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2015年冬季钦州湾浮游动物死体对海洋生态系统的影响 被引量:4
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作者 陆家昌 姜发军 +2 位作者 许铭本 赖俊翔 覃仙玲 《广西科学》 CAS 2016年第4期325-330,共6页
【目的】了解浮游动物死体在广西近海的可能规模及其对海洋生态系统的影响。【方法】于2015年冬季在钦州湾选择6个站位进行垂直拖网,采用中性红染色法区分浮游动物死体,研究冬季钦州湾浮游动物死体的组成、分布及其对丰度、优势度和多... 【目的】了解浮游动物死体在广西近海的可能规模及其对海洋生态系统的影响。【方法】于2015年冬季在钦州湾选择6个站位进行垂直拖网,采用中性红染色法区分浮游动物死体,研究冬季钦州湾浮游动物死体的组成、分布及其对丰度、优势度和多样性指数的影响。【结果】调查期间,浮游动物死体的平均丰度为2 252个/m3,占浮游动物总丰度的24.5%。共鉴定浮游动物31种(类),其中出现死体的有15种(类)。在优势种(类)中,除强额孔雀水蚤(Parvocalanus crassirostris)外,其它优势种(类)一旦在某站位发现活体,则其死体出现的概率为100%。死体的出现提高了多样性指数,缩小了多样性指数的空间差异。【结论】冬季钦州湾约有1/4的浮游动物是死体。死体的存在会误导我们对浮游动物丰度和多样性的理解,应该引起重视。 展开更多
关键词 浮游动物 桡足类 死体 冬季 钦州湾
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再谈胎儿利益之保护——以死体胎儿的期待利益为视角 被引量:1
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作者 李美燕 《东南大学学报(哲学社会科学版)》 CSSCI 北大核心 2010年第S2期109-112,共4页
人的生命源于胚胎的发育,人们对此观点未加质疑。但是,对胎儿利益保护的争论未曾停止过。本文以一则交通事故案件为视角,探讨非自然原因致使胎儿为死体时,是否可请求保护其期待利益。通过引证国外的立法、判例、学说,来探究对胎儿利益... 人的生命源于胚胎的发育,人们对此观点未加质疑。但是,对胎儿利益保护的争论未曾停止过。本文以一则交通事故案件为视角,探讨非自然原因致使胎儿为死体时,是否可请求保护其期待利益。通过引证国外的立法、判例、学说,来探究对胎儿利益保护完善的思路,以期我国在新形势下,对胎儿利益保护的立法能够符合时代要求;通过对我国立法的检索,对司法实践中涉及胎儿利益案例的归纳,以期法律能在司法实践中的具有更强的操作性。 展开更多
关键词 立法模式 死体胎儿 期待利益 赔偿请求权范围
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夏季南黄海浮游甲壳动物死体比例的初步研究
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作者 王明飞 庄昀筠 +2 位作者 葛汝平 陈洪举 刘光兴 《海洋与湖沼》 CAS CSCD 北大核心 2022年第5期1108-1120,共13页
浮游动物死体是海洋沉降碳通量的重要组成部分,研究浮游动物死体对于准确评估特定海区生物泵碳通量具有十分重要的意义。为了解夏季南黄海浮游甲壳动物在自然海区的死亡情况,采用2019年7~8月在南黄海获取的浮游动物样品,使用中性红染色... 浮游动物死体是海洋沉降碳通量的重要组成部分,研究浮游动物死体对于准确评估特定海区生物泵碳通量具有十分重要的意义。为了解夏季南黄海浮游甲壳动物在自然海区的死亡情况,采用2019年7~8月在南黄海获取的浮游动物样品,使用中性红染色法分析了浮游甲壳动物死体的平面分布及其受控环境因素。结果表明,夏季南黄海浮游甲壳动物平均丰度为(1378.3±929.84)ind./m^(3),其死体比例在5.0%~68.8%之间,平均为33.3%±16.6%。桡足类是浮游甲壳动物的主要类群,平均丰度为(1202.9±937.4)ind./m^(3),死体比例在3.6%~69.7%之间,平均为38.6%±17.0%,与全球海域浮游桡足类的平均死体比例相当。不同浮游甲壳动物优势种的死体比例存在差异。其中,拟长腹剑水蚤(Oithona similis)死体比例最高(62.0%),鸟喙尖头溞(Penilia avirostris)最低(17.9%)。与环境因子的相关性分析结果表明,海水温度和盐度是影响夏季南黄海浮游甲壳动物死体比例的主要影响因子。小拟哲水蚤(Paracalanus parvus)死体比例和表层温度显著正相关,拟长腹剑水蚤和近缘大眼剑水蚤(Corycaeus affinis)的死体比例与表底温差具有显著的正相关;而表层盐度与克氏纺锤水蚤(Acartia clausi)的死体比例存在正相关关系。该研究结果可为深入认识南黄海海洋生态动力学过程和海洋碳通量等相关研究提供重要的参考资料。 展开更多
关键词 南黄海 浮游动物 甲壳动物 桡足类 死体
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试论印尼死体化生型谷物神话 被引量:3
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作者 张玉安 《东南亚南亚研究》 1994年第2期42-45,共4页
谷物起源神话是原始农耕文化的信息库。它反映了人类初民从采集经济向原始农业经济的转变,是原始农业产生这一“新石器时代革命”的宝贵记录。 印尼的谷物起源神话丰富多彩,类型齐全,其中死体化生型谷物神话所占有比例最大,特色颇为鲜... 谷物起源神话是原始农耕文化的信息库。它反映了人类初民从采集经济向原始农业经济的转变,是原始农业产生这一“新石器时代革命”的宝贵记录。 印尼的谷物起源神话丰富多彩,类型齐全,其中死体化生型谷物神话所占有比例最大,特色颇为鲜明。下面,仅对这类神话所透露的一些信息和印尼原始农耕文化的有关特点试作简要的分析和推论。 展开更多
关键词 农耕文化 印尼 起源神话 死体 神话素 母系氏族社会 块根植物 农作物 加里曼丹 原始农业
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与死神亲密接触——科学家解析人体“濒死体验”
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作者 桂亮 《健康》 2002年第7期19-20,2,共3页
长期以来,人体濒死那一刹那间究竟是什么感觉一直是个不解之谜。在本文中,几位曾经濒临死亡的人畅谈了自己的“濒死体验”,而一些科学家对之进行了研究和解释。
关键词 死体 亲密接触 人体 科学家 临床死亡 死亡线 霍克斯 美国广播公司 苏珊·布莱克摩尔 精神医疗
