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Improved outcome with stan.ardized plan.for clin.cal man.gemen. of acute decompen.ated chron.c heart failure

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Journ.l of Geriatric Cardiology 2019年第1期16卷 12-18页

作者： marie-louise Edvin.son.Albin.Sten.erg Karin.Astrom-Olsson Departmen. of Emergen.y an. In.ern.l Medicin. University'Hospital of LundSweden In.titute of Clin.cal Scien.es L und UniversityL undSweden Departmen. of Cardiology University>Hospital of MalmoSweden

Backgroun. Our overall goal is to improve clin.cal care for in.atien.s with chron.c heart failure(CHF).A retrospective assessmen. of CHF patien.s admitted to our hospital over the past decade(2005 vs.2014)in.icated a n.ed for better strategies to evaluate clin.cal treatmen.,implemen. best practices an. achieve optimal patien. *** that purpose,we developed a stan.ardized plan.to improve in.hospital treatmen. of acute decompen.ated CHF ***&Results Retrospective chart reviews were con.ucted to compare three cohorts of CHF patien.s admitted to the Un.versity Hospital of Lun. at differen. time poin.s over a 12-year period:2005(365 patien.s),2014(172 patien.s)an. 2017-2018(57 patien.s).Little improvemen. was seen.between.2005 an. 2014 with respect to on.-year mortality(35%vs.34%)an. adequate treatmen. with recommen.ed medication.,e.g.,use of ren.n.an.ioten.in.system blockers(45%vs.51%).A stan.ardized treatmen. plan.was devised to improve outcomes.A third cohort,treated un.er the plan.2017-2018),was compared with the 2014 ***-year mortality(18%vs.34%)an. 30-day readmission.5%vs.30%)were dramatically decreased,an. adheren.e to medication.guidelin.s was *** elemen.s of the plan.in.luded well-defin.d treatmen. procedures,en.an.ed commun.cation.an. teamwork,education.adequate time for treatmen.(5 days)an. post-discharge follow-up as *** peptide(n.-proBn.)levels were useful for assessin. patien. status,progn.sis an. respon.e to *** Developmeof a stan.ard plan.for clin.cal man.gemen. of acute decompen.ated CHF patien.s resulted in.sign.fican. improvemen.s in.patien. outcome,as reflected in.decreased rates of 30-day readmission.an. on.-year mortality.

关键词： Chron.c heart failure Medication n.-proBn. Progn.sis

Deteriorated fun.tion.of cutan.ous microcirculation.in.chron.c con.estive heart failure

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Journ.l of Geriatric Cardiology 2011年第2期8卷 82-87页

作者： marie-louise Edvin.son.Erik Uddman.Sven.E An.ersson Departmen. of Emergen.y Medicin. Lund University Hospital SE- 221 85 LUND Sweden

Backgroun. Chron.c con.estive heart failure is a complex con.ition.that leads to dysfun.tion.in.the peripheral microcirculation. We have previously shown.that vascular reactivity is reduced with in.reasin. age. In.this study, we examin.d a group of very old patien.s with severe chron.c heart failure to test the hypothesis that vascular fun.tion.is further compromised by a combin.tion.of heart failure an. agin.. Methods Cutan.ous forearm blood flow was measured by laser Doppler flowmetry an. compared amon. three groups： Group 1 （n.= 20, mean.±SE： 85.5 ±4 years）, heart failure patien.s with n.w York Heart Association.class Ⅳ （n.HA Ⅳ） an. with a n.-proBn. level ≥5000 n./L; Group 2 （n.= 15, mean.±SE： 76.5 ±2 years）, heart failure patien.s with n.HA II an. n.-proBn. ≤2000 n./L, an. Group 3 （n.= 10, mean.±SE： 67.6 ±3.0 years）, healthy con.rols with n. clin.cal sign. of heart failure. The vasodilator respon.e to the ion.ophoretic admin.stration.of acetylcholin. （ACh）, actin. via an.en.othelial mechan.sm, an. sodium n.troprusside （Sn.）, actin. via a smooth muscle cell mechan.sm, were studied. Results All patien.s with heart failure had sign.fican.ly reduced vascular reactivity in.epen.en. of the mode of stimulation.（ACh, Sn. or heat） when.compared to healthy con.rols. However, the respon.es did n.t differ between.the two groups of heart failure patien.s. Con.lusion. Cutan.ous vascular reactivity is reduced in.heart failure patien.s an. does n.t correlate with the severity of the con.ition.or age of patien.s.

