Background： Patients on hemodialysis have a high-mortality risk. Tiffs study analyzed factors associated with death in patients on maintenance hemodialysis （MHD）. While some studies used baseline data of MHD patien...Background： Patients on hemodialysis have a high-mortality risk. Tiffs study analyzed factors associated with death in patients on maintenance hemodialysis （MHD）. While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to iliad the characteristics of patients preceding death.Methods： Participants were selected from 16 blood purification centers in China from January 2012 to December 2014, Patients＇ data were collected retrospectively. Based on survival status, the participants were divided into two groups： survival group and the death group. Logistic regression analysis was performed to determine/＇actors associated with all-cause mortality.展开更多
Using a dedicated data sample taken in 2018 on the J/ψpeak,we perform a detailed study of the trigger efficiencies of the BESIII detector.The efficiencies are determined from three representative physics processes,na...Using a dedicated data sample taken in 2018 on the J/ψpeak,we perform a detailed study of the trigger efficiencies of the BESIII detector.The efficiencies are determined from three representative physics processes,namely Bhabha scattering,dimuon production and generic hadronic events with charged particles.The combined efficiency of all active triggers approaches 100%in most cases,with uncertainties small enough not to affect most physics analyses.展开更多
AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS...AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS:Twenty-two patients with 24 HCC lesionsconfirmed by biopsy or surgical resection underwentMR imaging in 4-9wks after TACE with a superconducting1.5 T MR scanner, including SE T1WI, T2WI and FMPSPGRdynamic contrast scanning. The signal intensities of alllesions on SE T1WI, T2WI and the enhancement patternson FMPSPGR dynamic contrast scanning were observed,and the comparison was made between MRI findingsand pathological results in ail the cases.RESULTS:Of the 24 lesions, the signal intensities werevarious on SE T1WI and T2WI. On T1WI, 13 lesionsappeared as hyperintense, 4 lesions were isointenseand the other 7 lesions were hypointensese.Histologically, hyperintense lesions showed on T1WIwere viable tumor or hemorrhage; isointensities werecoagulative necrosis or inflammatory infiltration;hypointensities were tumor, liquified necrosis,coagulative necrosis or inflammatory infiltration. OnT2WI, 15 lesions appeared as hyperintense, 3 lesionswere isointense and the other 6 lesions werehypointensese. Hyperintense lesions showed on T2WIwere residuals of viable tumor, hemorrhage, liquefiednecrosis or inflammatory infiltration; isointense lesionswere residuals of viable tumor or inflammatoryinfiltration; hypointense lesions were coagulativenecrosis. On FMPSPGR dynamic contrast scanning, 18of the 24 lesions enhanced on early-phase dynamicscanning conesponding to residuals of viable tumor andthe other 6 lesions had no enhancement at this phasebecause complete necrosis were seen in the histologicexamination. On delayed-phase dynamic scanning, 6lesions had permanent enhancement appeared asinhomogeneous hyperintensity and both residuals ofviable tumor and inflammatory infiltration were foundby histologic examination. 18 lesions were hypointenseat this phase and 8 of them coexisted with peripheralring-like enhancemen展开更多
