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Outgrowth endothelial cells form a functional cerebral barrier and restore its integrity after damage 预览
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作者 Rais Reskiawan Abdulkadir Mansour Alwjwaj +2 位作者 Othman Ahmad Othman Kamini Rakkar Ulvi Bayraktutan 《中国神经再生研究:英文版》 SCIE CAS CSCD 2020年第6期1071-1078,共8页
Breakdown of blood-brain barrier,formed mainly by brain microvascular endothelial cells(BMECs),represents the major cause of mortality during early phases of ischemic strokes.Hence,discovery of novel agents that can e... Breakdown of blood-brain barrier,formed mainly by brain microvascular endothelial cells(BMECs),represents the major cause of mortality during early phases of ischemic strokes.Hence,discovery of novel agents that can effectively replace dead or dying endothelial cells to restore blood-brain barrier integrity is of paramount importance in stroke medicine.Although endothelial progenitor cells(EPCs)represent one such agents,their rarity in peripheral blood severely limits their adequate isolation and therapeutic use for acute ischemic stroke which necessitate their ex vivo expansion and generate early EPCs and outgrowth endothelial cells(OECs)as a result.Functional analyses of these cells,in the present study,demonstrated that only OECs endocytosed DiI-labelled acetylated low-density lipoprotein and formed tubules on matrigel,prominent endothelial cell and angiogenesis markers,respectively.Further analyses by flow cytometry demonstrated that OECs expressed specific markers for sternness(CD34),immaturity(CD133)and endothelial cells(CD31)but not for hematopoietic cells(CD45).Like BMECs,OECs established an equally tight in vitro model of human BBB with astrocytes and pericytes,suggesting their capacity to form tight junctions.Ischemic injury mimicked by concurrent deprivation of oxygen and glucose(4 hours)or deprivation of oxygen and glucose followed by reperfusion(20 hours)affected both barrier integrity and function in a similar fashion as evidenced by decreases in transendothelial electrical resistance and increases in paracellular flux,respectively.Wound scratch assays comparing the vasculoreparative capacity of cells revealed that,compared to BMECs,OECs possessed a greater proliferative and directional migratory capacity.In a triple culture model of BBB established with astrocytes,pericytes and BMEC,exogenous addition of OECs effectively repaired the damage induced on endothelial layer in serum-free conditions.Taken together,these data demonstrate that OECs may effectively home to the site of vascular injury and re 展开更多
关键词 cell-based therapy endothelial progenitor cells ENDOTHELIUM ischemic stroke NEURODEGENERATION novel therapeutics outgrowth endothelial cells regenerative medicine stem cells translational medicine
