乙型肝炎肝硬化并发自发性细菌性腹膜炎患者血清白蛋白和肝纤维化指标的变化

目的 分析乙型肝炎肝硬化并发SBP患者血清肝纤维化指标及白蛋白水平的变化。方法 在我院2013年1月~2015年6月收治的31例乙型肝炎肝硬化并发自发性细菌性腹膜炎（SBP）患者和同期住院的31例乙型肝炎肝硬化未发生SBP患者,采用放射免疫法检测纤维化指标。结果 SBP组血清PCⅢ、Ⅳ-C、LN和HA水平分别为307.4±20.2μg/L、230.6±20.3μg/L、251.3±16.3μg/L、472.6±22.6μg/L,均显著高于非SBP组（269.8±16.5μg/L、181.6±17.9μg/L、215.6±13.3μg/L、436.1±20.3μg/L （均P<0.05）;SBP组血清和腹水ALB水平分别为23.3±2.2 g/L和10.0±1.3g/L,均显著低于非SBP组（28.9±2.7 g/L和15.9±1.5 g/L（均P<0.05）;SBP患者血清PCⅢ、Ⅳ-C、LN和HA水平均与ALB呈负相关（均P<0.05）。结论 乙型肝炎肝硬化患者并发SBP时可能影响血清肝纤维化指标水平。     

恩替卡韦与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者临床效果分析

目的 探讨恩替卡韦与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者的临床效果。 方法 2015年6月~2016年7月我院收治的140例慢性乙型肝炎患者,按照随机分组法将所有患者分为观察组（n=70)和对照组（n=70）。对照组患者口服恩替卡韦片治疗,在观察组,采用恩替卡韦片联合水飞蓟宾胶囊治疗。采用时间分辨免疫荧光法检测血清HBeAg,采用荧光定量PCR法检测血清HBV DNA,采用ELISA法检测血清白细胞介素-6 （IL-6）、TNF-α）和转化生长因子-β （TGF-β,使用FACSCalibur流式细胞仪检测外周血淋巴细胞亚群。 结果 在治疗24 w末,观察组临床症状如乏力、食欲不振、腹胀复常率分别为87.1%、90.0%、82.9%,显著高于对照组的41.4%、71.4%、58.6% （P<0.05）;观察组血清HBeAg和HBV DNA转阴率分别为0.0%和88.6%,与对照组的0.0%和68.6%比,无统计学差异（P>0.05）;观察组血清TBIL、ALT和AST水平分别为（16.49±3.17） μmol/L、（47.36±8.24） U/L和（40.58±5.26） U/L,显著低于对照组的（23.56±3.48） μmol/L、（68.25±7.93） U/L和（66.24±8.24） U/L（P<0.05）;观察组血清IL-6、TNF-α和TGF-β水平分别为（204.8±27.4） μg/L、（68.2±12.5） μg/L和（158.2±15.2） μg/L,显著低于对照组的（264.2±29.2） μg/L、（107.4±13.7） μg/L和（193.5±17.3） μg/L （P<0.05）;观察组外周血CD4+细胞百分比和CD4+/CD8+细胞比值分别为（40.36±3.61）%和（1.50±0.32）,显著高于对照组的【（33.46±3.17） %和（1.33±0.27）,P<0.05】。 结论 恩替卡韦片与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者效果确切,可有效抑制HBV DNA复制,缓解机体炎症反应,提高患者的免疫功能。     

