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简介：Heartfailureposesanincreasingproblemforglobalhealthcaresystems.Theepidemiologicaldatawhichhavebeenaccruedoverthelast30yearshavepredominantlybeenaccumulatedfromexperiencewithinNorthAmericaandEurope.TheEuropeanexperienceinheartfailure,althoughsimilartothatinNorthAmerica,hasrecentlydemonstrateddifferencesinhospitalizationwhichmayunderliethedifferencesbetweenhealthcaresystemconfigurations.Despitethepredictedincreaseinthenumberofpatientsaffectedbyheartfailure,overthelast30yearsaclearmanagementalgorithmhasevolvedfortheuseofpharmacotherapies,device-basedtherapies,andmechanicaltherapies,includingleftventricularassistdevicesandcardiactransplantation.Althoughthetreatmentofsuchpatientshasbeenclearlydelineatedinnationalandinternationalguidelines,theunderuseofallavailableandappropriatetherapiesremainsasignificantproblem.ThepurposeofthisreviewistoprovideaEuropeanperspectiveonmanagementofheartfailure.

简介：TheDigoxinInvestigationGrouptrialhasmultipleflawsinthetrialdesignforthefindingstobeuniversallyapplicable.Digoxininlowserumconcentrations(0.5-0.9ng/mL)hasbeenshowntodecreasemortalityinheartfailurepatients.Multipletrialsindifferentpatientpopulationsalsoshowbenefitofdigoxininheartfailurepatients,includingwomen,elderlypatients,renaldiseasepatients,andpatientswithheartfailurewithpreservedejectionfraction.Retrospectiveobservationaldatalinkingdigoxinusefortreatmentofatrialfibrillationtoincreasedmortalityisnotseeninsubgroupsofrandomizedcontrolledtrialsorpopulationregistries.Digoxinremainsausefuldruginthetoolboxofphysiciansdealingwithheartfailurepatients.

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简介：在世界的许多区域，一座桥将在它的期望的服务生活期间经历多重极端危险。州的高速公路和交通官员(AASHTO)的当前的美国协会负担和电阻因素设计(LRFD)说明基于失败可能性被提出，它充分为死了的负担和非极端的实时负担被校准。对地震负担效果的设计独立被建立。设计对搜索效果被使用能力减小的概念也独立提出(或增加搜索深度)。而且，搜索效果因为后者用基于力量的分析被提出，不能直接被连接到一个LRFD限制状态方程。这份报纸(在二部分)介绍一个基于概率的过程由于卡车在桥上估计联合危险效果，地震并且搜索，由对待效果作为相等的负担效果搜索以便它能在基于可靠性的失败计算被包括。部分地我这个系列，为把scour深度当作相等的负担效果的一般原则被介绍。在第二部分，相应的桥失败概率，出现象同时让卡车负担和等价物搜索负担效果一样搜索份量上被讨论。有条件的部分失败可能性和必要条件的关键公式被建立。以便说明方法论，死者的一个例子，卡车，地震并且在一个简单的桥堆积基础上搜索效果被代表。

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简介：AbstractChronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.

简介：AbstractOver the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target treatments to patients most likely to benefit and avoid treatment in patients less likely to benefit. Future advances in a precision medicine approach to COPD will depend on more precise characterization of individual patients, possibly using quantitative imaging, new physiological techniques, novel biomarkers and genetic profiling. Precision medicine has led to significant improvements in the management of COPD and clinicians should use all available information to optimize the treatment of individual patients.

简介：AbstractChronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of pulmonary embolism (PE), and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.

简介：Chronicsubduralhematoma(CSDH)representsoneofthemostfrequenttypesofintracranialhemorrhage.ManagementofthepatientswithCSDHhasbeenevolvedthroughavastvarietyofmethodsandtechniques.Althoughthereisgeneralagreementthatsurgicaltherapyisusuallythepreferredtreatment,therearefewotherneurosurgicalconditionsthatsparksuchstrongdiscussionsanddifferencesofopinionconcerningtheoptimalsurgicaltechnique.1,2Inthispaper,wereviewadvancesinsurgicaltreatmentofCSDH.

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简介：AbstractThere is considerable epidemiological evidence indicating that air pollution has adverse effects on human health and is closely related to respiratory diseases, including chronic obstructive pulmonary disease (COPD). These effects, which can be divided into short- and long-term effects, can manifest as an exacerbation of existing symptoms, impaired lung function, and increased hospitalization and mortality rates. Long-term exposure to air with a high concentration of pollutants may also increase the incidence of COPD. The combined effects of different pollutants may become more complex in the future; hence, there is a need for more intensive research on specific at-risk populations, and formulating corresponding protective strategies is crucial. We aimed to review the epidemiological evidence on the effect of air pollution on COPD, the possible pathophysiological mechanisms underlying this effect, as well as protective measures against the effects of air pollutants in patients with COPD.

