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
The Atlantic Multidecadal Oscillation （AMO）, the multidecadal variation of North Atlantic sea surface temperature （SST）, exhibits an oscillation with a period of 65-80 years and an amplitude of 0.4℃. Observationa...The Atlantic Multidecadal Oscillation （AMO）, the multidecadal variation of North Atlantic sea surface temperature （SST）, exhibits an oscillation with a period of 65-80 years and an amplitude of 0.4℃. Observational composite analyses reveal that the warm phase AMO is linked to warmer winters in East China, with enhanced precipitation in the north of this region and reduced precipitation in the south, on multidecadal time scales. The pattern is reversed during the cold phase AMO. Whether the AMO acts as a forcing of the multidecadal winter climate of East China is explored by investigating the atmospheric response to warm AMO SST anomalies in a large ensemble of atmospheric general circulation model （AGCM） experiments. The results from three AGCMs are consistent and suggest that the AMO warmth favors warmer winters in East China. This influence is realized through inducing negative surface air pressure anomalies in the hemispheric-wide domain extending from the midlatitude North Atlantic to midlatitude Eurasia. These negative surface anomalies favor the weakening of the Mongolian Cold High, and thus induce a weaker East Asian Winter Monsoon.展开更多
引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impair...引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impairment of Cognition Classification Consensus Study,VICCCS）,旨在就VCI的诊断原则（VICCCS-1）和诊断方案（VICCCS-2）达成一致意见.本文提供了VICCCS-2的相关内容.方法使用VICCCS-1达成的原则和已发表的诊断指南作为在线德尔菲（Delphi）调查的参考基点,以期对VCI的临床诊断达成共识.结果共进行了6轮调查,每轮有65～79名专家参与,他们就VICCCS修订的轻度和重度VCI的诊断指南达成共识,并肯定了美国国立神经疾病与卒中研究所-加拿大卒中网（National Institute of Neurological Disorders and Stroke–Canadian Stroke Network,NINDS-CSN）发布的神经心理学评估方案和对影像学检查的推荐意见.讨论VICCCS-2建议规范化应用NINDS-CSN推荐的神经心理学和影像学评估方案诊断VCI,以促进研究协作.展开更多
Nonalcoholic fatty liver disease （NAFLD） is an increasingly recognized cause of liver-related morbidity and mortality. It can develop secondary to numerous causes but a great majority of NAFLD cases occur in patient...Nonalcoholic fatty liver disease （NAFLD） is an increasingly recognized cause of liver-related morbidity and mortality. It can develop secondary to numerous causes but a great majority of NAFLD cases occur in patients who are obese or present with other components of metabolic syndrome （hypertension, dyslipidemia, diabetes）. This is called primary NAFLD and insulin resistance plays a key role in its pathogenesis. Obesity is characterized by expanded adipose tissue, which is under a state of chronic inflammation. This disturbs the normal storage and endocrine functions of adipose tissue. In obesity, the secretome （adipokines, oytokines, free fatty acids and other lipid moieties） of fatty tissue is amplified, which through its autocrine, paracrine actions in fat tissue and systemic effects especially in the liver leads to an altered metabolic state with insulin resistance （IR）. IR leads to hyperglycemia and reactive hyperinsulinemia, which stimulates lipid-accumulating processes and impairs hepatic lipid metabolism. IR enhances free fatty acid delivery to liver from the adipose tissue storage due to uninhibited lipolysis. These changes result in hepatic abnormal fat accumulation, which may initiate the hepatic IR and further aggravate the altered metabolic state of whole body. Hepatic steatosis can also be explained by the fact that there is enhanced dietary fat delivery and physical inactivity. IR and NAFLD are also seen in various lipodystrophic states in contrary to popular belief that these problems only occur due to excessive adiposity in obesity. Hence, altered physiology of adipose tissue is central to development of IR, metabolic syndrome and NAFLD.展开更多
