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
Gastric cancer(GC) remains an important cause of cancer death worldwide with a high mortality rate due to the fact that the majority of GC cases are diagnosed at an advanced stage when the prognosis is poor and the tr...Gastric cancer(GC) remains an important cause of cancer death worldwide with a high mortality rate due to the fact that the majority of GC cases are diagnosed at an advanced stage when the prognosis is poor and the treatment options are limited. Unfortunately, the existing circulating biomarkers for GC diagnosis and prognosis display low sensitivity and specificity and the GC diagnosis is based only on the invasive procedures such as upper digestive endoscopy. There is a huge need for less invasive or non-invasive tests but also highly specific biomarkers in case of GC. Body fluids such as peripheral blood, urine or saliva,stomach wash/gastric juice could be a source of specific biomarkers, providing important data for screening and diagnosis in GC. This review summarized the recently discovered circulating molecules such as microRNAs, long non-coding RNAs, circular RNAs, which hold the promise to develop new strategies for early diagnosis of GC.展开更多
Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population.Diabetes-related heart disease occurs in the form of coronary artery disease(CAD)...Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population.Diabetes-related heart disease occurs in the form of coronary artery disease(CAD),cardiac autonomic neuropathy or diabetic cardiomyopathy(DbCM).The prevalence of cardiac failure is high in the diabetic population and DbCM is a common but underestimated cause of heart failure in diabetes.The pathogenesis of diabetic cardiomyopathy is yet to be clearly defined.Hyperglycemia,dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn implicated.The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DbCM.In the early stages of the disease diastolic dysfunction is the only abnormality,but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction.Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction,but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used recently for early detection of DbCM.The management of DbCM involves improvement in lifestyle,control of glucose and lipid abnormalities,and treatment of hypertension and CAD,if present.The role of vasoactive drugs and antioxidants is being explored.This review discusses the pathophysiology,diagnostic evaluation and management options of DbCM.展开更多
In industry-oriented peri-urban areas, the heavy metal accumulation in soils caused by industrialization has become a potential threat. The top soil samples from 27 paddy fields and 75 vegetable fields were collected ...In industry-oriented peri-urban areas, the heavy metal accumulation in soils caused by industrialization has become a potential threat. The top soil samples from 27 paddy fields and 75 vegetable fields were collected from a typical industry- based peri-urban area of about 8 km^2 in Wuxi, China, to study the accumulation and distribution of As, Hg, Cu, Zn, Pb, Cr, and Cd in comparison with heavy metal contents in soils near developed industrial sites （Guangzhou, China; Wallsend Burn of Tyneside, UK; and Osnabrück, Germany）. Kriging interpolation was used to determine the metals, spatial distribution. The results showed that most soils, compared to the background values, contained elevated contents of As, Hg, Cu, Zn, and Pb with some having elevated contents of Cd and Cr. Except for less than 10% of the soil samples of Cu, Zn and Cd contents, these heavy metal contents were lower than the soil threshold levels of the Grade Ⅱ criteria for the Chinese environmental quality standard. Probably, because of the scattered distribution and diversity of industries in the study area, spatial distributions of these heavy metals from Kriging interpolation indicated little similarity. Nevertheless, when compared with other areas in the Taihu Lake region, mean contents of Cu, Zn, Pb, and Cd were relatively high in the Wuxi peri-urban area. Additionally, compared to soils in agricultural areas around Guangzhou, Osnabrück, or Wallsend Burn, contents of most heavy metals in soils from this area were lower.展开更多
Acute pancreatitis (AP) is a common and potentially lethal acute inflammatory process with a highly variable clinical course. It is still unclear why some patients progress to organ failure and others do not. Physicia...Acute pancreatitis (AP) is a common and potentially lethal acute inflammatory process with a highly variable clinical course. It is still unclear why some patients progress to organ failure and others do not. Physicians, ability to predict which patients will develop severe disease is limited. Routine clinical and laboratory data and multi-factorial clinical scores measured on admission and during the first 48 h of hospitalization are currently the standards of care used to estimate the magnitude of the inflammatory response to injury. Current literature highlights several common environmental, metabolic and genetic factors that increase the risk of AP development and subsequent adverse sequelae. Several cytokines have been found to play a critical role in the pathogenesis of AP by driving the subsequent inflammatory response, to include tumor necrosis factor-α (TNF-α), Interleukin-1 (IL-1), IL-6 and monocyte chemotactic protein-1 (MCP-1). Large, prospective studies are still needed to address these questions by identifying AP risk factors and serum biomarkers of severe disease.展开更多