关键词： heart failure cutan.ous microcirculation en.othelial respon.es acetylcholin. smooth muscle respon.es

基于旅游者视角的世界遗产文化与自然融合价值认知研究——以桂林喀斯特为例

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浙江大学学报（人文社会科学版） 2024年第1期54卷 112-128页

作者：张柔然 [英]王家宁玛丽·路易斯·斯蒂格·索伦森剑桥大学麦克唐纳考古研究所剑桥CB23ER 深圳大学建筑与城市规划学院广东深圳518060 约克大学考古系约克YO17EP

现有的世界遗产体系中,遗产的文化和自然融合价值评估标准仍不完善。以遗产思辨研究为分析框架,挖掘多元的利益相关者对融合价值的理解,有助于填补相关评估标准的空白。在中国的文化背景中,桂林山水的自然与文化价值相互融合、相辅相成... 详细信息

现有的世界遗产体系中,遗产的文化和自然融合价值评估标准仍不完善。以遗产思辨研究为分析框架,挖掘多元的利益相关者对融合价值的理解,有助于填补相关评估标准的空白。在中国的文化背景中,桂林山水的自然与文化价值相互融合、相辅相成,游客在游览过程中能够自我理解、阐释和创造桂林山水的文化与自然融合价值。游客不仅是桂林山水文化的体验者,更是其文化价值的创造者。他们的亲身感受与理解,证实并塑造了桂林的自然与文化价值。游客的话语为重新审视遗产的文化与自然价值提供了中国旅游者的智慧,强调在评估遗产价值时应采取更加民主的方式,尊重本土知识,并以文化与自然融合的视角解读遗产价值。确保民众的话语权对于全面理解和阐释遗产价值以及制定更加合理的世界遗产保护、申报和管理策略具有至关重要的意义。

关键词：遗产思辨研究文化与自然融合价值桂林喀斯特话语分析

Reduced peripheral vascular reactivity in.refractory an.in. pectoris:Effect of en.an.ed extern.l coun.erpulsation

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Journ.l of Geriatric Cardiology 2011年第4期8卷 215-223页

作者： Susan.e M Bon.esson.marie-louise Edvin.son.Thomas Pettersson.Lars Edvin.son Departmen. of Medicin. Kristianstad HospitalSE-29185 KristianstadSweden Departmen. of Health Scien.es Lun. Lund UniversitySE-22100 LundSweden Departmen. of Emergen.y Medicin. Lund University HospitalSE-22185 LundSweden

Objective To examin. if the skin.microvascular bed is altered an. can.be modified by en.an.ed extern.l coun.erpulsation.EECP)in.patien.s with chron.c refractory *** Twen.y patien.s diagn.sed with refractory an.in. were divided in.o EECP(n.10)or n. EECP(n.10)*** data were compared to matched healthy subjects(n.20).The cutan.ous forearm microvascular blood flow was measured by Laser-Doppler *** vascular respon.iven.ss to ion.ophoretic admin.stration.of acetylcholin.(ACh),sodium n.troprusside(Sn.)an. local skin.warmin. were *** of Can.dian.Cardiovascular Society(CCS)-class,blood pressure an. plasma samples were *** EECP patien.s showed reduced CCS-class compared to n. EECP(Pn. n. EECP(Pn.(Pn. differen.e in.restin. blood flow between.the two refractory groups at baselin. as well as after EECP an. seven.weeks of *** to heatin.,the respon.es to ACh an. Sn. in.the cutan.ous microcirculation.were lower in.both groups of refractory an.in. patien.s as compared to healthy subjects(Pn.s correspon.ed positively to the treatmen. shown.by reduced plasma level of soluble in.erleukin.2 receptor an. *** Refractory an.in. patien.s have reduced respon.iven.ss in.their cutan.ous microcirculation.to ACh,Sn. an. heat compared to healthy *** EECP reduced the CCS-class,this effect was n.t associated with improvemen.s in.respon.iven.ss of the cutan.ous microcirculation.

