Dihadron azimuthal correlations containing a high transverse momentum(pr)trigger particle are sensit-ive to the properties of the nuclear medium created at RHIC through the strong interactions occurring between the tr...Dihadron azimuthal correlations containing a high transverse momentum(pr)trigger particle are sensit-ive to the properties of the nuclear medium created at RHIC through the strong interactions occurring between the traversing parton and the medium,ie.jet-quenching.Previous measurements revealed a strong modification to di-hadron azimuthal correlations in Au+Au collisions with respect to ptp and d+Au collisions.The modification in-creases with the collision centrality,suggesting a path-length or energy density dependence to the je-quenching ef-fect.This paper reports STAR measurements of dihadron azimuthal correlations in mid-central(20%-60%)Au+Au collisions at√^(S)NN=200 GeV as a function of the trigger particle's azimuthal angle relative to the event plane,Ф_(s)=|Ф_(t)-ψ_(Ep)|.The azimuthal correlation is studied as a function of both the trigger and associated particle pr.The subtractions of the combinatorial background and anisotropic flow,assuming Zero Yield At Minimum(ZYAM),are described.The correlation results are first discussed with subtraction of the even harmonic(elliptic and quadrangu-lar)flow backgrounds.The away-side correlation is strongly modifed,and the modification varies withФ_(s),with a double-peak structure for out-of-plane trigger particles.The near-side ridge(long range pseudo-rapidity△_(η)correla-tion)appears to drop with increasingФ_(s)while the jet-like component remains approximately constant.The correla-tion functions are further studied with the subtraction of odd harmonic triangular flow background arising from fluc-tuations.It is found that the triangular flow,while responsible for the majority of the amplitudes,is not sufficient to explain theφs-dependence of the ridge or the away-side double-peak structure.The dropping ridge withФ_(s)could be attributed to aФ_(s)-dependent lliptie anisotropy;however,the physics mechanism of the ridge remains an open ques-tion.Even with aФ_(s)-dependent elliptic flow,the away-side correlation structure is robust.These results,with exte展开更多
Background: Transarterial chemoembolization(TACE) is recommended as the standard care for unresectable hepatocellular carcinoma(HCC) at Barcelona Clinic Liver Cancer(BCLC) stage A-B. However, the efficacy of TACE on l...Background: Transarterial chemoembolization(TACE) is recommended as the standard care for unresectable hepatocellular carcinoma(HCC) at Barcelona Clinic Liver Cancer(BCLC) stage A-B. However, the efficacy of TACE on large(> 10 cm) stage A-B HCC is far from satisfactory, and it is proposed that hepatic artery infusion chemotherapy(HAIC)might be a better first-line treatment of this disease. Hence, we compared the safety and efficacy of HAIC with the modified FOLFOX(mFOLFOX) regimen and those ofTACE in patients with massive unresectable HCC.Methods: A prospective, non-randomized, phase II study was conducted on patients with massive unresectable HCC. The protocol involved HAIC with the mFOLFOX regimen(oxaliplatin, 85 mg/m^2 intra-arterial infusion; leucovorin,400 mg/m^2 intra-arterial infusion; and fluorouracil, 400 mg/m2 bolus infusion and 2400 mg/m^2 continuous infusion)every 3 weeks and TACE with 50 mg of epirubicin, 50 mg of lobaplatin, 6 mg of mitomycin, and lipiodol and polyvinyl alcohol particles. The tumor responses, time-to-progression(TTP), and safety were assessed.Results: A total of 79 patients were recruited for this study: 38 in the HAIC group and 41 in the TACE group. The HAIC group exhibited higher partial response and disease control rates than did the TACE group(52.6% vs. 9.8%, P < 0.001;83.8% vs. 52.5%, P = 0.004). The median TTPs for the HAIC and TACE groups were 5.87 and 3.6 months(hazard radio[HR] = 2.35,95% confidence interval [CI] = 1.16-4.76, P = 0.015). More patients in the HAIC group than in the TACE group underwent resection(10 vs. 3,P = 0.033). The proportions of grade 3-4 adverse events(AE) and serious adverse events(SAE) were lower in the HAIC group than in the TACE group(grade 3-4 AEs: 13 vs. 27, P = 0.007;SAEs: 6 vs. 15,p = 0.044). More patients in the TACE group than in the HAIC group had the study treatment terminated early due to intolerable treatment-related adverse events or the withdrawal of consent(10 vs. 2,P = 0.026).Conclusions: HAIC with mFOLFOX yielded significantly bette展开更多
Background XS0601, consisting of active ingredients （Chuangxiongol and paeoniflorin）, has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of thi...Background XS0601, consisting of active ingredients （Chuangxiongol and paeoniflorin）, has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention （PCI）. Methods A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 patients were randomized into treatment with the oral administration of XS0601, or a placebo for 6 months after successful PCI. Angiographic follow-up was scheduled at 6 months, and clinical follow-ups performed at 1, 3 and 6 months after PCI. The primary end point was angiographic restenosis. The secondary end points were the combined incidence of death, target lesion nonfatal myocardial infarction, repeat angioplasty, and coronary artery