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Clinic Evaluation of Heart Failure of Old People in the Department of Internal Medicine of Point G University Hospital from 2008 to 2012 预览
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作者 Assétou Soukho Kaya Abdel Kader Traoré +17 位作者 Djibril Sy Djenebou Traoré Ilo Diall Youssouf Fofana Ibahima Amadou Dembélé Boua Daoud Camara Mamadou Saliou Karim Dao Mamadou Cissoko Kaly Kéï ta Barry Boubacar Sangaré Mamadou Mallé Alassane A. Doumbia Hadiza A. Kaï lou Mamadou Dembélé Hamar Alassane Traoré 《内科学期刊(英文)》 2019年第3期83-88,共6页
Justification: Heart failure (HF) is the evolutionary end of all cardiac diseases. Given the aging population, the rate of incidence is increasing among the elderly. Objectives: The study aims to determine the prevale... Justification: Heart failure (HF) is the evolutionary end of all cardiac diseases. Given the aging population, the rate of incidence is increasing among the elderly. Objectives: The study aims to determine the prevalence of heart failure in the elderly;to describe the clinical aspects;describe etiologies;describe the therapeutic aspects;and describe the evolution of heart failure among the elderly. Method: This was a retrospective study over five years on the operating records of patients hospitalized in the internal medicine department of Hospital Point G. Result: The study included records of 22 elderly patients who were with heart failure of a total of 595 patients hospitalized from 1st January 2008 to 31st December 2012. The prevalence rate was 3.7%, and the average age was 67 ± 7.79 years. The sex ratio was equal to 1. HTA accounted for the cardiovascular risk factors in 77.3%. 72.7% of patients had the symptom of dyspnea and 95.5% of patients had the symptom of IMO. According to the cardiac ultrasound, dilation of the OG represented 68.2% of cases, followed by impaired LVEF (63.6%). The etiologies of IC were represented by dilated cardiomyopathy (95.5%), followed by 13.6% in cardiothyreosis. Drug treatment was dominated by the use of diuretics, ACE inhibitors and sodium diet respectively 95.5%;81.8% and 45.5% of cases. The clinical outcome was favorable in 73%. We recorded four (4) cases of death, which accounted for 18% of patients. 展开更多
关键词 HEART Failure CLINIC ETIOLOGY THERAPEUTICS The ELDER
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大剂量甲泼尼龙联合利妥昔单抗及新鲜冰冻血浆治疗伴有TP53基因异常的B细胞慢性淋巴增殖性疾病六例
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作者 史珂 夏奕 +4 位作者 朱华渊 王莉 范磊 徐卫 李建勇 《中华血液学杂志》 CAS CSCD 北大核心 2019年第5期388-392,共5页
目的探究大剂量甲泼尼龙联合利妥昔单抗及新鲜冰冻血浆(HDMP+RTX+FFP)治疗伴有TP53基因异常[TP53缺失和(或)突变]的B细胞慢性淋巴增殖性疾病(B-CLPD)的疗效.方法自2008年5月至2012年5月前瞻性入组6例伴有TP53基因异常的B-CLPD患者,给予... 目的探究大剂量甲泼尼龙联合利妥昔单抗及新鲜冰冻血浆(HDMP+RTX+FFP)治疗伴有TP53基因异常[TP53缺失和(或)突变]的B细胞慢性淋巴增殖性疾病(B-CLPD)的疗效.方法自2008年5月至2012年5月前瞻性入组6例伴有TP53基因异常的B-CLPD患者,给予最多6个周期的HDMP+RTX+FFP治疗并进行疗效评估和随访.结果6例B-CLPD患者中包括4例B-CLPD-不能分类型(B-CLPD-U),1例B细胞型幼淋巴细胞白血病(B-PLL)和1例套细胞淋巴瘤(MCL).中位治疗3(2~6)个周期,4例获得完全缓解(CR),其中3例达微小残留病(MRD)阴性的CR;1例疾病稳定(SD),1例疾病进展(PD).中位随访30(4~56)个月,2例无治疗反应(NR)的患者均较快进展、死亡.4例CR患者均无进展,全部存活.治疗后患者的骨髓造血功能显著改善,但IgA、IgG及IgM水平明显下降.所有患者对此方案都表现出了良好的耐受性.骨髓抑制发生率较低,常见不良事件为不超过3级的中性粒细胞减少及感染,均可控.结论HDMP+RTX+FFP是治疗伴有TP53基因异常B-CLPD患者有效且易耐受的治疗方案. 展开更多
