AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to Jun...AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to June 1998,473 patientswith unresectable hepatocellular carcinoma ware divided intotwo groups:216 patients in group A received more than20mL iodized oil during the first TACE treatment;257patients in group B received 5-15mL iodized oil in the sameway.The Child's classification and ICG-R15 for evaluatingthe liver function of the patients ware done before thetreatment.During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil(Lipiodol)ware Epirubicin and Mitomycin.Ingroup A,112 cases received 20-29mL Lipiodol in the firstprocedure,85 cases 30-39mL,19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL.In group B,119 cases received 5-10mL Lipiodol,138 cases received 11-15mL,and the average dose was11.8mL.RESULTS:High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15<20.But thepatients with child grade B or ICG-R15>20 had higher risk ofliver failure after high-dose TACE.More type Ⅱ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients(P<0.01).The resection rate and complete tumornecrosis rate in group A ware higher than those of group B(P<0.05).The 1-,2-,3-year survival rates of group Apatients with Child grade A ware 79.2%,51.8% and 34.9%,respectively,better then those of group B(P<0.001).CONCLUSION:High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and small portal veins of the tumor.High-dose TACE for treatment oflarge and hypervascular hepatocallular carcinoma ispractically acceptable with the better effect than 展开更多
Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an ind...Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for pulmonary embolism （PE）. In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis. Data Sources： We searched the terms ＂chronic obstructive pulmonary disease,＂ ＂＇pulmonary embolism,＂ ＂exacerbations,＂ and ＂＇thromboembolic＂ in PubMed database and collected the results up to April 2018. The language was limited to English. Study Selection： We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review. Results： The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation. Conclusions： According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of h展开更多
Background Post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP） is regarded as one of the worrisome complications of endoscopic retrograde cholangiopancreatography （ERCP）. Results of randomized c...Background Post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP） is regarded as one of the worrisome complications of endoscopic retrograde cholangiopancreatography （ERCP）. Results of randomized controlled trials evaluating the preventive effect of ulinastatin and gabexate mesylate （GM） on PEP are contradictory. The present study was designed to evaluate the prophylactic effect of ulinastatin and GM on PEP with meta-analyses of randomized controlled trials （RCTs）. Methods Five electronic databases were searched for RCTs evaluating the preventive effect of ulinastatin and GM on PEP. Summary effects were assessed with the methods recommended by the Cochrane Collaboration. Results Twelve studies involving 5105 participants were included in our meta-analyses. Administration of ulinastatin decreased the incidence of PEP only at sufficient doses （OR, 0.39; 95% C/, 0.19 to 0.81; P=0.01）. Number needed to treat （NNT） was 6. And administration of ulinastatin also reduced the incidence of post-ERCP hyperamylasemia （PEHA） （OR, 0.40; 95% C/, 0.28 to 0.58; P〈0.000 01）. Slow infusion of high-dose GM was effective for PEP prevention （OR, 0.44; 95% Cl, 0.25 to 0.79; P=0.006）, and rapid infusion of low-dose GM also showed efficacy for PEP prophylaxis （OR, 0.37; 95% C/, 0.20 to 0.69; P=0.002）. NNT was 7 and 6 respectively. However, administration of GM at low doses and by slow infusions was ineffective （OR, 0.99; 95% Cl, 0.64 to 1.55; P=0.98）. Administration of GM had the tendency to reduce PEHA rate, but not to a statistical significance （OR, 0.86; 95% CI, 0.73 to 1.01; P=0.06）. When low-quality studies were excluded, the meta-analysis with two high-quality studies indicated that ulinastatin did not reduce the rate of PEP （OR, 0.63; 95% Cl, 0.32 to 1.26; P=0.19） and PEHA incidence （OR, 0.80; 95% Cl, 0.31 to 2.07; P=0.64）. The meta-analysis with six high-quality studies showed that GM administration decreased PEP incidence （OR, 0.52; 95% CI, 0.29 to 0.91;展开更多
Selective laser melting(SLM)is an emerging layer-wise additive manufacturing technique that can generate complex components with high performance.Particulate-reinforced aluminum matrix composites(PAMCs)are important m...Selective laser melting(SLM)is an emerging layer-wise additive manufacturing technique that can generate complex components with high performance.Particulate-reinforced aluminum matrix composites(PAMCs)are important materials for various applications due to the combined properties of Al matrix and reinforcements.Considering the advantages of SLM technology and PAMCs,the novel SLM PAMCs have been developed and researched in recent years.Therefore,the current research progress about the SLM PAMCs is reviewed.Firstly,special attention is paid to the solidification behavior of SLM PAMCs.Secondly,the important issues about the design and fabrication of high-performance SLM PAMCs,including the selection of reinforcement,the influence of parameters on the processing and microstructure,the defect evolution and phase control,are highlighted and discussed comprehensively.Thirdly,the performance and strengthening mechanism of SLM PAMCs are systematically figured out.Finally,future directions are pointed out on the advancement of high-performance SLM PAMCs.展开更多
Landsat Thematic Mapper （TM） and Enhanced Thematic Mapper Plus （ETM＋） images in 1985, 1986, 1993, 1994 and 2001 were used to quantify the land use and land cover changes （LUCC） in the Zhejiang coastal region wi...Landsat Thematic Mapper （TM） and Enhanced Thematic Mapper Plus （ETM＋） images in 1985, 1986, 1993, 1994 and 2001 were used to quantify the land use and land cover changes （LUCC） in the Zhejiang coastal region with a stratified unsupervised classification technique in conjunction with visual interpretation and to attempt an identification of the socioeconomic driving forces. In level I an overall accurate classification was achieved using a modified Anderson＇s Ⅰ/Ⅱ/Ⅲ-level classification scheme. The overall accuracy of the land use classification at Anderson level Ⅰ were 89.7% （1985）, 91.6% （1993）, and 90.4% （2001）. The most rapid land use change was a dramatic increase in urban or built-up areas, which quadrupled from 1985 to 2001. Over 90% of this newly expanded built-up area was originally paddy fields or other croplands. In different parts of the Zhejiang coastal region, urban land expansion was spatially uneven. Temporally, land use development did not stabilized, and the two study periods of time （1985-1993 and 1993-2001） had different transition styles. Socioeconomic factors, such as gross domestic product, total population, and financial expenditure, were all highly correlated with the expansion of urban or built-up areas. Based on the degree of urban sprawl and socioeconomic factors, cities and towns were further divided into six subgroups, which may help decision makers improve land use for the region.展开更多
