In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a n...In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.展开更多
Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,...Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,we report a novel batorigin CoV causing severe and fatal pneumonia in humans.Methods:We collected clinical data and bronchoalveolar lavage(BAL)specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital,Hubei province,China.Nucleic acids of the BAL were extracted and subjected to next-generation sequencing.Virus isolation was carried out,and maximum-likelihood phylogenetic trees were constructed.Results:Five patients hospitalized from December 18 to December 29,2019 presented with fever,cough,and dyspnea accompanied by complications of acute respiratory distress syndrome.Chest radiography revealed diffuse opacities and consolidation.One of these patients died.Sequence results revealed the presence of a previously unknownβ-CoV strain in all five patients,with 99.8%to 99.9%nucleotide identities among the isolates.These isolates showed 79.0%nucleotide identity with the sequence of SARS-CoV(GenBank NC_004718)and 51.8%identity with the sequence of MERS-CoV(GenBank NC_019843).The virus is phylogenetically closest to a bat SARS-like CoV(SL-ZC45,GenBank MG772933)with 87.6%to 87.7%nucleotide identity,but is in a separate clade.Moreover,these viruses have a single intact open reading frame gene 8,as a further indicator of bat-origin CoVs.However,the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV,indicating that these viruses might use the same receptor.Conclusion:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.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 Diabetes management could be improved by diabetes education, through influencing attitudes towards diabetes, knowledge and behaviors of patients. The purpose of this study was to characterize the impact of ...Background Diabetes management could be improved by diabetes education, through influencing attitudes towards diabetes, knowledge and behaviors of patients. The purpose of this study was to characterize the impact of diabetes education on glycemic control, and to assess the attitude, knowledge and self-care behavior in patients with type 2 diabetes in China. Methods This questionnaire-based survey was conducted in 50 medical centers across China from April to July of 2010. The patients with type 2 diabetes were eligible for the study. The information of glycemic control and diabetes education was collected. The diabetes attitude scale-3 formulae, a questionnaire of diabetes knowledge and Summary of Diabetes Self-care Activities scale were used to assess attitude, knowledge and the self-care of patients, respectively. Results Among the 5961 eligible respondents （3233 males; mean age （59.50＋12.48） years; mean hemoglobin Alc （HbAlc） （8.27＋2.23）%）, most patients （79.8%） considered themselves educated on diabetes. Compared with patients without diabetes education, their educated counterparts showed significant lower value of HbAlc, after controlling for age, gender, body mass index and duration of diabetes （P 〈0.01）. The patients who received diabetes education also performed significant higher scores on attitude, knowledge and self-care than their uneducated counterparts. Patients with lower income or education level tended to have higher glucose levels, and showed lower percentage of patients received diabetic education. Conclusions Chinese patients with diabetes education achieved better glycemic control than un-educated patients. Our study indicates effort is required to provide professional education to patients, with emphasis on lower income and lower education level populations.展开更多
Since December 2019,an epidemic caused by novel coronavirus (2019-nCoV) infection has occurred unexpectedly in China.As of 8 pm,31 January 2020,more than 20 pediatric cases have been reported in China.Of these cases,t...Since December 2019,an epidemic caused by novel coronavirus (2019-nCoV) infection has occurred unexpectedly in China.As of 8 pm,31 January 2020,more than 20 pediatric cases have been reported in China.Of these cases,ten patients were identified in Zhejiang Province,with an age of onset ranging from 112 days to 17 years.Following the latest National recommendations for diagnosis and treatment of pneumonia caused by 2019-nCo V (the 4th edition) and current status of clinical practice in Zhejiang Province,recommendations for the diagnosis and treatment of respiratory infection caused by 2019-nCoV for children were drafted by the National Clinical Research Center for Child Health,the National Children's Regional Medical Center,Children's Hospital,Zhejiang University School of Medicine to further standardize the protocol for diagnosis and treatment of respiratory infection in children caused by 2019-nCoV.展开更多
AIM： To investigate the functional, morphological changes of the gut barrier during the restitution process after hemorrhagic shock, and the regional differences of the large intestine and small intestine in response...AIM： To investigate the functional, morphological changes of the gut barrier during the restitution process after hemorrhagic shock, and the regional differences of the large intestine and small intestine in response to ischemia/ reperfusion injury. METHODS： Forty-seven Sprague-Dawley rats with body weight of 250-300 g were divided into two groups： control group （sham shock n = 5） and experimental group （n = 42）. Experimental group was further divided into six groups （n = 7 each） according to different time points after the hemorrhagic shock, including 0^th group, 1^st group, 3^rd group, 6th h group, 12^th group and 24^th group. All the rats were gavaged with 2 mL of suspension of lactulose （L） （100 mg/2 mL） and mannitol （M） （50 mg/each） at the beginning and then an experimental rat model of hemorrhagic shock was set up. The specimens from