关键词： refractory an.in. pectoris flowmetry microcirculation en.an.ed extern.l coun.erpulsation

In.reased mortality in.elderly heart failure patien.s receivin. in.usion.of furosemide compared to elderly heart failure patien.s receivin. bolus in.ection

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Journ.l of Geriatric Cardiology 2020年第6期17卷 359-364页

作者： Ran. Sager Isak Lin.stedt Lars Edvin.son.marie-louise Edvin.son Departmen. of Emergen.y an. In.ern.l Medicin. Lund University Hospital of SkåneSweden Departmen. of Medicin. Institute of Clinical Sciences in LundLund UniversitySweden

Heart failure(HF)is a con.ition.of cardiac dysfun.tion.an. fluid *** activation.via the ren.n.n.ioten.in.aldosteron. system an. the sympathetic n.rvous system are the pathophysiological corn.rston.s.[1]Furthermore,HF is a disorder widely associated with grave adverse outcomes an. poor progn.sis.[2]A loop diuretic is the fun.amen.al drug used to preven. multiorgan.failure an. improve symptoms in.these patien.s.[3]

关键词： Furosemide Heart failure In.usion In.ection Mortality

Brain.n.triuretic peptide is a poten. vasodilator in.aged human.microcircula- tion.an. shows a blun.ed respon.e in.heart failure patien.s

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Journ.l of Geriatric Cardiology 2014年第1期11卷 50-56页

作者： marie-louise Edvin.son.Erik Uddman.Lars Edvin.son.Sven.E. An.ersson Departmen. of Emergen.y an. In.ern.l Medicin. Institute of Clinical Sciences Lund University Lund University Hospital SE- 221 85 Lund Sweden

Backgroun. Brain.n.triuretic peptide （Bn.） is n.rmally presen. in.low levels in.the circulation. but it is elevated in.parallel with the degree of con.estion.in.heart failure subjects （CHF）. Bn. has n.triuretic effects an. is a poten. vasodilator. It is suggested that Bn. could be a therapeutic altern.tive in.CHF. However, we postulated that the high levels of circulatin. Bn. in.CHF may down.egulate the respon.e of microvascular n.triuretic receptors. This was tested by comparin. 15 CHF patien.s （Bn. 〉 3000 n./L） with 10 matched, healthy con.rols. Methods Cutan.ous microvascular blood flow in.the forearm was measured by laser Doppler Flowmetry. Local heatin. （＋44°C, 10 min. was used to evoke a maximum local dilator respon.e. Results n.n.in.asive ion.ophoretic admin.stration.of either Bn. or acetylcholin. （ACh）, a kn.wn.en.othelium-depen.en. dilator, elicited an.in.rease in.local flow. The n.tric oxide syn.hase in.ibitor, l-n.Argin.n.- methyl-ester （L-n.ME）, blocked the Bn. respon.e （in.con.rols）. In.erestin.ly, respon.es to Bn. in.CHF patien.s were reduced to about on. third of those seen.in.healthy con.rols （in.rease in.flow： 251% in.CHF vs. 908% in.con.rols; P 〈 0.001）. In.con.rast, the vasodilator respon.es to ACh an. to local heatin. were on.y somewhat atten.ated in.CHF patien.s. Thus, dilator capacity an. n.tric oxide sign.llin. were n.t af- fected to the same exten. as Bn.-mediated dilation. in.icatin. a specific down.egulation.of the latter respon.e. Con.lusion. The fin.in.s show for the first time that microvascular respon.es to Bn. are markedly reduced in.CHF patien.s. This is con.isten. with the hypothesis of Bn. receptor fun.tion.is down.egulated in.CHF.

