In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a n...In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.展开更多
Background Despite the recent advances in medicine, fever of unknown origin （FUO） remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospect...Background Despite the recent advances in medicine, fever of unknown origin （FUO） remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospective study to investigate the causes of FUO and the change of major causes of FUO during the past 26 years. Methods The clinical data were retrospectively analyzed from 997 patients with FUO hospitalized at the Peking Union Medical College Hospital （PUMCH） between January 2004 and October 2010. Furthermore, the results were compared to that reported in previous studies of FUO in PUMCH since 1985. Results Of the 997 FUO cases, definite diagnosis was eventually achieved in 797 （79.9%） patients. The most common cause of FUO was infectious diseases （479 cases, 48.0%）, with tuberculosis accounting for 45.3% （217/479） of the cases of infections. One hundred and sixty-eight （16.9%） patients were diagnosed with connective tissue diseases, with Still＇s disease and vasculitis accounted for 31.5% （53/168） and 24.4% （41/168） of this category, respectively. Neoplasms and miscellaneous causes were found in 7.9% （79/997） and 7.1% （71/997）, respectively. However, no definite diagnosis had been made in the remaining 200 （20.1%） cases until they were discharged from the hospital. Conclusions During different periods, infectious diseases, especially tuberculosis, were the leading etiology of FUO and the proportion of tuberculosis had no significant difference. While the frequency of neoplasms was descending, the proportion of lymphoma in neoplasm was ascending; the frequency of undiagnosed＇cases was increasing, but in most FUO cases the causes can be diagnosed eventually after careful analysis of clinical data.展开更多
Metamaterials based on effective media can be used to produce a number of unusual physical properties(for example,negative refraction and invisibility cloaking)because they can be tailored with effective medium parame...Metamaterials based on effective media can be used to produce a number of unusual physical properties(for example,negative refraction and invisibility cloaking)because they can be tailored with effective medium parameters that do not occur in nature.Recently,the use of coding metamaterials has been suggested for the control of electromagnetic waves through the design of coding sequences using digital elements‘0’and‘1,'which possess opposite phase responses.Here we propose the concept of an anisotropic coding metamaterial in which the coding behaviors in different directions are dependent on the polarization status of the electromagnetic waves.We experimentally demonstrate an ultrathin and flexible polarization-controlled anisotropic coding metasurface that functions in the terahertz regime using specially designed coding elements.By encoding the elements with elaborately designed coding sequences(both 1-bit and 2-bit sequences),the x-and y-polarized waves can be anomalously reflected or independently diffused in three dimensions.The simulated far-field scattering patterns and near-field distributions are presented to illustrate the dual-functional performance of the encoded metasurface,and the results are consistent with the measured results.We further demonstrate the ability of the anisotropic coding metasurfaces to generate a beam splitter and realize simultaneous anomalous reflections and polarization conversions,thus providing powerful control of differently polarized electromagnetic waves.The proposed method enables versatile beam behaviors under orthogonal polarizations using a single metasurface and has the potential for use in the development of interesting terahertz devices.展开更多
AIM To study hepatocarcinogenesis of hepatitis C virus (HCV). METHODS Expression of HCV antigens (CP10, NS3 and NS5) and several cancer associated gene products (ras p21, c myc, c erbB 2, mutated p53 and p16 pr...AIM To study hepatocarcinogenesis of hepatitis C virus (HCV). METHODS Expression of HCV antigens (CP10, NS3 and NS5) and several cancer associated gene products (ras p21, c myc, c erbB 2, mutated p53 and p16 protein) in the tissues of hepatocellular carcinoma (HCC, n =46) and its surrounding liver tissue were studied by the ABC (avidin biotin complex) immunohistochemical method. The effect of HCV infection on expression of those gene products in HCC was analyzed by comparing HCV antigen positive group with HCV antigen negative group. RESULTS Positive immunostaining with one, two or three HCV antigens was found in 20 (43 5%) cases, with either of two or three HCV antigens in 16 (34 8%) cases, and with three HCV antigens in 9 (19 6%) cases. Deletion rate of p16 protein expression in HCC with positive HCV antigen (80%, 16/20) was significantly higher than that in HCC with negative HCV antigen. Whereas no significant difference of the other gene product expression was observed between the two groups. CONCLUSION HCV appears related to about one third of cases of HCC in Chongqing, the southwest of China, and it may be involved in hepatocarcinogenesis by inhibiting the function of p16 gene, which acts as a negative regulator of cell cycle.展开更多