Background：One-lung ventilation （OLV） is a common ventilation technology during thoracic surgery that can cause serious clinical problems.We aimed to conduct a meta-analysis to compare oxygenation and intrapulmonar...Background：One-lung ventilation （OLV） is a common ventilation technology during thoracic surgery that can cause serious clinical problems.We aimed to conduct a meta-analysis to compare oxygenation and intrapulmonary shunt during OLV in adults undergoing thoracic surgery with dexmedetomidine （Dex） versus placebo to assess the influence and safety of using Dex.Methods：Randomized controlled trials comparing lung protection in patients who underwent thoracic surgery with Dex or a placebo were retrieved from PubMed,EMBASE,MEDLINE,Cochrane Library,and China CNKI database.The following information was extracted from the paper：arterial oxygen partial pressure （PaO2）,PaO2/inspired oxygen concentration （PaO2/FiO2,oxygenation index [OI]）,intrapulmonary shunt （calculated as Qs/Qt）,mean arterial pressure （MAP）,heart rate （HR）,tumor necrosis factor-α （TNF-α）,interleukin （IL）-6,superoxide dismutase （SOD）,and malondialdehyde （MDA）.Results：Fourteen randomized controlled trials were included containing a total of 625 patients.Compared with placebo group,Dex significantly increased PaO2/FiO2 （standard mean difference [SMD] =0.98,95% confidence interval [CI] [0.72,1.23],P 〈 0.00001）.Besides,Qs/Qt （SMD=-1.22,95% CI [-2.20,-0.23],P =0.020）,HR （SMD=-0.69,95% CI [-1.20,0.17],P =0.009）,MAP （SMD=-0.44,95% CI [-0.84,0.04],P =0.030）,the concentrations ofTNF-α （SMD =-1.55,95% CI [-2.16,-0.95],P 〈0.001）,and IL-6 （SMD =-1.53,95% CI [-2.37,-0.70],P =0.0003） were decreased in the treated group,when compared to placebo group.No significant difference was found in MDA （SMD =-1.14,95% CI [-3.48,1.20],P =0.340） and SOD （SMD =0.41,95% CI [-0.29,1.10],P =0.250） between the Dex group and the placebo group.Funnel plots did not detect any significant publication bias.Conclusions：Dex may improve OI and reduce intrapulmonary shunt during OLV in adults undergoing thoracic surgery.However,this conclusion might be weakened by the limited number of pooled studies and p展开更多
AIM: To investigate the effectiveness and safety of limited endoscopic sphincterotomy (EST) plus large balloon dilation (LBD) for removing choledocholithiasis in patients with periampullary diverticula (PAD). METHODS:...AIM: To investigate the effectiveness and safety of limited endoscopic sphincterotomy (EST) plus large balloon dilation (LBD) for removing choledocholithiasis in patients with periampullary diverticula (PAD). METHODS: A total of 139 patients with common bile duct (CBD) stones were treated with LBD (10-20 mm balloon diameter) after limited EST. Of this total, 73 patients had PAD and 66 patients did not have PAD (controls). The results of stone removal and complications were retrospectively evaluated. RESULTS: There were no significant differences between the PAD and the control groups in overall successful stone removal (94.5% vs 93.9%), stone removal in first session (69.9% vs 81.8%), mechanical lithotripsy (12.3% vs 13.6%), and complications (11.0% vs 7.6%). Clinical outcomes were also similar between the types of PAD, but the rate of stone removal in first session and the number of sessions were significantly lower and more frequent, respectively, in type B PAD (papilla located near the diverticulum) than controls [23/38 (60.5%) vs 54/66 (81.8%), P = 0.021; and 1 (1-2) vs 1 (1-3), P = 0.037, respectively] and the frequency of pancreatitis was significantly higher in type A PAD (papilla located inside or in the margin of the diverticulum) than in controls (16.1% vs 3.0%, P = 0.047). CONCLUSION: Limited EST plus LBD was an effective and safe procedure for removing choledocholithiasis in patients with PAD. However, some types of PAD should be managed with caution.展开更多
多年来,全球肠外肠内营养学界同道们都在寻求营养不良诊断标准的统一,既需要确定营养不良诊断标准,也需要考虑营养不良指标在不同国家、不同种族的正常值和按临床研究得到的切割点(cut-off point)。全球(营养)领导层倡议营养不良(Global...多年来,全球肠外肠内营养学界同道们都在寻求营养不良诊断标准的统一,既需要确定营养不良诊断标准,也需要考虑营养不良指标在不同国家、不同种族的正常值和按临床研究得到的切割点(cut-off point)。全球(营养)领导层倡议营养不良(Global Leadership Initiative on Malnutrition,GLIM)诊断标准于2018年9月在美国肠外肠内营养学会(American Society for Parenteral and Enteral Nutrition,ASPEN)和欧洲临床营养和代谢学会(European Society for Clinical Nutrition and Metabolism,ESPEN)网站发表。2019年初在纸质版杂志《JPEN》及《Clinical Nutrition》发表。GLIM在《全国科学技术名词审定委员会-肠外肠内营养学分名词-2019》有记载。GLIM中的某些阈值可能会随着时间的推移而有演变,但是从主观评定营养不良(如SGA、PG-SGA),发展到用表现型指标、病因型指标诊断营养不良的方向是正确的。高质量的前瞻性临床有效性验证报告和前瞻性多中心临床应用数据分析,将是GLIM改进的基础。2016年《疾病分类与代码》GB/T(中国ICD-10扩充版)及2019年《关于全国三级公立医院绩效考核通知〔2019〕》以及国家医保局信息业务数据库等三个方面文件均收录了营养风险、营养不良、重度(严重)营养不良作为疾病名称。目前临床各学科都在推行个体化医疗,但是临床各科室的实际情况不同。对肠外肠内营养支持疗法的临床应用来说,与对癌症患者的精准医疗、靶向治疗是有很大的距离。2004年12月,中华医学会肠外肠内营养学分会(Chinese Society for Parenteral and Enteral Nutritional,CSPEN)常委会组建营养风险-不足-营养支持-结局-成本效果比(Nutritional risk-undernutrition-support-outcome-cost effectiveness ratio,NUSOC)多中心分享数据库协作组,该协作组的目标是分出哪些患者需要肠外肠内营养支持疗法,合理应用前提下让患者受益。中国的疾病诊断相关分组展开更多