Heavy summer rainfall induces significant soil erosion and shallow landslide activity on the loess hillslopes of the Xining Basin at the northeast margin of the Qinghai-Tibet Plateau. This study examines the mechanica...Heavy summer rainfall induces significant soil erosion and shallow landslide activity on the loess hillslopes of the Xining Basin at the northeast margin of the Qinghai-Tibet Plateau. This study examines the mechanical effects of five native shrubs that can be used to reduce shallow landslide activity. We measured single root tensile resistance and shear resistance, root anatomical structure and direct shear and triaxial shear for soil without roots and five root- soil composite systems. Results show that Atriplex canescens （Pursh） Nutt. possessed the strongest roots, followed by Caragana korshinskii Kom., Zygophyllum xanthoxylon （Bunge） Maxim., Nitraria tangutorum Bobr. and Lycium chinense Mill. Single root strength and shear resistance relationships with root diameter are characterized by power or exponential relations, consistent with the Mohr- Coulomb law. Root mechanical strength reflects their anatomical structure, especially the percentage of phloem and xylem cells, and the degree and speed of periderm lignifications. The cohesion force of root- soil composite systems is notably higher than that of soil without roots, with increasing amplitudes of cohesion force for A. canescens, C. korshinskii, Z. xanthoxylon, N. tangutorurn and L. chinense of 75.9%, 75.1%, 36.2%, 24.6% and 17.0 % respectively. When subjected to shear forces, the soil without root samples show much greater lateral deformation thanthe root-soil composite systems, reflecting the restraining effects of roots. Findings from this paper indicate that efforts to reduce shallow landslides in this region by enhancing root reinforcement will be achieved most effectively using A. canescens and C. korshinskii.展开更多
We quantitatively study the Raman and photoluminescence （PL） emission from single-layer molybdenum disulfide （MoS2） on dielectric （SiO2, hexagonal boron nitride, mica and the polymeric dielectric Gel-Film） and c...We quantitatively study the Raman and photoluminescence （PL） emission from single-layer molybdenum disulfide （MoS2） on dielectric （SiO2, hexagonal boron nitride, mica and the polymeric dielectric Gel-Film） and conducting substrates （Au and few-layer graphene）. We find that the substrate can affect the Raman and PL emission in a twofold manner. First, the absorption and emission intensities are strongly modulated by the constructive/destructive interference within the different substrates. Second, the position of the Alg Raman mode peak and the spectral weight between neutral and charged excitons in the PL spectra are modified by the substrate. We attribute this effect to substrate-induced changes in the doping level and in the decay rates of the excitonic transitions. Our results provide a method to quantitatively study the Raman and PL emission from MoSa-based vertical heterostructures and represent the first step in ad hoc tuning the PL emission of 1L MoS2 by selecting the proper substrate.展开更多
Gradual degeneration and loss of dopaminergic neurons in the substantia nigra,pars compacta and subsequent reduction of dopamine levels in striatum are associated with motor deficits that characterize Parkinson’s dis...Gradual degeneration and loss of dopaminergic neurons in the substantia nigra,pars compacta and subsequent reduction of dopamine levels in striatum are associated with motor deficits that characterize Parkinson’s disease(PD).In addition,half of the PD patients also exhibit frontostriatal-mediated executive dysfunction,including deficits in attention,short-term working memory,speed of mental processing,and impulsivity.The most commonly used treatments for PD are only partially or transiently effective and are available or applicable to a minority of patients.Because,these therapies neither restore the lost or degenerated dopaminergic neurons,nor prevent or delay the disease progression,the need for more effective therapeutics is critical.In this review,we provide a comprehensive overview of the current understanding of the molecular signaling pathways involved in PD,particularly within the context of how genetic and environmental factors contribute to the initiation and progression of this disease.The involvement of molecular chaperones,autophagy-lysosomal pathways,and proteasome systems in PD are also highlighted.In addition,emerging therapies,including pharmacological manipulations,surgical procedures,stem cell transplantation,gene therapy,as well as complementary,supportive and rehabilitation therapies to prevent or delay the progression of this complex disease are reviewed.展开更多
