简介：AsreadersofCancerBiologyandMedicinewellknow,therehasbeenaseismicshiftinhumanmolecularbiologyoverthepastfewyears,asmomentousinitsownwayasthediscoveryofthedouble-helicalstructureofDNAbyWatsonandCrick60yearsago,theelucidationofthegeneticcodeshortlythereafter,theadventofrecombinantDNAandgenecloning

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简介：Hypertensionisaleadingriskfactorforcardiovasculardisease,theleadingcauseofdeathandmorbidityinoursocietyandonaglobalscale.Majorcomponentsofcardiovasculardiseaseincludestroke,coronaryarterydisease,heartfailure,andchronickidneydisease,inallofwhichhypertensionplaysamajorrole.Theriskofthesecomplicationsincreasesdirectlyandlinearlywithsystolicbloodpressurestartingat115mmHg.Althoughusuallyasymptomatic,hypertensionisreadilydetectableonphysicalexaminationandisamenabletobothlifestylemodificationandpharmacologictreatmentinmostpatients.However,largeproportionsofthehypertensivepopulationremainundetectedandundertreated.Numerousguidelineshavebeenissuedduringthepastfewdecadestopromotedetectionandoptimaltherapy.Despitetheincreaseinriskwithsystolicbloodpressuregreaterthan115mmHg,thegenerallyacceptedthresholdfordiagnosisandtreatmenthasbeensystolicbloodpressuregreaterthan139mmHganddiastolicbloodpressuregreaterthan80mmHgbecauseuntilrecentlytreatmenttolowerlevelshasbeenassociatedwithanunfavorablerelationbetweenclinicalbenefitandharm.Inthepastseveralyears,newguidelines,advisories,commentaries,andclinicaltrialshaveprovidedevidenceforapotentialchangeincurrentrecommendationsforthemanagementofhypertension.Inthisregard,thelong-awaitedeighthreportoftheJointNationalCommitteeonthePrevention,Detection,Evaluation,andTreatmentofHighBloodPressurerecommendedpatientsolderthan60yearsbetreatedtoasystolicbloodpressureoflessthan150mmHg,whichhasgeneratedconsiderablecontroversyandcaution.ThestrikingfindingsoftheSystolicBloodPressureInterventionTrial(SPRINT)havereceivedconsiderableattentionbecauseofthedemonstrationthatintensivetherapytoatargetsystolicbloodpressurebelow120mmHgdecreasescardiovascularmortalityandmorbiditymorethanlessintensivetreatmenttoatargetsystolicbloodpressurebelow140mmHg

简介：Thispaperreviewscurrentrecommendationsontheappropriateevaluationandmanagementofcardiacarrhythmiasinthepregnantpatient.Mostarrhythmiasduringpregnancyarebenignandrequirenointervention.Whenrequired,thedecisiontotreatshouldbebasedonsymptomseverityandtheassociatedrisktomotherandfetusposedbypotentiallyrecurringarrhythmiaepisodesthroughoutthepregnancy.Anytreatmentstrategyinthispatientpopulationhasinherentrisktobothmotherandunbornchild.Beforetheinitiationofanyintervention,documentationofaclinicalarrhythmiaandcorrelationwithclinicalsymptomsshouldbeobtained.Thereisnoroleforempirictherapy.

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简介：Iatrogenicaortocoronarydissection(IACD)isararebutpotentiallylife-threateningcomplicationduringcoronarycatheterizations.Althoughtheincidencewasrelativelylow,thedissectionoftenleadstoprocedurefailurewithincreasedriskofmyocardialinfarctionanddeath.IACDismainlycausedbydisruptionofintimaattheostiaofleftorrightcoronaryarteryduringinterventionalprocedures,andappearsasluminalfillingdefectsorpersistenceofcontrast(“extraluminalcap”)orintimaltearoutsidethecoronarylumen.Dissectioncoulddisseminateantegradelyandleadtosubtotalortotalocclusionofthecoronarylumen.Similarly,itcouldextendretrogradelyintothesinusofValsalvaandcusp,oreventheascendingaorta,aorticarch,ordescendingaorta,leadingtohemodynamiccollapse.EarlyidentificationandpromptmanagementiscrucialtotheprognosisofpatientswithIACD.Immediatebail-outstentingshouldbeperformedasrapidlyaspossibleinmostcasesofseveredissection,evenwhensignificantpropagationhasalreadyoccurred.Surgeryshouldonlybeconsideredwhenstentingfailedtosealthedissectionandthepatientshadhemodynamiccompromise.

