Purpose： The purpose of this review was to critically analyse the cun;ent evidence investigating the effect of an athlete＇s hydration status on physical performance. Methods： A literature search of multiple databas...Purpose： The purpose of this review was to critically analyse the cun;ent evidence investigating the effect of an athlete＇s hydration status on physical performance. Methods： A literature search of multiple databases was used to identify studies that met the inclusion criteria for this review. The included studies were then critically appraised using the Downs and Black protocol. Results： Nine articles were found to meet the inclusion criteria, with an average score of 79% for methodological quality representative of a ＂high＂ standard of research. Conclusion： The evidence suggests that dehydration has a negative impact on physical performance for activities lasting more than 30 s in duration. However dehydration was found to have no significant impact on physical performance for activities lasting less than 15 s in duration.展开更多
The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product(GDP) in 196...The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product(GDP) in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.展开更多
The aim of our study was to explore the value of second-line treatment for advanced non-small cell lung cancer (NSCLC). One patient with metastatic adenocarcinoma of NSCLC was given second-line treatment of pemertrexe...The aim of our study was to explore the value of second-line treatment for advanced non-small cell lung cancer (NSCLC). One patient with metastatic adenocarcinoma of NSCLC was given second-line treatment of pemertrexed/cisplatin. Follow-up was made to observe progression free survival (PFS) and survival time. She was given 4 cycles first-line treatment of recombinant human endostatin plus gemcitabine/cisplatin previously; the efficacy was CR and PFS was 10.2 months. After the 5th cycle treatment of pemetrexed/cisplatin, the efficacy of the primary tumor was CR, and bone metastases was stable. PFS was 6.6 months, and the patient has been survival for 22 months. Quality of life (QOL) of the patient was improved. When advanced NSCLC is recurrence or metastasis, starting second-line treatment of pemetrexed/cisplatin timely can prolong survival time and improve QOL.展开更多
Georgia has been the country of vines and wine since ancient times, and historically vine growing and wine making has performed the function of one of the leading branches of economy. The diverse and rich information ...Georgia has been the country of vines and wine since ancient times, and historically vine growing and wine making has performed the function of one of the leading branches of economy. The diverse and rich information about growing vines and producing wine in Georgia can be found in historical and modem scientific literatures as well. Javakhishvili reviewed 413 vine species from the ancient period in his work： ＂Economic History of Georgia＂. Nowadays there are more than 420 species in Georgia or 2.5% of the whole world assortment, from which 27 are for wine, 14 edible and 41 standard species. According to the ecological and economic conditions, Georgia is divided into 11 main regions from the viewpoint of specialization and concentration of vine growing, of which Kakheti, Kartli, Imereti, Racha and Lechkhumi are the most important regions. All these regions are both producers and users of grapes and wine. The climate of Kakheti is favorable to develop the vine industry here. They are： Rkatsiteli, Saperavi, Mtsvane, Kabeme and Khikhvi. Kakheti gives more than half of branded wines of the republic. Fifty-four percent of vineyards of the country are placed, and 65%-68% of total wines in Georgia are produced in Kakheti.展开更多
Everyone has his heroes, like the college coaches, many of them play a important role in our college life, and they hve a legendary life here at the same time. In America, college student pay attention to NCAA （Natio...Everyone has his heroes, like the college coaches, many of them play a important role in our college life, and they hve a legendary life here at the same time. In America, college student pay attention to NCAA （National Collegiate Athletic Association）, there are many famous coaches in it, such as Nich Saban, Jerry Tarkanian, and more. The authors are very interested in the competitive life of those who are the top five coaches in the world. So the authors concentrate on the winning rate, the contribution rate, and the cycle of the honors to evaluate each coach, by standardizing the metrics, they get the final scores of each metric for basketball; according to the scores, they get the top five coaches in a century. And in this paper, the authors also take the gender and timeline into account.展开更多