AIM:To establish the frequency and clinical features of connective tissue diseases(CTDs)in a cohort of Chinese patients with primary biliary cirrhosis(PBC).METHODS:Three-hundred and twenty-two Chinese PBC patients wer...AIM:To establish the frequency and clinical features of connective tissue diseases(CTDs)in a cohort of Chinese patients with primary biliary cirrhosis(PBC).METHODS:Three-hundred and twenty-two Chinese PBC patients were screened for the presence of CTD,and the systemic involvement was assessed.The differences in clinical features and laboratory findings between PBC patients with and without CTD were documented.The diversity of incidence of CTDs in PBC of different countries and areas was discussed.For the comparison of normally distributed data,Student’s t test was used,while non-parametric test(Wilcoxon test)for the non-normally distributed data and 2×2χ2or Fisher’s exact tests for the ratio.RESULTS:One-hundred and fifty(46.6%)PBC patients had one or more CTDs.The most common CTD was Sj gren’s syndrome(SS,121 cases,36.2%).There were nine cases of systemic sclerosis(SSc,2.8%),12of systemic lupus erythematosus(SLE,3.7%),nine of rheumatoid arthritis(RA,2.8%),and 10 of polymyositis(PM,3.1%)in this cohort.Compared to patients with PBC only,the PBC+SS patients were more likely to have fever and elevated erythrocyte sedimentation rate(ESR),higher serum immunoglobulin G(IgG)levels and more frequent rheumatoid factor(RF)and interstitial lung disease(ILD)incidences;PBC+SSc patients had higher frequency of ILD;PBC+SLE patients had lower white blood cell(WBC)count,hemoglobin(Hb),platelet count,γ-glutamyl transpeptidase and immunoglobulin M levels,but higher frequency of renal involvement;PBC+RA patients had lower Hb,higher serum IgG,alkaline phosphatase,faster ESR and a higher ratio of RF positivity;PBC+PM patients had higher WBC count and a tendency towards myocardial involvement.CONCLUSION:Besides the common liver manifestation of PBC,systemic involvement and overlaps with other CTDs are not infrequent in Chinese patients.When overlapping with other CTDs,PBC patients manifested some special clinical and laboratory features which may have effect on the prognosis.展开更多
Background Percutaneous coronary intervention （PCI） had become the major therapeutic procedure for coronary artery disease （CAD）, but the high rate of in-stent restenosis （ISR） still remained an unsolved clinica...Background Percutaneous coronary intervention （PCI） had become the major therapeutic procedure for coronary artery disease （CAD）, but the high rate of in-stent restenosis （ISR） still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus （DM） was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent （DES）. Methods A total of 920 patients with diabetes who diagnosed CAD and underwent coronary DES implantation at Beijing Anzhen Hospital in China were consecutively enrolled from January 2012 to December 2012. Of these, 440 patients underwent the second angiography within ≥ 6 months due to the progression of treated target lesions. Finally, 368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group （n = 74） and the non-ISR group （n = 294）. The independent predictors of ISR in patients with DM were explored by multivariate Cox＇s proportional hazards regression models. Results A total of 368 patients （260 women and 108 men） with a mean ages of 58.71 ± 10.25 years were finally enrolled in this study. Of these, ISR occurred in 74/368 diabetic patients （20.11%） by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly higher serum very low density lipoprotein cholesterol （VLDL-C）, triglyceride （TG） and uric acid （UA） levels, more numbers of target vessel lesions, higher prevalence of multi-vessel disease, higher SYNTAX score, higher rate of previous but lo展开更多
Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases...Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases.This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications,and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.Methods:Totally 25 patients with stable COPD (COPD group),25 patients with OSA (OSA group),25 patients with OS (OS group),and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital.The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1),tumor necrosis factor-α(TNF-α),and T-lymphocyte subsets were detected.One-way analysis of variance,x^2 test and Pearson correlation were used to manage the data.Results:The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control,OSA,and COPD groups (x^2 =20.69,P < 0.05 and x^2 =11.03,P < 0.05,respectively).The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F =127.40,P < 0.05 and F =846.77,P < 0.05,respectively).The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F =25.40,P < 0.05 and F =75.08,P < 0.05,respectively).There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4^+/CD8^+ lymphocytes (r =-0.77,P < 0.05 and r =-0.83,P < 0.05,respectively).Conclusions:The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone.Patients with OS exhibited more severe vascular endothelial injury,stronger inflammatory response,and lower cellular immune function.展开更多
Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to deter...Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to determine the prevalence and identify the risk factors of TB among elderly people in China.Methods:A multistage cluster-sampled cross-sectional survey was conducted in 2013,and 27 clusters were selected from 10 counties of 10 provinces in China.All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray(CXR)and a symptom questionnaire.Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive.Prevalence was calculated,a multiple logistic regression model was performed to confirm the risk factors,and population attributable fraction(PAF)of each risk factor was calculated to indicate the public health significance.Results:Of 38888 eligible people from 27 clusters,34269 participants finished both questionnaire and physical examination.There were 193 active pulmonary TB cases,62 of which were bacteriologically confirmed.The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100000(95%CI:483.73-642.65)and 180.92 per 100000(95%CI:135.89-225.96),respectively.Male sex,older age,living in rural areas,underweight,diabetes,close contact of pulmonary TB(PTB)and previous TB history are all risk factors for TB.The risk of TB increased with increasing age and decreasing body mass index(BMI)after adjusting for other factors,and there is a positive dose-response relationship.Conclusions:In China,active case finding(ACF)could be implemented among elderly people aged 65 and above with underweight,diabetes,close contact history and previous TB history as a priority,which will get significant yields and be cost-effective.展开更多
Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infecti...Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically diff展开更多
AIM: To investigate whether expression of cancer stem cell (CSC) markers is associated with recurrence and survival in hepatocellular carcinoma (HCC) patients.
