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CA Cancer J Clin:美国癌症学会2013年肺癌筛查指南

2013-10-23 beijia688 dxy

研究要点:肺癌筛查的主要方式是低剂量CT,而不是胸部X线检查;支持对部分高危个体采用小剂量CT扫描进行肺癌筛查;能够进行大规模、高质量肺癌筛查的临床医生和治疗中心,应当与年龄55~74岁、有至少30包/年吸烟史、目前仍吸烟或戒烟不足15年、身体相对健康者讨论肺癌筛查问题。医生应清楚55岁至74岁患者的吸烟状态和吸烟史(表1)。拥有高容量,高品质的肺癌筛查和治疗能力的医学中心应发起对年龄在55岁到7

研究要点:

肺癌筛查的主要方式是低剂量CT,而不是胸部X线检查;支持对部分高危个体采用小剂量CT扫描进行肺癌筛查;

能够进行大规模、高质量肺癌筛查的临床医生和治疗中心,应当与年龄55~74岁、有至少30包/年吸烟史、目前仍吸烟或戒烟不足15年、身体相对健康者讨论肺癌筛查问题。

医生应清楚55岁至74岁患者的吸烟状态和吸烟史(表1)。拥有高容量,高品质的肺癌筛查和治疗能力的医学中心应发起对年龄在55岁到74岁,有至少30包/年的吸烟史,目前还在吸烟或在戒烟不足15年,目前还表现的很健康的这部分人群进行肺癌筛查的讨论。讨论的核心内容应包含以下筛查相关的获益、不确定因素和损害。


获益:低密度CT(LDCT)可大幅减少肺癌死亡率。

不足:LDCT难以检出所有肺癌或所有早期肺癌,也并非所有LDCT检出的肺癌患者都可免于肺癌死亡。

损害:假阳性结果出现的机率会很大,需要定期检查,对一些病例,需要侵入式手术确定异常是否肺癌或非肺癌相关性的偶然性发现。少于1000分之1的假阳性结果会因诊断性手术而产生一种主要的并发症。从诊断评估60天内的记录来看,死亡很少且多为肺癌患者。

戒烟辅导仍然是需要引起仍吸烟者临床高度重视的一个优先级的讨论,应告知其患肺癌的风险。筛查不应该被视为戒烟的替代品。对于低剂量CT检查的潜在获益,限制和损害的内容,需要在作出任何肺癌筛查决定之前做出充分的知情并与临床医生共同决策。

1.若有降低肺癌死亡风险的价值、且可容忍LDCT及进一步相关检查所带来的损害和成本,即使这些检查发生率小但并发症和死亡风险不可忽视,则可接受每年LDCT筛查。

2.若认为避免检查引起的高假阳性率结果和较低的并发症风险更为重要,或认为肺癌死亡风险较筛查并发症死亡风险高很多,则可拒绝LDCT筛查。

医师不应与不符合上述标准的患者讨论LDCT肺癌筛查。若需要进行肺癌筛查,则应适时通知患者,对于标准年龄范围以外(年龄过大或过小)和/或烟草暴露时间少于标准和/或肺损伤严重至需要补氧(或其他健康相关NLST暴露标准)的患者而言,其筛查获益与损害有太多的不确定性,因此不推荐此类患者进行筛查。

选择筛查的成人在74岁之前应遵循每年一次LDCT筛查NLST方案。胸部X线射线检查(CXR)不得用于癌症筛查。

不管可能与否,接受肺癌筛查的成人应在有LDCT成熟技术的院所完成有序的筛查项目,并接受多学科专家小组对异常肺损伤的评估、诊断和治疗。若不能接受有序的、经验证的筛查项目,而患者又有强烈的筛查意愿,则最好接受大剂量肺CT扫描,诊断性检查,以及肺癌手术。若不符合上述临床情境,且不能转化为上述临床情境,则癌症筛查的风险较NLST筛查试验中观察到的风险或有实质性的增加,因此不推荐进行筛查。医师应利用自己的专业知识技能帮助甄别患者的临床特征。

同时,很少有政府或商业保险覆盖肺癌LDCT筛查项目。决定提供筛查的临床医生有责任帮助患者决定是否要自费接受初次筛查,并且帮助患者了解所需支付的金额。鉴于有充分证据表明筛查高危个体可明显降低肺癌死亡率,公立和私立医疗保险机构都应当将高危每年接受(小剂量CT)肺癌筛查的费用纳入赔付范围。


