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| 1 | 澳大利亚临床共识指南:儿童卒中的诊断和急性期处理显示文摘卒中是导致儿童死亡的十大原因之一,幸存的致残患儿将面临几十年的残疾生活,给患儿及其家庭带来了巨大负担。由于安全性和有效性的证据有限,以及诊断的延误,目前卒中患儿无法接受再灌注治疗。儿童卒中诊断和急性期处理的澳大利亚临床共识指南,旨在最大限度地减少临床诊疗中的不确定性,并记录与成人卒中不同的危险因素、病因和假性卒中情况的最佳证据。临床问题的阐述来自于对2007年至2017年数据库的系统检索,但仅限于英语和儿科研究。该指南应用SIGN方法和国家健康与医学研究委员会系统对证据进行筛选和分类,通过推荐、评估、发展和评价系统(GRADE系统)对推荐进行强弱分级。该指南提供了60多项基于证据的推荐,以帮助参与院前和急症处理的临床医师快速识别儿童卒中,选择最合适的初步检查方案来确定诊断、明确病因,并选择最恰当的干预措施以挽救脑组织、预防复发。同时,指南也提供了颅内压和先天性心脏病管理方面的推荐。该指南的实施需要将院前和急诊系统重组,包括建立区域性卒中网络,建立儿科卒中疾病编码,快速MRI,以及对能够提供再灌注治疗的初级儿科卒中中心进行认证。该指南能够审核治疗的基准时间线,获得急性期的干预措施及预后判断。它还将促进澳大利亚儿童卒中登记的发展,并与国际登记处建立数据联系,以便准确收集卒中发病率、治疗和结果相关的数据。 | Medley TL Miteff C Andrews I Ware T Cheung M Monagle P Mandelstam S Wray A Pridmore C Troedson C Dale RC Fahey M Sinclair A Walsh P Stojanovski S Macka MT 徐佳丽(译) 吴川杰(译) 肖潇(译) 吕俊萱(译) 张博维(译) 吉训明(译) | 2019 | 中国脑血管病杂志2019，16，4： | 9 |
| 2 | 钠-葡萄糖共转运蛋白-2抑制剂或胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病:临床实践指南显示文摘临床问题对于存在不同心血管风险及肾脏结局的2型糖尿病患者,在原有生活方式干预和/或其他降糖药物的基础上加用钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂的获益及风险是什么?现行做法几十年来,2型糖尿病的治疗决策都以控制血糖为主导。SGLT-2抑制剂和GLP-1受体激动剂在传统观念中常被用于二甲双胍治疗后血糖仍控制不佳的患者。目前这一现状已经发生了改变,这得益于多项临床研究结果。研究显示SGLT-2抑制剂和GLP-1受体激动剂拥有独立于药物降糖作用之外的对于动脉粥样硬化性心血管病(CVD)和慢性肾脏病(CKD)的获益。建议本指南阐述了针对不同风险分层的成人2型糖尿病患者使用SGLT-2抑制剂或GLP-1受体激动剂的建议。•伴有3种或更少的心血管风险因素且不存在CVD或CKD:不建议启动SGLT-2抑制剂或GLP-1受体激动剂治疗。(推荐等级:弱)•伴有3种以上心血管风险因素且不存在CVD或CKD:建议启动SGLT-2抑制剂治疗,不建议启动GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD或CKD:建议启动SGLT-2抑制剂治疗和GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD和CKD:建议启动SGLT-2抑制剂治疗(推荐等级:强)和GLP-1受体激动剂治疗。(推荐等级:弱)•对于那些想要进一步降低CVD和CKD结局风险的患者:推荐优先启用SGLT-2抑制剂治疗而非GLP-1受体激动剂治疗。(推荐等级:弱)这项指南是如何制订的一个由患者、临床医生和方法学家共同组成的国际小组提出了这些推荐意见。这些推荐意见基于可信度较高的指南的标准,并使用GRADE分级方法进行评估。该小组采用了息者个体化的观点。证据一项关于获益与风险的系统综述和网络meta分析(764项随机对照研究,包括421346例参与者)发现SGLT-2抑制剂和GLP-1受体激动剂可以降低总体死亡率、心肌梗死发生率、终末期肾病或肾衰竭的发生率(中等至高等质量的证据)。在不同的亚组中这些药物对卒中、因心力衰竭所致住院和其他主要不良事件有不同的影响。药物绝对获益的程度因患者个体风险的不同有很大的差异。(例如,对于接受了超过5年药物治疗的1000例患者,在最低风险人群中死亡人数减少了5人,在最高风险人群中死亡人数减少了48人)。一项关于预后的综述确认了14种风险预测模型,其中一种(RECODe)在证据总结中报告了大部分基线风险评估数据,小组利用该模型以支持风险分层的建议。考虑到患者的价值观及个体差异,指南推荐的支撑证据包括一项对已发表论文的系统综述、一项患者焦点小组研究、一项临床问题总结,以及一项指南调查。指南解读我们依据不同的CVD和CKD风险水平,综合考虑获益、风险和其他因素的平衡,以及每一个风险组别的实际问题,来对推荐意见进行分层。本指南强烈建议CVD和CKD患者使用SGLT-2抑制剂治疗,这说明专家组认为其具有显著的获益。而对于其他成人2型糖尿病患者,推荐等级较弱,这说明专家组想要在获益、风险及治疗花费上取得一个更好的平衡。临床医生通过该指南可以使用可靠的风险计算模型,如RECODe,来明确其患者的个体心血管和肾脏疾病风险。医患交互式总结临床证据和制订决策有助于患者知晓治疗选择,包括进行共同决策。2型糖尿病人群(全球患病率不断增长1-2)正面临着不断增加的心血管疾病、肾脏病和其他并发症的风险3。数十年来,2型糖尿病的管理始终以控制血糖及糖化血红蛋白(HbA1c)为治疗目标4-5,但是,最近的高质量随机对照研究已经对这种以血糖为中心的治疗模式发起了挑战。研究结果显示,强化血糖控制未必会降低大血管不良事件,它还可能带来不利影响监管机构现在要求新型糖尿病药物必须证明其具有心血管和肾脏获益才能获得批准。对两类新药--钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂(见框图1)的临床试验结果显示,在现有治疗方案(常规治疗)之上加用这些药物,对死亡、心肌梗死、卒中、心力衰竭和肾脏的结局(如进展为终末期肾病)都有获益8-12。 | Sheyu Li Per Olav Vandvik Lyubov Lytvyn Gordon H Guyatt Suetonia C Palmer Rene Rodriguez-Gutierrez Farid Foroutan Thomas Agoritsas Reed A C Siemieniuk Michael Walsh Lawrie Frere David J Tunnicliffe Evi V Nagler Veena Manja Bjφrn Olav Asvold Vivekanand Jha Mieke Vermandere Karim Gariani Qian Zhao Yan Ren Emma Jane Cartwright Patrick Gee Alan Wickes Linda Fems Robin Wright Ling Li Qiukui Hao Reem A Mustafa 无 郭鹤鸣(译) | 2021 | 英国医学杂志中文版2021，24，9： | 7 |
