AIM:To evaluate clinical response to initial corticosteroid(CS) treatment in Chinese ulcerative colitis patients(UC) and identify predictors of clinical response.METHODS:Four hundred and twenty-three UC patients who w...AIM:To evaluate clinical response to initial corticosteroid(CS) treatment in Chinese ulcerative colitis patients(UC) and identify predictors of clinical response.METHODS:Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China,and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors.Short-term outcomes within one month were classified as primary response and primary non-response.Longterm outcomes within one year were classified as prolonged CS response,CS dependence and secondary non-response.CS refractoriness included primary and secondary non-response.Multivariate analyses were performed to identify predictors associated with clinical response.RESULTS:Within one month,95.0%and 5.0%of the cases were classified into primary response andnon-response,respectively.Within one year,41.6%of cases were assessed as prolonged CS response,while49.5%as CS dependence and 4.0%as secondary nonresponse.The rate of CS refractoriness was 8.9%,while the cumulative rate of surgery was 6.9%within one year.After multivariate analysis of all the variables,tenesmus was found to be a negative predictor of CS dependence(OR=0.336;95%CI:0.147-0.768;P=0.013)and weight loss as a predictor of CS refractoriness(OR=5.662;95%CI:1.111-28.857;P=0.040).After one-month treatment,sustained high Sutherland score(≥6)also predicted CS dependence(OR=2.347;95%CI:0.935-5.890;P=0.014).CONCLUSION:Tenesmus was a negative predictor of CS dependence,while weight loss and sustained high Sutherland score were strongly associated with poor CS response.展开更多
Background Although recent studies have indicated that both orthostatic hypotension and orthostatic hypertension independently predict cardiovascular events,the underlying mechanisms are still controversial.The aim of...Background Although recent studies have indicated that both orthostatic hypotension and orthostatic hypertension independently predict cardiovascular events,the underlying mechanisms are still controversial.The aim of the study was to investigate the relationships between orthostatic changes and organ damage in subjects over 60 years old.Methods This is a prospective observational cohort study.One thousand nine hundred and ninety-seven subjects over 60 years old were enrolled.Participants were grouped according to whether they had a drop>20 mmHg in systolic or>10 mmHg in diastolic BP(orthostatic hypotension),an increase in mean orthostatic systolic blood pressure>20 mm Hg(orthostatic hypertension),or normal changes within 3 min of orthostatism.Multiple regression modeling was used to investigate the relationship between orthostatic hypotension,orthostatic hypertension and subclinical organ damage with adjustment for confounders.Results Orthostatic hypotension and orthostatic hypertension were found in 461(23.1%)and 189(9.5%)participants,respectively.Measurement of carotid intima-media thickness(IMT),brachial-ankle pulse wave velocity(baPWV),clearance of creatinine,and microalbuminuria were associated with orthostatic hypotension;measurement of IMT and baPWV were associated with orthostatic hypertension in a cruse model.After adjustment,IMT[odds ratio(OR),95%confidence interval(CI)per one-SD increment:1.385,1.052-1.823;P=0.02],baPWV(OR=1.627,95%CI:1.041-2.544;P=0.033)and microalbuminuria(OR=1.401,95%CI:1.002-1.958;P=0.049)were still associated with orthostatic hypotension,while orthostatic hypertension was only associated with IMT(OR=1.730,95%CI:1.143-2.618;P=0.009).Conclusions Orthostatic hypotension seems to be independently correlated with increased carotid atherosclerosis,arterial stiffness and renal damage in subjects over 60 years old.Orthostatic hypertension correlates with carotid atherosclerosis only.展开更多