jejunum, ileum and colon tissues and the blood samples from the portal vein were taken at 0, 1, 3, 6, 12 and 24 h after shock resuscitation, respectively. The morphological changes of the intestinal mucosa, including the histology of intestinal mucosa, the thickness of mucosa, the height of villi, the index of mucosal damage and the numbers of goblet cells, were determined by light microscope and/or electron microscope. The concentrations of the bacterial endotoxin lipopolysaccharides （LPS） from the portal vein blood, which reflected the gut barrier function, were examined by using Limulus test. At the same time point, to evaluate intestinal permeability, all urine was collected and the concentrations of the metabolically inactive markers such as L and M in urine were measured by using GC-9A gas chromatographic instrument.RESULTS： After the hemorrhagic shock, the mucosal epithelial injury was obvious in small intestine even at the 0th h, and it became more serious at the 1^stand the 3^rd h. The tissue restitution was also found after 3 h, though the injury was still serious. Most of the injured mucosal restitution was established after 6 展开更多
The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effecti...The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effective aperture of 3.6 m–4.9 m) and a wide field of view (FOV) (5°). It has an innovative active reflecting Schmidt configuration which continuously changes the mirror’s surface that adjusts during the observation process and combines thin deformable mirror active optics with segmented active optics. Its primary mirror (6.67m×6.05 m) and active Schmidt mirror (5.74m×4.40 m) are both segmented, and composed of 37 and 24 hexagonal sub-mirrors respectively. By using a parallel controllable fiber positioning technique, the focal surface of 1.75 m in diameter can accommodate 4000 optical fibers. Also, LAMOST has 16 spectrographs with 32 CCD cameras. LAMOST will be the telescope with the highest rate of spectral acquisition. As a national large scientific project, the LAMOST project was formally proposed in 1996, and approved by the Chinese government in 1997. The construction started in 2001, was completed in 2008 and passed the official acceptance in June 2009. The LAMOST pilot survey was started in October 2011 and the spectroscopic survey will launch in September 2012. Up to now, LAMOST has released more than 480 000 spectra of objects. LAMOST will make an important contribution to the study of the large-scale structure of the Universe, structure and evolution of the Galaxy, and cross-identification of multiwaveband properties in celestial objects.展开更多
Mesozoic contraction deformation in the Yanshan and Taihang mountains is characterized by basement-involved thrust tectonics,basement-cored buckling anticlines and ductile thrust and nappe tectonics.Most of these defo...Mesozoic contraction deformation in the Yanshan and Taihang mountains is characterized by basement-involved thrust tectonics,basement-cored buckling anticlines and ductile thrust and nappe tectonics.Most of these deformations are orientated west-east,west-northwest and northeast to north-northeast.The contraction deformations began in the Permian,continued through the Triassic and Jurassic and terminated in the Early Cretaceous,and constitute an important part of the destruction of the North China Craton.It is estimated,from balanced cross-section reconstructions,that the north-south shortening of the central part of the Yanshan belt before 135 Ma was around 38%.The initial crust thickness,pre-dating the major contraction deformation in late Paleozoic and early Mesozoic,was estimated to be around 35 km based on paleogeographic characteristics.Assuming that the inferred depth of ductile thrusting deformation,20-25 km,was the crust thickness involved in the contraction deformation,and also assuming that the N-S contraction deformation was accommodated by vertical crust thickening,the thickness of the crust after the contraction deformation was expected to be around 47-50 km.This was the approximate crust thickness required for the eclogitization of the lower crust for delamination.The gravity potential accumulated by the isostatic uplift of the thickened crust,together with the decrease in crustal strength caused by the coeval magmatisms associated with the contraction deformation,led to the subsequent extensional collapse of the middle and upper crust although the regional stress regime associated with the plate interactions remained constant.It is inferred that the Mesozoic contraction deformations in the Yanshan and Taihang mountains were not only a significant tectonic process contributing to the destruction of the craton in middle and upper crust but also stimulated delamination at a deep level and the extension of the shallow crust.In other words,both the suspected delamination of the lower crust and upper ma展开更多
AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider...AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider usingthis technique in patients with HCH. This study was to assessthe efficacy, safety, and complications of percutaneousradiofrequency ablation (PRFA) under ultrasonographyguidance in patients with HCH.METHODS: Twelve patients (four men and eight women,age ranged 33-56 years, mean age was 41.7 years) with 15hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) weretreated using the RF-2000 generator and 10-needle LeVeenelectrode percutaneously guided by B-ultrasound. Lesionslarger than 3 cm were treated by multiple overlappingablations that encompass the entire lesion as well as a rimof normal liver tissue (approximately 0.5 cm).RESULTS: All the patients who received PRFA therapy hadno severe pain, bleeding or bile leakage during and afterthe procedures. Nine to 34 months′ follow-up (mean, 21months) by ultrasound and/or spiral CT scan demonstratedthat the ablated lesions in this group were shrunk remarkably,and the shrunken range was 38-79 % (mean, 67 % per 21months). The contrast enhancement was disappeared withinthe tumor or at its periphery in all cases on spiral CT scansobtained 3 to 6 months after treatment.CONCLUSION: The results of this study suggest that PRFAtherapy is a mini-invasive, simple, safe, and effective methodfor the treatment of selected patients with HCH.展开更多
