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Central nervous system efficacy of aumolertinib versus gefitinib in patients with untreated,EGFR-mutated,advanced non-small cell lung cancer:data froma randomized phase III trial(AENEAS)

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Cancer Communications 2024年第9期44卷 1005-1017页

作者： Shun Lu Xiaorong Dong Hong Jian Jianhua Chen Gongyan Chen Yuping Sun Yinghua Ji ZipingWang Jianhua Shi Junguo Lu Shaoshui Chen Dongqing Lv Guojun Zhang Chunling Liu Juan Li Xinmin Yu Zhong Lin Zhuang Yu ZhehaiWang Jiuwei Cui Xingxiang Xu Jian Fang Jifeng Feng Zhi Xu RuiMa Jie Hu Nong Yang Xiangdong Zhou XiaohongWu Chengping Hu Zhihong Zhang You Lu Yanping Hu Liyan Jiang Qiming wang Renhua Guo Jianying Zhou Baolan Li Chunhong Hu Wancheng Tong Helong Zhang LinMa Yuan Chen Zhijun Jie Yu Yao Longzhen Zhang JieWeng Weidong Li Jianping Xiong Xianwei Ye Jianchun Duan Haihua Yang Meili Sun HongyingWei JiaweiWei Zheyu Zhang QiongWu Department of Medical Oncology Shanghai Chest Hospital Shanghai JiaoTong UniversityShanghaiP.R.China Cancer Center Union Hospital Tongji Medical College Huazhong University of Science and TechnologyWuhanHubeiP.R.China Department of Medical Oncology-Chest Hunan Cancer Hospital&The Affiliated Cancer Hospital of Central South University Xiangya School of MedicineChangshaHunanP.R.China Thoracic OncologyMedicine HarbinMedical University Cancer HospitalHarbinHeilongjiangP.R.China Department of Oncology Jinan Central HospitalJinanShandongP.R.China Department of Oncology First Affiliated Hospital of Xinxiang Medical UniversityXinxiangHenanP.R.China Department of Chest Medicine Beijing Cancer HospitalBeijingP.R.China Department of Internal Medicine Linyi Cancer HospitalLinyiShandongP.R.China Department of Respiratory Medicine Nantong Tumor HospitalNantongJiangsuP.R.China Department of Oncology Binzhou Medical University HospitalBinzhouShandongP.R.China Breath Internal Medicine Taizhou Hospital of Zhejiang ProvinceLinhaiZhejiangP.R.China Department of Respiration The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanP.R.China Department of Lung Internal Medicine Affiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiXinjiangP.R.China Department of Thoracic Oncology Sichuan Cancer HospitalChengduSichuanP.R.China Thoracic Medical Oncology Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital)HangzhouZhejiangP.R.China Department of Thoracic Oncology The Fifth Subsidiary Sun Yat-sen University HospitalZhuhaiGuangdongP.R.China Department of Oncology The Affiliated Hospital of QingdaoUniversityQingdaoShandongP.R.China Department of Oncology Shandong Cancer HospitalJinanShandongP.R.China Department of Oncology The First BethuneHospital of Jilin UniversityChangchunJilinP.R.China Department of Respiration Northern Jiangsu People’s Hospital Affiliated to Yangzhou UniversityYangzhouJiangsuP.R.China Department of Internal

