Abdominal Aortic Aneurysms: Endovascular Options and Outcomes — Proliferating Therapy,But Effective?

Abdominal aortic aneurysm (AAA) has a reported prevalence rate of 1.4% in the US. AAA rupture accounts for an estimated 15,000 deaths per year, rendering it the 10th leading cause of death in men over the age of 55. Endovascular repair (EVR) has proliferated in the last two decades as an increasingly popular alternative to traditional open surgery, and is now the default treatment in the majority of centres worldwide. This review article outlines the evidence supporting this stance. The development of EVR is reviewed, alongside trends in utilisation of this therapy over time. The evidence for the relative short-term and long-term outcomes of EVR and open AAA repair is discussed, and ongoing controversies surrounding the use of EVR are considered.     

多奈哌齐治疗轻中度阿尔茨海默病作用机制研究进展

多奈哌齐是第2代胆碱酯酶抑制剂,对轻中度阿尔茨海默病有较好疗效。近年关于多奈哌齐作用机制的相关研究较为丰富,本文拟就我国阿尔茨海默病诊断与治疗现状和多奈哌齐治疗轻中度阿尔茨海默病作用机制研究进展进行概述。     

Pharmacokinetics,efficacy and safety profiles of etanercept monotherapy in Japanese patients with rheumatoid arthritis: review of seven clinical trials

Abstract

Conventional synthetic disease-modifying anti-rheumatic drugs, including methotrexate, may not be tolerated by all patients with rheumatoid arthritis (RA), and limited international data for etanercept (ETN) monotherapy are available. The aim of this review was to summarize the clinical program for ETN monotherapy in Japanese patients with RA, which has included a pharmacokinetic study, clinical trials for registration, long-term studies, and once-weekly dosing studies. Pharmacokinetic results showed that serum concentrations of ETN were linear with dose levels and were similar to other international studies. Across interventional studies, 652 Japanese patients with active RA were treated with ETN. In the registration studies, ETN treatment led to consistent improvement in American College of Rheumatology 20/50/70 scores, European League Against Rheumatism Good Response, Disease Activity Score 28 erythrocyte sedimentation rate remission, and Health Assessment Questionnaire disability index. In the long-term studies, efficacy was maintained for up to 180 weeks. Similar results were seen in the once-weekly studies. Across the studies, more than 870 patient-years of exposure to ETN were recorded. Discontinuations owing to lack of efficacy or adverse events were modest and no new safety signals were recorded. These studies demonstrated that ETN monotherapy is efficacious and well-tolerated in Japanese patients with RA.     

中学生学业拖延与班级环境的关系

目的 从个体和班级两个层面考察班级环境对中学生学业拖延的影响.方法 选取1972名中学生进行问卷调查,使用HLM进行分析,同时对学生进行个别访谈.结果 问题型、中间型、良好型班级在复习、作业和自我任务上的拖延得分存在显著差异(F=16.927,5.832,5.504;P＜0.01);从个体层面来看,师生关系、同学关系能显著地负向预测复习拖延(t=-3.206,-3.765；P＜0.01)和作业拖延(t=-3.822,-3.797;P＜0.001),竞争能显著负向预测作业拖延(t=-2.323,P＜0.05)；从班级层面来看,竞争能量著地负向预测复习和自我任务拖延(t=-2.542,-3.074;P＜0.05).结论 班级环境是影响学业拖延的重要因素.     

傅青主保产无忧散的临床应用进展

为了解傅青主保产无忧散的临床应用情况，本文从傅青主保产无忧散的起源、药理作用、临床研究等方面对保产无忧散进行梳理分析，发现保产无忧散有养血、益气、理气的作用。临床上具有防治难产，治疗多种原因导致的先兆流产、早产，可将晚期妊娠臀位、横位转为头位以利于阴道分娩，对过期妊娠有一定的催引产效果，对于妊娠期特发性黄疸、肝功能异常等妊娠期并发症有防治作用，还可用于治疗胃脘痛，配合针刺促卵泡发育治疗女性不孕症，值得进一步研究。     

Investigating how electroencephalogram measures associate with delirium: A systematic review

Delirium is a common neurocognitive disorder in hospital settings, characterised by fluctuating impairments in attention and arousal following an acute precipitant. Electroencephalography (EEG) is a useful method to understand delirium pathophysiology. We performed a systematic review to investigate associations between delirium and EEG measures recorded prior, during, and after delirium. A total of 1,655 articles were identified using PsycINFO, Embase and MEDLINE, 31 of which satisfied inclusion criteria. Methodological quality assessment was undertaken, resulting in a mean quality score of 4 out of a maximum of 5. Qualitative synthesis revealed EEG slowing and reduced functional connectivity discriminated between those with and without delirium (i.e. EEG during delirium); the opposite pattern was apparent in children, with cortical hyperexcitability. EEG appears to have utility in differentiating those with and without delirium, but delirium vulnerability and the long-term effects on brain function require further investigation. Findings provide empirical support for the theory that delirium is a disorder of reduced functional brain integration.     

David Kupfer: A Career Retrospective

David Kupfer's research career spanned 50 years and he authored or co-authored over 160 papers and book chapters. Although best known for his work centering on cytochrome P450 metabolism of prostaglandins, steroids, and proestrogenic compounds, David's research also contributed key advances in the areas of P450 induction and catalytic mechanism, breast cancer therapy, and analytical methodology. His research is reviewed here.     

Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization’s prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.     

神经胶质细胞在电针治疗神经病理性疼痛中的作用研究进展

神经病理性疼痛是临床中较为常见的慢性疼痛综合征之一,大量文献研究显示神经病理性疼痛与神经胶质细胞生理活动密切相关,神经胶质细胞通过释放各种神经活性物质,发挥信号转导通路功能,在疼痛的产生和维持中起作用,电针刺激可通过抑制神经胶质细胞活化参与镇痛效应。本文就电针治疗神经病理性疼痛的国内外最新文献研究,对神经胶质细胞与神经病理性疼痛的关系及其参与电针镇痛机制的研究进展进行综述。     

Efficacy of photodynamic therapy versus antibiotics as an adjunct to scaling and root planing in the treatment of periodontitis: A systematic review and meta-analysis

BackgroundTo determine whether treatment with antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) yield better clinical periodontal outcomes than antibiotics (AB) as adjunct to SRP in periodontitis.MethodsElectronic searches were conducted in databases (MEDLINE, PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to and including April 2017.ResultsFive randomized trials were included. All studies used the combined approach aPDT + SRP and AB + SRP in the test and control group respectively. The follow up period ranged from 12 to 48 weeks. All studies used diode lasers. The wavelengths, power density and duration of irradiation used were 670 nanometre, 75 milliwatts per square centimeters and 60 s respectively. None of the studies showed additional benefits of aPDT at follow up. Considering the effects of adjunctive aPDT as compared to AB, a high degree of heterogeneity for periodontal probing depth (PPD) (p < 0.0001, I² = 87.47%) was noticed among both the groups. Meta-analysis showed significant clinical attachment level (CAL) gain (WMD = 0.60, 95% CI = 0.25 to 0.95, p = 0.001), and not PPD reduction (WMD = 0.67, 95% CI = –0.36 to 1.71, p = 0.204) for aPDT as compared to AB at follow up.ConclusionIt remains debatable whether aPDT is more effective as compared to adjunctive AB in the treatment of periodontitis, given that the scientific evidence is weak. Precautions must be exercised when interpreting the results of this study due to the small sample size and high heterogeneity among studies.