06-18 国际期刊速递丨今日热点：脑卒中、心衰、冠状动脉、氯吡格雷、机械血栓切除术、基底动脉闭塞

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2007至2017年间退伍军人事务卫生保健系统心衰住院后再入院率和死亡率的趋势

JAMA CardiologyJustin T. Parizo, Shun Kohsaka, etc.昨天 23:13

等 46 用户推荐阅读本文

ImportanceThe Centers for Medicare & Medicaid Services and the Veterans Affairs Health Care System provide incentives for hospitals to reduce 30-day readmission and mortality rates. In contrast with the large body of evidence describing readmission and mortality in the Medicare system, it is unclear how heart failure readmission and mortality rates have changed during this period in the Veterans Affairs Health Care System.医疗保险和医疗补助服务中心和退伍军人事务保健系统鼓励医院减少30天的再入院率和死亡率。与描述医疗保险系统中的再入院和死亡率的大量证据相反，尚不清楚在此期间退伍军人事务保健系统中心力衰竭再入院和死亡率的变化。ObjectivesTo evaluate trends in readmission and mortality after heart failure admission in the Veterans Affairs Health Care System, which had no financial penalties, in a decade involving focus on heart failure readmission reduction (2007-2017).评估退伍军人事务卫生保健系统（退伍军人事务卫生保健系统）在十年内（2007-2017年）在减少心衰再入院率和死亡率方面的趋势，该系统没有经济处罚。Design, Setting, and ParticipantsThis cohort study used >这项队列研究使用了2007年1月至2017年9月所有退伍军人事务-付费心衰入院患者的数据。所有退伍军人事务-支付退伍军人事务和非退伍军人事务设施的住院费用，主要诊断为心力衰竭，当住院费用由退伍军人事务支付。数据分析于2018年10月至2020年3月进行。ExposuresAdmission for a primary diagnosis of heart failure at discharge.出院时心力衰竭的初步诊断入院。Main Outcomes and MeasuresThirty-day all-cause readmission and mortality rates.30天全因再入院率和死亡率。ResultsA total of 164 566 patients with 304 374 hospital admissions were included. Among the 304 374 hospital admissions between 2007 and 2017, 298 260 (98.0%) were for male patients, and 195 205 (64.4%) were for white patients. The mean (SD) age was 70.8 (11.5) years. The adjusted odds ratio of 30-day readmission declined throughout the study period to 0.85 (95% CI, 0.83-0.88) in 2015 to 2017 compared with 2007 to 2008. The adjusted odds ratio of 30-day mortality remained stable, with an adjusted odds ratio of 1.01 (95% CI, 0.96-1.06) in 2015 to 2017 compared with 2007 to 2008. Stratification by left ventricular ejection fraction showed similar readmission reduction trends and no significant change in mortality, regardless of strata.共有164 566名患者和304 374名住院患者。在2007年至2017年的304 374例住院患者中，男性患者298 260例（98.0%），白人患者195 205例（64.4%）。平均年龄（SD）为70.8（11.5）岁。与2007年至2008年相比，在整个研究期间，2015年至2017年30天再入院的调整比值比下降至0.85（95%可信区间，0.83-0.88）。经调整的30天死亡率比值比保持稳定，2015年至2017年与2007年至2008年相比，经调整的比值比为1.01（95%CI，0.96-1.06）。按左室射血分数分层显示相似的再入院减少趋势，死亡率无明显变化，与分层无关。Conclusions and RelevanceIn this analysis of an integrated health care system that provided guidance and nonfinancial incentives for reducing readmissions, such as public reporting of readmission rates, risk-adjusted 30-day readmission declined despite inclusion of clinical variables in risk adjustment, but mortality did not decline. Future investigations should focus on evaluating the effectiveness of specific approaches to readmission reduction to inform efficient and effective application in individual health systems, hospitals, and practices.在对为减少再入院率提供指导和非财务激励的综合医疗保健系统（如再入院率的公开报告）的分析中，尽管在风险调整中包含了临床变量，但风险调整后的30天再入院率有所下降，但死亡率并未下降。今后的调查应侧重于评估减少再入院人数的具体方法的有效性，以便为在个别卫生系统、医院和做法中有效和有效地应用提供信息。

扫描二维码查看全文Early Recent, June 17, 202010.1001/jamacardio.2020.202802

经桡动脉冠状动脉手术后未闭和闭塞性止血的预测因素

CATHETER CARDIO INTE ArticleAndrea Pacchioni, Michele Bellamoli, etc.昨天 22:00

等 8 用户推荐阅读本文评估冠状动脉手术后桡动脉血瘀期间未闭和闭塞性血瘀（分别为PH和OH）的独立预测因子。桡动脉闭塞（RAO）是经桡动脉插管的血栓性并发症，可导致桡动脉永久性闭塞。鞘血管直径比、术后压缩时间、闭塞性止血、抗凝不足和抗凝过度都是RAO的预测因素。作为先前发表的一项研究的一部分，研究了残余抗凝与RAO风险之间的关系，837名患者接受了经桡动脉诊断冠状动脉造影或经皮冠状动脉介入治疗。记录手术过程中使用的累积肝素剂量和取鞘前测得的ACT。所有患者均尝试用倒巴布试验测定PH值（NCT02762344）。增加累积肝素剂量和ACT值时，PH值的获得频率较低（分别为p <； .0001和p=.0034）。在logistic回归分析中，累积肝素剂量和ACT值都是OH（OR 1.017，95%IC 1.011–1.023p <； .0001和OR 1.004，95%ic1.001–1.006，p=.0004）的独立预测因子，而RAO的调整概率与这两个参数呈指数关系。

