背景：以前的血管内超声（intravascular ultrasound，IVUS）试验证实，他汀治疗可减缓或阻止动脉粥样硬化的进展，但是迄今尚无应用动脉粥样斑块体积百分比（percent atheroma volume，PAV）证实粥样硬化消退的确切证据。PAV是最严格...背景：以前的血管内超声（intravascular ultrasound，IVUS）试验证实，他汀治疗可减缓或阻止动脉粥样硬化的进展，但是迄今尚无应用动脉粥样斑块体积百分比（percent atheroma volume，PAV）证实粥样硬化消退的确切证据。PAV是最严格的评价病变进展和消退的IVUS测量指标。
目标：评价极高强度他汀治疗是否能逆转IVUS确定的冠状动脉粥样硬化。
设计和地点：于美国、加拿大、欧洲和澳大利亚53个社区和3级保健中心进行前瞻性开标盲法终点试验（A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden，ASTEROID）。应用马达驱动回撤IVUS评价基线和治疗24个月时冠状动脉粥样斑块负荷。每对基线和随访IVUS测量结果均进行盲法分析。
病例：从2002年11月到2003年10月，507例患者有基线IVUS检查结果，并接受至少1个剂量的研究药物。在24个月后，349例患者具有可用于评估的系列IVUS检查结果。
干预：所有患者均接受瑞舒伐他汀40ms／d强化治疗。
主要观测指标：预先设定了两个一级疗效指标：PAV变化和基线最严重病变10min节段动脉粥样斑块体积变化。二级疗效指标为整个动脉标准化总斑块体积的变化。结果：平均（SD）LDL—C水平由基线时的130．4（34．3）ms／dL降至60．8（20．0）ms／扎，平均下降了53．2％（P〈0．001）。平均（SD）HDL-C水平从基线时的43．1（11．1）ms／dL升至49．0（12．6）ms／dL，平均增加了14．7％（P〈0．001）。整个血管PAV平均（SD）变化为-0．98％（3．15％），中位数为-0．79％（97．5％CI，-1．21％～-0．53％）（与基线比较，P〈0．001）。最严重病变10min节段斑块体积平均（SD）变化为-6．1（10．1）mm^3，中位数为-5．6mm^3（97．5％CI，-6．8～-4．0mm^3）（与基线比较，P〈0．001）。总斑块体积变化中位数降低了6．8％，�展开更多
AIM： To determine the effects of the calcineurin inhibitors, cyclosporine and tacrolimus, on hepatitis C virus （HCV） replication and activity of recurrent hepatitis C in patients post liver transplantation. METHODS...AIM： To determine the effects of the calcineurin inhibitors, cyclosporine and tacrolimus, on hepatitis C virus （HCV） replication and activity of recurrent hepatitis C in patients post liver transplantation. METHODS： The data of a cohort of 107 patients who received liver transplantation for HCV-associated liver cirrhosis between 1999 and 2003 in our center were retrospectively analyzed. The level of serum HCV-RNA and the activity of recurrent hepatitis were compared between 47 patients who received either cyclosporine or tacrolimus as the primary immunosuppressive agent and an otherwise similar immunosuppressive regimen which did not lead to biliary complications within the first 12 mo after transplantation. RESULTS： HCV-RNA increased within 3 mo after transplantation but the differences between the cyclosporine group and the tacrolimus group were insignificant （P=0.49 at 12 too）. In addition, recurrent hepatitis as determined by serum transarninases and histological grading of portal inflammation and fibrosis showed no significant difference after 12 mo （P= 0.34）.CONCLUSION： Cyclosporine or tacrolimus as a primary immunosuppressive agent does not influence the induction or severity of recurrent hepatitis in HCV- infected patients after liver transplantation.展开更多
A new theoretical approach to language has emerged in the past 10-15 years that allows linguistic observations about form-meaning pairings constructions — to be stated directly. Constructionist approaches aim to acco...A new theoretical approach to language has emerged in the past 10-15 years that allows linguistic observations about form-meaning pairings constructions — to be stated directly. Constructionist approaches aim to account for the full range of facts about language, without assuming that a particular subset of the data is part of a privileged 揷ore? Researchers argue that unusual constructions shed light on more general issues, and serve to illuminate what is required for a complete account of language.展开更多
