AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or d...AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN).Enteral nutrition was started within 48 h after admission in EEN group,whereas from the 8 th day in DEN group.All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1,3,7 and 14 after admission.The clinical outcome variables were also recorded.RESULTS:Sixty SAP patients were enrolled to this study.The CD4+ T-lymphocyte percentage,CD4+/CD8+ ratio,and the CRP levels in EEN group became significantly lower than in DEN group from the 7 th day after admission.In contrast,the immunoglobulin G(IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7 th day after admission.No difference of CD8+ T-lymphocyte percentage,IgM and IgA levels was found between the two groups.The incidences of multiple organ dysfunction syndrome,systemic inflammatory response syndrome,and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group.However,there was no difference of hospital mortality between the two groups.CONCLUSION:EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression.EEN can improve the clinical outcome,but not decrease the hospital mortality of SAP patients.展开更多
The irregular domain and lack of ordering make it challenging to design deep neural networks for point cloud processing.This paper presents a novel framework named Point Cloud Transformer(PCT)for point cloud learning....The irregular domain and lack of ordering make it challenging to design deep neural networks for point cloud processing.This paper presents a novel framework named Point Cloud Transformer(PCT)for point cloud learning.PCT is based on Transformer,which achieves huge success in natural language processing and displays great potential in image processing.It is inherently permutation invariant for processing a sequence of points,making it well-suited for point cloud learning.To better capture local context within the point cloud,we enhance input embedding with the support of farthest point sampling and nearest neighbor search.Extensive experiments demonstrate that the PCT achieves the state-of-the-art performance on shape classification,part segmentation,semantic segmentation,and normal estimation tasks.展开更多
Humans can naturally and effectively find salient regions in complex scenes.Motivated by this observation,attention mechanisms were introduced into computer vision with the aim of imitating this aspect of the human vi...Humans can naturally and effectively find salient regions in complex scenes.Motivated by this observation,attention mechanisms were introduced into computer vision with the aim of imitating this aspect of the human visual system.Such an attention mechanism can be regarded as a dynamic weight adjustment process based on features of the input image.Attention mechanisms have achieved great success in many visual tasks,including image classification,object detection,semantic segmentation,video understanding,image generation,3D vision,multimodal tasks,and self-supervised learning.In this survey,we provide a comprehensive review of various attention mechanisms in computer vision and categorize them according to approach,such as channel attention,spatial attention,temporal attention,and branch attention;a related repository https://github.com/MenghaoG uo/Awesome-Vision-Attentions is dedicated to collecting related work.We also suggest future directions for attention mechanism research.展开更多
Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several ...Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. Th展开更多
A new approach, the conditional nonlinear optimal perturbation (CNOP) is introduced to study the predictability of El Ni駉-Southern Oscillation (ENSO) using a theoretical coupled ocean-atmosphere model. The difference...A new approach, the conditional nonlinear optimal perturbation (CNOP) is introduced to study the predictability of El Ni駉-Southern Oscillation (ENSO) using a theoretical coupled ocean-atmosphere model. The differences between CNOP and linear singular vector (LSV) are demonstrated. The results suggest that the nonlinear model and CNOP are superior in determining error growth for studying predictability of the ENSO. In particular, the CNOP approach is used to explore the nature of the 憇pring predictability barrier?in ENSO prediction.展开更多
OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases w...OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases were collected and reviewed in order to summarize the latest extraction separation, pharmacokinetics, and the pharmacological effects of astrageloside IV. RESULTS: Protective effects of Astrageloside IV on the cardiovascular system, immune, digestive, nervous system were identified, and the action mechanisms were associated with regulation of the calcium balance, anti-oxydant, antiapoptosis, antivirus, and so on. CONCLUSION: Astrageloside IV has broad application prospects, especially in cardiovascular diseases, digestive diseases, cancer and other modern high incidence, high-risk diseases, and could be developed as a medicine.展开更多
