新闻-4

1. Updated recommendations from the Advisory Committee on Immunization Practices, which appear in the February 3 Annals of Internal Medicine recommended that all adults equal or greater than 65 year of age receive 13-valent pneumococcal conjugate vaccination and 23–valent pneumococcal polysaccharide vaccination.
2. A long term follow–up study in the March 15 Clinical Infectious Disease monitored the benefits of the herpes zoster vaccine over time, and found that, by year 10, efficacy against herpes zoster virus had failed to 14%.
3. A study in the March Journal of Allergy and Clinical Immunology found that, among 70,000 patients with documented allergy to penicillin who received a cephalosporin, the most common adverse reaction was nonallergic reaction.
4. Based on the findings of a 5–year study of thyroid nodules in the March 3 JAMA, editorialists suggest that repeated ultrasonography is unnecessary in patients with benign fine-needle aspirate on baseline examination and no suspicious feature ultrasonography.
5. The study on the website of JAMA Dermatology demonstrates that patients diagnosed with bullous pemphigoid have no excess risk for malignancy.
6. Three recently published reports (December 4, 2014 New England Journal of Medicine: March 3, 2015 Journal of American College of Cardiology: Feb 28, 2015 The Lancets ) comparing the risks and benefits of dual antiplatelet therapy to those aspirin alone found that dual therapy was associated with no significant mortality benefit.
7. A study in the website of The Lancets Neurology compared antiplatelet therapy to anticoagulant therapy in patients with extracranial carotid  or vertebral artery dissection. Anticoagulation was found to be potentially beneficial for patients with angiographically documented thrombosis.
8. Two randomized controlled trials(ESCAPE and EXTEND-IA)in the March 12 New England Journal of Medicine assessed the benefits of endovascular therapy in patients with acute ischemic stroke, documented occlusion of the internal carotid artery or proximal middle cerebral artery branches, and salvageable brain tissue visible on computed  tomographic perfusion imaging. These trials were stopped early due to internal analysis showing significantly  higher rates of good outcomes in patients who receive endovascular therapy and significantly

lower mortality in patients who received endovascular therapy.

1. 2月3日内科年鉴杂志发表了免疫咨询委员最新建议, 所有等于或大于65岁的成年人均需接受13价肺炎球菌结合疫苗和23价肺炎球菌多糖疫苗 (Ann Intern Med 2015 Feb 3; 162:214)。

2. 3月15日临床感染性疾病杂志发表了长期随访监测带状疱疹疫苗益处结果。他们发现, 到了苐十年疫苗的保护功效未能到14％ (Clin Infet Dis 2015 Mar 15; 60:900)。

3. 三月的过敏和临床免疫学杂志的研究发现，在70000例证明对青霉素过敏，接受了头孢菌素的患者中，最常见的不良反应是非过敏性反应 (J Alergy Clin Immunol 2015 Mar; 135:745)。

4. 基于3月3日JAMA 5年的甲状腺结节研究结果，编辑们建议, 反复超声检查对于细针穿刺良性，无可疑超声检查的患者是不必要的 (JAMA 2015 Mar 3; 313:926)。

5. JAMA皮肤科网站上的研究表明，诊断为大疱性类天疱疮的患者, 恶性肿瘤的风险并不增加 (Jama Dermatol 2015 Feb 11; (e-pub))。

6. 最近发表的报告比较了双重抗血小板治疗与单独使用阿司匹林治疗的风险和益处。 他们发现双重治疗并不显著降低死亡率 (N Engl J Med 2014 Dec; 371: 2155)。

7. 在刺血针神经内科杂志网站上, 一项研究比较了抗凝治疗与抗血小板治疗颅外颈动脉或椎动脉夹层形成。抗凝治疗被认为是有利于血管造影证实了的血栓形成的患者 (Lancet Neurol 2015 Feb 12; (e-pub))。

8. 3月12日的新英格兰医学杂志两个随机对照试验评估了血管内机械性除血拴术治疗急性缺血性卒中的益处。结果表明，接受血管腔内机械性除血拴术治疗的患者预后较好死亡率较低 (N Engl J Med 2015 Mar 12; 372:1009)