AIM： To evaluate the expression of fibrinogenlike protein 2 （fgl2） and its correlation with disease progression in both mice and patients with severe viral hepatitis. METHODS： Balb/cJ or A/J mice were infected int...AIM： To evaluate the expression of fibrinogenlike protein 2 （fgl2） and its correlation with disease progression in both mice and patients with severe viral hepatitis. METHODS： Balb/cJ or A/J mice were infected intraperitoneally （ip） with 100 PFU of murine hepatitis virus type 3 （MHV-3）, liver and serum were harvested at 24, 48, and 72 h post infection for further use. Liver tissues were obtained from 23 patients with severe acute chronic （AOC） hepatitis B and 13 patients with mild chronic hepatitis B. Fourteen patients with mild chronic hepatitis B with cirrhosis and 4 liver donors served as normal controls. In addition, peripheral blood mononuciear cells （PBMC） were isolated from 30 patients （unpaired） with severe AOC hepatitis B and 10 healthy volunteers as controls. Procoagulant activity representing functional prothrombinase activity in PBMC and white blood cells was also assayed. A polyclonal antibody against fgl2 was used to detect the expression of both mouse and human fgl2 protein in liver samples as well as in PBMC by immunohistochemistry staining in a separate set of studies. Alanine aminotransferase （ALT） and total bilirubin （TBil） in serum were measured to assess the severity of liver injury.RESULTS： Histological changes were found in liver sections 12-24 h post MHV-3 infection in Balb/cJ mice. In association with changes in liver histology, marked elevations in serum ALT and TBil were observed. House fgl2 （mfgl2） protein was detected in the endothelium of intrahepatic veins and hepatic sinusoids within the liver 24 h after MHV-3 infection. Liver tissues from the patients with severe AOC hepatitis B had classical pathological features of acute necroinflammation. Human fgl2 （hfgl2） was detected in 21 of 23 patients （91.30%） with severe AOC hepatitis B, while only 1 of 13 patients （7.69%） with mild chronic hepatitis B and cirrhosis had hfgl2 mRNA or protein expression. Twenty-eight of thirty patients （93.33%） with severe AOC hepatitis B and 1 of 展开更多
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。
文摘The Atlantic Multidecadal Oscillation （AMO）, the multidecadal variation of North Atlantic sea surface temperature （SST）, exhibits an oscillation with a period of 65-80 years and an amplitude of 0.4℃. Observational composite analyses reveal that the warm phase AMO is linked to warmer winters in East China, with enhanced precipitation in the north of this region and reduced precipitation in the south, on multidecadal time scales. The pattern is reversed during the cold phase AMO. Whether the AMO acts as a forcing of the multidecadal winter climate of East China is explored by investigating the atmospheric response to warm AMO SST anomalies in a large ensemble of atmospheric general circulation model （AGCM） experiments. The results from three AGCMs are consistent and suggest that the AMO warmth favors warmer winters in East China. This influence is realized through inducing negative surface air pressure anomalies in the hemispheric-wide domain extending from the midlatitude North Atlantic to midlatitude Eurasia. These negative surface anomalies favor the weakening of the Mongolian Cold High, and thus induce a weaker East Asian Winter Monsoon.
文摘引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impairment of Cognition Classification Consensus Study,VICCCS）,旨在就VCI的诊断原则（VICCCS-1）和诊断方案（VICCCS-2）达成一致意见.本文提供了VICCCS-2的相关内容.方法使用VICCCS-1达成的原则和已发表的诊断指南作为在线德尔菲（Delphi）调查的参考基点,以期对VCI的临床诊断达成共识.结果共进行了6轮调查,每轮有65～79名专家参与,他们就VICCCS修订的轻度和重度VCI的诊断指南达成共识,并肯定了美国国立神经疾病与卒中研究所-加拿大卒中网（National Institute of Neurological Disorders and Stroke–Canadian Stroke Network,NINDS-CSN）发布的神经心理学评估方案和对影像学检查的推荐意见.讨论VICCCS-2建议规范化应用NINDS-CSN推荐的神经心理学和影像学评估方案诊断VCI,以促进研究协作.