bypass graft surgery. Results A total of 308 patients （91.9%） completed the study and 145 cases （47.1%） received angiographic follow-up. The restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group （26.0% vs. 47.2%, P 〈 0.05）, and the minimum lumen diameter （MLD） was greater [（2.08 ± 0.89） mm for XS0601 vs. （1.73 ± 0.94） mm for placebo, P 〈 0.05]. XS0601 also significantly reduced the combined incidence of major adverse cardiac event （10.4% in the XS0601 group vs. 22.7% in the placebo group, P 〈 0.05）. The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group （7.1% and 11.0%） as compared with those in placebo group （19.5% and 42.9%） （P 〈 0.05）. No significant side effects occurred within the 6-month follow-up period in the XS0601 group.Conclusion Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.展开更多
Understanding the responses of soil organic carbon(SOC) fractions to altitudinal gradient variation is important for understanding changes in the carbon balance of forest ecosystems.In our study the SOC and its fracti...Understanding the responses of soil organic carbon(SOC) fractions to altitudinal gradient variation is important for understanding changes in the carbon balance of forest ecosystems.In our study the SOC and its fractions of readily oxidizable carbon(ROC),water-soluble carbon(WSC) and microbial biomass carbon(MBC) in the soil organic and mineral horizons were investigated for four typical forest types,including mixed coniferous broad-leaved forest(MCB),dark coniferous spruce-fir forest(DCSF),dark coniferous spruce forest(DCS),and Ermans birch forest(EB),along an altitudinal gradient in the Changbai Mountain Nature Reserve in Northeast China.The results showed that there was no obvious altitudinal pattern in the SOC.Similar variation trends of SOC with altitude were observed between the organic and mineral horizons.Significant differences in the contents of SOC,WSC,MBC and ROC were found among the four forest types and between horizons.The contents of ROC in the mineral horizon,WSC in the organic horizon and MBC in both horizons in the MCB and EB forests were significantly greater than those in either DCSF or DCS forest.The proportion of soil WSC to SOC was the lowest among the three main fractions.The contents of WSC,MBC and ROC were significantly correlated(P < 0.05) with SOC content.It can be concluded that vegetation types and climate were crucial factors in regulating the distribution of soil organic carbon fractions in Changbai Mountain.展开更多
Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in bra...Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.展开更多
目的:评估阴性症状评估量表4条目(4-item Negative Symptom Assessment,NSA-4)中文版在精神分裂症患者中的信效度。方法:纳入172例精神分裂症患者进行NSA-4中文版及阴性症状评定量表(Scale for Assessment of Negative Symptoms,SANS)、...目的:评估阴性症状评估量表4条目(4-item Negative Symptom Assessment,NSA-4)中文版在精神分裂症患者中的信效度。方法:纳入172例精神分裂症患者进行NSA-4中文版及阴性症状评定量表(Scale for Assessment of Negative Symptoms,SANS)、PANSS、卡尔加里精神分裂症抑郁量表(Calgary Depression Scale for Schizophrenia,CDSS)评估。采用Cronbachα系数评价NSA-4中文版的内部一致性,采用组内相关系数(intraclass correlation coefficients,ICC)评价评分者间一致性,以Spearman相关分析评价重测信度。采用Spearman相关分析,以NSA-4中文版与SANS的相关性评价其效标效度,与PANSS、CDSS的相关性评价其聚合效度和区分效度。结果:NSA-4中文版的Cronbachα系数为0.788,ICC为0.661~0.958,重测信度r=0.860。NSA-4中文版与SANS的相关系数为r=0.801,与PANSS总分、PANSS阴性症状分及总体阴性症状评定的相关系数为r=0.528~0.834,与PANSS阳性症状分、一般病理分、CDSS总分相关系数为r=0.069~0.358。结论:NSA-4中文版具有良好的信效度,适用于精神分裂症患者阴性症状的临床快速评定。展开更多
Nitrogen(N)is a critical element for plant growth and productivity that influences photosynthesis and chlorophyll fluorescence.We investigated the effect of low-N stress on leaf photosynthesis and chlorophyll fluoresc...Nitrogen(N)is a critical element for plant growth and productivity that influences photosynthesis and chlorophyll fluorescence.We investigated the effect of low-N stress on leaf photosynthesis and chlorophyll fluorescence characteristics of maize cultivars with difference in tolerance to low N levels.The low-N tolerant cultivar ZH311 and low-N sensitive cultivar XY508 were used as the test materials.A field experiment(with three N levels:N0,0 kg ha–1;N1,150 kg ha–1;N2,300 kg ha–1)in Jiyanyang,Sichuan Province,China,and a hydroponic experiment(with two N levels:CK,4 mmol L–1;LN,0.04 mmol L–1)in Chengdu,Sichuan Province,China were conducted.Low-N stress significantly decreased chlorophyll content and rapid light response curves of the maximum fluorescence under light(Fm′),fluorescence instable state(Fs),non-photochemical quenching(qN),the maximum efficiency of PSII photochemistry under dark-adaption(Fv/Fm),potential activity of PSII(Fv/Fo),and actual photochemical efficiency of PSII(ΦPSII)of leaves.Further,it increased the chlorophyll(Chl)a/Chl b values and so on.The light compensation point of ZH311 decreased,while that of XY508 increased.The degree of variation of these indices in low-N tolerant cultivars was lower than that in low-N sensitive cultivars,especially at the seedling stage.Maize could increase Chl a/Chl b,apparent quantum yield and light saturation point to adapt to N stress.Compared to low-N sensitive cultivars,low-N tolerant cultivars maintained a higher net photosynthetic rate and electron transport rate to maintain stronger PSII activity,which further promoted the ability to harvest and transfer light.This might be a photosynthetic mechanism by which low-N tolerant cultivar adapt to low-N stress.展开更多
Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currentl...Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currently no highly-recommended method of thrombus removal during interventional procedures. We describe a new method for opening culprit vessels to treat STEMI: intracoronary arterial retrograde thrombolysis (ICART) with PCI. Methods & Results Eight patients underwent ICART. The guidewire was advanced to the distal coronary artery through the occlusion lesion. Then, we inserted a microcatheter into the distal end of the occluded coronary artery over the guidewire. Urokinase (5–10 wu) mixed with contrast agents was slowly injected into the occluded section of the coronary artery through the microcatheter. The intracoronary thrombus gradually dissolved in 3–17 min, and the effect of thrombolysis was visible in real time. Stents were then implanted according to the characteristics of the recanalized culprit lesion to achieve full revascularization. One patient experienced premature ventricular contraction during vascular revascularization, and no malignant arrhythmias were seen in any patient. No reflow or slow flow was not observed post PCI. Thrombolysis in myocardial infarction flow grade and myocardial blush grade post-primary PCI was 3 in all eight patients. No patients experienced bleeding or stroke. Conclusions ICART was accurate and effective for treating intracoronary thrombi in patients with STEMI in this preliminary study. ICART was an effective, feasible, and simple approach to the management of STEMI, and no intraprocedural complications occurred in any of the patients. ICART may be a breakthrough in the treatment of acute STEMI.展开更多
Acute-on-chronic liver failure （ACLF） is a severe life-threatening complication. Liver transplantation is the only available therapeutic option; however, several limitations have restricted its use in patients. The ...Acute-on-chronic liver failure （ACLF） is a severe life-threatening complication. Liver transplantation is the only available therapeutic option; however, several limitations have restricted its use in patients. The use of corticosteroids as an optional therapy for ACLF has received a great deal of interest. The rationale behind its use is the possible role of the immune system in initiating and perpetuating hepatic damage. In order to assess the relationship between myeloid dendritic cells （mDCs） and the efficacy of methylprednisolone （MP） treatment for hepatitis B virus （H BV）-associated ACLF patients, we recruited 30 HBV-associated ACLF patients who had received MP treatment at lO-day intervals; 26 patients received conservative medical （CM） management as a control. The functionality of DC subsets was lower in these ACLF patients compared with healthy subjects. In addition, compared with survivors, dead/transplanted patients had lower functional mDC in both groups. Furthermore, a decreased numbers of mDC at baseline was associated with high mortality of ACLF patients. Importantly, MP treatment resulted in a significant decrease in 28-day mortality, and all MP patients exhibited an initial rapid decrease in circulating mDC numbers within 10 days of MP treatment. Subsequently, MP survivors displayed a continuous increase in mDC numbers accompanied by a decrease in total bilirubin levels by more than 30%. However, MP dead/ transplanted patients lacked these sequential responses compared with survivors. This evidence suggests strongly that the higher mDC numbers at baseline and the recovery of mDC number at the end of treatment may represent a prognostic marker for favorable response to corticosteroid treatment in ACLF patients.展开更多
Background Treatment of ischemic heart disease remains an important challenge, though there have been enormous progresses in cardiovascular therapeutics. This study was conducted to evaluate whether Tongxinluo （TXL）...Background Treatment of ischemic heart disease remains an important challenge, though there have been enormous progresses in cardiovascular therapeutics. This study was conducted to evaluate whether Tongxinluo （TXL） treatment around the transplantation of mesenchymal stem cells （MSCs） can improve survival and subsequent activities of implanted cells in swine hearts with acute myocardial infarction （AMI） and reperfusion. Methods Twenty-eight Chinese mini-pigs were divided into four groups including a control group （n=7）; group 2, administration of low-close TXL alone from the 3rd day prior to AMI to the 4th day post transplantation （n=-7）; group 3, MSCs alone （n=-7） and group 4, TXL ＋ MSCs （n=7）. AMI models were made by occlusion of the left anterior descending coronary artery for 90 minutes. Autologous bone marrow-MSCs （3×10^7 cells/animal） were then injected into the post-infarct myocardium immediately after AMI and reperfusion. The survival and differentiation of implanted cells in vivo were detected by immunofluorescent analysis. The data of cardiac function were obtained at baseline （1 week after transplantation） and endpoint （6 weeks after transplantation） by single photon emission computed tomography （SPECT） and magnetic resonance imaging （MRI）. Apoptosis was detected by TUNEL assay and the oxidative stress level was investigated in the post-infarct myocardium at endpoint. Results At endpoint, there was less fibrosis and inflammatory cell infiltration with more surviving myocardium in group 4 than in the control group. In group 4 the survival and differentiation of implanted MSCs were significantly improved more than that seen in group 3 alone （P〈0.0001）; the capillary density was also significantly greater than in the control group, group 2 or 3 both in the infarcted zone （P〈0.0001） and the peri-infarct zone （P〈0.0001）. MRI showed that parameters at baseline were not significantly different between the 4 groups. At endpoint, regional wall展开更多
Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasiveand has a high rate of en bloc resection. However, a high...Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasiveand has a high rate of en bloc resection. However, a high rate of esophageal stricture is observed after ESD for large lesions, which can dramatically decrease the patient's quality of life. Stricture prevention is necessary to allow for endoscopic therapy to expand. We, herein, review the most recent evidence and discuss the role of the metallic self-expandable stent and the biodegradable stent in esophageal stricture prevention. Limited studies suggested that prophylactic stenting could reduce the stricture rate without increasing the number of complications. In addition, the number of bougie dilation procedures was significantly lower with stent placement. Esophageal stenting is a promising option for post-ESD stricture prevention. However, current evidence is too preliminary to formulate practice standards. Future studies are needed to further validate the efficacy and safety of prophylactic stenting and determine the best strategy for stricture prevention. Stent migration is the most common complication. A new stent that has advantages of a low migration rate and minimal tissue reaction will need to be developed. Therefore, randomized controlled trials with long-term follow-up periods are required before prophylactic stenting could be considered a valid option to prevent post-ESD stricture.展开更多
AIM： To determine the prognostic value of lymphatic and/or blood vessel invasion （LBVI） in patients with stage 11 gastric cancer. METHODS： From January 2001 to December 2006, 487 patients with histologically confi...AIM： To determine the prognostic value of lymphatic and/or blood vessel invasion （LBVI） in patients with stage 11 gastric cancer. METHODS： From January 2001 to December 2006, 487 patients with histologically confirmed primary gas- tric adenocarcinoma were diagnosed with stage 11 gas- tric cancer according to the new 7th edition American Joint Committee on Cancer stage classification at the Department of Gastric Cancer and Soft Tissue Surgery, Fudan University Shanghai Cancer Center. All patients underwent curative gastrectomy with standard lymph node （LN） dissection. Fifty-one patients who died in the postoperative period, due to various complications or other conditions, were excluded. Clinicopathologicalfindings and clinical outcomes were analyzed. Patients were subdivided into four groups according to the status of LBVI and LN metastases. These four patient groups were characterized with regard to age, sex, tumor site, pT category, tumor grading and surgical procedure （subtotal resection vs total resection）, and compared for 5-year overall survival by univariate and multivariate analysis. RESULTS： The study was composed of 320 men and 116 women aged 58.9 ± 11.5 years （range： 23-88 years）. The 5-year overall survival rates were 50.7% and the median survival time was 62 too. Stage Ⅱ a cancer was observed in 334 patients, including 268 T3N0, 63 T2N1, and three TIN2, and stage Ⅱb was observed in 102 patients, including 49 patients T3N1, 51 T2N2, one TIN3, and one T4aN0. The incidence of LBVI was 28.0% in stage II gastric cancer with 19.0% （51/269） and 42.5% （71/167） in LN-negative and LN- positive patients, respectively. In 218 patients （50.0%）, there was neither a histopathologically detectable LBVI nor LN metastases （LBVI-/LN-, group I）; in 51 patients （11.7%）, LBVI with no evidence of LN me- tastases was detected （LBVILN-, group 11）. In 167 patients （38.3%）, LN metastases were found. Among those patients, LBVI was not determined in 96 patients （22.0%）展开更多
基金Supported in part by the Offices of NP and HEP within the U.S.DOE Office of Sciencethe U.S.NSF+18 种基金the Sloan Foundationthe DFG cluster of excellence‘Origin and Structure of the Universe’of Germany,CNRS/IN2P3STFC and EPSRC of the United KingdomFAPESP CNPq of Brazil,Ministry of Ed.Sci.of the Russian FederationNNSFCCASMoSTMoE of ChinaGA and MSMT of the Czech RepublicFOM and NWO of the NetherlandsDAEDSTCSIR of IndiaPolish Ministry of Sci.Higher Ed.,Korea Research Foundation,Ministry of Sci.,Ed.Sports of the Rep.Of CroatiaRussian Ministry of Sci.and TechRos-Atom of Russia。
