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Weight loss increases skeletal muscle mitochondrial energy efficiency in obese mice

Life Metabolism 2023年第2期2卷 23-34页

作者： Patrick J.Ferrara Marisa J.Lang Jordan M.Johnson Shinya Watanabe Kelsey L.McLaughlin John Alan Maschek anthony R.P.Verkerke Piyarat Siripoksup Amandine Chaix James E.Cox Kelsey H.Fisher-Wellman Katsuhiko Funai Diabetes&Metabolism Research Center University of UtahSalt Lake CityUtah 84112United States Department of nutrition&Integrative Physiology University of UtahSalt Lake CityUtah 84112United States East Carolina Diabetes&Obesity Institute East Carolina UniversityGreenvilleNorth Carolina 27834United States Department of Physiology East Carolina UniversityGreenvilleNorth Carolina 27834United States Metabolomics Core Research Facility University of UtahSalt Lake CityUtah 84112United States Molecular Medicine Program University of UtahSalt Lake CityUtah 84112United States Department of Biochemistry University of UtahSalt Lake CityUtah 84112United States

Weight loss from an overweight state is associated with a disproportionate decrease in whole-body energy expenditure that may contribute to the heightened risk for weight *** suggests that this energetic mismatch originates from lean *** this phenomenon is well documented,the mechanisms have remained *** hypothesized that increased mitochondrial energy efficiency in skeletal muscle is associated with reduced expenditure under weight ***(WT)male C57BL6/n mice were fed with high-fat diet for 10 weeks,followed by a subset of mice that were maintained on the obesogenic diet(OB)or switched to standard chow to promote weight loss(WL)for additional 6 *** energy efficiency was evaluated using high-resolution respirometry and *** spectrometric analyses were employed to describe the mitochondrial proteome and *** loss promoted~50%increase in the efficiency of oxidative phosphorylation(ATP produced per O_(2) consumed,or P/O)in skeletal ***,Weight loss did not appear to induce significant changes in mitochondrial proteome,nor any changes in respiratory supercomplex ***,it accelerated the remodeling of mitochondrial cardiolipin(CL)acyl-chains to increase tetralinoleoyl CL(TLCL)content,a species of lipids thought to be functionally critical for the respiratory *** further show that lowering TLCL by deleting the CL transacylase tafazzin was sufficient to reduce skeletal muscle P/O and protect mice from diet-induced weight *** findings implicate skeletal muscle mitochondrial efficiency as a novel mechanism by which weight loss reduces energy expenditure in obesity.

关键词： energy efficiency energy expenditure mitochondria oxidative phosphorylation phospholipids weight loss

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首尔国立大学美术馆

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城市环境设计 2014年第6期83卷 76-81页

作者： Minsuk Cho Wim Eckert Roberto Otero Shiro Ogata George Bucher Piet Eckert Young Joon Kim anthony Fonfenot Philipp Oswalt Tae Hong Park Andreas Huhn Rodrigo Patricio Sabine Schaaf Rob de Maat Franz Blok Don Weber Pilar Armand-Ugón Emese Barcosi Matteo Poli Isabel Silva Isabel Gasanellas

首尔国立大学美术馆位于大学校园入口附近的小山丘边,它的选址造就了它的特色。我们基本上可以把大楼看作一个矩形盒子,但这个盒子理论上因为倾斜的山坡而被对角割开了。此建筑靠小小的中央核心点支撑着,由于这是它与地面的唯一接触点,... 详细信息

首尔国立大学美术馆位于大学校园入口附近的小山丘边,它的选址造就了它的特色。我们基本上可以把大楼看作一个矩形盒子,但这个盒子理论上因为倾斜的山坡而被对角割开了。此建筑靠小小的中央核心点支撑着,由于这是它与地面的唯一接触点,因此它几乎是完全的悬桁结构,随着山势向上、下伸展,准确地顺应着地貌形势而建。

关键词：首尔国立大学美术馆美术博物馆博物馆

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陌生的方法——布鲁门伯格与罗蒂论隐喻

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跨文化研究 2019年第2期 49-68,272页

作者：安东尼·雷诺兹林振华(译) 美国纽约大学广东省深圳市福田区城市绿洲学校

隐喻乃帮助人类进步的实用工具,对隐喻的这个理解仍然是布鲁门伯格著作的重要假设,同时也成为罗蒂新实用主义的研究方法。布氏的隐喻学影响了罗蒂,而罗蒂也以布氏为同道。布氏为罗蒂提供了一个思想史模型,按其设想,这是绝对隐喻(其在传... 详细信息