1. In cohort study in February Annals of the Rheumatic Disease, researchers show that, compared with matched controls, patients with psoriatic arthritis who did not receive prescriptions for disease–modifying anti-rheumatic drus had significantly higher risk for major adverse cardiovascular events.
2. In a retrospective study in the February 24 issue of JAMA, researchers assessed risk for bleeding and adverse cardiovascular events associated with concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDS)(and anti-thrombotic agents in patient who were discharged after first myocardial infarction (MI ). Compared with no NSAID use, fatal and nonfatal adverse cardiovascular events were about 40% more common in patients using NSAIDs, use of NSAIDs with more than 1 antithrombotic drug was associated with twice as many major bleeding events and the addition of NSAIDs to double and triple antithrombotic regimen was associated with an approximately 4–fold higher risk for major bleeding events.
3. In a retrospective study on the website of the BMJ, researchers determining the rates of hospital readmissions and death during the first–year period after hospitalization for heart failure (HF ), acute MI or pneumonia in patients more than 65 years of age. They found that risks for hospital readmission and death remained significantly elevated for more than 3 months after hospitalization for all 3 groups.
4. In a study on the website of Neurology, researchers examined the association between giant cell arteritis and varicella–zoster virus (VZV ). Their finding suggest that at least some cases of giant cell arteritis may be might be due to infection with VZV.
5. In a study in February 26 New England Journal of Medicine, babies  at high risk for developing peanut allergy where randomized to avoidance or regular consumption of peanuts until the age of 5 year. Peanut consumption appears to be protective against development of allergy in children with negative skin test -prick tests at baseline and positive skin- prick tests at baseline but no reaction to oral peanut
6. In a study on the website of The Lancet, patients with chronic obstructive pulmonary disease and severe airflow obstruction were randomized to receive roflumilast or placebo in addition to their regular regimens of long–acting beta–agonists, inhaled corticosteroids, and long–acting muscarinic antagonists. The addition of roflumilast was associated with modest clinical benefit and  adverse effects.
7. Findings from a study on the website of the BMJ suggest that the  benefits of moderate consumption of alcohol are more limited than those found in previous studies.
8. In a study on the website of The BMJ, researchers used a primary care research database to determine optimal strategies for intensifying management of hypertension. The following factors were associated with excessive risk for adverse cardiovascular events and death: Using a systolic blood pressure of 150 mmHg as a threshold for intensifying treatment, time to treatment intensification greater than 1.4 months, time to follow-up greater than2.7 months after treatment intensification.
9. In a meta–analysis in the February 10 issue of JAMA, researchers evaluate the benefit of lowering blood pressure in patients with type 2 diabetes. They found that reducing systolic blood pressure by 10 mmHg was associated with a decrease of less than 30% in the relative risk for all–cause mortality, adverse cardiovascular events, albuminuria, retinopathy and stroke.
10. In a study in the February Annals of Neurology, researchers show that, compared with matched controls, patients with breast, colorectal, lung and pancreatic pancreatic cancers  are at significantly elevated risk for ischemic and hemorrhagic stroke during the first 3 months after diagnosis.

1.风湿病杂志一项队列研究表明，没有得到特定抗风湿治疗的银屑病关节炎患者主要心血管不良事件的风险, 与对照组相比显著增高 (Ann Rheum dis 2015 Feb; 74:326)。

2.在2月24日的JAMA上, 一项回顾性研究评估了首次心肌梗死出院后的病人同时使用抗血栓药物和非甾体抗炎药（NSAIDs）不良心血管事件和出血的风险。与没有使用NSAIDS相比，使用NSAIDs的患者致死性和非致死性心血管不良事件多40％，大出血事件增加 2 至 4 倍 (JAMA 2015 Feb 24; 313:805)。

3.在英国医学杂志网站上, 一项回顾性研究评估了超过65岁的患者因心脏衰竭（HF），急性心肌梗死或肺炎住院治疗后的第一年期间再住院和死亡的比率。他们发现，再住院和死亡的风险在所有3组均显著增高 (BMJ 2015 Feb 6; 350:h411)。

4.神经内科杂志网站上的一项研究评估了巨细胞动脉炎和水痘 – 带状疱疹病毒（VZV）之间的关联 (Neurology 2015 Feb 18; (e-pub))。

5.在2月26日的新英格兰医学杂志的一项研究中，有发展花生过敏高风险的婴儿，被随机分配避免或经常食用花生直到5年岁。结果表明, 食用花生可预防儿童发生过敏 (N Engl J Med 2015 Feb 26; 372:803)。

6.在柳叶刀杂志网站上的一项研究中，患有慢性阻塞性肺疾病和严重气流阻塞患者被随机分配接受罗氟司特 (roflumilast)或安慰剂, 除了他们本身使用的长效β受体激动剂，吸入糖皮质激素和长效毒蕈碱受体拮抗剂。结果表明, 加罗氟司特有一定的临床益处和副作用 (lancet 2015 Feb 12; (e-pub))。