超声引导下经皮微波消融治疗原发性肝癌患者疗效分析*

目的 探讨超声引导下经皮微波消融联合胸腺素-α1治疗原发性肝癌（PLC）患者的疗效。方法 2011年3月~2013年3月我院收治的PLC患者104例,随机分为观察组52例和对照组52例。对照组采用超声引导下经皮微波消融术治疗,观察组于术后皮下注射胸腺素-α1 4周。比较治疗前和治疗后外周血T淋巴细胞亚群、肝功能、甲胎蛋白（AFP）水平变化和两组肿瘤复发或转移及3年生存情况。结果 在治疗4周时,观察组外周血CD3⁺、CD4⁺、CD4⁺/CD8⁺比值分别为71.49±6.57%、43.12±2.89%、15.89±3.24,显著高于对照组的43.21±3.74%、24.56±2.36%、5.42±2.13 （P<0.05）;观察组血清白蛋白（ALB）为39.84±2.56 g/L,显著高于对照组的34.12±1.87 g/L,丙氨酸氨基转移酶 （ALT）、天门冬氨酸氨基转移酶（AST）、AFP水平分别为34.87±3.08 U/L、43.39±2.08 U/L、85.42±10.42 μg/L,显著低于对照组的61.39±3.64 U/L、56.74±3.46 U/L、164.29±14.35 μg/L;随访3年,观察组肿瘤复发率和转移率分别为30.8%和15.4%,显著低于对照组的50.0%和32.7%（P<0.05）,观察组生存率为23.1%（12/52）,显著高于对照组的5.8%（3/52,P<0.05）。结论 超声引导下经皮微波消融后继续接受α-1胸腺素治疗PLC患者效果显著,可降低肿瘤复发或转移,延长生存时间,值得研究。     

肝细胞癌患者血浆SPINK1水平及其与患者预后的关系分析

目的 分析肝细胞癌（HCC）患者血浆丝氨酸蛋白酶抑制剂Kazal 1型（SPINK1）水平及与其患者术后预后的关系。方法 2014年5月~2015年9月我院收治的HCC患者80例、肝硬化患者40例,选择正常人30例,所有纳入对象在晨起空腹取静脉血,采用ELISA法测定血浆SPINK1和甲胎蛋白（AFP）水平,绘制受试者工作特征曲线（ROC）,评价血浆SPINK1和AFP对HCC的诊断效能,并分析术前血浆SPINK1水平与HCC患者预后的关系。结果 HCC患者血浆SPINK1为（2.4±0.3） μg/L,显著高于肝硬化患者的（2.0±0.2） μg/L或正常人的（1.3±0.1） μg/L,肝硬化患者血浆SPINK1水平显著高于正常人（P<0.05）;HCC患者血浆AFP水平为（125.7±14.5） μg/L,显著高于肝硬化患者的（35.4±4.2）μg/L或正常人的【（3.6±0.5）μg/L,P<0.05】;ROC曲线分析结果显示,以1.70 μg/L为截断点,血浆SPINK1水平诊断HCC的灵敏度为77.2%,特异度为67.6%,而以最佳截断点为124.8μg/L,血浆AFP 水平则分别为63.4%和62.5%;42例术前血浆SPINK1水平>1.7 μg/L的HCC患者术后总生存期（OS）为（12.2±1.3） m,无瘤生存期（DFS）为（11.2±1.2） m,显著短于38例血浆SPINK1<1.7 μg/L组的（20.5±2.1） m和（15.7±1.9） m,而复发率为38.1%,显著高于术前血浆SPINK1<1.7 μg/L患者的18.4%（x²=5.18,P<0.05）。结论 HCC患者血浆SPINK1呈高水平状态,SPINK1诊断HCC的灵敏度、特异度较AFP高,且SPINK1与HCC患者预后密切相关,临床可将其作为HCC肿瘤标志物。     