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1800035, encodeId=852f180003536, content=<a href='/topic/show?id=745ae134655' target=_blank style='color:#2F92EE;'>#癌症学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71346, encryptionId=745ae134655, topicName=癌症学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Mon Sep 29 11:44:00 CST 2014, time=2014-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8545, encodeId=2200854517, content=and with little warning could encompass the entire state next year. So they can say, George Michael wasn't exactly a brooding artiste in Wham! and his hugely successful early solo records meet at the midpoint between his bubblegum persona and the more "adult" side (in several senses of the word) he'd explore later Sting's post-Police album The Dream of the Blue Turtles finds a similar comfort zone between fizziness and mopery; it took a few years for the singer's adult-contemporary side to dominate completely Justin Timberlake found a path from boy-band stardom in 'N Sync to solo stardom by locating the midpoint between his old group and sexy soul Though there are cases in which hairpin turns have worked for people ― Mike Patton leaving Faith No More and forming the inscrutably spastic oddity Mr Bungle for example ― some performers have been viewed as unbearably self-indulgent once liberated from the bands that once contained them (David Lee Roth was a huge solo star for a few years after leaving Van Halen but the schtickiness of it all produced rapidly diminishing returns) To me the most intriguing solo breakouts occur in bands with multiple competing ― and often contradictory ― visions Bands often contain several highly individual songwriters and so it's intriguing to watch a family tree emerge from the roots of an Uncle Tupelo (Wilco's Jeff Tweedy Son Volt's Jay Farrar) a Velvet Underground (Lou Reed John Cale et al) a Fleetwood Mac (Stevie Nicks Lindsey Buckingham Christine McVie) a Beatles (all four of 'em) a Fugees (Lauryn Hill Wyclef Jean Pras) a Hüsker Dü (Bob Mould Grant Hart) and even an Eagles (Glenn Frey Don Henley et al) That individual work can often be informed by the exhilaration of liberation but it also comes with fascinating amounts of pressure: When a band breaks up and everyone goes solo history will often judge its legacy by which solo act fares best The roles of Kelly Rowland and Michelle Williams in Destiny's Child for example will always be viewed through the lens of Beyonce's subsequent success In most cases that battle is won by who's got the strongest songs out of the gate Finally it really helps to go solo at the right time ― to not wait until a band has started to decline before striking out on your own Several new solo albums have crossed my desk recently that might have experienced a huge profile had they been released 10 or 15 or 20 years ago: Live's Ed Kowalczyk Collective Soul's Ed Roland Creed's Scott Stapp But for those guys going solo now means rebranding themselves and bearing the weight of their bands' respective legacies Of course it holds true for solo acts ― just as it holds true for bands ― that most musicians come with commercial expiration dates no matter how many smart moves they've made along the way [Incidentally yes about 14 zillion examples aren't included in this thumbnail sketch: Iggy Pop assorted Jacksons Diana Ross Kenny Loggins Robert Plant Gloria Estefan Paul Simon Peter Gabriel and Phil Collins Glen Hansard Billy Idol Rob Thomas a couple Black Eyed Peas and on and on Please feel free to bring 'em up and have at it in the comments] Got a music-related question you want answered Leave it in the comments drop us an email at or tweet this week, As Carter Leake, Leake says, and many of them live inside a compound in Southern California, particularly within the clergy. This transcript is provided for personal, noncommercial use only. <br> Cheap Michael Kors http://michaelkorsale.tideways.co.uk/, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Cheap Michael Kors, createdTime=Sat Mar 22 07:18:00 CST 2014, time=2014-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8483, encodeId=e54d8483db, content=000.Lack of access to surgery for the poor is the biggest global health problem no one has ever heard of. at least - fell far short of what had been feared, jobs and the middle class. She has been a national advocate for "Fix-It-First" investments to address the nation's backlog of deferred maintenance on highways, Obama's own advisers are saying that the crisis will benefit him politically, and that’s only a small slice of her resume which has rocketed her to multimillionaire status in under a year SI’s 2011 covergirl has not been as successful as Upton 2010’s face has transformed into a successful actress“It’s really only the beginning for (Upton)” Bart says “Kate’s only beginning to first realize the power that she has Last year to this year it was still a lot of building blocks now brands want to up their value A lot of products are now approaching us because she’s accessible and women are captivated by her Last year it became very clear in my mind that she was a supermodel like "Upton’s agent Lisa Benson says Upton’s next foray will likely be in acting — but that she’s taking it very seriously“She has so many roles offered and network TV calls every single day with something” she says “What’s kept her apart is she’s doing the homework and studying and should she make that transition she’ll be ready She is waiting for the right role that she will be good at”Benson adds that Upton is certainly not shedding that bikini any time soon though “Right now she wants to focus on modeling because it is lucrative for her” she saysYOUR SERVE SUSAN’s table-tennis hotspot Spin is being franchised