The environmental challenges from coal mining include coal mine accidents,land subsidence,damage to the water environment,mining waste disposal and air pollution.These are either environmental pollution or landscape c...The environmental challenges from coal mining include coal mine accidents,land subsidence,damage to the water environment,mining waste disposal and air pollution.These are either environmental pollution or landscape change.A conceptual framework for solving mine environmental issues is proposed.Clean processes,or remediation measures,are designed to address environmental pollution.Restoration measures are proposed to handle landscape change.The total methane drainage from 56 Chinese high methane concentration coal mines is about 101.94 million cubic meters.Of this methane,19.32 million,35.58 million and 6.97 million cubic meters are utilized for electricity generation,civil fuel supplies and other industrial purposes,respectively.About 39% of the methane is emitted into the atmosphere.The production of coal mining wastes can be decreased 10% by reuse of mining wastes as underground fills,or by using the waste as fuel for power plants or for raw material to make bricks or other infrastructure materials.The proper use of mined land must be decided in terms of local physical and socio-economical conditions.In European countries more than 50% of previously mined lands are reclaimed as forest or grass lands.However,in China more than 70% of the mined lands are reclaimed for agricultural purposes because the large population and a shortage of farmlands make this necessary.Reconstruction of rural communities or native residential improvement is one environmental problem arising from mining.We suggest two ways to reconstruct a farmer's house in China.展开更多
Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the dia...Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC.展开更多
Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with...Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC detection.Further investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.展开更多
Background: Two trials were performed to evaluate a partially defatted Hermetia illucens(HI) larvae meal as potential feed ingredient in rainbow trout(Oncorhynchus mykiss Walbaum) diets. In the first trial, 360 trout(...Background: Two trials were performed to evaluate a partially defatted Hermetia illucens(HI) larvae meal as potential feed ingredient in rainbow trout(Oncorhynchus mykiss Walbaum) diets. In the first trial, 360 trout(178.9 ± 9.8 g of mean initial body weight) were randomly divided into three experimental groups(4 tanks/treatment, 30 fish/tank). The fish were fed for 78 days with isonitrogenous, isolipidic and isoenergetic diets containing increasing levels of HI, on as fed basis: 0%(HI0, control diet), 25%(HI25) and 50%(HI50) of fish meal substitution, corresponding to dietary inclusion levels of 0, 20% and 40%. In the second trial, 36 trout(4 tanks/treatment, 3 fish/tank) were used to evaluate the in vivo apparent digestibility coefficients(ADC) of the same diets used in the first trial.Results: Survival, growth performance, condition factor, somatic indexes, and dorsal fillet physical quality parameters were not affected by diet. The highest dietary inclusion of HI larvae meal increased dry matter and ether extract contents of trout dorsal fillet. The use of HI larvae meal induced a decrease of valuable polyunsaturated fatty acids(PUFA) even if differences were only reported at the highest level of HI inclusion. The insect meal worsened the lipids health indexes of the same muscle. Dietary inclusion of insect meal did not alter the villus height of the fish. No differences were found among treatments in relation to ADC of ether extract and gross energy, while ADC of dry matter and crude protein were higher in HI25 if compared to HI50.Conclusions: The obtained results showed that a partially defatted HI larvae meal can be used as feed ingredient in trout diets up to 40% of inclusion level without impacting survival, growth performance, condition factor, somatic indexes, dorsal fillet physical quality parameters, and intestinal morphology of the fish. However, further investigations on specific feeding strategies and diet formulations are needed to limit the observed negative effects of the insect meal on the FA展开更多
基金Supported by a grant of the Romanian National Authority for Scientific Research and Innovation,CNCS-UEFISCDI,No.PN-Ⅲ-P4-ID-PCCF2016-0158(contract PCCF17/2018)within PNCDI Ⅲ
文摘Gastric cancer(GC) remains an important cause of cancer death worldwide with a high mortality rate due to the fact that the majority of GC cases are diagnosed at an advanced stage when the prognosis is poor and the treatment options are limited. Unfortunately, the existing circulating biomarkers for GC diagnosis and prognosis display low sensitivity and specificity and the GC diagnosis is based only on the invasive procedures such as upper digestive endoscopy. There is a huge need for less invasive or non-invasive tests but also highly specific biomarkers in case of GC. Body fluids such as peripheral blood, urine or saliva,stomach wash/gastric juice could be a source of specific biomarkers, providing important data for screening and diagnosis in GC. This review summarized the recently discovered circulating molecules such as microRNAs, long non-coding RNAs, circular RNAs, which hold the promise to develop new strategies for early diagnosis of GC.