隐喻乃帮助人类进步的实用工具,对隐喻的这个理解仍然是布鲁门伯格著作的重要假设,同时也成为罗蒂新实用主义的研究方法。布氏的隐喻学影响了罗蒂,而罗蒂也以布氏为同道。布氏为罗蒂提供了一个思想史模型,按其设想,这是绝对隐喻(其在传统中仍具有潜在可操作性)的概念不断恢复或转化的过程。另外,布氏还为罗蒂呈现了一个设想为哲学实用主义的起源(和胜利)的现代性模型。不过,二人的研究仍然有很大差别,因为罗蒂开创的方法与布氏的隐喻学方法方枘圆凿。布氏眼中隐喻的实用作用,其实是其隐喻学研究的对象而非方法。隐喻湮没于语言的本义,然后才谈得上实用主义的胜利;而隐喻学的任务在于,点明那些在日趋实用的过程中变得平常的隐喻。

关键词：布鲁门伯格罗蒂隐喻

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会计学教程与案例原书第10版

会计学教程与案例原书第10版

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2001年

作者：（美）安东尼（anthony R.n.）（美）霍金斯（Hawkins D.F.）（美）麦钱特（Merchant K.A.）王立彦徐惠玲刘军霞陈沅译

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Empirical estimates of regional carbon budgets imply reduced global soil heterotrophic respiration

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national Science Review 2021年第2期8卷 60-73页

作者： Philippe Ciais Yitong Yao Thomas Gasser Alessandro Baccini Yilong Wang Ronny Lauerwald Shushi Peng Ana Bastos Wei Li Peter A.Raymond Josep G.Canadell Glen P.Peters Rob J.Andres Jinfeng Chang Chao Yue A.Johannes Dolman Vanessa Haverd Jens Hartmann Goulven Laruelle Alexandra G.Konings anthony W.King Yi Liu Sebastiaan Luyssaert Fabienne Maignan Prabir K.Patra Anna Peregon Pierre Regnier Julia Pongratz Benjamin Poulter Anatoly Shvidenko Riccardo Valentini Rong Wang Grégoire Broquet Yi Yin Jakob Zscheischler Bertrand Guenet Daniel S.Goll Ashley-P.Ballantyne Hui Yang Chunjing Qiu Dan Zhu State Key Laboratory of Soil Erosion and Dryland Farming on the Loess Plateau Northwest A&F University CSIRO Oceans and Atmosphere 15. Institute for Geology CEN—Center for Earth System Research and SustainabilityUniversity of Hamburg 16. Department of Earth System ScienceStanford University 17. Department of Earth System ScienceStanford UniversityStanford 18. School of Geographical SciencesNanjing University of Information Science and Technology 19. Department of Ecological SciencesVrije Universiteit Amsterdam 20. Research Institute for Global ChangeJAMSTEC Laboratoire des Sciences du Climat et de l'Environnement CEA-CNRS-UVSQ-UPSACLAY Center for Environmental Remote Sensing Chiba University Institute of Soil Science and Agrochemistry Siberian Branch of the Russian Academy of Sciences (SB RAS) Tuva State University Republic of Tuva Max Planck Institute for Meteorology nASA Goddard Space Flight Center Biospheric Sciences Lab. 26. Department for Innovation in BiologicalAgro-food and Forest systems (DIBAF)University of Tuscia RUDn University Department of Environmental Science and Engineering Shanghai Key Laboratory of Atmospheric Particle Pollution and PreventionInstitute of Atmospheric SciencesFudan University 29. Division of Geological and Planetary SciencesCalifornia Institute of Technology 30. Climate and Environmental Physics and Oeschger Centre for Climate Change ResearchUniversity of Bern 31. Department of Ecosystem and Conservation Sci

Resolving regional carbon budgets is critical for informing land-based mitigation policy. For nine regions covering nearly the whole globe, we collected inventory estimates of carbon-stock changes complemented by satellite estimates of biomass changes where inventory data are missing. The net land–atmospheric carbon exchange(nEE) was calculated by taking the sum of the carbon-stock change and lateral carbon fluxes from crop and wood trade, and riverine-carbon export to the ocean. Summing up nEE from all regions, we obtained a global ‘bottom-up’ nEE for net land anthropogenic CO2uptake of –2.2 ± 0.6 Pg C yr-1consistent with the independent top-down nEE from the global atmospheric carbon budget during 2000–2009. This estimate is so far the most comprehensive global bottom-up carbon budget accounting, which set up an important milestone for global carbon-cycle studies. By decomposing nEE into component fluxes, we found that global soil heterotrophic respiration amounts to a source of CO2of 39 Pg C yr-1with an interquartile of 33–46 Pg C yr-1—a much smaller portion of net primary productivity than previously reported.

