简介：AbstractBackground:Although endovascular therapy has been widely used for focal aortoiliac occlusive disease (AIOD), its performance for extensive AIOD (EAIOD) is not fully evaluated. We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency.Methods:Between January 2008 and June 2018, patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II (TASC II) C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled. Demographic, diagnosis, procedure characteristics, and follow-up information were reviewed. Univariate analysis was used to identify the correlation between the variables and the primary patency. A multivariate logistic regression model was used to identify the independent risk factors associated with primary patency. Five- and 10-year primary and secondary patency, as well as survival rates, were calculated by Kaplan-Meier analysis.Results:A total of 148 patients underwent endovascular treatment in our center. Of these, 39.2% were classified as having TASC II C lesions and 60.8% as having TASC II D lesions. The technical success rate was 88.5%. The mean follow-up time was 79.2 ± 29.2 months. Primary and secondary patency was 82.1% and 89.4% at 5 years, and 74.8% and 83.1% at 10 years, respectively. The 5-year survival rate was 84.2%. Compared with patients without loss of primary patency, patients with this condition showed significant differences in age, TASC II classification, infrainguinal lesions, critical limb ischemia (CLI), and smoking. Multivariate logistic regression analysis showed age <61 years (adjusted odds ratio [aOR]: 6.47; 95% CI: 1.47-28.36; P = 0.01), CLI (aOR: 7.81; 95% CI: 1.92-31.89; P = 0.04), and smoking (aOR: 10.15; 95% CI: 2.79-36.90; P < 0.01) were independent risk factors for the loss of primary patency.Conclusions:Endovascular therapy was an effective treatment for EAIOD with encouraging patency and survival rate. Age <61 years, CLI, and smoking were independent risk factors for the loss of primary patency.

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简介：Thecurrentulcerativecolitis(UC)treatmentalgorithminvolvesastep-uptherapeuticstrategy,mainlyaimingatinducingandmaintainingitsclinicalremission.Althoughthistherapeuticstrategymayseemtobecost-efficientandreducetheriskofsideeffects,recenttrialsandcasereportshaveshownthattop-downtherapyusingin·iximabinducesarapidclinicalresponse,enhancespatientqualityoflife,promotesmucosalhealing,reducessurgeriesandindirectcostoftreatmentforpatientswithsevereUC.Moreover,sincelong-termtreatmentwithin·iximabissafeandwelltolerated,earlyaggressivetop-downtherapeuticstrategymaybeamoreeffectiveapproach,atleastinasubgroupofsevereextensiveUCpatients.

简介：IntroductionExtensiveReading,asthenameindicates,isaguideforstudentsintothevastseaofknowledge.Readingdemonstratestostudentsthatthereisnoendinlearningknowledge.However,readingandlanguagelearningbasedontextbooksisfarfromenoughbecausetheknowledgefromthemistoonarrow,thevocabularyistoolimitedandthecontentsarenotcurrentenoughinthesetimesofinformationexchange.Throughoutmyteachingexperiments,Ihavefoundthatnewspaperclippingscanbecomeaverygoodwaytobringmorebenefitstostudents’learningthanIexpected.Itcanbroadenthestudents’horizons,

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简介：Extensiveaneurysmsinvolvingtheascendingaorta,aorticarch,andthedescendingaortastandasatherapeuticdilemmainsimultaneousmanagementofmultiplesitesofpathologyoftheaorticarchandthedescendingthoracicaorta.Wesystematicallyreviewedaboutliteraturesofstentedelephanttrunkoperation(SET)identifiedthroughsearchesoftheelectronicdatabasesEMBASEandMedline,andaimedtosummarizestudiesofpatientsundergoingSETforextensiveaneurysms.Since1996,KatoMintroducedahybridtechniquebyusingstentedgraftimplantationtothedescendingaortafortreatmentofthoracicaorticaneurysmordissection.Ithasbeendescribeagoodoptionforextensivethoracicaorticaneurysmsandinafashionsimilartotheelephanttrunktechnique.

简介：Ltmedisease(Lymeborreliosis)iscausedbythetick-bornespiro-elraeteBorreliaburgdooCeri.Erythemamigrans,anearlyskinlesion,isthemostcommonclinicalpresentation.Theorganismmayspread,causingvariouslatermanifestations.

简介：春季是传染性疾病的高发时段，预防工作一定要做到及时、有效。也许从下面的短文中我们可以得到一些启示！

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简介：LastWednesday,AgricultureSecretaryAnnVenemanannouncedthefirstcaseofmadcowdiseaseintheUnitedStates.Atestseemedtoshowbovinespongiformencephalopathy,orB-S-E.inacowfromWashingtonstate.Thenextday,alaboratoryinWaybridge,England,Confirmed(证实）thecase。

