Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases...Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.展开更多
Constructing step-scheme(S-scheme)heterojunctions has been confirmed as a promising strategy for enhancing the photocatalytic activity of composite materials.In this work,a series of sulfur-doped g-C3N4(SCN)/TiO2 S-sc...Constructing step-scheme(S-scheme)heterojunctions has been confirmed as a promising strategy for enhancing the photocatalytic activity of composite materials.In this work,a series of sulfur-doped g-C3N4(SCN)/TiO2 S-scheme photocatalysts were synthesized using electrospinning and calcination methods.The as-prepared SCN/TiO2 composites showed superior photocatalytic performance than pure TiO2 and SCN in the photocatalytic degradation of Congo Red(CR)aqueous solution.The significant enhancement in photocatalytic activity benefited not only from the 1D well-distributed nanostructure,but also from the S-scheme heterojunction.Furthermore,the XPS analyses and DFT calculations demonstrated that electrons were transferred from SCN to TiO2 across the interface of the SCN/TiO2 composites.The built-in electric field,band edge bending,and Coulomb interaction synergistically facilitated the recombination of relatively useless electrons and holes in hybrid when the interface was irradiated by simulated solar light.Therefore,the remaining electrons and holes with higher reducibility and oxidizability endowed the composite with supreme redox ability.These results were adequately verified by radical trapping experiments,ESR tests,and in situ XPS analyses,suggesting that the electron immigration in the photocatalyst followed the S-scheme heterojunction mechanism.This work can enrich our knowledge of the design and fabrication of novel S-scheme heterojunction photocatalysts and provide a promising strategy for solving environmental pollution in the future.展开更多
Hierarchical heterostructure photocatalysts with broad spectrum solar light utilization,particularly in the nearinfrared(NIR)region,are emerging classes of advanced photocatalytic materials for solar-driven CO2 conver...Hierarchical heterostructure photocatalysts with broad spectrum solar light utilization,particularly in the nearinfrared(NIR)region,are emerging classes of advanced photocatalytic materials for solar-driven CO2 conversion into value-added chemical feedstocks.Herein,a novel two-demensional/three-demensional(2 D/3 D)hierarchical composite is hydrothermally synthesized by assembling vertically-aligned ZnIn2 S4(ZIS)nanowall arrays on nitrogen-doped graphene foams(NGF).The prepared ZIS/NGF composite shows enhancement in photothermal conversion ability and selective CO2 capture as well as solar-driven CO2 photoreduction.At273 K and 1 atm,the ZIS/NGF composite with 1.0 wt%NGF achieves a comparably high CO2-to-N2 selectivity of 30.1,with an isosteric heat of CO2 adsorption of 48.2 kJ mol^-1.And in the absence of cocatalysts and sacrificial agents,the ZIS/NGF composite with cyclability converts CO2 into CH4,CO and CH3 OH under simulated solar light illumination,with the respective evolution rates about 9.1,3.5,and 5.9 times higher than that of the pristine ZIS.In-depth analysis using in-situ irradiated X-ray photoelectron spectroscopy(ISI-XPS)in conjunction with Kelvin probe measurements reveals the underlying charge transfer pathway and process from ZIS to NGF.展开更多
Cytology triage has been generally recommended for human papillomavirus （HPV）-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA det...Cytology triage has been generally recommended for human papillomavirus （HPV）-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA detection in cervical exfoliated cells can be a potential triage for HPV-positive women from a clinic-based population. Both the primary HPV testing and Papanicolaou （Pap） test were performed on all eligible HPV-positive women. HPV E6/E7 mRNA was detected by QuantiVirus HPV E6/E7 mRNA assay in cervical exfoliated cells. All HPV-positive women underwent colposcopy and further biopsy if indicated. The data were assessed by Pearson＇s Chi-squared test and the receiver operating characteristic curve. A total of 404 eligible HPV-positive women were enrolled. Positive rate of E6/E7 mRNA in high-grade squamous intraepithelial lesion （HSIL） cases was higher than that in low-grade squamous intraepithelial lesion （LSIL） or normal cases. There was no statistical difference found between mRNA and cytological testing with sensitivity （89.52% vs. 86.67%, P=0.671）, specificity （48.96% vs. 48.96%, P=1.000）, positive predictive value （39.00% vs. 38.24%, P=1.000）, and negative predictive value （92.76% vs. 90.97%, P=-0.678） for detecting ≥HSIL. HPV E6/E7 mRNA detection in cervical exfoliated cells shows the same performance as Pap triage for HSIL identification for HPV-positive women. Detection of HPV E6/E7 mRNA may be used as a new triage option for HPV-positive women.展开更多