Background:China is facing challenges of the shifting presentation of tuberculosis(TB)from younger to elderly due to an ageing population,longer life expectancy and reactivation disease.However,the burden of elderly T...Background:China is facing challenges of the shifting presentation of tuberculosis(TB)from younger to elderly due to an ageing population,longer life expectancy and reactivation disease.However,the burden of elderly TB and influence factors are not yet clear.To fill the gap,we generated a cohort study to measure the magnitude of TB incidence and associated factors among the elderly population aged 65 years and above in China.Methods:In this cohort established in 2013 through a prevalence survey conducted in selected sites,a total of 34076 elderlies without TB were enrolled into two-year follow-up.We used both active and passive case findings to find out all TB patients among them.The person-year(PY)incidence rates for both bacteriologically positive TB and active TB were calculated.Cox proportional regression model was performed to test effect of risk factors,and the population attributable fraction(PAF)of each risk factor contributing to incident TB among elderlies was calculated.Results:Over the two-year follow-up period,a total of 215 incident active TB were identified,62 of which were bacteriologically positive.The incidence rates for active TB and bacteriologically positive TB were 481.8 per 100000 PY(95%CI:417.4–546.2 per 100000 PY)and 138.9 per 100000 PY(95%CI:104.4–173.5 per 100000 PY),respectively.Incident cases detected by active case finding were significantly higher(P<0.001).Male,non-Han nationality,previously treated TB,ex/current smoker and body mass index(BMI)<18.5 presented as independent predictors for developing TB disease.For developing bacteriologically positive TB,the biggest contribution was from self-reported ex or current smoker(18.06%).And,for developing active TB,the biggest contribution was from non-Han nationality(35.40%),followed by male(26.80%)and age at 75 years and above(10.85%).Conclusions:Ageing population in China had a high TB incidence rate and risk to develop TB disease,implying that National TB Program(NTP)needs to prioritize for elderly.Active case finding should be app展开更多
Soybean cyst nematode （SCN; Heterodera glycines） Is one of the most Important pests affecting soybean production. The best method of control of SCN is through the development of resistant cultlvars. However, limited...Soybean cyst nematode （SCN; Heterodera glycines） Is one of the most Important pests affecting soybean production. The best method of control of SCN is through the development of resistant cultlvars. However, limited progress has been made in soybean breeding In China because most modern cultlvars have no resistance to SCN. The distribution and phenotype of 432 immune or highly resistant Chinese accessions were surveyed and a primary core collection was selected as a representative sample for further analyses. Using evenly distributed simple sequence repeat markers, five selection methods were applied to the primary core collection and the optimal method was chosen to establish a core collection, which consisted of 28 accessions. These encompassed 70.8% of the ailelic variation present in the overall resistant collection. The 28 accessions differed from the reference resistant accessions at the genomlc level, Indicating that Chinese resistant accessions are distinct from known resistant accessions. This applied core collection provides a rational framework for undertaking diversity surveys, using genetic variation for the investigation of complex traits and for the discovery of novel traits.展开更多
With the great development of liver transplantation in China, long survival and quality of life after liver transplantation have been matters of growing interest. This study was designed to investigate the impact of p...With the great development of liver transplantation in China, long survival and quality of life after liver transplantation have been matters of growing interest. This study was designed to investigate the impact of personality and coping skills on the quality of life after liver transplantation. METHODS:Fifty-five outpatients who had been followed up after liver transplantation at our center were assessed by general quality of life inventory (GQOLI-74 ), a medical coping modes questionnaire (MCMQ), an eysenck personality questionnaire (EPQ), and a general condition questionnaire (GCQ). RESULTS: The score for material well-being was the lowest (63.22±12.67) and for psychological well-being the highest (73.43±12.60) in 4 dimensions of the GQOLI in post transplantation patients. Their main coping method was confrontation (21.40±3.70). The main characteristics of their personality were extraversation (E score 12.96±4.13) and neuroticism (N score 8.20±4.90) . The total score of the GQOLI was positively correlated with confrontation and E score, and it was negatively correlated with acceptance and N score. The physical well-being positively associated with the E score. The psychological well-being was positively correlated with confrontation and L score, and was negatively correlated with acceptance, P and N score. Social well-being was positively correlated with confrontation and E score, and was negatively correlated with acceptance and N score. Material well-being was not correlated with coping methods and personality. CONCLUSION:The quality of life in post liver transplantation patients is associated with their psychological characteristics.展开更多
Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact ...Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact on the lungs and outcomes of preterm infants.This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI(gestational age[GA]<28 weeks)and ELBWI(birth weight[BW]<1000 g),admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018,were analyzed.The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation(DRI).The secondary outcomes were survival rates,incidence of bronchopulmonary dysplasia(BPD),and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled.The incidence of DRI,chest compressions,and administration of epinephrine was 55.9%(532/952),12.5%(119/952),and 7.0%(67/952),respectively.Multivariate analysis revealed that the risk factors for DRI were GA<28 weeks(odds ratio[OR],3.147;95%confidence interval[CI],2.082–4.755),BW<1000 g(OR,2.240;95%CI,1.606–3.125),and antepartum infection(OR,1.429;95%CI,1.044–1.956).The survival rate was 65.9%(627/952)and was dependent on GA.The rate of BPD was 29.3%(181/627).Multivariate analysis showed that the risk factors for BPD were male(OR,1.603;95% CI,1.061–2.424),DRI(OR,2.094;95% CI,1.328–3.303),respiratory distress syndrome exposed to≥2 doses of pulmonary surfactants(PS;OR,2.700;95%CI,1.679–4.343),and mechanical ventilation≥7 days(OR,4.358;95% CI,2.777–6.837).However,a larger BW(OR,0.998;95% CI,0.996–0.999),antenatal steroid(OR,0.577;95%CI,0.379–0.880),and PS use in the delivery room(OR,0.273;95%CI,0.160–0.467)were preventive factors for BPD(all P<0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.展开更多