文摘Dihadron azimuthal correlations containing a high transverse momentum(pr)trigger particle are sensit-ive to the properties of the nuclear medium created at RHIC through the strong interactions occurring between the traversing parton and the medium,ie.jet-quenching.Previous measurements revealed a strong modification to di-hadron azimuthal correlations in Au+Au collisions with respect to ptp and d+Au collisions.The modification in-creases with the collision centrality,suggesting a path-length or energy density dependence to the je-quenching ef-fect.This paper reports STAR measurements of dihadron azimuthal correlations in mid-central(20%-60%)Au+Au collisions at√^(S)NN=200 GeV as a function of the trigger particle's azimuthal angle relative to the event plane,Ф_(s)=|Ф_(t)-ψ_(Ep)|.The azimuthal correlation is studied as a function of both the trigger and associated particle pr.The subtractions of the combinatorial background and anisotropic flow,assuming Zero Yield At Minimum(ZYAM),are described.The correlation results are first discussed with subtraction of the even harmonic(elliptic and quadrangu-lar)flow backgrounds.The away-side correlation is strongly modifed,and the modification varies withФ_(s),with a double-peak structure for out-of-plane trigger particles.The near-side ridge(long range pseudo-rapidity△_(η)correla-tion)appears to drop with increasingФ_(s)while the jet-like component remains approximately constant.The correla-tion functions are further studied with the subtraction of odd harmonic triangular flow background arising from fluc-tuations.It is found that the triangular flow,while responsible for the majority of the amplitudes,is not sufficient to explain theφs-dependence of the ridge or the away-side double-peak structure.The dropping ridge withФ_(s)could be attributed to aФ_(s)-dependent lliptie anisotropy;however,the physics mechanism of the ridge remains an open ques-tion.Even with aФ_(s)-dependent elliptic flow,the away-side correlation structure is robust.These results,with exte
基金supported by the National Natural Science Foundation of China(No.81625017 and No.81572385)the Fundamental Research Funds for the Central Universities of China(No.16ykjc36)
文摘Background: Transarterial chemoembolization(TACE) is recommended as the standard care for unresectable hepatocellular carcinoma(HCC) at Barcelona Clinic Liver Cancer(BCLC) stage A-B. However, the efficacy of TACE on large(> 10 cm) stage A-B HCC is far from satisfactory, and it is proposed that hepatic artery infusion chemotherapy(HAIC)might be a better first-line treatment of this disease. Hence, we compared the safety and efficacy of HAIC with the modified FOLFOX(mFOLFOX) regimen and those ofTACE in patients with massive unresectable HCC.Methods: A prospective, non-randomized, phase II study was conducted on patients with massive unresectable HCC. The protocol involved HAIC with the mFOLFOX regimen(oxaliplatin, 85 mg/m^2 intra-arterial infusion; leucovorin,400 mg/m^2 intra-arterial infusion; and fluorouracil, 400 mg/m2 bolus infusion and 2400 mg/m^2 continuous infusion)every 3 weeks and TACE with 50 mg of epirubicin, 50 mg of lobaplatin, 6 mg of mitomycin, and lipiodol and polyvinyl alcohol particles. The tumor responses, time-to-progression(TTP), and safety were assessed.Results: A total of 79 patients were recruited for this study: 38 in the HAIC group and 41 in the TACE group. The HAIC group exhibited higher partial response and disease control rates than did the TACE group(52.6% vs. 9.8%, P < 0.001;83.8% vs. 52.5%, P = 0.004). The median TTPs for the HAIC and TACE groups were 5.87 and 3.6 months(hazard radio[HR] = 2.35,95% confidence interval [CI] = 1.16-4.76, P = 0.015). More patients in the HAIC group than in the TACE group underwent resection(10 vs. 3,P = 0.033). The proportions of grade 3-4 adverse events(AE) and serious adverse events(SAE) were lower in the HAIC group than in the TACE group(grade 3-4 AEs: 13 vs. 27, P = 0.007;SAEs: 6 vs. 15,p = 0.044). More patients in the TACE group than in the HAIC group had the study treatment terminated early due to intolerable treatment-related adverse events or the withdrawal of consent(10 vs. 2,P = 0.026).Conclusions: HAIC with mFOLFOX yielded significantly bette
基金THIS STUDY WAS SUPPORTED BY GRANTS FROM NATIONAL TENTH FIVE-YEAR PROJECTS PLAN (NO. 2001BA701A20)
文摘Background XS0601, consisting of active ingredients （Chuangxiongol and paeoniflorin）, has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention （PCI）. Methods A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 patients were randomized into treatment with the oral administration of XS0601, or a placebo for 6 months after successful PCI. Angiographic follow-up was scheduled at 6 months, and clinical follow-ups performed at 1, 3 and 6 months after PCI. The primary end point was angiographic restenosis. The secondary end points were the combined incidence of death, target lesion nonfatal myocardial infarction, repeat angioplasty, and coronary artery bypass graft surgery. Results A total of 308 patients （91.9%） completed the study and 145 cases （47.1%） received angiographic follow-up. The restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group （26.0% vs. 47.2%, P 〈 0.05）, and the minimum lumen diameter （MLD） was greater [（2.08 ± 0.89） mm for XS0601 vs. （1.73 ± 0.94） mm for placebo, P 〈 0.05]. XS0601 also significantly reduced the combined incidence of major adverse cardiac event （10.4% in the XS0601 group vs. 22.7% in the placebo group, P 〈 0.05）. The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group （7.1% and 11.0%） as compared with those in placebo group （19.5% and 42.9%） （P 〈 0.05）. No significant side effects occurred within the 6-month follow-up period in the XS0601 group.Conclusion Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.