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云南的松针红斑病病原菌形态鉴定 被引量:4
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作者 赵光材 李楠 +2 位作者 寻良栋 张毅宁 李应龙 《森林病虫通讯》 北大核心 1995年第2期20-22,共3页
本文报道在云南寄生于云南松PinusyunnanensisFranch.、加勒比松P.caribaeaMorelet、湿地松P.elliottiiEngelm.和火松P.taedaL.上的松褥盘孢菌Doth-istr... 本文报道在云南寄生于云南松PinusyunnanensisFranch.、加勒比松P.caribaeaMorelet、湿地松P.elliottiiEngelm.和火松P.taedaL.上的松褥盘孢菌Doth-istromapiniHulbary形态鉴定。该菌侵染导致松针的衰弱死亡后,进行死体分解的菌是乔松散斑壳Lophodermiumpini-excelsaeAhmad、星状拟盘多毛孢菌PestalotiOpsisstella-ta(Belk.&Curt.)H.T.SumetCao、污斑拟盘多毛孢菌Pestalotiopsisfoedans(Sacc.&Ell.)Stey.,它们加速了死亡部分的分解而使症状更加显得严重。 展开更多
关键词 松针 红斑病 松褥盘孢菌 死体分解菌
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南极乔治王岛长城湾活有孔虫和死有孔虫的比较分析
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作者 李元芳 张青松 《地理研究》 1986年第3期54-62,共9页
本文对中国首次南极考察队在长城湾采集的海底底质样品作了有孔虫分析,初步查明有孔虫属种,并揭示了长城湾有孔虫组合和分布规律。
关键词 活有孔虫 长城湾 南极乔治王岛 比较分析 活体有孔虫 有孔虫组合 胶结壳 死体 维斯特福尔德丘陵 现代有孔虫
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Effects of Oestrogen on Ischemia-induced Neurogenesis in the Dentate Gyrus of Rats 被引量:4
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作者 王明 鲁亚平 +3 位作者 朱国萍 张晓盼 韩莹 余中宾 《Zoological Research》 CAS CSCD 北大核心 2007年第1期88-94,共7页
To study the effects of oestrogcn on ischemia-induced neurogenesis in the hippocampal dentate gyms, thirty-two adult male rats were randomly divided into four groups: the control surgery group with eestrogen administ... To study the effects of oestrogcn on ischemia-induced neurogenesis in the hippocampal dentate gyms, thirty-two adult male rats were randomly divided into four groups: the control surgery group with eestrogen administration (SE), the control surgery group with normal saline administration (SN), the middle cerebral artery occlusion (MCAO) group with oestrogen administration (ME) and the MCAO group with normal saline administration (MN). The MCAO rats were occluded for 90 rain by an intraluminal filament and then recirculated. After 1, 3, 12, 24 and 28 h of MCAO, the rats of the four groups were killed to investigate the infarct volume, apoptosis and neurogenesis. The cerebral infarct volume in the ME group was significantly smaller than that of the MN group (P 〈 0.05). No significant cell loss was seen in the dentate gyms. Cerebral ischemia led to increased neurogenosis, which is independent of cell death in the ipsilateral dentate gyrus(P 〈 0.05). BrdU-pesitive cells in the ipsilateral dentate gyms of the ME group were significantly increased when compared with those of the MN group(P 〈 0.05). In the SE group, BrdU-positive cells in both the ipsilateral and contralateral dentate gyms, were increased when compared with those of the SN group ( P 〈 0.05 ). We concluded that ocstregen plays an important role in neurogenesis, which is independent of ischemia-induced by MCAO in the hippocampal dentate gyms of rats. 展开更多
关键词 Cerebral ischemia Infarct volume NEUROGENESIS OESTROGEN Cell death Dentate gyrus