Background Macrophage activation syndrome(MAS)is a major cause of morbidity and mortality in pediatric rheumatology.We aimed to further understand the clinical features,treatment,and outcome of MAS in China.Methods A ...Background Macrophage activation syndrome(MAS)is a major cause of morbidity and mortality in pediatric rheumatology.We aimed to further understand the clinical features,treatment,and outcome of MAS in China.Methods A multi-center cohort study was performed in seven hospitals in China from 2012 to 2018.Eighty patients with MAS were enrolled,including 53 cases with systemic juvenile idiopathic arthritis(SJIA-MAS),10 cases of Kawasaki disease(KD-MAS),and 17 cases of connective tissue disease(CTD-MAS).The clinical and laboratory data were collected before(pre-),at onset,and during full-blown stages of MAS.We compared the data among the SJIA-MAS,KD-MAS,and CTD-MAS subjects.Results 51.2%of patients developed MAS when the underlying disease was first diagnosed.In patients with SJIA,22.6%(12/53)were found to have hypotension before the onset of SJIA-MAS.These patients were also found to have significantly increased aspartate aminotransferase(AST)and lactate dehydrogenase(LDH),as well as decreased albumin(P<0.05),but no difference in alanine aminotransferase,ferdtin,and ratio of ferritin/erythrocyte sedimentation rate(ESR)at onset of MAS when compared to pre-MAS stages of the disease.In addition,ferritin and ratio of ferritin/ESR were significantly elevated in patients at full-blown stages of SJIA-MAS compared to pre-MAS stage.Significantly increased ferritin and ratio of ferritin/ESR were also observed in patients with SJIA compared to in KD and CTD.Receiver-operating characteristic analysis showed that 12,217.5μg/L of ferritin and 267.5 of ferritin/ESR ratio had sensitivity(80.0%and 90.5%)and specificity(88.2%and 86.7%),respectively,for predicting full-blown SJIA-MAS.The majority of the patients received corticosteroids(79/80),while biologic agents were used in 12.5%(10/80)of cases.Tocilizumab was the most commonly selected biologic agent.The overall mortality rate was 7.5%.Conclusions About half of MAS occurred when the underlying autoimmune diseases(SJIA,KD,and CTD)were first diagnosed.Hypotension could be an importa展开更多
AIM:To investigate the mRNA expression of cyclooxygensae-2(COX-2)in benign and malignant ascites,and to explore the difference in COX-2 mRNA expression among different diseases.METHODS:A total of 36 samples were colle...AIM:To investigate the mRNA expression of cyclooxygensae-2(COX-2)in benign and malignant ascites,and to explore the difference in COX-2 mRNA expression among different diseases.METHODS:A total of 36 samples were collected from the Fifth Affiliated Hospital of Sun Yat-Sen University and divided into two experimental groups:benign ascites(n=21)and malignant ascites(n=15).Benign ascites included cirrhotic ascites(n=10)and tuberculous ascites(n=5).Malignant ascites included oophoroma(n=7),cancer of colon(n=5),cancer of the liver(n=6),gastric cancer(n=2),and bladder carcinoma(n=1).The mRNA expression of COX-2 in ascites was examined with reverse transcriptase polymerase chain reaction(RT-PCR)technology,and the positive rate of COX-2 mRNA was compared between different diseases.RESULTS:The positive rate of COX-2 mRNA in malignant ascites was 42.9%(9/21),which was significantly higher than in benign ascites,6.7%(1/15),difference being significant between these two groups(χ2=4.051,P=0.044).The proportion of the positive rate in the malignant ascites was as follows:ovarian cancers57.1%(4/7),colon cancer 40.0%(2/5),liver cancer33.3%(2/6),gastric cancer 50.0%(1/2),and bladder cancer 0.00%(0/1).However,there was no significant difference in COX-2 mRNA expression among various tumors with malignant ascites(χ2=1.614,P=0.806).Among the benign ascites,COX-2 mRNA levels were different between the tuberculous ascites(0/5)and cirrhotic ascites(1/10),but there was no significant difference(P=1.000).CONCLUSION:COX-2 mRNA,detected by RT-PCR,is useful in the differential diagnosis of benign and malignant ascites,which also has potential value in the clinical diagnosis of tumors.展开更多
Background： Drug is all important cause of liver injury and accounts for up to 40% of instances offidminant hepatic failure. Drug-induced liver injury （DILl） is increasing while the diagnosis becomes more difficult...Background： Drug is all important cause of liver injury and accounts for up to 40% of instances offidminant hepatic failure. Drug-induced liver injury （DILl） is increasing while the diagnosis becomes more difficult. Though many drugs may cause DILl, Chinese herbal medicines have recently emerged as a major cause due to their extensive use in China. We aimed to provide drug safety information to patients and health carets by analyzing the clinical and pathological characteristics of the DILl and the associated drug types. Methods： A retrospective analysis was conducted in 287 patients diagnosed with DILl enrolled in our hospital from January 2011 to December 2015. The categories of causative drugs, clinical and pathological characteristics were reviewed. Results： Western medicines ranked as the top cause of DILl, accounting for 163 out of the 287 DILl patients （56.79%） in our study. Among the Western medicine, antituberculosis drugs were the highest cause （18.47%, 53 patients） of DILl. Antibiotics （18 patients, 6.27%） and antithyroid （18 patients, 6.27%） drugs also ranked among the major causes of DILl. Chinese herbal medicines are another major cause of DILl, accounting for 36.59% of cases （105 patients）. Most of the causative Chinese herbal medicines were those used to treat osteopathy, arthropathy, dermatosis, gastropathy, leukotrichia, alopecia, and gynecologic diseases. Hepatocellular hepatitis was prevalent in DILl, regardless of Chinese herbal medicine or Western medicine-induced DILI. Conclusions： Risks and the rational use of medicines should be made clear to reduce the occurrence of DILl. For patients with liver injury of unknown origin, liver tissue pathological examination is recommended for further diagnosis.展开更多
Pharmacological, laser scanning confocal microscopic （LSCM）, and spectrophotographic approaches were used to study the roles of hydrogen sulfide （H2S） and nitric oxide （NO） in signaling transduction of stomatal ...Pharmacological, laser scanning confocal microscopic （LSCM）, and spectrophotographic approaches were used to study the roles of hydrogen sulfide （H2S） and nitric oxide （NO） in signaling transduction of stomatal movement in response to ethylene in Viciafaba L. Ethylene treatment resulted in the dose-dependent stomatal closure under light, and this effect was blocked by the inhibitors of H2S biosynthesis in V. faba L. Additionally, ethylene induces H2S generation and increases L-/D-cysteine desulfhydrase （pyridoxalphosphate-dependent enzyme） activity in leaves of V. faba L. Inhibitors of H2S biosynthesis have no effect on the ethylene-induced stomatal closure, NO accumulation, and nitrate reductase （NR） activity in guard cells or leaves of II. faba L. Moreover, the ethylene-induced increase of H2S levels and L-/D- cysteine desulfhydrase activity declined when NO generation was inhibited. Therefore, we conclude that H2S and NO probably are involved in the signal transduction pathway of ethylene-induced stomatal closure. H2S may represent a novel component downstream of NO in the ethylene-induced stomatal movement in V. faba L.展开更多
