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Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention

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World Journal of Cardiology 2014年第8期6卷 865-872页

作者： Richard A Brogan Christopher J Malkin Philip D Batin alexander D Simms james M McLenachan Christopher P Gale Leeds Institute of Cardiovascular and Metabolic Medicine Division of Epidemiology and BiostatisticsUniversity of LeedsLeeds LS2 9JTUnited Kingdom York and Hull Medical School University of YorkYorkYO10 5DDUnited Kingdom Department of Cardiology Leeds Teaching Hospital NHS TrustLeeds LS2 9JTUnited Kingdom Department of Cardiology Pinderfields General HospitalMid Yorkshire NHS TrustWakefield WF5 9LZUnited Kingdom Department of Cardiology York Teaching Hospital NHS Foundation TrustYork YO10 5DDUnited Kingdom

Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction(NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention(PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed.

关键词： ST segment elevation myocardial infarction Risk stratification Primary percutaneous coronary intervention Harm Risk scores

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Daclatasvir vs telaprevir plus peginterferon alfa/ribavirin for hepatitis C virus genotype 1

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World Journal of Gastroenterology 2016年第12期22卷 3418-3431页

作者： Ira Jacobson Stefan Zeuzem Robert Flisiak Brygida Knysz Stefan Lueth Dorota Zarebska-Michaluk Ewa Janczewska Peter Ferenci Moises Diago Anna Linda Zignego Rifaat Safadi Yaacov Baruch Dzhamal Abdurakhmanov Stephen Shafran Dominique Thabut Rafael Bruck Adrian Gadano alexander james Thompson Justin Kopit Fiona Mc Phee Tracy Michener Eric A Hughes Philip D Yin Stephanie Noviello Weill Cornell Medical College New YorkNY 10029United States Icahn School of Medicine at Mount Sinai New YorkNY 10029United States JW Goethe University Hospital 60323 FrankfurtGermany Uniwersytet Medyczny w Bialymstoku 15-089 BialystokPoland EMC and Medical University 50-220 WroclawPoland Universitatsklinikum Hamburg-Eppendorf 20246 HamburgGermany Wojewodzki Szpital Zespolony w Kielcach 25-736 KielcePoland ID Clinic 41-400 MyslowicePoland Medizinische Universitat Wien 1090 ViennaAustria Clinica Quiron 46010 ValenciaSpain Universita degli Studi di Firenze 50121 FlorenceItaly Holy Family Hospital Nazareth 6004Israel Rambam Medical Center Haifa 31096Israel 1st Moscow State Medical University N.A.I.M.Sechenov 119991 MoscowRussia University of Alberta Hospital EdmontonAlberta T6G 2B7Canada Groupe Hospitalier Pitie-Salpetriere 75013 ParisFrance Tel Aviv Sourasky Medical Center and Tel Aviv University Tel Aviv 64239Israel Hospital Italiano de Buenos Aires Buenos Aires C1181ACHArgentina St.Vincents Hospital and the University of Melbourne Melbourne 3065Australia Fiona McPhee Bristol-Myers Squibb Research and DevelopmentWallingfordCT 06492United States Bristol-Myers Squibb Research and Development PrincetonNJ 08450United States