文摘Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population.Diabetes-related heart disease occurs in the form of coronary artery disease(CAD),cardiac autonomic neuropathy or diabetic cardiomyopathy(DbCM).The prevalence of cardiac failure is high in the diabetic population and DbCM is a common but underestimated cause of heart failure in diabetes.The pathogenesis of diabetic cardiomyopathy is yet to be clearly defined.Hyperglycemia,dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn implicated.The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DbCM.In the early stages of the disease diastolic dysfunction is the only abnormality,but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction.Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction,but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used recently for early detection of DbCM.The management of DbCM involves improvement in lifestyle,control of glucose and lipid abnormalities,and treatment of hypertension and CAD,if present.The role of vasoactive drugs and antioxidants is being explored.This review discusses the pathophysiology,diagnostic evaluation and management options of DbCM.
基金Project supported by the RURBIFARM (Sustainable Farming at the Rural-Urban Interface) project of the European Union (No. ICA4-CT-2002-10021)the Knowledge Innovation Program of the Chinese Academy of Sciences (No. KZCX3-SW-427)the National Key Basic Research Support Foundation of China (No. 2002CB410810).
文摘In industry-oriented peri-urban areas, the heavy metal accumulation in soils caused by industrialization has become a potential threat. The top soil samples from 27 paddy fields and 75 vegetable fields were collected from a typical industry- based peri-urban area of about 8 km^2 in Wuxi, China, to study the accumulation and distribution of As, Hg, Cu, Zn, Pb, Cr, and Cd in comparison with heavy metal contents in soils near developed industrial sites （Guangzhou, China; Wallsend Burn of Tyneside, UK; and Osnabrück, Germany）. Kriging interpolation was used to determine the metals, spatial distribution. The results showed that most soils, compared to the background values, contained elevated contents of As, Hg, Cu, Zn, and Pb with some having elevated contents of Cd and Cr. Except for less than 10% of the soil samples of Cu, Zn and Cd contents, these heavy metal contents were lower than the soil threshold levels of the Grade Ⅱ criteria for the Chinese environmental quality standard. Probably, because of the scattered distribution and diversity of industries in the study area, spatial distributions of these heavy metals from Kriging interpolation indicated little similarity. Nevertheless, when compared with other areas in the Taihu Lake region, mean contents of Cu, Zn, Pb, and Cd were relatively high in the Wuxi peri-urban area. Additionally, compared to soils in agricultural areas around Guangzhou, Osnabrück, or Wallsend Burn, contents of most heavy metals in soils from this area were lower.
文摘Acute pancreatitis (AP) is a common and potentially lethal acute inflammatory process with a highly variable clinical course. It is still unclear why some patients progress to organ failure and others do not. Physicians, ability to predict which patients will develop severe disease is limited. Routine clinical and laboratory data and multi-factorial clinical scores measured on admission and during the first 48 h of hospitalization are currently the standards of care used to estimate the magnitude of the inflammatory response to injury. Current literature highlights several common environmental, metabolic and genetic factors that increase the risk of AP development and subsequent adverse sequelae. Several cytokines have been found to play a critical role in the pathogenesis of AP by driving the subsequent inflammatory response, to include tumor necrosis factor-α (TNF-α), Interleukin-1 (IL-1), IL-6 and monocyte chemotactic protein-1 (MCP-1). Large, prospective studies are still needed to address these questions by identifying AP risk factors and serum biomarkers of severe disease.