Background Recurrent respiratory tract infection (RRTI) is a disease occurred frequently in preschool children.Methods A total of 120 RRTI children were randomly divided into active group,remission group,intervention ...Background Recurrent respiratory tract infection (RRTI) is a disease occurred frequently in preschool children.Methods A total of 120 RRTI children were randomly divided into active group,remission group,intervention group and control group,meanwhile 30 healthy children were selected as the healthy group.Children in the intervention group were given oral Bifidobaeterium tetravaccine tablets (Live) for 2 months,while the control group received routine treatment.Stool sample were detected to analyze the bacterial strains.The occurrence of respiratory tract infection (RTI) was compared between different groups during 1 year follow-up.Results Compared with the healthy group,the number of Bifidobacteria and Lactobacilli in the active group,remission group,intervention group and control group was significantly decreased (P < 0.05).The number of Bifidobacteria and Lactobacilli in the intervention group was significantly higher compared to other RRTI groups (P < 0.05).During the follow-up period,the average annual frequency of different acute RTI and use of antibiotics were significantly reduced (P < 0.05),the average duration of cough,fever and use of antibiotics at each episode were also significantly shortened (P < 0.05) in the intervention group compared to the control group.Conclusions Children with RRTI are susceptible to intestinal flora imbalance.Oral probiotics can effectively improve the RRTI intestinal microecological balance in children and reduce the frequency of RTI.展开更多
AIM: To evaluate the effectiveness and safety of percutaneous hepatic cryoablation in combination with percutaneous ethanol injection (PEI) in patients with unresectable hepaocellular carcinoma (HCC).METHODS: A total ...AIM: To evaluate the effectiveness and safety of percutaneous hepatic cryoablation in combination with percutaneous ethanol injection (PEI) in patients with unresectable hepaocellular carcinoma (HCC).METHODS: A total of 105 masses in 65 HCC patients underwent percutaneous hepatic cryoablation. The cryoablation was performed with the Cryocare system (Endocare, Irvine, CA, USA) using argon gas as a cryogen.Two freeze-thaw cycles were performed, each reaching a temperature of -180 ℃ at the tip of the probe. PEI was given in 36 patients with tumor masses larger than 6 cm in diameter 1-2 weeks after cryoablation and then once per week for 4 to 6 sessions. The efficacy was evaluated with survival, change of tumor size and alpha-fetoprotein (AFP) levels. RESULTS: During a follow-up duration of 14 months in average with a range of 5 to 21 months, 33 patients (50.8 %)were free of tumors, 22 patients (33.8 %) alive with tumor recurrence: two had bone metastases, three were found to have lung metastases, and the remaining 17 recurrences occurred in the liver, of whom only 3 developed a cryosite recurrence. Among the 41 patients who were followed up for more than one year, 32(78 %) were alive despite of tumor recurrence. Seven patients (10.8 %) died due to disease recurrence. Three patients (4.6 %) died due to some noncancer-related causes. Among the 43 patients who had a CT scan available for review, 38 (88.4 %) had a shrinkage of tumor mass. Among the 22 patients who received biopsies of cryoablated tumor mass, all biopsies except one, showed only dead or scar tissues. Of the patients who had an increased AFP preablatively, 91.3 % had a decrease of AFP to normal or nearly normal levels during postablative 3-6 months. Complications of cryoablation included liver capsular cracking in one patient,transient thrombocytopenia in 4 patients and asymptomatic right-sided pleural effusions in 2 patients. Two patients developed liver abscess at the previous cryoablation site at 2 and 4 months, respectively,following cryoablation, a展开更多
AIM： To investigate the value of two-dimensional （2D） and three-dimensional （3D） double contrast-enhanced ultrasonography （DCUS） imaging for evaluation of gas- tric lesions. METHODS： 2D and 3D DCUS imaging wit...AIM： To investigate the value of two-dimensional （2D） and three-dimensional （3D） double contrast-enhanced ultrasonography （DCUS） imaging for evaluation of gas- tric lesions. METHODS： 2D and 3D DCUS imaging with both oral and intravenous administrations of contrast agents was used to assess gastroscopiclly-confirmed gastric lesions in 46 patients with benign and malignant diseases. Initially, liquid-based ultrasound contrast agent （Xinzhang） was given orally at dose of 500-600 mL for conventional ultrasound examination of the gastric lesions, and then a microbubble-based contrast agent （SonoVue） was injected intravenously at dose of 1.2-2.4 mL in bolus fashion to assess the perfusion pattern of the lesions using contrast imaging modes. The parameters derived from time-intensity curves including the arrival time （AT）, time to peak （lq-P）, peak intensity （PI） and en- hanced intensity （EI） were measured on the 2D DCUS imaging. 3D DCUS of the lesions was acquired to dem- onstrate the value of this imaging mode. RESULTS： There were 22 cases with benign lesions including chronic gastritis （n= 5）, gastric ulcer （n = 9）, gastric polyps （n = 3）, gastric stromal tumors （n = 5）, and 24 cases with malignant lesions including gastric cancer （n = 20）, gastric cardia carcinoma （n = 3） and post-operative recurrent gastric cancer （n = 1） in the study, The oral contrast-enhanced ultrasonography （CEUS） imaging of the stomach clearly demonstrated the anatomy of the stomach and morphologic features of gastric lesions, With optimal scanning window and imaging display under oral CEUS, intravenous CEUS clearly showed the perfusion of gastric lesions with various characteristic manifestations. Both 2D and 3D DCUS images clearly demonstrated normal gastric wall as a three-layer structure, from the inside out, hypere- choic mucosa, hypoechoic muscularis and hyperechoic serosa, respectively. There were statistical significant differences of AT （8.68±2.06 vs 10.43 ±展开更多