Although studies on the balance between yield and quality of japonica soft super rice are limited, they are crucial for super rice cultivation. In order to investigate the effects of nitrogen application rate on grain...Although studies on the balance between yield and quality of japonica soft super rice are limited, they are crucial for super rice cultivation. In order to investigate the effects of nitrogen application rate on grain yield and rice quality, two japonica soft super rice varieties, Nanjing 9108 （NJ 9108） and Nanjing 5055 （NJ 5055）, were used under seven N levels with the application rates of 0, 150, 187.5,225, 262.5, 300, and 337.5 kg ha^-1. With the increasing nitrogen application level, grain yield of both varieties first increased and then decreased. The highest yield was obtained at 300 kg ha^-1. The milling quality and protein content increased, while the appearance quality, amylose content, gel consistency, cooking/eating quality, and rice flour viscosity decreased. Milling was significantly negatively related with the eating/cooking quality whereas the appearance was significantly positively related with cooking/eating quality. These results suggest that nitrogen level significantly affects the yield and rice quality of japonica soft super rice. We conclude that the suitable nitrogen application rate for japonica soft super rice, NJ 9108 and NJ 5055, is 270 kg ha^-1, under which they obtain high yield as well as superior eating/cooking quality.展开更多
Axillary lymph node assessment is one of the important indicators in the clinical pathological staging of breast cancer.Studies have shown that sentinel lymph node biopsy(SLNB)has the advantages of fewer complications...Axillary lymph node assessment is one of the important indicators in the clinical pathological staging of breast cancer.Studies have shown that sentinel lymph node biopsy(SLNB)has the advantages of fewer complications and less trauma than conventional axillary lymph node dissection(ALND)/[1] Common mapping methods for SLNB include blue dye,radioisotopes,a combination of blue dye and radioisotopes,and fluorescence imaging.展开更多
AIM:To construct normal values for the tests of the psychometric hepatic encephalopathy score(PHES)and to evaluate its usefulness in the diagnosis of minimal hepatic encephalopathy(MHE)among Chinese individuals with c...AIM:To construct normal values for the tests of the psychometric hepatic encephalopathy score(PHES)and to evaluate its usefulness in the diagnosis of minimal hepatic encephalopathy(MHE)among Chinese individuals with cirrhosis.METHODS:The five tests of PHES,number connection test-A(NCT-A),number connection test-B,serial dotting test,line tracing test and digit symbol test(DST),were administered to all enrolled subjects in a quiet room with sufficient light.Cirrhotic subjects with overt HE were excluded by the West-Haven criteria and a detailed neurological examination.Based on the nomograms of healthy volunteers,the patients were classified as having MHE when their PHES was less than-4.RESULTS:In total,146 healthy volunteers completed all the PHES tests.Age and education years were confirmed to be predictors of all five tests.In total,53patients with liver cirrhosis completed the PHES.Of the patients with liver cirrhosis,24(45.3%),22(41.5%)and 7(13.2%)had Child-Pugh grades A,B and C,respectively.MHE was diagnosed in 26 patients(49.1%).Compared with compensated cirrhotic patients(Child A),decompensated cirrhotic patients(Child B and C)had a higher proportion of MHE(65.5%vs 29.2%).No differences in age and education years were found between the MHE and non-MHE groups.NCT-A and DST were able to diagnose MHE with a sensitivity of 76.9%and a specificity of 96.3%(AUC=0.866,K=0.735).CONCLUSION:The proportion of MHE is associated with liver function.NCT-A and DST are simple tools that can be used for the diagnosis of MHE in China.展开更多
Objective： To determine whether additional Chinese medicine（CM） could prolong survival and improve the quality of life（QOL） in patients with advanced non-small cell lung cancer（NSCLC） compared with Western medi...Objective： To determine whether additional Chinese medicine（CM） could prolong survival and improve the quality of life（QOL） in patients with advanced non-small cell lung cancer（NSCLC） compared with Western medicine（WM） alone. Methods： This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage Ⅲ–Ⅳ NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network（NCCN） guidelines. In the integrative medicine（IM） group, individualized CM（Chinese patent medicines and injections） and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months. Results： The median survival was 16.60 months in the IM group and 13.13 months in the WM group（P〈0.01）. The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group（P〈0.05）. The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course（P〈0.05）. Conclusions： Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio-and chemotherapy may be attenuated as CM is used in combination with conventional treatments.展开更多
基金supported(in part)by the Entrusted Project of National Center for Medical Service Administration,National Health and Family Planning Commission China(No.[2019]099)the First Level Funding of the Second Medical Leading Talent Project in Hubei Provincethe Special Project for Emergency of the Ministry of Science and Technology(2020YFC0841300)。
文摘In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.