关键词： Heart failure Cutan.ous microcirculation En.othelial respon.es Acetylcholin., Brain.n.triuretic peptide n.tric oxide

Evaluation.of Three <i>Helicobacter pylori</i>Eradication.Protocols in.a Digestive En.oscopy Cen.er in.Dakar

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Open.Journ.l of Gastroen.erology 2021年第11期11卷 244-254页

作者： Salamata Diallo marie louise bassèn. marieme Polele Fall Alia Issa Mame Aisse Thioubou Departmen. of Gastroen.erology an. Hepatology Hospital Aristide Le Dantec Dakar Senegal Departmen. of Gastroen.erology an. Hepatology Hospital de la Paix Ziguinchor Senegal

In.roduction. The treatmen. of Helicobacter pylori (H. pylori) requires the combin.tion.of an.ibiotic therapy with an.an.isecretory agen.. Due to in.reasin. an.ibiotic resistan.e, which varies from on. geographical re... 详细信息

n.>In.roduction.n.> The treatment of Helicobacter pylori (H. pylori) requires the combination of antibiotic therapy with an antisecretory agent. Due to increasing antibiotic resistance, which varies from one geographical region to another, several eradication protocols exist. Objective: Tn.n.n.he n.n.on.n.bjective isn.n. evaluaten.n. and compare the efficacy of three treatment regimens for H. pylori infection: 1) Arm A: Omeprazole + Amoxicillin + Clarithromycin for 10 days;2) Arm B: Omeprazole + Amoxicillin + Metronidazole for 10 days;3) Arm C: Sequential treatment = Omeprazole + Amoxicillin for 5 days then Omeprazole + Clarithromycin + Metronidazole for 5 days. Patients and Method: This was a prospective randomised study conducted from February 2016 to July 2016 and from April 2017 to September 2017 in the digestive endoscopy center of the gastroenterology and hepatology department of the University Hospital Cen.er Aristide Le Dan.ec. Our study population.con.isted of all patien.s aged 18 years or older referred for upper GI en.oscopy. We in.luded all patien.s whose in.ication.for the examin.tion.was epigastralgia an./or dyspepsia an. whose rapid urease test was positive. Patien.s were ran.omized to the differen. treatmen. arms. A 13C-urea breath test was performed at least 4 weeks after stoppin. an.ibiotics an. 2 weeks after stoppin. proton.pump in.ibitor (PPI). Results: We in.luded 120 patien.s. There were 95 women.an. 25 men. The mean.age was 40 years. Epigastralgia an. dyspepsia were presen. in.90% an. 59% of cases, respectively. Upper G

关键词： Helicobacter pylori Epigastralgia Dyspepsia An.ibiotics Resistan.es

Microscopy Method to Compare Cyst n.matode In.ection.of Differen. Plan. Species

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Advan.es in.Bioscien.e an. Biotechn.logy 2016年第6期7卷 311-318页

作者： Rin. Kooliyottil louise-marie Dan.uran. Byju n. Govin.an.Guy R. Kn.dsen Departmen. of Plan. Soil an. En.omological Scien.es University of Idaho Moscow ID USA Biological Systems En.in.erin. Washington State University Pullman WA USA

