Medical English | Day3
2014/11/3 医学生

     医学生微信：medics

     新浪微博：福洋医学

     学医路上，我们一起走!

    

     primitive

     ['pr?m?t?v]

     adj. 原始的，远古的；简单的，粗糙的

     n. 原始人

     词根prim-表示“第一”

     primaeval原始的；初期的

     primitively 最初地；自学而成地

     primigravida[,praimi'ɡr?vid?] 初孕妇

     词组primitive reflex原始反射

     primitive pit原窝

     primitive attribute原始属性

     例句It showed that primitive instincts to do with motivation and survival are activiated when people are reminded of their lost relationships.

     研究显示，当人们被提醒到失去的感情时，与动机和求生相关联的原始本能会被激发。

     news.iciba.com

    

     Question肖锋翻译和整理

     Name 5 diagnoses that should be considered when Bell's Palsy presents bilaterally.

     当发现有双侧贝尔氏麻痹时，要考虑哪5个诊断。

    

     AnswerWhen Bell's palsy is bilateral, myasthenia gravis, brain stem lesions, lymphoma, sarcoidosis, and Lyme disease should be considered.

     当贝尔氏麻痹累及双侧时，要考虑重症肌无力，脑干病变，淋巴瘤，结节病，莱姆病 (JEM, ePub, online April 11, 2012)。

    

     Tofacitinib versus Methotrexate in Rheumatoid Arthritis.

     类风湿性关节炎患者使用Tofacitinib和甲氨蝶呤的疗效比较

     Eun Bong Lee ,Roy Fleischmann ,Stephen Hall ,Bethanie Wilkinson ,John D Bradley ,David Gruben

     NEJM

     2014-06-19

     索引：N. Engl. J. Med..2014 Jun 19;370(25):2377-2386.

     中文摘要来源：麦毓麟翻译 穆冰审核

     BACKGROUND:

     Methotrexate is the most frequently used first-line antirheumatic drug. We report the findings of a phase 3 study of monotherapy with tofacitinib, an oral Janus kinase inhibitor, as compared with methotrexate monotherapy in patients with rheumatoid arthritis who had not previously received methotrexate or therapeutic doses of methotrexate.

     METHODS:

     We randomly assigned 958 patients to receive 5 mg or 10 mg of tofacitinib twice daily or methotrexate at a dose that was incrementally increased to 20 mg per week over 8 weeks; 956 patients received a study drug. The coprimary end points at month 6 were the mean change from baseline in the van der Heijde modified total Sharp score (which ranges from 0 to 448, with higher scores indicating greater structural joint damage) and the proportion of patients with an American College of Rheumatology (ACR) 70 response (≥70% reduction in the number of both tender and swollen joints and ≥70% improvement in three of five other criteria: the patient's assessment of pain, level of disability, C-reactive protein level or erythrocyte sedimentation rate, global assessment of disease by the patient, and global assessment of disease by the physician).

     Results

     Mean changes in the modified total Sharp score from baseline to month 6 were significantly smaller in the tofacitinib groups than in the methotrexate group, but changes were modest in all three groups (0.2 points in the 5-mg tofacitinib group and <0.1 point in the 10-mg tofacitinib group, as compared with 0.8 points in the methotrexate group [P<0.001 for both comparisons]). Among the patients receiving tofacitinib, 25.5% in the 5-mg group and 37.7% in the 10-mg group had an ACR 70 response at month 6, as compared with 12.0% of patients in the methotrexate group (P<0.001 for both comparisons). Herpes zoster developed in 31 of 770 patients who received tofacitinib (4.0%) and in 2 of 186 patients who received methotrexate (1.1%). Confirmed cases of cancer (including three cases of lymphoma) developed in 5 patients who received tofacitinib and in 1 patient who received methotrexate. Tofacitinib was associated with increases in creatinine levels and in low-density and high-density lipoprotein cholesterol levels.

     Conclusions

     In patients who had not previously received methotrexate or therapeutic doses of methotrexate, tofacitinib monotherapy was superior to methotrexate in reducing signs and symptoms of rheumatoid arthritis and inhibiting the progression of structural joint damage. The benefits of tofacitinib need to be considered in the context of the risks of adverse events. (Funded by Pfizer; ORAL Start ClinicalTrials.gov number, NCT01039688 .).

    

     研究背景：

     甲氨蝶呤是使用最广泛的一线抗风湿药物。本项3期研究在类风湿性关节炎患者中开展，对比单药使用tofacitinib(一种口服Janus激酶抑制剂)或甲氨蝶呤的疗效，所有患者先前均未接受甲氨蝶呤治疗或治疗剂量的甲氨蝶呤。

     研究方法：

     我们将958名患者随机分配至每日两次tofacitinib 5mg或10mg(试验组)，或8周内逐渐递增至20mg的每周1次甲氨蝶呤(对照组)。956名患者接受了药物治疗。6月时的共同主要终点为van der Heijde调整的总Sharp评分平均变化(范围0-448，评分越高提示结构性关节破坏越严重)以及获得美国风湿病学会(ACR) 70反应(压痛和肿胀关节数目减少≥70%以及5个其他标准中有3个改善≥70%，5个其他标准为：患者评估的疼痛、伤残程度、C反应蛋白水平或红细胞沉降率、患者对疾病的总体评价和医师对疾病的总体评价)的患者比例。

     研究结果：

     6月时试验组的调整总Sharp评分平均变化要显著小于对照组，但3组间的变化均较小(5mg试验组 0.2分，10mg 试验组<0.1分，对照组0.8分[所有比较P均<0.001])。5mg试验组中有25.5%患者、10mg试验组中有37.7%在6月时获得了ACR 70反应，对照组为12.0%(所有比较P均<0.001)。770名试验组患者中有31名(4.0%)出现带状疱疹，186名对照组患者有2名(1.1%)。试验组患者中有5名最后确诊癌症(其中3例淋巴瘤)，对照组有1名。使用Tofacitinib和升高的肌酐、低密度和高密度脂蛋白水平相关。

     研究结论：

     在之前未接受甲氨蝶呤治疗或治疗剂量的甲氨蝶呤患者中，tofacitinib单药治疗较甲氨蝶呤相比，在减少类风湿性关节炎体征和症状、抑制结构性关节破坏进展方面更优。评估tofacitinib获益的时候需要考虑不良事件的风险。

     文献更多内容点击阅读原文

     推荐三枚不错的微信号生物谷微信号：BIOONNEWS(←长按复制搜索)

     这里不仅有生命科学领域最前沿的研究、最有趣的知识，还有医药产业最权威的资讯、最火爆的话题，更有一大波神秘活动等着你!生物谷，生物Good!

     赛先生微信号：Iscientists(←长按复制搜索)

     中国最佳科学读品。由饶毅、鲁白、谢宇三位顶尖科学家主编。——上帝忘了给我们翅膀，于是，科学家带领我们飞翔。

     科学网微信号：sciencenet-cas(←长按复制搜索)

     全球最大的华人科学社区，关注科学与教育。经验与技巧，思考与感悟，尽在科学网。

     阅读原文

    http://www.duyihua.cn
返回 医学生 返回首页 返回百拇医药