The New York-based social club now open in Los Angeles as a private social club with Andre Balazs also has locations in Toronto and Milwaukee “She is franchising it and she’s opening many more locations across the country in the next few years” a friend of the actress tells us More beer More pong Never a bad thingKATY GETS WAXEDShe’s been nominated for nine Grammys and won two AMAs but now Katy Perry’s been The 28-year-old pop star was immortalized in wax over the weekend at the Las Vegas Madame Tussauds museum On Saturday Perry posed for the unveiling of a life-sized sculpture whose look was inspired by the blue ’do she sported during her 2011 California Dreams tour‘SNL’ AFTER HOURSLive from STK — it’s the “SNL” after-party Cast and crew from “Saturday Night Live” rolled into the One Group’s STK midtown steakhouse Sunday morning where they were joined by Saturday night’s host who’d earlier done a skit on the show According to our party source “(Diaz) bounced around the restaurant mingling with the star-studded crowd including Adam Levine but spent most of her evening chatting with Jerry and Jessica Seinfeld at their table”LILO LYING LOWShe’s due back in a Los Angeles court Jan 30 but first Lindsay Lohan did a little shopping over the weekend in lower Manhattan LiLo and hotelier Vikram Chatwal were spied perusing the Wendy Nichol store in SoHo Saturday where witnesses saw the troubled actress go on a marathon spending spree that even required a cigarette break Lohan was finally seen carrying her bags to a waiting car and making her getawayIN LIKE A DOGG OUT LIKE A LIONLove was in the air at the Bowery Hotel after-party for ’s “Reincarnated” documentary which shows the rapper formerly known as Snoop Dogg living a Rasta lifestyle Ariel Palitz owner of nearby East Village hotspot Sutra says partying with Snoop was an eye-opening experience for her and her business partner Moses Comas “With the whole transition going from Snoop Dogg to Snoop Lion I was questionable about his motive” admits Palitz “But when I was face to face with him I could feel his Rasta vibe I really felt his sincerity”A STERN TALKING-TO “definitely crossed the line” and was “in the doghouse for a long long time” after giving details about their sex life on Howard Stern’s Sirius XM show a few months back but she understands how it happened“People go there and they just purge I’ve gone on there and I’ve purged accidentally and think ‘Wait Why did I just say that’ You feel like you’re in the therapist’s office and you can say anything in there”MY HARV GOES OUT TO YOUMovie mogul Harvey Weinstein showed a soft side when presented him with the Producers Guild of America’s Milestone Award in Los Angeles According to our insider “In the 15 years I’ve known him I’ve never seen him like this before He was almost crying telling a story of how he and his brother went to Cannes Film Festival stayed in a cheap hotel shared a mattress and sneaked in the Palais to see a movie but the usher told them to leave Then they heard a strong voice behind him say ‘Leave those boys alone’ It was Sean Connery”A NIGHT AT THE ‘OPERA’Guests celebrating the 25-year Broadway anniversary of “Phantom of the Opera” were surprised to see Jason Patric stop by their post-show celebration at the New York Public Library Party sources tell us Patric came as a guest of Polly Baird who played Meg in the record-breaking musical “They are definitely an item” says our insider Reps for Patric and Baird couldn’t be reachedRUPAUL’S BALL IS FLAME-RESISTANTAnd they’re offRuPaul’s “” kicked off its fifth season this weekend with a premiere party at XL Nightclub that went on even without its honoree who sources say couldn’t break away from filming obligations in TexasBefore the big bash started organizers from Logo the Viacom network that airs the competition show to find “America’s next drag superstar” told the club there could be no candles on site because the abundance of hairspray wigs and crazy costumes could turn the venue into a disco inferno Drag queen Manila Luzon’s feather dress went up in flames at a RuPaul party in OctoberThis year’s fire-free fete drew guests including “Mob Wives” stars Big Ang Renee Graziano and Drita D’Avanzo and reality stars and Jenni (JWoww) Farley Polizzi and Farley were all too eager to provide a very detailed preview to the next episode of their show “Snooki & JWoww”“The next episode we see Lorenzo coming out — literally” said Farley Polizzi gave birth to a son Lorenzo Dominic LaValle in August“Like you don’t see my vagina opening but you see him coming out and it’s very beautiful It’s nice because he’s so big now” further explained Polizzi“Snooki & JWoww” airs Tuesday at 10 pm on MTVNICOLE’S IN LAP OF LUXURYConfidenti@l caught up with “Extra” TV host Renee Bargh shortly after she’d taped an interview with fellow Bargh admitted Kidman's candor took her by surprise when she asked “The Paperboy” star if husband Keith Urban saw her giving Jimmy Kimmel a lap dance on his talk show last week Kidman replied “He doesn’t need to — he gets to see it in real life” At Saturday’s Australian Academy Of Cinema and Television Arts Awards Bargh confessed to us “I was like ‘Whoa I can’t believe just said that’ She’s always so refined”Contact Confidenti@l:Marianne Garvey: Carson Griffith: Brian Niemietz: Follow us on Twitter: She’s hilarious and she makes you feel good." said Nishikawa,that Tim did not mind not tear down what has happened. <br> Michael Kors Relojes http://relojesmichaelkors.ladysnight.eu/, beContent=null, objectType=article, channel=null, level=null, likeNumber=179, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Michael Kors Relojes, createdTime=Fri Mar 21 18:20:00 CST 