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
In this paper, a concept of surface nanocrystallization (SNC) of metallic materials is introduced. Three types of SNC processes are classified. Different SNC mechanisms and possible techniques for SNC are discussed wi...In this paper, a concept of surface nanocrystallization (SNC) of metallic materials is introduced. Three types of SNC processes are classified. Different SNC mechanisms and possible techniques for SNC are discussed with emphasis on mechanically induced surface self-nanocrystallization. Further development and prospects are addressed with respect to the properties and behaviors of the materials with a nanocrystalline surface. Enhancement of the behavior of the engineering materials by means of the SNC technology and its industrial application possibilities are analyzed.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
Nasopharyngeal carcinoma (NPC) has remarkable epidemiological features, including regional, racial, and familial aggregations. The aim of this review is to describe the epidemiological characteristics of NPC and to pr...Nasopharyngeal carcinoma (NPC) has remarkable epidemiological features, including regional, racial, and familial aggregations. The aim of this review is to describe the epidemiological characteristics of NPC and to propose possible causes for the high incidence patterns in southern China. Since the etiology of NPC is not completely understood, approaches to primary prevention of NPC remain under consideration. This situation highlights the need to conduct secondary prevention, including improving rates of early detection, early diagnosis, and early treatment in NPC patients. Since the 1970's, high-risk populations in southern China have been screened extensively for early detection of NPC using anti-Epstein-Barr virus (EBV) serum biomarkers. This review summarizes several large screening studies that have been conducted in the high-incidence areas of China. Screening markers, high-risk age range for screening, time intervals for blood re-examination, and the effectiveness of these screening studies will be discussed. Conduction of prospective randomized controlled screening trials in southern China can be expected to maximize the cost-effectiveness of early NPC detection screening.展开更多
基金United Kingdom National Institute for Health ResearchCanadian Institutes of Health Research+4 种基金Presidents FundCanadian Institutes of Health ResearchJohnson & JohnsonBMJthe American Society for Clinical Oncology
文摘大量证据显示随机对照临床试验(randomised controlled trial,RCT)的报告质量不理想。报告不透明,则读者既不能评判试验结果是否真实可靠,也不能从中提取可用于系统综述的信息。最近的方法学分析表明,报告不充分和设计不合理与对治疗效果产生评价偏倚有关。这种系统误差对RCT损害严重,而RCT正是以其能减少或避免偏倚而被视为评价干预措施的金标准。为了提高RCT的报告质量,一个由专家和编辑组成的工作组制定了临床试验报告的统一标准(Consolidated Standards of Reporting Trials,CONSORT)声明。CONSORT声明于1996年首次发表,并于2001年更新。声明由对照检查清单和流程图组成,供作者在报告RCT时使用。许多核心医学期刊和主要国际性编辑组织都已认可CONSORT声明。该声明促进了对RCT的严格评价和解释。2001年,在对CONSORT进行修订时,人们就已经清楚地认识到,解释和说明制定CONSORT声明的原理,有助于研究人员等撰写或评价临床试验报告。一篇CONSORT说明与详述文章于2001年同2001版CONSORT声明一起发表。2007年1月的专家会议之后,对CONSORT声明作了进一步修订并已发表,即"CONSORT2010声明"。这次更新对原版对照检查清单作了文字上的修改,使其更为明晰,并收入了与一些新近才认识到的主题相关的建议,如选择性报告结局产生的偏倚。说明与详述文件旨在加强人们对CONSORT声明的理解、应用和传播,这次也作了大量修订,对每一项新增或更新的清单条目的含义和增改理由进行了解释,提供了优秀的报告实例,还尽可能地提供了相关的经验性研究的参考文献。文中收入了若干流程图实例。"CONSORT2010声明"、其说明与详述文件,以及相关网站(www.consort-statement.org),对于改进随机临床试验报告必将有所裨益。
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In this paper, a concept of surface nanocrystallization (SNC) of metallic materials is introduced. Three types of SNC processes are classified. Different SNC mechanisms and possible techniques for SNC are discussed with emphasis on mechanically induced surface self-nanocrystallization. Further development and prospects are addressed with respect to the properties and behaviors of the materials with a nanocrystalline surface. Enhancement of the behavior of the engineering materials by means of the SNC technology and its industrial application possibilities are analyzed.
基金This work Was partially funded by the National Natural Science Foundation of China ( grant No, 40172038) the Major State Basic Research Program of the Peoples Republic of CHina No.G+99043202).
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Nasopharyngeal carcinoma (NPC) has remarkable epidemiological features, including regional, racial, and familial aggregations. The aim of this review is to describe the epidemiological characteristics of NPC and to propose possible causes for the high incidence patterns in southern China. Since the etiology of NPC is not completely understood, approaches to primary prevention of NPC remain under consideration. This situation highlights the need to conduct secondary prevention, including improving rates of early detection, early diagnosis, and early treatment in NPC patients. Since the 1970's, high-risk populations in southern China have been screened extensively for early detection of NPC using anti-Epstein-Barr virus (EBV) serum biomarkers. This review summarizes several large screening studies that have been conducted in the high-incidence areas of China. Screening markers, high-risk age range for screening, time intervals for blood re-examination, and the effectiveness of these screening studies will be discussed. Conduction of prospective randomized controlled screening trials in southern China can be expected to maximize the cost-effectiveness of early NPC detection screening.