乙型肝炎肝硬化患者血清血小板衍生生长因子和叶酸水平变化

目的 分析乙型肝炎肝硬化患者血清血小板衍生生长因子（PDGF）和叶酸水平变化。方法 2015年1月~2016年12月期间我院收治的110例乙型肝炎肝硬化患者,常规行肝功能Child-Pugh分级,采用ELISA法检测血清PDGF水平,采用化学发光法检测血清叶酸水平,采用放射免疫法检测血清Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（Ⅳ-C）、层粘连蛋白（LN）和透明质酸酶（HA）水平。结果 32例Child-Pugh C级患者血清PDGF水平为（190.7±11.4）pg/ml,显著高于42例B级或36例A级患者的（128.5±8.1） pg/ml或（79.5±4.9） pg/ml（P<0.05）;Child-Pugh C级患者血清叶酸水平为（2.7±0.5） μg/L,显著低于B级或A级患者的（5.3±0.5） μg/L或（7.1±0.8） μg/L（P<0.05）;Child-Pugh C级患者血清谷丙转氨酶（ALT）、总胆红素（TBIL）水平和INR水平分别为（102.4±6.9） U/L、（60.7±5.8） μmol/L和（1.9±0.2）,均显著高于B级患者【分别为（78.9±4.5） U/L、（36.4±3.2） μmol/L和（1.5±0.2）】或A级患者[分别为（56.8±3.9） U/L、（26.8±2.8） μmol/L和（1.2±0.1）,均P<0.05】;Child-Pugh C级患者血清白蛋白（ALB）为（23.9±2.4） g/L,显著低于B级患者的（30.8±2.7） g/L或A级患者的（41.0±3.3） g/L（均P<0.05）;Child-Pugh C级患者血清PCⅢ、Ⅳ-C、LN和HA水平分别为（279.7±19.2） μg/L、（140.4±8.0） μg/L、（159.7±8.2） μg/L和（237.8±9.1） μg/L,均显著高于B级分别为【（238.5±17.8） μg/L、（94.8±6.2） μg/L、（129.5±7.3） μg/L和（174.1±8.6） μg/L或A级患者（分别为158.6±13.6）μg/L、（75.4±5.1） μg/L、（96.8±6.8） μg/L和（128.3±6.9）μg/L,均P<0.05】;肝硬化患者血清PDGF水平与ALT、TBIL、INR和肝纤维化指标均呈正相关,与ALB呈负相关（均P<0.05）,叶酸水平与ALT、TBIL、INR和肝纤维化指标均呈负相关,与ALB呈正相关（均P<0.05）。结论 随着肝功能损害程度的加重,肝硬化患者血清PDGF水平逐渐升高,而叶酸水平逐渐降低,其临床意义还有待于进一步研究。     

经导管肝动脉化疗栓塞联合射频消融治疗原发性肝癌患者临床疗效评价*

目的 评价经导管肝动脉化疗栓塞（TACE）与射频消融（RFA）联合治疗原发性肝癌患者的临床疗效。方法 采用随机数字表法将60例原发性肝癌患者分为联合组30例和TACE组30例,分别给予TACE联合RFA或TACE治疗,对比分析两组患者的近期和远期临床疗效。结果 联合组完全缓解和部分缓解率分别为26.7%和50.0%,显著高于TACE组的6.7%和23.3%,差异均具有统计学意义（P<0.05）;联合组患者生存时间为（2.86±0.48）年,显著长于TACE组的（0.93±0.27） 年,差异具有统计学意义（P<0.05）;联合组患者治疗后1年、2年、3年血清AFP水平分别为（475.4±200.7） μg/L、（416.4±229.0） μg/L、（320.4±243.5） μg/L,显著低于TACE组的（639.1±190.9） μg/L、（623.4±234.6） μg/L、（674.4±300.2） μg/L,差异均具有统计学意义（P<0.05）;联合组患者1 a、2 a、3 a生存率分别为86.7%、66.7%、56.7%,显著高于TACE组的46.7%、26.7%、10.0%,差异均具有统计学意义（P<0.05）。结论 TACE与RFA联合治疗原发性肝癌患者,临床疗效显著。     