关键词： carbon budget human appropriation of ecosystems soil carbon

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Risk factors for fracture in adult kidney transplant recipients

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World Journal of Transplantation 2016年第2期6卷 370-379页

作者： Kyla L naylor Guangyong Zou William D Leslie anthony B Hodsman ngan n Lam Eric McArthur Lisa-Ann Fraser Gregory A Knoll Jonathan D Adachi S Joseph Kim Amit X Garg Institute for Clinical Evaluative Sciences 2nd Institute of Health Policy Management and EvaluationUniversity of Toronto Department of Epidemiology and Biostatistics Western University Department of Medicine University of Manitoba Division of nephrology Western University Division of nephrology University of Alberta Division of Endocrinology Western University Division of nephrology Kidney Research CentreOttawa Hospital Research InstituteUniversity of Ottawa Division of Rheumatology McMaster University Division of nephrology University Health NetworkUniversity of Toronto

AIM: To determine the general and transplant-specific risk factors for fractures in kidney transplant ***: We conducted a cohort study of all adults who received a kidney-only transplant(n = 2723) in Ontario, Canada between 2002 and 2009. We used multivariable Cox proportional hazards regression to determine general and transplant-specific risk factors for major fractures(proximal humerus, forearm, hip, and clinical vertebral). The final model was established using the backward elimination strategy, selecting risk factors with a P-value ≤ 0.2 and forcing recipient age and sex into the model. We also assessed risk factors for other fracture locations(excluding major fractures, and fractures involving the skull, hands or feet). RESULTS: There were 132 major fractures in the follow-up(8.1 fractures per 1000 person-years). General risk factors associated with a greater risk of major fracture were older recipient age [adjusted hazard ratio(a HR) per 5-year increase 1.11, 95%CI: 1.03-1.19] and female sex(a HR = 1.81, 95%CI: 1.28-2.57). Transplant-specific risk factors associated with a greater risk of fracture included older donor age(5-year increase)(a HR = 1.09, 95%CI: 1.02-1.17) and end-stage renal disease(ESRD) caused by diabetes(a HR = 1.72, 95%CI: 1.09-2.72) or cystic kidney disease(a HR = 1.73, 95%CI: 1.08-2.78)(compared to glomerulonephritis as the reference cause). Risk factors across the two fracture locations were not consistent(major fracture locations vs other). Specifically, general risk factors associated with an increased risk of other fractures were diabetes and a fall with hospitalization prior to transplantation, while length of time on dialysis, and renal vascular disease and other causes of ESRD were the transplant-specific risk factors associated with a greater risk of other ***: Both general and transplant-specific risk factors were associated with a higher risk of fractures in kidney transplant recipients. Results ca

关键词： Fracture Risk factors Kidney transplant recipient Prognostication Cohort study

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血管性认知损害诊断的进一步规范化：血管性认知损害分类共识研究组指南

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国际脑血管病杂志 2018年第4期26卷 241-250页

作者： Olivia A. Skrobot Sandra E. Black Christopher Chen Charles DeCarli Timo Erkinjuntti Gary A. Ford Rajesh n. Kalaria John O'Brien Leonardo Pantoni Florence Pasquier Gustavo C. Roman Anders Wallin Perminder Sachdev Ingmar Skoog the VICCCS group Yoav Ben-Shlomo anthony P. Passmore Seth Love Patrick G. Kehoe 朱婷珂徐俊 Translational Health Sciences University of Bristol Bristol UK Sunnybrook Research Institute University of Toronto Ontario Canada Department of Pharmacology National University of Singapore Singapore Department of neurology and Center for neuroscience University of California at Davis Sacramento California USA neurology University of Helsinki and Helsinki University Hospital Helsinki Finland Divison of Medical Sciences Oxford University Oxford UK Institute of neuroscience Newcastle University Newcastle UK Department of Psychiatry University of Cambridge School of Clinical Medicine Cambridge UK nEUROFARBA Department University of FlorenceFlorence Italy Inserm U1171 University of Lille Lille France Methodist neurological Institute Houston Texas USA Memory Clinic at Department of neuropsychiatry Sahlgrenska University Hospital Molndal Sweden Institute of neuroscience and Physiology Sahlgrenska AcademyUniversity of Gothenburg Sweden School of Psychiatry University of New South WalesSydney Australia neuropsychiatric Institute Prince of Wales Hospital Randwick New South WalesAustralia Population Health Sciences University of Bristol Bristol UK Institute of Institute of Clinical Sciences Block B Queens University Belfast Belfast UK 116044 大连医科大学 116044 苏北人民医院神经内科扬州225001 首都医科大学附属北京天坛医院神经内科北京100069

