正古代，北方的人要吃南方的水 果，差不多是异想天开。比如荔枝，就吃出个中国历史大名人——杨贵妃，因为傍了当时世界最强国家的统治者，动用国防力量来运送才吃上口。香蕉的情形大抵也 如此，即使是历史向前推30年，在中国的许多地方，香蕉也还是稀罕物，是"高档水果"的代表。而现在，不分地域，不分时令，香蕉走进了寻常百姓的日常生 活。在美国它甚至是最廉价的水果。这一切，除了现代物流的发达，最根本原因就是人们掌握了香蕉成熟的密码——要它什么时候成熟，它就会什么时候成熟。香蕉 等各种水果成熟的钥匙，是一种叫乙烯的气体。随着香蕉的长大，释放的乙烯越来越多。这些乙烯

OBJECTIVE： To evaluate the efficacy and toxicity of methotrexate (MTX) monotherapy compared with MTX combination with non-biological disease-modifying antirheumatic drugs (DMARDs) in adults with rheumatoid arthritis. METHOD： A systematic review of randomised trials comparing MTX alone and in combination with other non-biological DMARDs was carried out. Trials were identified in Medline， EMBASE， the Cochrane Library and ACR/EULAR meeting abstracts. Primary outcomes were withdrawals for adverse events or lack of efficacy. RESULTS： A total of 19 trials (2025 patients) from 6938 citations were grouped by the type of patients randomised. Trials in DMARD naive patients showed no significant advantage of the MTX combination versus monotherapy; withdrawals for lack of efficacy or toxicity were similar in both groups (relative risk (RR) = 1.16; 95% CI 0.70 to 1.93). Trials in MTX or non-MTX DMARD inadequate responder patients also showed no difference in withdrawal rates between the MTX combo versus mono groups (RR = 0.86; 95% CI 0.49 to 1.51 and RR = 0.75; 95% CI 0.41 to 1.35)， but in one study the specific combination of MTX with sulfasalazine and hydroxychloroquine showed a better efficacy/toxicity ratio than MTX alone with RR = 0.3 (95% CI 0.14 to 0.65). Adding leflunomide to MTX non-responders improved efficacy but increased the risk of gastrointestinal side effects and liver toxicity. Withdrawals for toxicity were most significant with ciclosporin and azathioprine combinations. CONCLUSION： In DMARD naive patients the balance of efficacy/toxicity favours MTX monotherapy. In DMARD inadequate responders the evidence is inconclusive. Trials are needed that compare currently used MTX doses and combination therapies.

TRAF4 is an adapter protein overexpressed in certain cancers， but its contributions to tumorigenesis are unclear. In lung cancer cells and primary lung tumors， we found that TRAF4 is overexpressed. RNA interference-mediated attenuation of TRAF4 expression blunted the malignant phenotype in this setting， exerting inhibitory effects on cell proliferation， anchorage-independent growth， and tumor development in a xenograft mouse model. Unexpectedly， we discovered that TRAF4， but not Skp2， was required for activation of the pivotal cell survival kinase Akt through ubiquitination. Furthermore， TRAF4 attenuation impaired glucose metabolism by inhibiting expression of Glut1 and HK2 mediated by the Akt pathway. Overall， our work suggests that TRAF4 offers a candidate molecular target for lung cancer prevention and therapy. Cancer Res; 73(23); 6938-50. ©2013 AACR.

摘 要： 小时候常听父母说，要做个听话的好孩子。当子女长大，父母变老，为人子女也希望年迈的父母做个听话的老人，享享清福。然而，许多老人的执拗、倔强、不听劝说，甚至偏执逆反，常常使子女和父母之间出现争执，给双方添上许多焦虑和烦恼。为何老人会变得执拗呢？

