• 【当地卫生部门对儿童肥胖监测的协作方法。】 复制标题 收藏 收藏
    DOI:10.1097/PHH.0000000000000615 复制DOI
    作者列表:Alleman E,Murphy E,Baskerville K,Chugh R
    BACKGROUND & AIMS: :DuPage County Health Department collected de-identified data from health forms submitted by participating schools for academic years 2011-2015 for kindergarten, sixth-, and ninth-grade students to determine the prevalence of obesity and elevated blood pressure among public school students. The prevalence of obesity in students for the 2014-2015 school year was 15.1%, and the prevalence of elevated blood pressure was 22.8%. Students in the "obese" body mass index percentile category had an elevated blood pressure prevalence of 44.2%, which was higher than students in the "nonobese" category (P < .001). Significant differences were also observed both by sex and by grade. The results identify the need to support implementation and evaluation of policies to reduce childhood obesity and improve health outcomes. By partnering with schools to obtain preexisting health data, state or local health departments with limited resources may replicate these methods to develop a childhood obesity surveillance system.
    背景与目标: : 杜佩奇县卫生部门从参与学校提交的2011-2015学年幼儿园,六年级和九年级学生的健康表格中收集了不识别的数据,以确定公立学校学生中肥胖和血压升高的患病率。2014-2015学年学生的肥胖患病率为15.1%,血压升高的患病率为22.8%。“肥胖” 体重指数百分位类别的学生的血压患病率升高为44.2%,高于 “非肥胖” 类别的学生 (P <.001)。按性别和等级也观察到显着差异。结果表明需要支持实施和评估减少儿童肥胖和改善健康结果的政策。通过与学校合作以获取先前存在的健康数据,资源有限的州或地方卫生部门可以复制这些方法来开发儿童肥胖监测系统。
  • 【Α c螺旋位移作为蛋白质激酶变构调节的一般方法。】 复制标题 收藏 收藏
    DOI:10.1016/j.drudis.2012.11.009 复制DOI
    作者列表:Palmieri L,Rastelli G
    BACKGROUND & AIMS: :Owing to their crucial role in the modulation of cell pathways, protein kinases are important targets for several human diseases, including but not limited to cancer. The classic approach of targeting the ATP active site has recently come up against selectivity issues, which can be considerably reduced by following an allosteric modulation approach. Being closely related to protein kinase inactivation, allosteric targeting via displacement of the conserved structural αC helix enables a direct and specific modulation mechanism. A structure-based survey of the allosteric regulation of αC helix conformation in various kinase families is provided, highlighting key allosteric pockets and modulation mechanisms that appear to be more broadly conserved than was previously thought.
    背景与目标: : 由于其在调节细胞途径中的关键作用,蛋白激酶是多种人类疾病的重要靶标,包括但不限于癌症。靶向ATP活性位点的经典方法最近出现了选择性问题,通过采用变构调节方法可以大大减少选择性问题。与蛋白激酶失活密切相关,通过置换保守的结构 α c螺旋进行变构靶向可实现直接和特定的调节机制。提供了对各种激酶家族中 α c螺旋构象的变构调节的基于结构的调查,强调了关键的变构口袋和调节机制,这些机制似乎比以前认为的更为保守。
  • 【降低ST段抬高型心肌梗死放射状入路围手术期死亡率和出血率。来自ORPKI波兰国家注册中心的数据的倾向得分分析。】 复制标题 收藏 收藏
    DOI:10.4244/EIJ-D-17-00078 复制DOI
    作者列表:Siudak Z,Tokarek T,Dziewierz A,Wysocki T,Wiktorowicz A,Legutko J,Żmudka K,Dudek D
    BACKGROUND & AIMS: AIMS:We sought to evaluate bleeding complications and periprocedural outcomes of the radial approach (RA) as compared to the femoral approach (FA) during percutaneous coronary intervention (PCI) in "real-world" patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS:The study group consisted of 22,812 consecutive patients with STEMI treated with PCI and stent implantation between January 2014 and June 2015 in 151 tertiary invasive cardiology centres in Poland (the ORPKI Polish National Registry). Patients treated using the RA and FA were compared using a propensity score analysis to avoid possible selection bias. The analysis was carried out in an "as-treated" manner. The FA was used in 9,334 (40.9%) and the RA in 13,478 (59.1%) patients. After propensity score matching, a higher total amount of contrast (191.8±8.0 vs. 174.8±68.8 ml; p=0.001) and lower radiation doses (1,279.5±1,346.3 vs. 1,182.6±887 mGy; p=0.02) were reported in FA. More access-site-related bleeding complications after both angiography (0.17% vs. 0.02%; p=0.004) and PCI (0.23% vs. 0.09%; p=0.049) were reported in the FA group. Periprocedural death (1.94% vs. 0.93%; p=0.001) was more common after PCI performed with the FA. CONCLUSIONS:The radial approach was associated with a lower incidence of periprocedural death in STEMI patients as well as a significant reduction of bleeding complications at the access site.