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Pinacidil reduces neuronal apoptosis following cerebral ischemia-reperfusion in rats through both mitochondrial and death-receptor signal pathways 被引量:6
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作者 张鸿 宋利春 +2 位作者 刘艳艳 马英 吕永利 《Neuroscience Bulletin》 SCIE CAS CSCD 2007年第3期145-150,共6页
Objective To investigate effect of pinacidil, an ATP sensitive potassium channel (KATP) opener, on the neuronal apoptosis and its signaling transduction mechanism following focal cerebral ischemia-reperfusion in rat... Objective To investigate effect of pinacidil, an ATP sensitive potassium channel (KATP) opener, on the neuronal apoptosis and its signaling transduction mechanism following focal cerebral ischemia-reperfusion in rats. Methods One hundred male Wistar rats were randomly divided into four groups: A, sham-operated group; B, ischemia-reperfusion group; C, KATe opener treatment group; and D, KATe opener and blocker treatment group. The middle cerebral artery occlusion (MCAO) model was established by using the intraluminal suture occlusion method, neuronal apoptosis was determined by TUNEL staining, and expressions of caspase-8, caspase-9 and caspase-3 mRNA were detected by in situ hybridization. Results (1) The numbers of apoptotic neurons at 12 h, 24 h, 48 h, and 72 h were significantly less in group C than in groups B and D (P 〈 0.01 or P 〈 0.05); and there was no difference between groups B and D at all time points (P 〉 0.05). (2) The expressions of caspase-3 mRNA and caspase-8 mRNA at all times and the expressions of caspase-9 mRNA at 12 h, 24 h, 48 h, 72 h were significantly lower in group C than in groups B and D (P 〈 0.01 or P 〈 0.05); and there were no differences between groups B and D at all time points (P 〉 0.05). Conclusions KATP opener can significantly decrease the neuronal apoptosis and the expressions of caspase-3, caspase-8 and caspase-9 mRNAs following cerebral ischemiareperfusion. The neuronal apoptosis may be decreased by the inhibition of both mitochondrial and death-receptor signal pathways. 展开更多
关键词 PINACIDIL GLIPIZIDE cerebral ischemia apoptosis mitochondria death-receptors signal pathway caspase-3 CASPASE-8 caspase-9
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从创世神话看纳西族的游牧民性与农耕民性 被引量:1
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作者 诹访哲郎 姜铭 《云南民族大学学报(哲学社会科学版)》 CSSCI 北大核心 1989年第2期34-42,共9页
前言 “纳西族与古代羌族具有十分密切的关系。纳西族是作为游牧民的古代羌族南下的一支,定居、从事农耕生产后转化而成的。”关于纳西族起源的问题,由于方国瑜、李霖灿、J·F·Rock等学者引用取材范围很广的各种“证据”进行... 前言 “纳西族与古代羌族具有十分密切的关系。纳西族是作为游牧民的古代羌族南下的一支,定居、从事农耕生产后转化而成的。”关于纳西族起源的问题,由于方国瑜、李霖灿、J·F·Rock等学者引用取材范围很广的各种“证据”进行了论证后已经成了论定。《中国少数民族》、《云南少数民族》、《纳西族简史》等书也采纳了这个说法。 展开更多
关键词 纳西族 游牧民 笨教 创世神话 死体 羌族 卵生说 天柱 白狼语 起源论
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Expression Profiles of TRAIL Receptors and Their Clinical Significance in Human Hepatocellular Carcinoma 被引量:1
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作者 何松青 陈孝平 +4 位作者 赵永忠 张万广 王海平 杨彩虹 王少发 《The Chinese-German Journal of Clinical Oncology》 CAS 2003年第1期25-29,59,共6页