关键词 慢性淋巴细胞白血病 治疗方法
直接抗病毒药物治疗HCV相关肝硬化的效果及安全性 预览
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作者 游国琼 王丽 +1 位作者 段萌 朱鹏 《临床肝胆病杂志》 CAS 北大核心 2019年第1期187-190,共4页
肝硬化在临床上十分常见,也是包括慢性HCV感染在内的多种慢性肝病的共同临床结局。在直接抗病毒药物(DAA)出现前,基于PEG-IFN及利巴韦林(RBV)的抗HCV治疗常由于肝硬化的存在而疗效不佳,甚至失代偿期肝硬化本身即是应用PEG-IFN治疗的绝... 肝硬化在临床上十分常见,也是包括慢性HCV感染在内的多种慢性肝病的共同临床结局。在直接抗病毒药物(DAA)出现前,基于PEG-IFN及利巴韦林(RBV)的抗HCV治疗常由于肝硬化的存在而疗效不佳,甚至失代偿期肝硬化本身即是应用PEG-IFN治疗的绝对禁忌证。DAAs已逐渐成为临床治疗HCV感染的一线药物,大量研究显示DAAs用于HCV相关肝硬化患者的治疗具有良好的疗效及耐受度。一方面,DAAs治疗代偿期肝硬化患者的疗效及安全性均要优于PEG-IFN/RBV;另一方面,肝硬化失代偿患者也可耐受DAAs治疗,虽然获得的持续病毒学应答比例可能较普通患者更低,但是DAAs仍能使肝硬化失代偿患者在多方面获益。综述了DAAs用于治疗HCV相关肝硬化患者的最新研究,以求为临床诊治提供参考。 展开更多
关键词 肝炎病毒属 肝硬化 抗病毒药 治疗学 综述
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腹膜后Castleman病1例报告 预览
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作者 任雪康 王树鹏 +1 位作者 王守乾 刘亚辉 《临床肝胆病杂志》 CAS 北大核心 2019年第8期1815-1816,共2页
1 病例资料患者女性,64岁,因“间断性上腹部疼痛不适2年,加重3个月”于2017年1月15日入本院。病程中伴有恶心、呕吐等症状。既往:高血压病史2年,血压最高170/90 mm Hg,未规律口服降压药物,血压控制欠佳。2006年因急性阑尾炎行开腹阑尾... 1 病例资料患者女性,64岁,因“间断性上腹部疼痛不适2年,加重3个月”于2017年1月15日入本院。病程中伴有恶心、呕吐等症状。既往:高血压病史2年,血压最高170/90 mm Hg,未规律口服降压药物,血压控制欠佳。2006年因急性阑尾炎行开腹阑尾切除术。否认其他病史。体格检查:腹部平坦,未见腹壁静脉曲张,上腹部轻度压痛,无反跳痛及压痛,右下腹部可见一长约5 cm陈旧性斜形手术瘢痕。愈合良好,未见胃肠型及蠕动波。肝脾肋下未触及,胆囊未触及,墨菲征阴性,胃震水音阴性,Courvoisier征阴性。肝肾区无叩痛,腹部叩诊呈鼓音,移动性浊音阴性。肠鸣音3次/min。辅助检查:患者术前肝功能、肾功能、凝血常规、尿常规均正常,平均血小板体积12 fL,血小板分布宽度17.8%。 展开更多
关键词 巨淋巴结增生 诊断 治疗学
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Reactive oxygen species mediates a metabolic memory of high glucose stress signaling in bovine retinal pericytes
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作者 Li-Wei Zhang Han Zhao Bai-Hua Chen 《国际眼科杂志:英文版》 SCIE CAS 2019年第7期1067-1074,共8页
AIM: To investigate the role of reactive oxygen species (ROS) and antioxidant mechanism underlying the metabolic memory of bovine retinal pericytes (BRPs) induced by high glucose.METHODS: Effects of high glucose level... AIM: To investigate the role of reactive oxygen species (ROS) and antioxidant mechanism underlying the metabolic memory of bovine retinal pericytes (BRPs) induced by high glucose.METHODS: Effects of high glucose levels and culture time on BRPs viability were evaluated by CCK-8. BRPs were grown in high-glucose media (30 mmol/L) for 4d followed by culture in normal glucose condition (5.6 mmol/L) for 4d in an experimental group. In contrast, in negative and positive control groups, BRPs were grown in either normal-glucose media or high-glucose media for 8d, respectively. The ROS levels, apoptosis, the expression and activity of manganese superoxide dismutase (MnSOD) in BRPs, as well as the protective