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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton lisa J Woodhouse Craig S Anderson Sandeep Ankolekar lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset jeffrey l saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS AlREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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腔内血管疗法治疗卒中的有效性被证实

生物医学工程与临床 2015年第3期19卷 236-236页

作者： jeffrey l.saver

据jeffrey *** 2015年4月17日（N Engl J Med,2015 Apr 17）报道,美国加州大学洛杉矶分校（University of California los Angeles）的研究人员通过研究证实,治疗缺血性发作的腔内血管治疗（ET）技术或是该类疾病患者的最佳选择,其减少... 详细信息

据jeffrey *** 2015年4月17日（N Engl J Med,2015 Apr 17）报道,美国加州大学洛杉矶分校（University of California los Angeles）的研究人员通过研究证实,治疗缺血性发作的腔内血管治疗（ET）技术或是该类疾病患者的最佳选择,其减少患者残疾事件的发生。采用血管内支架治疗或许是治疗急性缺血性发作患者的最佳方法;相对于单独t-PA溶栓治疗,对于患者ET联合t-PA积极治疗结果,脑功能恢复了提高到60%。研究者随机选择了196例卒中患者接受t-PA治疗,即利用破坏血凝的药物或t-PA外加ET治疗。

关键词：腔内血管治疗卒中有效性血管内支架治疗急性缺血性 t-PA 疗法美国加州大学

急性缺血性卒中患者早期处理指南：美国心脏协会／美国卒中协会对医疗专业人员的指南（续前）

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国际脑血管病杂志 2013年第8期21卷 564-605页

作者： Edward C. Jauch jeffrey l. saver Harold P. Adams Askiel Bruno J.J. (Buddy) Connors Bart M. Demaerschalk Pooja Khatri Paul W. McMullan Adnan I. Qureshi Kenneth Rosenfield Phillip A. Scott Debbie R. Summers David Z. Wang Max Wintermark Howard Yonas 李海峰(译) 岳耀先(译) 王琦(译) 张贤军(译) 丁晓君(译) 不详青岛大学医学院附属医院神经内科 266003

7静脉溶栓7．1静脉rtPA急性卒中的静脉溶栓治疗现已得到普遍接受。美国FDA于1996年批准静脉应用rtPA，部分基于NINDSrtPA卒中试验结果。

关键词：美国心脏协会卒中协会急性缺血性卒中医疗专业早期处理静脉溶栓治疗指南患者

急性缺血性卒中患者早期处理指南：美国心脏协会／美国卒中协会对医疗专业人员的指南

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国际脑血管病杂志 2013年第7期21卷 481-516页

作者： Edward C. Jauch jeffrey l. saver Harold P. Adams Askiel Bruno J.J. (Buddy) Connors Bart M. Demaerschalk Pooja Khatri Paul W. McMullan Jr, Adnan I. Qureshi Kenneth Rosenfield Phillip A. Scott Debbie R. Summers David Z. Wang Max Wintermark Howard Yonas 李海峰(译) 岳耀先(译) 王琦(译) 张贤军(译) 丁晓君(译) 不详青岛大学医学院附属医院神经内科 266003

背景和目的作者提供了关于成年急性缺血性卒中患者评估和治疗方面的现有证据和处理推荐的一份概述。目标读者为涉及急性缺血性卒中患者发病48h内诊治的院前诊疗人员、医生、综合医疗保健人员和医院管理者。该指南将取代先前的2007年版... 详细信息

背景和目的作者提供了关于成年急性缺血性卒中患者评估和治疗方面的现有证据和处理推荐的一份概述。目标读者为涉及急性缺血性卒中患者发病48h内诊治的院前诊疗人员、医生、综合医疗保健人员和医院管理者。该指南将取代先前的2007年版指南及其2009年更新版。方法著述委员会成员由美国卒中协会卒中委员会的科学声明监督委员会指定，代表各个领域的医疗专家。在形成共识的整个过程中，严格遵循美国心脏协会的利益冲突原则。委员会成员被分配给与其专业领域相关的内容，对卒中文献进行回顾，重点为前一版指南发表之后的文献，然后按照美国心脏协会卒中委员会的证据强度分级方案起草推荐意见。结果本指南的目的是减少卒中相关的残疾和死亡。本指南支持卒中医疗体系的全局性概念以及从患者识别、急救医疗服务激活、转送和分诊到急诊室和卒中单元内最初数小时诊治的卒中诊治细节。本指南讨论了早期卒中评估和一般治疗、缺血性卒中治疗、特殊干预措施，如再灌注策略以及脑复苏的一般生理学干预原则。结论由于许多推荐意见基于有限的证据，还迫切需要对急性缺血性卒中的治疗做进一步的研究。