文摘Background Despite the recent advances in medicine, fever of unknown origin （FUO） remains a diagnostic and therapeutic challenge even to expert physicians. To increase the knowledge of FUO, we conducted a retrospective study to investigate the causes of FUO and the change of major causes of FUO during the past 26 years. Methods The clinical data were retrospectively analyzed from 997 patients with FUO hospitalized at the Peking Union Medical College Hospital （PUMCH） between January 2004 and October 2010. Furthermore, the results were compared to that reported in previous studies of FUO in PUMCH since 1985. Results Of the 997 FUO cases, definite diagnosis was eventually achieved in 797 （79.9%） patients. The most common cause of FUO was infectious diseases （479 cases, 48.0%）, with tuberculosis accounting for 45.3% （217/479） of the cases of infections. One hundred and sixty-eight （16.9%） patients were diagnosed with connective tissue diseases, with Still＇s disease and vasculitis accounted for 31.5% （53/168） and 24.4% （41/168） of this category, respectively. Neoplasms and miscellaneous causes were found in 7.9% （79/997） and 7.1% （71/997）, respectively. However, no definite diagnosis had been made in the remaining 200 （20.1%） cases until they were discharged from the hospital. Conclusions During different periods, infectious diseases, especially tuberculosis, were the leading etiology of FUO and the proportion of tuberculosis had no significant difference. While the frequency of neoplasms was descending, the proportion of lymphoma in neoplasm was ascending; the frequency of undiagnosed＇cases was increasing, but in most FUO cases the causes can be diagnosed eventually after careful analysis of clinical data.
基金supported by the National Science Foundation of China(61571117,61522106,61138001,61302018 and 61401089)Natural Science Foundation of the Jiangsu Province(BK2012019)the 111 Project(111-2-05).
文摘Metamaterials based on effective media can be used to produce a number of unusual physical properties(for example,negative refraction and invisibility cloaking)because they can be tailored with effective medium parameters that do not occur in nature.Recently,the use of coding metamaterials has been suggested for the control of electromagnetic waves through the design of coding sequences using digital elements‘0’and‘1,'which possess opposite phase responses.Here we propose the concept of an anisotropic coding metamaterial in which the coding behaviors in different directions are dependent on the polarization status of the electromagnetic waves.We experimentally demonstrate an ultrathin and flexible polarization-controlled anisotropic coding metasurface that functions in the terahertz regime using specially designed coding elements.By encoding the elements with elaborately designed coding sequences(both 1-bit and 2-bit sequences),the x-and y-polarized waves can be anomalously reflected or independently diffused in three dimensions.The simulated far-field scattering patterns and near-field distributions are presented to illustrate the dual-functional performance of the encoded metasurface,and the results are consistent with the measured results.We further demonstrate the ability of the anisotropic coding metasurfaces to generate a beam splitter and realize simultaneous anomalous reflections and polarization conversions,thus providing powerful control of differently polarized electromagnetic waves.The proposed method enables versatile beam behaviors under orthogonal polarizations using a single metasurface and has the potential for use in the development of interesting terahertz devices.
文摘AIM To study hepatocarcinogenesis of hepatitis C virus (HCV). METHODS Expression of HCV antigens (CP10, NS3 and NS5) and several cancer associated gene products (ras p21, c myc, c erbB 2, mutated p53 and p16 protein) in the tissues of hepatocellular carcinoma (HCC, n =46) and its surrounding liver tissue were studied by the ABC (avidin biotin complex) immunohistochemical method. The effect of HCV infection on expression of those gene products in HCC was analyzed by comparing HCV antigen positive group with HCV antigen negative group. RESULTS Positive immunostaining with one, two or three HCV antigens was found in 20 (43 5%) cases, with either of two or three HCV antigens in 16 (34 8%) cases, and with three HCV antigens in 9 (19 6%) cases. Deletion rate of p16 protein expression in HCC with positive HCV antigen (80%, 16/20) was significantly higher than that in HCC with negative HCV antigen. Whereas no significant difference of the other gene product expression was observed between the two groups. CONCLUSION HCV appears related to about one third of cases of HCC in Chongqing, the southwest of China, and it may be involved in hepatocarcinogenesis by inhibiting the function of p16 gene, which acts as a negative regulator of cell cycle.