    背景与目标:
  • 【遵循基于可水解酰基酶的机制的双底物酰基转移酶反应稳态动力学的理论方法。溶血磷脂酰胆碱的研究应用: rab的溶血磷脂酰胆碱酰基转移酶】 复制标题 收藏 收藏
    DOI:10.1042/bj2660047 复制DOI
    作者列表:Martín J,Pérez-Gil J,Acebal C,Arche R
    BACKGROUND & AIMS: :A kinetic model is proposed for catalysis by an enzyme that has several special characteristics: (i) it catalyses an acyl-transfer bi-substrate reaction between two identical molecules of substrate, (ii) the substrate is an amphiphilic molecule that can be present in two physical forms, namely monomers and micelles, and (iii) the reaction progresses through an acyl-enzyme-based mechanism and the covalent intermediate can react also with water to yield a secondary hydrolytic reaction. The theoretical kinetic equations for both reactions were deduced according to steady-state assumptions and the theoretical plots were predicted. The experimental kinetics of lysophosphatidylcholine:lysophosphatidylcholine acyltransferase from rabbit lung fitted the proposed equations with great accuracy. Also, kinetics of inhibition by products behaved as expected. It was concluded that the competition between two nucleophiles for the covalent acyl-enzyme intermediate, and not a different enzyme action depending on the physical state of the substrate, is responsible for the differences in kinetic pattern for the two activities of the enzyme. This conclusion, together with the fact that the kinetic equation for the transacylation is quadratic, generates a 'hysteretic' pattern that can provide the basis of self-regulatory properties for enzymes to which this model could be applied.
    背景与目标: : 提出了一种动力学模型,用于通过具有以下几个特殊特征的酶进行催化 :( i) 它催化两个相同的底物分子之间的酰基转移双底物反应,(ii) 底物是两亲分子,可以以两种物理形式存在,即单体和胶束,(iii) 反应通过基于酰基酶的机理进行,共价中间体也可以与水反应产生二次水解反应。根据稳态假设推导了两个反应的理论动力学方程,并预测了理论曲线。溶血磷脂酰胆碱的实验动力学: 来自兔肺的溶血磷脂酰胆碱酰基转移酶非常准确地拟合了所提出的方程。此外,产品抑制的动力学表现与预期的一样。结论是,两个亲核试剂之间对共价酰基酶中间体的竞争,而不是取决于底物物理状态的不同酶作用,是造成酶两种活性动力学模式差异的原因。该结论以及转酰化的动力学方程是二次的事实,产生了 “滞后” 模式,可以为可以应用该模型的酶提供自我调节特性的基础。
  • 【与消化类型和体重有关的大型食草动物的纤维消化率-体外方法。】 复制标题 收藏 收藏
    DOI:10.1016/j.cbpa.2012.10.026 复制DOI
    作者列表:Steuer P,Südekum KH,Müller DW,Kaandorp J,Clauss M,Hummel J
    BACKGROUND & AIMS: :The coexistence of different ungulate species in a given ecosystem has been the focus of many studies. Differences between ruminant foregut fermenters and hindgut fermenters were remarkable for example in the way they ingest and digest high fibre diets. Digestion trials based on total collections are difficult to conduct or are sometimes even not possible for wild animals in the field or in zoos. To gain information on the fibre digestion achieved by these animals and the influence of body mass (BM) thereon, a method using spot sampling is desirable. In this study, in vitro fermentation of faecal neutral detergent fibre (NDF) was used as a measure of fibre digestion in large ungulates. Food and faecal samples of 10 ruminant foregut fermenting and 7 hindgut fermenting species/breeds were collected. All animals received 100% grass hay with ad libitum access. The NDF of food and faeces was fermented in vitro in a Hohenheim gas test (HGT) for 96 h. The digestion type generally had an effect on the gas production (GP) of faecal NDF in the HGT with hindgut fermenters showing higher values than ruminant foregut fermenters. At any time interval of incubation, BM had no influence on GP. The results are in accordance with both findings that ruminant foregut fermenters have longer mean retention times and more comprehensive particle reduction and findings of a lack of influence of BM on digesta mean retention time. It can be stated that the HGT (96 h) is a useful and quick method to show also small differences within groups in fibre digestion.