| 3 | Paediatric cholestatic liver disease:Diagnosis,assessment of disease progression and mechanisms of fibrogenesis显示文摘Cholestatic liver disease causes significant morbidity and mortality in children.The diagnosis and management of these diseases can be complicated by an inability to detect early stages of fibrosis and a lack of adequate interventional therapy.There is no single gold standard test that accurately reflects the presence of liver disease,or that can be used to monitor fibrosis progression,particularly in conditions such as cystic fibrosis.This has lead to controversy over how suspected liver disease in children is detected and diagnosed.This review discusses the challenges in using commonly available methods to diagnose hepatic fibrosis and monitor disease progression in children with cholestatic liver disease.In addition,the review examines the mechanisms hypothesised to be involved in the development of hepatic fibrogenesis in paediatric cholestatic liver injury which may ultimately aid in identifying new modalities to assist in both disease detection and therapeutic intervention. | Tamara N Pereira Meagan J Walsh Peter J Lewindon Grant A Ramm | 2010 | World Journal of Gastrointestinal Pathophysiology2010，1，2： | 7 |
| 4 | 男性不育的手术技术显示文摘男性不育的评估和手术治疗领域经过数次演变和扩展后,目前已经有了更精确的诊断和适应个人的治疗方法,死亡率逐渐降低,成功率逐渐提高.男性不育手术目前被分为四个主要的大类:1)诊断手术;2)改善精子生成的手术;3)提高精子运输的手术;4)提取精子用于IVF—ICSI的手术.尽管现在的男性不育治疗效果比以前有了显著的提高,但还是有些达不到妊娠的要求,这可能是由一些我们还不知道的因素造成的。医生在治疗不育时应提倡“夫妻双方共同治疗”的准则,要求在实施具体的治疗方案之前,夫妻双方都进行彻底的评估,并进行广泛讨论决定方案。 | Natalya A Lopushnyan Thomas J Walsh | 2012 | Asian Journal of Andrology2012，14，1： | 7 |
| 5 | Gastroenterologist perceptions of faecal microbiota transplantation显示文摘AIM: To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation(FMT).METHODS: A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014. Basic descriptive statistical analyses were performed.RESULTS: Fifty-two clinicians participated. Twenty one percent had previously referred patients for FMT,8% more than once. Ninety percent would refer patients with Clostridium difficile infection(CDI) for FMT if easily available,37% for ulcerative colitis,13% for Crohn's disease and 6% for irritable bowel syndrome. Six percent would not refer any indication,including recurrent CDI. Eighty-six percent would enroll patients in FMT clinical trials. Thirty-seven percent considered the optimal mode of FMT administration transcolonoscopic,17% nasoduodenal,13% enema and 8% oral capsule. The greatest concerns regarding FMT were: 42% lack of evidence,12% infection risk,10% non infectious adverse effects/lack of safety data,10% aesthetic,10% lack of efficacy,4% disease exacerbation,and 2% inappropriate use; 6% had no concerns. Seventy seven percent believed there is a lack of accessibility while 52% had an interest in learning how to provide FMT. Only 6% offered FMT at their institution.CONCLUSION: Despite general