文摘Nonalcoholic fatty liver disease （NAFLD） is an increasingly recognized cause of liver-related morbidity and mortality. It can develop secondary to numerous causes but a great majority of NAFLD cases occur in patients who are obese or present with other components of metabolic syndrome （hypertension, dyslipidemia, diabetes）. This is called primary NAFLD and insulin resistance plays a key role in its pathogenesis. Obesity is characterized by expanded adipose tissue, which is under a state of chronic inflammation. This disturbs the normal storage and endocrine functions of adipose tissue. In obesity, the secretome （adipokines, oytokines, free fatty acids and other lipid moieties） of fatty tissue is amplified, which through its autocrine, paracrine actions in fat tissue and systemic effects especially in the liver leads to an altered metabolic state with insulin resistance （IR）. IR leads to hyperglycemia and reactive hyperinsulinemia, which stimulates lipid-accumulating processes and impairs hepatic lipid metabolism. IR enhances free fatty acid delivery to liver from the adipose tissue storage due to uninhibited lipolysis. These changes result in hepatic abnormal fat accumulation, which may initiate the hepatic IR and further aggravate the altered metabolic state of whole body. Hepatic steatosis can also be explained by the fact that there is enhanced dietary fat delivery and physical inactivity. IR and NAFLD are also seen in various lipodystrophic states in contrary to popular belief that these problems only occur due to excessive adiposity in obesity. Hence, altered physiology of adipose tissue is central to development of IR, metabolic syndrome and NAFLD.
基金financially supported by the National Natural Science Foundation of China(Grant No.41162010)Excellent Talents in University of New Century by Ministry of Education of the People's Republic of China(Grant No.NCET-04-G983)International Science & Technology Cooperation Program of China(Grant No.2011DFG93160)
文摘Heavy summer rainfall induces significant soil erosion and shallow landslide activity on the loess hillslopes of the Xining Basin at the northeast margin of the Qinghai-Tibet Plateau. This study examines the mechanical effects of five native shrubs that can be used to reduce shallow landslide activity. We measured single root tensile resistance and shear resistance, root anatomical structure and direct shear and triaxial shear for soil without roots and five root- soil composite systems. Results show that Atriplex canescens （Pursh） Nutt. possessed the strongest roots, followed by Caragana korshinskii Kom., Zygophyllum xanthoxylon （Bunge） Maxim., Nitraria tangutorum Bobr. and Lycium chinense Mill. Single root strength and shear resistance relationships with root diameter are characterized by power or exponential relations, consistent with the Mohr- Coulomb law. Root mechanical strength reflects their anatomical structure, especially the percentage of phloem and xylem cells, and the degree and speed of periderm lignifications. The cohesion force of root- soil composite systems is notably higher than that of soil without roots, with increasing amplitudes of cohesion force for A. canescens, C. korshinskii, Z. xanthoxylon, N. tangutorurn and L. chinense of 75.9%, 75.1%, 36.2%, 24.6% and 17.0 % respectively. When subjected to shear forces, the soil without root samples show much greater lateral deformation thanthe root-soil composite systems, reflecting the restraining effects of roots. Findings from this paper indicate that efforts to reduce shallow landslides in this region by enhancing root reinforcement will be achieved most effectively using A. canescens and C. korshinskii.