扫描二维码查看全文（附全文PDF下载）Early Recent, June 17, 202010.1002/ccd.2906603

POINT研究基于CYP2C19等位基因状态的氯吡格雷预防脑卒中的疗效观察

Stroke research-articleJames F. Meschia, Ronald L. Walton, etc.昨天 21:29

等 27 用户推荐阅读本文Background and Purpose:Clopidogrel is an antiplatelet drug that is metabolized to its active form by the CYP2C19 enzyme. The CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) found a significant interaction between loss-of-function allele status for theCYP2C19 gene and the effect of dual antiplatelet therapy with aspirin and clopidogrel on the rate of early recurrent stroke following acute transient ischemic attack/minor stroke. The POINT (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial), similar in design to CHANCE but performed largely in North America and Europe, demonstrated a reduction in early recurrent stroke with dual antiplatelet therapy compared with aspirin alone. This substudy was done to evaluate a potential interaction between loss-of-function CYP2C19 alleles and outcome by treatment group in POINT.氯吡格雷是一种抗血小板药物，由CYP2C19酶代谢为活性形式。CHANCE试验（氯吡格雷治疗急性非致残性脑血管事件高危患者）发现，CYP2C19基因功能等位基因缺失状态与阿司匹林和氯吡格雷双重抗血小板治疗对急性短暂性脑缺血后早期复发卒中率的影响之间存在显着的交互作用攻击/轻微中风。这一点（新的短暂性脑缺血发作（TIA）和轻度缺血性卒中试验中的血小板定向抑制）在设计上与CHANCE相似，但主要在北美和欧洲实施，表明与单独使用阿司匹林相比，使用双重抗血小板治疗可减少早期复发性卒中。这个亚研究是为了评估功能丧失的CYP2C19等位基因与治疗组治疗结果之间的潜在相互作用。Methods:Of the 269 sites in 10 countries that enrolled patients in POINT, 134 sites participated in this substudy. DNA samples were genotyped for CYP2C19 *2, *3, and *17 alleles and classified as being carriers or noncarriers of loss-of-function alleles. Major ischemia consisted of ischemic stroke, myocardial infarction, or ischemic vascular death.在POINT研究的10个国家的269个城市中有134个城市参与了这个亚研究。对CYP2C19*2、*3和*17等位基因的DNA样本进行基因分型，并将其归类为功能丧失等位基因的携带者或非携带者。主要缺血包括缺血性中风、心肌梗死或缺血性血管死亡。Results:Nine hundred thirty-two patients provided analyzable DNA. The rates of major ischemia were 6.7% for the aspirin group versus 2.3% for the dual antiplatelet therapy group (hazard ratio, 0.33 [95% CI, 0.09–1.21]; P=0.09) among carriers of loss-of-function allele. The rates of major ischemia were 5.6% for the aspirin group versus 3.7% for the dual antiplatelet therapy group (hazard ratio, 0.65 [95% CI, 0.32–1.34]; P=0.25) among noncarriers. There was no significant interaction by genotype for major ischemia (P=0.36) or stroke (P=0.33).932名患者提供了可分析的DNA。在功能丧失等位基因携带者中，阿司匹林组的严重缺血发生率为6.7%，而双抗血小板治疗组为2.3%（危险比为0.33[95%CI，0.09–1.21]；P=0.09）。在非携带者中，阿司匹林组的严重缺血发生率为5.6%，而双重抗血小板治疗组为3.7%（危险比为0.65[95%CI，0.32-1.34]；P=0.25）。大面积缺血（P=0.36）或中风（P=0.33）基因型之间无显着交互作用。Conclusions:This substudy of POINT found no significant interaction with CYP2C19 loss-of-function carrier status and outcome by treatment group. Failure to confirm the findings from the CHANCE trial may be because the loss-of-function alleles tested are not clinically important in this context or because the 2 trials had differences in racial/ethnic composition. Additionally, differences between the 2 trials might be due to chance as our statistical power was limited to 50%.这个亚研究发现，治疗组的CYP2C19功能丧失携带者状态和预后没有明显的相互作用。未能证实CHANCE试验的结果可能是因为在这种情况下，所测试的等位基因功能丧失在临床上并不重要，或者是因为这两个试验在种族/民族组成上存在差异。另外，这两个试验之间的差异可能是由于偶然性，因为我们的统计能力被限制在50%。Registration:URL: https://www.clinicaltrials.gov. Unique identifier: NCT00991029.URL：https/-www.clinicatrials.gov.Uniqueidentifier:NCT00991029.