干扰素α-2b与聚乙二醇干扰素α-2a治疗慢性乙型肝炎患者疗效比较研究*

目的 观察干扰素α-2b与聚乙二醇干扰素α-2a（PEG-IFNα-2a）治疗慢性乙型肝炎（CHB）患者的临床疗效。方法 将116例CHB患者分成两组,每组58例。给予对照组普通干扰素α-2b治疗,给予观察组PEG-IFNα-2a,疗程均为48 w。检测血清层黏连蛋白（LN）、透明质酸（HA）、Ⅳ型胶原（Ⅳ-C）、Ⅲ型前胶原肽（PⅢP）及血清白介素4（IL-4）、白介素6（IL-6）、白介素10（IL-10）和干扰素γ（IFN-γ）变化。结果 在治疗结束时,观察组HBV DNA转阴率、HBeAg转阴率、HBeAg血清转换率和ALT复常率分别为75.9%、29.3%、22.4%和70.7%,显著高于对照组的51.7%、19.0%、10.3%和55.2%（P<0.05）;观察组血清LN为（148.5±46.0） μg/L,显著低于对照组【（162.6±26.7） μg/L,P<0.05】,血清HA为（158.7±67.9）μg/L,显著低于对照组【（201.4±55.1） μg/L,P<0.05】,血清Ⅳ-C为（108.3±33.4） μg/L,显著低于对照组【（119.2±62.4） μg/L,P<0.05】,血清PⅢP为（145.8±47.2） μg/L,显著低于对照组【（155.3±36.7）μg/L,P<0.05】;观察组血清IL-4水平为（1.5±0.6） pg/ml,显著低于对照组【（3.9±1.6） pg/ml,P<0.05】,而IL-6水平为（6.9±1.3） pg/ml,显著高于对照组【（3.6±0.9） pg/ml,P<0.05】,IL-10水平为（22.6±13.4） pg/ml,显著低于对照组【（17.3±11.4） pg/ml,P<0.05】,IFN-γ水平为（37.2±10.2） pg/ml,显著高于对照组【（28.3±10.5） pg/ml,P<0.05】;观察组血小板计数减少发生率为51.7%,显著高于对照组的12.1%（P<0.05）。结论 PEG-IFNα-2a治疗CHB患者临床疗效优于普通干扰素α-2b,能持久有效地抑制HBV复制,改善血清肝纤维化指标,但不良反应较大,应及时处理。     

细菌感染诱发乙型肝炎肝硬化患者发生肝性脑病60例回顾性研究

目的 总结乙型肝炎肝硬化患者发生肝性脑病（HE）与细菌感染的相关性。方法 回顾性分析60例由细菌感染诱发的肝性脑病和60例乙型肝炎肝硬化的临床资料,应用SPSS 20.0统计软件包进行统计学分析。结果 60例HE患者血清白蛋白为（24.3±6.1） g/L,显著低于肝硬化患者的（26.8±3.9） g/L;肝硬化患者血清丙氨酸氨基转移酶、总胆红素、肌酐、INR和白细胞计数分别为（112.6±18.5） U/L、（79.7±23.0） μmol/L、（71.5±16.1） μmol、（1.9±0.4）和（6.8±2.5）×10⁹/L,明显低于HE组的（201.3±59.4） U/L、（112.6±33.4） μmol/L、（98.6±26.4） μmol、（2.1±0.60和（10.9±2.7）×10⁹/L,差异具有统计学意义（P<0.05）;腹膜炎和呼吸系统感染患者发生3期和4期HE的比率显著高于泌尿系统或其他部位感染者 （x²=13.34,P<0.001）。结论 合并细菌感染的乙型肝炎肝硬化患者更容易诱发肝性脑病,应注意预防。     