Background:The initial randomized,double-blinded,actively controlled,phase III ANEAS study(NCT03849768)demonstrated that aumolertinib showed superior efficacy relative to gefitinib as first-line therapy in epidermal growth factor receptor(EGFR)-mutated advanced non-small cell lung cancer(NSCLC).Metastatic disease in the central nervous system(CNS)remains a challenge in the management of *** study aimed to compare the efficacy of aumolertinib versus gefitinib among patients with baseline CNS metastases in the ANEAS ***:Eligible patients were enrolled and randomly assigned in a 1:1 ratio to orally receive either aumolertinib or gefitinib in a double-blinded *** with asymptomatic,stable CNS metastases were ***-up imaging of the same modality as the initial CNS imaging was performed every 6 weeks for 15 months,then every *** responsewas assessed by a neuroradiological blinded,independent central review(neuroradiological-BICR).The primary endpoint for this subgroup analysis was CNS progression-free survival(PFS).Results:Of the 429 patients enrolled and randomized in the ANEAS study,106 patients were found to have CNS metastases(CNS Full Analysis Set,cFAS)at baseline by neuroradiological-BICR,and 60 of them had CNS target lesions(CNS Evaluable for Response,cEFR).Treatment with aumolertinib significantly prolonged median CNS PFS compared with gefitinib in both cFAS(29.0 vs.8.3 months;hazard ratio[HR]=0.31;95%confidence interval[CI],0.17-0.56;P<0.001)and cEFR(29.0 vs.8.3 months;HR=0.26;95%CI,0.11-0.57;P<0.001).The confirmed CNS overall response rate in cEFRwas 85.7%and 75.0%in patients treated with aumolertinib and gefitinib,*** risk analysis showed that the estimated probability of CNS progression without prior non-CNS progression or death was consistently lower with aumolertinib than with gefitinib in patients with and without CNSmetastases at *** new safety findings were ***:The

关键词： aumolertinib brain metastasis non-small cell lung cancer third-generation EGFR-TKI

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Anaplastic pleomorphic xanthoastrocytoma with disseminated growth pattern at the time of diagnosis as well as after treatment:case report and review of literature

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Chinese Neurosurgical Journal 2017年第4期3卷 238-242页

作者： Meng Zhu Chen Zhang Kai Zhao Leilei Wang Jian Sun Yugong Feng Weicheng Yao Shizhu Yu Cuiyun Sun Xuejun Yang Department of Neurosurgery Affiliated Hospital of Qingdao UniversityShandong 266003 People's Republic of ChinaDepartment of NeurosurgeryTianjin Medical University General Hospital Tianjin 300052 People's Republic of China Department of Neurosurgery Tianjin Medical University General Hospital Tianjin 300052 People's Republic of China Department of Neurosurgery Affiliated Hospital of Logistics University of People's Armed Police Force Tianjin 300052 People's Republic of China Department of Neurosurgery Cangzhou Central Hospital Hebei 061001 People's Republic of China Department of Neurosurgery Affiliated Hospital of Qingdao UniversityShandong 266003 People's Republic of China Department of Neuropathology Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin 300052 People's Republic of China

Background:Pleomorphic xanthoastrocytoma (PXA) is usually considered a relatively benign and localized entity. However, cases of PXA with anaplastic features have been reported in recent years. Anaplastic pleomorphic xanthoastrocytoma has been added to the 2016 WHO classification of CNS tumors as a distinct entity. Case presentation:We describe a rare case of PXA with dissemination, both at the time of diagnosis and after treatment. The 20-year-old male presented with signs of high intracranial pressure and sudden-onset transient seizures. Imaging examinations showed diffuse lesions widely distributed in the left hemisphere, and on histopathological examination, he was diagnosed with anaplastic PXA. The patient underwent surgical treatment and adjuvant concurrent chemoradiation. Follow-up MRI revealed early recurrence and distant spread of the tumor. Conclusions:Anaplastic PXA usually has unique characteristics, including dissemination, early recurrence, and chemoresistance. A strategy based on early diagnosis and aggressive treatment is warranted. However, sufficiently powered studies are required to generate evidence-based guidelines.

关键词： Anaplastic pleomorphic xanthoastrocytoma Dissemination Treatment

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Development of organ transplantation in China and organ donation

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Oncology and Translational Medicine 2024年第6期10卷 257-261页

作者： Shaofa Wang Xiaoping Chen institute of Organ Transplantation Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Key Laboratory of Organ Transplantation Ministry of EducationWuhanChina NHC Key Laboratory of Organ Transplantation WuhanChina Key Laboratory of Organ Transplantation Chinese Academy of Medical SciencesWuhanChina