effect of adeno-associated viral (AAV)-mediated over expression of MnSOD were determined separately by DCHFA, ELISA and Western blot.RESULTS: Comparing the result of cells apoptosis, activity and protein expression of MnSOD and caspase-3, the cell culture system that exposed in sequence in 30 mmol/L and normal glucose for 4d was demonstrated as a suitable model of metabolic memory. Furthermore, delivery of antioxidant gene MnSOD can decrease BRPs apoptosis, reduce activated caspase-3, and reverse hyperglycemic memory by reducing the ROS of mitochondria.CONCLUSION: Increased ROS levels and decreased MnSOD levels may play important roles in pericyte loss of diabetic retinopathy. BRPs cultured in high glucose for 4d followed by normal glucose for 4d could be an appropriate model of metabolic memory. rAAV-MnSOD gene therapy provides a promising strategy to inhibit this blinding disease. 展开更多
关键词 diabetic RETINOPATHY metabolic memory manganese superoxide DISMUTASE molecular THERAPEUTICS reactive oxygen species
慢加急性肝衰竭并发急性肾损伤的研究进展 预览
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作者 张海月(综述) 龚作炯(审校) 《疑难病杂志》 CAS 2019年第10期1072-1076,共5页
急性肾损伤(AKI)是由各种因素导致肾功能突然损伤、肾小球滤过率急剧下降的一组临床综合征。AKI是慢加急性肝衰竭(ACLF)患者常见并发症之一,是影响肝衰竭患者预后的独立危险因素。AKI的早期诊断、有效处理对降低ACLF患者病死率,改善预... 急性肾损伤(AKI)是由各种因素导致肾功能突然损伤、肾小球滤过率急剧下降的一组临床综合征。AKI是慢加急性肝衰竭(ACLF)患者常见并发症之一,是影响肝衰竭患者预后的独立危险因素。AKI的早期诊断、有效处理对降低ACLF患者病死率,改善预后意义重大。文章对ACLF患者AKI的发病机制、生物学标志物、诊断标准、分类、治疗等方面的最新研究进行了综述。 展开更多
关键词 急性肾损伤 慢加急性肝衰竭 发病机制 诊断 治疗
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帕金森病发病机制与治疗研究进展 预览
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作者 辛陈琦(综述) 张承武 李林(审校) 《医学研究生学报》 CAS 北大核心 2019年第6期646-651,共6页
帕金森病是一种以多巴胺能神经元进行性死亡为主要病理特征的神经系统退行性病变,其临床表现为运动及非运动症状两种形式。我国帕金森病患者数量大概为500万,占世界上总帕金森病患者人数的一半。帕金森病的发病机制目前还不是很明确,主... 帕金森病是一种以多巴胺能神经元进行性死亡为主要病理特征的神经系统退行性病变,其临床表现为运动及非运动症状两种形式。我国帕金森病患者数量大概为500万,占世界上总帕金森病患者人数的一半。帕金森病的发病机制目前还不是很明确,主要观点认为与蛋白质异常聚集、线粒体功能障碍、氧化应激等相关。临床上帕金森病常用的治疗手段包括以左旋多巴为首的药物疗法、手术疗法和物理疗法。随着对帕金森病研究的深入以及生物医学领域研究进展,细胞替换法、基因疗法、脑深部电刺激越来越受到人们的重视。文章从帕金森病的发病机制出发,简要介绍其潜在的治疗靶点并归纳现有的治疗手段,为更好的认识及治疗帕金森病提供参考。 展开更多
关键词 帕金森病 发病机制 治疗
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Ebola virus disease: Recent advances in diagnostics and therapeutics
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作者 Supriya Jagga Ashish Ranjan Sharma +1 位作者 Chiranjib Chakraborty Sang-Soo Lee 《亚太热带医药杂志:英文版》 SCIE CAS 2019年第9期385-395,共11页
Ebola virus disease(EVD)is associated with haemorrhagic fever in humans and nonhuman primates,with a high rate of fatality(up to 90%).Some outbreaks in human history have proven the lethality of EVD.The recent epidemi... Ebola virus disease(EVD)is associated with haemorrhagic fever in humans and nonhuman primates,with a high rate of fatality(up to 90%).Some outbreaks in human history have proven the lethality of EVD.The recent epidemic of 2014 and 2015 in West Africa was the deadliest