The atmospheric concentrations of carbonyls and BTEX （benzene,toluene,ethylbenzene,m,p-xylene and o-xylene） were measured simultaneously at a same sampling site in Beijing from September 2008 to August 2010.The aver...The atmospheric concentrations of carbonyls and BTEX （benzene,toluene,ethylbenzene,m,p-xylene and o-xylene） were measured simultaneously at a same sampling site in Beijing from September 2008 to August 2010.The average concentrations of the total measured carbonyls during autumn,winter,spring,and summer were 37.7,31.3,39.7,50.5 μg/m 3,respectively,and maximal values for their diurnal variations usually happened at noontime.In contrast to carbonyls,the average concentrations of the total measured BTEX during the four seasons were 27.2,31.9,23.2,19.1 μg/m 3,respectively,andminimal values for their diurnal variations always occurred in the early afternoon.The average concentration for carbonyls increased about 24% from September 2008–August 2009 to September 2009–August 2010,for BTEX,increased about 15%.Integrated life time cancer risks for three carcinogens （benzene,formaldehyde and acetaldehyde） in Beijing exceeded the value of 1E-06,and the hazard quotient （HQ） of non-cancer risk of exposure to formaldehyde exceeded unity.展开更多
It is a novel idea to make steamed bread by adding potato flour into wheat flour considering the production and nutritional factors of potato. In this study, the influence of potato flour（0–35%） on dough rheology a...It is a novel idea to make steamed bread by adding potato flour into wheat flour considering the production and nutritional factors of potato. In this study, the influence of potato flour（0–35%） on dough rheology and quality of steamed bread were investigated. Potato flour addition significantly influenced the dough rheological properties and steamed bread quality, such as increased water absorption, the maximum gaseous release height, total volume of CO_2 and hardness, while decreased dough stability and specific volume of steamed bread. Moreover, correlation analysis suggested that dough height at the maximum development time, dough stability, water absorption and the phase tangent can be used for predicting the technological quality of steamed bread. Potato-wheat steamed bread had higher dietary fibre, ash content and antioxidant activity than those of wheat steamed bread. The estimated glycemic index decreased from 73.63（0%） to 60.01（35%）. Considering the sensory evaluation, the steamed bread with 20% potato flour is acceptable. In conclusion, adding appropriate quantity of potato flour to wheat flour for steamed bread production will not only maintain the technological quality, but also can improve the nutritional value of the steamed bread.展开更多
Ligustrazine （2,3,5,6-tetramethylpyrazine） is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mecha- nism of action of ligustraz...Ligustrazine （2,3,5,6-tetramethylpyrazine） is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mecha- nism of action of ligustrazine use against ischemic cerebrovascular diseases remains unclear at present. This study summarizes its protective effect, the optimum time window of administra- tion, and the most effective mode of administration for clinical treatment of cerebral ischemia/ reperfusion injury. We examine the effects of ligustrazine on suppressing excitatory amino acid release, promoting migration, differentiation and proliferation of endogenous neural stem cells. We also looked at its effects on angiogenesis and how it inhibits thrombosis, the inflammatory response, and apoptosis after cerebral ischemia. We consider that ligustrazine gives noticeable protection from cerebral ischemia/reperfusion injury. The time window of ligustrazine admin- istration is limited. The protective effect and time window of a series of derivative monomers of ligustrazine such as 2-[（1,1-dimethylethyl）oxidoimino]methyl]-3,5,6-trimethylpyrazine, CXC137 and CXC 195 after cerebral ischemia were better than ligustrazine.展开更多
Background:Effective therapeutic options are limited for patients with advanced esophageal squamous cell carcinoma(ESCC).The incorporation of an immune checkpoint inhibitor and a molecular anti-angiogenic agent into t...Background:Effective therapeutic options are limited for patients with advanced esophageal squamous cell carcinoma(ESCC).The incorporation of an immune checkpoint inhibitor and a molecular anti-angiogenic agent into the commonly adopted chemotherapy may produce synergistic effects.Therefore,we aimed to investigate the efficacy and safety of camrelizumab plus apatinib combined with chemotherapy as the first-line treatment of advanced ESCC.Methods:In this single-arm prospective phase II trial,patients with unresectable locally advanced or recurrent/metastatic ESCC received camrelizumab 200 mg,liposomal paclitaxel 150 mg/m2,and nedaplatin 50 mg/m2 on day 1,and apatinib 250 mg on days 1-14.The treatments were repeated every 14 days for up to 9 cycles,followed by maintenance therapy with camrelizumab and apatinib.The primary endpoint was objective response rate(ORR)according to the Response Evaluation Criteria in Solid Tumors(version 1.1).Secondary endpoints included disease control rate(DCR),progression-free survival(PFS),overall survival(OS),and safety.Results:We enrolled 30 patients between August 7,2018 and February 23,2019.The median follow-up was 24.98 months(95%confidence interval[CI]:23.05-26.16 months).The centrally assessed ORR was 80.0%(95%CI:61.4%-92.3%),with a median duration of response of 9.77 months(range:1.54 to 24.82+months).The DCR reached 96.7%(95%CI:82.8%-99.9%).The median PFS was 6.85 months(95%CI:4.46-14.20 months),and the median OS was 19.43 months(95%CI:9.93 months–not reached).The most common grade 3-4 treatmentrelated adverse events(AEs)were leukopenia(83.3%),neutropenia(60.0%),and increased aspartate aminotransferase level(26.7%).Treatment-related serious AEs included febrile neutropenia,leukopenia,and anorexia in one patient(3.3%),and single cases of increased blood bilirubin level(3.3%)and toxic epidermal necrolysis(3.3%).No treatment-related deaths occurred.Conclusions:Camrelizumab plus apatinib combined with liposomal paclitaxel and nedaplatin as first-line treatment demonstrated feas展开更多
