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Approaches to antiretroviral therapy in China

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Cell Research 2005年第Z1期15卷 895-902页

作者： Bruce L GILLIAM Robert R redfield Division of Clinical Care and Research Institute of Human Virology University of Maryland Baltimore MD 21201 USA

China has recognized the threat of HIV to its population and responded with a national antiretroviral treatment (ARt) program. However, high ARt failure rates and the spread of resistance within populations are important realities to consider when developing and managing ARt programs in China and worldwide. Concepts which will define treatment success and local and national programmatic goals are 1) access to ARt, 2) durability of ARt at the patient level, 3) scalability of treatment modalities, and the 4) sustainability of the program at the community or national level. In the face of limited resources, China must also consider when to start ARV therapy, which agents to use, when to switch them, and how to treat highly experienced patients with drug resistance. the optimal ARV regimen to start with is changing frequently with the introduction of new agents and the presentation of new data. Currently, a regimen including tenofovir, emtricitabine or lamivudine and a nonnucleoside reverse transcriptase inhibitor appears to have optimal characteristics to treat HIV/AIDS in China. However, critical to all of these choices is the evaluation of programs implemented to insure wide scale success. China has wisely begun this process of evaluating the perfor- mance of local programs through systematic monitoring and evaluation of treatment outcomes. this will allow regi- mens and programs that work to be expanded, and programs with high failure rates to be eliminated. In the end, evidence based data supporting treatment strategies will allow China to successfully confront its AIDS epidemic early and prevent its tragic consequences

关键词： antiretroviral therapy scalability HIV/AIDS.

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AN UNQUIEt MIND

英语学习 1998年第8期 7-9页

作者：简墨 Dr.Kay redfield Jamison

Flights of the Mindthere is a particular kind ofpain,elation,loneliness,andterror involved in this kind *** you're high it's tremendous,the ideas and feelings arefast and frequent like shooting stars,and youfollow the... 详细信息

关键词： AN UNQUIEt MIND

Commentary on “Prevalence and evolution of drug resistance HIV-1 vari-ants in Henan, China”

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Cell Research 2005年第Z1期15卷 850-851页

作者： Bruce L GILLIAM Robert R redfield Richard Y ZHAO Robert C GALLO Institute of Human Virology University of Maryland Baltimore MD 21201 USA Institute of Human Virology University of Maryland Baltimore MD 21201 USA Department of Microbiology-Immunology University of Maryland School of Medicine Baltimore MD 21201 USA Institute of Human Virology University of Maryland Baltimore MD 21201 USA .Department of Pathology University of Maryland School of Medicine Baltimore MD 21201 USA

Critical to the implementation and scale-up of successful antiretroviral therapy worldwide is an understanding of the effcacy, toxicitie and durability of antiretroviral regimens in the specific populations, which the... 详细信息

关键词： HIV Commentary on Prevalence and evolution of drug resistance HIV-1 vari-ants in Henan

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美国桥梁建造者面临的若干设计论点

世界桥梁 1983年第3期 1-7页

作者： t.Y.Li■ Charles redfield 戴振藩大桥局桥研所

本文试图将直接影响桥梁建造者的几个论点指出来。虽然那些讨论主要针对在北美的桥梁建造者,有许多观点实际上可以应用到全世界的其他地区。特别是将讨论五个主要项目。

关键词：力筋箱形截面混凝土桥节段施工预制节段湿接头跨径桥面板桥墩长期挠度局部应力高架公路桥施工法美国美利坚合众国北美洲论点

射血分数正常心力衰竭的患病率和临床结局的变化趋势

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世界核心医学期刊文摘（心脏病学分册） 2006年第12期2卷 5-6页

作者： Owan t.E. Hodge D.O. Herges R.M. M.M. redfield 马超 Cardiovascular Research Guggenheim 9 Mayo Clinic 200 First St. SW Rochester MN 55905 United States Dr.

Background: the prevalence of heart failure with preserved ejection fraction may be changing as a result of changes in population demographics and in the prevalence and treatment of risk factors for heart failure. Changes in the prevalence of heart failure with preserved ejection fraction may contribute to changes in the natural history of heart failure. We performed a study to define secular trends in the prevalence of heart failure with preserved ejection fraction among patients at a single institution over a 15-year period. Methods: We studied all consecutive patients hospitalized with decompensated heart failure at Mayo Clinic Hospitals in Olmsted County, Minnesota, from 1987 through 2001. We classified patients as having either preserved or reduced ejection fraction. the patients were also classified as community patients(Olmsted County residents) or referral patients. Secular trends in the type of heart failure, associated cardiovascular disease, and survival were defined. Results: A total of 6076 patients with heart failure were discharged over the 15-year period; data on ejection fraction were available for 4596 of these patients(76 percent). Of these, 53 percent had a reduced ejection fraction and 47 percent had a preserved ejection fraction. the proportion of patients with the diagnosis of heart failure with preserved ejection fraction increased over time and was significantly higher among community patients than among referral patients(55 percent vs. 45 percent). the prevalence rates of hypertension, atrial fibrillation, and diabetes among patients with heart failure increased significantly over time. Survival was slightly better among patients with preserved ejection fraction(adjusted hazard ratio for death, 0.96; P=0.01). Survival improved over time for those with reduced ejection fraction but not for those with preserved ejection fraction. Conclusions: the prevalence of heart failure with preserved ejection fraction increased over a 15-year period, whi

关键词：射血分数生存率心力衰竭患病率

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我与躁郁症共处的30年

作者： (美)凯·雷德菲尔德·杰米森(Kay redfield Jamison)

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社区人群心力衰竭发病率及存活率的变化趋势

世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 7-8页

作者： Roger V.L. Weston S.A. redfield M.M. 姜馨 Division of Cardi ovascular Diseases Mayo Clinic 200 First St SW Rochester MN 55095 United St atesDr.

