Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux dis...Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.展开更多
Photochemical aging of volatile organic compounds(VOCs)in the atmosphere is an important source of secondary organic aerosol(SOA).To evaluate the formation potential of SOA at an urban site in Lyon(France),an outdoor ...Photochemical aging of volatile organic compounds(VOCs)in the atmosphere is an important source of secondary organic aerosol(SOA).To evaluate the formation potential of SOA at an urban site in Lyon(France),an outdoor experiment using a Potential Aerosol Mass(PAM)oxidation flow reactor(OFR)was conducted throughout entire days during JanuaryFebruary 2017.Diurnal variation of SOA formations and their correlation with OH radical exposure(OHexp),ambient pollutants(VOCs and particulate matters,PM),Relative Humidity(RH),and temperature were explored in this study.Ambient urban air was exposed to high concentration of OH radicals with OHexp in range of(0.2-1.2)×10^12 molecule/(cm^3·sec),corresponding to several days to weeks of equivalent atmospheric photochemical aging.The results informed that urban air at Lyon has high potency to contribute to SOA,and these SOA productions were favored from OH radical photochemical oxidation rather than via ozonolysis.Maximum SOA formation(36μg/m^3)was obtained at OHexp of about 7.4×10^11 molecule/(cm^3·sec),equivalent to approximately 5 days of atmospheric oxidation.The correlation between SOA formation and ambient environment conditions(RH&temperature,VOCs and PM)was observed.It was the first time to estimate SOA formation potential from ambient air over a long period in urban environment of Lyon.展开更多
目的探讨社区人群Corne ll乘积(Corne ll p rod uc t,CP)、Sokolow-Lyon电压(Sokolow-Lyon volta g e,SL)诊断的左心室肥厚情况。方法选择社区2559例年龄在65～75岁人群,测量身高、体重、腰围、血压,并计算体质量指数(BMI)及测量心电图...目的探讨社区人群Corne ll乘积(Corne ll p rod uc t,CP)、Sokolow-Lyon电压(Sokolow-Lyon volta g e,SL)诊断的左心室肥厚情况。方法选择社区2559例年龄在65～75岁人群,测量身高、体重、腰围、血压,并计算体质量指数(BMI)及测量心电图,并计算CP值、SL值、CP诊断的左心室肥厚(CP-LVH)患者总数及SL诊断的左心室肥厚(SL-LVH)患者总数。结果不同性别患者身高、体重、腰围、BMI、收缩压、SL的数值和SL占比、CP的数值和CP占比比较,差异均有统计学意义(均P<0.05)。CP-LVH患者总数131例(5.12%),SL-LVH患者总数182例(7.11%)。联合CP和SL诊断的心电图监测左心室肥厚(ECG-LVH)的总检出为281例(10.98%)。结论社区人群中心电图诊断左心室肥厚的发生率较低。展开更多
文摘Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.
基金the Institute for Research on Catalysis and the Environment of Lyon(IRCELYON)supported by the"Investissement d’Avenir"PEPS Program Project(ASTRAL)of the University of Lyon and French National center for Scientific Research(French:center national de la recherche scientifique,CNRS)as part of the ANR-11-IDEX-0007 programby the European Research Council under the Horizon 2020 Research and Innovation Program Project of the European Union under Convention N°690958(MARSU)。
文摘Photochemical aging of volatile organic compounds(VOCs)in the atmosphere is an important source of secondary organic aerosol(SOA).To evaluate the formation potential of SOA at an urban site in Lyon(France),an outdoor experiment using a Potential Aerosol Mass(PAM)oxidation flow reactor(OFR)was conducted throughout entire days during JanuaryFebruary 2017.Diurnal variation of SOA formations and their correlation with OH radical exposure(OHexp),ambient pollutants(VOCs and particulate matters,PM),Relative Humidity(RH),and temperature were explored in this study.Ambient urban air was exposed to high concentration of OH radicals with OHexp in range of(0.2-1.2)×10^12 molecule/(cm^3·sec),corresponding to several days to weeks of equivalent atmospheric photochemical aging.The results informed that urban air at Lyon has high potency to contribute to SOA,and these SOA productions were favored from OH radical photochemical oxidation rather than via ozonolysis.Maximum SOA formation(36μg/m^3)was obtained at OHexp of about 7.4×10^11 molecule/(cm^3·sec),equivalent to approximately 5 days of atmospheric oxidation.The correlation between SOA formation and ambient environment conditions(RH&temperature,VOCs and PM)was observed.It was the first time to estimate SOA formation potential from ambient air over a long period in urban environment of Lyon.
文摘目的探讨社区人群Corne ll乘积(Corne ll p rod uc t,CP)、Sokolow-Lyon电压(Sokolow-Lyon volta g e,SL)诊断的左心室肥厚情况。方法选择社区2559例年龄在65～75岁人群,测量身高、体重、腰围、血压,并计算体质量指数(BMI)及测量心电图,并计算CP值、SL值、CP诊断的左心室肥厚(CP-LVH)患者总数及SL诊断的左心室肥厚(SL-LVH)患者总数。结果不同性别患者身高、体重、腰围、BMI、收缩压、SL的数值和SL占比、CP的数值和CP占比比较,差异均有统计学意义(均P<0.05)。CP-LVH患者总数131例(5.12%),SL-LVH患者总数182例(7.11%)。联合CP和SL诊断的心电图监测左心室肥厚(ECG-LVH)的总检出为281例(10.98%)。结论社区人群中心电图诊断左心室肥厚的发生率较低。