We report a rare case of a 74-year-old man with metachronous gallbladder cancer and bile duct cancer who underwent curative resection twice, with the operations nine years apart. At the age of 65 years, the patient un...We report a rare case of a 74-year-old man with metachronous gallbladder cancer and bile duct cancer who underwent curative resection twice, with the operations nine years apart. At the age of 65 years, the patient underwent a cholecystectomy and resection of the liver bed for gallbladder cancer. This was a welldifferentiated adenocarcinoma, with negative resection margins （T2NOM0, stage Ⅰ B）. Nine years later, during a follow-up examination, abdominal computed tomography and MRCP showed an enhanced 1.7 cm mass in the hilum that extended to the second branch of the right intrahepatic bile duct. We diagnosed this lesion as a perihilar bile duct cancer, Bismuth type Ⅲ a, and performed bile duct excision, right hepatic Iobectomy and Roux-en-Y hepaticojejunostomy. The histological diagnosis was a well-differentiated adenocarcinoma with one regional lymph node metastasis （TINIM0, stage Ⅱ B）. Twelve months after the second operation, the patient is well, with no signs of recurrence. This case is compared with 11 other cases of metachronous biliary tract cancer published in the world medical literature.展开更多
AIM： To determine the factors affecting mortality in pa- tients who developed graft-versus-host disease （GvHD） after liver transplantation （LT）. METHODS： We performed a review of studies of GvHD following LT pub...AIM： To determine the factors affecting mortality in pa- tients who developed graft-versus-host disease （GvHD） after liver transplantation （LT）. METHODS： We performed a review of studies of GvHD following LT published in the English literature and ac- cessed the PubMed, Medline, EBSCO, EMBASE, and Google Scholar databases. Using relevant search phras- es, 88 articles were identified. Of these, 62 articles con- raining most of the study parameters were considered eligible for the study. Risk factors were first examined using a univariate Kaplan-Meier model, and variables with a significant association （P 〈 0.05） were then sub- jected to multivariate analyses using a Cox proportional- hazards model. RESULTS： The 61 articles reported 87 patients, 58 male and 29 female, mean age, 40.4 ± 15.5 years （range： 8 mo to 74 years）, who met the inclusion criteria for the present study. Deaths occurred in 59 （67.8%） patients, whereas 28 （32.2%） survived after a mean follow-up period of 280.8 ± 316.2 d （range： 27-2285 d）. Among the most frequent symptoms were rash （94.2%）, fever （66.6%）, diarrhea （54%）, and pancytopenia （54%）. The average time period between LT and first symptom on- set was 60.6 ± 190.1 d （range： 2-1865 d）. The Kaplan- Meier analysis revealed that pancytopenia （42.8% vs 59.3%, P = 0.03）, diarrhea （39.2% vs 61.0%, P = 0.04）, age difference between the recipient and the donor （14.6 ± 3.1 years vs 22.6 ± 2.7 years, P 〈 0.0001）, and time From first symptom occurrence to diagnosis or treatment （13.3 ± 2.6 mo vs 15.0 ± 2.3 mo, P 〈 0.0001） were significant factors affecting mortality, whereas age, sex, presence of rash and fever, use of immunosuppressive agents, acute rejection before GvHD, etiological causes, time of onset, and donor type were not associated with mortality risk. The Cox proportional-hazards model, de- termined that an age difference between the recipient and donor was an independent risk Factor （P = 0.03; hazard ratio, 7.395, 95% confidence interval, 1.2-46.7）. CONCLUSION： This study showed that an age differ- ence between the recipient and donor is an independent risk factor for mortality in patients who develop GvHD after LT.展开更多