There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessar...There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.展开更多
The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of ...The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.展开更多
目的分析1990~2019年中国结直肠癌(colorectal cancer,CRC)疾病负担的变化趋势。方法利用2019年全球疾病负担数据,采用发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)、过早死亡损失寿命年(years of life lost,Y...目的分析1990~2019年中国结直肠癌(colorectal cancer,CRC)疾病负担的变化趋势。方法利用2019年全球疾病负担数据,采用发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)、过早死亡损失寿命年(years of life lost,YLL)、伤残损失寿命年(years lived with disability,YLD)及其标化率和平均年度百分比变化率(annual average percentage change,AAPC)对1990~2019年间中国CRC疾病负担情况进行分析。结果与1990年相比,2019年中国CRC发病例数、标化发病率、死亡例数和标化死亡率分别上升了474.03%、144.01%、230.14%和36.15%。2010年以后中国CRC标化死亡率和标化发病率逐渐超过全球水平。1990~2019年,中国CRC的总体标化发病率(AAPC=3.6%,P<0.05)、标化死亡率(AAPC=1.4%,P<0.05)和标化DALY率(AAPC=1.2%,P<0.05)总体均呈上升趋势。男性发病率、死亡率和DALY率均高于女性,且随着年龄的增长而逐渐升高。与1990年相比,2019年CRC的DALY、YLL和YLD分别上升了134.3%、127.69%和445.00%,标化DALY、YLL和YLD分别上升了30.53%、27.03%和187.29%。结论从1990年到2019年,中国CRC标化发病率和标化死亡率呈现不断增长趋势,尤其是在男性和老年人群中,应采取针对性的措施进行预防和管理。展开更多
AIM: To study the effect of blocking intestinal lymphatic circulation in two-hit rats and explore the significance of intestinal lymphatic circulation in two-hit. METHODS: Wistar rats were divided equally into three g...AIM: To study the effect of blocking intestinal lymphatic circulation in two-hit rats and explore the significance of intestinal lymphatic circulation in two-hit. METHODS: Wistar rats were divided equally into three groups: mesenteric lymph duct ligation group, non- ligation group and sham group. Mesenteric lymph was diverted by ligation of mesenteric lymph duct, and the two-hit model was established by hemorrhage and lipopolysaccharide (LPS) methods. All rats were sampled for serum pre-experiment and 24 h post- experiment. The organs including kidney, liver, lung and heart were collected for pathomorphologic observation and biochemical investigation. The nitric oxide (NO), malondialdehyde (MDA) and superoxide dismutase (SOD) were determined in serum and tissue homogenate. RESULTS: Pathomorphology study showed that the structures of kidney, lung, liver and heart tissues were normal in sham group; congestion, degeneration and necrosis in non-ligation group; but only mild lesions in ligation group. After two-hits, the contents of AST, ALT, BUN, Cr and LDH-1 in the serum of non-ligation group and ligation group were obviously higher than that in pre-experiment group and sham group, but obviously lower than that in non-ligation group. The contents of NO2-/NO3-, NOS, iNOS and MDA in the serum of non- ligation group were significantly increased, compared with pre-experiment and sham group, but SOD was significantly lower. These parameters were significantly different in ligation group compared with that in sham group, but NO2-/NO3-, iNOS and MDA in ligation group were significantly lower than that in non-ligation group. CONCLUSION: Ligation of mesenteric lymph duct could improve the disturbance of organic function and morphologic damage in two-hit rats; the lymphatic mechanism in two-hit should be emphasized.展开更多
Objective： This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head （ONFH） base...Objective： This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head （ONFH） based on a comprehensive analysis of the clinical literature. Data Sources： For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words： ＆quot;corticosteroid＆quot;, ＆quot;osteonecrosis of the femoral head＆quot;,＆quot;risk factors＆quot;, ＆quot;diagnosis＆quot;, ＆quot;prognosis＆quot;, and ＆quot;treatment＆quot;. Study Selection： Articles on relationships between corticosteroid and ONFH were selected for this review. Articles on the diagnosis, prognosis, and intervention of earlier-stage ONFH were also reviewed. Results： The incidence of corticosteroid-induced ONFH was associated with high doses of corticosteroids, and underlying diseases in certain predisposed individuals mainly occurred in the first 3 months of corticosteroid prescription. The enhanced awareness and minimized exposure to the established risk factors and earlier definitive diagnosis are essential for the success of joint preservation. When following up patients with ONFH, treatment should be started if necessary. Surgical treatment yielded better results than conservative therapy in earlier-stage ONFH. The ideal purpose of earlier intervention and treatment is permanent preservation of the femoral head without physical restrictions in daily living. Conclusions： Clinicians should enhance their precaution awareness of corticosteroid-induced ONFH. For high-risk patients, regular follow-up is very important in the 1st year after high-dose prescription of corticosteroids. Patients with suspected ONFH should be referred to orthopedists for diagnosis and treatment in its earlier stage to preserve the joint.展开更多
基金supported(in part)by the Entrusted Project of National Center for Medical Service Administration,National Health and Family Planning Commission China(No.[2019]099)the First Level Funding of the Second Medical Leading Talent Project in Hubei Provincethe Special Project for Emergency of the Ministry of Science and Technology(2020YFC0841300)。
文摘In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.