扫描二维码查看全文（附全文PDF下载）Early Recent, June 17, 202010.1161/STROKEAHA.119.02871304

急性脑卒中护理中的城乡不平等与住院死亡率

Stroke research-articleGmerice Hammond, Alina A. Luke, etc.昨天 21:29

等 74 用户推荐阅读本文Background and Purpose:The rural-urban life-expectancy gap is widening, but underlying causes are incompletely understood. Prior studies suggest stroke care may be worse for individuals in more rural areas, and technological advancements in stroke care may disproportionately impact individuals in more rural areas. We sought to examine differences and 5-year trends in the care and outcomes of patients hospitalized for stroke across rural-urban strata.城乡居民预期寿命差距不断拉大，但对其深层次原因认识不足。先前的研究表明，对更多农村地区的个人来说，中风护理可能更糟，而中风护理的技术进步可能对更多农村地区的个人产生不成比例的影响。我们试图研究城乡阶层中风住院患者在护理和预后方面的差异和5年趋势。Methods:Retrospective cohort study using National Inpatient Sample >采用2012-2017年全国住院患者样本数据进行回顾性队列研究。农村按居住县按国家卫生统计中心六级分类方案进行分类。Results:There were 792 054 hospitalizations for acute stroke in our sample. Rural patients were more often white (78% versus 49%), older than 75 (44% versus 40%), and in the lowest quartile of income (59% versus 32%) compared with urban patients. Among patients with acute ischemic stroke, intravenous thrombolysis and endovascular therapy use were lower for rural compared with urban patients (intravenous thrombolysis: 4.2% versus 9.2%, adjusted odds ratio, 0.55 [95% CI, 0.51–0.59],P<0.001; endovascular therapy: 1.63% versus 2.41%, adjusted odds ratio, 0.64 [0.57–0.73], P<0.001). Urban-rural gaps in both therapies persisted from 2012 to 2017. Overall, stroke mortality was higher in rural than urban areas (6.87% versus 5.82%,P<0.001). Adjusted in-patient mortality rates increased across categories of increasing rurality (suburban, 0.97 [0.94–1.0],P=0.086; large towns, 1.05 [1.01–1.09], P=0.009; small towns, 1.10 [1.06–1.15], P<0.001; micropolitan rural, 1.16 [1.11–1.21],P<0.001; and remote rural 1.21 [1.15–1.27], P<0.001 compared with urban patients. Mortality for rural patients compared with urban patients did not improve from 2012 (adjusted odds ratio, 1.12 [1.00–1.26], P<0.001) to 2017 (adjusted odds ratio, 1.27 [1.13–1.42], P<0.001).我们的样本中有792054例急性中风住院治疗。与城市患者相比，农村患者更常是白人（78%对49%），年龄大于75岁（44%对40%），收入最低的四分之一（59%对32%）。在急性缺血性卒中患者中，农村患者静脉溶栓和血管内治疗的使用率低于城市患者（静脉溶栓：4.2%对9.2%，校正比值比，0.55[95%CI，0.51-0.59]，P<0.001；血管内治疗：1.63%对2.41%，校正比值比，0.64[0.57-0.73]，P<0.001）。从2012年到2017年，两种疗法的城乡差距持续存在。总的来说，农村中风死亡率高于城市（6.87%对5.82%，P<0.001）。调整后住院死亡率在农村人口增加的不同类别中增加（郊区，0.97[0.94-1.0]，P=0.086；大城镇，1.05[1.01-1.09]，P=0.009；小城镇，1.10[1.06-1.15]，P<0.001；小城镇，1.16[1.11-1.21]，P<0.001；边远农村，1.21[1.15-1.27]，P<0.001）。从2012年到2017年，农村患者的死亡率与城市患者相比没有提高（调整后的比值比为1.12[1.00–1.26]，P<0.001）（调整后的比值比为1.27[1.13–1.42]，P<0.001）。Conclusions:Rural patients with stroke were less likely to receive intravenous thrombolysis or endovascular therapy and had higher in-hospital mortality than their urban counterparts. These gaps did not improve over time. Enhancing access to evidence-based stroke care may be a target for reducing rural-urban disparities.农村卒中患者接受静脉溶栓或血管内治疗的可能性较低，住院死亡率高于城市患者。这些差距并没有随着时间的推移而改善。提高获得循证中风护理的机会可能是减少城乡差距的一个目标。