Exosomes derived from human adipose-derived stem cells (hADSCs-Exos) have shown potential as an effectivetherapeutic tool for repairing bone defects. Although metal-organic framework (MOF) scaffolds are promisingstrat...Exosomes derived from human adipose-derived stem cells (hADSCs-Exos) have shown potential as an effectivetherapeutic tool for repairing bone defects. Although metal-organic framework (MOF) scaffolds are promisingstrategies for bone tissue regeneration, their potential use for exosome loading remains unexplored. In this study,motivated by the potential advantages of hADSCs-Exos and Mg-GA MOF, we designed and synthesized anexosome-functionalized cell-free PLGA/Mg-GA MOF (PLGA/Exo-Mg-GA MOF) scaffold, taking using of thebenefits of hADSCs-Exos, Mg2+, and gallic acid (GA) to construct unique nanostructural interfaces to enhanceosteogenic, angiogenic and anti-inflammatory capabilities simultaneously. Our in vitro work demonstrated thebeneficial effects of PLGA/Exo-Mg-GA MOF composite scaffolds on the osteogenic effects in human bonemarrow-derived mesenchymal stem cells (hBMSCs) and angiogenic effects in human umbilical endothelial cells(HUVECs). Slowly released hADSCs-Exos from composite scaffolds were phagocytosed by co-cultured cells,stabilized the bone graft environment, ensured blood supply, promoted osteogenic differentiation, and acceleratedbone reconstruction. Furthermore, our in vivo experiments with rat calvarial defect model showed thatPLGA/Exo-Mg-GA MOF scaffolds promoted new bone formation and satisfactory osseointegration. Overall, weprovide valuable new insights for designing exosome-coated nanocomposite scaffolds with enhanced osteogenesisproperty.展开更多
文摘Background： Patients on hemodialysis have a high-mortality risk. Tiffs study analyzed factors associated with death in patients on maintenance hemodialysis （MHD）. While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to iliad the characteristics of patients preceding death.Methods： Participants were selected from 16 blood purification centers in China from January 2012 to December 2014, Patients＇ data were collected retrospectively. Based on survival status, the participants were divided into two groups： survival group and the death group. Logistic regression analysis was performed to determine/＇actors associated with all-cause mortality.
基金Supported in part by National Key Basic Research Program of China(2015CB856700)National Natural Science Foundation of China(NSFC)(11625523,11635010,11735014,11822506,11835012,11935015,11935016,11935018,11961141012)+15 种基金the Chinese Academy of Sciences(CAS)Large-Scale Scientific Facility ProgramJoint Large-Scale Scientific Facility Funds of the NSFC and CAS(U 1732263,U 1832207)CAS Key Research Program of Frontier Sciences(QYZDJ-SSWSLH003,QYZDJ-SSW-SLH040)100 Talents Program of CASINPAC and Shanghai Key Laboratory for Particle Physics and CosmologyERC(758462)German Research Foundation DFG under Contracts Nos.Collaborative Research Center CRC 1044,FOR 2359Istituto Nazionale di Fisica Nucleare,ItalyMinistry of Development o f Turkey(DPT2006K-120470)National Science and Technology fundOlle Engkvist Foundation(200-0605)STFC(United Kingdom)The Knut and Alice Wallenberg Foundation(Sweden)(2016.0157)The Royal Society,UK(DH140054,DH160214)The Swedish Research CouncilU.S.Department of Energy(DEFG02-05ER41374,DE-SC-0012069)。
文摘Using a dedicated data sample taken in 2018 on the J/ψpeak,we perform a detailed study of the trigger efficiencies of the BESIII detector.The efficiencies are determined from three representative physics processes,namely Bhabha scattering,dimuon production and generic hadronic events with charged particles.The combined efficiency of all active triggers approaches 100%in most cases,with uncertainties small enough not to affect most physics analyses.