Active-phase engineering is regularly utilized to tune the selectivity of metal nanoparticles （NPs） in heterogeneous catalysis. However, the lack of understanding of the active phase in electrocatalysis has hampered...Active-phase engineering is regularly utilized to tune the selectivity of metal nanoparticles （NPs） in heterogeneous catalysis. However, the lack of understanding of the active phase in electrocatalysis has hampered the development of efficient catalysts for CO2 electroreduction. Herein, we report the systematic engineering of active phases of Pd NPs, which are exploited to select reaction pathways for CO2 electroreduction. In situ X-ray absorption spectroscopy, in situ attenuated total reflection-infrared spectroscopy, and density functional theory calculations suggest that the formation of a hydrogen-adsorbed Pd surface on a mixture of the α- and β-phases of a palladium-hydride core （α＋β PdHx@PdHx） above -0.2 V （vs. a reversible hydrogen electrode） facilitates formate production via the HCOO intermediate, whereas the formation of a metallic Pd surface on the β-phase Pd hydride core （β PdHx@Pd） below -0.5 V promotes CO production via the COOH＂ intermediate. The main product, which is either formate or CO, can be selectively produced with high Faradaic efficiencies （〉90%） and mass activities in the potential window of 0.05 to -0.9 V with scalable application demonstration.展开更多
Converting solar energy into chemical energy by artificial photosynthesis is promising in addressing the issues of the greenhouse effect and fossil fuel crisis.Herein,a novel photocatalyst,i.e.CdS/TiO_(2) hollow micro...Converting solar energy into chemical energy by artificial photosynthesis is promising in addressing the issues of the greenhouse effect and fossil fuel crisis.Herein,a novel photocatalyst,i.e.CdS/TiO_(2) hollow microspheres(HS),were dedicatedly designed to boost overall photocatalytic efficiency.TiO_(2) nanoparticles were in-situ decorated on the inside and outside the shell of Cd S HS,ensuring close contact between TiO_(2) and CdS.The CdS/TiO2 HS with abundant mesopores inside of the shell boost the light absorption via multiscattering effect as well as accessible to reactions in all directions.The heterojunction was scrutinized and the charge transfer across it was revealed by in-situ irradiated X-ray photoelectron spectroscopy(ISI-XPS).Ultimately,the charge transfer in this composite was determined to follow stepscheme mechanism,which not only facilitates the separation of charge carriers but also preserves strong redox ability.Benefited from the intimate linkage between Cd S and TiO_(2) and the favorable step-scheme heterojunction,enhanced photocatalytic CO_(2) reduction activity was accomplished.The CH4 yield rate of CdS/TiO_(2) reaches 27.85μmol g^(–1) h^(–1),which is 145.6 and 3.8 times higher than those of pristine CdS and TiO_(2),respectively.This work presents a novel insight into constructing step-scheme photocatalytic system with desirable performance.展开更多
Background:The efficacy of entecavir(ETV)add-on peg-interferon therapy compared with ETV monotherapy in treatment-naive hepatitis B virus(HBV)patients remains controversial.We investigated whether adding peg-interfero...Background:The efficacy of entecavir(ETV)add-on peg-interferon therapy compared with ETV monotherapy in treatment-naive hepatitis B virus(HBV)patients remains controversial.We investigated whether adding peg-interferon to ongoing ETV treatment leads to a better curative effect or not.Methods:All patients have been recruited between August 2013 and January 2015 from the Shanghai Public Health Clinical Center and Zhongshan Hospital(China).Eligible HBV patients(n=144)were randomly divided(1:1)to receive either ETV monotherapy(n=70)or peg-interferon add-on therapy from week 26 to 52(«=74).Patients were followed-up for at least 2 years.Indexes including hepatitis B surface antigen(HBsAg)and hepatitis B e antigen(HBeAg)seroconversion rate,sustained virologic response,transient elastography value,and histological scores were evaluated every 3 months until the end of the study.The rate of patients with HBsAg loss was defined as the