基金This study was supported by grants from the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(No.2016-I2M-1-014)the National Major Science&Technology Project for Control and Prevention of Major Infectious Diseases in China(Nos.2017ZX10103004,2018ZX10305409,2017ZX10204401)the National Natural Science Foundation(No.81930063)
文摘Background:Human infections with zoonotic coronaviruses(CoVs),including severe acute respiratory syndrome(SARS)-CoV and Middle East respiratory syndrome(MERS)-CoV,have raised great public health concern globally.Here,we report a novel batorigin CoV causing severe and fatal pneumonia in humans.Methods:We collected clinical data and bronchoalveolar lavage(BAL)specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital,Hubei province,China.Nucleic acids of the BAL were extracted and subjected to next-generation sequencing.Virus isolation was carried out,and maximum-likelihood phylogenetic trees were constructed.Results:Five patients hospitalized from December 18 to December 29,2019 presented with fever,cough,and dyspnea accompanied by complications of acute respiratory distress syndrome.Chest radiography revealed diffuse opacities and consolidation.One of these patients died.Sequence results revealed the presence of a previously unknownβ-CoV strain in all five patients,with 99.8%to 99.9%nucleotide identities among the isolates.These isolates showed 79.0%nucleotide identity with the sequence of SARS-CoV(GenBank NC_004718)and 51.8%identity with the sequence of MERS-CoV(GenBank NC_019843).The virus is phylogenetically closest to a bat SARS-like CoV(SL-ZC45,GenBank MG772933)with 87.6%to 87.7%nucleotide identity,but is in a separate clade.Moreover,these viruses have a single intact open reading frame gene 8,as a further indicator of bat-origin CoVs.However,the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV,indicating that these viruses might use the same receptor.Conclusion:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
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
文摘Background Diabetes management could be improved by diabetes education, through influencing attitudes towards diabetes, knowledge and behaviors of patients. The purpose of this study was to characterize the impact of diabetes education on glycemic control, and to assess the attitude, knowledge and self-care behavior in patients with type 2 diabetes in China. Methods This questionnaire-based survey was conducted in 50 medical centers across China from April to July of 2010. The patients with type 2 diabetes were eligible for the study. The information of glycemic control and diabetes education was collected. The diabetes attitude scale-3 formulae, a questionnaire of diabetes knowledge and Summary of Diabetes Self-care Activities scale were used to assess attitude, knowledge and the self-care of patients, respectively. Results Among the 5961 eligible respondents （3233 males; mean age （59.50＋12.48） years; mean hemoglobin Alc （HbAlc） （8.27＋2.23）%）, most patients （79.8%） considered themselves educated on diabetes. Compared with patients without diabetes education, their educated counterparts showed significant lower value of HbAlc, after controlling for age, gender, body mass index and duration of diabetes （P 〈0.01）. The patients who received diabetes education also performed significant higher scores on attitude, knowledge and self-care than their uneducated counterparts. Patients with lower income or education level tended to have higher glucose levels, and showed lower percentage of patients received diabetic education. Conclusions Chinese patients with diabetes education achieved better glycemic control than un-educated patients. Our study indicates effort is required to provide professional education to patients, with emphasis on lower income and lower education level populations.
文摘Since December 2019,an epidemic caused by novel coronavirus (2019-nCoV) infection has occurred unexpectedly in China.As of 8 pm,31 January 2020,more than 20 pediatric cases have been reported in China.Of these cases,ten patients were identified in Zhejiang Province,with an age of onset ranging from 112 days to 17 years.Following the latest National recommendations for diagnosis and treatment of pneumonia caused by 2019-nCo V (the 4th edition) and current status of clinical practice in Zhejiang Province,recommendations for the diagnosis and treatment of respiratory infection caused by 2019-nCoV for children were drafted by the National Clinical Research Center for Child Health,the National Children's Regional Medical Center,Children's Hospital,Zhejiang University School of Medicine to further standardize the protocol for diagnosis and treatment of respiratory infection in children caused by 2019-nCoV.