Conditional nonlinear optimal perturbation (CNOP),which is a natural extension of singular vector (SV) into the nonlinear regime,is applied to ensemble prediction study by using a quasi-geostrophic model under the per...Conditional nonlinear optimal perturbation (CNOP),which is a natural extension of singular vector (SV) into the nonlinear regime,is applied to ensemble prediction study by using a quasi-geostrophic model under the perfect model assumption. SVs and CNOPs have been utilized to generate the initial pertur-bations for ensemble prediction experiments. The results are compared for forecast lengths of up to 14 d. It is found that the forecast skill of samples,in which the first SV is replaced by CNOP,is com-paratively higher than that of samples composed of only SVs in the medium range (day 6―day 14). This conclusion is valid under the condition that analysis error is a kind of fast-growing ones regardless of its magnitude,whose nonlinear growth is faster than that of SV in the later part of the forecast. Fur-thermore,similarity index and empirical orthogonal function (EOF) analysis are performed to explain the above numerical results.展开更多
The mitochondria-mediated caspase activation pathway is a major apoptotic pathway characterized by mitochondrial outer membrane permeabilization （MOMP） and subsequent release of cytochrome c into the cytoplasm to ac...The mitochondria-mediated caspase activation pathway is a major apoptotic pathway characterized by mitochondrial outer membrane permeabilization （MOMP） and subsequent release of cytochrome c into the cytoplasm to activate caspases. MOMP is regulated by the Bcl-2 family of proteins. This pathway plays important roles not only in normal development, main- tenance of tissue homeostasis and the regulation of immune system, but also in human diseases such as immune disorders, neurodegeneration and cancer. In the past decades the molecular basis of this pathway and the regulatory mechanism have been comprehen- sively studied, yet a great deal of new evidence indi- cates that cytochrome c release from mitochondria does not always lead to irreversible cell death, and that caspase activation can also have non-death functions. Thus, many unsolved questions and new challenges are still remaining. Furthermore, the dysfunction of this pathway involved in cancer development is obvious, and targeting the pathway as a therapeutic strategy has been extensively explored, but the efficacy of the tar- geted therapies is still under development. In this review we will discuss the mitochondria-mediated apoptosis pathway and its physiological roles and therapeutic implications.展开更多
Various active components have been extracted from the root of Polygonum cuspidatum. However, the genetic basis for their activity is virtually unknown. In this study, 25600002 short reads （2.3 Gb） of P. cuspidatum ...Various active components have been extracted from the root of Polygonum cuspidatum. However, the genetic basis for their activity is virtually unknown. In this study, 25600002 short reads （2.3 Gb） of P. cuspidatum root transcriptome were obtained via lllumina HiSeq 2000 sequencing. A total of 86418 urtigenes were assembled de novo and annotated. Twelve, 18, 60 and 54 unigenes were respectively mapped to the mevalonic acid （MVA）, methyl-D-erythritol 4-phosphate （MEP）, shikimate and resveratrol biosynthesis pathways, suggesting that they are involved in the biosynthesis of pharmaceutically important anthra- quinone and resveratrol. Eighteen potential UDP-glycosyltransferase unigenes were identified as the candidates most likely to be involved in the biosynthesis of glycosides of secondary metabolites. Identification of relevant genes could be important in eventually increasing the yields of the medicinally useful constituents of the P. cuspidatum root. From the previously published transcriptome data of 19 non-model plant taxa, 1127 shared orthologs were identified and characterized. This information will be very useful for future functional, phylogenetic and evolutionary studies of these plants.展开更多
Rock bursts signify extreme behavior in coal mine strata and severely threaten the safety of the lives of miners, as well as the effectiveness and productivity of miners. In our study, an elastic-plastic-brittle model...Rock bursts signify extreme behavior in coal mine strata and severely threaten the safety of the lives of miners, as well as the effectiveness and productivity of miners. In our study, an elastic-plastic-brittle model for the deformation and failure of coal/rock was established through theoretical analyses, laboratory experiments and field testing, simulation and other means, which perfectly predict sudden and delayed rock bursts. Based on electromagnetic emission (EME), acoustic emission (AE) and microseism (MS) effects in the process from deformation until impact rupture of coal-rock combination samples, a multi-parameter identification of premonitory technology was formed, largely depending on these three forms of emission. Thus a system of classification for forecasting rock bursts in space and time was established. We have presented the intensity weakening theory for rock bursts and a strong-soft-strong (3S) structural model for controlling the impact on rock surrounding roadways, with the objective of laying a theoretical foundation and establishing references for parameters for the weakening control of rock bursts. For the purpose of prevention, key technical parameters of directional hydraulic fracturing are revealed. Based on these results, as well as those from deep-hole controlled blasting in coal seams and rock, integrated control techniques were established and anti-impact hydraulic props, suitable for roadways subject to hazards from rockbursts have also been developed. These technologies have been widely used in most coal mines in China, subject to these hazards and have achieved remarkable economic and social benefits.展开更多