7. 来自英国医学杂志网站上的一项研究结果表明，适度饮酒的好处比以前的研究发现少 (BMJ 2015 Feb 10; 350:h384)。

8.在英国医学杂志网站上的一项研究中，研究人员使用了基层医疗研究数据库，以确定加强高血压管理的最优策略。以下因素都与不良心血管事件和死亡的过度风险有关:采用大于150毫米汞柱作为加强治疗阈值收缩压，强化治疗时间大于1.4个月, 跟进强化治疗时间大于2.7个月 (BMJ 2015 Feb 5; 350:h158)。

9.在2月10日的JAMA上，一项荟萃分析评价了降低2型糖尿病患者血压的益处。他们发现，降低收缩压10毫米汞柱，所有原因死亡率，心血管不良事件，蛋白尿，视网膜病变和中风的相对风险降低30％ (JAMA 2015 Feb 10; 313: 603)。

10.神经病学年鉴的一项研究表明，乳腺癌，结肠直肠癌，肺癌和胰腺癌胰腺癌在诊断后的3个月内, 缺血性和出血性中风的风险显著升高 (Ann Neurol 2015 Feb; 77:291)。

新闻-2

1. In a study in the January 8, 2015 issue of Blood, researchers assessed the risk for venous and arterial thrombosis after superficial venous thrombosis. Compared to controls, patients with superficial venous thrombosis are at higher risk for deep venous thrombosis, pulmonary embolism and adverse arterial events.

2. In a study on the website of The Lancet, researchers compare the effects of statins in women to those in men. Compared with the effects seen in men, statin use in women was associated with similar effects on lipid levels and comparable overall reductions in major vascular events and all-cause mortality.

3. Based on the findings from a meta-analysis in the January 2015 issue of Mayo Clinic Procedings and a randomized study in the February 2015 issue of Atherosclerosis, coenzyme Q10 should not be recommended for patients with statin-related myopathy, because use is associated with no significant improvements in frequency or severity of muscle symptoms.

4. In the January 20, 2015 issue of Neurology, a double-blind crossover study compared pregabain with an active placebo (low-dose diphenhydramine) in patients with radiographically confirmed lumbar stenosis and > 3 months of neurogenic claudication. The result indicates that pregabalin did not have any significant therapeutic effects compared with placebo.

5. In the January 29, 2015 New England Journal of Medicine, a phase II trial compared the selective bradykinin B2-receptor antagonist, icatibant, with usual care for the management of angioedema of the upper aerodigestive tract induced by angiotensin –converting-enzyme inhibitors. Compared with patients who received usual care, those who received icatibant had significantly shorter times to the full resolution of angioedema and were more likely to have full resolution of their symptoms within 4 hr.

6. In the January 13, 2015 issue of JAMA, data from the Wisconsin Sleep Cohort Study are used to assess risk for development of obstructive sleep apnea (OSA) in individuals with and without asthma. Their results suggest that asthma is associated with increased risk for OSA independent of body-mass index (BMI).

7. In a retrospective study in the January 27, 2015 issue of Neurology, researchers analyzed data on 200 patients with s confirmed diagnosis of acute encephalitis seen at a tertiary care medical center in Minnesota. Their findings  indicate that etiology remained unknown in 30% of cases.

8. In a meta-analysis in the January 6, 2015 Annuals of Internal Medicine, researchers compared the efficacies of several pharmacologic options for the initial treatment of osteoarthritis of the knee. They found that intra-articular hyaluronic acid was the most effective agent for pain.
9. In a population-based, retrospective cohort study in the December 2014 American Journal of Gastroenterology, researchers estimated that annual incidence of esophageal cancer in patients with Barrett esophagus is <0.5%.

10. In a trial in the January 29, 2015 New England Journal of Medicine, researchers randomized women with singleton pregnancies and hypertension (preexisting or gestational) to a diastolic blood pressure (BP) target of either 85 mmHg or 100 mmHg. Women randomized to tighter control BP had less risk of developing abnormally  low platelet counts or elevated liver function tests.