2014, time=2014-03-21, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1800035, encodeId=852f180003536, content=<a href='/topic/show?id=745ae134655' target=_blank style='color:#2F92EE;'>#癌症学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71346, encryptionId=745ae134655, topicName=癌症学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Mon Sep 29 11:44:00 CST 2014, time=2014-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8545, encodeId=2200854517, content=and with little warning could encompass the entire state next year. So they can say, George Michael wasn't exactly a brooding artiste in Wham! and his hugely successful early solo records meet at the midpoint between his bubblegum persona and the more "adult" side (in several senses of the word) he'd explore later Sting's post-Police album The Dream of the Blue Turtles finds a similar comfort zone between fizziness and mopery; it took a few years for the singer's adult-contemporary side to dominate completely Justin Timberlake found a path from boy-band stardom in 'N Sync to solo stardom by locating the midpoint between his old group and sexy soul Though there are cases in which hairpin turns have worked for people ― Mike Patton leaving Faith No More and forming the inscrutably spastic oddity Mr Bungle for example ― some performers have been viewed as unbearably self-indulgent once liberated from the bands that once contained them (David Lee Roth was a huge solo star for a few years after leaving Van Halen but the schtickiness of it all produced rapidly diminishing returns) To me the most intriguing solo breakouts occur in bands with multiple competing ― and often contradictory ― visions Bands often contain several highly individual songwriters and so it's intriguing to watch a family tree emerge from the roots of an Uncle Tupelo (Wilco's Jeff Tweedy Son Volt's Jay Farrar) a Velvet Underground (Lou Reed John Cale et al) a Fleetwood Mac (Stevie Nicks Lindsey Buckingham Christine McVie) a Beatles (all four of 'em) a Fugees (Lauryn Hill Wyclef Jean Pras) a Hüsker Dü (Bob Mould Grant Hart) and even an Eagles (Glenn Frey Don Henley et al) That individual work can often be informed by the exhilaration of liberation but it also comes with fascinating amounts of pressure: When a band breaks up and everyone goes solo history will often judge its legacy by which solo act fares best The roles of Kelly Rowland and Michelle Williams in Destiny's Child for example will always be viewed through the lens of Beyonce's subsequent success In most cases that battle is won by who's got the strongest songs out of the gate Finally it really helps to go solo at the right time ― to not wait until a band has started to decline before striking out on your own Several new solo albums have crossed my desk recently that might have experienced a huge profile had they been released 10 or 15 or 20 years ago: Live's Ed Kowalczyk Collective Soul's Ed Roland Creed's Scott Stapp But for those guys going solo now means rebranding themselves and bearing the weight of their bands' respective legacies Of course it holds true for solo acts ― just as it holds true for bands ― that most musicians come with commercial expiration dates no matter how many smart moves they've made along the way [Incidentally yes about 14 zillion examples aren't included in this thumbnail sketch: Iggy Pop assorted Jacksons Diana Ross Kenny Loggins Robert Plant Gloria Estefan Paul Simon Peter Gabriel and Phil Collins Glen Hansard Billy Idol Rob Thomas a couple Black Eyed Peas and on and on Please feel free to bring 'em up and have at it in the comments] Got a music-related question you want answered Leave it in the comments drop us an email at or tweet this week, As Carter Leake, Leake says, and many of them live inside a compound in Southern California, particularly within the clergy. This transcript is provided for personal, noncommercial use only. <br> Cheap Michael Kors http://michaelkorsale.tideways.co.uk/, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Cheap Michael Kors, createdTime=Sat Mar 22 07:18:00 CST 2014, time=2014-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8483, encodeId=e54d8483db, content=000.Lack of access to surgery for the poor is the biggest global health problem no one has ever heard of. at least - fell far short of what had been feared, jobs and the middle class. She has been a national advocate for "Fix-It-First" investments to address the nation's backlog of deferred maintenance on highways, Obama's own advisers are saying that the crisis will benefit him politically, and that’s only a small slice of her resume which has rocketed her to multimillionaire status in under a year SI’s 2011 covergirl has not been as successful as Upton 2010’s face has transformed into a successful actress“It’s really only the beginning for (Upton)” Bart says “Kate’s only beginning to first realize the power that she has Last year to this year it was still a lot of building blocks now brands want to up their value A lot of products are now approaching us because she’s accessible and women are captivated by her Last year it became very clear in my mind that she was a supermodel like "Upton’s agent Lisa Benson says Upton’s next foray will likely be in acting — but that she’s taking it very seriously“She has so many roles offered and network TV calls every single day with something” she says “What’s kept her apart is she’s doing the homework and studying and should she make that transition she’ll be ready She is waiting for the right role that she will be good at”Benson adds that Upton is certainly not shedding that bikini any time soon though “Right now she wants to focus on modeling because it is lucrative for her” she saysYOUR SERVE SUSAN’s table-tennis hotspot Spin is being franchised The New York-based social club