引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impair... 详细信息

引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impairment of Cognition Classification Consensus Study,VICCCS）,旨在就VCI的诊断原则（VICCCS-1）和诊断方案（VICCCS-2）达成一致意见.本文提供了VICCCS-2的相关内容.方法使用VICCCS-1达成的原则和已发表的诊断指南作为在线德尔菲（Delphi）调查的参考基点,以期对VCI的临床诊断达成共识.结果共进行了6轮调查,每轮有65～79名专家参与,他们就VICCCS修订的轻度和重度VCI的诊断指南达成共识,并肯定了美国国立神经疾病与卒中研究所-加拿大卒中网（national Institute of neurological Disorders and Stroke–Canadian Stroke network,nInDS-CSn）发布的神经心理学评估方案和对影像学检查的推荐意见.讨论VICCCS-2建议规范化应用nInDS-CSn推荐的神经心理学和影像学评估方案诊断VCI,以促进研究协作.

关键词：血管性认知损害血管性痴呆指南标准共识德尔菲法

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An international survey of classification and treatment choices for group D retinoblastoma

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International Journal of Ophthalmology(English edition) 2017年第6期10卷 961-967页

作者： Christina Scelfo Jasmine H Francis Vikas Khetan Thomas Jenkins Brian Marr David H Abramson Carol L Shields Jacob Pe’er Francis Munier Jesse Berry J.William Harbour Andrey Yarovoy Evandro Lucena Timothy G Murray Pooja Bhagia Evelyn Paysse Samuray Tuncer Guillermo L Chantada Annette C Moll Tatiana Ushakova David A Plager Islamov Ziyovuddin Carlos A Leal Miguel A Materin Xun-Da Ji Jose W Cursino Rodrigo Polania Hayyam Kiratli Charlotta All-Ericsson Rejin Kebudi Santosh G Honavar Vicktoria Vishnevskia-Dai Sidnel Epelman anthony B Daniels Jeanie D Ling Fousseyni Traore Marco A Ramirez-Ortiz Ophthalmic Oncology Service Department of Surgery Memorial Sloan Kettering Cancer Center New York 10065 USA Department of Ophthalmology Weill-Cornell Medical Center New York 10065 USA Department of Vitreoretinal and Ocular Oncology Sankara Nathralaya Chennai 600066 India Ocular Ontology Service Wills Eye Hospital Thomas Jefferson University Pennsylvania 19107 USA Hadassah - Hebrew University Medical Center Jerusalem 91120 Israel jules-Gonin Eye Hospital Lausanne 1004 Switzerland USC Roski Eye Institute Children＇s Hospital of Los Angeles California 90033 USA Ocular Oncology Service Bascom Palmer Eye Institute University of Miami Miller School of Medicine Florida 33136 USA Ocular Oncology Department S.N. Fyodorov Eye Microsurgery Federal State Institution Moscow 127486 Russia Department of Ocular Oncology Instituto Nacional de Cancer Rio de Janeiro 1122 Brazil Murray Ocular Oncology and Retina Miami Children＇s Hospital Florida 33143 USA St. Joseph＇s Children＇s Hospital New Jersey 07504 USA Department of Ophthalmology Baylor College of Medicine Texas 77030 USA Department of Ophthalmology Ocular Oncology Istanbul Medical Faculty Istanbul University Istanbul 34452 Turkey Oncology Department Hospital JP Garrahan Buenos Aires 1245 Argentina Department of Ophthalmology VU University Medical Center Amsterdam 1081 the Netherlands Department of Head and neck Tumors Science Research Institute of Pediatric Oncology and Hematology N.N. Blokhin Russian Cancer Research Center Moscow 115478 Russia Pediatric Ophthalmology and Adult Strabismus Riley Hospital for Children Indiana University Medical Center Indiana 46202 USA national Oncology Center of Uzbekistan Tashkent 110508 Uzbekistan nstituto nacional de Pediatria Coyoacan 04530 Mexico Department of Ophthalmology and Visual Science Smilow Cancer Hospital at Yale New Haven CT 06520 USA Xin Hua Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200092 China Department of Ophthalmology Santa Casa Mi