Circular RNAs(circRNAs)are ideal biomarkers of oral squamous cell carcinoma(OSCC)because of their highly stable closed-loop structure,and they can act as microRNA(miRNA)sponges to regulate OSCC progression.By analyzin...Circular RNAs(circRNAs)are ideal biomarkers of oral squamous cell carcinoma(OSCC)because of their highly stable closed-loop structure,and they can act as microRNA(miRNA)sponges to regulate OSCC progression.By analyzing clinical samples,we identified circCPNE1,a dysregulated circRNA in OSCC,and its expression level was negatively correlated with the clinical stage of OSCC patients.Gain-of-function assays revealed the tumor-suppressive effect of circCPNE1,which was then identified as a miR-330-3p sponge.MiR-330-3p was recognized as a tumor promoter in multiple studies,consistent with our finding that it could promote the proliferation,migration,and invasion of OSCC cells.These results indicated that selective inhibition of miR-330-3p could be an effective strategy to inhibit OSCC progression.Therefore,we designed cationic polylysine-cisplatin prodrugs to deliver antagomiR-330-3p(a miRNA inhibitory analog)via electrostatic interactions to form PP@miR nanoparticles(NPs).Paratumoral administration results revealed that PP@miR NPs effectively inhibited subcutaneous tumor progression and achieved partial tumor elimination(2/5),which confirmed the critical role of miR-330-3p in OSCC development.These findings provide a new perspective for the development of OSCC treatments.展开更多
Objective:To explore the clinical effect of perioperative nursing guided by the concept of enhanced recovery after surgery and summarize them.Methods:Pubmed,Chinese National Knowledge Infrastructure(CNKI),Chinese Biom...Objective:To explore the clinical effect of perioperative nursing guided by the concept of enhanced recovery after surgery and summarize them.Methods:Pubmed,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Wanfang Database,and VIP Database were searched to obtain the relevant literature involving enhanced recovery after surgery(ERAS)guidance,obtain the effective clinical data,review the reports in literature,and obtain the effective scheme.Results:Compared with the traditional nursing program,perioperative nursing principles guided by the concept of ERAS provide more accurate nursing care to patients and reduce the occurrence of intraoperative stress events through comprehensive nursing measures such as preoperative pre-rehabilitation measures,intraoperative body temperature and fluid management,postoperative analgesia,prevention of nausea and vomiting,early mobilization,catheter nursing,and better out-of-hospital follow-up.Conclusions:Perioperative nursing principles guided by the concept of ERAS can significantly reduce the incidence of perioperative complications,shorten the hospital stay of patients,and promote postoperative rehabilitation of patients.The transformation and implementation of this concept can bring significant benefits to hospitals,medical care,and patients.展开更多
针对基于标记编码的加密图像可逆数据隐藏存在图像冗余未充分利用和信息泄露问题,提出一种基于MSB(Most Significant Bit)二维标记的加密图像可逆数据隐藏(Reversible Data Hiding in Encrypted Image,RDH-EI)算法.为提高算法的嵌入容量...针对基于标记编码的加密图像可逆数据隐藏存在图像冗余未充分利用和信息泄露问题,提出一种基于MSB(Most Significant Bit)二维标记的加密图像可逆数据隐藏(Reversible Data Hiding in Encrypted Image,RDH-EI)算法.为提高算法的嵌入容量,在二维标记图生成阶段,根据原始与预测像素值构造出差异序列,生成MSB二维标记(l1,l2).第一维l1和第二维l2分别记录原始与预测像素值初始连续相同MSBs位数和后继连续相反MSBs(Subsequent Consecutive Opposite MSBs,SCO-MSBs)位数.SCO-MSBs的使用提高像素冗余的利用率,结合范式哈夫曼编码实现嵌入容量的提升.为提高算法的安全性,在伪标记图与加密图像构造阶段,将二维标记图生成的编码流与保存所有辅助信息的额外数据流进行有效信息合并生成原始流后加密,同时在构造加密图像过程中生成用于标识可嵌入位置的伪标记图.原始流加密能有效防止图像信息泄露,伪标记图则用于确定嵌入的预留空间位置.实验结果表明,与现有同类算法相比,本文算法能防止标记图泄露并抵抗唯密文攻击,嵌入容量提高0.208 bpp以上,且算法实现完全可逆的同时,运行时间将近现有算法的1/4.展开更多
BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet tran...BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.展开更多
Simulation experiments were performed to investigate the characteristics of information extraction in multiple-image radiography(MIR) based on geometrical optics approximation. Different Poisson noise levels were adde...Simulation experiments were performed to investigate the characteristics of information extraction in multiple-image radiography(MIR) based on geometrical optics approximation. Different Poisson noise levels were added to the simulation, and the results show that Poisson noise deteriorates the extraction results, with the degree of refraction > USAXS > absorption. The effects of Poisson noise are negligible when the detector's