基金Clinical Important Item of Chinese Health Ministry,No.97030220
文摘AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS:Twenty-two patients with 24 HCC lesionsconfirmed by biopsy or surgical resection underwentMR imaging in 4-9wks after TACE with a superconducting1.5 T MR scanner, including SE T1WI, T2WI and FMPSPGRdynamic contrast scanning. The signal intensities of alllesions on SE T1WI, T2WI and the enhancement patternson FMPSPGR dynamic contrast scanning were observed,and the comparison was made between MRI findingsand pathological results in ail the cases.RESULTS:Of the 24 lesions, the signal intensities werevarious on SE T1WI and T2WI. On T1WI, 13 lesionsappeared as hyperintense, 4 lesions were isointenseand the other 7 lesions were hypointensese.Histologically, hyperintense lesions showed on T1WIwere viable tumor or hemorrhage; isointensities werecoagulative necrosis or inflammatory infiltration;hypointensities were tumor, liquified necrosis,coagulative necrosis or inflammatory infiltration. OnT2WI, 15 lesions appeared as hyperintense, 3 lesionswere isointense and the other 6 lesions werehypointensese. Hyperintense lesions showed on T2WIwere residuals of viable tumor, hemorrhage, liquefiednecrosis or inflammatory infiltration; isointense lesionswere residuals of viable tumor or inflammatoryinfiltration; hypointense lesions were coagulativenecrosis. On FMPSPGR dynamic contrast scanning, 18of the 24 lesions enhanced on early-phase dynamicscanning conesponding to residuals of viable tumor andthe other 6 lesions had no enhancement at this phasebecause complete necrosis were seen in the histologicexamination. On delayed-phase dynamic scanning, 6lesions had permanent enhancement appeared asinhomogeneous hyperintensity and both residuals ofviable tumor and inflammatory infiltration were foundby histologic examination. 18 lesions were hypointenseat this phase and 8 of them coexisted with peripheralring-like enhancemen
文摘Background：One-lung ventilation （OLV） is a common ventilation technology during thoracic surgery that can cause serious clinical problems.We aimed to conduct a meta-analysis to compare oxygenation and intrapulmonary shunt during OLV in adults undergoing thoracic surgery with dexmedetomidine （Dex） versus placebo to assess the influence and safety of using Dex.Methods：Randomized controlled trials comparing lung protection in patients who underwent thoracic surgery with Dex or a placebo were retrieved from PubMed,EMBASE,MEDLINE,Cochrane Library,and China CNKI database.The following information was extracted from the paper：arterial oxygen partial pressure （PaO2）,PaO2/inspired oxygen concentration （PaO2/FiO2,oxygenation index [OI]）,intrapulmonary shunt （calculated as Qs/Qt）,mean arterial pressure （MAP）,heart rate （HR）,tumor necrosis factor-α （TNF-α）,interleukin （IL）-6,superoxide dismutase （SOD）,and malondialdehyde （MDA）.Results：Fourteen randomized controlled trials were included containing a total of 625 patients.Compared with placebo group,Dex significantly increased PaO2/FiO2 （standard mean difference [SMD] =0.98,95% confidence interval [CI] [0.72,1.23],P 〈 0.00001）.Besides,Qs/Qt （SMD=-1.22,95% CI [-2.20,-0.23],P =0.020）,HR （SMD=-0.69,95% CI [-1.20,0.17],P =0.009）,MAP （SMD=-0.44,95% CI [-0.84,0.04],P =0.030）,the concentrations ofTNF-α （SMD =-1.55,95% CI [-2.16,-0.95],P 〈0.001）,and IL-6 （SMD =-1.53,95% CI [-2.37,-0.70],P =0.0003） were decreased in the treated group,when compared to placebo group.No significant difference was found in MDA （SMD =-1.14,95% CI [-3.48,1.20],P =0.340） and SOD （SMD =0.41,95% CI [-0.29,1.10],P =0.250） between the Dex group and the placebo group.Funnel plots did not detect any significant publication bias.Conclusions：Dex may improve OI and reduce intrapulmonary shunt during OLV in adults undergoing thoracic surgery.However,this conclusion might be weakened by the limited number of pooled studies and p
基金Supported by A Grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare and Family Affairs,Republic of Korea (A091047)
文摘AIM: To investigate the effectiveness and safety of limited endoscopic sphincterotomy (EST) plus large balloon dilation (LBD) for removing choledocholithiasis in patients with periampullary diverticula (PAD). METHODS: A total of 139 patients with common bile duct (CBD) stones were treated with LBD (10-20 mm balloon diameter) after limited EST. Of this total, 73 patients had PAD and 66 patients did not have PAD (controls). The results of stone removal and complications were retrospectively evaluated. RESULTS: There were no significant differences between the PAD and the control groups in overall successful stone removal (94.5% vs 93.9%), stone removal in first session (69.9% vs 81.8%), mechanical lithotripsy (12.3% vs 13.6%), and complications (11.0% vs 7.6%). Clinical outcomes were also similar between the types of PAD, but the rate of stone removal in first session and the number of sessions were significantly lower and more frequent, respectively, in type B PAD (papilla located near the diverticulum) than controls [23/38 (60.5%) vs 54/66 (81.8%), P = 0.021; and 1 (1-2) vs 1 (1-3), P = 0.037, respectively] and the frequency of pancreatitis was significantly higher in type A PAD (papilla located inside or in the margin of the diverticulum) than in controls (16.1% vs 3.0%, P = 0.047). CONCLUSION: Limited EST plus LBD was an effective and safe procedure for removing choledocholithiasis in patients with PAD. However, some types of PAD should be managed with caution.