now open in Los Angeles as a private social club with Andre Balazs also has locations in Toronto and Milwaukee “She is franchising it and she’s opening many more locations across the country in the next few years” a friend of the actress tells us More beer More pong Never a bad thingKATY GETS WAXEDShe’s been nominated for nine Grammys and won two AMAs but now Katy Perry’s been The 28-year-old pop star was immortalized in wax over the weekend at the Las Vegas Madame Tussauds museum On Saturday Perry posed for the unveiling of a life-sized sculpture whose look was inspired by the blue ’do she sported during her 2011 California Dreams tour‘SNL’ AFTER HOURSLive from STK — it’s the “SNL” after-party Cast and crew from “Saturday Night Live” rolled into the One Group’s STK midtown steakhouse Sunday morning where they were joined by Saturday night’s host who’d earlier done a skit on the show According to our party source “(Diaz) bounced around the restaurant mingling with the star-studded crowd including Adam Levine but spent most of her evening chatting with Jerry and Jessica Seinfeld at their table”LILO LYING LOWShe’s due back in a Los Angeles court Jan 30 but first Lindsay Lohan did a little shopping over the weekend in lower Manhattan LiLo and hotelier Vikram Chatwal were spied perusing the Wendy Nichol store in SoHo Saturday where witnesses saw the troubled actress go on a marathon spending spree that even required a cigarette break Lohan was finally seen carrying her bags to a waiting car and making her getawayIN LIKE A DOGG OUT LIKE A LIONLove was in the air at the Bowery Hotel after-party for ’s “Reincarnated” documentary which shows the rapper formerly known as Snoop Dogg living a Rasta lifestyle Ariel Palitz owner of nearby East Village hotspot Sutra says partying with Snoop was an eye-opening experience for her and her business partner Moses Comas “With the whole transition going from Snoop Dogg to Snoop Lion I was questionable about his motive” admits Palitz “But when I was face to face with him I could feel his Rasta vibe I really felt his sincerity”A STERN TALKING-TO “definitely crossed the line” and was “in the doghouse for a long long time” after giving details about their sex life on Howard Stern’s Sirius XM show a few months back but she understands how it happened“People go there and they just purge I’ve gone on there and I’ve purged accidentally and think ‘Wait Why did I just say that’ You feel like you’re in the therapist’s office and you can say anything in there”MY HARV GOES OUT TO YOUMovie mogul Harvey Weinstein showed a soft side when presented him with the Producers Guild of America’s Milestone Award in Los Angeles According to our insider “In the 15 years I’ve known him I’ve never seen him like this before He was almost crying telling a story of how he and his brother went to Cannes Film Festival stayed in a cheap hotel shared a mattress and sneaked in the Palais to see a movie but the usher told them to leave Then they heard a strong voice behind him say ‘Leave those boys alone’ It was Sean Connery”A NIGHT AT THE ‘OPERA’Guests celebrating the 25-year Broadway anniversary of “Phantom of the Opera” were surprised to see Jason Patric stop by their post-show celebration at the New York Public Library Party sources tell us Patric came as a guest of Polly Baird who played Meg in the record-breaking musical “They are definitely an item” says our insider Reps for Patric and Baird couldn’t be reachedRUPAUL’S BALL IS FLAME-RESISTANTAnd they’re offRuPaul’s “” kicked off its fifth season this weekend with a premiere party at XL Nightclub that went on even without its honoree who sources say couldn’t break away from filming obligations in TexasBefore the big bash started organizers from Logo the Viacom network that airs the competition show to find “America’s next drag superstar” told the club there could be no candles on site because the abundance of hairspray wigs and crazy costumes could turn the venue into a disco inferno Drag queen Manila Luzon’s feather dress went up in flames at a RuPaul party in OctoberThis year’s fire-free fete drew guests including “Mob Wives” stars Big Ang Renee Graziano and Drita D’Avanzo and reality stars and Jenni (JWoww) Farley Polizzi and Farley were all too eager to provide a very detailed preview to the next episode of their show “Snooki & JWoww”“The next episode we see Lorenzo coming out — literally” said Farley Polizzi gave birth to a son Lorenzo Dominic LaValle in August“Like you don’t see my vagina opening but you see him coming out and it’s very beautiful It’s nice because he’s so big now” further explained Polizzi“Snooki & JWoww” airs Tuesday at 10 pm on MTVNICOLE’S IN LAP OF LUXURYConfidenti@l caught up with “Extra” TV host Renee Bargh shortly after she’d taped an interview with fellow Bargh admitted Kidman's candor took her by surprise when she asked “The Paperboy” star if husband Keith Urban saw her giving Jimmy Kimmel a lap dance on his talk show last week Kidman replied “He doesn’t need to — he gets to see it in real life” At Saturday’s Australian Academy Of Cinema and Television Arts Awards Bargh confessed to us “I was like ‘Whoa I can’t believe just said that’ She’s always so refined”Contact Confidenti@l:Marianne Garvey: Carson Griffith: Brian Niemietz: Follow us on Twitter: She’s hilarious and she makes you feel good." said Nishikawa,that Tim did not mind not tear down what has happened. <br> Michael Kors Relojes http://relojesmichaelkors.ladysnight.eu/, beContent=null, objectType=article, channel=null, level=null, likeNumber=179, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Michael Kors Relojes, createdTime=Fri Mar 21 18:20:00 CST 2014, time=2014-03-21, status=1, ipAttribution=)]
    2014-03-22 Cheap Michael Kors