Objective： To observe wet cupping therapy（WCT） on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis（NT-CS）. Methods： Fifty-seven NT-CS patients were randomly divid...Objective： To observe wet cupping therapy（WCT） on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis（NT-CS）. Methods： Fifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture（JA） group according a random number table. WCT group（30 cases） was treated with WCT for 10 min, and JA group（27 cases） was treated with acupuncture for 10 min. The treatment efficacies were evaluated with a Visual Analogue Scale（VAS）. Blood perfusion at Dazhui（GV 14） and Jianjing（GB 21） acupoints（affected side） was observed with a laser speckle flowmetry, and its variations before and after treatment in both groups were compared as well. Results： In both groups, the VAS scores significantly decreased after the intervention（P〈0.01）, while the blood perfusion at the two acupoints significantly increased after intervention（P〈0.05）; however, the increasement magnitude caused by WCT was obvious compared with JA（P〈0.05）. Conclusion： WCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.展开更多
Conditional nonlinear optimal perturbation (CNOP) is a nonlinear generalization of linear singular vector (LSV) and features the largest nonlinear evolution at prediction time for the initial perturbations in a given ...Conditional nonlinear optimal perturbation (CNOP) is a nonlinear generalization of linear singular vector (LSV) and features the largest nonlinear evolution at prediction time for the initial perturbations in a given constraint. It was proposed initially for predicting the limitation of predictability of weather or climate. Then CNOP has been applied to the studies of the problems related to predictability for weather and climate. In this paper, we focus on reviewing the recent advances of CNOP's applications, which involves the ones of CNOP in problems of ENSO amplitude asymmetry, block onset, and the sensitivity analysis of ecosystem and ocean's circulations, etc. Especially, CNOP has been primarily used to construct the initial perturbation fields of ensemble forecasting, and to determine the sensitive area of target observation for precipitations. These works extend CNOP's applications to investigating the nonlinear dynamical behaviors of atmospheric or oceanic systems, even a coupled system, and studying the problem of the transition between the equilibrium states. These contributions not only attack the particular physical problems, but also show the superiority of CNOP to LSV in revealing the effect of nonlinear physical processes. Consequently, CNOP represents the optimal precursors for a weather or climate event; in predictability studies, CNOP stands for the initial error that has the largest negative effect on prediction; and in sensitivity analysis, CNOP is the most unstable (sensitive) mode. In multi-equilibrium state regime, CNOP is the initial perturbation that induces the transition between equilibriums most probably. Furthermore, CNOP has been used to construct ensemble perturbation fields in ensemble forecast studies and to identify sensitive area of target observation. CNOP theory has become more and more substantial. It is expected that CNOP also serves to improve the predictability of the realistic predictions for weather and climate events plays an increasingly important role in exploring th展开更多
AIM:To compare the effects and postoperative complications between tissue selecting therapy stapler(TST)and Milligan-Morgan hemorrhoidectomy(M-M).METHODS:Four hundred and eighty patients with severe prolapsing hemorrh...AIM:To compare the effects and postoperative complications between tissue selecting therapy stapler(TST)and Milligan-Morgan hemorrhoidectomy(M-M).METHODS:Four hundred and eighty patients with severe prolapsing hemorrhoids,who were admitted to the Shenyang Coloproctology Hospital between 2009and 2012,were randomly divided into observation(n=240)and control(n=240)groups.Hemorrhoidectomies were performed with TST in the observation group and with the M-M technique in the control group.The therapeutic effects,operation security,and postoperative complications in the two groups were compared.The immediate and long-term complications were assessed according to corresponding criteria.Pain was assessed on a visual analogue scale.The efficacy was assessed by specialized criteria.The follow-up was conducted one year after the operation.RESULTS:The total effective rates of the observation and control groups were 99.5%(217/218)and 98.6%(218/221)respectively;the difference was not statistically significant(P=0.322).Their were significant differences between observation and control groups in intraoperative blood loss(5.07±1.14 vs 2.45±0.57,P=0.000),pain(12 h after the surgery:5.08±1.62 vs 7.19±2.01,P=0.000;at first dressing change:2.64±0.87 vs 4.34±1.15,P=0.000;first defecation:3.91±1.47 vs 5.63±1.98,P=0.001),urine retention(n=22 vs n=47,P=0.001),anal pendant expansion after the surgery(2.35±0.56 vs 5.16±1.42,P=0.000),operation time(18.3±5.6 min vs 29.5±8.2 min,P=0.000),and the length of hospital stay(5.3±0.6 d vs 11.4±1.8 d,P=0.000).Moreover TST showed significant reductions compared to M-M in the rates of long-term complications such as fecal incontinence(n=3 vs n=16,P=0.003),difficult bowel movement(n=1 vs n=9,P=0.011),intractable pain(n=2 vs n=12,P=0.007),and anal discharge(n=3 vs n=23,P=0.000).CONCLUSION:TST for severe prolapsing hemorrhoids is a satisfactory technique for more rapid recovery,lower complication rates,and higher operation security.展开更多