目的这份更新版指南旨在为未破裂颅内动脉瘤患者的管理提供全面的循证建议。方法写作组采用系统文献回顾（1977年1月至2014年6月），参考同期已发表的循证指南、个人文件和专家意见来总结现有的证据，指出现有知识的差距；如果合适，则...目的这份更新版指南旨在为未破裂颅内动脉瘤患者的管理提供全面的循证建议。方法写作组采用系统文献回顾（1977年1月至2014年6月），参考同期已发表的循证指南、个人文件和专家意见来总结现有的证据，指出现有知识的差距；如果合适，则根据美国心脏协会（ American Heart Association, AHA）标准做出推荐。本指南经过了包括卒中委员会领导层以及AHA科学声明监督委员会在内的广泛同行评议，然后由AHA科学咨询和协调委员会审批通过。结果本指南对未破裂颅内动脉瘤患者的医疗诊治提出了循证建议，涉及临床表现、自然史、流行病学、危险因素、筛查、诊断、影像学以及手术和血管内治疗的转归。展开更多
Tea is the world＇s oldest and most popular caffeine-containing beverage with immense economic, medicinal, and cultural importance. Here, we present the first high-quality nucleotide sequence of the repeat-rich （80.9...Tea is the world＇s oldest and most popular caffeine-containing beverage with immense economic, medicinal, and cultural importance. Here, we present the first high-quality nucleotide sequence of the repeat-rich （80.9%）, 3.02-Gb genome of the cultivated tea tree Camellia sinensis. We show that an extraordinarily large genome size of tea tree is resulted from the slow, steady, and long-term amplification of a few LTR retrotransposon families. In addition to a recent whole-genome duplication event, lineage-specific expansions of genes associated with flavonoid metabolic biosynthesis were discovered, which enhance catechin production, terpene enzyme activation, and stress tolerance, important features for tea flavor and adaptation. We demonstrate an independent and rapid evolution of the tea caffeine synthesis pathway relative to cacao and coffee. A comparative study among 25 Camellia species revealed that higher expression levels of most flavonoid- and caffeinebut not theanine-related genes contribute to the increased production of catechins and caffeine and thus enhance tea-processing suitability and tea quality. These novel findings pave the way for further metabolomic and functional genomic refinement of characteristic biosynthesis pathways and will help develop a more diversified set of tea flavors that would eventually satisfy and attract more tea drinkers worldwide.展开更多
AIM： To investigate whether microproteinuria in patients with inflammatory bowel disease （IBD） is associated with the disease activity or the treatment with 5-aminosalicylic acid （5-ASA）. METHODS： We prospective...AIM： To investigate whether microproteinuria in patients with inflammatory bowel disease （IBD） is associated with the disease activity or the treatment with 5-aminosalicylic acid （5-ASA）. METHODS： We prospectively studied microproteinuria in 86 consecutive patients with IBD, 61 with ulcerative colitis （UC） and 25 with Crohn＇s disease （CD）, before as well as 2 and 6 months after their inclusion in the study. Forty-six patients received 5-ASA for a period of 28.8 months （range 1-168 too）. Microalbuminuria （mALB） and urine levels of the renal tubular proteins β2-microglobulin （β2mGLB） and β-N-acetyI-D-glucosamidase （β-NAG） as well as the creatinine clearance were determined in a 12-h overnight urine collection. Tumor necrosis factor-α （TNF-α） serum levels were also measured. RESULTS： A total of 277 measurements （194 in UC patients and 83 in CD patients） were performed. The prevalence of abnormal microoproteinuria in UC and CD patients was 12.9% and 6.0% for mALB, 22.7% and 27.7% for B2mGLB, and 11.3% and 8.4% for β-NAG, respectively, mALB was not associated with IBD activity. β2mGLB and B-NAG urine levels were correlated to UC activity （UCAI： P〈0.01; UCEI： P〈0.005）. mALB in UC patients and β-NAG urine levels in CD patients were related to TNF-α serum levels. An association was noticed between microproteinuria and smoking habit. Treatment with 5-ASA was not correlated to the severity of microproteinuria or to the changes of creatinine clearance.CONCLUSION： Microproteinuria is mainly associated with UC and its activity but not affected by 5-ASA.展开更多