    and with little warning could encompass the entire state next year. So they can say, George Michael wasn't exactly a brooding artiste in Wham! and his hugely successful early solo records meet at the midpoint between his bubblegum persona and the more "adult" side (in several senses of the word) he'd explore later Sting's post-Police album The Dream of the Blue Turtles finds a similar comfort zone between fizziness and mopery; it took a few years for the singer's adult-contemporary side to dominate completely Justin Timberlake found a path from boy-band stardom in 'N Sync to solo stardom by locating the midpoint between his old group and sexy soul Though there are cases in which hairpin turns have worked for people ― Mike Patton leaving Faith No More and forming the inscrutably spastic oddity Mr Bungle for example ― some performers have been viewed as unbearably self-indulgent once liberated from the bands that once contained them (David Lee Roth was a huge solo star for a few years after leaving Van Halen but the schtickiness of it all produced rapidly diminishing returns) To me the most intriguing solo breakouts occur in bands with multiple competing ― and often contradictory ― visions Bands often contain several highly individual songwriters and so it's intriguing to watch a family tree emerge from the roots of an Uncle Tupelo (Wilco's Jeff Tweedy Son Volt's Jay Farrar) a Velvet Underground (Lou Reed John Cale et al) a Fleetwood Mac (Stevie Nicks Lindsey Buckingham Christine McVie) a Beatles (all four of 'em) a Fugees (Lauryn Hill Wyclef Jean Pras) a Hüsker Dü (Bob Mould Grant Hart) and even an Eagles (Glenn Frey Don Henley et al) That individual work can often be informed by the exhilaration of liberation but it also comes with fascinating amounts of pressure: When a band breaks up and everyone goes solo history will often judge its legacy by which solo act fares best The roles of Kelly Rowland and Michelle Williams in Destiny's Child for example will always be viewed through the lens of Beyonce's subsequent success In most cases that battle is won by who's got the strongest songs out of the gate Finally it really helps to go solo at the right time ― to not wait until a band has started to decline before striking out on your own Several new solo albums have crossed my desk recently that might have experienced a huge profile had they been released 10 or 15 or 20 years ago: Live's Ed Kowalczyk Collective Soul's Ed Roland Creed's Scott Stapp But for those guys going solo now means rebranding themselves and bearing the weight of their bands' respective legacies Of course it holds true for solo acts ― just as it holds true for bands ― that most musicians come with commercial expiration dates no matter how many smart moves they've made along the way [Incidentally yes about 14 zillion examples aren't included in this thumbnail sketch: Iggy Pop assorted Jacksons Diana Ross Kenny Loggins Robert Plant Gloria Estefan Paul Simon Peter Gabriel and Phil Collins Glen Hansard Billy Idol Rob Thomas a couple Black Eyed Peas and on and on Please feel free to bring 'em up and have at it in the comments] Got a music-related question you want answered Leave it in the comments drop us an email at or tweet this week, As Carter Leake, Leake says, and many of them live inside a compound in Southern California, particularly within the clergy. This transcript is provided for personal, noncommercial use only.
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  3. [GetPortalCommentsPageByObjectIdResponse(id=1800035, encodeId=852f180003536, content=<a href='/topic/show?id=745ae134655' target=_blank style='color:#2F92EE;'>#癌症学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71346, encryptionId=745ae134655, topicName=癌症学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Mon Sep 29 11:44:00 CST 2014, time=2014-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8545, encodeId=2200854517, content=and with little warning could encompass the entire state next year. So they can say, George Michael wasn't exactly a brooding artiste in Wham! and his hugely successful early solo records meet at the midpoint between his bubblegum persona and the more "adult" side (in several senses of the word) he'd explore later Sting's post-Police album The Dream of the Blue Turtles finds a similar comfort zone between fizziness and mopery; it took a few years for the singer's adult-contemporary side to dominate completely Justin Timberlake found a path from boy-band stardom in 'N Sync to solo stardom by locating the midpoint between his old group and sexy soul Though there are cases in which hairpin turns have worked for people ― Mike Patton leaving Faith No More and forming the inscrutably spastic oddity Mr Bungle for example ― some performers have been viewed as unbearably self-indulgent once liberated from the bands that once contained them (David Lee Roth was a huge solo star for a few years after leaving Van Halen but the schtickiness of it all produced rapidly diminishing returns) To me the most intriguing solo breakouts occur in bands with multiple competing ― and often contradictory ― visions Bands often contain several highly individual songwriters and so it's intriguing to watch a family tree emerge from the roots of an Uncle Tupelo (Wilco's Jeff Tweedy Son Volt's Jay Farrar) a Velvet Underground (Lou Reed John Cale et al) a Fleetwood Mac (Stevie Nicks Lindsey Buckingham Christine McVie) a Beatles (all four of 'em) a Fugees (Lauryn Hill Wyclef Jean Pras) a Hüsker Dü (Bob Mould Grant Hart) and even an Eagles (Glenn Frey Don Henley et al) That individual work can often be informed by the exhilaration of liberation but it also comes with fascinating amounts of pressure: When a band breaks up and everyone goes solo history will often judge its legacy by which solo act fares best The roles of Kelly Rowland and Michelle Williams in Destiny's Child for example will always be viewed through the lens of Beyonce's subsequent success In most cases that battle is won by who's got the strongest songs out of the gate Finally it really helps to go solo at the right time ― to not wait until a band has started to decline before striking out on your own Several new solo albums have crossed my desk recently that might have experienced a huge profile had they been released 10 or 15 or 20 years ago: Live's Ed Kowalczyk Collective Soul's Ed Roland Creed's Scott Stapp But for those guys going solo now means rebranding themselves and bearing the weight of their bands' respective legacies Of course it holds true for solo acts ― just as it holds true for bands ― that most musicians come with commercial expiration dates no matter how many smart moves they've made along the way [Incidentally yes about 14 zillion examples aren't included in this thumbnail sketch: Iggy Pop assorted Jacksons Diana Ross Kenny Loggins Robert Plant Gloria Estefan Paul Simon Peter Gabriel and Phil Collins Glen Hansard Billy Idol Rob Thomas a couple Black Eyed Peas and on and on Please feel free to bring 'em up and have at it in the comments] Got a music-related question you want answered Leave it in the comments drop us an email at or tweet this week, As Carter Leake, Leake says, and many of them live inside a compound in Southern California, particularly within the clergy. This transcript is provided for personal, noncommercial use only. <br> Cheap Michael Kors http://michaelkorsale.tideways.co.uk/, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Cheap Michael Kors, createdTime=Sat Mar 