当环境保护与可持续发展成为世界范围的热点问题时,世界贸易组织(简称WTO)的成员方能否为保护全球公域环境而基于本国与产品无关的生产过程和生产方法(non-product-related Processes and Production Methods,简称NPR-PPMs)标准采取贸...当环境保护与可持续发展成为世界范围的热点问题时,世界贸易组织(简称WTO)的成员方能否为保护全球公域环境而基于本国与产品无关的生产过程和生产方法(non-product-related Processes and Production Methods,简称NPR-PPMs)标准采取贸易措施(以下简称单边NPR-PPMs措施)成为WTO体制内环境和贸易问题争论的焦点。本文分析了将单边NPR-PPMs措施纳入WTO环境议题的必要性、可行性,提出了明确单边NPR-PPMs措施在WTO体制内的应有地位以及通过立法途径完善对单边NPR-PPMs措施规范的建议。展开更多
Background: Magnetic resonance imaging (MRI) studies in primary progressive multiple sclerosis (PPMS) have shown a reduced frequency of enhancement with the contrast agent gadolinium-DTPA (Gd-DTPA), in comparison with...Background: Magnetic resonance imaging (MRI) studies in primary progressive multiple sclerosis (PPMS) have shown a reduced frequency of enhancement with the contrast agent gadolinium-DTPA (Gd-DTPA), in comparison with relapsing-remitting multiple sclerosis (RRMS), and it has been suggested that there may be a less important role for inflammation in its pathogenesis. However, the earliest clinical stages of PPMS have not been studied and thus it has not been possible to exclude the existence of an early inflammatory phase. Abstract:Objective: To study the presence, characteristics, and implications of inflammation in early PPMS. Methods: 45 patients with a mean disease duration of 3.3 years had triple dose Gd enhanced MRI, expanded disability status scale (EDSS), and multiple sclerosis functional composite (MSFC) assessments at baseline. Repeat MRI was done at 1 and 2 months in 24 patients, and at 6 months in 38. Results: Enhancing brain lesions were present in 42%of patients at baseline but enhancing cord lesions were uncommon (7%); 85%of enhancing lesions enhanced for one month or less. Patients with enhancing lesions had greater disability (EDSS, p = 0.027; MSFC, p = 0.026) and more MRI abnormalities (greater T2 load, p = 0.008; greater T1 hypointensity load, p = 0.001; and reduced partial brain volume, p = 0.012) than those without enhancement. Enhancement at 6 months was seen in 32%of patients and was restricted to a subset of patients who enhanced at baseline. Conclusions: Enhancement is present in some cases of early PPMS and is associated with greater disease impact in terms of both clinical and MRI measures.展开更多
文摘当环境保护与可持续发展成为世界范围的热点问题时,世界贸易组织(简称WTO)的成员方能否为保护全球公域环境而基于本国与产品无关的生产过程和生产方法(non-product-related Processes and Production Methods,简称NPR-PPMs)标准采取贸易措施(以下简称单边NPR-PPMs措施)成为WTO体制内环境和贸易问题争论的焦点。本文分析了将单边NPR-PPMs措施纳入WTO环境议题的必要性、可行性,提出了明确单边NPR-PPMs措施在WTO体制内的应有地位以及通过立法途径完善对单边NPR-PPMs措施规范的建议。
文摘Background: Magnetic resonance imaging (MRI) studies in primary progressive multiple sclerosis (PPMS) have shown a reduced frequency of enhancement with the contrast agent gadolinium-DTPA (Gd-DTPA), in comparison with relapsing-remitting multiple sclerosis (RRMS), and it has been suggested that there may be a less important role for inflammation in its pathogenesis. However, the earliest clinical stages of PPMS have not been studied and thus it has not been possible to exclude the existence of an early inflammatory phase. Abstract:Objective: To study the presence, characteristics, and implications of inflammation in early PPMS. Methods: 45 patients with a mean disease duration of 3.3 years had triple dose Gd enhanced MRI, expanded disability status scale (EDSS), and multiple sclerosis functional composite (MSFC) assessments at baseline. Repeat MRI was done at 1 and 2 months in 24 patients, and at 6 months in 38. Results: Enhancing brain lesions were present in 42%of patients at baseline but enhancing cord lesions were uncommon (7%); 85%of enhancing lesions enhanced for one month or less. Patients with enhancing lesions had greater disability (EDSS, p = 0.027; MSFC, p = 0.026) and more MRI abnormalities (greater T2 load, p = 0.008; greater T1 hypointensity load, p = 0.001; and reduced partial brain volume, p = 0.012) than those without enhancement. Enhancement at 6 months was seen in 32%of patients and was restricted to a subset of patients who enhanced at baseline. Conclusions: Enhancement is present in some cases of early PPMS and is associated with greater disease impact in terms of both clinical and MRI measures.