基金Supported by the Grants from the Health Research Foundation (A2003189) and the Science Research Project (2004B30601001) of Guangdong Province, China
文摘AIM： To investigate the functional, morphological changes of the gut barrier during the restitution process after hemorrhagic shock, and the regional differences of the large intestine and small intestine in response to ischemia/ reperfusion injury. METHODS： Forty-seven Sprague-Dawley rats with body weight of 250-300 g were divided into two groups： control group （sham shock n = 5） and experimental group （n = 42）. Experimental group was further divided into six groups （n = 7 each） according to different time points after the hemorrhagic shock, including 0^th group, 1^st group, 3^rd group, 6th h group, 12^th group and 24^th group. All the rats were gavaged with 2 mL of suspension of lactulose （L） （100 mg/2 mL） and mannitol （M） （50 mg/each） at the beginning and then an experimental rat model of hemorrhagic shock was set up. The specimens from jejunum, ileum and colon tissues and the blood samples from the portal vein were taken at 0, 1, 3, 6, 12 and 24 h after shock resuscitation, respectively. The morphological changes of the intestinal mucosa, including the histology of intestinal mucosa, the thickness of mucosa, the height of villi, the index of mucosal damage and the numbers of goblet cells, were determined by light microscope and/or electron microscope. The concentrations of the bacterial endotoxin lipopolysaccharides （LPS） from the portal vein blood, which reflected the gut barrier function, were examined by using Limulus test. At the same time point, to evaluate intestinal permeability, all urine was collected and the concentrations of the metabolically inactive markers such as L and M in urine were measured by using GC-9A gas chromatographic instrument.RESULTS： After the hemorrhagic shock, the mucosal epithelial injury was obvious in small intestine even at the 0th h, and it became more serious at the 1^stand the 3^rd h. The tissue restitution was also found after 3 h, though the injury was still serious. Most of the injured mucosal restitution was established after 6
文摘The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effective aperture of 3.6 m–4.9 m) and a wide field of view (FOV) (5°). It has an innovative active reflecting Schmidt configuration which continuously changes the mirror’s surface that adjusts during the observation process and combines thin deformable mirror active optics with segmented active optics. Its primary mirror (6.67m×6.05 m) and active Schmidt mirror (5.74m×4.40 m) are both segmented, and composed of 37 and 24 hexagonal sub-mirrors respectively. By using a parallel controllable fiber positioning technique, the focal surface of 1.75 m in diameter can accommodate 4000 optical fibers. Also, LAMOST has 16 spectrographs with 32 CCD cameras. LAMOST will be the telescope with the highest rate of spectral acquisition. As a national large scientific project, the LAMOST project was formally proposed in 1996, and approved by the Chinese government in 1997. The construction started in 2001, was completed in 2008 and passed the official acceptance in June 2009. The LAMOST pilot survey was started in October 2011 and the spectroscopic survey will launch in September 2012. Up to now, LAMOST has released more than 480 000 spectra of objects. LAMOST will make an important contribution to the study of the large-scale structure of the Universe, structure and evolution of the Galaxy, and cross-identification of multiwaveband properties in celestial objects.
基金supported by the National Natural Science Foundation of China (Grants Nos. 90814002,40672150,40272086)
文摘Mesozoic contraction deformation in the Yanshan and Taihang mountains is characterized by basement-involved thrust tectonics,basement-cored buckling anticlines and ductile thrust and nappe tectonics.Most of these deformations are orientated west-east,west-northwest and northeast to north-northeast.The contraction deformations began in the Permian,continued through the Triassic and Jurassic and terminated in the Early Cretaceous,and constitute an important part of the destruction of the North China Craton.It is estimated,from balanced cross-section reconstructions,that the north-south shortening of the central part of the Yanshan belt before 135 Ma was around 38%.The initial crust thickness,pre-dating the major contraction deformation in late Paleozoic and early Mesozoic,was estimated to be around 35 km based on paleogeographic characteristics.Assuming that the inferred depth of ductile thrusting deformation,20-25 km,was the crust thickness involved in the contraction deformation,and also assuming that the N-S contraction deformation was accommodated by vertical crust thickening,the thickness of the crust after the contraction deformation was expected to be around 47-50 km.This was the approximate crust thickness required for the eclogitization of the lower crust for delamination.The gravity potential accumulated by the isostatic uplift of the thickened crust,together with the decrease in crustal strength caused by the coeval magmatisms associated with the contraction deformation,led to the subsequent extensional collapse of the middle and upper crust although the regional stress regime associated with the plate interactions remained constant.It is inferred that the Mesozoic contraction deformations in the Yanshan and Taihang mountains were not only a significant tectonic process contributing to the destruction of the craton in middle and upper crust but also stimulated delamination at a deep level and the extension of the shallow crust.In other words,both the suspected delamination of the lower crust and upper ma
文摘AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider usingthis technique in patients with HCH. This study was to assessthe efficacy, safety, and complications of percutaneousradiofrequency ablation (PRFA) under ultrasonographyguidance in patients with HCH.METHODS: Twelve patients (four men and eight women,age ranged 33-56 years, mean age was 41.7 years) with 15hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) weretreated using the RF-2000 generator and 10-needle LeVeenelectrode percutaneously guided by B-ultrasound. Lesionslarger than 3 cm were treated by multiple overlappingablations that encompass the entire lesion as well as a rimof normal liver tissue (approximately 0.5 cm).RESULTS: All the patients who received PRFA therapy hadno severe pain, bleeding or bile leakage during and afterthe procedures. Nine to 34 months′ follow-up (mean, 21months) by ultrasound and/or spiral CT scan demonstratedthat the ablated lesions in this group were shrunk remarkably,and the shrunken range was 38-79 % (mean, 67 % per 21months). The contrast enhancement was disappeared withinthe tumor or at its periphery in all cases on spiral CT scansobtained 3 to 6 months after treatment.CONCLUSION: The results of this study suggest that PRFAtherapy is a mini-invasive, simple, safe, and effective methodfor the treatment of selected patients with HCH.