Lawrence E. Murr is Mr.J Mrs. Macintosh Murehison Professor and Chairman of the Department of Metallurgical and Materials Engineering and Ph.D. Program Director in the Materials Research Technology Institute at The Un...Lawrence E. Murr is Mr.J Mrs. Macintosh Murehison Professor and Chairman of the Department of Metallurgical and Materials Engineering and Ph.D. Program Director in the Materials Research Technology Institute at The University of Texas at El Paso. Dr. Murr received his B.Sc. in physical science from Albright College, and his B.S.E.E. in electronics, his M.S. in engineering mechanics, and his Ph.D. in solidstate science, all from the Pennsylvania State University. Dr. Murr has published 20 books, over 750 scientific and technical articles in a wide range of research areas in materials science and engineering, environmental science and engineering, manufacturing science and engineering （especially rapid prototype/layered manufacturing）,展开更多
This article reviews the progress made in CO2 separation and capture research and engineering. Various technologies, such as absorption, adsorption, and membrane separation, are thoroughly discussed. New concepts such...This article reviews the progress made in CO2 separation and capture research and engineering. Various technologies, such as absorption, adsorption, and membrane separation, are thoroughly discussed. New concepts such as chemical-looping combustion and hydrate-based separation are also introduced briefly. Future directions are suggested. Sequestration methods, such as forestation, ocean fertilization and mineral carbonation techniques are also covered. Underground injection and direct ocean dump are not covered.展开更多
19 颅内出血史
根据最初的 FDA 标签和2013年AHA/ASA指南,颅内出血史是静脉阿替普酶治疗缺血性卒中的一项额外禁忌证或排除标准。最近修订后的标签仅将近期 ICH 列为一项警告,并且在禁忌证中删除了ICH史。与前面讨论的静脉阿替普酶治...19 颅内出血史
根据最初的 FDA 标签和2013年AHA/ASA指南,颅内出血史是静脉阿替普酶治疗缺血性卒中的一项额外禁忌证或排除标准。最近修订后的标签仅将近期 ICH 列为一项警告,并且在禁忌证中删除了ICH史。与前面讨论的静脉阿替普酶治疗排除标准相似,文献回顾仅在大样本回顾性研究中发现了少量这类病例。缺乏相关数据可能是修订后的FDA 标签不再将 ICH 史作为禁忌证而仅将近期ICH 列为一项警告的原因。在这种情况下,FDA 如何定义“近期”一词尚不清楚。有趣的是,对在静脉阿替普酶治疗前通过 MRI 检测脑微出血（ cerebral microbleed, CMBs）存在情况进行的研究可为这个卒中亚组患者提供更多的见解。从病理生理学角度,这种微出血的原因尚不清楚,可能反映再灌注损伤或脑血管自动调节功能破坏。因此,在静脉阿替普酶治疗后出现这些损害可能没有意义或是人为信号。展开更多
背景:全身复发仍然是局部晚期直肠癌患者需要面临的难题。该研究是采用短程放疗后行化疗和延迟手术对比术前诱导治疗后直接手术疗效的临床试验(the Rectal cancer And Preoperative Induction therapy followed by Dedicated Operation,...背景:全身复发仍然是局部晚期直肠癌患者需要面临的难题。该研究是采用短程放疗后行化疗和延迟手术对比术前诱导治疗后直接手术疗效的临床试验(the Rectal cancer And Preoperative Induction therapy followed by Dedicated Operation,RAPIDO),旨在不影响局部控制效果的前提下减少远处转移。方法:在这项多中心、随机、开放的Ⅲ期试验中,参与者来自于荷兰、瑞典、西班牙、斯洛文尼亚、丹麦、挪威和美国的共54个医学中心。纳入患者年龄在18岁及以上,ECOG评分为0~1分,且为经活检确诊局部晚期原发直肠腺癌的初诊患者,盆腔MRI评估为高危(至少符合一项标准:cT4a或cT4b,壁外血管侵犯,cN2,直肠系膜筋膜受累,或侧方淋巴结增大)。患者具备化疗适应证,并可在随机分组前5周内完成分期评估。展开更多
文摘背景：以前的血管内超声（intravascular ultrasound，IVUS）试验证实，他汀治疗可减缓或阻止动脉粥样硬化的进展，但是迄今尚无应用动脉粥样斑块体积百分比（percent atheroma volume，PAV）证实粥样硬化消退的确切证据。PAV是最严格的评价病变进展和消退的IVUS测量指标。
目标：评价极高强度他汀治疗是否能逆转IVUS确定的冠状动脉粥样硬化。