Objective To investigate the expression profiles and their clinical significance of TRAIL receptors (TRAILR) in human hepatocellular carcinoma (HCC). Methods The expression profiles of TRAILR were determined in 60 s... Objective To investigate the expression profiles and their clinical significance of TRAIL receptors (TRAILR) in human hepatocellular carcinoma (HCC). Methods The expression profiles of TRAILR were determined in 60 samples from hepatocellular carcinoma, 20 from normal liver tissue and two HCC cell lines HepG2, SMMC-7721 by in situ hybridization. Results Both DR4 and DR5 were present in all HCC tissues as well as normal hepatic tissues. In contrast, 54 HCC tissues did not express DcR1 and 25 did not express DcR2. But both DcR were detectable in all of the normal liver tissues. The expression patterns of DR and DcR in HCC samples (higher DR expression level and lower DcR expression level) were quite different from those in normal tissue. DR5, DR4, and DcR2 expressed in both cell lines, while no DcR1 expression was detected. The expression level of DR was correlated with HCC differentiation and stage. The weaker expression was more commonly found in HCC with poor differentiation and late stage, while the stronger expression was more common in HCC with middle to high-differentiation and early stage. No relationship was found between DR and gender, age, negative or positive HBsAg, tumor size, grade or metastasis. Multidrug resistance cell lines expressed lower level DR. Conclusion TRAILR expression was prevalent and discrepancy of receptor types was exited in HCC. Loss of DcR1 may contribute for TRAIL therapy for HCC. Key words TRAILR - apoptosis - hepatocellular carcinoma Supported by the Major Fundation of Ministry of Health, NO. 2001–2003 展开更多
关键词 TRAILR APOPTOSIS hepatocellular carcinoma
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名著名言
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作者 郭峰 《天风》 北大核心 2001年第8期42-42,共1页
通过律法了解到的上帝是背对着我们(出33:18-20),通过福音和基督我们才看到上帝的脸。 我们索拜上帝的地方就是耶稣基督,因为上帝已决定除了通过这个人之外,其它任何地方都找不到他,离开基督,我们祈祷、信仰、希望或生存就没任何依据。... 通过律法了解到的上帝是背对着我们(出33:18-20),通过福音和基督我们才看到上帝的脸。 我们索拜上帝的地方就是耶稣基督,因为上帝已决定除了通过这个人之外,其它任何地方都找不到他,离开基督,我们祈祷、信仰、希望或生存就没任何依据。 当我们把基督的死体验为我们自己的死时,十字架才意味着上帝在基督的死亡中与我们相遇。当基督的死成为我们的死时,我们才能通过他的死与上帝相遇。 展开更多
关键词 基督 上帝 信仰 死时 死体 可能的事 律法 耶稣基督 路德 交道
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突变体的离体选择(下)
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作者 D.S.Ingram M.V.Macdonald 金守鸣 《世界农业》 1987年第7期38-40,共3页
这一问题在很大程度上取决于作物的类型和病原体的生物学性质。对于具有贮藏器官或类似结构的作物以及引起严重腐烂的病原体来说,如果希望获得有效的抗性,必须完全排斥病原体。而对谷类、豆类等作物以及导致衰弱的病原体来说,部分抗性... 这一问题在很大程度上取决于作物的类型和病原体的生物学性质。对于具有贮藏器官或类似结构的作物以及引起严重腐烂的病原体来说,如果希望获得有效的抗性,必须完全排斥病原体。而对谷类、豆类等作物以及导致衰弱的病原体来说,部分抗性也许比完全抗性更为合乎需要。前者使病原体生长迟缓,由此延迟流行病蔓延。而后者往往对病原体施加强大的选择压力,导致易感病变异体的抗性快速崩溃。遗憾的是。 展开更多
关键词 离体选择 突变体 致病毒素 死体营养性病原 病原体抗性 抗性因子 生化标志 培养滤液 培养细胞 繁殖体
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Molecular Cloning and Bioinformatical Analysis of a cDNA Encoding Mitochondrial 50S Ribosomal Protein L21 from Hevea brasiliensis Muell. Arg.