AIM: To evaluate daclatasvir vs telaprevir, each combined with peginterferon alfa-2a/ribavirin(peg IFN/RBV), in treatment-naive hepatitis C virus(HCV) genotype(GT) 1-infected ***: In this phase 3, randomized, open-label, noninferiority study, 602 patients were randomly assigned(2:1) to daclatasvir vs telaprevir, stratified by IL28 B rs12979860 host genotype(CC vs non-CC), cirrhosis status(compensated cirrhosis vs no cirrhosis), and HCV GT1 subtype(GT1a vs GT1b). Patients were selected by study inclusion criteria from a total of 793 enrolled patients. Patients received daclatasvir 60 mg once daily or telaprevir 750 mg 3 times daily plus peg IFN/RBV. Daclatasvir recipients received 24 wk of daclatasvir plus peg IFN/RBV; those without an extended rapid virologic response(e RVR; undetectable HCV-RNA at weeks 4 and 12) received an additional 24 wk of peg IFN/RBV. Telaprevir-treated patients received 12 wk of telaprevir plus peg IFN/RBV followed by 12(with e RVR) or 36(no e RVR) wk of peg IFN/RBV. The primary objective was to compare for noninferiority of sustained virologic response rates at posttreatment week 12(SVR12) in GT1b-infected patients. Key secondary objectives were to demonstrate that the rates of anemia(hemoglobin < 10 g/d L) and rashrelated events, through week 12, were lower with daclatasvir + peg IFN/RBV than with telaprevir + peg IFN/RBV among GT1b-infected patients. Resistance testing was performed using population-based sequencing of the NS5 A region for all patients at baseline, and for patients with virologic failure or relapse and HCV-RNA ≥ 1000 IU/m L, to investigate any link between NS5 A polymorphisms associated with daclatasvir resistance and virologic outcome. RESULTS: Patient demographics and disease characteristics were generally balanced across treatment arms; however, there was a higher proportion of black/African Americans in the daclatasvir groups(6.0% and 8.2% in the GT1 b and GT1 a groups, respectively) than in the telaprevi

关键词： Direct-acting antiviral Chronic hepatitis C Daclatasvir Genotype 1b NS5A inhibitor Liver disease

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嫦娥五号月球样品研究获得最年轻火山活动年龄刷新月球演化认知

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中国科技成果 2022年第21期23卷 F0002-F0002,I0001页

作者：无刘敦一车晓超 alexander Nemchin 龙涛王晨 Marc Norman Katherine Joy Romain Tartese james Head 杨之青杨淳刘建辉谢士稳包泽民范润龙中国地质科学院地质研究所不详

我国在2020年完成了举世瞩目的嫦娥五号月球采样返回任务.中国地质科学院地质研究所离子探针中心(以下简称:离子探针中心)团队积极参与我国深空探测计划,于2021年7月12日成功申请到首批嫦娥五号月壤样品,在短时间内集中力量,联合国际团... 详细信息

我国在2020年完成了举世瞩目的嫦娥五号月球采样返回任务.中国地质科学院地质研究所离子探针中心(以下简称:离子探针中心)团队积极参与我国深空探测计划,于2021年7月12日成功申请到首批嫦娥五号月壤样品,在短时间内集中力量,联合国际团队高质高效地完成了研究工作,取得了重要成果,刷新了人类对月球演化的理解,并受到国内外媒体的广泛关注.

关键词：嫦娥五号月球样品中国地质科学院深空探测地质研究所离子探针火山活动国内外媒体

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消化不良

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英国医学杂志中文版 2014年第2期17卷 95-101页

作者： alexander C Ford Paul Moayyedi 张璐(译) 夏志伟(校) Leeds Gastroenterology Institute St James's University Hospital Leeds UK Leeds Institute of Biomedical and Clinical Sciences Leeds University Leeds UK Gastroenterology Division McMaster University Health Sciences Center Hamilton ON Canada 北京大学第三医院消化内科

消化不良的定义不尽相同，但总体来说描述的都是上腹部的疼痛和不适。消化不良患者的生命年限正常，但生活质量会因此而降低，工作效率也饱受影响。据估计，英国针对消化不良上的花费约为每年10亿英镑（约合11．6亿欧元或15．5亿美元）... 详细信息

消化不良的定义不尽相同，但总体来说描述的都是上腹部的疼痛和不适。消化不良患者的生命年限正常，但生活质量会因此而降低，工作效率也饱受影响。据估计，英国针对消化不良上的花费约为每年10亿英镑（约合11．6亿欧元或15．5亿美元），所以，恰当地处理这种状况就显得尤为重要。