关键词： AHA科学声明急性脑梗死急诊医疗服务再灌注卒中组织型纤溶酶原激活剂

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糖尿病前期与未来卒中事件风险的荟萃分析

英国医学杂志中文版 2012年第5期15卷 306-306页

作者： Meng lee jeffrey l saver Keun-Sik Hong Sarah Song Kuo-Hsuan Chang Bruce Ovblagele 谭婷婷(译) 周智广(校) Chang Gung University College ~ Medicine Chang Gung Memorial Hospital Chlayi Taiwan Stroke Center Geffen School ofMedicineUniversity of CaliforniaLos Angeles CAUSAv Departrnent ofNeurology nsan Paik HospitalInje University South Korea Chang Gung UniversityCollege of Medicine Chang Gung MemorialHospital LinkuoTaiwan Stroke Center andDepa~ment ofNeuroscience University of California9500 Gilman Drive#9127 La JoUa SanDiego CA 92093-9127USA 中南大学湘雅医学院第二医院内分泌科

目的评估糖尿病前期与脑卒中风险的相关性，及其相关性是否随不同的糖尿病前期诊断标准而变化。设计前瞻性研究的系绕性回顾及荟萃分析。

关键词：糖尿病前期荟萃分析脑卒中风险诊断标准相关性

Kaplansky Density and Kadison Transitivity Theorems for Irreducible Representations of Real C^-Algebras

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Acta Mathematica Sinica,English Series 2007年第10期23卷 1827-1832页

作者： jeffrey l.BOERSEMA Department of Mathematics Seattle UniversitySeattleWA 98122USA

We prove analogs of the Kaplansky Density Theorem and the Kadison Transitivity Theorem for irreducible representations of a real C＊-algebra on a real Hilbert space. Specifically, if a C＊-algebra is acting irreducibly on a real Hilbert space, then the Hilbert space has either a real, complex, or quaternionic structure with respect to which the density and transitivity theorems hold.

关键词： real C*-algebra irreducible * representation transitivity

Relationships between Gene Structure and Genome Instability in Flowering Plants

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Molecular Plant 2018年第3期11卷 407-413页

作者： jeffrey l. Bennetzen Xuewen Wang State Key laboratory of Tea Plant Biology and Utilization/Key laboratory of Tea Biology and Processing Ministry of Agriculture Anhui Agricultural University HefeiAnhui 230036 People's Republic of China Department of Genetics University of Georgia Athens GA 30602 USA

Flowering plant （angiosperm） genomes are exceptional in their variability with respect to genome size, ploidy, chromosome number, gene content, and gene arrangement. Gene movement, although observed in some of the earliest plant genome comparisons, has been relatively underinvestigated. We present here- in a description of several interesting properties of plant gene and genome structure that are pertinent to the successful movement of a gene to a new location. These considerations lead us to propose a model that can explain the frequent success of plant gene mobility, namely that Small Insulated Genes Move Around （SlGMAR）. The SIGMAR model is then compared with known processes for gene mobilization, and predic- tions of the SIGMAR model are formulated to encourage future experimentation. The overall results indicate that the frequent gene movement in angiosperm genomes is partly an outcome of the unusual properties of angiosperm genes, especially their small size and insulation from epigenetic silencing.

关键词： epigenetic silencing gene insulators gene movement illegitimate recombination inaccurate DNA break repair transposon mobilization

Beyond dichotomies in species and speciation

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National Science Review 2022年第12期9卷 15-17页

作者： jeffrey l.Feder Patrik Nosil Department of Biological Sciences University of Notre Dame Centre d'Ecologie Fonctionnelle et Evolutive University MontpellierCNRS EPHE IRD

Speciation is not as mysterious as D arwin once described it [1].Nevertheless,important questions *** discussed by Wu[2] and highlighted in a series of papers in National Science Review (NSR),these issues equate with imposing dichotomous perspectives on speciation,when the nature of species and the processes creating them can complicate discrete categorization.

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Molecular mechanisms of the suppression of axon regeneration by KlF transcription factors

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Neural Regeneration Research 2014年第15期9卷 1418-1421页

作者： Akintomide Apara jeffrey l.Goldberg University of Miami Miller School of Medicine MiamiFL USA Shiley Eye CenterUniversity of California San Diego La JollaCA USA

Molecular mechanisms of the Kruppel-like family of transcription factors （KlFs） have been studied more in proliferating cells than in post-mitotic cells such as neurons. We recently found that KlFs regulate intrinsic axon growth ability in central nervous system （CNS） neurons in- cluding retinal ganglion cells, and hippocampal and cortical neurons. With at least 15 of 17 KlF family members expressed in neurons and at least 5 structurally unique subfamilies, it is import- ant to determine how this complex family functions in neurons to regulate the intricate genetic programs of axon growth and regeneration. By characterizing the molecular mechanisms of the KlF family in the nervous system, including binding partners and gene targets, and comparing them to defined mechanisms defined outside the nervous system, we may better understand how KlFs regulate neurite growth and axon regeneration.

关键词： optic nerve regeneration axon growth retina retinal ganglion cells spinal cord transcription factors