This article provides a concise overview of the development of organ transplantation in *** by international advancements in organ transplantation,China embarked on its own organ transplantation research journey in *** clinical evaluation phase is marked by the first cadaveric kidney transplant in 1960 and the first living-donor kidney transplant in *** 1989,the annual number of successful kidney transplants had surpassed ***,57 liver transplants were performed between 1977 and 1983;limitations in technology and the scarcity of cyclosporine A resulted in unfavorable outcomes for most recipients,with the majority succumbing within 3 months of *** factors led to a near-complete halt in liver,heart,and lung transplants for the following *** all 4 conditions met-(1)mature surgical techniques,(2)powerful immunosuppressive agents available for clinical use,(3)new organ preservation solutions that ensure the quality and transportation of donor organs,and(4)reasonable and legal sources of organs-China's organ transplantation field has experienced rapid *** 2014,there were 9652 organ transplants,and this number grew to 20,225 by *** the progress,China's organ donation rate per million remains relatively low,3.86 ranking 48th globally in 2022,underscoring the need for increased public awareness and support for organ donation.

关键词： Organ transplantation Organ donation China Historical development Clinical milestones Brain death Public awareness

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外科创新技术/器械临床研究方法学——IDEAL框架与推荐系列文章之一:IDEAL框架与推荐介绍

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中国胸心血管外科临床杂志 2021年第2期28卷 131-136页

作者：喻佳洁陕飞 Peter McCulloch Allison Hirst 胡建昆孙鑫李幼平刘伦旭刘雪梅董念国陈寄梅乔贵宾李鹤成四川大学华西医院中国循证医学中心成都610041 北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤中心北京100142 IDEAL Collaboration Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUnited KingdomOX39DU 四川大学华西医院胃肠外科胃癌研究室成都610041 博鳌乐城真实世界数据研究创新中心海南琼海571435 四川大学华西医院胸外科成都610041 四川大学华西医院中国胸心血管外科临床杂志编辑部成都610041 华中科技大学同济医学院附属协和医院心脏大血管外科武汉430022 广东省心血管病研究所广东省人民医院(广东省医学科学院)广东省华南结构性心脏病重点实验室心外科广州510080 广东省人民医院胸外科广州510080 上海交通大学医学院附属瑞金医院胸外科上海200025

外科技术和器械的快速创新是外科临床研究和实践的重要内容,其评价总体思路与药物干预类似,但具体方法学存在很大差异。2009年IDEAL协作网提出一套适用于外科创新干预的方法学框架—IDEAL框架,将外科创新技术发展分为5个阶段,涵盖从概... 详细信息

外科技术和器械的快速创新是外科临床研究和实践的重要内容,其评价总体思路与药物干预类似,但具体方法学存在很大差异。2009年IDEAL协作网提出一套适用于外科创新干预的方法学框架—IDEAL框架,将外科创新技术发展分为5个阶段,涵盖从概念提出到推广应用的全生命周期。2019年,协作网更新IDEAL框架,在原有基础上增加临床前评价(Pre-IDEAL),梳理明确各阶段研究目的、核心问题和伦理依据。作为IDEAL框架和推荐系统的首篇文章,本文将详细介绍IDEAL推荐和框架的产生、发展、具体内容、应用推广现状,旨在促进该方法在国内外科临床研究领域的应用和传播。

关键词：外科创新框架与推荐 IDEAL 临床研究

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Exploring ideal operative time for best outcomes in gastric cancer surgery:A multi-institutional study based on KLASS-07 database

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Chinese Journal of Cancer research 2023年第6期35卷 660-674页