关键词：消化不良生命年限生活质量工作效率上腹部

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福鼎市医院

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建筑实践 2020年第4期 172-177页

作者： james Brearley Steve Whitford 杨庆安黄帆林祥杰郑莉莉窦义年罗怀丽吴佳荣昱李福明邹红飞 Gonzalo Fernandez 熊娟 alexander Abke 王粲朱家亮 BAU建筑事务所

地点:福建省宁德市Location:Ningde, Fujian Province项目概况:福鼎市地处福建省北部的临海峡谷地区,近年来随着福鼎的飞速发展,该地区现有的医疗卫生设施已不能满足日益增长的需求。为了改善这一供需矛盾,并提高城区的医疗卫生水平,当... 详细信息

地点:福建省宁德市Location:Ningde, Fujian Province项目概况:福鼎市地处福建省北部的临海峡谷地区,近年来随着福鼎的飞速发展,该地区现有的医疗卫生设施已不能满足日益增长的需求。为了改善这一供需矛盾,并提高城区的医疗卫生水平,当地政府决定对福鼎市医院进行扩建,新建一栋包含4,000床位的百胜新院,项目选址于桐山溪河畔。新建的百胜新院将是一家全时制三级乙等综合性医院,其中包括急诊中心、外科、妇产科、重症监护科、传染病区、高级诊疗及化验科、妇幼科、教学及研究区以及康复科等。

关键词：福鼎市门诊部

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Impact of COVID-19 on presentation,management,and outcomes of acute care surgery for gallbladder disease and acute appendicitis

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World Journal of Gastrointestinal Surgery 2021年第8期13卷 859-870页

作者： Orly Nadell Farber Giselle I Gomez Ashley L Titan Andrea T Fisher Christopher J Puntasecca Veronica Toro Arana Arielle Kempinsky Clare E Wise Kovi E Bessoff Mary T Hawn james R Korndorffer Jr Joseph D Forrester Micaela M Esquivel Department of Surgery Stanford University School of MedicinePalo AltoCA 94305United States

BACKGROUND The ongoing coronavirus disease 2019(COVID-19)pandemic has significantly disrupted both elective and acute medical *** from the early months suggest that acute care patient populations deferred presenting to the emergency department(ED),portending more severe disease at the time of ***,care for this patient population trended towards initial non-operative *** To examine the presentation,management,and outcomes of patients who developed gallbladder disease or appendicitis during the *** A retrospective chart review of patients diagnosed with acute cholecystitis,symptomatic cholelithiasis,or appendicitis in two EDs affiliated with a single tertiary academic medical center in Northern California between March and June,2020 and in the same months of *** were selected through a research repository using international classification of diseases(ICD)-9 and ICD-10 *** both years,313 patients were identified with either type of gallbladder disease,while 361 patients were identified with acute *** primary outcome was overall incidence of *** outcomes included presentation,management,complications,and 30-d re-presentation *** between different variables were explored using pearson’s r correlation *** were compared using the Welch’s t-Test,Chi-squared tests,and Fisher’s exact test as *** Patients with gallbladder disease and appendicitis both had more severe presentations in *** respect to gallbladder disease,more patients in the COVID-19 cohort presented with acute cholecystitis compared to the control cohort[50%(80)vs 35%(53);P=0.01].Patients also presented with more severe cholecystitis in 2020 as indicated by higher mean Tokyo Criteria Scores[mean(SD)1.39(0.56)vs 1.16(0.44);P=0.02].With respect to appendicitis,more patients were diagnosed with a perforated appendix at presentation in 2020[20%(36)vs 16%(29);P=0.0

关键词： COVID-19 Cholecystitis Biliary colic Appendicitis Acute care surgery

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体重调整固定剂量普通肝素与低分子肝素治疗急性静脉血栓栓塞的比较

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美国医学会杂志（中文版） 2007年第5期26卷 259-264页

