EASL慢性乙型肝炎临床实践指南更新-1CHB治疗目标-4HBV合并HCV感染-38HBVHIV合并感染患者-37HBV母婴传播的预防-41IFNα应答的预测因子-11

标志性病变-20非药物治疗-41非药物治疗-42非药物治疗-43

-38PCOS治疗-39PCOS治疗-41PCOS治疗-42

肺叶肺段的判断-37肺叶肺段的判断-40肺叶肺段的判断-38肺叶肺段的判断-41肺叶肺段的判断-39肺叶肺段的判断-43肺叶肺段的判断-44

数据来源：财政部网站 制图：蔡华伟我国基础研究投入比重常年在5%左右徘徊，在公布此数据的国家中处最低水平近日，国家自然科学基金委发布我国基础研究2020年的预期发展目标，探讨提升我国基础研究投入水平的可能性与路径。2012年，全社会研究与试验发展（R&D）经费投入首次突破万亿

作者：Pedro A. Lemos, Celso K. Takimura, Francisco R.M. Laurindo, Paulo S.... area除以管腔面积计算。研究结果：内膜组织面积以及新生内膜容积阻塞率在使用传统方法和IVUS/OCT类似方法计算时呈现出显著的相关性（R2=0.89

厦大生命科学学院林圣彩教授课题组的一项研究发现了细胞“饥饿”信号传导通路中的关键一环，从而揭示了细胞“饥饿”信号传导机制的过程，这一发现被认为对研究包括肥胖、糖尿病、脂肪肝等在内的代谢疾病的发生发展机制及治疗新方法有着重大意义。\r\n \r\n林圣彩介绍，控制细胞新陈代谢平衡的是一种名为AMPK的蛋白激酶，它决定身体中的脂肪是储存还是燃烧。其作用机理是：当细胞能量水平较高时，细胞中存在充足的能量分子ATP，并使用ATP进行“合成代谢”，将多余能量作为脂肪储存下来；当细胞“饥饿”时，细胞中存在的ATP会转变为低能量分子AMP，AMPK将关闭合成代谢，反而激发分解代谢，让脂肪燃烧为能量。为此，AMPK又被誉为“细胞能量感受器”。多年来，它一直是生命科学领域研究的“热门”。\r\n \r\n此前的研究表明，当细胞“饥饿”信号 AMP上升时，AMPK活性能被激活，促进增加ATP的生成，维持细胞能量平衡。但该细胞“饥饿”信号如何传递到激活AMPK的复合体上仍是一片空白。\r\n \r\n林圣彩课题组研究发现，一种自己多年来的研究对象——名为AXIN的蛋白是调控AMPK的重要因子。简言之，AXIN是一个桥梁，是它将低能量分子AMP结合的AMPK和其上游激酶LKB1连接在一起，三者形成一个复合体，促进LKB1对AMPK的磷酸化激活，使得AMPK的活性升高，从而完成信号传递过程。\r\n \r\n

一项最新的研究发现，有一类不正常基因，总比其他健康人群，更有普遍的存在与Ⅱ型糖尿病的患者身上。\r\n\r\nⅡ型糖尿病患者已知存在高癌症风险，特别是像淋巴瘤和白血病这样的血癌。由英国伦敦帝国理工大学和法国法国科学研究中心带领的科学家们，最近表示：一种称为“克隆马赛克事件（CMEs）”的基因，可能可以解释这一人群疾病的部分问题。

骨和内分泌的经典之作！ \r\n\r\nAdvances made during the last 35 years have improved our understanding of the mechanisms of steroid hormone action on bone and how physiologic, pathologic, or iatrogenic changes in hormone levels can lead to increased fracture risk. Estrogens, androgens, and glucocorticoids alter the cellular composition of bone by regulating the supply and lifespan of osteoclasts and osteoblasts. Additionally, they influence the survival of osteocytes, long-lived cells that are entombed within the mineralized matrix and mediate the homeostatic adaptation of bone to mechanical forces. Altered redox balance is a proximal underlying mechanism of some of these effects, and sex steroid deficiency or glucocorticoid excess contributes to the aging of the skeleton.

Brachytherapy (BT) plays a crucial role in the management of invasive cervix cancer from stage I to IV.\r\nIntracavitary techniques are based on afterloading devices, with different types of applicators. CT and/or MRI compatible applicators allow a\r\nsectional image based approach with a better assessment of gross tumour volume (GTV) and definition and delineation of target volume (CTV) compared to traditional approaches. Accurate and reproducible delineation of GTV, CTV and PTV, as well as of critical organs has a direct impact on BT treatment planning, especially if it is possible to adapt the pear-shape isodose by optimisation using DVH analysis. When introducing a 3D image based approach for GTV and CTV assessment, there is a need for a common language to describe the concepts and to define the terms which are to be used.

After decades of focusing almost exclusively on treating HIV, public health experts are now considering a new approach, moving to establish more effective prevention strategies to curb spread of the disease. Recent tests show that anti-HIV drugs that can hamper the growth of the virus responsible for AIDS may also prevent progression of the disease if given to infected individuals soon after their exposure to HIV. The same drugs can also prevent infections from taking hold among healthy people who are exposed to the virus; both approaches would be critical ways of controlling spread of the virus and keeping new cases of HIV to a minimum.\r\n\r\nRead more: http://healthland.time.com/2012/11/21/recommendations-for-routine-hiv-testing-represent-advances-in-preventing-hiv/#ixzz2CripWt9p

这段时间在国内，主要目的是拜访国际大药厂在中国的研发中心，向他们推荐R10K项目。因为R10K这个项目的主要目的就是通过高通量测序免疫组库来找到疾病的特异性诊断指标和能用来指导治疗的生物标记物(biomarkers).在国内碰到了很多成功的海归。所谓成功，无非就是手头掌握着大笔经费，管着许多人。总结

下午，内分泌科会诊大夫被请到急诊室会诊，是一个男性患者，41岁，糖尿病7年，因发热3天来诊，体温最高41.5℃，随机血糖：16.9mmol/L，血常规...，小便频，无尿频尿痛。查体：T40℃，P124次/分，R21次/分，BP140/90mmHg。神志清，精神可……全身皮肤黏膜无出血

CT平扫-16CT复查-17DSA检查所见-3重视医学研究转化，不断探索新技术-58DSA检查所见-42TCCF的介入治疗-41

F8电极接触不良-36周期性-24常见的癫痫样放电-28常见癫痫发作类型的脑电图特征-41常见的癫痫样放电-29不典型失神发作-55

ECOG调控多种信号通路-43ECOG调控异常甲基化-44EGCG与肿瘤-41EGCG与肿瘤-42Gln通过c-myc及p53信号通路抗氧化应激-53n-3

TR,TE及T1加权,T2加权-41大叶性肺炎-10MRI原理-39肠梗阻-32肺部真菌感染-20肺分叶分段-5肺动脉高压-28

病例四-41病例十一-58病例四-42病例五-43病例一-33

EVB防治方法的种类与选择-16EVB内镜治疗时机的选择-52EV再出血的预防（二级预防）-41