扫描二维码查看全文（附全文PDF下载）Early Recent, June 17, 202010.1161/STROKEAHA.120.02931805

机械血栓切除术治疗基底动脉闭塞

Stroke research-articleHyo Sung Kwak, Jung Soo Park, etc.昨天 21:29

等 38 用户推荐阅读本文Background and Purpose:Basilar artery occlusion (BAO) is associated with a high risk of disability and mortality. The objective of this study was to investigate prognostic factors in patients with acute basilar artery occlusion treated with mechanical thrombectomy, focusing on collateral status and recanalization time from symptom onset.基底动脉闭塞（BAO）是一种高致残率和高死亡率的疾病。本研究的目的是探讨机械血栓切除术治疗急性基底动脉闭塞患者的预后因素，重点是侧支状态和症状出现后再通时间。Methods:Eligible patients from January 2012 to October 2019 who underwent endovascular treatment due to acute BAO were reviewed. The baseline posterior circulation collateral status was assessed with the basilar artery on computed tomography angiography score and posterior circulation collateral score. Good outcomes were defined as a modified Rankin Scale score of ≤2 at 3 months and successful recanalization as Thrombolysis in Cerebral Infarction grades 2b, 3. The associations between baseline and clinical parameters and favorable outcomes were evaluated with logistic regression.回顾2012年1月至2019年10月因急性肺动脉栓塞接受血管内治疗的合格患者。根据ct血管造影评分和后循环侧支循环评分，用基底动脉评估基线后循环侧支循环状态。良好的预后定义为3个月时改良的Rankin评分≤2，再通成功率为脑梗死2b、3级溶栓。用logistic回归分析基线和临床参数与预后的关系。Results:Our sample included a total of 81 eligible patients (49 males, mean age 70.3 years) with a median baseline and discharge National Institutes of Health Stroke Scale score of 12. Patients with good outcomes showed a lower baseline National Institutes of Health Stroke Scale score, a greater proportion of distal BAO, and a higher basilar artery on computed tomography angiography and posterior circulation collateral score (P<0.001). According to subgroup analysis of patients within and over 6 or 12 hours, the time from symptom onset to recanalization was not correlated with good outcomes. Multivariable logistic analysis showed baseline National Institutes of Health Stroke Scale <15 (odds ratio, 8.49 [95% CI, 2.01–35.82]; P=0.004), posterior circulation collateral score ≥6 (odds ratio, 3.79 [95% CI, 1.05–13.66]; P=0.042), and distal BAO (odds ratio, 3.67 [95% CI, 1.10–12.26]; P=0.035) were independent predictors of good outcomes.研究样本包括81名符合条件的患者（49名男性，平均年龄70.3岁），平均基线和出院国家卫生研究院卒中量表得分为12分。结果良好的患者在CT血管造影和后循环侧支评分上显示基线国立卫生研究院卒中量表评分较低，远端BAO比例较大，基底动脉较高（P<0.001）。根据6或12小时内及以上患者的亚组分析，从症状出现到再通的时间与良好的预后无关。多变量logistic分析显示基线国立卫生研究院卒中量表<15（比值比[OR]，8.49[95%可信区间，2.01-35.82]；P=0.004），后循环侧支评分≥6（OR 3.79 [95% CI 1.05–13.66]; P=0.042），远端BAO（ OR 3.67 [95% CI 1.10–12.26]；P=0.035)）是良好预后的独立预测因子。Conclusions:This study suggested that good collateral circulation and distal BAO are independent predictors of clinical outcome after endovascular treatment in patients with acute BAO. In particular, patients with good initial collateral status and distal BAO may consider endovascular treatment even if the treatment is started beyond the standard time limits.本研究提示，良好的侧支循环和远端BAO是急性BAO患者血管内治疗后临床疗效的独立预测因子。特别是，有良好初始侧支状态和远端BAO的患者，即使开始治疗超过标准时间限制，也可以考虑血管内治疗。

扫描二维码查看全文（附全文PDF下载）Early Recent, June 17, 202010.1161/STROKEAHA.120.029861CONTENTS今日发文一览

StrokeEarly Recent, June 17, 2020今日发布24篇文章research-articleNo.01 P.0-0Stroke Systems of Care中风护理系统06-17 21:29 | 10.1161/STROKEAHA.120.030288research-articleNo.02 P.0-0Simulation Methods in Acute Stroke Treatment急性脑卒中治疗的模拟方法06-17 21:29 | 10.1161/STROKEAHA.119.026732research-articleNo.03 P.0-0Essential Workflow and Performance Measures for Optimizing Acute Ischemic Stroke Treatment in India优化印度急性缺血性卒中治疗的基本流程和绩效措施06-17 21:29 | 10.1161/STROKEAHA.119.026733research-articleNo.04 P.0-0Leaving No Large Vessel Occlusion Stroke Behind无大血管闭塞卒中06-17 21:29 | 10.1161/STROKEAHA.119.026735research-articleNo.05 P.0-0Optimal Imaging at the Primary Stroke Center初级中风中心的最佳成像06-17 21:29 | 10.1161/STROKEAHA.119.026734research-articleNo.06 P.0-0Optimization of Endovascular Therapy in the Neuroangiography Suite to Achieve Fast and Complete (Expanded Treatment in Cerebral Ischemia 2c-3) Reperfusion优化血管内治疗以实现快速、完全（脑缺血扩大治疗2c-3）再灌注06-17 21:29 | 10.1161/STROKEAHA.119.026736research-articleNo.07 P.0-0Path From Clinical Research to Implementation从临床研究到实施的路径06-17 21:29 | 10.1161/STROKEAHA.119.026731research-articleNo.08 P.0-0Efficacy of Clopidogrel for Prevention of Stroke Based on CYP2C19 Allele Status in the POINT TrialPOINT研究基于CYP2C19等位基因状态的氯吡格雷预防脑卒中的疗效观察06-17 21:29 | 10.1161/STROKEAHA.119.028713research-articleNo.09 P.0-0Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality急性脑卒中护理中的城乡不平等与住院死亡率06-17 21:29 | 10.1161/STROKEAHA.120.029318research-articleNo.10 P.0-0Mechanical Thrombectomy in Basilar Artery Occlusion机械血栓切除术治疗基底动脉闭塞06-17 21:29 | 10.1161/STROKEAHA.120.029861research-articleNo.11 P.0-0Endovascular Thrombectomy for Acute Ischemic Stroke Beyond 6 Hours From Onset急性缺血性脑卒中发病6h以上的血管内血栓清除术06-17 21:29 | 10.1161/STROKEAHA.119.027974research-articleNo.12 P.0-0Theophylline as an Add-On to Thrombolytic Therapy in Acute Ischemic Stroke茶碱在急性缺血性脑卒中溶栓治疗中的应用06-17 21:29 | 10.1161/STROKEAHA.119.027446research-articleNo.13 P.0-0Intravenous Fibrinolysis for Central Retinal Artery Occlusion静脉溶栓治疗视网膜中央动脉阻塞06-17 21:29 | 10.1161/STROKEAHA.119.028743research-articleNo.14 P.0-0Pivotal Trial of the Neuroform Atlas Stent for Treatment of Anterior Circulation Aneurysms神经型寰椎支架治疗前循环动脉瘤的关键试验06-17 21:29 | 10.1161/STROKEAHA.119.028418research-articleNo.15 P.0-0Assessing the Predictive Validity of Simple Dementia Risk Models in Harmonized Stroke Cohorts脑卒中协调队列中简单痴呆风险模型的预测有效性评估06-17 21:29 | 10.1161/STROKEAHA.120.027473research-articleNo.16 P.0-0Corticospinal Fibers With Different Origins Impact Motor Outcome and Brain After Subcortical Stroke不同来源皮质脊髓纤维对脑卒中后运动功能和脑功能的影响06-17 21:29 | 10.1161/STROKEAHA.120.029508research-articleNo.17 P.0-0Predicting Longitudinal Progression in Functional Mobility After Stroke脑卒中后功能活动性纵向进展的预测06-17 21:29 | 10.1161/STROKEAHA.120.029913letterNo.18 P.0-0Letter by van der Ende et al Regarding Article, “Redefined Measure of Early Neurological Improvement Shows Treatment Benefit of Alteplase Over Placebo”van der Ende et al关于“重新定义的早期神经功能改善的测量显示阿替普酶比安慰剂的治疗益处”一文的信06-17 21:29 | 10.1161/STROKEAHA.120.029914research-articleNo.19 P.0-0Quantitative Histogram Analysis on Intracranial Atherosclerotic Plaques颅内动脉粥样硬化斑块的定量直方图分析06-17 21:29 | 10.1161/STROKEAHA.120.029062obituaryNo.20 P.0-0In Memoriam: Robert J. Wityk纪念：罗伯特.J.维泰克06-17 21:29 | 10.1161/STROKEAHA.120.030498research-articleNo.21 P.0-0Matrix Metalloproteinase-9 and Monocyte Chemoattractant Protein-1 Are Associated With Collateral Status in Acute Ischemic Stroke With Large Vessel Occlusion基质金属蛋白酶-9和单核细胞趋化蛋白-1与大血管闭塞急性缺血性卒中侧支循环状态相关06-17 21:29 | 10.1161/STROKEAHA.120.029395research-articleNo.22 P.0-03K3A-Activated Protein C Variant Does Not Interfere With the Plasma Clot Lysis Activity of Tenecteplase3K3A活化蛋白C变异不影响替萘普酶的血浆溶解活性06-17 21:29 | 10.1161/STROKEAHA.120.028793research-articleNo.23 P.0-0Thrombolysis Outcomes in Acute Ischemic Stroke by Fluid-Attenuated Inversion Recovery Hyperintense Arteries液体衰减反转恢复高强度动脉溶栓治疗急性缺血性脑卒中的疗效06-17 21:29 | 10.1161/STROKEAHA.119.028550letterNo.24 P.0-0Response by Agarwal et al to Letter Regarding Article, “Redefined Measure of Early Neurological Improvement Shows Treatment Benefit of Alteplase Over Placebo”Agarwal等人对关于“重新定义的早期神经功能改善的测量显示阿替普酶比安慰剂的治疗益处”一文的回复06-17 21:29 | 10.1161/STROKEAHA.120.030262