简介：印射响应许多ligands和房间刺激涉及大量的细胞的小径和功能的家族asestransduce信号。MAPK的异常或不恰当的功能现在在从癌症到煽动性的疾病到肥胖和糖尿病的疾病被识别了。在许多房间类型，MAPKERK1/2被连接到细胞增殖。因为在地岬和B-Raf的变化，能激活ERK1/2串联，在许多人的肿瘤被发现，ERK1/2被认为在一些癌症起一个作用。发信号的反常ERK1/2也在polycystic肾疾病被发现了，并且象cardio-facio-cutaneous症候群那样的严肃的发展混乱在ERK1/2串联的部件从变化产生。ERK1/2在区分得好的房间是必要的并且在神经原并且在上皮的极性的维护被连接了到长期的potentiation。另外，ERK1/2为在胰腺的贝它房间的胰岛素基因抄写是重要的，它响应传播葡萄糖的增加生产胰岛素在有机体允许有效葡萄糖利用和存储。导致或镇压的营养素和荷尔蒙胰岛素分泌物以在贝它房间上反映能分泌的需求的一种方式激活或禁止ERK1/2。在这和另外的规章的小径的骚乱可以导致对某些人的混乱的病原学的ERK1/2的贡献。

简介：Asthmadevelopsinaboutoneadultperthousandpopulationperyear,andepidemiologicalstudiesindicatethatabout10%ofcasescanbeattributedtoexposuresatwork.However,occupationalasthmaisidentifiedlesscommonlythanthisinclinicalpractice;anincidenceof800-1000casesperyearisestimatedbytheUKSurveillanceofWork-RelatedandOccupationalRespiratoryDiseasescheme.Occupationalasthmaiseasilymissedbecause,apartfromitsassociationwithwork,

简介：HeartdiseaseistheleadingkillerofAmericans.Butitkillsmorewomenthanmen.TheAmericanHeartAssociationsaysheartdiseaseandothercardiovascular(心血管的)disorderskillaboutfivehundredthousandwomenayear.Thatismorethanthenextsevencausesofdeathcombined.

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简介：AbstractBackground:The prevalence rates of freezing of gait (FOG) in Parkinson’s disease (PD) vary widely, ranging from 14.0 to 55.1%. Our aim is to calculate the overall prevalence of FOG in all PD patients with different disease durations and severities.Methods:Using Medline/PubMed/Embase, we carried out a systematic literature search for studies reporting the PD and clinically relevant FOG.Results:After primary screening, a total of 35 studies were identified and further analyzed for inclusion into the analysis, and 29 studies fulfilled the quality criteria and included in this meta-analysis. The overall prevalence of FOG in PD was 39.9% (95% CI 35.3-44.5%). The FOG identified by the freezing of gait questionnaire item 3 may be more prevalent (43.8%, 95% CI 38.5-49.1%) than the FOG identified by the Unified Parkinson’s Disease Rating Scale item 14 (36.0%, 95% CI 29.0-43.1%). Disease duration and severity are both the clinical features associated with the FOG. The highest FOG prevalence rate in PD patients was seen in patients with disease durations ≥ 10 years, at 70.8%, followed that of PD patients with disease durations ≥ 5 years (53.3%), and PD patients with disease durations < 5 years (22.4%). FOG presented in 28.4% of PD patients with Hoehn and Yahr staging (H&Y) score ≤ 2.5, and in 68.4% of PD patients with H&Y score ≥ 2.5.Conclusion:This meta-analysis confirms that the prevalence of FOG in PD is considerable, and highlights the need for accurate identification of FOG in PD.

简介：AbstractBackgroundSince early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.MethodsPatients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to 3 tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-squared test or Fisher’s exact test. Logistic regression analysis was performed to explore the risk factors for disease progression.ResultsSeventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U= 4.932, P= 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2 = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U= 2.057, P= 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ2 = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U= 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U= 1.315, P= 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2 = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628-44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; P= 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, P= 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, P = 0.028) were risk factors for disease progression.ConclusionsSeveral factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature at admission, respiratory failure, albumin, and C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.

简介：Paget'sdiseaseofboneisafocaldisorderofboneremodellingcausedbyabnormallyincreasedosteoclast-mediatedboneresorption.qtleaffectedboneschangeinshaw,sizeanddirection,whiletherestoftheskeletonremainsnormal.TheclinicalconsequencesofthediseasewerefirstdescribedbySirJanlesPagetin1876(Figure1).

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简介：Agluten-freedietiscurrentlytheonlyeffectivemeansoftreatingindividualswithceliacdisease.Suchadietenablesceliacpatientstocontroltheirsymptomsandavoidvariouscomplicationsassociatedwiththiscondition.However,whilethequalityofgluten-freefoodshassignificantlyimprovedduringrecentdecades,maintenanceofagluten-freedietdoesnotnecessarilyensureadequatenutritionalintake.Becauseoatsareanimportantsourceofproteins,lipids,vitamins,minerals,andfibre,theirinclusioninagluten-freedietmightimprovethenutritionalstatusofaceliacpatient.AlthoughoatsareincludedinthelistofglutenfreeingredientsspecifiedinEuropeanregulations,theirsafetywhenconsumedbyceliacpatientsremainsdebatable.Somestudiesclaimthatpureoatsaresafeformostceliacpeople,andcontaminationwithothercerealsourcesisthemainproblemfacingpeoplewiththisdisease.However,itisnecessarytoconsiderthatoatsincludemanyvarieties,containingvariousaminoacidsequencesandshowingdifferentimmunoreactivitiesassociatedwithtoxicprolamins.Asaresult,severalstudieshaveshownthattheimmunogenicityofoatsvariesdependingonthecultivarconsumed.Thus,itisessentialtothoroughlystudythevarietyofoatsusedinafoodingredientbeforeincludingitinagluten-freediet.