简介：AbstractChronic pruritus is a very common clinical symptom that seriously affects people’s quality of life. Pruritus is associated not only with skin diseases but also with a variety of systemic diseases. It brings great challenges to clinical management. To standardize the management of chronic pruritus, experts of the Allergic Disease Committee of Chinese Dermatologist Association discussed many times and finally formed this guideline to provide reference and guidance for the clinical work of dermatologists and other physicians at all levels.

简介：Migraine,amoderatetoseverechronicheadacheoccurringononeorbothsides,isacommondiseaseaffectsyoungpeople.Althoughhearinglossinsubjectswithmigraineisnotrare,thecorrelationofmigrainewithhearinglossisnotclear.Inthisstudy,weexaminedhearinglossinyoungmigrainesubjectstodetermineifmigrainemaybeafactorincausingcochleardysfunction.Sevencollegestudentswithmigraineandthreeagematchedsubjectswithouthistoryofmigrainewereassessedusingextendedhighfrequencyaudiometryanddistortionproductotoacousticemissions(DPOAEs).Therewasnosignificantdifferenceinregularaudiomeirythresholdbetweenthemigrainegroupandthecontrolgroup.However,highfrequencyaudiometry(9-16kHz)showedthresholdsat25dBnHLorhigherinsixoutoftwentyearsinthemigrainegroup.TheamplitudeofDPOAEswerereducedformorethan10dBinthemigrainegroupincomparisonwiththecontrolgroup.ThesedatasuggestthatmigrainemayaffectcochleardysfunctionevidencedbythereducedamplitudeofDPOAEandhighfrequencypure-toneaudiometry.

简介：Chronicpancreatitisisanongoingdiseasecharacterizedbypersistentinflammationofpancreatictissues.Withdiseaseprogression,patientswithchronicpancreatitismaydeveloptroublesomecomplicationsinadditiontoexocrineandendocrinepancreaticfunctionalloss.Amongthem,apseudoaneurysm,mainlyinducedbydigestiveenzymeerosionofvesselsinproximitytothepancreas,isarareandlife-threateningcomplicationifbleedingofthepseudoaneurysmoccurs.Atpresent,noprospectiverandomizedtrialshaveinvestigatedthetherapeuticstrategyforthisrarebutcriticalsituation.Theroleofarterialembolization,thetimingofsurgicalinterventionandevensurgicalproceduresarestillcontroversial.Inthisreview,wesuggestthatdynamicabdominalcomputedtomographyandangiographyshouldbeperformedfirsttolocalizethebleedersandtoevaluatetheassociatedcomplicationssuchaspseudocystformation,followedbyarterialembolizationtostopthebleedingandtoachieveearlystabilizationofthepatient’scondition.Withadvancesandimprovementsinendoscopicdevicesandtechniques,therapeuticendoscopyforpancreaticpseudocystsistechnicallyfeasible,safeandeffective.Surgicalinterventionisrecommendedforableedingpseudoaneurysminpatientswithchronicpancreatitiswhoareinanunstablecondition,forthoseinwhomarterialembolizationofthebleedingpseudoaneurysmfails,andwhenendoscopicmanagementofthepseudocystisunsuccessful.Ifableedingpseudoaneurysmislocatedoverthetailofthepancreas,resectionisapreferentialprocedure,whereasifthelesionissituatedovertheheadorbodyofthepancreas,relativelyconservativesurgicalproceduresarerecommended.

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简介：Primarysclerosingcholangitis（PSC）isachronicprogressiveinflammatorydiseaseaffectingthebileducts,leadingtofibrosisandeventuallycirrhosisinmostpatients.Itsetiologyisunknownandsofarnoeffectivemedicaltherapyisavailable.Livertransplantation（LTX）istheonlycurativetreatmentandatpresentPSCisthemainindicationforLTXintheScandinaviancountries.ClosetohalfofthePSCpatientsexperienceoneormoreepisodesofacutecellularrejection（ACR）followingtransplantationandapproximately1/5ofthetransplantedpatientsdeveloprecurrentdiseaseinthegraft.Inaddition,somereportsindicatethatACRearlyafterLTXforPSCcaninfluencetheriskforrecurrentdisease.Fortheseimportantpost-transplantationentitiesaffectingPSCpatients,wehavereviewedthecurrentliteratureonepidemiology,pathogenesis,treatmentandthepossibleinfluenceofrejectionontheriskofrecurrentdiseaseintheallograft.

简介：ＲＥＳＵＬＴＳＯＦ　ＨＥＰＡＴＥＣＴＯＭＹＦＯＲ６００ＣＡＳＥＳＷＩＴＨＰＲＩＭＡＲＹＬＩＶＥＲＣＡＮＣＥＲＬｉＧｕｏｈｕｉ李国辉；ＬｉＪｉｎｑｉｎｇ李锦清；Ｚｈａｎｇｙａｑｉ张亚奇；Ｙｕａｎｙｕｎｆｅｉ元云飞；ＣｈｅｎＭｉｎｓｈａｎ陈敏山；ＧｕｏＲ...

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