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简介：Ventriculartachycardia(VT)inthepresenceofstructuralheartdiseaseisassociatedwithsuddencardiacdeathandwarrantspromptattention.Implantablecardioverterdefibrillators(ICDs)whilehighlyeffectiveinterminatingsustainedventriculararrhythmiasandreducingmortality,havenoeffectonthearrhythmiasubstrateandrecurrentshocksforVTterminationoccurinapproximately20%ofpatients.Shocksworsenqualityoflifeandareassociatedwithprogressionofheartfailureandincreasedmortality.Antiarrhythmicdrugs,mainlyintheformofbeta-blockersoramiodarone,aremoderatelyeffectiveinreducingICDtherapiesbutdrugintoleranceandserioustoxicitiesofamiodaronenecessitatedrugcessationinaquarterofpatients.CatheterablationhasemergedasaneffectivetreatmentforcontroloffrequentVTepisodesandcanbelifesavingincasesofincessantVTorVTstorm.Asexperienceincreases,itisbeingusedincreasinglyearlier,ratherthanalastresorttherapy.Efficacyvarieswiththenatureoftheunderlyingheartdisease.Intramuralarrhythmiasubstrateandfailuretocreatepermanentablationlesionsremainchallengesandrepeatproceduresarenecessaryinathirdtoahalfofpatients.ForidiopathicVTsorPVCsthataresymptomaticorworsenLVfunction,catheterablationisoftenaneffectivetherapy.

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简介：尽管关于在组织的知识管理(千米；公里)的实现的许多理论被建议了并且学习，没有合并企业过程，大多数应用趋于独自站。知识的不同范畴提供不同好处并且当一种有效千米；公里方式仍然保持战略上重要，并且还仍然是understudied，怎么把千米；公里的各种各样的范畴集成到一条混合途径。因此，在这糊为新服务开发(NSD)和结果的测量集成主要千米；公里应用程序的一个混合模型金融好处被开发了。建议千米；公里模型合并新闻组，知识论坛，知识财产管理和一个混血儿为沿着二轴分享组织上的知识意味着的知识应用程序进程，明确对含蓄、单个对集体。在台湾的最大的管理咨询公司之一，中国，其过程NSD当模特儿，用千米；公里应用程序独自正在站，为案例研究被选择。一套混合千米；公里进程被开发实现建议千米；公里模型，并且它为把混合千米；公里惯例集成到企业进程与更大的金融好处说明一个应用程序。把确认基于增加的知识价值(KVA)，建议千米；公里模型为在一个组织以内分享NSD知识提供一个新操作系统。通过由测量完成的金融结果的案例研究，建议千米；公里模型被发现向一个独占的混合平台提供一个实验进程模型在一个组织以内探讨创新途径和千米；公里的实际的值。