    背景与目标: : 给定生态系统中不同有蹄类物种的共存一直是许多研究的重点。反刍动物前肠发酵罐和后肠发酵罐之间的差异很明显,例如它们在摄取和消化高纤维饮食的方式上。基于总收集物的消化试验很难进行,有时甚至无法进行野外或动物园中的野生动物。为了获得有关这些动物实现的纤维消化以及体重 (BM) 对其的影响的信息,需要使用斑点采样的方法。在这项研究中,粪便中性洗涤剂纤维 (NDF) 的体外发酵被用作大型有蹄类动物中纤维消化的量度。收集了10个反刍动物前肠发酵和7个后肠发酵物种/品种的食物和粪便样品。所有动物都可以随意访问100% 草干草。食物和粪便的NDF在Hohenheim气体测试 (HGT) 中体外发酵96小时。消化类型通常对HGT中粪便NDF的产气 (GP) 有影响,后肠发酵罐的产气值高于反刍前肠发酵罐。在任何孵育时间间隔,BM对GP均无影响。结果与反刍动物前肠发酵罐具有更长的平均保留时间和更全面的颗粒还原以及BM对消化平均保留时间缺乏影响的两个发现一致。可以说,HGT (96 h) 是一种有用且快速的方法,可以显示纤维消化组之间的微小差异。
  • 【减轻可卡因对细胞外多巴胺影响的直接方法: 靶向多巴胺转运蛋白。】 复制标题 收藏 收藏
    DOI:10.1002/(SICI)1098-2396(199708)26:4<423::AID-SYN10 复制DOI
    作者列表:Morgan AE,Porter SP,Clarkson FA,Volkow ND,Fowler JS,Dewey SL
    BACKGROUND & AIMS: Using in vivo microdialysis techniques, the effects of RTI-55 and/or cocaine on extracellular dopamine (DA) concentrations were measured in the nucleus accumbens (NACC) of freely moving rats. In control animals, cocaine (20 mg/kg) increased NACC DA approximately 458% 60 minutes following administration, returning to baseline values within 200 minutes. Similarly, RTI-55 administration (0.25 mg/kg) increased NACC DA levels approximately 347%. When combined, however, cocaine further increased NACC DA to 705% of baseline values when given 4 hours following RTI-55. This increase was significantly larger than cocaine alone (P < 0.05). In addition, chronic RTI-55 administration (5 days) further potentiated cocaine's ability to increase NACC DA (783%) but this did not reach statistical significance (P > 0.1) compared to acute RTI55/cocaine animals. These findings indicate that RTI-55, a drug that binds directly to the dopamine transporter (DAT) with higher affinity than cocaine, does not appear to be effective in attenuating cocaine's effects on NACC dopamine levels. In fact, acute RTI-55 potentiates cocaine's effects on NACC DA.