enthusiasm,most gastroenterologists have limited experience with,or access to,FMT. The greatest concerns were lack of supportive evidence and safety issues. However a significant proportion would refer indications other than CDI for FMT despite insufficient evidence. These data provide guidance on where education and training are required. | Sudarshan Paramsothy Alissa J Walsh Thomas Borody Douglas Samuel Johan van den Bogaerde Rupert WL Leong Susan Connor Watson Ng Hazel M Mitchell Nadeem O Kaakoush Michael A Kamm | 2015 | World Journal of Gastroenterology2015，21，38： | 5 |
| 6 | 蛋白酶和木聚糖酶对育肥猪的生长性能、营养消化率以及粪便气味的影响显示文摘菜籽粕(RSM)和小麦干酒糟及其可溶物(DDGS)作为副产物可应用到猪的日粮中。然而,与小麦和豆粕型日粮相比,RSM和DDGS中含有较高的非淀粉多糖(NSP),其可限制猪对日粮的有效利用。采用2×2因素试验设计研究生长育肥猪饲粮中添加木聚糖酶(0和200mg·kg-1)和蛋白酶(0和200mg·kg-1)对其生长性能、胴体品质、表观回肠消化率、全消化道养分消化率及粪便气体排放的影响及两种酶之间的相互作用。试验1,对猪的生长性能进行评估。将体重为34.2±2.1kg的育肥猪128头随机分配到4个处理组:以DDGS(300g·kg-1)和RSM(210g·kg-1)的基础日粮;基础日粮中添加蛋白酶200mg·kg-1;基础日粮中添加木聚糖酶200mg·kg-1;基础日粮中添加蛋白酶200mg·kg-1和木聚糖酶200mg·k-1。试验1中,在生长育肥-出栏期间(0~出栏),日粮中添加蛋白酶的试验猪较不添加蛋白酶的试验猪相比具有较低的平均日增重(ADG)(P〈0.001)。生长阶段(0—28d),蛋白酶和木聚糖酶对猪的日均采食量(ADFI,P〈0.01)和体重(BW,P〈0.01)的影响存在相互作用。在育肥阶段(28d~出栏),日粮中添加蛋白酶和木聚糖酶的试验猪与仅添加一种没酶的试验猪相比具有较低的ADFI和BW。然而,蛋白酶和木聚糖酶的相互作用在生长期间(0~28d)内并不显著。试验2,选择体重78±2.3kg公猪24只,将其置于代谢笼中进行代谢试验,试验期间按照试验l中的日粮进行饲喂。木聚糖酶和蛋白酶对总能(GE)中的AID存在相互作用(P〈0.05)。与对照组相比,饲粮中添加蛋白酶可以增加GE中的AID,但饲粮中添加两种酶时可降低GE中的AID。饲粮中添加木聚糖酶交不添加木聚糖组相比,猪粪便的臭气排放量降低(598和1306OuE/m3;P〈0.05)。研究表明,蛋白酶可提高GE的AID;木聚糖酶可以减少粪便异味的排放,然而当生长猪育肥以RSM和DDGS为基础饲粮时,两种酶均不能提高其生长性能。 | O'Shea C J Mc Alpine P O Solan P Curran T Varley P F Walsh A M Doherty J V O | 2014 | 饲料博览2014，0，10： | 4 |
| 7 | Simulation in endoscopy:Practical educational strategies to improve learning显示文摘In gastrointestinal endoscopy, simulation-based training can help endoscopists acquire new skills and accelerate the learning curve. Simulation creates an ideal environment for trainees, where they can practice specific skills, perform cases at their own pace, and make mistakes with no risk to patients. Educators also benefit from the use of simulators, as they can structure training according to learner needs and focus solely on the trainee. Not all simulation-based training,however, is effective. To maximize benefits from this instructional modality,educators must be conscious of learners' needs, the potential benefits of training,and associated costs. Simulation should be integrated into training in a manner that is grounded in educational theory and empirical data. In this review, we focus on four best practices in simulation-based education: deliberate practice with mastery learning, feedback and debriefing, contextual learning, and innovative educational strategies. For each topic, we provide definitions,supporting evidence, and practical tips for implementation. | Rishad Khan Michael A Scaffidi Samir C Grover Nikko Gimpaya Catharine M Walsh | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，3： | 3 |
| 8 | 巨噬细胞、细胞因子和脓毒症显示文摘巨噬细胞激活以及巨噬细胞因子白介素1(IL-1)、白介素6(IL-6)和肿瘤坏死因子(TNF)分泌的增加与脓毒症的发生发展有着密切的联系。采用这些细胞因子的桔抗物(如TNF单抗、消炎痛等)以及用小剂量内毒素诱导内毒素耐受性均能降低巨噬细胞因子分泌反应并提高脓毒症动物的生存率。本文对有关进展作综合介绍。 | Walsh CJ León P O'Riordain MG Ayala A 密磊 | 1993 | 国外医学(创伤与外科基本问题分册)1993，14，1： | 3 |
