The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in...The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.展开更多
The theory of branch atheromatous disease(BAD) has been commonly underused in clinical practice and research since it was proposed in 1989. In this study, we sought to explore clinical characteristics of its substyp...The theory of branch atheromatous disease(BAD) has been commonly underused in clinical practice and research since it was proposed in 1989. In this study, we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD. A total of 176 consecutive patients with BAD were classified into two groups: paramedianpontine artery group(PPA group, n=70) and lenticulostriate artery group(LSA group, n=106). Bivariate analyses were used to explore the relationship between white matter hyperintensities(WMHs), National Institutes of Health Stroke Scale(NIHSS) scores and prognosis evaluated by the modified Rank Scale(m RS) at 6th month after stroke. The differences in prevalence of diabetes mellitus and a history of ischemic heart disease were statistically significant between PPA group and LSA group(χ~2=8.255, P=0.004; χ~2=13.402, P〈0.001). The bivariate analyses demonstrated a positive correlation between NIHSS and poor prognosis in patients with BAD and in the two subtype groups, and a positive correlation between WMHs and poor prognosis in the PPA group. It is concluded that a significantly higher prevalence of diabetes mellitus and a history of ischemic heart disease exist in the PPA group than in the LSA group. In addition, high grades of NIHSS scores imply poor prognosis in patients with BAD and in the two subtype groups. Moreover, WMHs are a positive predictor for poor prognosis in patients in the PPA group.展开更多
In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since u...In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since updated,is now very widely accepted around the world.Nevertheless,the authoritative United States Preventative Task Force had in August 2012acknowledged that we know surprisingly little about whether screening adults with no signs or symptoms of CKD improve health outcomes and that we deserve better information on CKD.More recently,the American Society of Nephrology and the American College of Physicians,two very well respected United States professional physician organizations were strongly at odds coming out with exactly opposite recommendations regarding the need or otherwise for"CKD screening"among the asymptomatic population.In this review,we revisit the various angles and perspectives of these conflicting arguments,raise unanswered questionsregarding the validity and veracity of the NKF KDOQI CKD staging model,and raise even more questions about the soundness of its evidence-base.We show clinical evidence,from a Mayo Clinic Health System Renal Unit in Northwestern Wisconsin,United States,of the pitfalls of the current CKD staging model,show the inexactitude and unpredictable vagaries of current CKD prediction models and call for a more cautious and guarded application of CKD staging paradigms in clinical practice.The impacts of acute kidney injury on CKD initiation and CKD propagation and progression,the effects of such phenomenon as the syndrome of late onset renal failure from angiotensin blockade and the syndrome of rapid onset end stage renal disease on CKD initiation,CKD propagation and CKD progression to end stage renal disease all demand further study and analysis.Yet more research on CKD staging,CKD prognostication and CKD predictions are warranted.Finally and most importantly,cognizant of the very serious limitations and drawbacks of the NKF K/DOQI CKD staging model,the need to individualize CKD care,both in terms of patient care and prognostication,cannot be overemphasized.展开更多
Background: With the promotion of national control programs on parasitic and tropical diseases in China,the National Institute of Parasitic Diseases(NIPD),Chinese Center for Disease Control and Prevention has gained s...Background: With the promotion of national control programs on parasitic and tropical diseases in China,the National Institute of Parasitic Diseases(NIPD),Chinese Center for Disease Control and Prevention has gained significant experience in the global health arena through international cooperation over the last seven decades allowing a multilateral impact in the elimination of major endemic diseases.Methods:: The achievements of NIPD since 1950 has been analyzed with emphasis on the various stages that started with research and control of the endemic parasitic and other tropical diseases at the national level and progressed via international cooperation into a global presence.Results: The major achievements contributed by NIPD consist of(i)improving technical capability;(ii)promoting control and elimination of parasitic and tropical diseases;(iii)participating in global health governance and cooperation;and(iv)developing a cooperation model for technical assistance and global public health development.It is expected that NIPD’s experience of international cooperation will be essential for the dissemination of China's successful experience in global health governance,emergency response and development,with focus on malaria and neglected tropical diseases such as schistosomiasis,soil-borne and food-borne helminthiases and echinococcosis.Conclusions: NIPD’s new tasks will not only continue to promote national control of endemic parasitic infections and disease elimination programs in China,but also play a leading role in global health and disease elimination programs in the future.展开更多
文摘The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation's medical research agency-making important discoveries that improve health and save lives.Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 78 years as reported in 2009, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.