primary endpoint criteria.Results:At week 26,no patient achieved HBsAg seroconversion in either group.At week 52,one patient in the monotherapy group was HBsAg-negative but there was none in the combination therapy group.The monotherapy group showed significantly better liver function recovery results than the combination therapy group.At week 78,one patient in the combination group had HBsAg seroconverted.At week 104,only three patients in the combination therapy group were HBsAg-negative compared with one patient in monotherapy.The mean alanine aminotransferase and aspartate aminotransferase levels and transient elastography values decreased significantly compared with baseline.Both groups showed a favorable decrease in alpha-fetoprotein(monotherapy:4.5[2.8,7.1]vs.2.2[1.8,3.1]ng/mL,P<0.001;combination therapy:5.7[3.0,18.8]vs.3.2[2.0,4.3]ng/mL,P<0.001)and an improved result of liver biopsy examination scores.The combination group showed a better improvement in histology compared with the monotherapy group(mean transient elastography value 6.6[4.9,9.8]vs.7.8[5.4,11.1]kPa,P=0.028).But there wa展开更多
Autoclaved aerated concrete(AAC) panels have ultra-light weight,excellent thermal insulation and energy absorption,so it is an ideal building material for protective structures.To improve the blast resistance of the A...Autoclaved aerated concrete(AAC) panels have ultra-light weight,excellent thermal insulation and energy absorption,so it is an ideal building material for protective structures.To improve the blast resistance of the AAC panels,three schemes are applied to strengthen the AAC panels through spraying 4 mm thick polyurea coating from top,bottom and double-sides.In three-point bending tests,the polyurea-coated AAC panels have much higher ultimate loads than the un-coated panels,but slightly lower than those strengthened by the carbon fiber reinforced plastics(CEFRPs).Close-in explosion experiments reveal the dynamic strengthening effect of the polyurea coating.Critical scaled distances of the strengthened AAC panels are acquired,which are valuable for the engineering application of the AAC panels in the extreme loading conditions.Polyurea coatings efficiently enhance the blast resistance of the bottom and double-sided polyurea-coated AAC panels.It is interesting that the polyurea-coated AAC panels have much more excellent blast resistance than the CFRP reinforced AAC panels,although the latter have better static mechanical properties.展开更多
Background:About 10%of patients get a surgical-site infection(SSI)after radical gastrectomy for gastric cancer,but SSI remains controversial among surgeons.The aim of this study was to explore the risk factors for SSI...Background:About 10%of patients get a surgical-site infection(SSI)after radical gastrectomy for gastric cancer,but SSI remains controversial among surgeons.The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI.Methods:The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer.SSI was defined in accordance with the National Nosocomial Infection Surveillance System.We evaluated patient-related and peri-operative variables that could be risk factors for SSIs.The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI.Results:Among the 590 patients,386 were men and 204 were women.The mean age was 56.6(28-82)years and 14.2%(84/590)of these patients had an SSI.Among them,incisional SSI was observed in 23 patients(3.9%)and organ/space SSI in 61 patients(10.3%).Multivariate logistic regression analysis identified sex(odds ratios[ORs]=2.548,and 95%confidence interval[CI]:1.268-5.122,P=0.009),total gastrectomy(OR=2.327,95%CI:1.352-4.004,P=0.002),albumin level(day 3 after surgery)<30 g/L(OR=1.868,95%CI:1.066-3.274,P=0.029),and post-operative total parenteral nutrition(OR=2.318,95%CI:1.026-5.237,P=0.043)as independent risk factors for SSI.Conclusions:SSI was common among patients after radical gastrectomy for gastric cancer.The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.展开更多
加速康复外科多学科团队(enhanced recovery after surgery in a multiple disciplinary team,ERAS-MDT)的建设目前仍处于探索过程中,以"患者为中心",医-药-护等相关多学科合作的模式被认为是ERAS-MDT团队发展的方向。临床药...加速康复外科多学科团队(enhanced recovery after surgery in a multiple disciplinary team,ERAS-MDT)的建设目前仍处于探索过程中,以"患者为中心",医-药-护等相关多学科合作的模式被认为是ERAS-MDT团队发展的方向。临床药师在团队中围绕ERAS的临床策略开展"以患者为中心、以合理用药为核心"的临床药学工作,在围手术期疼痛管理、血栓管理、营养支持治疗、血糖管理等多方面发挥重要的作用,对推动加速康复外科的进程起着重要作用。本文综述了国内外临床药师在ERAS的多个环节的作用和工作模式,旨在为临床药师在该领域的工作提供参考。展开更多
基金This project is supported by China Roche Pharmaceuticals.
文摘Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.
