POEMS(polyneuropathy,organomegaly,endocrinopathy,M-protein and skin changes)综合征是一种单克隆浆细胞异常增殖的副肿瘤综合征,患病率约为0.3/10万[1]。该病累积神经、内分泌、骨骼、免疫及造血等系统,临床上诊断需要2个基本要素...POEMS(polyneuropathy,organomegaly,endocrinopathy,M-protein and skin changes)综合征是一种单克隆浆细胞异常增殖的副肿瘤综合征,患病率约为0.3/10万[1]。该病累积神经、内分泌、骨骼、免疫及造血等系统,临床上诊断需要2个基本要素:多发性周围神经病和单克隆浆细胞病[2]。周围神经病变是超过60%的POEMS综合征患者的首发症状,不少患者早期就诊于神经内科并被误诊为慢性炎性脱髓鞘性多发性神经根神经病(chronic inflammatory demyelinating polyneuropathy,CIDP)等原发性神经系统疾病[3]。由于神经病变进展缓慢、致残率高,多数患者就诊时症状严重且已造成神经不可逆性损伤,给患者生活带来极大不便,因此早识别、早诊断、及时治疗至关重要。本文报告1例采用达雷妥尤单抗(Daratumumab,Dara)联合方案治疗伴有严重周围神经病变的POEMS综合征,分析了神经病变的发病机制,并强调了POEMS综合征诊断的复杂性以及Daratumumab作为新一代药物在治疗中的潜在优势。展开更多
Purpose:The quantitative rankings of over 55,000 institutions and their institutional programs are based on the individual rankings of approximately 30 million scholars determined by their productivity,impact,and qual...Purpose:The quantitative rankings of over 55,000 institutions and their institutional programs are based on the individual rankings of approximately 30 million scholars determined by their productivity,impact,and quality.Design/methodology/approach:The institutional ranking process developed here considers all institutions in all countries and regions,thereby including those that are established,as well as those that are emerging in scholarly prowess.Rankings of individual scholars worldwide are first generated using the recently introduced,fully indexed ScholarGPS database.The rankings of individual scholars are extended here to determine the lifetime and last-five-year Top 20 rankings of academic institutions over all Fields of scholarly endeavor,in 14 individual Fields,in 177 Disciplines,and in approximately 350,000 unique Specialties.Rankings associated with five specific Fields(Medicine,Engineering&Computer Science,Life Sciences,Physical Sciences&Mathematics,and Social Sciences),and in two Disciplines(Chemistry,and Electrical&Computer Engineering)are presented as examples,and changes in the rankings over time are discussed.Findings:For the Fields considered here,the Top 20 institutional rankings in Medicine have undergone the least change(lifetime versus last five years),while the rankings in Engineering&Computer Science have exhibited significant change.The evolution of institutional rankings over time is largely attributed to the recent emergence of Chinese academic institutions,although this emergence is shown to be highly Field-and Discipline-dependent.Practical implementations:Existing rankings of academic institutions have:(i)often been restricted to pre-selected institutions,clouding the potential discovery of scholarly activity in emerging institutions and countries;(ii)considered only broad areas of research,limiting the ability of university leadership to act on the assessments in a concrete manner,or in contrast;(iii)have considered only a narrow area of research for comparison,diminishing the broader applicability and impact of the assessment.In general,existing institutional rankings depend on which institutions are included in the ranking process,which areas of research are considered,the breadth(or granularity)of the research areas of interest,and the methodologies used to define and quantify research performance.In contrast,the methods presented here can provide important data over a broad range of granularity to allow responsible individuals to gauge the performance of any institution from the Overall(all Fields)level,to the level of the Specialty.The methods may also assist identification of the root causes of shifts in institution rankings,and how these shifts vary across hundreds of thousands of Fields,Disciplines,and Specialties of scholarly endeavor.Originality/value:This study provides the first ranking of all academic institutions worldwide over Fields,Disciplines,and Specialties based on a unique methodology that quantifies the productivity,impact,and quality of individual scholars.展开更多
Zong Baihua’s aesthetic character and the creative philosophy of small poems are integrated and intertwined with each other,with distinctive aesthetic characteristics and unique artistic concepts.Whether it is his“r...Zong Baihua’s aesthetic character and the creative philosophy of small poems are integrated and intertwined with each other,with distinctive aesthetic characteristics and unique artistic concepts.Whether it is his“rounded and integrated aesthetics centered on Chinese art”,“vivid and charming natural cosmology”,or“personality aesthetics that mutually mirrors with the nature universe”,they all have extraordinary inspirations and guidance for us today to explore the reform of new literature and art,the reform of new poems,and even the contemplation of the cosmos,society,and life,with positive and profound significance.展开更多
文摘Purpose:The quantitative rankings of over 55,000 institutions and their institutional programs are based on the individual rankings of approximately 30 million scholars determined by their productivity,impact,and quality.Design/methodology/approach:The institutional ranking process developed here considers all institutions in all countries and regions,thereby including those that are established,as well as those that are emerging in scholarly prowess.Rankings of individual scholars worldwide are first generated using the recently introduced,fully indexed ScholarGPS database.The rankings of individual scholars are extended here to determine the lifetime and last-five-year Top 20 rankings of academic institutions over all Fields of scholarly endeavor,in 14 individual Fields,in 177 Disciplines,and in approximately 350,000 unique Specialties.Rankings associated with five specific Fields(Medicine,Engineering&Computer Science,Life Sciences,Physical Sciences&Mathematics,and Social Sciences),and in two Disciplines(Chemistry,and Electrical&Computer Engineering)are presented as examples,and changes in the rankings over time are discussed.Findings:For the Fields considered here,the Top 20 institutional rankings in Medicine have undergone the least change(lifetime versus last five years),while the rankings in Engineering&Computer Science have exhibited significant change.The evolution of institutional rankings over time is largely attributed to the recent emergence of Chinese academic institutions,although this emergence is shown to be highly Field-and Discipline-dependent.Practical implementations:Existing rankings of academic institutions have:(i)often been restricted to pre-selected institutions,clouding the potential discovery of scholarly activity in emerging institutions and countries;(ii)considered only broad areas of research,limiting the ability of university leadership to act on the assessments in a concrete manner,or in contrast;(iii)have considered only a narrow area of research for comparison,diminishing the broader applicability and impact of the assessment.In general,existing institutional rankings depend on which institutions are included in the ranking process,which areas of research are considered,the breadth(or granularity)of the research areas of interest,and the methodologies used to define and quantify research performance.In contrast,the methods presented here can provide important data over a broad range of granularity to allow responsible individuals to gauge the performance of any institution from the Overall(all Fields)level,to the level of the Specialty.The methods may also assist identification of the root causes of shifts in institution rankings,and how these shifts vary across hundreds of thousands of Fields,Disciplines,and Specialties of scholarly endeavor.Originality/value:This study provides the first ranking of all academic institutions worldwide over Fields,Disciplines,and Specialties based on a unique methodology that quantifies the productivity,impact,and quality of individual scholars.
文摘Zong Baihua’s aesthetic character and the creative philosophy of small poems are integrated and intertwined with each other,with distinctive aesthetic characteristics and unique artistic concepts.Whether it is his“rounded and integrated aesthetics centered on Chinese art”,“vivid and charming natural cosmology”,or“personality aesthetics that mutually mirrors with the nature universe”,they all have extraordinary inspirations and guidance for us today to explore the reform of new literature and art,the reform of new poems,and even the contemplation of the cosmos,society,and life,with positive and profound significance.