基金the"9.5"National Major Project of National Committee of Sciences and Technology,No.96-907-03-02
文摘AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to June 1998,473 patientswith unresectable hepatocellular carcinoma ware divided intotwo groups:216 patients in group A received more than20mL iodized oil during the first TACE treatment;257patients in group B received 5-15mL iodized oil in the sameway.The Child's classification and ICG-R15 for evaluatingthe liver function of the patients ware done before thetreatment.During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil(Lipiodol)ware Epirubicin and Mitomycin.Ingroup A,112 cases received 20-29mL Lipiodol in the firstprocedure,85 cases 30-39mL,19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL.In group B,119 cases received 5-10mL Lipiodol,138 cases received 11-15mL,and the average dose was11.8mL.RESULTS:High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15<20.But thepatients with child grade B or ICG-R15>20 had higher risk ofliver failure after high-dose TACE.More type Ⅱ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients(P<0.01).The resection rate and complete tumornecrosis rate in group A ware higher than those of group B(P<0.05).The 1-,2-,3-year survival rates of group Apatients with Child grade A ware 79.2%,51.8% and 34.9%,respectively,better then those of group B(P<0.001).CONCLUSION:High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and small portal veins of the tumor.High-dose TACE for treatment oflarge and hypervascular hepatocallular carcinoma ispractically acceptable with the better effect than
文摘Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for pulmonary embolism （PE）. In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis. Data Sources： We searched the terms ＂chronic obstructive pulmonary disease,＂ ＂＇pulmonary embolism,＂ ＂exacerbations,＂ and ＂＇thromboembolic＂ in PubMed database and collected the results up to April 2018. The language was limited to English. Study Selection： We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review. Results： The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation. Conclusions： According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of h
文摘Background Post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP） is regarded as one of the worrisome complications of endoscopic retrograde cholangiopancreatography （ERCP）. Results of randomized controlled trials evaluating the preventive effect of ulinastatin and gabexate mesylate （GM） on PEP are contradictory. The present study was designed to evaluate the prophylactic effect of ulinastatin and GM on PEP with meta-analyses of randomized controlled trials （RCTs）. Methods Five electronic databases were searched for RCTs evaluating the preventive effect of ulinastatin and GM on PEP. Summary effects were assessed with the methods recommended by the Cochrane Collaboration. Results Twelve studies involving 5105 participants were included in our meta-analyses. Administration of ulinastatin decreased the incidence of PEP only at sufficient doses （OR, 0.39; 95% C/, 0.19 to 0.81; P=0.01）. Number needed to treat （NNT） was 6. And administration of ulinastatin also reduced the incidence of post-ERCP hyperamylasemia （PEHA） （OR, 0.40; 95% C/, 0.28 to 0.58; P〈0.000 01）. Slow infusion of high-dose GM was effective for PEP prevention （OR, 0.44; 95% Cl, 0.25 to 0.79; P=0.006）, and rapid infusion of low-dose GM also showed efficacy for PEP prophylaxis （OR, 0.37; 95% C/, 0.20 to 0.69; P=0.002）. NNT was 7 and 6 respectively. However, administration of GM at low doses and by slow infusions was ineffective （OR, 0.99; 95% Cl, 0.64 to 1.55; P=0.98）. Administration of GM had the tendency to reduce PEHA rate, but not to a statistical significance （OR, 0.86; 95% CI, 0.73 to 1.01; P=0.06）. When low-quality studies were excluded, the meta-analysis with two high-quality studies indicated that ulinastatin did not reduce the rate of PEP （OR, 0.63; 95% Cl, 0.32 to 1.26; P=0.19） and PEHA incidence （OR, 0.80; 95% Cl, 0.31 to 2.07; P=0.64）. The meta-analysis with six high-quality studies showed that GM administration decreased PEP incidence （OR, 0.52; 95% CI, 0.29 to 0.91;
基金Project(GJHZ20190822095418365)supported by Shenzhen International Cooperation Research,ChinaProject(2019011)supported by NTUT-SZU Joint Research Program,China+2 种基金Project(2019040)supported by Natural Science Foundation of Shenzhen University,ChinaProject(JCYJ20190808144009478)supported by Shenzhen Fundamental Research Fund,ChinaProject(ZDYBH201900000008)supported by Shenzhen Bureau of Industry and Information Technology,China。
文摘Selective laser melting(SLM)is an emerging layer-wise additive manufacturing technique that can generate complex components with high performance.Particulate-reinforced aluminum matrix composites(PAMCs)are important materials for various applications due to the combined properties of Al matrix and reinforcements.Considering the advantages of SLM technology and PAMCs,the novel SLM PAMCs have been developed and researched in recent years.Therefore,the current research progress about the SLM PAMCs is reviewed.Firstly,special attention is paid to the solidification behavior of SLM PAMCs.Secondly,the important issues about the design and fabrication of high-performance SLM PAMCs,including the selection of reinforcement,the influence of parameters on the processing and microstructure,the defect evolution and phase control,are highlighted and discussed comprehensively.Thirdly,the performance and strengthening mechanism of SLM PAMCs are systematically figured out.Finally,future directions are pointed out on the advancement of high-performance SLM PAMCs.
文摘Landsat Thematic Mapper （TM） and Enhanced Thematic Mapper Plus （ETM＋） images in 1985, 1986, 1993, 1994 and 2001 were used to quantify the land use and land cover changes （LUCC） in the Zhejiang coastal region with a stratified unsupervised classification technique in conjunction with visual interpretation and to attempt an identification of the socioeconomic driving forces. In level I an overall accurate classification was achieved using a modified Anderson＇s Ⅰ/Ⅱ/Ⅲ-level classification scheme. The overall accuracy of the land use classification at Anderson level Ⅰ were 89.7% （1985）, 91.6% （1993）, and 90.4% （2001）. The most rapid land use change was a dramatic increase in urban or built-up areas, which quadrupled from 1985 to 2001. Over 90% of this newly expanded built-up area was originally paddy fields or other croplands. In different parts of the Zhejiang coastal region, urban land expansion was spatially uneven. Temporally, land use development did not stabilized, and the two study periods of time （1985-1993 and 1993-2001） had different transition styles. Socioeconomic factors, such as gross domestic product, total population, and financial expenditure, were all highly correlated with the expansion of urban or built-up areas. Based on the degree of urban sprawl and socioeconomic factors, cities and towns were further divided into six subgroups, which may help decision makers improve land use for the region.