基金the National Key Research Program of China(2016YFD0300503)the National Natural Science Foundation of China(31601246)+2 种基金the Major Independent Innovation Project in Jangsu Province,China(CX(15)1002)the Special Fund for Agro-scientific Research in the Public Interest,China(201303102)the Natural Science Foundation of the Jiangsu Higher Education Institutions,China(16KJB210014)
文摘Although studies on the balance between yield and quality of japonica soft super rice are limited, they are crucial for super rice cultivation. In order to investigate the effects of nitrogen application rate on grain yield and rice quality, two japonica soft super rice varieties, Nanjing 9108 （NJ 9108） and Nanjing 5055 （NJ 5055）, were used under seven N levels with the application rates of 0, 150, 187.5,225, 262.5, 300, and 337.5 kg ha^-1. With the increasing nitrogen application level, grain yield of both varieties first increased and then decreased. The highest yield was obtained at 300 kg ha^-1. The milling quality and protein content increased, while the appearance quality, amylose content, gel consistency, cooking/eating quality, and rice flour viscosity decreased. Milling was significantly negatively related with the eating/cooking quality whereas the appearance was significantly positively related with cooking/eating quality. These results suggest that nitrogen level significantly affects the yield and rice quality of japonica soft super rice. We conclude that the suitable nitrogen application rate for japonica soft super rice, NJ 9108 and NJ 5055, is 270 kg ha^-1, under which they obtain high yield as well as superior eating/cooking quality.
文摘Axillary lymph node assessment is one of the important indicators in the clinical pathological staging of breast cancer.Studies have shown that sentinel lymph node biopsy(SLNB)has the advantages of fewer complications and less trauma than conventional axillary lymph node dissection(ALND)/[1] Common mapping methods for SLNB include blue dye,radioisotopes,a combination of blue dye and radioisotopes,and fluorescence imaging.
文摘AIM:To construct normal values for the tests of the psychometric hepatic encephalopathy score(PHES)and to evaluate its usefulness in the diagnosis of minimal hepatic encephalopathy(MHE)among Chinese individuals with cirrhosis.METHODS:The five tests of PHES,number connection test-A(NCT-A),number connection test-B,serial dotting test,line tracing test and digit symbol test(DST),were administered to all enrolled subjects in a quiet room with sufficient light.Cirrhotic subjects with overt HE were excluded by the West-Haven criteria and a detailed neurological examination.Based on the nomograms of healthy volunteers,the patients were classified as having MHE when their PHES was less than-4.RESULTS:In total,146 healthy volunteers completed all the PHES tests.Age and education years were confirmed to be predictors of all five tests.In total,53patients with liver cirrhosis completed the PHES.Of the patients with liver cirrhosis,24(45.3%),22(41.5%)and 7(13.2%)had Child-Pugh grades A,B and C,respectively.MHE was diagnosed in 26 patients(49.1%).Compared with compensated cirrhotic patients(Child A),decompensated cirrhotic patients(Child B and C)had a higher proportion of MHE(65.5%vs 29.2%).No differences in age and education years were found between the MHE and non-MHE groups.NCT-A and DST were able to diagnose MHE with a sensitivity of 76.9%and a specificity of 96.3%(AUC=0.866,K=0.735).CONCLUSION:The proportion of MHE is associated with liver function.NCT-A and DST are simple tools that can be used for the diagnosis of MHE in China.
基金Supported by National Key Technologies Research and Development Program for the 11th Five-Year Plan(No.2006BAI04A05)
文摘Objective： To determine whether additional Chinese medicine（CM） could prolong survival and improve the quality of life（QOL） in patients with advanced non-small cell lung cancer（NSCLC） compared with Western medicine（WM） alone. Methods： This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage Ⅲ–Ⅳ NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network（NCCN） guidelines. In the integrative medicine（IM） group, individualized CM（Chinese patent medicines and injections） and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months. Results： The median survival was 16.60 months in the IM group and 13.13 months in the WM group（P〈0.01）. The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group（P〈0.05）. The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course（P〈0.05）. Conclusions： Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio-and chemotherapy may be attenuated as CM is used in combination with conventional treatments.
基金Supported by Shanghai Municipal Health Bureau,No.20124028The Ministry of Education Program for New Century Excellent Talents,No.NCET-13-0907+1 种基金Shanghai Municipal Science and Technology Commission,No.13ZR1439400Shanghai Top Clinical Medical Center of Acupuncture,Moxibustion and Tuina
文摘AIM: To evaluate the clinical efficacy and safety of acupuncture and moxibustion for the treatment of active Crohn’s disease (CD).