photon counts are about 1000 ph/pixel. A wider sampling range allows more accurate extraction results, but a narrower sampling range has a better signal-to-noise ratio for high Poisson noise levels, e.g., PN(10). The sampling interval can be suitably increased with a minor impact on the extraction results for low Poisson noise levels(PN(10000)). The extraction results are incomplete because a portion of the samplerocking curve is beyond the sampling range. This induces artifacts in the images, especially for strong refraction and USAXS signals. The artifacts are not obvious when the refraction angle and standard deviation of the USAXS are smaller than the sampling range by an order of magnitude.In general, the absorption barely affects the extraction results. However, additional Poisson noise will be generated when the sample is made of high-Z elements or has a large size due to the strong absorption. Here, the extraction results will deteriorate, and additional exposure time is required. This simulation provides important details on practical applications of MIR, with improvements in information extraction.展开更多
BACKGROUND Sperm granuloma is a rare disease in clinical andrology and its incidence is still unclear worldwide.According to the existing literature,sperm granuloma often occurs unilaterally.Clinical and ultrasound fe...BACKGROUND Sperm granuloma is a rare disease in clinical andrology and its incidence is still unclear worldwide.According to the existing literature,sperm granuloma often occurs unilaterally.Clinical and ultrasound features are similar to epididymal tuberculosis,chronic epididymitis and other diseases.Sperm granuloma is usually diagnosed based on postoperative histopathological and immunohistochemical examination.CASE SUMMARY A 46-year-old man was admitted to the hospital due to the presence of a left scrotal mass for 3 mo and aggravation of pain for 1 wk.The lesions at both sites were surgically resected.Postoperative pathological examination showed that the left spermatic cord mass and the right epididymal mass were consistent with sperm granuloma.The sperm granulomas then recurred 3 mo after surgery.There is little change in the local mass so far.CONCLUSION The case report is helpful for our understanding of this disease.In clinical diagnosis,it should be distinguished from epididymal tuberculosis,chronic epididymitis and other diseases.Color Doppler ultrasound can be used as a preferred examination method but postoperative pathological examination is still needed for diagnosis.展开更多
基金Supported by Grants from the Ministry of Public Health,No.201002020Hubei Provincial Outstanding Medical Academic Leader Program(2013)
文摘AIM:To evaluate clinical response to initial corticosteroid(CS) treatment in Chinese ulcerative colitis patients(UC) and identify predictors of clinical response.METHODS:Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China,and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors.Short-term outcomes within one month were classified as primary response and primary non-response.Longterm outcomes within one year were classified as prolonged CS response,CS dependence and secondary non-response.CS refractoriness included primary and secondary non-response.Multivariate analyses were performed to identify predictors associated with clinical response.RESULTS:Within one month,95.0%and 5.0%of the cases were classified into primary response andnon-response,respectively.Within one year,41.6%of cases were assessed as prolonged CS response,while49.5%as CS dependence and 4.0%as secondary nonresponse.The rate of CS refractoriness was 8.9%,while the cumulative rate of surgery was 6.9%within one year.After multivariate analysis of all the variables,tenesmus was found to be a negative predictor of CS dependence(OR=0.336;95%CI:0.147-0.768;P=0.013)and weight loss as a predictor of CS refractoriness(OR=5.662;95%CI:1.111-28.857;P=0.040).After one-month treatment,sustained high Sutherland score(≥6)also predicted CS dependence(OR=2.347;95%CI:0.935-5.890;P=0.014).CONCLUSION:Tenesmus was a negative predictor of CS dependence,while weight loss and sustained high Sutherland score were strongly associated with poor CS response.