基金Supported by the National Basic Research Program (973 Program) of China (No.2011CB403204)the Youth Fund for Creative Research Groups,Institute of Applied Ecology,Chinese Academy of Sciences
文摘Understanding the responses of soil organic carbon(SOC) fractions to altitudinal gradient variation is important for understanding changes in the carbon balance of forest ecosystems.In our study the SOC and its fractions of readily oxidizable carbon(ROC),water-soluble carbon(WSC) and microbial biomass carbon(MBC) in the soil organic and mineral horizons were investigated for four typical forest types,including mixed coniferous broad-leaved forest(MCB),dark coniferous spruce-fir forest(DCSF),dark coniferous spruce forest(DCS),and Ermans birch forest(EB),along an altitudinal gradient in the Changbai Mountain Nature Reserve in Northeast China.The results showed that there was no obvious altitudinal pattern in the SOC.Similar variation trends of SOC with altitude were observed between the organic and mineral horizons.Significant differences in the contents of SOC,WSC,MBC and ROC were found among the four forest types and between horizons.The contents of ROC in the mineral horizon,WSC in the organic horizon and MBC in both horizons in the MCB and EB forests were significantly greater than those in either DCSF or DCS forest.The proportion of soil WSC to SOC was the lowest among the three main fractions.The contents of WSC,MBC and ROC were significantly correlated(P < 0.05) with SOC content.It can be concluded that vegetation types and climate were crucial factors in regulating the distribution of soil organic carbon fractions in Changbai Mountain.
基金supported by the National Natural Science Foundation of China,No.81173354a grant from the Science and Technology Plan Project of Guangdong Province of China,No.2013B021800099a grant from the Science and Technology Plan Project of Shenzhen City of China,No.JCYJ20150402152005642
文摘Functional magnetic resonance imaging has been widely used to investigate the effects of acupuncture on neural activity. However, most functional magnetic resonance imaging studies have focused on acute changes in brain activation induced by acupuncture. Thus, the time course of the therapeutic effects of acupuncture remains unclear. In this study, 32 patients with amnestic mild cognitive impairment were randomly divided into two groups, where they received either Tiaoshen Yizhi acupuncture or sham acupoint acupuncture. The needles were either twirled at Tiaoshen Yizhi acupoints, including Sishencong（EX-HN1）, Yintang（EX-HN3）, Neiguan（PC6）, Taixi（KI3）, Fenglong（ST40）, and Taichong（LR3）, or at related sham acupoints at a depth of approximately 15 mm, an angle of ± 60°, and a rate of approximately 120 times per minute. Acupuncture was conducted for 4 consecutive weeks, five times per week, on weekdays. Resting-state functional magnetic resonance imaging indicated that connections between cognition-related regions such as the insula, dorsolateral prefrontal cortex, hippocampus, thalamus, inferior parietal lobule, and anterior cingulate cortex increased after acupuncture at Tiaoshen Yizhi acupoints. The insula, dorsolateral prefrontal cortex, and hippocampus acted as central brain hubs. Patients in the Tiaoshen Yizhi group exhibited improved cognitive performance after acupuncture. In the sham acupoint acupuncture group, connections between brain regions were dispersed, and we found no differences in cognitive function following the treatment. These results indicate that acupuncture at Tiaoshen Yizhi acupoints can regulate brain networks by increasing connectivity between cognition-related regions, thereby improving cognitive function in patients with mild cognitive impairment.