BACKGROUND The imbalance of Th17/Treg cells and the IL-23/IL-17 axis have been confirmed to be associated with sepsis and various inflammatory diseases. Early enteral nutrition (EEN) can modulate the inflammatory resp...BACKGROUND The imbalance of Th17/Treg cells and the IL-23/IL-17 axis have been confirmed to be associated with sepsis and various inflammatory diseases. Early enteral nutrition (EEN) can modulate the inflammatory response, improve immune dysfunction, and prevent enterogenic infection in critically ill patients;however, the precise mechanisms remain unclear. Considering the important roles of Th17 and Treg lymphocytes in the development of inflammatory and infectious diseases, we hypothesized that EEN could improve the immune dysfunction in sepsis by maintaining a balanced Th17/Treg cell ratio and by regulating the IL- 23/IL-17 axis. AIM To investigate the effects of EEN on the Th17/Treg cell ratios and the IL-23/IL-17 axis in septic patients. METHODS In this prospective clinical trial, patients were randomly divided into an EEN or delayed enteral nutrition (DEN) group. Enteral feeding was started within 48 h in the EEN group, whereas enteral feeding was started on the 4th day in the DEN group. The Th17 and Treg cell percentages and the interleukin levels were tested on days 1, 3, and 7 after admission. The clinical severity and outcome variables were also recorded. RESULTS Fifty-three patients were enrolled in this trial from October 2017 to June 2018. The Th17 cell percentages, Th17/Treg cell ratios, IL-17, IL-23, and IL-6 levels of the EEN group were lower than those of the DEN group on the 7th day after admission (P < 0.05). The duration of mechanical ventilation and of the intensive care unit stay of the EEN group were shorter than those of the DEN group (P <0.05). However, no difference in the 28-d mortality was found between the two groups (P = 0.728). CONCLUSION EEN could regulate the imbalance of Th17/Treg cell ratios and suppress the IL- 23/IL-17 axis during sepsis. Moreover, EEN could reduce the clinical severity of sepsis but did not reduce the 28-d mortality of septic patients.展开更多
Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases...Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases from 44 CBCC centers were included.Data of diagnosis,treatment and pathology were collected.Results:The average age was 63.5 year-old and most patients were male(84.3%).The most common histologic types were urothelial carcinoma(91.4%),adenocarcinoma(1.8%),and squamous carcinoma(1.9%).According to 1973 and 2004 WHO grading system,42.0%,41.0%,and 17.0% of patients were grade 1,2,and 3,and 16.0%,48.7%,and 35.3% of patients were papillary urothelial neoplasms of low malignant potential,low,and high grade,respectively.Non-muscle invasive bladder cancer(NMIBC)and muscle invasive bladder cancer(MIBC)were 25.2% and 74.1%,respectively(0.8% not clear).Carcinoma in situ was only 2.4%.Most patients were diagnosed by white-light cystoscopy with biopsy(74.3%).Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%,respectively.Diagnostic transurethral resection(TUR)provided detection rate of 16.9%.Most NMIBCs were treated with TUR(89.2%).After initial TUR,2.6%accepted second TUR,and 45.7%,69.9%,and 58.7% accepted immediate,induced,and maintenance chemotherapy instillation,respectively.Most MIBCs were treated with radical cystectomy(RC,59.7%).Laparoscopic RCs were 35.1%,while open RC 63.4%.Extended and standard pelvic lymph node dissection were 7% and 66%,respectively.Three most common urinary diversions were orthotopic neobladder(44%),ileal conduit(31%),and ureterocutaneostomy(23%).Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18%of T3 and T4 patients accepted adjuvant chemotherapy.Conclusion:Disease characteristics are similar to international reports,while differences of diagnosis and treatment exist.This study can provide evidences for revisions of the guideline on bladder cancer in China.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
基金Supported by Grants from the Key Project of the Eleventh Five-Year Plan of People's Liberation Army,No.06G041
文摘AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN).Enteral nutrition was started within 48 h after admission in EEN group,whereas from the 8 th day in DEN group.All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1,3,7 and 14 after admission.The clinical outcome variables were also recorded.RESULTS:Sixty SAP patients were enrolled to this study.The CD4+ T-lymphocyte percentage,CD4+/CD8+ ratio,and the CRP levels in EEN group became significantly lower than in DEN group from the 7 th day after admission.In contrast,the immunoglobulin G(IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7 th day after admission.No difference of CD8+ T-lymphocyte percentage,IgM and IgA levels was found between the two groups.The incidences of multiple organ dysfunction syndrome,systemic inflammatory response syndrome,and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group.However,there was no difference of hospital mortality between the two groups.CONCLUSION:EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression.EEN can improve the clinical outcome,but not decrease the hospital mortality of SAP patients.