文摘The theory of branch atheromatous disease(BAD) has been commonly underused in clinical practice and research since it was proposed in 1989. In this study, we sought to explore clinical characteristics of its substypes and biomarkers for prognosis of BAD. A total of 176 consecutive patients with BAD were classified into two groups: paramedianpontine artery group(PPA group, n=70) and lenticulostriate artery group(LSA group, n=106). Bivariate analyses were used to explore the relationship between white matter hyperintensities(WMHs), National Institutes of Health Stroke Scale(NIHSS) scores and prognosis evaluated by the modified Rank Scale(m RS) at 6th month after stroke. The differences in prevalence of diabetes mellitus and a history of ischemic heart disease were statistically significant between PPA group and LSA group(χ~2=8.255, P=0.004; χ~2=13.402, P〈0.001). The bivariate analyses demonstrated a positive correlation between NIHSS and poor prognosis in patients with BAD and in the two subtype groups, and a positive correlation between WMHs and poor prognosis in the PPA group. It is concluded that a significantly higher prevalence of diabetes mellitus and a history of ischemic heart disease exist in the PPA group than in the LSA group. In addition, high grades of NIHSS scores imply poor prognosis in patients with BAD and in the two subtype groups. Moreover, WMHs are a positive predictor for poor prognosis in patients in the PPA group.
文摘In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since updated,is now very widely accepted around the world.Nevertheless,the authoritative United States Preventative Task Force had in August 2012acknowledged that we know surprisingly little about whether screening adults with no signs or symptoms of CKD improve health outcomes and that we deserve better information on CKD.More recently,the American Society of Nephrology and the American College of Physicians,two very well respected United States professional physician organizations were strongly at odds coming out with exactly opposite recommendations regarding the need or otherwise for"CKD screening"among the asymptomatic population.In this review,we revisit the various angles and perspectives of these conflicting arguments,raise unanswered questionsregarding the validity and veracity of the NKF KDOQI CKD staging model,and raise even more questions about the soundness of its evidence-base.We show clinical evidence,from a Mayo Clinic Health System Renal Unit in Northwestern Wisconsin,United States,of the pitfalls of the current CKD staging model,show the inexactitude and unpredictable vagaries of current CKD prediction models and call for a more cautious and guarded application of CKD staging paradigms in clinical practice.The impacts of acute kidney injury on CKD initiation and CKD propagation and progression,the effects of such phenomenon as the syndrome of late onset renal failure from angiotensin blockade and the syndrome of rapid onset end stage renal disease on CKD initiation,CKD propagation and CKD progression to end stage renal disease all demand further study and analysis.Yet more research on CKD staging,CKD prognostication and CKD predictions are warranted.Finally and most importantly,cognizant of the very serious limitations and drawbacks of the NKF K/DOQI CKD staging model,the need to individualize CKD care,both in terms of patient care and prognostication,cannot be overemphasized.
基金This study was supported by National Natural Science Foundation of China,Grant No.81973108.
文摘Background: With the promotion of national control programs on parasitic and tropical diseases in China,the National Institute of Parasitic Diseases(NIPD),Chinese Center for Disease Control and Prevention has gained significant experience in the global health arena through international cooperation over the last seven decades allowing a multilateral impact in the elimination of major endemic diseases.Methods:: The achievements of NIPD since 1950 has been analyzed with emphasis on the various stages that started with research and control of the endemic parasitic and other tropical diseases at the national level and progressed via international cooperation into a global presence.Results: The major achievements contributed by NIPD consist of(i)improving technical capability;(ii)promoting control and elimination of parasitic and tropical diseases;(iii)participating in global health governance and cooperation;and(iv)developing a cooperation model for technical assistance and global public health development.It is expected that NIPD’s experience of international cooperation will be essential for the dissemination of China's successful experience in global health governance,emergency response and development,with focus on malaria and neglected tropical diseases such as schistosomiasis,soil-borne and food-borne helminthiases and echinococcosis.Conclusions: NIPD’s new tasks will not only continue to promote national control of endemic parasitic infections and disease elimination programs in China,but also play a leading role in global health and disease elimination programs in the future.