文摘Constructing step-scheme(S-scheme)heterojunctions has been confirmed as a promising strategy for enhancing the photocatalytic activity of composite materials.In this work,a series of sulfur-doped g-C3N4(SCN)/TiO2 S-scheme photocatalysts were synthesized using electrospinning and calcination methods.The as-prepared SCN/TiO2 composites showed superior photocatalytic performance than pure TiO2 and SCN in the photocatalytic degradation of Congo Red(CR)aqueous solution.The significant enhancement in photocatalytic activity benefited not only from the 1D well-distributed nanostructure,but also from the S-scheme heterojunction.Furthermore,the XPS analyses and DFT calculations demonstrated that electrons were transferred from SCN to TiO2 across the interface of the SCN/TiO2 composites.The built-in electric field,band edge bending,and Coulomb interaction synergistically facilitated the recombination of relatively useless electrons and holes in hybrid when the interface was irradiated by simulated solar light.Therefore,the remaining electrons and holes with higher reducibility and oxidizability endowed the composite with supreme redox ability.These results were adequately verified by radical trapping experiments,ESR tests,and in situ XPS analyses,suggesting that the electron immigration in the photocatalyst followed the S-scheme heterojunction mechanism.This work can enrich our knowledge of the design and fabrication of novel S-scheme heterojunction photocatalysts and provide a promising strategy for solving environmental pollution in the future.
基金supported by the National Natural Science Foundation of China (51961135303, 51932007, 21871217 and U1705251)the National Key Research and Development Program of China (2018YFB1502001)Innovative Research Funds of SKLWUT (2017-ZD-4)
文摘Hierarchical heterostructure photocatalysts with broad spectrum solar light utilization,particularly in the nearinfrared(NIR)region,are emerging classes of advanced photocatalytic materials for solar-driven CO2 conversion into value-added chemical feedstocks.Herein,a novel two-demensional/three-demensional(2 D/3 D)hierarchical composite is hydrothermally synthesized by assembling vertically-aligned ZnIn2 S4(ZIS)nanowall arrays on nitrogen-doped graphene foams(NGF).The prepared ZIS/NGF composite shows enhancement in photothermal conversion ability and selective CO2 capture as well as solar-driven CO2 photoreduction.At273 K and 1 atm,the ZIS/NGF composite with 1.0 wt%NGF achieves a comparably high CO2-to-N2 selectivity of 30.1,with an isosteric heat of CO2 adsorption of 48.2 kJ mol^-1.And in the absence of cocatalysts and sacrificial agents,the ZIS/NGF composite with cyclability converts CO2 into CH4,CO and CH3 OH under simulated solar light illumination,with the respective evolution rates about 9.1,3.5,and 5.9 times higher than that of the pristine ZIS.In-depth analysis using in-situ irradiated X-ray photoelectron spectroscopy(ISI-XPS)in conjunction with Kelvin probe measurements reveals the underlying charge transfer pathway and process from ZIS to NGF.
基金Project supported by the Special Fund for Scientific Research in the Public Interest from the National Health and Family Planning Commission of the People’s Republic of China(No.201402010)the National Key Technology R&D Program of China(No.2016YFC1302900)+2 种基金the Zhejiang Provincial Educational Project(No.Y201328819)the Zhejiang Provincial Medical & Hygienic Science and Technology Project(Nos.2013KYB147 and 2013KYA104)the Zhejiang Provincial Natural Science Foundation(No.LQ14H160007),China
文摘Cytology triage has been generally recommended for human papillomavirus （HPV）-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA detection in cervical exfoliated cells can be a potential triage for HPV-positive women from a clinic-based population. Both the primary HPV testing and Papanicolaou （Pap） test were performed on all eligible HPV-positive women. HPV E6/E7 mRNA was detected by QuantiVirus HPV E6/E7 mRNA assay in cervical exfoliated cells. All HPV-positive women underwent colposcopy and further biopsy if indicated. The data were assessed by Pearson＇s Chi-squared test and the receiver operating characteristic curve. A total of 404 eligible HPV-positive women were enrolled. Positive rate of E6/E7 mRNA in high-grade squamous intraepithelial lesion （HSIL） cases was higher than that in low-grade squamous intraepithelial lesion （LSIL） or normal cases. There was no statistical difference found between mRNA and cytological testing with sensitivity （89.52% vs. 86.67%, P=0.671）, specificity （48.96% vs. 48.96%, P=1.000）, positive predictive value （39.00% vs. 38.24%, P=1.000）, and negative predictive value （92.76% vs. 90.97%, P=-0.678） for detecting ≥HSIL. HPV E6/E7 mRNA detection in cervical exfoliated cells shows the same performance as Pap triage for HSIL identification for HPV-positive women. Detection of HPV E6/E7 mRNA may be used as a new triage option for HPV-positive women.