AIM： To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS： An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, AnOVA and Kruskal-Wallis tests using Prism. RESULTS： The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children＇s Hospital of Los Angeles （CHLA） version, 33% used the Children＇s Oncology Group （COG） version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were： Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were： Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center （P〈0.0001）. COnCLUSIOn： Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic r

关键词： retinoblastoma oncology retina enucleation chemotherapy intra-arterial chemotherapy ophthalmic arterychemosurgery cancer

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A history of high-power laser research and development in the United Kingdom

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High Power Laser Science and Engineering 2021年第2期9卷 41-126页

作者： Colin n.Danson Malcolm White John R.M.Barr Thomas Bett Peter Blyth David Bowley Ceri Brenner Robert J.Collins neal Croxford A.E.Bucker Dangor Laurence Devereux Peter E.Dyer anthony Dymoke-Bradshaw Christopher B.Edwards Paul Ewart Allister I.Ferguson John M.Girkin Denis R.Hall David C.Hanna Wayne Harris David I.Hillier Christopher J.Hooker Simon M.Hooker nicholas Hopps Janet Hull David Hunt Dino A.Jaroszynski Mark Kempenaars Helmut Kessler Sir Peter L.Knight Steve Knight Adrian Knowles Ciaran L.S.Lewis Ken S.Lipton Abby Littlechild John Littlechild Peter Maggs Graeme P.A.Malcolm OBE Stuart P.D.Mangles William Martin Paul McKenna Richard O.Moore Clive Morrison Zulfikar najmudin David neely Geoff H.C.new Michael J.norman Ted Paine anthony W.Parker Rory R.Penman Geoff J.Pert Chris Pietraszewski Andrew Randewich nadeem H.Rizvi nigel Seddon MBE Zheng-Ming Sheng David Slater Roland A.Smith Christopher Spindloe Roy Taylor Gary Thomas John W.G.Tisch Justin S.Wark Colin Webb S.Mark Wiggins Dave Willford Trevor Winstone AWE Aldermaston ReadingUK Oxford Centre for High Energy Density Science Department of PhysicsClarendon LaboratoryUniversity of OxfordOxfordUK Centre for Intertial Fusion Studies Blackett LaboratoryImperial College LondonLondonUK Formerly of Electrox LetchworthUK Formerly of Central Laser Facility Rutherford LaboratoryDidcotUK Formerly of Ferranti Defence Systems LincolnUK Leonardo EdinburghUK Retired AWEReadingUK Formerly of AWE ReadingUK Formerly of Laser Lines Ltd BanburyUK Formerly of Optilas Ltd Milton KeynesUK Retired Pro-Lite TechnologyCranfieldUK Specialised Imaging Ltd PitstoneUK Central Laser Facility STFC Rutherford Appleton LaboratoryDidcotUK Magna-Power Electronics Ltd ReadingUK DeBe Lasers Needham Laser TechnologiesWhitchurchUK Blackett Laboratory Imperial College LondonLondonUK SPIE Europe CardiffUK Professor Emeritus(Physics) University of HullKingston upon HullUK Kentech Instruments Ltd WallingfordUK Department of Physics Clarendon LaboratoryUniversity of OxfordOxfordUK Professor Emeritus Department of PhysicsUniversity of StrathclydeGlasgowUK Department of Physics Durham UniversityDurhamUK Professor Emeritus(Photonics) Heriot-Watt UniversityEdinburghUK Professor Emeritus University of SouthamptonSouthamptonUK Optical Surfaces Ltd KenleyUK JEH Lasers Ltd RugbyUK Scottish Universities Physics Alliance Department of PhysicsUniversity of StrathclydeGlasgowUK ITER Organization Saint-Paul-lez-DuranceFrance Manx Precision Optics Ltd BallasallaUK Laser Lines Ltd BanburyUK Elliot Scientific Ltd MetroTest Scientific GroupHarpendenUK Centre for Plasma Physics Queen’s University BelfastBelfastUK Retired Founderand former MDRofin-Sinar UK LtdHullUK Heraeus noblelight Ltd CambridgeUK Mirli Books ChelmsfordUK M Squared Lasers Ltd GlasgowUK University of Hertfordshire HatfieldUK E&EO UK Ltd Barton-upon-HumberUK Department of Physics University of YorkYorkUK IC Optical Systems Ltd BeckenhamUK Laser Micromachining Ltd St AsaphUK MBDA UK Ltd Brist

The first demonstration of laser action in ruby was made in 1960 by *** of Hughes Research Laboratories,*** laboratories worldwide began the search for lasers using different materials,operating at different *** the UK,academia,industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of *** historical review looks at the contribution the UK has made to the advancement of the technology,the development of systems and components and their exploitation over the last 60 years.