文摘目的:评估阴性症状评估量表4条目(4-item Negative Symptom Assessment,NSA-4)中文版在精神分裂症患者中的信效度。方法:纳入172例精神分裂症患者进行NSA-4中文版及阴性症状评定量表(Scale for Assessment of Negative Symptoms,SANS)、PANSS、卡尔加里精神分裂症抑郁量表(Calgary Depression Scale for Schizophrenia,CDSS)评估。采用Cronbachα系数评价NSA-4中文版的内部一致性,采用组内相关系数(intraclass correlation coefficients,ICC)评价评分者间一致性,以Spearman相关分析评价重测信度。采用Spearman相关分析,以NSA-4中文版与SANS的相关性评价其效标效度,与PANSS、CDSS的相关性评价其聚合效度和区分效度。结果:NSA-4中文版的Cronbachα系数为0.788,ICC为0.661~0.958,重测信度r=0.860。NSA-4中文版与SANS的相关系数为r=0.801,与PANSS总分、PANSS阴性症状分及总体阴性症状评定的相关系数为r=0.528~0.834,与PANSS阳性症状分、一般病理分、CDSS总分相关系数为r=0.069~0.358。结论:NSA-4中文版具有良好的信效度,适用于精神分裂症患者阴性症状的临床快速评定。
基金financially supported by the Sichuan Key Technology Support Program of China (2014NZ0040)the Special Fund for Agro-scientific Research in the Public Interest of China (20150312705)
文摘Nitrogen(N)is a critical element for plant growth and productivity that influences photosynthesis and chlorophyll fluorescence.We investigated the effect of low-N stress on leaf photosynthesis and chlorophyll fluorescence characteristics of maize cultivars with difference in tolerance to low N levels.The low-N tolerant cultivar ZH311 and low-N sensitive cultivar XY508 were used as the test materials.A field experiment(with three N levels:N0,0 kg ha–1;N1,150 kg ha–1;N2,300 kg ha–1)in Jiyanyang,Sichuan Province,China,and a hydroponic experiment(with two N levels:CK,4 mmol L–1;LN,0.04 mmol L–1)in Chengdu,Sichuan Province,China were conducted.Low-N stress significantly decreased chlorophyll content and rapid light response curves of the maximum fluorescence under light(Fm′),fluorescence instable state(Fs),non-photochemical quenching(qN),the maximum efficiency of PSII photochemistry under dark-adaption(Fv/Fm),potential activity of PSII(Fv/Fo),and actual photochemical efficiency of PSII(ΦPSII)of leaves.Further,it increased the chlorophyll(Chl)a/Chl b values and so on.The light compensation point of ZH311 decreased,while that of XY508 increased.The degree of variation of these indices in low-N tolerant cultivars was lower than that in low-N sensitive cultivars,especially at the seedling stage.Maize could increase Chl a/Chl b,apparent quantum yield and light saturation point to adapt to N stress.Compared to low-N sensitive cultivars,low-N tolerant cultivars maintained a higher net photosynthetic rate and electron transport rate to maintain stronger PSII activity,which further promoted the ability to harvest and transfer light.This might be a photosynthetic mechanism by which low-N tolerant cultivar adapt to low-N stress.
基金supported by the Hainan Province’s Key Research and Development Project(ZDYF 2017096&ZDYF2018118)National Natural Science Foundation of China(NSFC:81500202)+2 种基金Beijing Lisheng Cardiovascular Health Foundation Pilot Fund Project(LHJJ201610620)Provincial Key Science and Technology Projects supporting projects in Sanya(2018PT48)Sanya Medical and Health Science and Technology Innovation Project(2017YW10)
文摘Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currently no highly-recommended method of thrombus removal during interventional procedures. We describe a new method for opening culprit vessels to treat STEMI: intracoronary arterial retrograde thrombolysis (ICART) with PCI. Methods & Results Eight patients underwent ICART. The guidewire was advanced to the distal coronary artery through the occlusion lesion. Then, we inserted a microcatheter into the distal end of the occluded coronary artery over the guidewire. Urokinase (5–10 wu) mixed with contrast agents was slowly injected into the occluded section of the coronary artery through the microcatheter. The intracoronary thrombus gradually dissolved in 3–17 min, and the effect of thrombolysis was visible in real time. Stents were then implanted according to the characteristics of the recanalized culprit lesion to achieve full revascularization. One patient experienced premature ventricular contraction during vascular revascularization, and no malignant arrhythmias were seen in any patient. No reflow or slow flow was not observed post PCI. Thrombolysis in myocardial infarction flow grade and myocardial blush grade post-primary PCI was 3 in all eight patients. No patients experienced bleeding or stroke. Conclusions ICART was accurate and effective for treating intracoronary thrombi in patients with STEMI in this preliminary study. ICART was an effective, feasible, and simple approach to the management of STEMI, and no intraprocedural complications occurred in any of the patients. ICART may be a breakthrough in the treatment of acute STEMI.
基金ACKNOWLEDGEMENTS This study is supported by the National Natural Science Foundation of China （Nos. 30801039 and 81072424） and the major projects of viral hepatitis from Beijing Municipal Science and Technology Commission （No. H020920020890）. We thank the volunteers who generously participated in this study.
文摘Acute-on-chronic liver failure （ACLF） is a severe life-threatening complication. Liver transplantation is the only available therapeutic option; however, several limitations have restricted its use in patients. The use of corticosteroids as an optional therapy for ACLF has received a great deal of interest. The rationale behind its use is the possible role of the immune system in initiating and perpetuating hepatic damage. In order to assess the relationship between myeloid dendritic cells （mDCs） and the efficacy of methylprednisolone （MP） treatment for hepatitis B virus （H BV）-associated ACLF patients, we recruited 30 HBV-associated ACLF patients who had received MP treatment at lO-day intervals; 26 patients received conservative medical （CM） management as a control. The functionality of DC subsets was lower in these ACLF patients compared with healthy subjects. In addition, compared with survivors, dead/transplanted patients had lower functional mDC in both groups. Furthermore, a decreased numbers of mDC at baseline was associated with high mortality of ACLF patients. Importantly, MP treatment resulted in a significant decrease in 28-day mortality, and all MP patients exhibited an initial rapid decrease in circulating mDC numbers within 10 days of MP treatment. Subsequently, MP survivors displayed a continuous increase in mDC numbers accompanied by a decrease in total bilirubin levels by more than 30%. However, MP dead/ transplanted patients lacked these sequential responses compared with survivors. This evidence suggests strongly that the higher mDC numbers at baseline and the recovery of mDC number at the end of treatment may represent a prognostic marker for favorable response to corticosteroid treatment in ACLF patients.