作者： Shin-Hoo Park Ye-Rim Shin Hoon Hur Chang Min Lee Jae Seok Min Seung Wan Ryu Hyun Dong Chae Oh Jeong Chang-In Choi Kyo-Young Song Ho Goon Kim Ye Seob Jee Kwang Hee Kim Jeong Goo Kim Kyung Sook Yang Hua Huang Sungsoo Park Division of Foregut Surgery Korea University College of MedicineSeoul 02841Republic of Korea Division of Foregut Surgery Korea University Anam HospitalSeoul 02841Republic of Korea Department of Surgery Ajou University School of MedicineSuwon 16499Republic of Korea Division of Foregut Surgery Korea University Ansan HospitalAnsan 15355Republic of Korea Department of Surgery Dongnam Institute of Radiological and Medical SciencesCancer CenterBusan 46033Republic of Korea Department of Surgery Keimyung University Dongsan Medical CenterDaegu 41931Republic of Korea Department of Surgery Catholic University of Daegu School of MedicineDaegu 42472Republic of Korea Department of Surgery Chonnam National University Medical SchoolHwasun 58128Republic of Korea Department of Surgery Pusan National University HospitalPusan 49241Republic of Korea Department of Surgery Catholic University of Seoul St Mary’s HospitalSeoul 06591Republic of Korea Department of Surgery Chonnam National University Medical SchoolGwangju 61469Republic of Korea Department of Surgery Dankook University College of MedicineCheonan 31116Republic of Korea Department of Surgery Busan Paik HospitalInje UniversityBusan 14905Republic of Korea Department of Surgery Daejeon St.Mary’s HospitalCollege of Medicinethe Catholic University of KoreaDaejeon 34943Republic of Korea Department of Biostatistics Korea University College of MedicineSeoul 02841Republic of Korea Department of Gastric Cancer and Soft Tissue Sarcoma Fudan University Shanghai Cancer CenterShanghai 200433China Department of Oncology Shanghai Medical CollegeFudan UniversityShanghai 200433China

Objective:While a rushed operation can omit essential procedures,prolonged operative time results in higher ***,the optimal operative time range remains *** study aimed to estimate the ideal operative time range and evaluate its applicability in laparoscopic cancer ***:A prospectively collected multicenter database of 397 patients who underwent laparoscopic distal gastrectomy were retrospectively *** ideal operative time range was statistically calculated by separately analyzing the operative time of uneventful ***,intraoperative and postoperative outcomes were compared among the shorter,ideal,and longer operative time ***:The statistically calculated ideal operative time was 135.4-165.4 *** longer operative time(LOT)group had a lower rate of uneventful,perfect surgery than the ideal or shorter operative time(IOT/SOT)group(2.8%vs.8.8%and 2.2%vs.13.4%,all Psurgical experience.

关键词： Operative time laparoscopic surgery gastric cancer gastrectomy morbidity

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Bioresorbable Multilayer Photonic Cavities as Temporary Implants for Tether-Free Measurements of Regional Tissue Temperatures

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Biomedical Engineering Frontiers 2021年第1期2卷 89-102页

作者： Wubin Bai Masahiro Irie Zhonghe Liu Haiwen Luan Daniel Franklin Khizar Nandoliya Hexia Guo Hao Zang Yang Weng Di Lu Di Wu Yixin Wu Joseph Song Mengdi Han Enming Song Yiyuan Yang Xuexian Chen Hangbo Zhao Wei Lu Giuditta Monti Iwona Stepien Irawati Kandela Chad R.Haney Changsheng Wu Sang Min Won Hanjun Ryu Alina Rwei Haixu Shen Jihye Kim Hong-Joon Yoon Wei Ouyang Yihan Liu Emily Suen Huang-yu Chen Jerry Okina Jushen Liang Yonggang Huang Guillermo A.Ameer Weidong Zhou John A.Rogers Department of Materials Science and Engineering Northwestern UniversityEvanstonIllinois 60208USA Querrey Simpson institute for Bioelectronics Northwestern UniversityEvanstonIllinois 60208USA Department of Electrical Engineering University of Texas at ArlingtonArlingtonTX 76019USA Department of Mechanical Engineering Northwestern UniversityEvanstonIllinois 60208USA Department of Chemistry Northwestern UniversityEvanstonIllinois 60208USA Department of Biomedical Engineering Northwestern UniversityEvanstonIllinois 60208USA Department of Materials Science and Engineering University of Illinois Urbana-ChampaignUrbanaIllinois 61801USA Academy for Advanced Interdisciplinary Studies Peking UniversityBeijingChina Department of Aerospace and Mechanical Engineering University of Southern CaliforniaLos AngelesCA 90089USA The Center for Developmental Therapeutics Northwestern UniversityEvanstonIllinois 60208USA Center for Advanced Molecular Imaging Northwestern UniversityEvanstonIllinois 60208USA Department of Electrical and Computer Engineering Sungkyunkwan UniversitySuwonRepublic of Korea School of Advanced Materials Science and Engineering Sungkyunkwan University(SKKU)Suwon 16419Republic of Korea Department of Neurobiology Northwestern UniversityEvanstonIllinois 60208USA Department of Chemical Engineering Northwestern UniversityEvanstonIllinois 60208USA Department of Civil and Environmental Engineering Northwestern UniversityEvanstonIllinois 60208USA Department of Electrical Engineering and Computer Science Northwestern UniversityEvanstonIllinois 60208USA Northwestern Medicine Feinberg School of MedicineNorthwestern UniversityEvanstonIllinois 60208USA Center for Advanced Regenerative Engineering Northwestern UniversityEvanstonIllinois 60208USA