    背景与目标: 使用体内微透析技术,在自由运动的大鼠伏隔核 (NACC) 中测量了RTI-55和/或可卡因对细胞外多巴胺 (DA) 浓度的影响。在对照动物中,可卡因 (20 mg/kg) 在给药后约60分钟458% 增加NACC DA,在200分钟内恢复到基线值。类似地,RTI-55施用 (0.25 mg/kg) 使NACC DA水平增加约347%。然而,当合并时,当RTI-55后4小时给予时,可卡因进一步增加NACC DA至基线值的705%。这一增加显著大于单独使用可卡因 (P <0.05)。此外,慢性RTI-55给药 (5天) 进一步增强了可卡因增加NACC DA (783%) 的能力,但与急性RTI55/可卡因动物相比,这没有达到统计学意义 (P> 0.1)。这些发现表明,RTI-55是一种直接与多巴胺转运蛋白 (DAT) 结合的药物,其亲和力高于可卡因,似乎无法有效减轻可卡因对NACC多巴胺水平的影响。实际上,急性RTI-55增强了可卡因对NACC DA的影响。
  • 7 Dengue vaccines approach the finish line. 复制标题 收藏 收藏

    【登革热疫苗接近终点线。】 复制标题 收藏 收藏
    DOI:10.1086/518148 复制DOI
    作者列表:Edelman R
    BACKGROUND & AIMS: :The spread of dengue virus (DV) via its Aedes mosquito vector throughout most of the tropics has led to a worldwide resurgence of epidemic dengue, including dengue hemorrhagic fever. For the first time in 60 years, the pipeline of dengue vaccines looks promising. Strains of each of the 4 DV serotypes, attenuated by passage in tissue culture or by recombinant DNA technology, have been formulated into tetravalent vaccines and have entered successful phase 1 and 2 clinical trials in the United States and Southeast Asia. Antibody-dependent enhancement of wild-type DV infections by the vaccine represents a unique safety issue, which is under investigation. The Pediatric Dengue Vaccine Initiative (funded by the Bill and Melinda Gates Foundation), the World Health Organization, industry, the US military, and governments of tropical countries are collaborating to accelerate dengue vaccine development and phase 3 vaccine efficacy trials in countries where dengue is endemic. A protective tetravalent vaccine must be licensed soon if dengue is to be brought under control.
    背景与目标: : 登革热病毒 (DV) 通过其伊蚊传播媒介在整个热带地区的传播导致了包括登革出血发热在内的全球流行登革热的复兴。60年来第一次,登革热疫苗的管道看起来很有希望。通过组织培养中的传代或通过重组DNA技术减弱的4种DV血清型中的每种菌株已被配制成四价疫苗,并已在美国和东南亚成功进入1期和2期临床试验。疫苗对野生型DV感染的抗体依赖性增强是一个独特的安全性问题,正在研究中。小儿登革热疫苗倡议 (由比尔和梅琳达·盖茨基金会资助),世界卫生组织,工业界,美国军方和热带国家的政府正在合作,以加快登革热国家的登革热疫苗开发和3期疫苗功效试验流行。如果要控制登革热,必须尽快获得保护性四价疫苗的许可。
  • 【从参与式行动研究方法研究中风后社区生活和参与的障碍和支持。】 复制标题 收藏 收藏
    DOI:10.1310/5X2G-V1Y1-TBK7-Q27E 复制DOI
    作者列表:Hammel J,Jones R,Gossett A,Morgan E
    BACKGROUND & AIMS: :This participatory action research study focused on identifying community participation goals, barriers, and supports/strategies in partnership with people who have experienced a stroke. Goals demonstrate that participation is more than activity performance in context; instead, it relates to "being a part of" the community and having access to participation opportunities and supports. Results of community site audits from the first 20 participants document environmental (physical, cognitive, social) and system level barriers, as well as effective strategies for promoting participation via environmental modification and systems level changes. A consumer-directed, Web-based tool for documenting participation barriers and sharing strategies is discussed.
    背景与目标: : 这项参与性行动研究的重点是与中风患者合作,确定社区参与的目标,障碍和支持/策略。目标表明,参与不仅仅是活动绩效。相反,它与 “成为社区的一部分” 并获得参与机会和支持有关。前20名参与者的社区现场审核结果记录了环境 (物理,认知,社会) 和系统级障碍,以及通过环境修改和系统级变化促进参与的有效策略。讨论了一种以消费者为导向的基于Web的工具,用于记录参与障碍和共享策略。
  • 【比赛的自由市场方法: 时机尚未到来的提案。】 复制标题 收藏 收藏
    DOI:10.1097/ACM.0000000000001782 复制DOI
    作者列表:Arnold L,Sullivan C,Okah FA
    BACKGROUND & AIMS: :The authors respond to a proposal in this issue of Academic Medicine by Ray, Bishop, and Dow, who recommend adopting a free-market approach to the Match in which applicants and programs negotiate directly with each other to find and fill residency positions year-round. This Invited Commentary examines and responds to the reasons Ray and colleagues give for changing the Match and explores their proposal's implications and likelihood of success.The authors question Ray and colleagues' argument that assumptions underlying the National Resident Matching Program algorithm have been violated. The authors suggest there is insufficient evidence for the "July effect" and that the possibility for improvement in physician supply due to the year-round entry of graduates into the workforce ultimately faces the rate-limiting step of caps on residency positions allocated to programs. Most important, competency-based medical education, on which the free-market proposal depends, is not yet sufficiently developed.Nonetheless, the imbalanced ratio of applicants to positions in the Match is contributing to a rise in the numbers of student applications and program interviews. Although the proposed free-market approach might, as Ray and colleagues envision, curtail applications as well as reduce time and financial resources currently expended on the process, it would require significant changes on the part of applicants, residency programs, medical schools, and other stakeholders.Because the proposed free-market approach could reduce some negative effects of the imbalance of applicants and positions, it merits ongoing discussion along with other more immediate practical solutions to issues with the Match.