文摘We quantitatively study the Raman and photoluminescence （PL） emission from single-layer molybdenum disulfide （MoS2） on dielectric （SiO2, hexagonal boron nitride, mica and the polymeric dielectric Gel-Film） and conducting substrates （Au and few-layer graphene）. We find that the substrate can affect the Raman and PL emission in a twofold manner. First, the absorption and emission intensities are strongly modulated by the constructive/destructive interference within the different substrates. Second, the position of the Alg Raman mode peak and the spectral weight between neutral and charged excitons in the PL spectra are modified by the substrate. We attribute this effect to substrate-induced changes in the doping level and in the decay rates of the excitonic transitions. Our results provide a method to quantitatively study the Raman and PL emission from MoSa-based vertical heterostructures and represent the first step in ad hoc tuning the PL emission of 1L MoS2 by selecting the proper substrate.
文摘Gradual degeneration and loss of dopaminergic neurons in the substantia nigra,pars compacta and subsequent reduction of dopamine levels in striatum are associated with motor deficits that characterize Parkinson’s disease(PD).In addition,half of the PD patients also exhibit frontostriatal-mediated executive dysfunction,including deficits in attention,short-term working memory,speed of mental processing,and impulsivity.The most commonly used treatments for PD are only partially or transiently effective and are available or applicable to a minority of patients.Because,these therapies neither restore the lost or degenerated dopaminergic neurons,nor prevent or delay the disease progression,the need for more effective therapeutics is critical.In this review,we provide a comprehensive overview of the current understanding of the molecular signaling pathways involved in PD,particularly within the context of how genetic and environmental factors contribute to the initiation and progression of this disease.The involvement of molecular chaperones,autophagy-lysosomal pathways,and proteasome systems in PD are also highlighted.In addition,emerging therapies,including pharmacological manipulations,surgical procedures,stem cell transplantation,gene therapy,as well as complementary,supportive and rehabilitation therapies to prevent or delay the progression of this complex disease are reviewed.
基金Supported by the National Natural Science Foundation of China for Distinguished Young Scholars, No. 30225040 for Dr Ning Q,No. 30123019 for Dr Luo XP
文摘AIM： To evaluate the expression of fibrinogenlike protein 2 （fgl2） and its correlation with disease progression in both mice and patients with severe viral hepatitis. METHODS： Balb/cJ or A/J mice were infected intraperitoneally （ip） with 100 PFU of murine hepatitis virus type 3 （MHV-3）, liver and serum were harvested at 24, 48, and 72 h post infection for further use. Liver tissues were obtained from 23 patients with severe acute chronic （AOC） hepatitis B and 13 patients with mild chronic hepatitis B. Fourteen patients with mild chronic hepatitis B with cirrhosis and 4 liver donors served as normal controls. In addition, peripheral blood mononuciear cells （PBMC） were isolated from 30 patients （unpaired） with severe AOC hepatitis B and 10 healthy volunteers as controls. Procoagulant activity representing functional prothrombinase activity in PBMC and white blood cells was also assayed. A polyclonal antibody against fgl2 was used to detect the expression of both mouse and human fgl2 protein in liver samples as well as in PBMC by immunohistochemistry staining in a separate set of studies. Alanine aminotransferase （ALT） and total bilirubin （TBil） in serum were measured to assess the severity of liver injury.RESULTS： Histological changes were found in liver sections 12-24 h post MHV-3 infection in Balb/cJ mice. In association with changes in liver histology, marked elevations in serum ALT and TBil were observed. House fgl2 （mfgl2） protein was detected in the endothelium of intrahepatic veins and hepatic sinusoids within the liver 24 h after MHV-3 infection. Liver tissues from the patients with severe AOC hepatitis B had classical pathological features of acute necroinflammation. Human fgl2 （hfgl2） was detected in 21 of 23 patients （91.30%） with severe AOC hepatitis B, while only 1 of 13 patients （7.69%） with mild chronic hepatitis B and cirrhosis had hfgl2 mRNA or protein expression. Twenty-eight of thirty patients （93.33%） with severe AOC hepatitis B and 1 of