基金supported by the National Natural Science Foundation of China(Project Number 61521002)the Joint NSFC–DFG Research Program(Project Number 61761136018).
文摘The irregular domain and lack of ordering make it challenging to design deep neural networks for point cloud processing.This paper presents a novel framework named Point Cloud Transformer(PCT)for point cloud learning.PCT is based on Transformer,which achieves huge success in natural language processing and displays great potential in image processing.It is inherently permutation invariant for processing a sequence of points,making it well-suited for point cloud learning.To better capture local context within the point cloud,we enhance input embedding with the support of farthest point sampling and nearest neighbor search.Extensive experiments demonstrate that the PCT achieves the state-of-the-art performance on shape classification,part segmentation,semantic segmentation,and normal estimation tasks.
基金National Natural Science Foundation of China(Grant Nos.61521002 and 62132012)。
文摘Humans can naturally and effectively find salient regions in complex scenes.Motivated by this observation,attention mechanisms were introduced into computer vision with the aim of imitating this aspect of the human visual system.Such an attention mechanism can be regarded as a dynamic weight adjustment process based on features of the input image.Attention mechanisms have achieved great success in many visual tasks,including image classification,object detection,semantic segmentation,video understanding,image generation,3D vision,multimodal tasks,and self-supervised learning.In this survey,we provide a comprehensive review of various attention mechanisms in computer vision and categorize them according to approach,such as channel attention,spatial attention,temporal attention,and branch attention;a related repository https://github.com/MenghaoG uo/Awesome-Vision-Attentions is dedicated to collecting related work.We also suggest future directions for attention mechanism research.
文摘Background： Atopic dermatitis （AD） is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczemaJAD and to propose Chinese diagnostic criteria for adult/adolescent AD. Methods： A hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients （12 years and over） with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and-investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software. Results： A total of 2662 valid questionnaires were collected （1369 male and 1293 female）. Of all 2662 patients, 2062 （77.5%） patients had the disease after 12 years old, while only 600 （22.5%） patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine （80.4%） patients had the disease for more than 6 months. One thousand one hundred and forty-four （43.0%） patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight （58.2%） patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients. Conclusion： Late-onset of eczema or AD is common. Th
基金supported by the National Key Basic Research Proiect(Grant No.G1998040910)the National Natural Science Foundation of China(Grant Nos.40023001 and 40075015)of the Chinese Academy of Sciences (Grant No.KZCX2-208).
文摘A new approach, the conditional nonlinear optimal perturbation (CNOP) is introduced to study the predictability of El Ni駉-Southern Oscillation (ENSO) using a theoretical coupled ocean-atmosphere model. The differences between CNOP and linear singular vector (LSV) are demonstrated. The results suggest that the nonlinear model and CNOP are superior in determining error growth for studying predictability of the ENSO. In particular, the CNOP approach is used to explore the nature of the 憇pring predictability barrier?in ENSO prediction.
文摘OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases were collected and reviewed in order to summarize the latest extraction separation, pharmacokinetics, and the pharmacological effects of astrageloside IV. RESULTS: Protective effects of Astrageloside IV on the cardiovascular system, immune, digestive, nervous system were identified, and the action mechanisms were associated with regulation of the calcium balance, anti-oxydant, antiapoptosis, antivirus, and so on. CONCLUSION: Astrageloside IV has broad application prospects, especially in cardiovascular diseases, digestive diseases, cancer and other modern high incidence, high-risk diseases, and could be developed as a medicine.
基金supported by the National Natural Science Foundation of China (No. 41075094,40830101, 21177140,20977097)the National Basic Research and the Development Program (973) of China (No. 2010CB732304)+1 种基金the Special Fund for Environmental Research in the Public Interest (No. 201009001)the National Water Special Project (No. 2009ZX07210-009)
文摘The atmospheric concentrations of carbonyls and BTEX （benzene,toluene,ethylbenzene,m,p-xylene and o-xylene） were measured simultaneously at a same sampling site in Beijing from September 2008 to August 2010.The average concentrations of the total measured carbonyls during autumn,winter,spring,and summer were 37.7,31.3,39.7,50.5 μg/m 3,respectively,and maximal values for their diurnal variations usually happened at noontime.In contrast to carbonyls,the average concentrations of the total measured BTEX during the four seasons were 27.2,31.9,23.2,19.1 μg/m 3,respectively,andminimal values for their diurnal variations always occurred in the early afternoon.The average concentration for carbonyls increased about 24% from September 2008–August 2009 to September 2009–August 2010,for BTEX,increased about 15%.Integrated life time cancer risks for three carcinogens （benzene,formaldehyde and acetaldehyde） in Beijing exceeded the value of 1E-06,and the hazard quotient （HQ） of non-cancer risk of exposure to formaldehyde exceeded unity.