文摘Background Recurrent respiratory tract infection (RRTI) is a disease occurred frequently in preschool children.Methods A total of 120 RRTI children were randomly divided into active group,remission group,intervention group and control group,meanwhile 30 healthy children were selected as the healthy group.Children in the intervention group were given oral Bifidobaeterium tetravaccine tablets (Live) for 2 months,while the control group received routine treatment.Stool sample were detected to analyze the bacterial strains.The occurrence of respiratory tract infection (RTI) was compared between different groups during 1 year follow-up.Results Compared with the healthy group,the number of Bifidobacteria and Lactobacilli in the active group,remission group,intervention group and control group was significantly decreased (P < 0.05).The number of Bifidobacteria and Lactobacilli in the intervention group was significantly higher compared to other RRTI groups (P < 0.05).During the follow-up period,the average annual frequency of different acute RTI and use of antibiotics were significantly reduced (P < 0.05),the average duration of cough,fever and use of antibiotics at each episode were also significantly shortened (P < 0.05) in the intervention group compared to the control group.Conclusions Children with RRTI are susceptible to intestinal flora imbalance.Oral probiotics can effectively improve the RRTI intestinal microecological balance in children and reduce the frequency of RTI.
文摘AIM: To evaluate the effectiveness and safety of percutaneous hepatic cryoablation in combination with percutaneous ethanol injection (PEI) in patients with unresectable hepaocellular carcinoma (HCC).METHODS: A total of 105 masses in 65 HCC patients underwent percutaneous hepatic cryoablation. The cryoablation was performed with the Cryocare system (Endocare, Irvine, CA, USA) using argon gas as a cryogen.Two freeze-thaw cycles were performed, each reaching a temperature of -180 ℃ at the tip of the probe. PEI was given in 36 patients with tumor masses larger than 6 cm in diameter 1-2 weeks after cryoablation and then once per week for 4 to 6 sessions. The efficacy was evaluated with survival, change of tumor size and alpha-fetoprotein (AFP) levels. RESULTS: During a follow-up duration of 14 months in average with a range of 5 to 21 months, 33 patients (50.8 %)were free of tumors, 22 patients (33.8 %) alive with tumor recurrence: two had bone metastases, three were found to have lung metastases, and the remaining 17 recurrences occurred in the liver, of whom only 3 developed a cryosite recurrence. Among the 41 patients who were followed up for more than one year, 32(78 %) were alive despite of tumor recurrence. Seven patients (10.8 %) died due to disease recurrence. Three patients (4.6 %) died due to some noncancer-related causes. Among the 43 patients who had a CT scan available for review, 38 (88.4 %) had a shrinkage of tumor mass. Among the 22 patients who received biopsies of cryoablated tumor mass, all biopsies except one, showed only dead or scar tissues. Of the patients who had an increased AFP preablatively, 91.3 % had a decrease of AFP to normal or nearly normal levels during postablative 3-6 months. Complications of cryoablation included liver capsular cracking in one patient,transient thrombocytopenia in 4 patients and asymptomatic right-sided pleural effusions in 2 patients. Two patients developed liver abscess at the previous cryoablation site at 2 and 4 months, respectively,following cryoablation, a
基金Supported by A key medical project in Nanjing Military District of the Chinese People’s Liberation Army,No. 09Z039
文摘AIM： To investigate the value of two-dimensional （2D） and three-dimensional （3D） double contrast-enhanced ultrasonography （DCUS） imaging for evaluation of gas- tric lesions. METHODS： 2D and 3D DCUS imaging with both oral and intravenous administrations of contrast agents was used to assess gastroscopiclly-confirmed gastric lesions in 46 patients with benign and malignant diseases. Initially, liquid-based ultrasound contrast agent （Xinzhang） was given orally at dose of 500-600 mL for conventional ultrasound examination of the gastric lesions, and then a microbubble-based contrast agent （SonoVue） was injected intravenously at dose of 1.2-2.4 mL in bolus fashion to assess the perfusion pattern of the lesions using contrast imaging modes. The parameters derived from time-intensity curves including the arrival time （AT）, time to peak （lq-P）, peak intensity （PI） and en- hanced intensity （EI） were measured on the 2D DCUS imaging. 3D DCUS of the lesions was acquired to dem- onstrate the value of this imaging mode. RESULTS： There were 22 cases with benign lesions including chronic gastritis （n= 5）, gastric ulcer （n = 9）, gastric polyps （n = 3）, gastric stromal tumors （n = 5）, and 24 cases with malignant lesions including gastric cancer （n = 20）, gastric cardia carcinoma （n = 3） and post-operative recurrent gastric cancer （n = 1） in the study, The oral contrast-enhanced ultrasonography （CEUS） imaging of the stomach clearly demonstrated the anatomy of the stomach and morphologic features of gastric lesions, With optimal scanning window and imaging display under oral CEUS, intravenous CEUS clearly showed the perfusion of gastric lesions with various characteristic manifestations. Both 2D and 3D DCUS images clearly demonstrated normal gastric wall as a three-layer structure, from the inside out, hypere- choic mucosa, hypoechoic muscularis and hyperechoic serosa, respectively. There were statistical significant differences of AT （8.68±2.06 vs 10.43 ±
基金The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104)National Natural Science Foundation of China(81827805,82130060)Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication.