ABSTRACT To evaluate the efficacy and toxicity of methotrexate (MTX) monotherapy compared with MTX combination with non-biological disease-modifying antirheumatic drugs (DMARDs) in adults with rheumatoid arthritis. A systematic review of randomised trials comparing MTX alone and in combination with other non-biological DMARDs was carried out. Trials were identified in Medline， EMBASE， the Cochrane Library and ACR/EULAR meeting abstracts. Primary outcomes were withdrawals for adverse events or lack of efficacy. A total of 19 trials (2025 patients) from 6938 citations were grouped by the type of patients randomised. Trials in DMARD naive patients showed no significant advantage of the MTX combination versus monotherapy; withdrawals for lack of efficacy or toxicity were similar in both groups (relative risk (RR) = 1.16; 95% CI 0.70 to 1.93). Trials in MTX or non-MTX DMARD inadequate responder patients also showed no difference in withdrawal rates between the MTX combo versus mono groups (RR = 0.86; 95% CI 0.49 to 1.51 and RR = 0.75; 95% CI 0.41 to 1.35)， but in one study the specific combination of MTX with sulfasalazine and hydroxychloroquine showed a better efficacy/toxicity ratio than MTX alone with RR = 0.3 (95% CI 0.14 to 0.65). Adding leflunomide to MTX non-responders improved efficacy but increased the risk of gastrointestinal side effects and liver toxicity. Withdrawals for toxicity were most significant with ciclosporin and azathioprine combinations. In DMARD naive patients the balance of efficacy/toxicity favours MTX monotherapy. In DMARD inadequate responders the evidence is inconclusive. Trials are needed that compare currently used MTX doses and combination therapies.

违法伤医现象在全国范围内普遍存在，到目前为止还没能有效遏制。有效解决这一矛盾的重要前提之一是我们如何在医患矛盾中正确处理宽容与纵容的辩证关系。对患者的一些怨气，牢骚，难听话，不耐烦，甚至带个别脏字我们可以宽容，但对违法伤害医务工作者人身安全、违法破坏公共秩序的行为决不可纵容，只有这样才能切实做到依法治国，从制度上保障医患双方的权益，构建真正和谐的医患关系。

父母的养育方式，决定了孩子的思维方式。在我们的父母还在为孩子报英语班、奥数班的时候，发展式教育的理念《全脑教养法》已经风靡美国，改变了万千父母的教养方式。美国著名心理学者丹尼尔·西格尔的新作品《全脑教养法》全面阐述了这一教养趋势，情商之父丹尼尔·戈尔曼鼎力推荐。 孩子在该睡觉的时候却站在客厅里乱发脾气，在本该乖乖听话的公共场合突然乱发脾气，无法跟兄弟姐妹或同龄伙伴正常相处，总是有各种莫名其妙的担忧和恐惧——听起来并不陌生吧？养育孩子的路上总是充满挑战。是孩子存心与父母作对吗？不，是他们还未成熟的大脑在操纵着一切。读完《全脑教养法》，你会恍然大悟。 例如，在幼儿阶段，孩子的右脑及其控制的情绪支配着逻辑化的左脑；你只知道大脑分左右，其实还分上下层，“上层大脑”进行决策、平衡情绪，但要在二十多岁才发育成熟——难怪孩子们会时不时地失去控制。通过把这些发现应用到日常育儿实践中，你能把各种情绪爆发、与伙伴争执或不知名的恐惧转化为整合孩子大脑、培育“全脑儿童”的机会。“全脑教养12法”将帮助你培养更加平和、快乐的孩子。

摘 要： 雄黄是一味中药材，《中国药典》2010版（一部）等“国家标准”载注册的6938种中成药制剂中，其含雄黄的制剂有194种，占2.80%;可是雄黄又是一味有害元素砷的硫化物（As2S2），因此，雄黄的质量标准深受人们关注。综述雄黄的主要成分、有效有毒成分及其在储藏、注意、用量、功能与主治等方面的文献资料，对《雄黄》国家标准中质量缺陷的思考。

孩子不停哭闹，说肚子痛，爱跟父母拌嘴，许多父母以为这是子女一时任性，随口一句“别闹”就打发了.殊不知，一些被误认为是小孩耍脾气的表现，可能是儿童抑郁症的症状. 抑郁儿童可能不听话，爱哭闹，假装生病，拒绝上学，缠着父母;抑郁少年则倾向于生闷气，易流泪，爱闯祸，变得消极、疏离等.而处于生长发育期的孩子，各阶段情绪反应和行为模式均不相同，让家长很难判断，这些表现究竟是正常的“成长的烦恼”，还是忧郁症?

摘 要： 生活中，不少孩子在外面表现乖巧.听话.是个标准的乖乖女，小绅士，有的甚至有点“蔫”；但是到了家却像换了一个人，变得刁蛮.任性，对长辈又喊又叫.这就是俗话所说的“窝里横”。为什么孩子会有这种表现呢？对于“窝里横”宝宝，家长该做些什么呢？