    背景与目标: : 作者回应了Ray,Bishop和Dow在本期《学术医学》中的一项建议,他们建议采用自由市场的方法进行匹配,在该方法中,申请人和计划直接彼此进行谈判以找到并填补居住职位全年。这篇邀请的评论研究并回应了Ray和同事提出的改变比赛的原因,并探讨了他们的建议的含义和成功的可能性。作者质疑Ray和同事的论点,即违反了国家居民匹配计划算法的假设。作者认为,没有足够的证据证明 “7月效应”,并且由于毕业生全年进入劳动力市场而改善医生供应的可能性最终面临分配给住院医师职位上限的限速步骤程序。自由市场提案所依赖的最重要的基于能力的医学教育尚未得到充分发展。尽管如此,比赛中申请人与职位的不平衡比例正在导致学生申请和计划面试的数量增加。尽管如Ray及其同事所设想的那样,拟议的自由市场方法可能会减少申请并减少目前在该过程中花费的时间和财务资源,但这将需要申请人,居住计划,医学院,和其他利益相关者。由于提议的自由市场方法可以减少申请人和职位不平衡的一些负面影响,因此值得持续讨论以及其他更直接的实际解决方案来解决匹配问题。
  • 【通过结合临床,放射学和胸水分析参数来预测恶性和副恶性胸腔积液。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:2017-10-01
    来源期刊:Lung
    DOI:10.1007/s00408-017-0032-3 复制DOI
    作者列表:Herrera Lara S,Fernández-Fabrellas E,Juan Samper G,Marco Buades J,Andreu Lapiedra R,Pinilla Moreno A,Morales Suárez-Varela M
    BACKGROUND & AIMS: BACKGROUND:The usefulness of clinical, radiological and pleural fluid analytical parameters for diagnosing malignant and paramalignant pleural effusion is not clearly stated. Hence this study aimed to identify possible predictor variables of diagnosing malignancy in pleural effusion of unknown aetiology. METHODS:Clinical, radiological and pleural fluid analytical parameters were obtained from consecutive patients who had suffered pleural effusion of unknown aetiology. They were classified into three groups according to their final diagnosis: malignant, paramalignant and benign pleural effusion. The CHAID (Chi-square automatic interaction detector) methodology was used to estimate the implication of the clinical, radiological and analytical variables in daily practice through decision trees. RESULTS:Of 71 patients, malignant (n = 31), paramalignant (n = 15) and benign (n = 25), smoking habit, dyspnoea, weight loss, radiological characteristics (mass, node, adenopathies and pleural thickening) and pleural fluid analytical parameters (pH and glucose) distinguished malignant and paramalignant pleural effusions (all with a p < 0.05). Decision tree 1 classified 77.8% of malignant and paramalignant pleural effusions in step 2. Decision tree 2 classified 83.3% of malignant pleural effusions in step 2, 73.3% of paramalignant pleural effusions and 91.7% of benign ones. CONCLUSIONS:The data herein suggest that the identified predictor values applied to tree diagrams, which required no extraordinary measures, have a higher rate of correct identification of malignant, paramalignant and benign effusions when compared to techniques available today and proved most useful for usual clinical practice. Future studies are still needed to further improve the classification of patients.