文摘Active-phase engineering is regularly utilized to tune the selectivity of metal nanoparticles （NPs） in heterogeneous catalysis. However, the lack of understanding of the active phase in electrocatalysis has hampered the development of efficient catalysts for CO2 electroreduction. Herein, we report the systematic engineering of active phases of Pd NPs, which are exploited to select reaction pathways for CO2 electroreduction. In situ X-ray absorption spectroscopy, in situ attenuated total reflection-infrared spectroscopy, and density functional theory calculations suggest that the formation of a hydrogen-adsorbed Pd surface on a mixture of the α- and β-phases of a palladium-hydride core （α＋β PdHx@PdHx） above -0.2 V （vs. a reversible hydrogen electrode） facilitates formate production via the HCOO intermediate, whereas the formation of a metallic Pd surface on the β-phase Pd hydride core （β PdHx@Pd） below -0.5 V promotes CO production via the COOH＂ intermediate. The main product, which is either formate or CO, can be selectively produced with high Faradaic efficiencies （〉90%） and mass activities in the potential window of 0.05 to -0.9 V with scalable application demonstration.
基金financially supported by the National Natural Science Foundation of China(NSFC)(Nos.51872220,51932007,51961135303,21871217,U1905215 and U1705251)the National Key Research and Development Program of China(No.2018YFB1502001)the Fundamental Research Funds for the Central Universities(No.WUT:2019IVB050)。
文摘Converting solar energy into chemical energy by artificial photosynthesis is promising in addressing the issues of the greenhouse effect and fossil fuel crisis.Herein,a novel photocatalyst,i.e.CdS/TiO_(2) hollow microspheres(HS),were dedicatedly designed to boost overall photocatalytic efficiency.TiO_(2) nanoparticles were in-situ decorated on the inside and outside the shell of Cd S HS,ensuring close contact between TiO_(2) and CdS.The CdS/TiO2 HS with abundant mesopores inside of the shell boost the light absorption via multiscattering effect as well as accessible to reactions in all directions.The heterojunction was scrutinized and the charge transfer across it was revealed by in-situ irradiated X-ray photoelectron spectroscopy(ISI-XPS).Ultimately,the charge transfer in this composite was determined to follow stepscheme mechanism,which not only facilitates the separation of charge carriers but also preserves strong redox ability.Benefited from the intimate linkage between Cd S and TiO_(2) and the favorable step-scheme heterojunction,enhanced photocatalytic CO_(2) reduction activity was accomplished.The CH4 yield rate of CdS/TiO_(2) reaches 27.85μmol g^(–1) h^(–1),which is 145.6 and 3.8 times higher than those of pristine CdS and TiO_(2),respectively.This work presents a novel insight into constructing step-scheme photocatalytic system with desirable performance.
基金This study was supported by grants from the Major Science and Technology Special Project of China Thirteenth Five-year Plan(No.2013ZX10002004,No.2017ZX10203202-003-007)supported by the Shanghai Science and Technology Development Fund(No.17411969500)the Shanghai Public Health Clinical Center Fund(No.XKJS-2019HBV-06,No.KYGW-2019-32).