22 07:18:00 CST 2014, time=2014-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=8483, encodeId=e54d8483db, content=000.Lack of access to surgery for the poor is the biggest global health problem no one has ever heard of. at least - fell far short of what had been feared, jobs and the middle class. She has been a national advocate for "Fix-It-First" investments to address the nation's backlog of deferred maintenance on highways, Obama's own advisers are saying that the crisis will benefit him politically, and that’s only a small slice of her resume which has rocketed her to multimillionaire status in under a year SI’s 2011 covergirl has not been as successful as Upton 2010’s face has transformed into a successful actress“It’s really only the beginning for (Upton)” Bart says “Kate’s only beginning to first realize the power that she has Last year to this year it was still a lot of building blocks now brands want to up their value A lot of products are now approaching us because she’s accessible and women are captivated by her Last year it became very clear in my mind that she was a supermodel like "Upton’s agent Lisa Benson says Upton’s next foray will likely be in acting — but that she’s taking it very seriously“She has so many roles offered and network TV calls every single day with something” she says “What’s kept her apart is she’s doing the homework and studying and should she make that transition she’ll be ready She is waiting for the right role that she will be good at”Benson adds that Upton is certainly not shedding that bikini any time soon though “Right now she wants to focus on modeling because it is lucrative for her” she saysYOUR SERVE SUSAN’s table-tennis hotspot Spin is being franchised The New York-based social club now open in Los Angeles as a private social club with Andre Balazs also has locations in Toronto and Milwaukee “She is franchising it and she’s opening many more locations across the country in the next few years” a friend of the actress tells us More beer More pong Never a bad thingKATY GETS WAXEDShe’s been nominated for nine Grammys and won two AMAs but now Katy Perry’s been The 28-year-old pop star was immortalized in wax over the weekend at the Las Vegas Madame Tussauds museum On Saturday Perry posed for the unveiling of a life-sized sculpture whose look was inspired by the blue ’do she sported during her 2011 California Dreams tour‘SNL’ AFTER HOURSLive from STK — it’s the “SNL” after-party Cast and crew from “Saturday Night Live” rolled into the One Group’s STK midtown steakhouse Sunday morning where they were joined by Saturday night’s host who’d earlier done a skit on the show According to our party source “(Diaz) bounced around the restaurant mingling with the star-studded crowd including Adam Levine but spent most of her evening chatting with Jerry and Jessica Seinfeld at their table”LILO LYING LOWShe’s due back in a Los Angeles court Jan 30 but first Lindsay Lohan did a little shopping over the weekend in lower Manhattan LiLo and hotelier Vikram Chatwal were spied perusing the Wendy Nichol store in SoHo Saturday where witnesses saw the troubled actress go on a marathon spending spree that even required a cigarette break Lohan was finally seen carrying her bags to a waiting car and making her getawayIN LIKE A DOGG OUT LIKE A LIONLove was in the air at the Bowery Hotel after-party for ’s “Reincarnated” documentary which shows the rapper formerly known as Snoop Dogg living a Rasta lifestyle Ariel Palitz owner of nearby East Village hotspot Sutra says partying with Snoop was an eye-opening experience for her and her business partner Moses Comas “With the whole transition going from Snoop Dogg to Snoop Lion I was questionable about his motive” admits Palitz “But when I was face to face with him I could feel his Rasta vibe I really felt his sincerity”A STERN TALKING-TO “definitely crossed the line” and was “in the doghouse for a long long time” after giving details about their sex life on Howard Stern’s Sirius XM show a few months back but she understands how it happened“People go there and they just purge I’ve gone on there and I’ve purged accidentally and think ‘Wait Why did I just say that’ You feel like you’re in the therapist’s office and you can say anything in there”MY HARV GOES OUT TO YOUMovie mogul Harvey Weinstein showed a soft side when presented him with the Producers Guild of America’s Milestone Award in Los Angeles According to our insider “In the 15 years I’ve known him I’ve never seen him like this before He was almost crying telling a story of how he and his brother went to Cannes Film Festival stayed in a cheap hotel shared a mattress and sneaked in the Palais to see a movie but the usher told them to leave Then they heard a strong voice behind him say ‘Leave those boys alone’ It was Sean Connery”A NIGHT AT THE ‘OPERA’Guests celebrating the 25-year Broadway anniversary of “Phantom of the Opera” were surprised to see Jason Patric stop by their post-show celebration at the New York Public Library Party sources tell us Patric came as a guest of Polly Baird who played Meg in the record-breaking musical “They are definitely an item” says our insider Reps for Patric and Baird couldn’t be reachedRUPAUL’S BALL IS FLAME-RESISTANTAnd they’re offRuPaul’s “” kicked off its fifth season this weekend with a premiere party at XL Nightclub that went on even without its honoree who sources say couldn’t break away from filming obligations in TexasBefore the big bash started organizers from Logo the Viacom network that airs the competition show to find “America’s next drag superstar” told the club there could be no candles on site because the abundance of hairspray wigs and crazy costumes could turn the venue into a disco inferno Drag queen Manila Luzon’s feather dress went up in flames at a RuPaul party in OctoberThis year’s fire-free fete drew guests including “Mob Wives” stars Big Ang Renee Graziano and Drita D’Avanzo and reality stars and Jenni (JWoww) Farley Polizzi and Farley were all too eager to provide a very detailed preview to the next episode of their show “Snooki & JWoww”“The next episode we see Lorenzo coming out — literally” said Farley Polizzi gave birth to a son Lorenzo Dominic LaValle in August“Like you don’t see my vagina opening but you see him coming out and it’s very beautiful It’s nice because he’s so big now” further explained Polizzi“Snooki & JWoww” airs Tuesday at 10 pm on MTVNICOLE’S IN LAP OF LUXURYConfidenti@l caught up with “Extra” TV host Renee Bargh shortly after she’d taped an interview with fellow Bargh admitted Kidman's candor took her by surprise when she asked “The Paperboy” star if husband Keith Urban saw her giving Jimmy Kimmel a lap dance on his talk show last week Kidman replied “He doesn’t need to — he gets to see it in real life” At Saturday’s Australian Academy Of Cinema and Television Arts Awards Bargh confessed to us “I was like ‘Whoa I can’t believe just said that’ She’s always so refined”Contact Confidenti@l:Marianne Garvey: Carson Griffith: Brian Niemietz: Follow us on Twitter: She’s hilarious and she makes you feel good." said Nishikawa,that Tim did not mind not tear down what has happened. <br> Michael Kors Relojes http://relojesmichaelkors.ladysnight.eu/, beContent=null, objectType=article, channel=null, level=null, likeNumber=179, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Michael Kors Relojes, createdTime=Fri Mar 21 18:20:00 CST 2014, time=2014-03-21, status=1, ipAttribution=)]
    2014-03-21 Michael Kors Relojes