1.2015年1月8日血液杂志的一项研究评估了浅静脉血栓形成后深静脉和动脉血栓形成的风险。与对照组相比，浅静脉血栓患者形成深静脉血栓，肺栓塞和不良动脉事件的风险较高 (Blood 2015 Jan 18; 125:229)。
2.在柳叶刀杂志网站上的一项研究中，研究人员比较了他汀类药物在男性和女性的疗效。结果表明, 他汀类药物降低血脂水平, 减少主要血管事件和全因死亡率的效果在男性和女性相似 (Lancet 2015 Jan 8; (e-pub ahead of print))。
3.基于2015年1月梅奥诊所学报和2015年2月的动脉粥样硬化杂志的研究结果，辅酶Q10不应被推荐治疗他汀类药物相关性肌病。因为使用辅酶Q10对改善肌肉症状的频率和严重程度效果不显著 (Mayo Clin Proc 2015 Jan; 90:24) (Atherosclerosis 2015 Feb; 238: 329)。

4. 在2015年1月20日神经学期刊上，一项双盲交叉研究比较了普瑞巴林 (pregabalin)治疗影像学证实的腰椎狭窄,>3个月神经性跛行患者的疗效。结果表明，普瑞巴林与安慰剂相比, 没有任何显著的治疗效果 (Neurology 2015 Jan 20; 84:265)。

5.在2015年1月29日的新英格兰医学杂志上，一项II期临床试验比较了选择性缓激肽B2受体拮抗剂艾替班特 (icatibant)，与常规治疗对血管紧张素-converting酶抑制剂引起的上呼吸消化道血管性水肿的疗效。与常规治疗相比，接受艾替班特的患者，血管性水肿消除时间缩短, 更有可能在4小时内症状全部消除 (N Eng J Med 2015 Jan 29; 372: 418)。
6.在2015年1月13日JAMA杂志上，一项研究用来自威斯康星睡眠队列研究数据,来评估有和没有哮喘的患者发生阻塞性睡眠呼吸暂停（OSA）的风险。结果表明，哮喘的患者发生阻塞性睡眠呼吸暂停（OSA）的风险增加, 与体重指数（BMI）无关 (JAMA 2015 Jan 13; 313:156)。

7. 在2015年1月27日的神经学期刊一项回顾性研究中，研究人员分析了在明尼苏达州的三级医疗中心确诊的200例急性脑炎数据。结果表明, 30％的病例病因不明 (Neurology 2015 Jan 27; 84: 359)。

8.2015年1月6日内科年鉴一项荟萃分析，比较了几种初步治疗膝关节骨性关节炎的药物的疗效。他们发现，关节内透明质酸是对疼痛最有效一项药物 (Ann Intern Med 2015 Jan 6; 162:46)。
9.在2014年12月美国胃肠病学杂志一项以人群为基础一项回顾性队列研究中，研究人员估计， Barrett食管患者食管癌年发病率<0.5％ (Am J Gastroenterol 2014 Dec; 109:1862)。
10.在2015年1月29日的新英格兰医学杂志的试验中，研究人员将单胎妊娠高血压（预先存在或妊娠高血压）的孕妇随机分配到舒张压（BP）的目标85毫米汞柱或100毫米汞柱。血压严格控制组发生异常血小板计数降低或肝功能升高的风险较小 (N Engl J Med 2015 Jan 29; 372:407)。

新闻-1

1. In the December 24 and 31, 2014 issue of JAMA, a systemic review of addresses safety issues associated with metformin therapy in diabetic patients with chronic kidney disease. The review found that in patients with mild to moderate chronic kidney disease, use was associated with slight elevation of lactic acid but these were not clinically worrisome.

2. In a retrospective study in the December 2014 issue of JAMA Surgery, researchers compared outcomes after lobectomy, sublobar resection, or stereotactic ablative radiotherapy for management of none-small-cell lung cancer in older adults. They found  that unadjusted three-year mortality with highest after stereotactic ablative therapy;  after adjusting for baseline differences between groups, the three-year mortality after ablative radiotherapy was similar to that after lobectomy and 3- month motility was lower in patients who received stereotactic ablative therapy than in those who underwent surgery.

3. In a meta-analysis on the website of The BMJ, researchers evaluating the association between blood glucose concentration and the risk for pancreatic cancer show a strong linear dose-response relationship.

4. In a double-blind trial in the January 2015 Annals of the Rheumatic Diseases, patients with early rheumatoid arthritis were randomized to receive either low-dose or high-dose fish oil therapy in addition to their standard triple-therapy disease-modifying regimen. Compared with the low-dose fish oil therapy, height-dose therapy was associated with lower rate of failure of the disease-modifying regimen and shorter time to first remission.

5. In a study in the January 2015 Annals of the Rheumatic Diseases, researchers evaluated the utility of IgG4 levels in diagnosing IgG4-related disease. They found that an elevated level of IgG 4 is insufficient to diagnose IgG4-related disease.

6. The relationship between nerve impairment in the lower limbs and subsequent development of mobility problems was investigated in a prospective study in the December 2014 Journal of the American Geriatric Society. The findings suggest that peripheral nerve impairment at baseline he is directly associated with risk for incident disability in all-comers.