基金supported by the 111 Project (No.B07028)the Project for New Century Talents of Ministry of Education of China (No.NCET-04-0487)supported by the Natural Science Foundation of Jiangsu Province of China (No.50574095)
文摘The environmental challenges from coal mining include coal mine accidents,land subsidence,damage to the water environment,mining waste disposal and air pollution.These are either environmental pollution or landscape change.A conceptual framework for solving mine environmental issues is proposed.Clean processes,or remediation measures,are designed to address environmental pollution.Restoration measures are proposed to handle landscape change.The total methane drainage from 56 Chinese high methane concentration coal mines is about 101.94 million cubic meters.Of this methane,19.32 million,35.58 million and 6.97 million cubic meters are utilized for electricity generation,civil fuel supplies and other industrial purposes,respectively.About 39% of the methane is emitted into the atmosphere.The production of coal mining wastes can be decreased 10% by reuse of mining wastes as underground fills,or by using the waste as fuel for power plants or for raw material to make bricks or other infrastructure materials.The proper use of mined land must be decided in terms of local physical and socio-economical conditions.In European countries more than 50% of previously mined lands are reclaimed as forest or grass lands.However,in China more than 70% of the mined lands are reclaimed for agricultural purposes because the large population and a shortage of farmlands make this necessary.Reconstruction of rural communities or native residential improvement is one environmental problem arising from mining.We suggest two ways to reconstruct a farmer's house in China.
基金Supported by The NIHR Biomedical Research Centre funding scheme and the following for authors’ funding and supportAIG is funded by a scholarship from the Egyptian Government+5 种基金SAK is supported by a grant from the Higher Education Funding Council for England (HEFCE)SDTR is funded by grants from the British Medical Research Council (MRC), London, United KingdomThe British Engineering, Physics and Science Research Council (EPSRC), Swindon, United KingdomThe Alan Morement Memorial Fund AMMF, Essex, United KingdomBroad Foundation, Los Angeles, United StatesPfizer Global Research and Development Inc, Sandwich, United Kingdom and GlaxoSmithKline, Ware, United Kingdom
文摘Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC.
文摘Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC detection.Further investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.
基金Financial support for this work was provided by the University of Turin(ex 60%)grant(Es.fin.2015–2016)
文摘Background: Two trials were performed to evaluate a partially defatted Hermetia illucens(HI) larvae meal as potential feed ingredient in rainbow trout(Oncorhynchus mykiss Walbaum) diets. In the first trial, 360 trout(178.9 ± 9.8 g of mean initial body weight) were randomly divided into three experimental groups(4 tanks/treatment, 30 fish/tank). The fish were fed for 78 days with isonitrogenous, isolipidic and isoenergetic diets containing increasing levels of HI, on as fed basis: 0%(HI0, control diet), 25%(HI25) and 50%(HI50) of fish meal substitution, corresponding to dietary inclusion levels of 0, 20% and 40%. In the second trial, 36 trout(4 tanks/treatment, 3 fish/tank) were used to evaluate the in vivo apparent digestibility coefficients(ADC) of the same diets used in the first trial.Results: Survival, growth performance, condition factor, somatic indexes, and dorsal fillet physical quality parameters were not affected by diet. The highest dietary inclusion of HI larvae meal increased dry matter and ether extract contents of trout dorsal fillet. The use of HI larvae meal induced a decrease of valuable polyunsaturated fatty acids(PUFA) even if differences were only reported at the highest level of HI inclusion. The insect meal worsened the lipids health indexes of the same muscle. Dietary inclusion of insect meal did not alter the villus height of the fish. No differences were found among treatments in relation to ADC of ether extract and gross energy, while ADC of dry matter and crude protein were higher in HI25 if compared to HI50.Conclusions: The obtained results showed that a partially defatted HI larvae meal can be used as feed ingredient in trout diets up to 40% of inclusion level without impacting survival, growth performance, condition factor, somatic indexes, dorsal fillet physical quality parameters, and intestinal morphology of the fish. However, further investigations on specific feeding strategies and diet formulations are needed to limit the observed negative effects of the insect meal on the FA