Context: the epidemic of heart failure has yet to be fully investigated , and d ata on incidence, survival, and sexspecific temporal trends in community-based populations are limited. Objective: to test the hypothesis that the incidence of heart failure has declined and survival after heart failure diagnosis has improved over time but that secular trends have diverged by sex. Design, Setting, and Participants: Population-based cohort study using the resources of the Rochester Epidemiology Project conducted in Olmsted County , Minnesota. Patients were 4537 Olmsted County residents (57%women; mean > a ge, 74 > years) with a diagnosis of heart failure between 1979 and 2000. Fram ingham criteria and clinical criteria were used to validate the diagnosis Main O utcome Measures: Incidence of heart failure and survival after heart failure dia gnosis. Results: the incidence of heart failure was higher among men (378/100000 persons; 95%confidence interval >, 361-395 for men; 289/100000 persons; 95 %CI, 277-300 for women) and did not change over time among men or women. After a mean follow-up of 4.2 years (range, 0-23.8 years), 3347 deaths occurred, in cluding 1930 among women and 1417 among men. Survival after heart failure diagno sis was worse among men than women (relative risk, 1.33; 95%CI, 1.24-1.43) but overall improved over time (5-year age-adjusted survival, 43%in 1979-1984 v s 52%in 1996-2000, Ptrasting with less or no improvement for women and elderly persons. Conclusion: In this community-based cohort, the incidence of heart fa ilure has not declined during 2 decades, but survival after onset of heart failu re has increased overall, with less improvement among women and elderly persons.

关键词： Rochester 临床标准性别差异队列研究明尼苏达州

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社区中的收缩性和舒张性心力衰竭

世界核心医学期刊文摘（心脏病学分册） 2007年第4期3卷 2-3页

作者： Bursi F. Weston S.A. redfield M.M. V.L.Roger 马超 Division of Cardiovascular Diseases Mayo Clinic200 First St SWRochesterMN 55905United States Dr.

背景:心力衰竭(HF)综合征是一种异质性疾病。虽然可由射血分数(EF)和舒张功能来定义HF,但描述社区中HF特征的资料少见,因为大多数研究都是基于医院的回顾性研究并依赖有临床指征的检验。此外,很少运用标准化技术系统性评估舒张功能。目... 详细信息

背景:心力衰竭(HF)综合征是一种异质性疾病。虽然可由射血分数(EF)和舒张功能来定义HF,但描述社区中HF特征的资料少见,因为大多数研究都是基于医院的回顾性研究并依赖有临床指征的检验。此外,很少运用标准化技术系统性评估舒张功能。目的:前瞻性检测社区HF居民的EF、舒张功能和脑利钠肽(BNP)

关键词：舒张性心力衰竭收缩性脑利钠肽射血分数舒张功能障碍超声心动图检测临床指征心肌梗死病史异

无冠心病的患者中肥胖与左室重构、舒张功能异常的关系

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 37-38页

作者： Powell B.D. redfield M.M. Bybee K.A. C.S. Rihal 黄浙勇 Division of Cardiovascular Diseases Mayo Clinic Rochester MN United States Dr.

Obese patients frequently complain of dyspnea. Deconditioning and altered left ventricular(LV) systolic or diastolic function with elevated filling pressures may contribute to dyspnea. this study analyzed 4,281 patients who underwent diagnostic coronary angiography from January 1, 1995, to December 31, 2000. No patients had coronary artery stenoses >50%of the luminal diameter, and all underwent echocardiography within the same 6-year period. the association between body mass index(BMI) and LV structure and systolic and diastolic function was examined. All analyses controlled for age and gender, with the effect size for BMI expressed using a standardized coefficient(SC). A higher BMI was associated with greater LV mass(SC 0.18, pthickness(SC 0.17, ptolic diameter(SC 0.07, ptroke volume increased with a higher BMI(SC 0.12, p=0.001), but there was no association between BMI and the ejection fraction(SC 0.003, p=0.81). Hemodynamic data from invasive studies showed an association between a higher BMI and increased LV end-diastolic pressure(mean 17 mm Hg for BMIted after controlling for end-diastolic volume(SC 0.22, pty was associated with ventricular remodeling, which may normalize wall stress while increasing stroke volume to match metabolic demand. Obesity was not associated with decreased systolic function. However, obesity was associated with increased LV end-diastolic pressure, which suggests an association between obesity and diastolic dysfunction. In conclusion, ventricular remodeling, LV diastolic dysfunction, and elevated filling pressures may contribute to the prevalence of heart failure in obese patients.

关键词：舒张功能异常左室重构心室重构舒张期末容积冠状动脉造影室壁厚度左室结构室壁应力呼吸困难