7. In a study in the January 6, 2015 Annals of Internal Medicin, researchers sought to determine whether anticoagulation therapy can be safely discontinued 3-7 months after first unprovoked venous thromboembolism in patients whose D-dimer test is negative. Their findings support  continuation of anticoagulation therapy despite negative D-dimer test unless risk for bleeding is unacceptably high.
8. In a study in the January 1, 2015 Journal of Infectious Diseases, researchers used a rat model to study the effects of antiplatelet drugs and anticoagulants on the development of endocarditis. The incidence of endocarditis was significantly decreased with Abciximab (anti-glycoprotein IIb/III monoclonal antibody) and aspirin plus ticlopidine.

9. In a trial on the website of the BMJ, woman more than 55 years of age with mild prolapse of the pelvic organs were randomized to either pelvic floor training or watchful waiting. Pelvic floor training was associated with decrease in urinary and overall symptom scores.

10. In a meta-analysis on the website of the Annals of Internal Medicine, researchers evaluated the effects of antihypertensive therapy in patients with mild (stage I) hypertension. They show that, in this population of patients, blood pressure-lowering therapy is associated with significant reductions in stroke, cardiovascular-related death,  and overall death.

1. 2014年12月24日JAMA，就二甲双胍治疗合并慢性肾脏病的糖尿病相关的安全问题进行了系统性审查。审查发现，轻中度慢性肾脏疾病的病人，使用二甲双胍与乳酸轻度升高有关，但无临床意义 (JAMA 2014 Dec 24: 312:2668)。

2. 在2014年12月JAMA外科杂志上, 一项回顾性研究比较了肺叶切除术,部分肺叶切除术，或立体定向消融放疗 (sterotactic ablative radiotherapy)老年非小细胞肺癌的结果。他们发现,立体定向消融治疗未经调整的3年死亡率最高;调整群体间的基线差异后,立体定向消融治疗与肺叶切除三年死亡率相似,但3个月死亡率明显低于手术患者 (JAMA Surg 2014 Dec; 149:1244)。

3. BMJ网站上一项荟萃分析发现, 血糖浓度和胰腺癌风险之间有强烈的线性剂量 – 反应关系 (BMJ 2015 Jan 2; 349:g7371)。

4. 在2015年1月风湿性病杂志的一项双盲试验中,接受标准三联疗法的早期类风湿关节炎患者被随机分配接受低剂量或高剂量的鱼油治疗。与低剂量鱼油治疗相比,高剂量鱼油治疗患者三联疗法成功率较高,达到第一次缓解较快 (Ann Rheum Dis 2015 Jan; 74:89)。

5. 2015年1月风湿性病杂志的一项研究评估了IgG4水平诊断IgG4相关疾病的效用。他们发现,IgG 4升高不足以诊断IgG4相关的疾病 (Ann Rheum Dis 2015 Jan 74:14)。

6. 2014年12月美国老年病学协会杂志就下肢神经损害和下肢运动功能之间的关系进行了前瞻性研究。调查结果显示,周围神经损伤直接与残疾有关 (J Am Geriatr Soc 2014 Dec; 62:2273)。

7. 在2015年1月6内科年鉴的研究中，研究人员试图确定第一次无诱因静脉血栓栓塞患者的抗凝治疗是否可以在3-7个月后, D-二聚体检测阴性的前提下,安全地停止。他们的研究结果支持继续抗凝治疗，除非出血风险不可接受 (Ann Intern Med 2015 Jan 6; 162:27)。

8. 在2015年1月1日传染病杂志上,研究人员利用大鼠模型来研究抗血小板药物和抗凝药物对性心内膜炎发病的影响。心内膜炎的发病率在用阿昔单抗（抗糖蛋白Ⅱb/ III单克隆抗体）和阿司匹林加噻氯匹定 (ticlopidine) 治疗时显著下降 (J Infect Dis 2015 Jan 1; 211:72)。

9. 在BMJ的网站上的一项研究中,超过55岁的盆腔器官轻微脱垂的女患者被随机分配到盆底训练或观察等待组。盆底训练组尿濒和总体症状均减少 (BMJ 2014 Dec 22; 349:g7378)。

10. 内科医学年鉴网站上一项荟萃分析评估了轻度（Ⅰ期）高血压患者降压治疗的效果。结果表明, 降血压治疗与显著降低中风,降低心血管相关的死亡,和整体死亡相关联 (Ann Intern Med 2014 Dec 23; (e-pub ahead of print))。