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作者 邹智 杨礼富 《Agricultural Science & Technology》 CAS 2012年第6期1203-1206,共4页
[Objective] "Tapping panel dryness (TPD)", a syndrome known as tapping incision blocked partly or entirely during latex exploiting, has become the most important factor causing great losses for rubber production. ... [Objective] "Tapping panel dryness (TPD)", a syndrome known as tapping incision blocked partly or entirely during latex exploiting, has become the most important factor causing great losses for rubber production. Aiming to elucidate the molecular mechanism of tapping panel dryness occurrence, this study carried out molecular cloning and bioinformatical analysis of a mRPL21 cDNA sequence, a gene associated with TPD. [Method] In a preliminary study, an expressed sequence tag (EST) encoding a deduced protein homologous to mitochondrial 50S ribosomal protein L21 (mRPL21), which showed to be down-regulated in the latex of TPD-affected rubber trees, was isolated by suppression subtractive hybridization (SSH). After ESTs assembling and RT-PCR validation, an 853 bp cDNA sequence with an open reading frame (ORF) was cloned, which was named as HbmRPL21 under GenBank accession number of HM230670. [Result] Bioinformatical analysis suggests that HbmRPL21 encodes a deduced polypeptide of 271 amino acids with a theoretical molecular weight (Mw) of 30.52 kDa and isolectric point (pI) of 8.40, and HbmRPL21 is a mitochondrion-targeted protein with a conserved domain of Ribosomal_L21p involving translation. Homology analysis reveals high amino acid sequence identity of mRPL21 from plants, while diversity of that between plant and animal kingdom. [Conclusion] This study laid the basis for further revealing the biological functions of mRPL21 in TPD-affected rubber trees. 展开更多
关键词 Hevea brasiliensis Tapping panel dryness syndrome Mitochondrial 50S ribosomal protein L21
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94年日本生死话题畅销图书与《大往生》
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作者 白晓煌 《出版参考》 1995年第9期11-11,共1页
去年日本人对于社会流行的种种生死理念颇为笃信,应运而生的论及生老病死话题的图书遂成为畅销图书中的热点。 《图解死体论》(法藏馆版),发行速度出人预料,仅在两个月内即销售12000册。日本出版界有关人士说,当代日本青年的思想意识正... 去年日本人对于社会流行的种种生死理念颇为笃信,应运而生的论及生老病死话题的图书遂成为畅销图书中的热点。 《图解死体论》(法藏馆版),发行速度出人预料,仅在两个月内即销售12000册。日本出版界有关人士说,当代日本青年的思想意识正从外部世界转向宗教与内心世界,死亡与生存意识就是这一转势的具体影像。此前。 展开更多
关键词 畅销图书 往生 日本青年 死体 藏馆 发行速度 死理 社会流行 无疾而终 现代日本
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检验“临死”
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作者 今井淳 张琳 《佛教文化》 1997年第3期34-35,共2页
关键词 老龄化社会 急救车 大学附属医院 手术室 起搏器 死体 体验者 范畴研究 历史背景 往前移动
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EFFECT ON BLOOD CLOTTING AND FIBRINOLYSIS WITH ELECTRO-ACUPUNCTURE TREATMENTS AT "BAIHUI" AND "SHUIGU" ACUPOINTS FOR CEREBRAL INFARCTION IN RATS 被引量:1
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作者 王述菊 孙国杰 +2 位作者 吴绪平 黄伟 丁昀 《World Journal of Acupuncture-Moxibustion》 2008年第2期23-27,共5页
Objective To investigate the effective mechanism of the treatments with electroacupuncture (EA) at "BǎiHuì" (GV20) and "ShuǐGōu" acupoints for cerebral infarction. Methods Forty rats were randomly divi... Objective To investigate the effective mechanism of the treatments with electroacupuncture (EA) at "BǎiHuì" (GV20) and "ShuǐGōu" acupoints for cerebral infarction. Methods Forty rats were randomly divided into four groups as normal group (n = 10), sham-operation group (n = 10), model group (n = 10), EA group (n = 10). The acute cerebral infarction model in rats was developed by blocking the middle cerebral artery with an intraluminal thread. The contents of t-PA,PAI-1 ,D-D and Fib were estimated in each group. Results The contents of t-PA, PAI-1, D-D and Fib increased significantly (P〈0.01) in the model group as compared to the normal and sham-operation group. The contents of t-PA, PAI-1, D-D and Fib decreased significantly (P〈0.05-0.01) in the EA group as compared to the normal group. Conclusion The balance function of blood clotting and fibrinolysis were good and the cerebral abnormal blood was improved in EA group. 展开更多
关键词 acute cerebral infarction electroacupuncture t-PA PAI-1 D-dimer fibrinogen
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TNFα and reactive oxygen species in necrotic cell death 被引量:13
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作者 Michael J Morgan You-Sun Kim Zheng-gang Liu 《Cell Research》 SCIE CAS CSCD 2008年第3期343-349,共7页