of all time(11 284 deaths).To understand the transmission dynamics,we have reviewed the epidemiology of EVD to date.The absence of any licensed vaccines or approved drugs against Ebola virus(EBOV)further highlights the severity and crisis level of EVD.Some organizations(public and private)are making considerable efforts to develop novel therapeutic approaches or vaccines to contain the outbreak of EBOV shortly.Here,we summarized the various potential drugs and vaccines(undergoing multiple phases of clinical trials)that have arisen as an alternative against EBOV,and we highlighted the numerous issues and limitations hindering this process.Alternatively,an increasing focus on strengthening the medical and civic health structure could provide speedy benefits in containing the spread of EVD,as well as offer a resilient foundation for the deployment of novel drugs and vaccines to the affected countries,once such drugs and vaccines become available. 展开更多
关键词 EBOLA virus Vaccines THERAPEUTICS EBOLA outbreaks DIAGNOSTICS Epidemiology Haemorrhagic FEVER
双相障碍和酒精使用障碍共病的治疗进展
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作者 郭红 常翔宇 +1 位作者 杜易珊 夏炎 《中华行为医学与脑科学杂志》 CAS CSCD 北大核心 2019年第10期947-950,共4页
情绪障碍和物质使用障碍通常同时发生,但很少有循证证据来指导双相障碍和酒精使用障碍共病的治疗管理问题,因此缺乏相应的临床研究和专家共识.本研究回顾了近年来国内外有关双相障碍和酒精使用障碍共病的治疗研究进展,发现药物治疗或药... 情绪障碍和物质使用障碍通常同时发生,但很少有循证证据来指导双相障碍和酒精使用障碍共病的治疗管理问题,因此缺乏相应的临床研究和专家共识.本研究回顾了近年来国内外有关双相障碍和酒精使用障碍共病的治疗研究进展,发现药物治疗或药物与其他治疗方法联合治疗双相障碍和酒精使用障碍共病有一定的疗效,提示药物治疗或药物联合非药物治疗共病的综合治疗方式是未来的方向. 展开更多
关键词 双相障碍 酒精使用障碍 共病 治疗
A review of Behcet’s disease from the perspectives of both Western and Chinese Medicine
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作者 Zhang Jing Tang Yuping +5 位作者 Liu Pei Zhou Guisheng Kang An Yue Shijun Chen Yanyan Duan Jinao 《中医杂志:英文版》 SCIE CAS CSCD 2019年第1期139-148,共10页
Behcet’s disease is a condition with a complicated and unclear etiology that comprises multi-systemic, chronic, inflammatory vasculitis. Behcet’s disease can affect every tissue and organ in the body,and is characte... Behcet’s disease is a condition with a complicated and unclear etiology that comprises multi-systemic, chronic, inflammatory vasculitis. Behcet’s disease can affect every tissue and organ in the body,and is characterized by recurrent oral and genital ulcers, ocular inflammation, skin lesions, and other manifestations. The incidence of Behcet’s disease has a distinct regional specificity, and is most prevalent along the Silk Road, a route that stretched between the Mediterranean, Middle East and Far East.This article reviews the recent literature to evaluate the prevalence, clinical manifestations, pathogenesis and mechanism, and current treatments of Behcet’s disease. Furthermore, the etiology of Behcet’s disease will be evaluated from the aspect of Traditional Chinese Medicine(TCM) syndrome differentiation. As Behcet’s disease is complex and