简介：Watershedmanagementisanever-evolvingpracticeinvolvingthemanagementofland,water,biota,andotherresourcesinadefinedareaforecological,social,andeconomicpurposes.Inthispaper,weexplorethefollowingquestions:Howhaswatershedmanagementevolved?Whatnewtoolsareavailableandhowcantheybeintegratedintosustainablewatershedmanagement?Toaddressthesequestions,wediscusstheprocessofdevelopingintegratedwatershedmanagementstrategiesforsustainablemanagementthroughtheincorporationofadaptivemanagementtechniquesandtraditionalecologicalknowledge.Weaddressthenumerousbenefitsfromintegrationacrossdisciplinesandjurisdictionalboundaries,aswellastheincorporationoftechnologicaladvancements,suchasremotesensing,GIS,bigdata,andmulti-levelsocial-ecologicalsystemsanalysis,intowatershedmanagementstrategies.WeusethreecasestudiesfromChina,Europe,andCanadatoreviewthesuccessandfailureofintegratedwatershedmanagementinaddressingdifferentecological,social,andeconomicdilemmasingeographicallydiverselocations.Althoughprogresshasbeenmadeinwatershedmanagementstrategies,therearestillnumerousissuesimpedingsuccessfulmanagementoutcomes;manyofwhichcanberemediedthroughholisticmanagementapproaches,incorporationofcutting-edgescienceandtechnology,andcross-jurisdictionalcoordination.Weconcludebyhighlightingthatfuturewatershedmanagementwillneedtoaccountforclimatechangeimpactsbyemployingtechnologicaladvancementsandholistic,cross-disciplinaryapproachestoensurewatershedscontinuetoservetheirecological,social,andeconomicfunctions.Wepresentthreecasestudiesinthispaperasavaluableresourceforscientists,resourcemanagers,governmentagencies,andotherstakeholdersaimingtoimproveintegratedwatershedmanagementstrategiesandmoreefficientlyandsuccessfullyachieveecologicalandsocio-economicmanagementobjectives.

简介：Thecombinationofradiotherapy(RT)andfunction-preservingsurgeryisthemostusualcontemporaryapproachinthemanagementofsofttissuesarcomas(STS).Pre-andpostoperativeRTresultinsimilarlocalcontrolrates,asshownbyalandmarktrialinextremitySTS.Inthisreview,theroleofRTinthemanagementofextremitySTSwillbediscussed,butSTSinothersites,includingretroperitonealSTS,willalsobeaddressed.ThefocuswillconsidervariousaspectsofRTincludingstrategiestoreducethevolumeoftissuebeingirradiated,dose,scheduling,andthepossibleofomissionofRTinselectedcases.Finally,technologyadvancesthroughtheuseofintensity-modulatedradiotherapy(IMRT),image-guidedIMRT,intraoperativeradiotherapy(IORT)andparticletherapywillalsobediscussed.

简介：Accordingtothemostrecentepidemiologicaldata,theprevalenceofhypertensionrangedfromabout25%inChineselivingeitherinthemainlandorinTaiwanandKoreans,toapproximately40%inMongolians.Thecontrolrateofhypertensionwasabout35%inKoreansandJapanese,24%inMongolians,andlessthan10%inChinese.Fourplacebo-controlledtrialsinChinaunequivocallyprovedthatantihypertensivetherapymaypreventstrokeandothercardiovascularcomplicationsinhypertensionorpatientswithahistoryofstrokeortransientischemicattack.Fouractively-controlledtrialsinJapandidnotshowsignificantdifferencebetweenvariousclassesorcombinationsofantihypertensivedrugs.TwotrialsthatcomparedintensivewithlessintensivebloodpressurecontrolinelderlyJapanesehypertensivepatientsdidnotshowfurtherbenefitofcontrollingsystolicbloodpressuretoalevelbelow140mmHgincomparisonwithbloodpressurecontroltoalevelof140mmHgorabove.Thesetrialsthatcomparedvariousclassesofantihypertensivedrugsorintensivewithlessintensivebloodpressurecontroloftenhadsmallsamplesizeandhenceinadequatepowertodetectmodestormoderatebenefit.ThereisstillaneedforhighqualityoutcometrialdatainEastAsians.

简介：联网的控制系统服从于影响他们的网络拓扑学的对手条件。保证可靠系统操作，网络拓扑学需要在全面系统性能上为他们的影响被描绘并且设法。这份报纸为这追求介绍网络坚韧性深度的概念。分离事件系统被用作一个基础为网络拓扑学的动态行为建模，支持他们的分析，并且执行他们的管理。随机的分析联系连接可靠性可能性到网络坚韧性深度的概率的描述。几拓扑学管理策略被讨论，包括被动方法，随机的策略，和优化方法论。他们的各自的好处和限制被确定。由把排控制用作混血儿(连续、分离的事件)的一个平台是的系统和包檫除隧道一个通讯协议，结果与案例研究被表明。