基金supported in part by the Beijing Health System High Level Health Technology Talent Cultivation Plan—2015-3-028Beijing Chaoyang 1351 Talent Cultivation Plan—CYXX-2017-03+2 种基金National Natural Science Foundation of China—81200194,81770253Beijing Municipal Natural Science Foundation—7122072National Major Research Plan Training Program of China—91849111
文摘Background Although recent studies have indicated that both orthostatic hypotension and orthostatic hypertension independently predict cardiovascular events,the underlying mechanisms are still controversial.The aim of the study was to investigate the relationships between orthostatic changes and organ damage in subjects over 60 years old.Methods This is a prospective observational cohort study.One thousand nine hundred and ninety-seven subjects over 60 years old were enrolled.Participants were grouped according to whether they had a drop>20 mmHg in systolic or>10 mmHg in diastolic BP(orthostatic hypotension),an increase in mean orthostatic systolic blood pressure>20 mm Hg(orthostatic hypertension),or normal changes within 3 min of orthostatism.Multiple regression modeling was used to investigate the relationship between orthostatic hypotension,orthostatic hypertension and subclinical organ damage with adjustment for confounders.Results Orthostatic hypotension and orthostatic hypertension were found in 461(23.1%)and 189(9.5%)participants,respectively.Measurement of carotid intima-media thickness(IMT),brachial-ankle pulse wave velocity(baPWV),clearance of creatinine,and microalbuminuria were associated with orthostatic hypotension;measurement of IMT and baPWV were associated with orthostatic hypertension in a cruse model.After adjustment,IMT[odds ratio(OR),95%confidence interval(CI)per one-SD increment:1.385,1.052-1.823;P=0.02],baPWV(OR=1.627,95%CI:1.041-2.544;P=0.033)and microalbuminuria(OR=1.401,95%CI:1.002-1.958;P=0.049)were still associated with orthostatic hypotension,while orthostatic hypertension was only associated with IMT(OR=1.730,95%CI:1.143-2.618;P=0.009).Conclusions Orthostatic hypotension seems to be independently correlated with increased carotid atherosclerosis,arterial stiffness and renal damage in subjects over 60 years old.Orthostatic hypertension correlates with carotid atherosclerosis only.
基金supported by National Natural Science Foundation of China grants(Nos.82073000,51973136,81902779,and 82173326)Science Foundation of Sichuan Province(No.2022YFS0289,China)Interdisciplinary innovation project of West China College of Stomatology,Sichuan University(RD-03-202004,China).
文摘Circular RNAs(circRNAs)are ideal biomarkers of oral squamous cell carcinoma(OSCC)because of their highly stable closed-loop structure,and they can act as microRNA(miRNA)sponges to regulate OSCC progression.By analyzing clinical samples,we identified circCPNE1,a dysregulated circRNA in OSCC,and its expression level was negatively correlated with the clinical stage of OSCC patients.Gain-of-function assays revealed the tumor-suppressive effect of circCPNE1,which was then identified as a miR-330-3p sponge.MiR-330-3p was recognized as a tumor promoter in multiple studies,consistent with our finding that it could promote the proliferation,migration,and invasion of OSCC cells.These results indicated that selective inhibition of miR-330-3p could be an effective strategy to inhibit OSCC progression.Therefore,we designed cationic polylysine-cisplatin prodrugs to deliver antagomiR-330-3p(a miRNA inhibitory analog)via electrostatic interactions to form PP@miR nanoparticles(NPs).Paratumoral administration results revealed that PP@miR NPs effectively inhibited subcutaneous tumor progression and achieved partial tumor elimination(2/5),which confirmed the critical role of miR-330-3p in OSCC development.These findings provide a new perspective for the development of OSCC treatments.