intractable, its treatment warrants further research.Traditionally, Behcet’s disease is treated with Western Medicine(WM) via medications that act locally and systemically;this WM treatment protocol usually has a good effect, but relapse can occur after reducing the dosage. Thus, it may be ideal to treat Behcet’s disease via a combination of WM and TCM.Recent studies have indicated that such a combination of Chinese and Western treatments has a better effect than either treatment alone. The aim of the present review is to describe the clinical features of Behcet’s disease, and to outline its possible pathogenesis in terms of both TCM and WM. Based on these findings, the present review proposes a Behcet’s disease treatment protocol composed of a combination of Chinese and WM that can effectively improve the occurrence of relapse caused by the reduction of the dosage of Western medication. 展开更多
关键词 Behcet SYNDROME SYNDROME differentiation treatment VIRULENCE RECURRENCE THERAPEUTICS Review
自噬的分子机制与慢性髓细胞白血病的关系
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作者 高扬 张姝苑 +1 位作者 张荣娟 张志华 《国际输血及血液学杂志》 CAS 2019年第1期61-64,共4页
自噬是一种普遍存在于细胞的生理现象,与细胞的生长、增殖、分化、凋亡、癌变均有密切的关系。慢性髓细胞白血病(CML)是骨髓造血干细胞克隆性增殖形成的恶性肿瘤,自噬可能在其发生、治疗、耐药等方面发挥着重要作用。因此,研究自噬的分... 自噬是一种普遍存在于细胞的生理现象,与细胞的生长、增殖、分化、凋亡、癌变均有密切的关系。慢性髓细胞白血病(CML)是骨髓造血干细胞克隆性增殖形成的恶性肿瘤,自噬可能在其发生、治疗、耐药等方面发挥着重要作用。因此,研究自噬的分子机制及其与CML的关系,为针对自噬开发治疗CML的新药提供一定的理论指导。笔者就自噬的分子机制及自噬与CML的关系进行综述。 展开更多
关键词 自噬 白血病 髓细胞 慢性 疗法 耐药
限流支架治疗经颈静脉肝内门体分流术后复发性或持续性显性肝性脑病的效果和安全性 预览
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作者 何创业 陈辉 +11 位作者 吕勇 夏冬东 余天垒 袁旭龙 李凯 王钲钰 牛静 白苇 郭文刚 帖君 殷占新 韩国宏 《临床肝胆病杂志》 CAS 北大核心 2019年第8期1719-1722,共4页
目的 分析限流支架治疗经颈静脉肝内门体分流术(TIPS)后复发性或持续性肝性脑病的效果和安全性。方法 选取空军军医大学第一附属医院2013年1月-2018年8月TIPS术后明确诊断为持续性或复发性显性肝性脑病的患者11例。限流支架置入前后选... 目的 分析限流支架治疗经颈静脉肝内门体分流术(TIPS)后复发性或持续性肝性脑病的效果和安全性。方法 选取空军军医大学第一附属医院2013年1月-2018年8月TIPS术后明确诊断为持续性或复发性显性肝性脑病的患者11例。限流支架置入前后选用客观量表对肝性脑病患者进行准确评估。限流支架应尽量选择同类型和合适长度的金属覆膜支架,术中术后常规门静脉造影并测门静脉压力梯度。主要观察终点为肝性脑病的变化情况。采用配对 t 检验分析手术前后各项检测指标的变化。结果11例患者均成功置入限流支架,限流支架置入后1周内8例患者肝性脑病消失,2例患者降为1级,其中1例患者因肝硬化严重并发肝衰竭,肝性脑病改善不明显。直径4 mm限流支架2例,5 mm 8例,6 mm 1例,限流术后门静脉压力梯度升高[(6.09±0.70) mm Hg vs (15.36±2.94) mm Hg, t=2.53,P =0.003 8]。限流术后数字编码测试所需的时间较术前有显著下降[(269±80) s vs (464±90) s, t=2.94, P =0.001]。术后1个月患者Alb改善显著( t=1.75,P =0.013)。 4 mm限流支架的2例患者分别在术后6个月和12个月因消化道出血死亡;5 mm限流支架的8例患者有2例在术后3个月再出血,另1例术后15个月发生大量腹水,1例限流术后生存2年后因黄疸、顽固性腹水并发肝衰竭死亡;6 mm限流支架的1例患者术后25 d并发慢加急性肝衰竭死亡。结论 限流支架能够有效改善TIPS术后药物治疗无效的持续性或复发性显性肝性脑病且安全可行,但限流支架直径过小可能会引起支架再狭窄继发门静脉压力升高。 展开更多
关键词 肝性脑病 门体分流术 经颈静脉肝内 支架 治疗学
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肝纤维化诊断及治疗共识(2019年) 预览
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作者 陆伦根 +2 位作者 尤红 谢渭芬 贾继东 《实用肝脏病杂志》 CAS 2019年第6期793-803,共11页
肝纤维化是肝脏受到各种损伤后细胞外基质(即胶原、糖蛋白和蛋白多糖等)弥漫性过度沉积与异常分布的修复反应,是各种慢性肝病向肝硬化发展过程中的关键步骤。近年来对肝纤维化基础和临床研究及其认识方面有不少进展,我们为此组织了国内... 肝纤维化是肝脏受到各种损伤后细胞外基质(即胶原、糖蛋白和蛋白多糖等)弥漫性过度沉积与异常分布的修复反应,是各种慢性肝病向肝硬化发展过程中的关键步骤。近年来对肝纤维化基础和临床研究及其认识方面有不少进展,我们为此组织了国内本领域相关专家,就肝纤维化诊断和评估、肝纤维化治疗及肝纤维化治疗药物临床开发应用形成共识,以便更好地指导肝纤维化诊断和治疗及药物研发。 展开更多