文摘There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.
基金funded by the National Basic Research Program of China (973 Program, 2014CB845700)the National Natural Science Foundation of China (Grant Nos. 11390371)Funding for the project has been provided by the National Development and Reform Commission
文摘The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.
文摘目的分析1990~2019年中国结直肠癌(colorectal cancer,CRC)疾病负担的变化趋势。方法利用2019年全球疾病负担数据,采用发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)、过早死亡损失寿命年(years of life lost,YLL)、伤残损失寿命年(years lived with disability,YLD)及其标化率和平均年度百分比变化率(annual average percentage change,AAPC)对1990~2019年间中国CRC疾病负担情况进行分析。结果与1990年相比,2019年中国CRC发病例数、标化发病率、死亡例数和标化死亡率分别上升了474.03%、144.01%、230.14%和36.15%。2010年以后中国CRC标化死亡率和标化发病率逐渐超过全球水平。1990~2019年,中国CRC的总体标化发病率(AAPC=3.6%,P<0.05)、标化死亡率(AAPC=1.4%,P<0.05)和标化DALY率(AAPC=1.2%,P<0.05)总体均呈上升趋势。男性发病率、死亡率和DALY率均高于女性,且随着年龄的增长而逐渐升高。与1990年相比,2019年CRC的DALY、YLL和YLD分别上升了134.3%、127.69%和445.00%,标化DALY、YLL和YLD分别上升了30.53%、27.03%和187.29%。结论从1990年到2019年,中国CRC标化发病率和标化死亡率呈现不断增长趋势,尤其是在男性和老年人群中,应采取针对性的措施进行预防和管理。
基金Supported by National Science Foundation of China, No. 30370561Natural Science Foundation of Hebei Province, No. C2004000649
文摘AIM: To study the effect of blocking intestinal lymphatic circulation in two-hit rats and explore the significance of intestinal lymphatic circulation in two-hit. METHODS: Wistar rats were divided equally into three groups: mesenteric lymph duct ligation group, non- ligation group and sham group. Mesenteric lymph was diverted by ligation of mesenteric lymph duct, and the two-hit model was established by hemorrhage and lipopolysaccharide (LPS) methods. All rats were sampled for serum pre-experiment and 24 h post- experiment. The organs including kidney, liver, lung and heart were collected for pathomorphologic observation and biochemical investigation. The nitric oxide (NO), malondialdehyde (MDA) and superoxide dismutase (SOD) were determined in serum and tissue homogenate. RESULTS: Pathomorphology study showed that the structures of kidney, lung, liver and heart tissues were normal in sham group; congestion, degeneration and necrosis in non-ligation group; but only mild lesions in ligation group. After two-hits, the contents of AST, ALT, BUN, Cr and LDH-1 in the serum of non-ligation group and ligation group were obviously higher than that in pre-experiment group and sham group, but obviously lower than that in non-ligation group. The contents of NO2-/NO3-, NOS, iNOS and MDA in the serum of non- ligation group were significantly increased, compared with pre-experiment and sham group, but SOD was significantly lower. These parameters were significantly different in ligation group compared with that in sham group, but NO2-/NO3-, iNOS and MDA in ligation group were significantly lower than that in non-ligation group. CONCLUSION: Ligation of mesenteric lymph duct could improve the disturbance of organic function and morphologic damage in two-hit rats; the lymphatic mechanism in two-hit should be emphasized.
基金This study was supported by grants from the National Natura1 Science Foundation of China(No.81372013 and No.81672236)China-Japan Friendship Hospital Youth Science and Technology Excellence Proiect(No.2014-QNYC-A-06).
文摘Objective： This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head （ONFH） based on a comprehensive analysis of the clinical literature. Data Sources： For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words： ＆quot;corticosteroid＆quot;, ＆quot;osteonecrosis of the femoral head＆quot;,＆quot;risk factors＆quot;, ＆quot;diagnosis＆quot;, ＆quot;prognosis＆quot;, and ＆quot;treatment＆quot;. Study Selection： Articles on relationships between corticosteroid and ONFH were selected for this review. Articles on the diagnosis, prognosis, and intervention of earlier-stage ONFH were also reviewed. Results： The incidence of corticosteroid-induced ONFH was associated with high doses of corticosteroids, and underlying diseases in certain predisposed individuals mainly occurred in the first 3 months of corticosteroid prescription. The enhanced awareness and minimized exposure to the established risk factors and earlier definitive diagnosis are essential for the success of joint preservation. When following up patients with ONFH, treatment should be started if necessary. Surgical treatment yielded better results than conservative therapy in earlier-stage ONFH. The ideal purpose of earlier intervention and treatment is permanent preservation of the femoral head without physical restrictions in daily living. Conclusions： Clinicians should enhance their precaution awareness of corticosteroid-induced ONFH. For high-risk patients, regular follow-up is very important in the 1st year after high-dose prescription of corticosteroids. Patients with suspected ONFH should be referred to orthopedists for diagnosis and treatment in its earlier stage to preserve the joint.