CATHETER CARDIO INTEEarly Recent, June 17, 2020今日发布1篇文章ArticleNo.01 P.0-0Predictors of patent and occlusive hemostasis after transradial coronary procedures经桡动脉冠状动脉手术后未闭和闭塞性止血的预测因素06-17 22:00 | 10.1002/ccd.29066

JAMAEarly Recent, June 17, 2020今日发布2篇文章

ViewpointNo.01Sustainability, Business, and Health可持续性、商业和健康06-17 23:07 | 10.1001/jama.2020.8714No.02Identifying the Risks of Unproven Regenerative Medicine Therapies识别未经证实的再生医学疗法的风险06-17 23:07 | 10.1001/jama.2020.9375

JAMA CardiologyEarly Recent, June 17, 2020今日发布8篇文章

Original InvestigationNo.01Association of Prior Left Ventricular Ejection Fraction With Clinical Outcomes in Patients With Heart Failure With Midrange Ejection Fraction中射程射血分数心力衰竭患者左室射血分数与临床结局的关系06-17 23:13 | 10.1001/jamacardio.2020.2081No.02Development of Persistent Opioid Use After Cardiac Surgery心脏手术后持续使用阿片类药物的进展06-17 23:13 | 10.1001/jamacardio.2020.1445

Brief ReportNo.03Trends in Readmission and Mortality Rates Following Heart Failure Hospitalization in the Veterans Affairs Health Care System From 2007 to 20172007至2017年间退伍军人事务卫生保健系统心衰住院后再入院率和死亡率的趋势06-17 23:13 | 10.1001/jamacardio.2020.2028

Research LetterNo.04Initial Experience Prescribing Commercial Tafamidis, the Most Expensive Cardiac Medication in History处方史上最昂贵的心脏药物-商用达法米迪斯的初步经验06-17 23:13 | 10.1001/jamacardio.2020.1738

Invited CommentaryNo.05Slowing the Opioid Epidemic by Controlling a Source: Disabling the Pump通过控制来源减缓阿片类药物的流行：关闭泵06-17 23:13 | 10.1001/jamacardio.2020.1468

ReviewNo.06Use of Glucagon-Like Peptide-1 Receptor Agonists in Patients With Type 2 Diabetes and Cardiovascular Disease: A Review胰高血糖素样肽-1受体激动剂在2型糖尿病和心血管疾病患者中的应用06-17 23:13 | 10.1001/jamacardio.2020.1966

CorrectionNo.07Errors in Abstract, Results, and End Matter摘要、结果和最终结果中的错误06-17 23:13 | 10.1001/jamacardio.2020.2302No.08Changes to Author Contributions对作者贡献的更改06-17 23:13 | 10.1001/jamacardio.2020.2338