设计和地点：于美国、加拿大、欧洲和澳大利亚53个社区和3级保健中心进行前瞻性开标盲法终点试验（A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden，ASTEROID）。应用马达驱动回撤IVUS评价基线和治疗24个月时冠状动脉粥样斑块负荷。每对基线和随访IVUS测量结果均进行盲法分析。
病例：从2002年11月到2003年10月，507例患者有基线IVUS检查结果，并接受至少1个剂量的研究药物。在24个月后，349例患者具有可用于评估的系列IVUS检查结果。
干预：所有患者均接受瑞舒伐他汀40ms／d强化治疗。
主要观测指标：预先设定了两个一级疗效指标：PAV变化和基线最严重病变10min节段动脉粥样斑块体积变化。二级疗效指标为整个动脉标准化总斑块体积的变化。结果：平均（SD）LDL—C水平由基线时的130．4（34．3）ms／dL降至60．8（20．0）ms／扎，平均下降了53．2％（P〈0．001）。平均（SD）HDL-C水平从基线时的43．1（11．1）ms／dL升至49．0（12．6）ms／dL，平均增加了14．7％（P〈0．001）。整个血管PAV平均（SD）变化为-0．98％（3．15％），中位数为-0．79％（97．5％CI，-1．21％～-0．53％）（与基线比较，P〈0．001）。最严重病变10min节段斑块体积平均（SD）变化为-6．1（10．1）mm^3，中位数为-5．6mm^3（97．5％CI，-6．8～-4．0mm^3）（与基线比较，P〈0．001）。总斑块体积变化中位数降低了6．8％，�
文摘AIM： To determine the effects of the calcineurin inhibitors, cyclosporine and tacrolimus, on hepatitis C virus （HCV） replication and activity of recurrent hepatitis C in patients post liver transplantation. METHODS： The data of a cohort of 107 patients who received liver transplantation for HCV-associated liver cirrhosis between 1999 and 2003 in our center were retrospectively analyzed. The level of serum HCV-RNA and the activity of recurrent hepatitis were compared between 47 patients who received either cyclosporine or tacrolimus as the primary immunosuppressive agent and an otherwise similar immunosuppressive regimen which did not lead to biliary complications within the first 12 mo after transplantation. RESULTS： HCV-RNA increased within 3 mo after transplantation but the differences between the cyclosporine group and the tacrolimus group were insignificant （P=0.49 at 12 too）. In addition, recurrent hepatitis as determined by serum transarninases and histological grading of portal inflammation and fibrosis showed no significant difference after 12 mo （P= 0.34）.CONCLUSION： Cyclosporine or tacrolimus as a primary immunosuppressive agent does not influence the induction or severity of recurrent hepatitis in HCV- infected patients after liver transplantation.
文摘A new theoretical approach to language has emerged in the past 10-15 years that allows linguistic observations about form-meaning pairings constructions — to be stated directly. Constructionist approaches aim to account for the full range of facts about language, without assuming that a particular subset of the data is part of a privileged 揷ore? Researchers argue that unusual constructions shed light on more general issues, and serve to illuminate what is required for a complete account of language.
文摘目的这份更新版指南旨在为未破裂颅内动脉瘤患者的管理提供全面的循证建议。方法写作组采用系统文献回顾（1977年1月至2014年6月），参考同期已发表的循证指南、个人文件和专家意见来总结现有的证据，指出现有知识的差距；如果合适，则根据美国心脏协会（ American Heart Association, AHA）标准做出推荐。本指南经过了包括卒中委员会领导层以及AHA科学声明监督委员会在内的广泛同行评议，然后由AHA科学咨询和协调委员会审批通过。结果本指南对未破裂颅内动脉瘤患者的医疗诊治提出了循证建议，涉及临床表现、自然史、流行病学、危险因素、筛查、诊断、影像学以及手术和血管内治疗的转归。
基金This work was supported by the project of Yunnan Innovation Team Project, the Hundreds Oversea Talents Program of Yunnan Province, the Top Talents Program of Yunnan Province （Grant 20080A009）, the Key Project of the Natural Science Foundation of Yunnan Province （201401 PC00397）, National Science Foundation of China （U0936603）, Key Project of Natural Science Foundation of Yunnan Province （2008CC016）, Frontier Grant of Kunming Institute of Botany, CAS （672705232515）, Top Talents Program of Yunnan Province （20080A009）, and Hundreds Talents Program of Chinese Academy of Sciences （CAS） （to L.G.）.