Needle retention duration, as an essential link in acupuncture treatment, has always been valued by physicians in all ages of the Chinese history. In this article, related literatures in recent years on influence fact...Needle retention duration, as an essential link in acupuncture treatment, has always been valued by physicians in all ages of the Chinese history. In this article, related literatures in recent years on influence factors of needle retention duration have been collected and reviewed in terms of duration, type and state of illness, point selection and so on. Modern related researches, to a certain extent, have approved and advanced the viewpoints of the previous physicians. However, few of the studies are randomized controlled trials of evidence-based medicine. Most of them still remain in observation stage. Therefore, scientific designing methods should be adopted in the future for researching approaches of TCM. Systematic and through studies should be carried out on needle retention duration, so as to comprehend the principle and define the optimal duration for different diseases. In this way, a standardized and systematic model on acupuncture treatment can be established.展开更多
文摘Purpose： The purpose of this review was to critically analyse the cun;ent evidence investigating the effect of an athlete＇s hydration status on physical performance. Methods： A literature search of multiple databases was used to identify studies that met the inclusion criteria for this review. The included studies were then critically appraised using the Downs and Black protocol. Results： Nine articles were found to meet the inclusion criteria, with an average score of 79% for methodological quality representative of a ＂high＂ standard of research. Conclusion： The evidence suggests that dehydration has a negative impact on physical performance for activities lasting more than 30 s in duration. However dehydration was found to have no significant impact on physical performance for activities lasting less than 15 s in duration.
文摘The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product(GDP) in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.
文摘The aim of our study was to explore the value of second-line treatment for advanced non-small cell lung cancer (NSCLC). One patient with metastatic adenocarcinoma of NSCLC was given second-line treatment of pemertrexed/cisplatin. Follow-up was made to observe progression free survival (PFS) and survival time. She was given 4 cycles first-line treatment of recombinant human endostatin plus gemcitabine/cisplatin previously; the efficacy was CR and PFS was 10.2 months. After the 5th cycle treatment of pemetrexed/cisplatin, the efficacy of the primary tumor was CR, and bone metastases was stable. PFS was 6.6 months, and the patient has been survival for 22 months. Quality of life (QOL) of the patient was improved. When advanced NSCLC is recurrence or metastasis, starting second-line treatment of pemetrexed/cisplatin timely can prolong survival time and improve QOL.
文摘Georgia has been the country of vines and wine since ancient times, and historically vine growing and wine making has performed the function of one of the leading branches of economy. The diverse and rich information about growing vines and producing wine in Georgia can be found in historical and modem scientific literatures as well. Javakhishvili reviewed 413 vine species from the ancient period in his work： ＂Economic History of Georgia＂. Nowadays there are more than 420 species in Georgia or 2.5% of the whole world assortment, from which 27 are for wine, 14 edible and 41 standard species. According to the ecological and economic conditions, Georgia is divided into 11 main regions from the viewpoint of specialization and concentration of vine growing, of which Kakheti, Kartli, Imereti, Racha and Lechkhumi are the most important regions. All these regions are both producers and users of grapes and wine. The climate of Kakheti is favorable to develop the vine industry here. They are： Rkatsiteli, Saperavi, Mtsvane, Kabeme and Khikhvi. Kakheti gives more than half of branded wines of the republic. Fifty-four percent of vineyards of the country are placed, and 65%-68% of total wines in Georgia are produced in Kakheti.
文摘Everyone has his heroes, like the college coaches, many of them play a important role in our college life, and they hve a legendary life here at the same time. In America, college student pay attention to NCAA （National Collegiate Athletic Association）, there are many famous coaches in it, such as Nich Saban, Jerry Tarkanian, and more. The authors are very interested in the competitive life of those who are the top five coaches in the world. So the authors concentrate on the winning rate, the contribution rate, and the cycle of the honors to evaluate each coach, by standardizing the metrics, they get the final scores of each metric for basketball; according to the scores, they get the top five coaches in a century. And in this paper, the authors also take the gender and timeline into account.