作者： Clive Kearon Jeffrey S. Ginsberg Jim A. Julian james Douketis Susan Solymoss Paul Ockelford Sharon Jackson alexander G. Turpie Betsy MacKinnon Jack Hirsh Michael Gent 王春玲（译）孙艺红（译）胡大一（校） McMaster University and the Henderson Research Centre Hamilton Ontario McGill University Montreal Quebec McGill University and University of Auckland Auckland New Zealand

背景：普通肝素用于治疗急性静脉血栓栓塞时，通常在监测血凝下静脉输注给药，患者需要住院治疗。然而，体重调整后皮下注射固定剂量普通肝素可能既适用于住院也适用于门诊静脉血栓栓塞患者的治疗。目的：确定皮下注射体重调整固定剂量... 详细信息

背景：普通肝素用于治疗急性静脉血栓栓塞时，通常在监测血凝下静脉输注给药，患者需要住院治疗。然而，体重调整后皮下注射固定剂量普通肝素可能既适用于住院也适用于门诊静脉血栓栓塞患者的治疗。目的：确定皮下注射体重调整固定剂量普通肝素治疗静脉血栓栓塞是否与低分子肝素同样安全有效。设计、地点及患者：随机、开标、裁定者盲法、非劣效试验。708例急性静脉血栓栓塞患者来自加拿大和新西兰6所大学附属临床中心，年龄≥18岁。试验于1998年9月至2004年2月进行。在随机分组的患者中，11例从疗效分析中排除，8例从安全性分析中排除。干预：普通肝素皮下注射初始剂量为333U／kg，以后给予固定剂量250U／kg，每12小时1次（n=345）。低分子肝素（依诺肝素或达肝素）按100IU／kg剂量皮下注射，每12小时1次（n=352）。两种治疗均可院外进行，配合华法林治疗3个月。主要观测指标：随机分组后3个月内复发性静脉血栓栓塞事件及10天内严重出血情况。结果：普通肝素组有13例患者（3．8％）发生静脉血栓栓塞复发，而低分子肝素组有12例患者复发（3．4％；绝对差值，0．4％；95％可信区间，-2．6％～3．3％）。开始治疗后10天内普通肝素组有4例患者（1．1％）发生严重出血，而低分子肝素组有5例（1．4％；绝对差值，-0．3％；95％可信区间，-2．3％～1．7％）。院外治疗患者在普通肝素组占72％，低分子肝素组占68％。结论：对于急性静脉血栓栓塞患者而言，皮下注射固定剂量普通肝素与低分子肝素一样安全有效，适于门诊治疗。

关键词：低分子肝素治疗静脉血栓栓塞普通肝素固定剂量急性体重安全性分析皮下注射

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Impact of Varying Light and Dew on Ground Cover Estimates from Active NDVI,RGB,and LiDAR

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Plant Phenomics 2021年第1期3卷 263-276页

作者： David M.Deery David J.Smith Robert Davy Jose A.Jimenez-Berni Greg J.Rebetzke Richard A.james CSIRO Agriculture and Food CanberraACTAustralia CSIRO Agriculture and Food YancoNSWAustralia CSIRO Information Management and Technology CanberraACTAustralia Instituto Agricultura Sostenible Consejo Superior de Investigaciones CientificasCordobaSpain