基金financed by the Public Welfare Industry(Agriculture)Research Project of China(201503001-2)the Agricultural Special Financial in 2015 of Chinathe Basic Research Expenses Budget Incremental Project of Chinese Academy of Agricultural Sciences(2014ZL009)
文摘It is a novel idea to make steamed bread by adding potato flour into wheat flour considering the production and nutritional factors of potato. In this study, the influence of potato flour（0–35%） on dough rheology and quality of steamed bread were investigated. Potato flour addition significantly influenced the dough rheological properties and steamed bread quality, such as increased water absorption, the maximum gaseous release height, total volume of CO_2 and hardness, while decreased dough stability and specific volume of steamed bread. Moreover, correlation analysis suggested that dough height at the maximum development time, dough stability, water absorption and the phase tangent can be used for predicting the technological quality of steamed bread. Potato-wheat steamed bread had higher dietary fibre, ash content and antioxidant activity than those of wheat steamed bread. The estimated glycemic index decreased from 73.63（0%） to 60.01（35%）. Considering the sensory evaluation, the steamed bread with 20% potato flour is acceptable. In conclusion, adding appropriate quantity of potato flour to wheat flour for steamed bread production will not only maintain the technological quality, but also can improve the nutritional value of the steamed bread.
基金supported by a grant from the Health and Family Planning Commission of Heilongjiang Province Research Project in China,No.2014-195the Education Department Science and Technology Foundation of Heilongjiang Province in China,No.12531741the Natural Science Foundation of Heilongjiang Province of China,No.H2015083
文摘Ligustrazine （2,3,5,6-tetramethylpyrazine） is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mecha- nism of action of ligustrazine use against ischemic cerebrovascular diseases remains unclear at present. This study summarizes its protective effect, the optimum time window of administra- tion, and the most effective mode of administration for clinical treatment of cerebral ischemia/ reperfusion injury. We examine the effects of ligustrazine on suppressing excitatory amino acid release, promoting migration, differentiation and proliferation of endogenous neural stem cells. We also looked at its effects on angiogenesis and how it inhibits thrombosis, the inflammatory response, and apoptosis after cerebral ischemia. We consider that ligustrazine gives noticeable protection from cerebral ischemia/reperfusion injury. The time window of ligustrazine admin- istration is limited. The protective effect and time window of a series of derivative monomers of ligustrazine such as 2-[（1,1-dimethylethyl）oxidoimino]methyl]-3,5,6-trimethylpyrazine, CXC137 and CXC 195 after cerebral ischemia were better than ligustrazine.
基金This study was supported by the Chinese Society of Clinical Oncology(CSCO)-Hengrui Oncology Research Fund(No.Y-HR2018-364)。
文摘Background:Effective therapeutic options are limited for patients with advanced esophageal squamous cell carcinoma(ESCC).The incorporation of an immune checkpoint inhibitor and a molecular anti-angiogenic agent into the commonly adopted chemotherapy may produce synergistic effects.Therefore,we aimed to investigate the efficacy and safety of camrelizumab plus apatinib combined with chemotherapy as the first-line treatment of advanced ESCC.Methods:In this single-arm prospective phase II trial,patients with unresectable locally advanced or recurrent/metastatic ESCC received camrelizumab 200 mg,liposomal paclitaxel 150 mg/m2,and nedaplatin 50 mg/m2 on day 1,and apatinib 250 mg on days 1-14.The treatments were repeated every 14 days for up to 9 cycles,followed by maintenance therapy with camrelizumab and apatinib.The primary endpoint was objective response rate(ORR)according to the Response Evaluation Criteria in Solid Tumors(version 1.1).Secondary endpoints included disease control rate(DCR),progression-free survival(PFS),overall survival(OS),and safety.Results:We enrolled 30 patients between August 7,2018 and February 23,2019.The median follow-up was 24.98 months(95%confidence interval[CI]:23.05-26.16 months).The centrally assessed ORR was 80.0%(95%CI:61.4%-92.3%),with a median duration of response of 9.77 months(range:1.54 to 24.82+months).The DCR reached 96.7%(95%CI:82.8%-99.9%).The median PFS was 6.85 months(95%CI:4.46-14.20 months),and the median OS was 19.43 months(95%CI:9.93 months–not reached).The most common grade 3-4 treatmentrelated adverse events(AEs)were leukopenia(83.3%),neutropenia(60.0%),and increased aspartate aminotransferase level(26.7%).Treatment-related serious AEs included febrile neutropenia,leukopenia,and anorexia in one patient(3.3%),and single cases of increased blood bilirubin level(3.3%)and toxic epidermal necrolysis(3.3%).No treatment-related deaths occurred.Conclusions:Camrelizumab plus apatinib combined with liposomal paclitaxel and nedaplatin as first-line treatment demonstrated feas