| 9 | Infection After Spanning External Fixation for High-Energy Tibial Plateau Fractures: Is Pin Site–Plate Overlap a Problem?显示文摘 | Catherine Laible Emily Earl-Royal Roy Davidovitch Mike Walsh Kenneth A Egol | 2012 | Journal of Orthopaedic Trauma2012，，2： | 3 |
| 10 | Chelex 100 as a medium for simple extraction of DNA for PCR-based typing from forensic material 显示文摘 | Walsh P S Metzger D A Higuchi R | 1991 | Bio Techniques1991，10，： | 2 |
| 11 | Periodontal probing depth and subgingival temperature in smokers and non-smokers显示文摘 | Trikilis N Rawlinson A Walsh TF | 1999 | J Clin Periodontol1999，26，1： | 2 |
| 12 | Nosocomial fungal infections 显示文摘 | Walsh T J Pizzo P A | | Annu Rev Microbiol0，42，： | 2 |
| 13 | Robotic surgery of the pancreas显示文摘Pancreatic surgery is one of the most challenging and complex fields in general surgery.While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion.This is attributed to the retroperitoneal location of the pancreas,its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy.Herein,we describe the application of robotic technology to minimally invasive pancreatic surgery.The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes(e.g.,decreased length of stay,less surgical site infections)to conventional open surgery.However,it is unclear whether the robotic approach is truly superior to traditional laparoscopy;this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities. | Daniel Joyce Gareth Morris-Stiff Gavin A Falk Kevin El-Hayek Sricharan Chalikonda R Matthew Walsh | 2014 | World Journal of Gastroenterology2014，20，40： | 2 |
| 14 | Development of a regional climate model of the western Arctic 显示文摘 | Lynch A H Chapman W L Walsh J E | 1995 | Journal of Climate1995，8，： | 1 |
| 15 | Micro-computed tomography evaluation of trabeular bone structure on loaded mice tail vertebrae显示文摘 | Walsh A Lu Y el at | 2003 | Spine2003，28，2： | 1 |
| 16 | Detection of Potato mop top virus and Tobacco rattle virus using a multiplex real- time fluorescent reverse transcription polymerase chain reaction assay显示文摘 | Mumford R A Walsh K Barker I | 2000 | Phytopathology2000，90，5： | 1 |
| 17 | Chelex 100 as a medium for simple extraction of DNA for PCR based typing from forensic material 显示文摘 | Walsh P S Metzger D A | 1991 | Biotechniques1991，10，4： | 1 |
| 18 | Production, purification and application-relevant characterisation of an endo- 1, 3(4)-β-glucanase from Rhizomucor miehei显示文摘 | Boyce A Walsh G | 2007 | Applied Microbiology and Biotechnology2007，76，4： | 1 |
| 19 | Very pretenn adolescents show gender-dependent alteration of the structural brain correlates of spelling abilities 显示文摘 | Scott FE Mechelli A Allin MP Walshe M Rifkin L Murray RM | 2011 | Neuropsychologia2011，49，9： | 1 |
| 20 | Regulation of cerebral cortical size by control ofcell cycle exit in neural precursors显示文摘 | Chenn A Walsh CA | 2002 | Science2002，297，5580： | 1 |
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