Canopy ground cover(GC)is an important agronomic measure for evaluating crop establishment and early *** study evaluates the reliability of GC estimates,in the presence of varying light and dew on leaves,from three different ground-based sensors:(1)normalized difference vegetation index(NDVI)from the commercially available GreenSeeker®;(2)RGB images from a digital camera,where GC was determined as the portion of pixels from each image meeting a greenness criterion(i.e.,ðGreen−RedÞ/ðGreen+RedÞ>0);and(3)LiDAR using two separate approaches:(a)GC from LiDAR red reflectance(whereby red reflectance less than five was classified as vegetation)and(b)GC from LiDAR height(whereby height greater than 10 cm was classified as vegetation).Hourly measurements were made early in the season at two different growth stages(tillering and stem elongation),among wheat genotypes highly diverse for canopy *** active NDVI showed the least variation through time and was particularly stable,regardless of the available light or the presence of *** addition,between-sample-time pearson correlations for NDVI were consistently high and significant(P<0:0001),ranging from 0.89 to *** comparison,GC from LiDAR and RGB showed greater variation across sampling times,and LiDAR red reflectance was strongly influenced by the presence of *** times when the light was exceedingly low,correlations between GC from RGB and NDVI were consistently high(ranging from 0.79 to 0.92).The high reliability of the active NDVI sensor potentially affords a high degree of flexibility for users by enabling sampling across a broad range of acceptable light conditions.

关键词： LiDAR reflectance Impact

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北美科迪勒拉山系加拿大区段的起源、主要构造与生长速率

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世界地质 1993年第1期 86-87页

作者： james,W.H.Monger 陈华

北美科迪勒拉山系含有数个构造地层地体。它们是新生大陆、科迪勒拉地壳的主要地块,它们起源于:(1)遭受各种再造的小规模早元古宙克拉通岩石(Monashee地体);在克拉通边缘沉积于(?)过渡壳上的碎屑物质,它们源于晚元古宙和古生界克拉通(Ko... 详细信息

北美科迪勒拉山系含有数个构造地层地体。它们是新生大陆、科迪勒拉地壳的主要地块,它们起源于:(1)遭受各种再造的小规模早元古宙克拉通岩石(Monashee地体);在克拉通边缘沉积于(?)过渡壳上的碎屑物质,它们源于晚元古宙和古生界克拉通(Kootenay,Yukon-Tanana地体);(3)主要是古生代至侏罗纪时期的增生硅镁质地体(Stikine,alexander,Wrangellia);(4)形成于且归并于洋壳之上的增生杂岩,它们或者是以中古生代至中生代中期深海沉积为主(cache Creek,Bridge River地体)或源于岛弧和克拉通的晚中

关键词：克拉通地体物质稳定地块生长速率科迪勒拉山系地壳地球外壳地球内部迪勒区段加拿大北美洲北美

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Evaluation of utility in shoulder pathology:Correlating the American Shoulder and Elbow Surgeons and Constant scores to the EuroQoL

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World Journal of Orthopedics 2012年第3期3卷 20-24页

作者： Blaine T Bafus Richard E Hughes Bruce S Miller james E Carpenter Department of Orthopaedic Surgery Cleveland Clinic Foundation Cleveland OH 44115-2325 United States Department of Orthopaedic Surgery University of Michigan Ann Arbor MI 48109-2200 United States

AIM: To study whether health utility scores can be derived from shoulder-specific ***: Authors investigated two questions:(1) do the American Shoulder and Elbow Surgeons(ASES) score and the Constant score correlate with the EuroQo L(EQ-5D), a measure of health utility?(2) can the ASES and Constant scores be obtained from a complete study sample without bias? Thirty subjects with various shoulder diagnoses completed ASES, Constant, and EQ-5D instruments. pearson correlations were calculated to assess the associations between EQ-5D score and ASES and Constant ***: The correlation between EQ-5D score and ASES score was 0.60(P < 0.001); it was 0.54 for EQ-5D and Constant scores(P < 0.003). A multiple regression model containing ASES score, Constant score, age, and gender failed to adequately predict EQ-5D. Moreover, 25% of patients meeting the inclusion criteria did not complete the ASES questionnaire because they did not feel that specific questions, such as "do usual sport-list" and "throw ball overhand," applied to ***: Authors' results do not support the use of the ASES and Constant scores in predicting EuroQ ol health utility values. However, the Constant score was more suitable for this patient population because all patients were able to complete it.

关键词： Utility EuroQoL American Shoulder and Elbow Surgeons score Constant score Shoulder Outcomes

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