恩替卡韦治疗乙型肝炎肝硬化伴肝源性糖尿病患者疗效及其对糖代谢指标的影响

目的 探讨恩替卡韦治疗乙型肝炎肝硬化并发肝源性糖尿病（HD）患者疗效及其对糖代谢指标的影响。方法 采用随机数字表法将84例乙型肝炎肝硬化并发HD患者分为对照组42例和观察组42例,分别给予降糖、护肝等常规治疗或加用恩替卡韦抗病毒治疗,观察48 w。观察的糖代谢指标包括空腹血糖（FBG）、餐后2 h血糖 （2h PBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）和胰岛素抵抗指数（HOMA-IR）。采用放射免疫法测定血清肝纤维化指标,如层黏连蛋白（LN）、血清透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（Ⅳ-C）。结果 在治疗48 w末,观察组33例（78.6%）患者出现病毒学应答,对照组仅7例（16.7%）出现自发血清HBV DNA阴转,两组差异有统计学意义（P<0.05）;在治疗48 w末,观察组血清TBIL、ALT、ALB水平分别为（21.2±4.2） μmol/L、（43.3±12.7） IU/L和（39.4±1.8） g/L,与对照组的【（36.1±5.3） μmol/L、（77.1±15.2） IU/L和（33.9±3.4） g/L比,差异具有统计学意义（P<0.05）;FBG、2h PG、HbA1c、FINS和HOMA-IR水平分别为（5.3±0.7） mmol/L、（7.1±1.5） mmol/L、（6.1±0.6） %、（10.5±2.6） mU/L和（2.1±0.7）,显著低于对照组【（6.8±0.8） mmol/L、（10.3±1.6） mmol/L、（7.8±0.7） %、（15.6±4.0） mU/L和（3.1±0.6）,P<0.05】;血清LN、HA、PCⅢ、Ⅳ-C水平分别为（144.3±54.2） μg/L、（81.7±38.7） μg/L、（116.3±31.4） μg/L和（71.2±42.9） μg/L,显著低于对照组【（177.3±63.5） μg/L、（123.1±41.9） μg/L、（165.7±28.6） μg/L和（124.7±39.1） μg/L,P<0.01】。结论 恩替卡韦治疗乙型肝炎肝硬化并发HD患者可抑制HBV复制,改善肝功能,稳定HD病情。     

枯草杆菌二联活菌肠溶胶囊联合多烯磷脂酰胆碱治疗NAFLD疗效及对血清Pygo2、HMGB1和HIF-1α的影响

目的 探讨枯草杆菌二联活菌联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝病（NAFLD）患者的疗效及其对血清人尾肢同源蛋白2（Pygo2）、高迁移率族蛋白B1（HMGB1）和人缺氧诱导因子1α（HIF-1α）的影响。方法 2015年6月~2016年6月我院诊治的78例NAFLD患者被随机分为观察组39例和对照组39例,分别给予多烯磷脂酰胆碱和枯草杆菌二联活菌或单纯多烯磷脂酰胆碱治疗,观察3 m。采用ELISA法检测血清Pygo2、HMGB1和HIF-1α水平。结果 在治疗3 m末,观察组血清TG、TC、LDL-C和HDL-C水平分别为（1.2±0.2） mmol/L、（4.1±0.2） mmol/L、（3.1±0.1） mmol/L和（3.9±0.3） mmol/L,与对照组的（1.6±0.3） mmol/L、（5.1±0.3） mmol/L、（3.5±0.2） mmol/L和（3.2±0.2） mmol/L比,存在显著性差异（P<0.05）;血清MDA和SOD水平分别为（4.4±0.7） μmol/L和（168.9±15.7） U/L,与对照组的（5.4±0.8）μmol/L和（154.4±15.3） U/L比,存在显著性差异（P<0.05）;血清Pygo2、HMGB1和HIF-1α水平分别为（41.5±3.4） μg/L、（15.7±4.6） μg/L和（24.5±4.6） μg/L,明显低于对照组[（48.2±3.7） μg/L、（26.4±5.1） μg/L和（32.6±4.7） μg/L,P<0.05];脂肪肝分度为正常、轻度、中度和重度的比例分别为56.4%、35.9%、5.1%和2.6%,显著优于对照组(分别为10.3%、30.8%、41.0%和17.9%,P<0.05)。结论 枯草杆菌二联活菌联合多烯磷脂酰胆碱治疗NAFLD患者效果显著,可有效改善血脂水平,减轻氧化应激状态,具有良好的临床应用价值。     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