文摘Tea is the world＇s oldest and most popular caffeine-containing beverage with immense economic, medicinal, and cultural importance. Here, we present the first high-quality nucleotide sequence of the repeat-rich （80.9%）, 3.02-Gb genome of the cultivated tea tree Camellia sinensis. We show that an extraordinarily large genome size of tea tree is resulted from the slow, steady, and long-term amplification of a few LTR retrotransposon families. In addition to a recent whole-genome duplication event, lineage-specific expansions of genes associated with flavonoid metabolic biosynthesis were discovered, which enhance catechin production, terpene enzyme activation, and stress tolerance, important features for tea flavor and adaptation. We demonstrate an independent and rapid evolution of the tea caffeine synthesis pathway relative to cacao and coffee. A comparative study among 25 Camellia species revealed that higher expression levels of most flavonoid- and caffeinebut not theanine-related genes contribute to the increased production of catechins and caffeine and thus enhance tea-processing suitability and tea quality. These novel findings pave the way for further metabolomic and functional genomic refinement of characteristic biosynthesis pathways and will help develop a more diversified set of tea flavors that would eventually satisfy and attract more tea drinkers worldwide.
文摘AIM： To investigate whether microproteinuria in patients with inflammatory bowel disease （IBD） is associated with the disease activity or the treatment with 5-aminosalicylic acid （5-ASA）. METHODS： We prospectively studied microproteinuria in 86 consecutive patients with IBD, 61 with ulcerative colitis （UC） and 25 with Crohn＇s disease （CD）, before as well as 2 and 6 months after their inclusion in the study. Forty-six patients received 5-ASA for a period of 28.8 months （range 1-168 too）. Microalbuminuria （mALB） and urine levels of the renal tubular proteins β2-microglobulin （β2mGLB） and β-N-acetyI-D-glucosamidase （β-NAG） as well as the creatinine clearance were determined in a 12-h overnight urine collection. Tumor necrosis factor-α （TNF-α） serum levels were also measured. RESULTS： A total of 277 measurements （194 in UC patients and 83 in CD patients） were performed. The prevalence of abnormal microoproteinuria in UC and CD patients was 12.9% and 6.0% for mALB, 22.7% and 27.7% for B2mGLB, and 11.3% and 8.4% for β-NAG, respectively, mALB was not associated with IBD activity. β2mGLB and B-NAG urine levels were correlated to UC activity （UCAI： P〈0.01; UCEI： P〈0.005）. mALB in UC patients and β-NAG urine levels in CD patients were related to TNF-α serum levels. An association was noticed between microproteinuria and smoking habit. Treatment with 5-ASA was not correlated to the severity of microproteinuria or to the changes of creatinine clearance.CONCLUSION： Microproteinuria is mainly associated with UC and its activity but not affected by 5-ASA.
基金supported in part by Mr. and Mrs.MacIntosh Murshison Endowments at the University of Texas at El Paso and Lockheed Martin Aeronautics
文摘Lawrence E. Murr is Mr.J Mrs. Macintosh Murehison Professor and Chairman of the Department of Metallurgical and Materials Engineering and Ph.D. Program Director in the Materials Research Technology Institute at The University of Texas at El Paso. Dr. Murr received his B.Sc. in physical science from Albright College, and his B.S.E.E. in electronics, his M.S. in engineering mechanics, and his Ph.D. in solidstate science, all from the Pennsylvania State University. Dr. Murr has published 20 books, over 750 scientific and technical articles in a wide range of research areas in materials science and engineering, environmental science and engineering, manufacturing science and engineering （especially rapid prototype/layered manufacturing）,
文摘This article reviews the progress made in CO2 separation and capture research and engineering. Various technologies, such as absorption, adsorption, and membrane separation, are thoroughly discussed. New concepts such as chemical-looping combustion and hydrate-based separation are also introduced briefly. Future directions are suggested. Sequestration methods, such as forestation, ocean fertilization and mineral carbonation techniques are also covered. Underground injection and direct ocean dump are not covered.
文摘背景:全身复发仍然是局部晚期直肠癌患者需要面临的难题。该研究是采用短程放疗后行化疗和延迟手术对比术前诱导治疗后直接手术疗效的临床试验(the Rectal cancer And Preoperative Induction therapy followed by Dedicated Operation,RAPIDO),旨在不影响局部控制效果的前提下减少远处转移。方法:在这项多中心、随机、开放的Ⅲ期试验中,参与者来自于荷兰、瑞典、西班牙、斯洛文尼亚、丹麦、挪威和美国的共54个医学中心。纳入患者年龄在18岁及以上,ECOG评分为0~1分,且为经活检确诊局部晚期原发直肠腺癌的初诊患者,盆腔MRI评估为高危(至少符合一项标准:cT4a或cT4b,壁外血管侵犯,cN2,直肠系膜筋膜受累,或侧方淋巴结增大)。患者具备化疗适应证,并可在随机分组前5周内完成分期评估。