关键词 肝纤维化 诊断 治疗学 共识
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Intermediate-advanced hepatocellular carcinoma in Argentina:Treatment and survival analysis 预览
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作者 Federico Pi?ero Sebastián Marciano +13 位作者 Nora Fernández Jorge Silva Margarita Anders Alina Zerega Ezequiel Ridruejo Gustavo Romero Beatriz Ameigeiras Claudia D’Amico Luis Gaite Carla Bermúdez Virginia Reggiardo Luis Colombato Adrián Gadano Marcelo Silva 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3607-3618,共12页
BACKGROUND Hepatocellular carcinoma(HCC) represents the sixteenth most frequent cancer in Argentina. The rise of new therapeutic modalities in intermediate-advanced HCC opens up a new paradigm for the treatment of HCC... BACKGROUND Hepatocellular carcinoma(HCC) represents the sixteenth most frequent cancer in Argentina. The rise of new therapeutic modalities in intermediate-advanced HCC opens up a new paradigm for the treatment of HCC.AIM To describe real-life treatments performed in patients with intermediateadvanced HCC before the approval of new systemic options.METHODS This longitudinal observational cohort study was conducted between 2009 and2016 in 14 different regional hospitals from Argentina. Included subjects had intermediate-advanced Barcelona Clinic Liver Cancer(BCLC) HCC stages(BCLC B to D). Primary end point analyzed was survival, which was assessed for each BCLC stage from the date of treatment until last patient follow-up or death.Kaplan Meier survival curves and Cox regression analysis were performed, with hazard ratios(HR) calculations and 95% confidence intervals(95%CI).RESULTS From 327 HCC patients, 41% were BCLC stage B, 20% stage C and 39% stage D.Corresponding median survival were 15 mo(IQR 5-26 mo), 5 mo(IQR 2-13 mo)and 3 mo(IQR 1-13 mo)(P < 0.0001), respectively. Among BCLC-B patients(n =135), 57% received TACE with a median number of 2 sessions(IQR 1-3 sessions).Survival was significantly better in BCLC-B patients treated with TACE HR =0.29(CI: 0.21-0.40) than those without TACE. After tumor reassessment by RECIST 1.1 criteria following the first TACE, patients with complete response achieved longer survival (HR = 0.15(CI: 0.04-0.56, P = 0.005))Eighty-two patients were treated with sorafenib, mostly BCLC-B and C(87.8%). However,12.2% were BCLC-D. Median survival with sorafenib was 4.5 mo(IQR 2.3-11.7 mo);which was lower among BCLC-D patients 3.2 mo(IQR 2.0-14.1 mo). A total of 36 BCLC-B patients presented tumor progression after TACE. In these patients,treatment with sorafenib presented better survival when compared to those patients who received sorafenib without prior TACE [HR = 0.26(CI: 0.09-0.71);P= 0.013].CONCLUSION In this real setting, our results were lower than expected. This highlights unmet ne 展开更多