Lancet Glob HealthJuly 01, 2020: 8 (7), e860-e972今日发布30篇文章

EditorialArticleNo.01 P.e860Publishing in the time of COVID-19在COVID-19时代出版06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30260-6

CommentArticleNo.02 P.e861-e862A wake-up call: COVID-19 and its impact on children"s health and wellbeing一个警钟：COVID-19及其对儿童健康和福祉的影响06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30238-2ArticleNo.03 P.e863-e864Avoiding indirect effects of COVID-19 on maternal and child health避免COVID-19对母婴健康的间接影响06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30239-4ArticleNo.04 P.e865-e866MITS: an interim step towards improved cause of death >MITS：改进死因数据的过渡步骤06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30235-7ArticleNo.05 P.e867-e868Physical activity: moving from words to action体育活动：从言语到行动06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30256-4ArticleNo.06 P.e869-e870Strategies to increase timely uptake of hepatitis B vaccine birth dose提高乙肝疫苗及时接种率的对策06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30257-6ArticleNo.07 P.e871-e872Defining the combined benefit of intermittent preventive malaria treatment in pregnancy妊娠期疟疾间歇预防治疗综合效益的确定06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30216-3ArticleNo.08 P.e873-e874Trends and social determinants of adolescent marriage and fertility in China中国青少年婚姻与生育的趋势及社会决定因素06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30207-2ArticleNo.09 P.e875-e876New (or not so new?) lessons from maternal autopsy in Mozambique新的（或者不是新的？）莫桑比克产妇尸检的经验教训06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30258-8ArticleNo.10 P.e877-e878A call for action for COVID-19 surveillance and research during pregnancy呼吁在怀孕期间对COVID-19进行监测和研究06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30206-0ArticleNo.11 P.e879-e880Diagnosing malaria and other febrile illnesses during the COVID-19 pandemic在COVID-19大流行期间诊断疟疾和其他发热疾病06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30210-2ArticleNo.12 P.e881-e883Limiting the spread of COVID-19 in Africa: one size mitigation strategies do not fit all countries限制COVID-19在非洲的传播：单一规模的缓解战略并不适合所有国家06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30212-6ArticleNo.13 P.e884-e885Leveraging Africa"s preparedness towards the next phase of the COVID-19 pandemic利用非洲对COVID-19大流行病下一阶段的准备06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30234-5ArticleNo.14 P.e886-e887COVID-19 response in the Middle East and north Africa: challenges and paths forwardCOVID-19在中东和北非的反应：挑战和前进道路06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30233-3ArticleNo.15 P.e888-e889An appeal for practical social justice in the COVID-19 global response in low-income and middle-income countries呼吁在低收入和中等收入国家COVID-19全球对策中实现切实的社会公正06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30249-7

CorrespondenceArticleNo.16 P.e890-e892COVID-19 preparedness in Malawi: a national facility-based critical care assessmentCOVID-19马拉维的准备工作：基于国家设施的危重病护理评估06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30250-3ArticleNo.17 P.e893-e894An affordable videolaryngoscope for use during the COVID-19 pandemic在COVID-19大流行期间使用的价格合理的视频喉镜06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30259-XArticleNo.18 P.e895Use of the Demographic and Health Survey framework as a population surveillance strategy for COVID-19利用人口与健康调查框架作为COVID-19的人口监测策略06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30213-8ArticleNo.19 P.e896Human rights protections are needed alongside PPE for health-care workers responding to COVID-19卫生保健工作者对COVID-19的反应除了个人防护用品外，还需要人权保护06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30252-7ArticleNo.20 P.e897Decolonising COVID-19: delaying external debt repaymentsCOVID-19脱色：延迟偿还外债06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30253-9ArticleNo.21 P.e898Nicaragua"s response to COVID-19尼加拉瓜对COVID-19的反应06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30218-7ArticleNo.22 P.e899Nicaragua"s response to COVID-19 – Authors" reply尼加拉瓜对COVID-19的答复——作者的答复06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30220-5

CorrectionsArticleNo.23 P.e900Correction to Lancet Glob Health 2020; 8: e754–55对《柳叶刀环球健康》2020年的更正；8:e754–5506-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30255-2

ArticlesArticleNo.24 P.e901-e908Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study低收入和中等收入国家COVID-19流行病对母婴死亡率间接影响的早期估计：一项模型研究06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30229-1ArticleNo.25 P.e909-e919Initial findings from a novel population-based child mortality surveillance approach: a descriptive study一种新的基于人群的儿童死亡率监测方法的初步发现：一项描述性研究06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30205-9ArticleNo.26 P.e920-e930Use of the prevented fraction for the population to determine deaths averted by existing prevalence of physical activity: a descriptive study利用人口的预防分数确定现有体育活动普及率避免的死亡：一项描述性研究06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30211-4ArticleNo.27 P.e931-e941Use of controlled temperature chain and compact prefilled auto-disable devices to reach 2030 hepatitis B birth dose vaccination targets in LMICs: a modelling and cost-optimisation study使用可控温度链和紧凑型预充式自动关闭装置达到2030年LMICs乙型肝炎出生剂量疫苗接种目标：一项建模和成本优化研究06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30231-XArticleNo.28 P.e942-e953Overall, anti-malarial, and non-malarial effect of intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine on birthweight: a mediation analysis妊娠期磺胺多辛乙胺嘧啶间断预防治疗对出生体重的总体、抗疟和非疟作用：一项中介分析06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30119-4ArticleNo.29 P.e954-e964Chinese trends in adolescent marriage and fertility between 1990 and 2015: a systematic synthesis of national and subnational population data1990-2015年中国青少年婚姻与生育趋势：国家和国家以下人口数据的系统综合06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30130-3ArticleNo.30 P.e965-e972Quality of care and maternal mortality in a tertiary-level hospital in Mozambique: a retrospective study of clinicopathological discrepancies莫桑比克一家三级医院的护理质量和产妇死亡率：临床病理差异的回顾性研究06-18 06:42 | https://doi.org/10.1016/S2214-109X(20)30236-9