简介：Background:Forestecosystemsareincreasinglyseenasmulti-functionalproductionsystems,whichshouldprovide,besidestimberandeconomicbenefits,alsootherecosystemservicesrelatedtobiologicaldiversity,recreationalusesandenvironmentalfunctionsofforests.Thisstudyanalyzedtheperformanceofeven-agedrotationforestmanagement(RFM)continuouscoverforestry(CCF)andany-agedforestry(AAF)intheproductionofecosystemservices.AAFalowsbotheven-agedanduneven-agedmanagementschedules.Theecosystemservicesincludedintheanalyseswerenetpresentvalue,volumeofharvestedtimber,cowberryandbilberryyields,scenicvalueoftheforest,carbonbalanceandsuitabilityoftheforesttoSiberianjay.Methods:Dataenvelopmentanalysiswasusedtoderivenumericalefficiencyratiosforthethreemanagementsystems.Efficiencyratioisthesumofweightedoutputs(ecosystemservices)dividedbythesumofweightedinputs.ThelinearprogramingmodelproposedbyCharnes,CooperandRhodeswasusedtoderivetheweightsforcalculatingefficiencyscoresforthesilviculturalsystems.Resultsandconclusions:CCFprovidedmoreecosystemservicesthanRFM,andCCFwasmoreefficientthanRFMandAAFintheproductionofecosystemservices.Multi-objectivemanagementprovidedmoreecosystemservices(exceptharvestedtimber)thansingle-objectivemanagementthatmaximizedeconomicprofitability.Theuseoflowdiscountrate(resultinginlowcuttinglevelandhighgrowingstockvolume)ledtobettersupplyofmostecosystemsservicesthantheuseofhighdiscountrate.RFMwhereNPVwasmaximizedwithhighdiscountrateledtoparticularlypoorprovisionofmostecosystemservices.InCCFtheprovisionofecosystemserviceswaslesssensitivetochangesindiscountrateandmanagementobjectivethaninRFM.

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简介：Themyelodysplastic/myeloproliferativeneoplasms(MDS/MPNs)areauniquegroupofhematologicmalignanciescharacterizedbyconcomitantmyelodysplasticandmyeloproliferativefeatures.Accordingtothe2008WHOclassification,thecategoryincludesatypicalchronicmyeloidleukemia(aCML),chronicmyelomonocyticleukemia(CMML),juvenilemyelomonocyticleukemia(JMML),MDS/MPN-unclassifiable(MDS/MPN-U),andtheprovisionalentityrefractoryanemiawithringsideroblastsandthrombocytosis(RARS-T).Althoughdiagnosiscurrentlyremainsbasedonclinicopathologicfeatures,theincorporationofnextgenerationplatformshasallowedfortherecentmolecularcharacterizationofthesediseaseswhichhasrevealeduniqueandcomplexmutationalprofilesthatsupporttheirdistinctbiologyandisanticipatedtosoonplayanintegralroleindiagnosis,prognostication,andtreatment.Futuregoalsofresearchshouldincludethedevelopmentofdisease-modifyingtherapies,andfurthergeneticunderstandingofthecategorywilllikelyformthefoundationoftheseefforts.

简介：IllegallogginghasbecomeaseriousprobleminforestmanagementinASEAN.Inthepaper,theillegalloggingstatusinASEANisintroduced,anditissurethatIndonesia,Malaysia,Brunei,Laos,MyanmarandCambodiaareproductioncountries,ThailandandVietnamaretheprocessingcountries,andPhilippines,Singaporeareconsumercountriesinthewholesupplychainofillegallogging.Aswell,thetradeflowsofillegalforestproductsofASEANarechecked,thecauseofillegallogginganditsproducingimpactsareassessed.Totackleillegallogging,onefeasiblewayistodesignecologicalsupplychaintosuperviseillegalloggingprocess,andundertheconceptofecologicalsupplychain,theproductioncountries,processingcountriesandconsumercountriesshouldtakeactionstogether.Non-ASEANcountriesshouldimprovebordercontrol,introducepublicprocurementpolicies,promotemarket-basedinstruments,andstrengtheninternationalcooperation.ForASEANcountries,theyshouldestablishcooperationmechanismswithintheregion,takeaunifiedaction,increasegovernancecapacityandpromotelegalityverificationorsustainabilitycertification.

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