Objective and Impact ***-time monitoring of the temperatures of regional tissue microenvironments can serve as the diagnostic basis for treating various health conditions and *** thermal sensors allow measurements at surfaces or at near-surface regions of the skin or of certain body *** at depth require implanted devices connected to external readout electronics via physical interfaces that lead to risks for infection and movement constraints for the ***,surgical extraction procedures after a period of need can introduce additional risks and ***,we report a wireless,bioresorbable class of temperature sensor that exploits multilayer photonic cavities,for continuous optical measurements of regional,deep-tissue microenvironments over a timeframe of interest followed by complete clearance via natural body *** designs decouple the influence of detection angle from temperature on the reflection spectra,to enable high accuracy in sensing,as supported by in vitro experiments and optical *** with devices implanted into subcutaneous tissues of both awake,freely moving and asleep animal models illustrate the applicability of this technology for in vivo *** results demonstrate the use of bioresorbable materials in advanced photonic structures with unique capabilities in tracking of thermal signatures of tissue microenvironments,with potential relevance to human healthcare.

关键词： signature constraints multilayer

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特纳综合征中杏仁核介导的觉醒和认知评价的功能分离

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世界核心医学期刊文摘（神经病学分册） 2005年第12期1卷 22-22页

作者： Skuse D.H. Morris J.S. Dolan R.J. 方伯言 Prof. Behavioural and Brain Sciences Unit Institute of Child Health 30 Guilford Street London WC1N 1EH United Kingdom

The amygdala is preferentially activated by facial expressions of fear. Right and left amygdala are hypothesized to play distinct, but complementary, roles that influence somatic and cognitive responses to facial expressions. Right amygdala activation is linked to autonomic arousal, and thus indirectly influences left hemisphere cognitive processing centres. Left amygdala activation is more closely associated with cognitive processing and differentiation of facial emotions. A double-dissociation between the functions of left and right amygdala is implied by lesion studies but supportive evidence is inconsistent, partly because patients with structural anteromedial temporal anomalies have experienced variable surgical procedures. A functional dissociation can be demonstrated between arousal and the cognitive appraisal of fearful faces in the condition of X-monosomy or Turner syndrome. Previous research found Turner syndrome women of normal verbal intelligence are seriously impaired in their ability cognitively to differentiate fearful from other facial expressions but they acquire fear conditioning normally, with enhanced autonomic responses. These findings supported the dissociation hypothesis, which was formally tested in a study of 12 X-monosomic and 12 control females who participated in functional magnetic resonance imaging during which simultaneous skin conductance recordings were acquired. Faces depicting fear or neutral emotions were presented to both case and control subjects in random order. Arousal to (fearful-neutral) faces was associated with transiently increased skin conductance responses and bilateral amygdala activation in both groups, but X-monosomic females had proportionately greaterand more persistent -right amygdala activation than controls. In both groups, cognitive accuracy correlated positively with differential activity of left fusiform gyrus. There was a significant correlation between the left fusiform and left medial amygdala activation o