基金Supported by Grants from the Research Special Fund for Public Welfare Industry of Health,No.201202004the National Major Scientific and Technological Special Project for"Significant New Drugs Development",No.2012ZX09303006-002the National High Technology Research and Development Program of China,No.2011AA020111
文摘AIM:To establish the frequency and clinical features of connective tissue diseases(CTDs)in a cohort of Chinese patients with primary biliary cirrhosis(PBC).METHODS:Three-hundred and twenty-two Chinese PBC patients were screened for the presence of CTD,and the systemic involvement was assessed.The differences in clinical features and laboratory findings between PBC patients with and without CTD were documented.The diversity of incidence of CTDs in PBC of different countries and areas was discussed.For the comparison of normally distributed data,Student’s t test was used,while non-parametric test(Wilcoxon test)for the non-normally distributed data and 2×2χ2or Fisher’s exact tests for the ratio.RESULTS:One-hundred and fifty(46.6%)PBC patients had one or more CTDs.The most common CTD was Sj gren’s syndrome(SS,121 cases,36.2%).There were nine cases of systemic sclerosis(SSc,2.8%),12of systemic lupus erythematosus(SLE,3.7%),nine of rheumatoid arthritis(RA,2.8%),and 10 of polymyositis(PM,3.1%)in this cohort.Compared to patients with PBC only,the PBC+SS patients were more likely to have fever and elevated erythrocyte sedimentation rate(ESR),higher serum immunoglobulin G(IgG)levels and more frequent rheumatoid factor(RF)and interstitial lung disease(ILD)incidences;PBC+SSc patients had higher frequency of ILD;PBC+SLE patients had lower white blood cell(WBC)count,hemoglobin(Hb),platelet count,γ-glutamyl transpeptidase and immunoglobulin M levels,but higher frequency of renal involvement;PBC+RA patients had lower Hb,higher serum IgG,alkaline phosphatase,faster ESR and a higher ratio of RF positivity;PBC+PM patients had higher WBC count and a tendency towards myocardial involvement.CONCLUSION:Besides the common liver manifestation of PBC,systemic involvement and overlaps with other CTDs are not infrequent in Chinese patients.When overlapping with other CTDs,PBC patients manifested some special clinical and laboratory features which may have effect on the prognosis.
文摘Background Percutaneous coronary intervention （PCI） had become the major therapeutic procedure for coronary artery disease （CAD）, but the high rate of in-stent restenosis （ISR） still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus （DM） was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent （DES）. Methods A total of 920 patients with diabetes who diagnosed CAD and underwent coronary DES implantation at Beijing Anzhen Hospital in China were consecutively enrolled from January 2012 to December 2012. Of these, 440 patients underwent the second angiography within ≥ 6 months due to the progression of treated target lesions. Finally, 368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group （n = 74） and the non-ISR group （n = 294）. The independent predictors of ISR in patients with DM were explored by multivariate Cox＇s proportional hazards regression models. Results A total of 368 patients （260 women and 108 men） with a mean ages of 58.71 ± 10.25 years were finally enrolled in this study. Of these, ISR occurred in 74/368 diabetic patients （20.11%） by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly higher serum very low density lipoprotein cholesterol （VLDL-C）, triglyceride （TG） and uric acid （UA） levels, more numbers of target vessel lesions, higher prevalence of multi-vessel disease, higher SYNTAX score, higher rate of previous but lo
基金a grant of the National Natural Science Foundation of China (No. 81670084).
文摘Background:The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS).COPD and OSA both have increased risks of developing cardiovascular diseases.This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications,and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes.Methods:Totally 25 patients with stable COPD (COPD group),25 patients with OSA (OSA group),25 patients with OS (OS group),and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital.The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1),tumor necrosis factor-α(TNF-α),and T-lymphocyte subsets were detected.One-way analysis of variance,x^2 test and Pearson correlation were used to manage the data.Results:The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control,OSA,and COPD groups (x^2 =20.69,P < 0.05 and x^2 =11.03,P < 0.05,respectively).The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F =127.40,P < 0.05 and F =846.77,P < 0.05,respectively).The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F =25.40,P < 0.05 and F =75.08,P < 0.05,respectively).There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4^+/CD8^+ lymphocytes (r =-0.77,P < 0.05 and r =-0.83,P < 0.05,respectively).Conclusions:The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone.Patients with OS exhibited more severe vascular endothelial injury,stronger inflammatory response,and lower cellular immune function.
基金The National Twelfth Five-year Mega-Scientific Projects of Infectious Diseases in China(Grant No:2013ZX10003004-001).
文摘Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to determine the prevalence and identify the risk factors of TB among elderly people in China.Methods:A multistage cluster-sampled cross-sectional survey was conducted in 2013,and 27 clusters were selected from 10 counties of 10 provinces in China.All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray(CXR)and a symptom questionnaire.Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive.Prevalence was calculated,a multiple logistic regression model was performed to confirm the risk factors,and population attributable fraction(PAF)of each risk factor was calculated to indicate the public health significance.Results:Of 38888 eligible people from 27 clusters,34269 participants finished both questionnaire and physical examination.There were 193 active pulmonary TB cases,62 of which were bacteriologically confirmed.The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100000(95%CI:483.73-642.65)and 180.92 per 100000(95%CI:135.89-225.96),respectively.Male sex,older age,living in rural areas,underweight,diabetes,close contact of pulmonary TB(PTB)and previous TB history are all risk factors for TB.The risk of TB increased with increasing age and decreasing body mass index(BMI)after adjusting for other factors,and there is a positive dose-response relationship.Conclusions:In China,active case finding(ACF)could be implemented among elderly people aged 65 and above with underweight,diabetes,close contact history and previous TB history as a priority,which will get significant yields and be cost-effective.
文摘Background： Preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically diff
基金Supported by the National Natural Science Foundation of Chi-na,No.81260331the National Science and Technology Major Project of the Ministry of Science and Technology of China,No.2012ZX10002010001009the Innovation Project of Guangxi Graduate Education,No.2011105981002M232
文摘AIM: To investigate whether expression of cancer stem cell (CSC) markers is associated with recurrence and survival in hepatocellular carcinoma (HCC) patients.
基金This study was supported by The National Twelfth Five-year Mega-Scientific Projects of infectious diseases of China(grant No.:2013ZX10003004-001)the funder had no contribution to study design,data collection and analysis,result interpretation and paper writing.