关键词 HEPATOCELLULAR carcinoma THERAPEUTICS SURVIVAL Real-life
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妊娠对慢性HBV感染自然史的影响 预览
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作者 陈雨欣 黄睿 吴超 《临床肝胆病杂志》 CAS 北大核心 2019年第7期1430-1434,共5页
慢性HBV感染依然是我国严重的公共卫生问题,其中我国孕妇HBsAg携带率高达6.0%~7.8%。妊娠期间,母体免疫系统处于抑制状态,进而可能会影响HBV感染的自然史。目前,妊娠对HBV感染自然史的影响尚无定论。从妊娠期内母体的免疫抑制现象和妊... 慢性HBV感染依然是我国严重的公共卫生问题,其中我国孕妇HBsAg携带率高达6.0%~7.8%。妊娠期间,母体免疫系统处于抑制状态,进而可能会影响HBV感染的自然史。目前,妊娠对HBV感染自然史的影响尚无定论。从妊娠期内母体的免疫抑制现象和妊娠对慢性HBV感染者体内病毒复制、HBeAg血清学转换、肝功能及肝脏疾病进程的影响等方面,综述了妊娠对慢性HBV感染自然史的影响相关的研究进展,并建议临床应当密切监测慢性HBV感染的孕妇在妊娠期和产后的病毒学和肝功能实验室检查。 展开更多
关键词 乙型肝炎病毒 妊娠 治疗学 孕妇
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髌股疼痛综合征病因及治疗的新进展 预览
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作者 苏静亮 王晋东 +1 位作者 周元博 康波 《中华关节外科杂志(电子版)》 CAS CSCD 2019年第3期353-358,共6页
髌股疼痛综合征是膝关节疼痛中最常见诊断之一,常见于青春期和成年期活动量较大患者。髌股疼痛是由各种解剖,生物力学,心理,社会和行为等多种因素综合作用产生,如髌骨位置异常、双下肢生物力学不良、髋关节运动学改变、股四头肌失衡、... 髌股疼痛综合征是膝关节疼痛中最常见诊断之一,常见于青春期和成年期活动量较大患者。髌股疼痛是由各种解剖,生物力学,心理,社会和行为等多种因素综合作用产生,如髌骨位置异常、双下肢生物力学不良、髋关节运动学改变、股四头肌失衡、髌股内侧支持带损伤、髂胫束过紧等。目前以保守治疗为主,保守治疗方法包括运动疗法、髌骨扎贴、髌骨支具、足矫形垫等,保守治疗失败之后,可以考虑手术治疗。 展开更多
关键词 髌股疼痛综合征 病因学 治疗
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踝关节骨折伴急性三角韧带损伤诊疗现状概述 预览
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作者 顾龙枫 董立明 《中华关节外科杂志(电子版)》 CAS CSCD 2019年第3期359-364,共6页
踝关节骨折临床上发生率很高,常需手术治疗。当伴随三角韧带损伤时,则多见于旋前以及部分旋后外旋Ⅳ度的踝关节骨折。临床上此类诊断常较困难,手术修复的时机及方法目前也无统一标准。本文主要综述了近年来“踝关节骨折伴三角韧带损伤... 踝关节骨折临床上发生率很高,常需手术治疗。当伴随三角韧带损伤时,则多见于旋前以及部分旋后外旋Ⅳ度的踝关节骨折。临床上此类诊断常较困难,手术修复的时机及方法目前也无统一标准。本文主要综述了近年来“踝关节骨折伴三角韧带损伤”诊疗的研究进展。三角韧带损伤的诊断常需综合各项辅助检查及症状体征来判断,其中以应力试验及磁共振检查最为重要;术中骨折复位固定后发现踝关节不稳或三角韧带嵌顿阻止复位,则建议术中探查修复,修复的方法众多,目前以带线锚钉重建三角韧带为主。 展开更多
关键词 踝关节骨折 侧副韧带 诊断 治疗
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药物性胆汁淤积的发病机制及诊疗现状 预览 被引量:1
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作者 刘梦 杨玄子 于乐成 《临床肝胆病杂志》 CAS 北大核心 2019年第2期252-257,共6页
药物性胆汁淤积(DRIC)主要包括胆汁淤积型药物性肝损伤和混合型药物性肝损伤,其诊断应参考RUCAM量表判断药物与胆汁淤积之间的因果关系,尤其是充分排除其他病因。肝活组织病理学检查有助于鉴别诊断。发生DRIC后通常应及时停药和避免再刺... 药物性胆汁淤积(DRIC)主要包括胆汁淤积型药物性肝损伤和混合型药物性肝损伤,其诊断应参考RUCAM量表判断药物与胆汁淤积之间的因果关系,尤其是充分排除其他病因。肝活组织病理学检查有助于鉴别诊断。发生DRIC后通常应及时停药和避免再刺激,并给予熊去氧胆酸等药物治疗。DRIC发病机制复杂,涉及药物及其代谢产物对肝细胞和胆管树的直接毒性、免疫和炎症反应、药物代谢与外排通路中酶和转运载体的受抑及基因多态性、HLA基因多态性等。深入阐明这些机制,必将有助于DRIC的预警、预防及优化治疗。 展开更多
关键词 药物性肝损伤 胆汁淤积 诊断 治疗学
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肝衰竭时胆汁淤积的发生机制及处置对策 预览 被引量:1
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作者 毛青 《临床肝胆病杂志》 CAS 北大核心 2019年第2期258-261,共4页
肝衰竭是多种因素引起的严重肝脏损害。肝衰竭时胆汁淤积是一种以大量肝细胞坏死为主要原因的严重肝细胞性肝内胆汁淤积,表现为结合胆红素和非结合胆红素同时急剧增高,且其水平与肝衰竭严重程度呈正比。肝脏组织结构改变加重胆汁淤积,... 肝衰竭是多种因素引起的严重肝脏损害。肝衰竭时胆汁淤积是一种以大量肝细胞坏死为主要原因的严重肝细胞性肝内胆汁淤积,表现为结合胆红素和非结合胆红素同时急剧增高,且其水平与肝衰竭严重程度呈正比。肝脏组织结构改变加重胆汁淤积,肠道微生物群对胆红素和胆汁酸代谢有影响。治疗肝衰竭时胆汁淤积的根本措施是去除病因,促进肝细胞再生和肝功能恢复。 展开更多
关键词 肝功能衰竭 胆汁淤积 治疗学
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