基金supported by Emerging industry leading talent project of Shanxi Province(No.[2020]587)。
文摘Objective:To explore the clinical effect of perioperative nursing guided by the concept of enhanced recovery after surgery and summarize them.Methods:Pubmed,Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Wanfang Database,and VIP Database were searched to obtain the relevant literature involving enhanced recovery after surgery(ERAS)guidance,obtain the effective clinical data,review the reports in literature,and obtain the effective scheme.Results:Compared with the traditional nursing program,perioperative nursing principles guided by the concept of ERAS provide more accurate nursing care to patients and reduce the occurrence of intraoperative stress events through comprehensive nursing measures such as preoperative pre-rehabilitation measures,intraoperative body temperature and fluid management,postoperative analgesia,prevention of nausea and vomiting,early mobilization,catheter nursing,and better out-of-hospital follow-up.Conclusions:Perioperative nursing principles guided by the concept of ERAS can significantly reduce the incidence of perioperative complications,shorten the hospital stay of patients,and promote postoperative rehabilitation of patients.The transformation and implementation of this concept can bring significant benefits to hospitals,medical care,and patients.
基金Supported by Innovation Platform and Talent Program of Hunan Province,No.2021SK4050.
文摘BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.
基金supported by the Fundamental Research Funds for the Central Universities of Ministry of Education of China(Nos.lzujbky-2016-208 and lzujbky-2016-32)the Lanzhou University Construction Project for Innovation and Cooperative Education Base
文摘Simulation experiments were performed to investigate the characteristics of information extraction in multiple-image radiography(MIR) based on geometrical optics approximation. Different Poisson noise levels were added to the simulation, and the results show that Poisson noise deteriorates the extraction results, with the degree of refraction > USAXS > absorption. The effects of Poisson noise are negligible when the detector's photon counts are about 1000 ph/pixel. A wider sampling range allows more accurate extraction results, but a narrower sampling range has a better signal-to-noise ratio for high Poisson noise levels, e.g., PN(10). The sampling interval can be suitably increased with a minor impact on the extraction results for low Poisson noise levels(PN(10000)). The extraction results are incomplete because a portion of the samplerocking curve is beyond the sampling range. This induces artifacts in the images, especially for strong refraction and USAXS signals. The artifacts are not obvious when the refraction angle and standard deviation of the USAXS are smaller than the sampling range by an order of magnitude.In general, the absorption barely affects the extraction results. However, additional Poisson noise will be generated when the sample is made of high-Z elements or has a large size due to the strong absorption. Here, the extraction results will deteriorate, and additional exposure time is required. This simulation provides important details on practical applications of MIR, with improvements in information extraction.
文摘BACKGROUND Sperm granuloma is a rare disease in clinical andrology and its incidence is still unclear worldwide.According to the existing literature,sperm granuloma often occurs unilaterally.Clinical and ultrasound features are similar to epididymal tuberculosis,chronic epididymitis and other diseases.Sperm granuloma is usually diagnosed based on postoperative histopathological and immunohistochemical examination.CASE SUMMARY A 46-year-old man was admitted to the hospital due to the presence of a left scrotal mass for 3 mo and aggravation of pain for 1 wk.The lesions at both sites were surgically resected.Postoperative pathological examination showed that the left spermatic cord mass and the right epididymal mass were consistent with sperm granuloma.The sperm granulomas then recurred 3 mo after surgery.There is little change in the local mass so far.CONCLUSION The case report is helpful for our understanding of this disease.In clinical diagnosis,it should be distinguished from epididymal tuberculosis,chronic epididymitis and other diseases.Color Doppler ultrasound can be used as a preferred examination method but postoperative pathological examination is still needed for diagnosis.