文摘Background:China is facing challenges of the shifting presentation of tuberculosis(TB)from younger to elderly due to an ageing population,longer life expectancy and reactivation disease.However,the burden of elderly TB and influence factors are not yet clear.To fill the gap,we generated a cohort study to measure the magnitude of TB incidence and associated factors among the elderly population aged 65 years and above in China.Methods:In this cohort established in 2013 through a prevalence survey conducted in selected sites,a total of 34076 elderlies without TB were enrolled into two-year follow-up.We used both active and passive case findings to find out all TB patients among them.The person-year(PY)incidence rates for both bacteriologically positive TB and active TB were calculated.Cox proportional regression model was performed to test effect of risk factors,and the population attributable fraction(PAF)of each risk factor contributing to incident TB among elderlies was calculated.Results:Over the two-year follow-up period,a total of 215 incident active TB were identified,62 of which were bacteriologically positive.The incidence rates for active TB and bacteriologically positive TB were 481.8 per 100000 PY(95%CI:417.4–546.2 per 100000 PY)and 138.9 per 100000 PY(95%CI:104.4–173.5 per 100000 PY),respectively.Incident cases detected by active case finding were significantly higher(P<0.001).Male,non-Han nationality,previously treated TB,ex/current smoker and body mass index(BMI)<18.5 presented as independent predictors for developing TB disease.For developing bacteriologically positive TB,the biggest contribution was from self-reported ex or current smoker(18.06%).And,for developing active TB,the biggest contribution was from non-Han nationality(35.40%),followed by male(26.80%)and age at 75 years and above(10.85%).Conclusions:Ageing population in China had a high TB incidence rate and risk to develop TB disease,implying that National TB Program(NTP)needs to prioritize for elderly.Active case finding should be app
基金Supported by the State Key Basic Research and Development Plan of China(2004CB117203)National Key Technologies R & D Program in the 10th Five-Year Plan(2004BA525B06)the Hi-Tech Research and Development (863) Proaram of China(2003AA207060)
文摘Soybean cyst nematode （SCN; Heterodera glycines） Is one of the most Important pests affecting soybean production. The best method of control of SCN is through the development of resistant cultlvars. However, limited progress has been made in soybean breeding In China because most modern cultlvars have no resistance to SCN. The distribution and phenotype of 432 immune or highly resistant Chinese accessions were surveyed and a primary core collection was selected as a representative sample for further analyses. Using evenly distributed simple sequence repeat markers, five selection methods were applied to the primary core collection and the optimal method was chosen to establish a core collection, which consisted of 28 accessions. These encompassed 70.8% of the ailelic variation present in the overall resistant collection. The 28 accessions differed from the reference resistant accessions at the genomlc level, Indicating that Chinese resistant accessions are distinct from known resistant accessions. This applied core collection provides a rational framework for undertaking diversity surveys, using genetic variation for the investigation of complex traits and for the discovery of novel traits.
基金This study was supported by a grant from the Health Bureau of Zhejiang Province Research Program (No.2004A024).
文摘With the great development of liver transplantation in China, long survival and quality of life after liver transplantation have been matters of growing interest. This study was designed to investigate the impact of personality and coping skills on the quality of life after liver transplantation. METHODS:Fifty-five outpatients who had been followed up after liver transplantation at our center were assessed by general quality of life inventory (GQOLI-74 ), a medical coping modes questionnaire (MCMQ), an eysenck personality questionnaire (EPQ), and a general condition questionnaire (GCQ). RESULTS: The score for material well-being was the lowest (63.22±12.67) and for psychological well-being the highest (73.43±12.60) in 4 dimensions of the GQOLI in post transplantation patients. Their main coping method was confrontation (21.40±3.70). The main characteristics of their personality were extraversation (E score 12.96±4.13) and neuroticism (N score 8.20±4.90) . The total score of the GQOLI was positively correlated with confrontation and E score, and it was negatively correlated with acceptance and N score. The physical well-being positively associated with the E score. The psychological well-being was positively correlated with confrontation and L score, and was negatively correlated with acceptance, P and N score. Social well-being was positively correlated with confrontation and E score, and was negatively correlated with acceptance and N score. Material well-being was not correlated with coping methods and personality. CONCLUSION:The quality of life in post liver transplantation patients is associated with their psychological characteristics.
文摘Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact on the lungs and outcomes of preterm infants.This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI(gestational age[GA]<28 weeks)and ELBWI(birth weight[BW]<1000 g),admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018,were analyzed.The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation(DRI).The secondary outcomes were survival rates,incidence of bronchopulmonary dysplasia(BPD),and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled.The incidence of DRI,chest compressions,and administration of epinephrine was 55.9%(532/952),12.5%(119/952),and 7.0%(67/952),respectively.Multivariate analysis revealed that the risk factors for DRI were GA<28 weeks(odds ratio[OR],3.147;95%confidence interval[CI],2.082–4.755),BW<1000 g(OR,2.240;95%CI,1.606–3.125),and antepartum infection(OR,1.429;95%CI,1.044–1.956).The survival rate was 65.9%(627/952)and was dependent on GA.The rate of BPD was 29.3%(181/627).Multivariate analysis showed that the risk factors for BPD were male(OR,1.603;95% CI,1.061–2.424),DRI(OR,2.094;95% CI,1.328–3.303),respiratory distress syndrome exposed to≥2 doses of pulmonary surfactants(PS;OR,2.700;95%CI,1.679–4.343),and mechanical ventilation≥7 days(OR,4.358;95% CI,2.777–6.837).However,a larger BW(OR,0.998;95% CI,0.996–0.999),antenatal steroid(OR,0.577;95%CI,0.379–0.880),and PS use in the delivery room(OR,0.273;95%CI,0.160–0.467)were preventive factors for BPD(all P<0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
基金This study is funded by Zhejiang Basic Public Welfare Research Project(LGF19H100002).