文摘多年来,全球肠外肠内营养学界同道们都在寻求营养不良诊断标准的统一,既需要确定营养不良诊断标准,也需要考虑营养不良指标在不同国家、不同种族的正常值和按临床研究得到的切割点(cut-off point)。全球(营养)领导层倡议营养不良(Global Leadership Initiative on Malnutrition,GLIM)诊断标准于2018年9月在美国肠外肠内营养学会(American Society for Parenteral and Enteral Nutrition,ASPEN)和欧洲临床营养和代谢学会(European Society for Clinical Nutrition and Metabolism,ESPEN)网站发表。2019年初在纸质版杂志《JPEN》及《Clinical Nutrition》发表。GLIM在《全国科学技术名词审定委员会-肠外肠内营养学分名词-2019》有记载。GLIM中的某些阈值可能会随着时间的推移而有演变,但是从主观评定营养不良(如SGA、PG-SGA),发展到用表现型指标、病因型指标诊断营养不良的方向是正确的。高质量的前瞻性临床有效性验证报告和前瞻性多中心临床应用数据分析,将是GLIM改进的基础。2016年《疾病分类与代码》GB/T(中国ICD-10扩充版)及2019年《关于全国三级公立医院绩效考核通知〔2019〕》以及国家医保局信息业务数据库等三个方面文件均收录了营养风险、营养不良、重度(严重)营养不良作为疾病名称。目前临床各学科都在推行个体化医疗,但是临床各科室的实际情况不同。对肠外肠内营养支持疗法的临床应用来说,与对癌症患者的精准医疗、靶向治疗是有很大的距离。2004年12月,中华医学会肠外肠内营养学分会(Chinese Society for Parenteral and Enteral Nutritional,CSPEN)常委会组建营养风险-不足-营养支持-结局-成本效果比(Nutritional risk-undernutrition-support-outcome-cost effectiveness ratio,NUSOC)多中心分享数据库协作组,该协作组的目标是分出哪些患者需要肠外肠内营养支持疗法,合理应用前提下让患者受益。中国的疾病诊断相关分组
基金Natural science Foundation of Liaoning Province,China,grant number of 2020-ZLLH-40.
文摘Exosomes derived from human adipose-derived stem cells (hADSCs-Exos) have shown potential as an effectivetherapeutic tool for repairing bone defects. Although metal-organic framework (MOF) scaffolds are promisingstrategies for bone tissue regeneration, their potential use for exosome loading remains unexplored. In this study,motivated by the potential advantages of hADSCs-Exos and Mg-GA MOF, we designed and synthesized anexosome-functionalized cell-free PLGA/Mg-GA MOF (PLGA/Exo-Mg-GA MOF) scaffold, taking using of thebenefits of hADSCs-Exos, Mg2+, and gallic acid (GA) to construct unique nanostructural interfaces to enhanceosteogenic, angiogenic and anti-inflammatory capabilities simultaneously. Our in vitro work demonstrated thebeneficial effects of PLGA/Exo-Mg-GA MOF composite scaffolds on the osteogenic effects in human bonemarrow-derived mesenchymal stem cells (hBMSCs) and angiogenic effects in human umbilical endothelial cells(HUVECs). Slowly released hADSCs-Exos from composite scaffolds were phagocytosed by co-cultured cells,stabilized the bone graft environment, ensured blood supply, promoted osteogenic differentiation, and acceleratedbone reconstruction. Furthermore, our in vivo experiments with rat calvarial defect model showed thatPLGA/Exo-Mg-GA MOF scaffolds promoted new bone formation and satisfactory osseointegration. Overall, weprovide valuable new insights for designing exosome-coated nanocomposite scaffolds with enhanced osteogenesisproperty.