文摘Background:The efficacy of entecavir(ETV)add-on peg-interferon therapy compared with ETV monotherapy in treatment-naive hepatitis B virus(HBV)patients remains controversial.We investigated whether adding peg-interferon to ongoing ETV treatment leads to a better curative effect or not.Methods:All patients have been recruited between August 2013 and January 2015 from the Shanghai Public Health Clinical Center and Zhongshan Hospital(China).Eligible HBV patients(n=144)were randomly divided(1:1)to receive either ETV monotherapy(n=70)or peg-interferon add-on therapy from week 26 to 52(«=74).Patients were followed-up for at least 2 years.Indexes including hepatitis B surface antigen(HBsAg)and hepatitis B e antigen(HBeAg)seroconversion rate,sustained virologic response,transient elastography value,and histological scores were evaluated every 3 months until the end of the study.The rate of patients with HBsAg loss was defined as the primary endpoint criteria.Results:At week 26,no patient achieved HBsAg seroconversion in either group.At week 52,one patient in the monotherapy group was HBsAg-negative but there was none in the combination therapy group.The monotherapy group showed significantly better liver function recovery results than the combination therapy group.At week 78,one patient in the combination group had HBsAg seroconverted.At week 104,only three patients in the combination therapy group were HBsAg-negative compared with one patient in monotherapy.The mean alanine aminotransferase and aspartate aminotransferase levels and transient elastography values decreased significantly compared with baseline.Both groups showed a favorable decrease in alpha-fetoprotein(monotherapy:4.5[2.8,7.1]vs.2.2[1.8,3.1]ng/mL,P<0.001;combination therapy:5.7[3.0,18.8]vs.3.2[2.0,4.3]ng/mL,P<0.001)and an improved result of liver biopsy examination scores.The combination group showed a better improvement in histology compared with the monotherapy group(mean transient elastography value 6.6[4.9,9.8]vs.7.8[5.4,11.1]kPa,P=0.028).But there wa
基金Supports from the National Natural Science Foundation of China(11672130,51508567,51478465,and 51308544)the State Key Laboratory of Mechanics and Control of Mechanical Structures(MCMS-0217G03)the State Key Laboratory for Disaster Reduction in Civil Engineering(SLDRCE16-01)。
文摘Autoclaved aerated concrete(AAC) panels have ultra-light weight,excellent thermal insulation and energy absorption,so it is an ideal building material for protective structures.To improve the blast resistance of the AAC panels,three schemes are applied to strengthen the AAC panels through spraying 4 mm thick polyurea coating from top,bottom and double-sides.In three-point bending tests,the polyurea-coated AAC panels have much higher ultimate loads than the un-coated panels,but slightly lower than those strengthened by the carbon fiber reinforced plastics(CEFRPs).Close-in explosion experiments reveal the dynamic strengthening effect of the polyurea coating.Critical scaled distances of the strengthened AAC panels are acquired,which are valuable for the engineering application of the AAC panels in the extreme loading conditions.Polyurea coatings efficiently enhance the blast resistance of the bottom and double-sided polyurea-coated AAC panels.It is interesting that the polyurea-coated AAC panels have much more excellent blast resistance than the CFRP reinforced AAC panels,although the latter have better static mechanical properties.
基金Supportive foundations:Medical and Health Science and Technology Innovation Project of Chinese Academy of Medical Sciences(No.2016-12M-1-007)China Interna-tional Medical Exchange Foundation Xiansheng Anti-Tumor Therapy Special Research Fund(No.cimf-f-h001-314).
文摘Background:About 10%of patients get a surgical-site infection(SSI)after radical gastrectomy for gastric cancer,but SSI remains controversial among surgeons.The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI.Methods:The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer.SSI was defined in accordance with the National Nosocomial Infection Surveillance System.We evaluated patient-related and peri-operative variables that could be risk factors for SSIs.The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI.Results:Among the 590 patients,386 were men and 204 were women.The mean age was 56.6(28-82)years and 14.2%(84/590)of these patients had an SSI.Among them,incisional SSI was observed in 23 patients(3.9%)and organ/space SSI in 61 patients(10.3%).Multivariate logistic regression analysis identified sex(odds ratios[ORs]=2.548,and 95%confidence interval[CI]:1.268-5.122,P=0.009),total gastrectomy(OR=2.327,95%CI:1.352-4.004,P=0.002),albumin level(day 3 after surgery)<30 g/L(OR=1.868,95%CI:1.066-3.274,P=0.029),and post-operative total parenteral nutrition(OR=2.318,95%CI:1.026-5.237,P=0.043)as independent risk factors for SSI.Conclusions:SSI was common among patients after radical gastrectomy for gastric cancer.The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.
文摘加速康复外科多学科团队(enhanced recovery after surgery in a multiple disciplinary team,ERAS-MDT)的建设目前仍处于探索过程中,以"患者为中心",医-药-护等相关多学科合作的模式被认为是ERAS-MDT团队发展的方向。临床药师在团队中围绕ERAS的临床策略开展"以患者为中心、以合理用药为核心"的临床药学工作,在围手术期疼痛管理、血栓管理、营养支持治疗、血糖管理等多方面发挥重要的作用,对推动加速康复外科的进程起着重要作用。本文综述了国内外临床药师在ERAS的多个环节的作用和工作模式,旨在为临床药师在该领域的工作提供参考。