文摘Background Macrophage activation syndrome(MAS)is a major cause of morbidity and mortality in pediatric rheumatology.We aimed to further understand the clinical features,treatment,and outcome of MAS in China.Methods A multi-center cohort study was performed in seven hospitals in China from 2012 to 2018.Eighty patients with MAS were enrolled,including 53 cases with systemic juvenile idiopathic arthritis(SJIA-MAS),10 cases of Kawasaki disease(KD-MAS),and 17 cases of connective tissue disease(CTD-MAS).The clinical and laboratory data were collected before(pre-),at onset,and during full-blown stages of MAS.We compared the data among the SJIA-MAS,KD-MAS,and CTD-MAS subjects.Results 51.2%of patients developed MAS when the underlying disease was first diagnosed.In patients with SJIA,22.6%(12/53)were found to have hypotension before the onset of SJIA-MAS.These patients were also found to have significantly increased aspartate aminotransferase(AST)and lactate dehydrogenase(LDH),as well as decreased albumin(P<0.05),but no difference in alanine aminotransferase,ferdtin,and ratio of ferritin/erythrocyte sedimentation rate(ESR)at onset of MAS when compared to pre-MAS stages of the disease.In addition,ferritin and ratio of ferritin/ESR were significantly elevated in patients at full-blown stages of SJIA-MAS compared to pre-MAS stage.Significantly increased ferritin and ratio of ferritin/ESR were also observed in patients with SJIA compared to in KD and CTD.Receiver-operating characteristic analysis showed that 12,217.5μg/L of ferritin and 267.5 of ferritin/ESR ratio had sensitivity(80.0%and 90.5%)and specificity(88.2%and 86.7%),respectively,for predicting full-blown SJIA-MAS.The majority of the patients received corticosteroids(79/80),while biologic agents were used in 12.5%(10/80)of cases.Tocilizumab was the most commonly selected biologic agent.The overall mortality rate was 7.5%.Conclusions About half of MAS occurred when the underlying autoimmune diseases(SJIA,KD,and CTD)were first diagnosed.Hypotension could be an importa
基金Supported by Fund of Science and Technology Plan Project in Zhuhai,No.PC20061084
文摘AIM:To investigate the mRNA expression of cyclooxygensae-2(COX-2)in benign and malignant ascites,and to explore the difference in COX-2 mRNA expression among different diseases.METHODS:A total of 36 samples were collected from the Fifth Affiliated Hospital of Sun Yat-Sen University and divided into two experimental groups:benign ascites(n=21)and malignant ascites(n=15).Benign ascites included cirrhotic ascites(n=10)and tuberculous ascites(n=5).Malignant ascites included oophoroma(n=7),cancer of colon(n=5),cancer of the liver(n=6),gastric cancer(n=2),and bladder carcinoma(n=1).The mRNA expression of COX-2 in ascites was examined with reverse transcriptase polymerase chain reaction(RT-PCR)technology,and the positive rate of COX-2 mRNA was compared between different diseases.RESULTS:The positive rate of COX-2 mRNA in malignant ascites was 42.9%(9/21),which was significantly higher than in benign ascites,6.7%(1/15),difference being significant between these two groups(χ2=4.051,P=0.044).The proportion of the positive rate in the malignant ascites was as follows:ovarian cancers57.1%(4/7),colon cancer 40.0%(2/5),liver cancer33.3%(2/6),gastric cancer 50.0%(1/2),and bladder cancer 0.00%(0/1).However,there was no significant difference in COX-2 mRNA expression among various tumors with malignant ascites(χ2=1.614,P=0.806).Among the benign ascites,COX-2 mRNA levels were different between the tuberculous ascites(0/5)and cirrhotic ascites(1/10),but there was no significant difference(P=1.000).CONCLUSION:COX-2 mRNA,detected by RT-PCR,is useful in the differential diagnosis of benign and malignant ascites,which also has potential value in the clinical diagnosis of tumors.
文摘Background： Drug is all important cause of liver injury and accounts for up to 40% of instances offidminant hepatic failure. Drug-induced liver injury （DILl） is increasing while the diagnosis becomes more difficult. Though many drugs may cause DILl, Chinese herbal medicines have recently emerged as a major cause due to their extensive use in China. We aimed to provide drug safety information to patients and health carets by analyzing the clinical and pathological characteristics of the DILl and the associated drug types. Methods： A retrospective analysis was conducted in 287 patients diagnosed with DILl enrolled in our hospital from January 2011 to December 2015. The categories of causative drugs, clinical and pathological characteristics were reviewed. Results： Western medicines ranked as the top cause of DILl, accounting for 163 out of the 287 DILl patients （56.79%） in our study. Among the Western medicine, antituberculosis drugs were the highest cause （18.47%, 53 patients） of DILl. Antibiotics （18 patients, 6.27%） and antithyroid （18 patients, 6.27%） drugs also ranked among the major causes of DILl. Chinese herbal medicines are another major cause of DILl, accounting for 36.59% of cases （105 patients）. Most of the causative Chinese herbal medicines were those used to treat osteopathy, arthropathy, dermatosis, gastropathy, leukotrichia, alopecia, and gynecologic diseases. Hepatocellular hepatitis was prevalent in DILl, regardless of Chinese herbal medicine or Western medicine-induced DILI. Conclusions： Risks and the rational use of medicines should be made clear to reduce the occurrence of DILl. For patients with liver injury of unknown origin, liver tissue pathological examination is recommended for further diagnosis.
基金supported by the National Natural Science Foundation of China (30970288 and 31170237)the National Science Foundation of Shandong Province, China(ZR2010CM024)the Foundation of State Key Laboratory of Plant Physiology and Biochemistry, China(SKLPPBKF11001)
文摘Pharmacological, laser scanning confocal microscopic （LSCM）, and spectrophotographic approaches were used to study the roles of hydrogen sulfide （H2S） and nitric oxide （NO） in signaling transduction of stomatal movement in response to ethylene in Viciafaba L. Ethylene treatment resulted in the dose-dependent stomatal closure under light, and this effect was blocked by the inhibitors of H2S biosynthesis in V. faba L. Additionally, ethylene induces H2S generation and increases L-/D-cysteine desulfhydrase （pyridoxalphosphate-dependent enzyme） activity in leaves of V. faba L. Inhibitors of H2S biosynthesis have no effect on the ethylene-induced stomatal closure, NO accumulation, and nitrate reductase （NR） activity in guard cells or leaves of II. faba L. Moreover, the ethylene-induced increase of H2S levels and L-/D- cysteine desulfhydrase activity declined when NO generation was inhibited. Therefore, we conclude that H2S and NO probably are involved in the signal transduction pathway of ethylene-induced stomatal closure. H2S may represent a novel component downstream of NO in the ethylene-induced stomatal movement in V. faba L.