关键词： high-power lasers history United Kingdom

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AGnP精神科治疗药物监测共识指南：2011

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实用药物与临床 2016年第10期19卷 1193-1218页

作者： Hiemke C baumann P Bergemann n Conca A Dietmaier O Egberts K Fric M Gerlach M Greiner C Gründer G Haen E Havemann-Reinecke U Jaquenoud Sirot E Kirchherr H Laux G Lutz UC Messer T Müller MJ Pfuhlmann B Rambeck B Riederer P Schoppek B Stingl J Uhr M Ulrich S Waschgler R Zernig G 李文标(译) 果伟(译) 阮灿军(译) 贺静(译) 汤宜朗(审校) 王传跃(审校) Department of Psychiatry and Psychotherapy University MedicalCenter of MainzGermany Department of Psychiatry University of LausannePrilly-LausanneSwitzerland Psychiatric Hospital Bad ArolsenGermany Psychiatric Hospital BolzanoItaly Psychiatrc Hospital WeinsbergGermany Department Child and Adolescent Psychiatry University Hospital of WurzburgGermany Kliniken des Bezirks Oberbayern(kbo)Salzach-Inn-Klinikum Was-serburg a.InnGermany Federal Institute for Drugs and Medical Devices(BfArM) BonnGermany Department of Psychiatry and Psychotherapy University of AachenGermany Clinical Pharmacology Department of Psychiatry and Psychoso-maticsUniversity of RegensburgGermany Department of Psychiatry and Psychosomatics University of GotingenGermany Psychiatric Hospital KonigsfeldenBruggAargauSwitzerland Medical Laboratory Bremen Germany Department of Psychiatry and Psychotherapy University of TubingenGermany Psychiatric Hospital PfaffenhofenGermany Psychiatric Hospital Marburg and GieβenGermany Department of Psychiatry Psychotherapy and PsychosomaticsUniversity Hospital of WurzburgGermany Center of Epilepsy BielefeldGermany Psychiatric Hospital HaarGermany Department of Pharmacology of natural Products and ClinicalPharmacology University of UlmGermany Max Planck Institute of Psychiatry MunichGermany Aristo Pharma GmbH BerlinGermany Psychiatric Hospital FeldkirchAustria Experimental Psychiatry Unit Department of Psychiatry and PsychotherapyMedical University of InnsbruckAustria 首都医科大学附属北京安定医院北京 Emory University School of Medicine AtlantaUSA

治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代... 详细信息

治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代动力学药物-药物相互作用等情况下,测定药物浓度是很有用的。在精神科,有可能明显获益于TDM的主要患者群体包括儿童、孕妇、老年患者、智力障碍患者、涉及司法的患者、已知或怀疑携带药代动力学相关基因变异的患者,以及合并躯体疾病影响药代动力学的患者。然而,只有将TDM充分整合到临床治疗过程中去,才能发挥其优化药物治疗的潜在优势。为了促进TDM的合理应用,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für neuropsychopharmakologie und Pharmakopsychiatrie,AGnP)的TDM专家组在2004年发表了精神药物治疗药物监测指南。之后,随着知识不断更新,又有许多可能需要进行TDM的新药上市。因此,本次更新将神经精神药物的种类扩展到了128种,并将其TDM必要性划分为从"强烈推荐"到"可能有用"的四个等级。经过大量细致且全面的文献检索与分门别类的汇总整理,将基于循证医学理念的"治疗参考浓度范围"和"剂量相关参考浓度范围"呈现给大家。本共识指南引入了"实验室警戒浓度"的新概念,即实验室需要马上告知治疗医生的药物浓度上限。本共识指南还给出了诸如药物作为细胞色素P450酶的底物和抑制剂的性质,代谢物与母药浓度比值的常见范围,以及与结果解释相关的内容,还提供了何时将TDM与遗传药理学检测相结合的建议。遵循本指南,有助于改善许多患者精神药物治疗的效果,特别是那些存在药代动力学异常的患者。TDM是一门交叉学科,有时针对看起来不一致的数据,需要多学科坦诚地讨论,只有这样,患者才能从这种合作中获益。

关键词：共识指南药物分析药代动力学精神药物治疗参考浓度范围治疗药物监测治疗窗

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