基金This work was supported by the grants from the National Basic Research Program(973 Program)Ministry of Science and Technology,China(No.2005CB523303)
文摘Background Treatment of ischemic heart disease remains an important challenge, though there have been enormous progresses in cardiovascular therapeutics. This study was conducted to evaluate whether Tongxinluo （TXL） treatment around the transplantation of mesenchymal stem cells （MSCs） can improve survival and subsequent activities of implanted cells in swine hearts with acute myocardial infarction （AMI） and reperfusion. Methods Twenty-eight Chinese mini-pigs were divided into four groups including a control group （n=7）; group 2, administration of low-close TXL alone from the 3rd day prior to AMI to the 4th day post transplantation （n=-7）; group 3, MSCs alone （n=-7） and group 4, TXL ＋ MSCs （n=7）. AMI models were made by occlusion of the left anterior descending coronary artery for 90 minutes. Autologous bone marrow-MSCs （3×10^7 cells/animal） were then injected into the post-infarct myocardium immediately after AMI and reperfusion. The survival and differentiation of implanted cells in vivo were detected by immunofluorescent analysis. The data of cardiac function were obtained at baseline （1 week after transplantation） and endpoint （6 weeks after transplantation） by single photon emission computed tomography （SPECT） and magnetic resonance imaging （MRI）. Apoptosis was detected by TUNEL assay and the oxidative stress level was investigated in the post-infarct myocardium at endpoint. Results At endpoint, there was less fibrosis and inflammatory cell infiltration with more surviving myocardium in group 4 than in the control group. In group 4 the survival and differentiation of implanted MSCs were significantly improved more than that seen in group 3 alone （P〈0.0001）; the capillary density was also significantly greater than in the control group, group 2 or 3 both in the infarcted zone （P〈0.0001） and the peri-infarct zone （P〈0.0001）. MRI showed that parameters at baseline were not significantly different between the 4 groups. At endpoint, regional wall
文摘Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasiveand has a high rate of en bloc resection. However, a high rate of esophageal stricture is observed after ESD for large lesions, which can dramatically decrease the patient's quality of life. Stricture prevention is necessary to allow for endoscopic therapy to expand. We, herein, review the most recent evidence and discuss the role of the metallic self-expandable stent and the biodegradable stent in esophageal stricture prevention. Limited studies suggested that prophylactic stenting could reduce the stricture rate without increasing the number of complications. In addition, the number of bougie dilation procedures was significantly lower with stent placement. Esophageal stenting is a promising option for post-ESD stricture prevention. However, current evidence is too preliminary to formulate practice standards. Future studies are needed to further validate the efficacy and safety of prophylactic stenting and determine the best strategy for stricture prevention. Stent migration is the most common complication. A new stent that has advantages of a low migration rate and minimal tissue reaction will need to be developed. Therefore, randomized controlled trials with long-term follow-up periods are required before prophylactic stenting could be considered a valid option to prevent post-ESD stricture.
文摘AIM： To determine the prognostic value of lymphatic and/or blood vessel invasion （LBVI） in patients with stage 11 gastric cancer. METHODS： From January 2001 to December 2006, 487 patients with histologically confirmed primary gas- tric adenocarcinoma were diagnosed with stage 11 gas- tric cancer according to the new 7th edition American Joint Committee on Cancer stage classification at the Department of Gastric Cancer and Soft Tissue Surgery, Fudan University Shanghai Cancer Center. All patients underwent curative gastrectomy with standard lymph node （LN） dissection. Fifty-one patients who died in the postoperative period, due to various complications or other conditions, were excluded. Clinicopathologicalfindings and clinical outcomes were analyzed. Patients were subdivided into four groups according to the status of LBVI and LN metastases. These four patient groups were characterized with regard to age, sex, tumor site, pT category, tumor grading and surgical procedure （subtotal resection vs total resection）, and compared for 5-year overall survival by univariate and multivariate analysis. RESULTS： The study was composed of 320 men and 116 women aged 58.9 ± 11.5 years （range： 23-88 years）. The 5-year overall survival rates were 50.7% and the median survival time was 62 too. Stage Ⅱ a cancer was observed in 334 patients, including 268 T3N0, 63 T2N1, and three TIN2, and stage Ⅱb was observed in 102 patients, including 49 patients T3N1, 51 T2N2, one TIN3, and one T4aN0. The incidence of LBVI was 28.0% in stage II gastric cancer with 19.0% （51/269） and 42.5% （71/167） in LN-negative and LN- positive patients, respectively. In 218 patients （50.0%）, there was neither a histopathologically detectable LBVI nor LN metastases （LBVI-/LN-, group I）; in 51 patients （11.7%）, LBVI with no evidence of LN me- tastases was detected （LBVILN-, group 11）. In 167 patients （38.3%）, LN metastases were found. Among those patients, LBVI was not determined in 96 patients （22.0%）