关键词：特纳综合征杏仁核认知评价面部表情双重分离认知评估认知反应连锁基因自主反应成比例

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外科创新技术/器械临床研究方法学--IDEAL框架与推荐系列文章之二:IDEAL报告规范解读

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中国胸心血管外科临床杂志 2021年第3期28卷 263-270页

作者：喻佳洁 Allison Hirst Peter McCulloch 陕飞胡建昆孙鑫刘伦旭刘雪梅董念国陈寄梅乔贵宾李鹤成刘浩李幼平四川大学华西医院中国循证医学中心成都610041 IDEAL Collaboration Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUnited Kingdom0X39DU 北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤中心北京100142 四川大学华西医院胃肠外科胃癌研究室成都610041 博鳌乐城真实世界数据研究创新中心海南琼海571435 四川大学华西医院胸外科成都610041 四川大学华西医院中国胸心血管外科临床杂志编辑部成都610041 华中科技大学同济医学院附属协和医院心脏大血管外科武汉430022 广东省心血管病研究所广东省人民医院(广东省医学科学院)广东省华南结构性心脏病重点实验室心外科广州510080 广东省人民医院胸外科广州510080 上海交通大学医学院附属瑞金医院胸外科上海200025 四川大学华西医院骨科成都610041

严格遵守报告规范有助于研究者完整、清晰和透明地报道方法学和研究结果。目前国际报告规范网站收录的与外科干预相关的报告指南主要针对某种研究设计类型和部分研究内容。因IDEAL框架是对外科创新技术发展的所有阶段进行评估,而每个阶... 详细信息

严格遵守报告规范有助于研究者完整、清晰和透明地报道方法学和研究结果。目前国际报告规范网站收录的与外科干预相关的报告指南主要针对某种研究设计类型和部分研究内容。因IDEAL框架是对外科创新技术发展的所有阶段进行评估,而每个阶段都有其核心问题和关键要素,若仅采用已有针对设计类型的报告规范可能忽略这些重要特征,导致研究者不能全面准确地报道相关信息。2018年IDEAL协作网启动制订适用于外科创新技术发展不同阶段的报告规范。本文旨在从产生背景、制作过程和核心内容上对IDEAL报告规范进行解读,促进其在国内研究人员中的理解与应用。

关键词：报告规范 IDEAL 框架与推荐外科

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Sci Rep:科学家阐明线粒体的程序性细胞死亡过程

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现代生物医学进展 2016年第35期16卷 I0004-I0004页

作者： Ted D. Pham Phi Q. Pham Jinfeng Li Anthony G. Letai Douglas C. Wallace Peter J. Burke Department of Biomedical Engineering University of California Irvine CA USA Department of Chemical Engineering and Materials Science University of California Irvine CA USA Department of Chemical Engineering and Materials Science University of California Irvine CA USA Dana-Farber Cancer institute Harvard University Boston MA USA Center for Mitochondrial and Epigenomic Medicine Children’s Hospital of Philadelphia and Department of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia PA USA Department of Biomedical Engineering University of California Irvine CA USA Department of Chemical Engineering and Materials Science University of California Irvine CA USA Department of Electrical Engineering and Computer Science University of California Irvine CA USA

日前。发表在Scientific Reports杂志上的一篇研究报告中，来自加利福尼亚大学等机构的研究人员通过利用一种由石墨烯组成的新型传感器深入解析了线粒体的程序性细胞死亡过程，该研究或为驱动癌细胞自我毁灭提供了新的线索。研究者通过... 详细信息

日前。发表在Scientific Reports杂志上的一篇研究报告中，来自加利福尼亚大学等机构的研究人员通过利用一种由石墨烯组成的新型传感器深入解析了线粒体的程序性细胞死亡过程，该研究或为驱动癌细胞自我毁灭提供了新的线索。研究者通过研究开发了一种监测线粒体改变的电子学方法，该方法能够指示出细胞进行自我毁灭的开始阶段，我们机体每个细胞中都有数百个、甚至数千个线粒体。每个线粒体都有着内膜和外膜结构；作为细胞的能量工厂，线粒体会对细胞中的碳水化合物和脂肪进行代谢产能以便细胞利用并且储存。但同时线粒体还有第二个角色，那就是调节细胞的生死通路。