The Technology Transfer from Europe to China in the 17th–18th Centuries: Non-Invasive On-Site XRF and Raman Analyses of Chinese Qing Dynasty Enameled Masterpieces Made Using European Ingredients/Recipes

Two masterpieces of the Qing Dynasty (1644–1912 CE), one in gilded brass (incense burner) decorated with cloisonné enamels stylistically attributed to the end of the Kangxi Emperor’s reign, the other in gold (ewer offered by Napoleon III to the Empress as a birthday present), decorated with both cloisonné and painted enamels bearing the mark of the Qianlong Emperor, were non-invasively studied by optical microscopy, Raman microspectroscopy and X-ray microfluorescence spectroscopy (point measurements and mapping) implemented on-site with mobile instruments. The elemental compositions of the metal substrates and enamels are compared. XRF point measurements and mappings support the identification of the coloring phases and elements obtained by Raman microspectroscopy. Attention was paid to the white (opacifier), blue, yellow, green, and red areas. The demonstration of arsenic-based phases (e.g., lead arsenate apatite) in the blue areas of the ewer, free of manganese, proves the use of cobalt imported from Europe. The high level of potassium confirms the use of smalt as the cobalt source. On the other hand, the significant manganese level indicates the use of Asian cobalt ores for the enamels of the incense burner. The very limited use of the lead pyrochlore pigment (European Naples yellow recipes) in the yellow and soft green cloisonné enamels of the Kangxi incense burner, as well as the use of traditional Chinese recipes for other colors (white, turquoise, dark green, red), reinforces the pioneering character of this object in technical terms at the 17th–18th century turn. The low level of lead in the cloisonné enamels of the incense burner may also be related to the use of European recipes. On the contrary, the Qianlong ewer displays all the enameling techniques imported from Europe to obtain a painted decoration of exceptional quality with the use of complex lead pyrochlore pigments, with or without addition of zinc, as well as cassiterite opacifier.     

Formoterol Delivered via the Dry Powder Aerolizer® Inhaler Versus Albuterol MDI and Placebo in Mild-to-Moderate Asthma: A Randomized, Double-Blind, Double-Dummy Trial

The objectives of this study were to compare the efficacy and tolerability of twice-daily formoterol dry powder 12 µg and 24 µg (Foradil) delivered via Aerolizer inhaler with four times daily albuterol (salbutamol) 180 µg delivered via metered dose inhaler (MDI) and placebo. A total of 554 adolescents and adults (ages 12-75 years) with mild-to-moderate asthma were randomized to this 12-week, multicenter, double-blind, double-dummy, placebo-controlled, parallel-group study. Twelve-hour spirometry measurements were taken at weeks 0, 4, 8, and 12. A total of 484 patients completed the study (122, 116, 127, and 119 given formoterol 12 µg, formoterol 24 µg, albuterol, and placebo, respectively). For the primary efficacy variable, the forced expiratory volume in 1 second (FEV₁), both formoterol 12 µg and 24 µg were statistically superior to placebo at all time points on all test days (p ≤ 0.017) and to albuterol at most time points on all test days (p ≤ 0.001). The onset of improvement in FEV₁ was rapid, with 15% increase within 5 min in 57%, 71%, and 65% of formoterol 12 µg, formoterol 24 µg, and albuterol patients, respectively. Formoterol was also superior to placebo and albuterol in terms of secondary efficacy variables: FEV₁ area under the curve, percentage of predicted FEV₁, forced vital capacity and forced expiratory flow, asthma symptom scores, and peak expiratory flows. In conclusion, both formoterol doses were superior to placebo in all lung function measurements. Overall, compared with albuterol, both formoterol doses produced superior bronchodilation. Formoterol and albuterol were safe and well-tolerated.