    背景与目标:
  • 【为土著卫生人员确定多层次的文化上适当的戒烟策略: 一种概念映射方法。】 复制标题 收藏 收藏
    DOI:10.1093/her/cys111 复制DOI
    作者列表:Dawson AP,Cargo M,Stewart H,Chong A,Daniel M
    BACKGROUND & AIMS: :Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.
    背景与目标: : 澳大利亚原住民,包括土著卫生工作者 (ahw),吸烟率是非土著人口的两倍。这项研究利用概念映射方法来确定和确定与文化相关的策略以促进ahw戒烟。利益相关者参与者包括AHWs,其他卫生服务员工和烟草控制人员。通过34次访谈,3个焦点小组和利益相关者研讨会,对戒烟策略 (n = 74) 进行了头脑风暴。利益相关者将策略分为有意义的组,并根据感知的重要性和可行性对其进行评分。使用多维缩放和分层聚类分析开发了概念图。描述了十种独特的戒烟策略,这些策略针对个人,家庭和同龄人,社区,工作场所和公共政策。除更广泛的策略外,还提供了戒烟资源和服务,以解决使吸烟永久化并使戒烟困难的社会和环境压力源。与社区控制相比,在政府协调的卫生服务中工作的参与者对集群的重要性和可行性的评价有所不同。对于弱势人群中的卫生服务工作者,这些发现显然暗示了除了传统的烟草控制策略之外,还需要有针对性的策略来减轻社会和环境压力。概念图已应用于知识翻译中,以指导ahw戒烟计划的开发。
  • 【慢性嗳气患者的简单基于办公室的行为方法。】 复制标题 收藏 收藏
    DOI:10.1111/dote.12006 复制DOI
    作者列表:Katzka DA
    BACKGROUND & AIMS: :Chronic belching can be a difficult and socially disabling symptom often attributed to reflux with poor response to therapy. In patients where aerophagia is identified as a clear cause, treatment with baclofen may not be tolerated, and biofeedback therapy is time-intensive and may still not be effective. In this pilot study, an office-based easy-to-perform method based on sustained glottal opening was used in five patients with chronic belching, in whom reflux and other causes had been excluded. Treatment consisted of having the patient breathe slowly and diaphragmatically with his or her mouth open during supine, then sitting periods to prevent belching. When this was successful, patients were then counseled on continuing this breathing with mouth slightly ajar as an outpatient using this persistently. Wide mouth opening was used for rescue therapy of belching attacks. All five patients responded to the office-based therapy with complete cessation of belching during the visit. At 1-month follow up, four patients remained asymptomatic. One patient was asymptomatic but for two breakthrough attacks easily managed with the protocol. A simple office-based procedure based on complete glottal opening can be curative for a subset of patients with chronic eructation secondary to repetitive air swallowing.
    背景与目标: : 慢性嗳气可能是一种困难的社交障碍症状,通常归因于对治疗反应不佳的反流。在明确原因为吞气症的患者中,可能无法耐受巴氯芬的治疗,并且生物反馈疗法需要时间,并且可能仍然无效。在这项初步研究中,基于持续声门开放的基于办公室的易于执行的方法被用于五名慢性being的患者,其中排除了反流和其他原因。治疗包括让患者在仰卧时张着嘴缓慢地呼吸和隔膜,然后坐着以防止嗳气。成功后,建议患者继续使用这种呼吸,使其保持半开的嘴巴,作为持续使用这种呼吸的门诊患者。张开嘴巴用于抢救of气袭击。所有五名患者都对基于办公室的治疗做出了反应,在就诊期间完全停止了being气。在1个月的随访中,有4名患者无症状。一名患者无症状,但两次突破性发作很容易通过该方案进行。基于完全声门开放的简单的基于办公室的程序可以治愈一部分继发于反复吞咽空气的慢性勃起患者。
  • 【冠状动脉异常: 塑造具有挑战性问题景观的多学科方法。】 复制标题 收藏 收藏
    DOI:10.1111/chd.12490 复制DOI
    作者列表:Molossi S,Agrawal H
    BACKGROUND & AIMS: :Coronary artery anomalies, particularly anomalous aortic origin of a coronary artery with an interarterial course, are associated with sudden cardiac arrest or death in the young. There is paucity of data on risk stratification and longitudinal follow up is lacking in these patients. Collaboration and sharing of data among specialized centers might shed much needed light in this complex problem.