关键词：死亡过程癌细胞线粒体程序性 Sci 科学家 Rep 加利福尼亚大学

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中国5所医院红细胞输注情况病例对照研究

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中国输血杂志 2018年第9期31卷 978-981页

作者：李舟刘鱼 Jeffrey Carson D Zaccaro Michelle Yuan Marian Sullivan 孟婵秦莉周小玉李捷廖群刘静蔡伟吴秉婷 Ling Shi Paul Ness 王憬惺 Shan Hua 中国医学科学院北京协和医学院输血研究所成都四川610052 Medicine Rutgers Robert Wood Johnson MedicalSchool New Brunswick United States RTI International Research Triangle Park United States 北京协和医学院四川大学华西医院江苏省人民医院河南科技大学第二附属医院重庆市急救医疗中心 Pathology University of MassachusettsAmherst Boston United States Pathology Johns Hopkins Hospital Baltimore United States Pathology Stanford University Medical Center Palo Alto United States

目的调查参加研究的5所医院红细胞输注指征,输血前后血红蛋白（Hb）水平变化以及与红细胞输注相关的其他临床因素,对临床红细胞输注提供科学依据。方法对5家医院的血库信息系统查询2013年全年住院患者中首次红细胞输注病例,并从中随机选... 详细信息

目的调查参加研究的5所医院红细胞输注指征,输血前后血红蛋白（Hb）水平变化以及与红细胞输注相关的其他临床因素,对临床红细胞输注提供科学依据。方法对5家医院的血库信息系统查询2013年全年住院患者中首次红细胞输注病例,并从中随机选择1000例收集相关数据,病例不满1 000例的医院的全部病例纳入研究;将所有数据按照人口统计学特征、并发症、是否手术、红细胞特征以及Hb水平进行区分。根据主要疾病诊断将病例属于6大诊断组的病例分出,选择在同一时间段入院且在相同诊断组的未输血病例为作为对照,进行临床队列研究,对输注前Hb水平及其他红细胞输注相关临床因素进行统计学分析。结果从约5 000例红细胞输注患者中选择出属于6个诊断组的病例1 356例,对照病例1 201例,外科患者（病例数/对照数）包括骨科手术组（312/216）;普外科手术组（367/332）;内科患者包括实体瘤（230/232）;消化道出血（212/221）;心血管疾病（87/77）;血液系统恶性肿瘤（100/101）。Hb水平与手术患者和内科患者的红细胞输注均具有相关性。手术患者中,Hb为（70—90） g/L患者组相对于Hb〉100 g/L患者组,输注红细胞的OR值（95%可信区间）为27. 0（13. 9—52. 7）,内科患者中该OR值为71. 5（37. 8—135. 4）。外科患者红细胞输注只与红细胞输注前Hb水平相关;内科患者中主要诊断、不同医院以及年龄〉75岁等均是进行红细胞输注的独立因素。心血管疾病患者组相对于实体瘤患者组进行红细胞输注的OR值为2. 5（1. 2—4. 9）,血液系统恶性肿瘤患者组与消化道出血患者组相对于实体瘤患者组进行红细胞输注的OR值分别为0. 4（0. 2—0. 6）和0. 5（0. 3—0. 8）。其中46%的血液系统恶性肿瘤患者红细胞输注前的Hb〈60 g/L。结论红细胞输注前Hb水平是与红细胞输注最相关的因素。其他相关临床因素包括年龄、心血管疾病、主要诊断等仅与内科患者的红细胞输注相关,与外科患者红细胞输注无关。比较西方国家红细胞输注标准[输血前Hb：（70—80） g/L]与中国红细胞输注标准（输血前Hb：60 g/L）的临床研究将为科学合理的红细胞输注标准的制定提供依据。

关键词：医院红细胞输注病例

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