Lancet?Child Adolesc HealthJuly 01, 2020: 4 (7), 479-554今日发布21篇文章

EditorialArticleNo.01 P.P479Prioritising children"s rights in the COVID-19 response在COVID-19答复中优先考虑儿童权利06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30172-3

CommentArticleNo.02 P.P480-481Fever in neutropenia: time to re-evaluate an old paradigm?中性粒细胞减少症发热：是时候重新评估一个旧的范式了？06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30138-3ArticleNo.03 P.P481-482Early parenteral nutrition in critically ill children: lessons after discharge and beyond危重患儿出院后早期肠外营养06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30132-2ArticleNo.04 P.P483-484Addressing different types of anaemia in Indian children and adolescents解决印度儿童和青少年不同类型的贫血症06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30133-4ArticleNo.05 P.P484-485Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemic维持母乳银行的安全和服务：对COVID-19流行病的行动呼吁06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30134-6ArticleNo.06 P.P486-488Post-intensive care syndrome in paediatrics: setting our sights on survivorship儿科重症监护后综合征：以生存为目标06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30170-XArticleNo.07 P.P488-490Neurofibromatosis type 1-related tumours in paediatrics: an evolving treatment landscape儿科神经纤维瘤病1型相关肿瘤：一个不断发展的治疗前景06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30169-3ArticleNo.08 P.P490-491Creating equality for girls: on the right track but still a long way to go为女孩创造平等：在正确的轨道上，但仍有很长的路要走06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30171-1

CorrespondenceArticleNo.09 P.e17-e18The severity of COVID-19 in children on immunosuppressive medicationCOVID-19在儿童免疫抑制药物治疗中的作用06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30145-0ArticleNo.10 P.e19-e20Gastrointestinal features in children with COVID-19: an observation of varied presentation in eight childrenCOVID-19患儿胃肠道特征：8例不同表现的观察06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30165-6ArticleNo.11 P.e21-e23Septic shock presentation in adolescents with COVID-19青少年COVID-19感染性休克06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30164-4ArticleNo.12 P.e24-e25Ethnicity and COVID-19 in children with comorbidities共病儿童的种族和COVID-1906-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30167-X

ReflectionsArticleNo.13 P.P492-493Projections of pregnancy: art as the voice for the unheard妊娠预测：艺术为未闻之声06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30063-8ArticleNo.14 P.P494Christine Chambers克里斯汀·钱伯斯06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30064-X

ArticlesArticleNo.15 P.P495-50239·0°C versus 38·5°C ear temperature as fever limit in children with neutropenia undergoing chemotherapy for cancer: a multicentre, cluster-randomised, multiple-crossover, non-inferiority trial39.0°C与38.5°C耳温作为肿瘤化疗中性粒细胞减少症患儿发热极限的比较：一项多中心、集群随机、多交叉、非劣效性试验06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30092-4ArticleNo.16 P.P503-514Long-term developmental effect of withholding parenteral nutrition in paediatric intensive care units: a 4-year follow-up of the PEPaNIC randomised controlled trial儿科重症监护室保留肠外营养的长期发展效果：一项4年随访的PEPaNIC随机对照试验06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30104-8ArticleNo.17 P.P515-525Characterisation of the types of anaemia prevalent among children and adolescents aged 1–19 years in India: a population-based study印度1-19岁儿童和青少年贫血类型特征：一项基于人群的研究06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30094-8

ReviewArticleNo.18 P.P526-535Pros and cons of pre-emptive screening programmes before peanut introduction in infancy花生引种前先发制人筛选方案的利弊分析06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30029-8ArticleNo.19 P.P536-547Muscle and brain sodium channelopathies: genetic causes, clinical phenotypes, and management approaches肌肉和脑钠通道病：遗传原因、临床表型和治疗方法06-18 06:53 | https://doi.org/10.1016/S2352-4642(19)30425-0

Case ReportArticleNo.20 P.P548-551Horizontal transmission of severe acute respiratory syndrome coronavirus 2 to a premature infant: multiple organ injury and association with markers of inflammation严重急性呼吸综合征冠状病毒2在早产儿中的水平传播：多器官损伤及其与炎症标志物的关系06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30166-8ArticleNo.21 P.P552-554Cardiac dysfunction and thrombocytopenia-associated multiple organ failure inflammation phenotype in a severe paediatric case of COVID-19一例重症COVID-19患儿的心功能不全和血小板减少相关的多器官衰竭炎症表型06-18 06:53 | https://doi.org/10.1016/S2352-4642(20)30163-2

