荟萃分析类文章报告的27个条目及流程图进行了定义和介绍,对相关条目进行了详细的解释和说明。及时向国内读者和临床试验研究人员介绍该声明具有重要的现实意义和学术价值。北京中医药大学循证医学中心刘建平等在第一时间内翻译了该声明,本刊希望通过介绍中文版《系统综述与荟萃分析优先报告的条目:PRISMA声明》,以进一步提高国内系统综述文章撰写和报告的质量,同时也有助于改进研究设计的方法学质量。本文的英文原文"Preferred reporring items for systematic reviews and meta-analyses:the PRISMAstatement"发表于PLoS Med.2009;6(7):e1000097.doi:10.1371/journal.pmed.1000097。该文中文版本由北京中医药大学循证医学中心李迅、曹卉娟翻译,刘建平审校(Tel:010-64286760;E-mail:jianping_l@hotmail.com)。中文译文的翻译出版由国家重点基础研究发展计划(973计划)项目资助(No.200608504602)。
文摘Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologically. Risk factors determining independently the outcome of SAP are early multi-organ failure, infection of necrosis and extended necrosis (> 50%). Up to one third of patients with necrotizing pancreatitis develop in the late course infection of necroses. Morbidity of SAP is biphasic, in the first week strongly related to early and persistence of organ or multi-organ dysfunction. Clinical sepsis caused by infected necrosis leading to multi-organ failure syndrome (MOFS) occurs in the later course after the first week. To predict sepsis, MOFS or deaths in the first 48-72 h, the highest predictive accuracy has been objectified for procalcitonin and IL-8; the Sepsis- Related Organ Failure Assessment (SOFA)-score predicts the outcome in the first 48 h, and provides a daily assessment of treatment response with a high positive predictive value. Contrast-enhanced CT provides the highest diagnostic accuracy for necrotizing pancreatitis when performed after the first week of disease. Patients who suffer early organ dysfunctions or at risk of developing a severe disease require early intensive care treatment. Early vigorous intravenous fluid replacement is of foremost importance. The goal is to decrease the hematocrit or restore normal cardiocirculatory functions. Antibiotic prophylaxis has not been shown as an effective preventive treatment. Early enteral feeding is based on a high level of evidence, resulting in a reduction of local and systemic infection. Patients suffering infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. Hospital mortality of SAP after interventional or surgical debridement has decreased in high volume centers to below 20%.
文摘This special issue of Acta Mathematica Scientia is dedicated to the celebration of the 70th birthday of Constantine M. Dafermos. Costas is the Alumni-Alumnae University Professor of Brown University, a Fellow of the American Academy of Arts and Sciences, a Correspondent Member of the Academy of Athens, a Foreign Member of the Academia Nazionale dei Lincei, a SIAM Fellow, and an Honorary Professor of the Chinese Academy of Sciences. He is also an Editor-in-Chief of this journal.
基金supported by a grant (AG012694-16) from the National Institue of Aging,USA
文摘Death-mediating proteases such as caspases and caspase-3 in particular, have been implicated in neurodegenerative processes, aging and Alzheimer＇s disease. However, emerging evidence suggests that in addition to their classical role in cell death, caspases play a key role in modulating synaptic function. It is remarkable that active caspases-3, which can trigger widespread damage and degeneration, aggregates in structures as delicate as synapses and persists in neurons without causing acute cell death. Here, we evaluate this dichotomy, and discuss the hypothesis that caspase-3 may be a bifurcation point in cellular signaling, able to orient the neuronal response to stress down either pathological/apoptotic pathways or towards physiological cellular remodeling. We propose that temporal, spatial and other regulators of caspase activity are key determinants of the ultimate effect of caspase-3 activation in neurons. This concept has implications for differential roles of caspase-3 activation across the lifespan. Specifically, we propose that limited caspase-3 activation is critical for synaptic function in the healthy adult brain while chronic activation is involved in degenerative processes in the aging brain.
基金This work was supported by 863 High Science & Technology Committee(2001AA38020) The National Natural Science Foundation of
文摘Mo silicides Mo_5Si_3 with high quality were prepared using ion beamdeposition equipment with two Filter Metal Vacuum Are Deposition (FMEVAD). When the number ofalternant deposition times was 198, total thickness of the coating is 40nm. The coatings withdroplet free can be readily obtained, so the surface is smooth. TEM observation shows that Mo and Sialternant deposition coating is compact structure. The fine Mo silicide grains densely distributedin the coating. The coating adherence on silicon is excellent.