Death receptors, including the TNF receptor-1 (TNF-RI), have been shown to be able to initiate caspase-independent cell death. This form of "necrotic cell death" appears to be dependent on the generation of reacti... Death receptors, including the TNF receptor-1 (TNF-RI), have been shown to be able to initiate caspase-independent cell death. This form of "necrotic cell death" appears to be dependent on the generation of reactive oxygen species. Recent data have indicated that superoxide generation is dependent on the activation of NADPH oxidases, which form a complex with the adaptor molecules RIP1 and TRADD. The mechanism of superoxide generation further establishes RIP1 as the central molecule in ROS production and cell death initiated by TNFa and other death receptors. A role for the sustained JNK activation in necrotic cell death is also suggested. The sensitization of virus-infected cells to TNFα indicates that necrotic cell death may represent an alternative cell death pathway for clearance of infected cells. 展开更多
关键词 TNF NECROSIS Noxl TRADD RIP1 ROS JNK
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Apoptosis in oncology 被引量:5
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作者 FAN XIAO QIANG, YA JUN GUO (International Joint Cancer Institute, The Second Military Medical University, Shanghai 200423, China) 《Cell Research》 SCIE CAS CSCD 2001年第1期1-7,共7页
Apoptosis is a complex process involving a large array of genes and mutation of any of these genes may lead to malignancy formation. Re-acquirement of FasL by tumor cells may enable them to evade the surveillance of i... Apoptosis is a complex process involving a large array of genes and mutation of any of these genes may lead to malignancy formation. Re-acquirement of FasL by tumor cells may enable them to evade the surveillance of immune system and thus contributes to the growth of tumor. Apart from traditional therapies, inducing apoptosis of tumor cell by new methods employing death receptor ligands and making use of Fas counterattack is also being developed. 展开更多
关键词 APOPTOSIS MITOCHONDRIA death receptor death receptor ligand tumor therapy.
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Controversies in the treatment of Crohn’s disease: The case for an accelerated step-up treatment approach 被引量:4
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作者 Amandeep K Shergill Jonathan P Terdiman 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第17期2670-2677,共8页
The ideal treatment strategy for Crohn’s disease (CD) remains uncertain, as does the optimal endpoint of therapy. Top-down versus step-up describes two different approaches: early use of immunomodulators and biologic... The ideal treatment strategy for Crohn’s disease (CD) remains uncertain, as does the optimal endpoint of therapy. Top-down versus step-up describes two different approaches: early use of immunomodulators and biological agents in the former versus initial treatment with steroids in the latter, with escalation to immunomodulators or biological drugs in patients proven to be steroid refractory or steroid dependent. Top-down therapy has been associated with higher rates of mucosal healing. If mucosal healing proves to be associated with better long-term outcomes, such as a decreased need for hospitalization and surgery, top-down therapy may be the better approach for many patients. The main concern with the top-down approach is the toxicity of the immunomodulators and biological agents, which have been linked with infectious complications as well as an increased risk of lymphoma. It is unlikely that one strategy will be best for all patients given the underlying heterogeneity of CD presentation and severity. Ultimately, we must weigh the safety and efficacy of the therapies with the risks of the disease itself. Unfortunately our ability to risk stratify patients at diagnosis remains rudimentary. The purpose of this paper is to review the data that supports or refutes the differing treatment paradigms in CD, and to provide a rationale for an approach, termed the "accelerated step-up" approach, which attempts to balance the risks and benefits of our currently available therapies with the risk of disease related complications as we understand them in 2008. 展开更多
关键词 Crohn's disease TOP-DOWN Step-up Anti-tumor necrosis factor antibodies IMMUNOMODULATORS Mucosal healing
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