    背景与目标: : 冠状动脉异常,特别是具有动脉间病程的冠状动脉异常主动脉起源,与年轻人的心脏骤停或死亡有关。关于风险分层的数据很少,这些患者缺乏纵向随访。在这个复杂的问题上,专业中心之间的协作和数据共享可能会提供急需的信息。
  • 【新型吡咯并吡啶酮衍生物作为针对Cdc7的抗癌抑制剂: 基于溶剂化评分方法的对接的QSAR研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.ejps.2013.07.013 复制DOI
    作者列表:Wu X,Zeng H,Zhu X,Ma Q,Hou Y,Wu X
    BACKGROUND & AIMS: :A series of pyrrolopyridinone derivatives as specific inhibitors towards the cell division cycle 7 (Cdc7) was taken into account, and the efficacy of these compounds was analyzed by QSAR and docking approaches to gain deeper insights into the interaction mechanism and ligands selectivity for Cdc7. By regression analysis the prediction models based on Grid score and Zou-GB/SA score were found, respectively with good quality of fits (r(2)=0.748, 0.951; r(cv)(2)=0.712, 0.839). The accuracy of the models was validated by test set and the deviation of the predicted values in validation set using Zou-GB/SA score was smaller than that using Grid score, suggesting that the model based on Zou-GB/SA score provides a more effective method for predicting potencies of Cdc7 inhibitors.
    背景与目标: : 考虑了一系列吡咯并吡啶酮衍生物作为针对细胞分裂周期7 (Cdc7) 的特异性抑制剂,并通过QSAR和对接方法分析了这些化合物的功效,以更深入地了解Cdc7的相互作用机理和配体选择性。通过回归分析,发现基于网格得分和zou-gb/SA得分的预测模型拟合质量良好 (r(2)= 0.748,0.951; r(cv)(2)= 0.712,0.839)。通过测试集验证了模型的准确性,使用zou-gb/SA评分的验证集的预测值的偏差小于使用网格评分的预测值的偏差,这表明基于zou-gb/SA评分的模型为预测Cdc7抑制剂的效力提供了更有效的方法。
  • 【一种使用基于激光的直接体积测量设备确定固体分数的新方法。】 复制标题 收藏 收藏
    DOI:10.3109/10837450.2013.813540 复制DOI
    作者列表:Iyer RM,Hegde S,Singhal D,Malick W
    BACKGROUND & AIMS: :Material properties play a significant role in pharmaceutical processing. In the present study, a novel approach is used to determine solid fraction (SF) based on a direct measurement (DM) of the apparent volume of a sample. The sample was scanned with low intensity laser beams that integrate the sample thickness across the surface (area) and quantitate the apparent volume. The SF by DM method was compared against that obtained by volume displacement (VD) and manual measurement methods. SF was determined by all three methods for formulations of Avicel DG, lactose and a 1:1 mixture of the two. The results from DM method and variability were comparable to that obtained by VD method. The manual method provided lower and more variable results. The DM method was able to differentiate between SF of different ribbon and tablet formulations and at varying force levels. Tracking SF of compacts during tablet development can help in setting acceptable specifications and to understand material deformation behavior during compression. Further, the results of the study indicate that the DM method using laser scan technique was suitable for routine testing of SF of roller compacted ribbons and compressed tablets.
    背景与目标: : 材料特性在药物加工中起着重要作用。在本研究中,一种新颖的方法用于基于样品表观体积的直接测量 (DM) 来确定固体分数 (SF)。用低强度激光束扫描样品,该激光束整合了整个表面 (区域) 的样品厚度并定量了表观体积。将DM方法的SF与通过体积位移 (VD) 和手动测量方法获得的SF进行了比较。SF通过所有三种方法测定Avicel DG,乳糖和两者的1:1混合物的配方。DM方法和变异性的结果与VD方法的结果相当。手动方法提供了更低和更可变的结果。DM方法能够区分不同色带和片剂配方的SF以及不同的力水平。在平板电脑开发过程中跟踪压坯的SF可以帮助设置可接受的规格并了解压缩过程中的材料变形行为。此外,研究结果表明,使用激光扫描技术的DM方法适用于常规测试辊压带和压片的SF。

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