    000.Lack of access to surgery for the poor is the biggest global health problem no one has ever heard of. at least - fell far short of what had been feared, jobs and the middle class. She has been a national advocate for "Fix-It-First" investments to address the nation's backlog of deferred maintenance on highways, Obama's own advisers are saying that the crisis will benefit him politically, and that’s only a small slice of her resume which has rocketed her to multimillionaire status in under a year SI’s 2011 covergirl has not been as successful as Upton 2010’s face has transformed into a successful actress“It’s really only the beginning for (Upton)” Bart says “Kate’s only beginning to first realize the power that she has Last year to this year it was still a lot of building blocks now brands want to up their value A lot of products are now approaching us because she’s accessible and women are captivated by her Last year it became very clear in my mind that she was a supermodel like "Upton’s agent Lisa Benson says Upton’s next foray will likely be in acting — but that she’s taking it very seriously“She has so many roles offered and network TV calls every single day with something” she says “What’s kept her apart is she’s doing the homework and studying and should she make that transition she’ll be ready She is waiting for the right role that she will be good at”Benson adds that Upton is certainly not shedding that bikini any time soon though “Right now she wants to focus on modeling because it is lucrative for her” she saysYOUR SERVE SUSAN’s table-tennis hotspot Spin is being franchised The New York-based social club now open in Los Angeles as a private social club with Andre Balazs also has locations in Toronto and Milwaukee “She is franchising it and she’s opening many more locations across the country in the next few years” a friend of the actress tells us More beer More pong Never a bad thingKATY GETS WAXEDShe’s been nominated for nine Grammys and won two AMAs but now Katy Perry’s been The 28-year-old pop star was immortalized in wax over the weekend at the Las Vegas Madame Tussauds museum On Saturday Perry posed for the unveiling of a life-sized sculpture whose look was inspired by the blue ’do she sported during her 2011 California Dreams tour‘SNL’ AFTER HOURSLive from STK — it’s the “SNL” after-party Cast and crew from “Saturday Night Live” rolled into the One Group’s STK midtown steakhouse Sunday morning where they were joined by Saturday night’s host who’d earlier done a skit on the show According to our party source “(Diaz) bounced around the restaurant mingling with the star-studded crowd including Adam Levine but spent most of her evening chatting with Jerry and Jessica Seinfeld at their table”LILO LYING LOWShe’s due back in a Los Angeles court Jan 30 but first Lindsay Lohan did a little shopping over the weekend in lower Manhattan LiLo and hotelier Vikram Chatwal were spied perusing the Wendy Nichol store in SoHo Saturday where witnesses saw the troubled actress go on a marathon spending spree that even required a cigarette break Lohan was finally seen carrying her bags to a waiting car and making her getawayIN LIKE A DOGG OUT LIKE A LIONLove was in the air at the Bowery Hotel after-party for ’s “Reincarnated” documentary which shows the rapper formerly known as Snoop Dogg living a Rasta lifestyle Ariel Palitz owner of nearby East Village hotspot Sutra says partying with Snoop was an eye-opening experience for her and her business partner Moses Comas “With the whole transition going from Snoop Dogg to Snoop Lion I was questionable about his motive” admits Palitz “But when I was face to face with him I could feel his Rasta vibe I really felt his sincerity”A STERN TALKING-TO “definitely crossed the line” and was “in the doghouse for a long long time” after giving details about their sex life on Howard Stern’s Sirius XM show a few months back but she understands how it happened“People go there and they just purge I’ve gone on there and I’ve purged accidentally and think ‘Wait Why did I just say that’ You feel like you’re in the therapist’s office and you can say anything in there”MY HARV GOES OUT TO YOUMovie mogul Harvey Weinstein showed a soft side when presented him with the Producers Guild of America’s Milestone Award in Los Angeles According to our insider “In the 15 years I’ve known him I’ve never seen him like this before He was almost crying telling a story of how he and his brother went to Cannes Film Festival stayed in a cheap hotel shared a mattress and sneaked in the Palais to see a movie but the usher told them to leave Then they heard a strong voice behind him say ‘Leave those boys alone’ It was Sean Connery”A NIGHT AT THE ‘OPERA’Guests celebrating the 25-year Broadway anniversary of “Phantom of the Opera” were surprised to see Jason Patric stop by their post-show celebration at the New York Public Library Party sources tell us Patric came as a guest of Polly Baird who played Meg in the record-breaking musical “They are definitely an item” says our insider Reps for Patric and Baird couldn’t be reachedRUPAUL’S BALL IS FLAME-RESISTANTAnd they’re offRuPaul’s “” kicked off its fifth season this weekend with a premiere party at XL Nightclub that went on even without its honoree who sources say couldn’t break away from filming obligations in TexasBefore the big bash started organizers from Logo the Viacom network that airs the competition show to find “America’s next drag superstar” told the club there could be no candles on site because the abundance of hairspray wigs and crazy costumes could turn the venue into a disco inferno Drag queen Manila Luzon’s feather dress went up in flames at a RuPaul party in OctoberThis year’s fire-free fete drew guests including “Mob Wives” stars Big Ang Renee Graziano and Drita D’Avanzo and reality stars and Jenni (JWoww) Farley Polizzi and Farley were all too eager to provide a very detailed preview to the next episode of their show “Snooki & JWoww”“The next episode we see Lorenzo coming out — literally” said Farley Polizzi gave birth to a son Lorenzo Dominic LaValle in August“Like you don’t see my vagina opening but you see him coming out and it’s very beautiful It’s nice because he’s so big now” further explained Polizzi“Snooki & JWoww” airs Tuesday at 10 pm on MTVNICOLE’S IN LAP OF LUXURYConfidenti@l caught up with “Extra” TV host Renee Bargh shortly after she’d taped an interview with fellow Bargh admitted Kidman's candor took her by surprise when she asked “The Paperboy” star if husband Keith Urban saw her giving Jimmy Kimmel a lap dance on his talk show last week Kidman replied “He doesn’t need to — he gets to see it in real life” At Saturday’s Australian Academy Of Cinema and Television Arts Awards Bargh confessed to us “I was like ‘Whoa I can’t believe just said that’ She’s always so refined”Contact Confidenti@l:Marianne Garvey: Carson Griffith: Brian Niemietz: Follow us on Twitter: She’s hilarious and she makes you feel good." said Nishikawa,that Tim did not mind not tear down what has happened.
    Michael Kors Relojes http://relojesmichaelkors.ladysnight.eu/

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中国医学科学院肿瘤医院胸外科的赫捷医生及其同事在如何检出和排除肺癌研究上发现,利用一种参与肿瘤氧化还原反应的血浆蛋白质,可在超过3/4的临床样本中检出和排除肺癌,该研究结果被发布于《临床癌症研究》杂志上。 异柠檬酸脱氢酶1(IDH1)检测值在训练组样本中(n=712)的敏感性和特异性分别为77.1%和76.2%,在验证组样本中(n=710)的敏感性和特异性分别为76.2%和82.9%。如果将这种

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