The cyst n.matode, Globodera pallida, is an.obligate, biotrophic pathogen.of potato, causin. up to 80% yield loss. In.the presen. study, a n.n.destructive imagin. techn.que was used to compare the developmen. an. behavior of G. pallida in.its host Solan.m tuberosum an. in.the n.n.host S. sisymbriifolium. We used microscopy-rhizosphere chambers coupled with the fluorescen. stain.PKH26, an. compared this with destructively sampled acid fuchsin.stain.n.. n. sign.fican. differen.e (P ≥ 0.90) in.G. pallida n.mbers was foun. whether stain.d with PKH26 or acid fuchsin.for either plan. species in.icatin. n. toxic effect from the vital stain. PKH26 labelled J2s successfully located an. pen.trated roots of both S. tuberosum an. S. sisymbriifolium. Two days after in.culation. PKH26 stain.d G. pallida was clearly observed migratin. in.ercellularly through root tissues of both S. tuberosum an. the n.n.host S. sisymbriifolium. Overall, more n.matodes were observed in.S. tuberosum than.in.S. sisymbriifolium roots. n. live J2s were observed in.S. sisymbriifolium roots stain.d with either acid fuchsin.or PKH26 after 8 days. Un.erstan.in. the time lin. of developmen. of G. pallida in.S. sisymbriifolium is importan. towards comprehen.ive un.erstan.in. of plan. defen.e respon.es.

关键词： Cyst n.matode Solan.m sisymbriifolium n.n.Destructive Imagin.

Epidemiological, Clin.cal, Paraclin.cal, Etiological an. Therapeutic Aspects of Liver Cirrhosis in.the Hepato-Gastroen.erology Departmen. of the Hospital Aristide Le Dan.ec in.Dakar

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Open.Journ.l of Gastroen.erology 2022年第11期12卷 317-323页

作者： marie louise bassèn. Salamata Diallo marieme Polele Fall Mame Aissé Thioubou Tén. Sidibé Coumba Cissé Mamadou n.on. Gueye Departmen. of Gastroen.erology an. Hepatology Hospital Aristide Le Dantec Dakar Senegal Departmen. of Gastroen.erology an. Hepatology Peace Hospital Ziguinchor Senegal Departmen. of Gastroen.erology an. Hepatology Hospital Idrissa Pouye Dakar Senegal

In.roduction. Liver cirrhosis is a global public health issue. Our aim was to determin. the epidemiological, clin.cal, paraclin.cal an. therapeutic aspects of liver cirrhosis in.the hepato-gastroen.erology departmen. of the hospital Aristide Le Dan.ec in.Dakar. Patien.s an. Methods: We con.ucted a retrospective study with a descriptive focus coverin. the period from Jan.ary 1st, 2010 to December 31, 2020. We in.luded the medical records of patien.s which presen.ed body of clin.cal an. paraclin.cal argumen.s which supported the diagn.sis of cirrhosis. The data collected were related to age, gen.er, clin.cal, paraclin.cal, therapeutic an. progn.sis aspects of cirrhosis an. were an.lyzed with the software Sphin. Plus. Results: Prevalen.e of cirrhosis was 6.2%. Sex ratio was 2.1%. The average age was 38 years. Asthen.a (60.9%), altered performan.e status (60.1%), abdomin.l pain.(37.2%), gastroin.estin.l bleedin. (29.6%) an. abdomin.l swellin. (27.8%) were the most common.motives of con.ultation. Physical examin.tion.revealed primarily portal hyperten.ion.(74.9%), liver failure (2.4%), hepatomegaly (28.2%) an. an.mia (13.7%). Viral hepatitis B was the most common.etiology (81.9%). Abdomin.l screen.n. (ultrasoun./CT scan. showed hepatomegaly (80.6%), liver dysmorphia (87.7%), portal hyperten.ion.sign. (85.3%) an. portal vein.thrombosis (18.2%). 55.1% Patien.s were classified as Child Pugh A, 33.8% were Child Pugh B an. 11.1% were Child Pugh C. Ten.fovir Disoproxil Fumarate (TDF) was prescribed to all patien.s affected by hepatitis B virus on.y. Evolution.was characterized by clin.cal improvemen. an. progn.sis reclassification. Con.lusion. Liver cirrhosis is a frequen. pathology in.the hepato-gastroen.erology departmen. of the hospital Aristide Le Dan.ec in.Dakar. It affects youn. male adult. Hepatitis B virus is the leadin. cause. TDF is an.effective treatmen..

关键词： Cirrhosis Viral Hepatitis B Portal Hyperten.ion Liver Failure Hepatomegaly