NEJMJune 18, 2020: 382 (25)今日发布17篇文章

Perspectiven-perspectiveNo.01 P.2385-2387Grading Changes for USMLE Step 1 — A Golden Opportunity to Recalibrate Medical Education PrioritiesUSMLE第1步的分级变化-重新调整医学教育优先级的黄金机会06-18 05:01 | 10.1056/NEJMp2003880n-perspectiveNo.02 P.2387-2389The Impact of a Pass/Fail Step 1 — A Residency Program Director’s View通过/失败步骤1的影响-派驻计划主管的观点06-18 05:01 | 10.1056/NEJMp2004929n-perspectiveNo.03 P.2389-2392Objective Measures Needed — Program Directors’ Perspectives on a Pass/Fail USMLE Step 1所需的客观措施-项目主管对USMLE通过/失败步骤1的看法06-18 05:01 | 10.1056/NEJMp2006148n-perspectiveNo.04 P.2393-2395A Test of Diversity — What USMLE Pass/Fail Scoring Means for Medicine多样性测试——USMLE及格/不及格对医学的意义06-18 05:01 | 10.1056/NEJMp2004356n-perspectiveNo.05 P.e96“We Signed Up for This!” — Student and Trainee Responses to the Covid-19 Pandemic“我们报名了！“-学生和学员对Covid-19流行病的反应06-18 05:01 | 10.1056/NEJMp2005234

Original Articleresearch-articleNo.06 P.2397-2410Systematic or Test-Guided Treatment for Tuberculosis in HIV-Infected Adults成人HIV感染者结核病的系统或试验指导治疗06-18 05:01 | 10.1056/NEJMoa1910708research-articleNo.07 P.2411-2418Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19羟基氯喹在Covid-19住院患者中的观察研究06-18 05:01 | 10.1056/NEJMoa2012410research-articleNo.08 P.2419-2430Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer曲妥珠单抗灭活素治疗HER2阳性胃癌06-18 05:01 | 10.1056/NEJMoa2004413research-articleNo.09 P.2431-2440Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19肾素-血管紧张素-醛固酮系统阻滞剂与Covid-19的风险06-18 05:01 | 10.1056/NEJMoa2006923research-articleNo.10 P.2441-2448Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19肾素-血管紧张素-醛固酮系统抑制剂与Covid-19的风险06-18 05:01 | 10.1056/NEJMoa2008975research-articleNo.11 P.e102Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19Covid-19的心血管疾病、药物治疗和死亡率06-18 05:01 | 10.1056/NEJMoa2007621

Images in Clinical MedicineNo.12 P.2449Angioedema after t-PA Infusiont-PA输注后血管水肿06-18 05:01 | 10.1056/NEJMicm1913828No.13 P.e97Unrepaired Tetralogy of Fallot in Adulthood成人法洛四联症06-18 05:01 | 10.1056/NEJMicm1912128

Case Records of the Massachusetts General Hospitaln-case-record-mghNo.14 P.2450-2457Case 19-2020: A 74-Year-Old Man with Acute Respiratory Failure and Unclear Goals of Care病例19-2020:74岁急性呼吸衰竭患者，护理目标不明确06-18 05:01 | 10.1056/NEJMcpc2002419

EditorialeditorialNo.15 P.2459-2460Empirical Antituberculosis Therapy in Advanced HIV Disease — Too Much, Too Late艾滋病晚期患者的经验性抗结核治疗-太多，太晚06-18 05:01 | 10.1056/NEJMe2009679editorialNo.16 P.2461-2462The Urgency of Care during the Covid-19 Pandemic — Learning as We Go在Covid-19大流行期间的紧急护理-我们正在学习06-18 05:01 | 10.1056/NEJMe2015903editorialNo.17 P.2462-2464Inhibitors of the Renin–Angiotensin–Aldosterone System and Covid-19肾素-血管紧张素-醛固酮系统和Covid-19抑制剂06-18 05:01 | 10.1056/NEJMe2012924

StrokeEarly Recent, June 18, 2020今日发布1篇文章review-articleNo.01 P.0-0Selective Serotonin Reuptake Inhibitors for Stroke Recovery选择性5-羟色胺再摄取抑制剂在脑卒中康复中的应用06-18 17:16 | 10.1161/STROKEAHA.120.029329

CirculationEarly Recent, June 18, 2020今日发布1篇文章research-articleNo.01 P.0-0Associations Between HDL Particles and Ischemic Events by Vascular Domain, Gender, and Ethnicity: A Pooled Cohort Analysis高密度脂蛋白颗粒与血管领域、性别和种族缺血性事件的相关性：一项联合队列分析06-18 17:32 | 10.1161/CIRCULATIONAHA.120.045713

CATHETER CARDIO INTEEarly Recent, June 18, 2020今日发布1篇文章ArticleNo.01 P.0-0Procedural and 1‐year clinical outcomes of orbital atherectomy for treatment of coronary in‐stent restenosis: A single‐center, retrospective study眼眶切除术治疗冠状动脉支架内再狭窄的手术和1年临床结果：一项单中心回顾性研究06-18 17:32 | 10.1002/ccd.28983

EBioMedicineEarly Recent, June 18, 2020今日发布1篇文章

Research paperArticleNo.01 P.0-0Machine learning guided association of adverse drug reactions with in vitro target-based pharmacology机器学习指导下药物不良反应与体外靶向药理学的关联06-18 17:37 | https://doi.org/10.1016/j.ebiom.2020.102837

EClinicalMedicineEarly Recent, June 18, 2020今日发布1篇文章ArticleNo.01 P.0-0Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak: Preliminary >意大利新型冠状病毒SARS-CoV2爆发期间急诊呼吸衰竭的严重程度及呼吸机支持的预后：头盔CPAP与无创正压通气作用的初步研究06-18 18:28 | https://doi.org/10.1016/j.eclinm.2020.100419

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