文摘We report a rare case of a 74-year-old man with metachronous gallbladder cancer and bile duct cancer who underwent curative resection twice, with the operations nine years apart. At the age of 65 years, the patient underwent a cholecystectomy and resection of the liver bed for gallbladder cancer. This was a welldifferentiated adenocarcinoma, with negative resection margins （T2NOM0, stage Ⅰ B）. Nine years later, during a follow-up examination, abdominal computed tomography and MRCP showed an enhanced 1.7 cm mass in the hilum that extended to the second branch of the right intrahepatic bile duct. We diagnosed this lesion as a perihilar bile duct cancer, Bismuth type Ⅲ a, and performed bile duct excision, right hepatic Iobectomy and Roux-en-Y hepaticojejunostomy. The histological diagnosis was a well-differentiated adenocarcinoma with one regional lymph node metastasis （TINIM0, stage Ⅱ B）. Twelve months after the second operation, the patient is well, with no signs of recurrence. This case is compared with 11 other cases of metachronous biliary tract cancer published in the world medical literature.
文摘AIM： To determine the factors affecting mortality in pa- tients who developed graft-versus-host disease （GvHD） after liver transplantation （LT）. METHODS： We performed a review of studies of GvHD following LT published in the English literature and ac- cessed the PubMed, Medline, EBSCO, EMBASE, and Google Scholar databases. Using relevant search phras- es, 88 articles were identified. Of these, 62 articles con- raining most of the study parameters were considered eligible for the study. Risk factors were first examined using a univariate Kaplan-Meier model, and variables with a significant association （P 〈 0.05） were then sub- jected to multivariate analyses using a Cox proportional- hazards model. RESULTS： The 61 articles reported 87 patients, 58 male and 29 female, mean age, 40.4 ± 15.5 years （range： 8 mo to 74 years）, who met the inclusion criteria for the present study. Deaths occurred in 59 （67.8%） patients, whereas 28 （32.2%） survived after a mean follow-up period of 280.8 ± 316.2 d （range： 27-2285 d）. Among the most frequent symptoms were rash （94.2%）, fever （66.6%）, diarrhea （54%）, and pancytopenia （54%）. The average time period between LT and first symptom on- set was 60.6 ± 190.1 d （range： 2-1865 d）. The Kaplan- Meier analysis revealed that pancytopenia （42.8% vs 59.3%, P = 0.03）, diarrhea （39.2% vs 61.0%, P = 0.04）, age difference between the recipient and the donor （14.6 ± 3.1 years vs 22.6 ± 2.7 years, P 〈 0.0001）, and time From first symptom occurrence to diagnosis or treatment （13.3 ± 2.6 mo vs 15.0 ± 2.3 mo, P 〈 0.0001） were significant factors affecting mortality, whereas age, sex, presence of rash and fever, use of immunosuppressive agents, acute rejection before GvHD, etiological causes, time of onset, and donor type were not associated with mortality risk. The Cox proportional-hazards model, de- termined that an age difference between the recipient and donor was an independent risk Factor （P = 0.03; hazard ratio, 7.395, 95% confidence interval, 1.2-46.7）. CONCLUSION： This study showed that an age differ- ence between the recipient and donor is an independent risk factor for mortality in patients who develop GvHD after LT.
基金Supported by Program of China Postdoctoral Science Foundation:200801054Program of National Natural Science Foundation:30801483
文摘Needle retention duration, as an essential link in acupuncture treatment, has always been valued by physicians in all ages of the Chinese history. In this article, related literatures in recent years on influence factors of needle retention duration have been collected and reviewed in terms of duration, type and state of illness, point selection and so on. Modern related researches, to a certain extent, have approved and advanced the viewpoints of the previous physicians. However, few of the studies are randomized controlled trials of evidence-based medicine. Most of them still remain in observation stage. Therefore, scientific designing methods should be adopted in the future for researching approaches of TCM. Systematic and through studies should be carried out on needle retention duration, so as to comprehend the principle and define the optimal duration for different diseases. In this way, a standardized and systematic model on acupuncture treatment can be established.