基金the State Key Development Program for Basic Research of China (Grant No.2006CB400503)the Chinese Academy of Sciences (Grant No.KZCX3-SW-230)the National Natural Science Foundation of China (Grant Nos.40221503 and 40675030)
文摘Conditional nonlinear optimal perturbation (CNOP),which is a natural extension of singular vector (SV) into the nonlinear regime,is applied to ensemble prediction study by using a quasi-geostrophic model under the perfect model assumption. SVs and CNOPs have been utilized to generate the initial pertur-bations for ensemble prediction experiments. The results are compared for forecast lengths of up to 14 d. It is found that the forecast skill of samples,in which the first SV is replaced by CNOP,is com-paratively higher than that of samples composed of only SVs in the medium range (day 6―day 14). This conclusion is valid under the condition that analysis error is a kind of fast-growing ones regardless of its magnitude,whose nonlinear growth is faster than that of SV in the later part of the forecast. Fur-thermore,similarity index and empirical orthogonal function (EOF) analysis are performed to explain the above numerical results.
文摘The mitochondria-mediated caspase activation pathway is a major apoptotic pathway characterized by mitochondrial outer membrane permeabilization （MOMP） and subsequent release of cytochrome c into the cytoplasm to activate caspases. MOMP is regulated by the Bcl-2 family of proteins. This pathway plays important roles not only in normal development, main- tenance of tissue homeostasis and the regulation of immune system, but also in human diseases such as immune disorders, neurodegeneration and cancer. In the past decades the molecular basis of this pathway and the regulatory mechanism have been comprehen- sively studied, yet a great deal of new evidence indi- cates that cytochrome c release from mitochondria does not always lead to irreversible cell death, and that caspase activation can also have non-death functions. Thus, many unsolved questions and new challenges are still remaining. Furthermore, the dysfunction of this pathway involved in cancer development is obvious, and targeting the pathway as a therapeutic strategy has been extensively explored, but the efficacy of the tar- geted therapies is still under development. In this review we will discuss the mitochondria-mediated apoptosis pathway and its physiological roles and therapeutic implications.
基金supported by the National Science and Technology Major Program (Grant No.2008ZX10005-004)
文摘Various active components have been extracted from the root of Polygonum cuspidatum. However, the genetic basis for their activity is virtually unknown. In this study, 25600002 short reads （2.3 Gb） of P. cuspidatum root transcriptome were obtained via lllumina HiSeq 2000 sequencing. A total of 86418 urtigenes were assembled de novo and annotated. Twelve, 18, 60 and 54 unigenes were respectively mapped to the mevalonic acid （MVA）, methyl-D-erythritol 4-phosphate （MEP）, shikimate and resveratrol biosynthesis pathways, suggesting that they are involved in the biosynthesis of pharmaceutically important anthra- quinone and resveratrol. Eighteen potential UDP-glycosyltransferase unigenes were identified as the candidates most likely to be involved in the biosynthesis of glycosides of secondary metabolites. Identification of relevant genes could be important in eventually increasing the yields of the medicinally useful constituents of the P. cuspidatum root. From the previously published transcriptome data of 19 non-model plant taxa, 1127 shared orthologs were identified and characterized. This information will be very useful for future functional, phylogenetic and evolutionary studies of these plants.
基金Project 2010CB226805 supported by the National Natural Science Foundation of Chinaprovided by the National Basic Research Program of China (2010CB226805)+1 种基金the National Eleventh Five-Year Key Science & Technology Project (2006BAK04B02, 2006BAK04B06)the National Natural Science Foundation of China (50474068), are gratefully acknowledged
文摘Rock bursts signify extreme behavior in coal mine strata and severely threaten the safety of the lives of miners, as well as the effectiveness and productivity of miners. In our study, an elastic-plastic-brittle model for the deformation and failure of coal/rock was established through theoretical analyses, laboratory experiments and field testing, simulation and other means, which perfectly predict sudden and delayed rock bursts. Based on electromagnetic emission (EME), acoustic emission (AE) and microseism (MS) effects in the process from deformation until impact rupture of coal-rock combination samples, a multi-parameter identification of premonitory technology was formed, largely depending on these three forms of emission. Thus a system of classification for forecasting rock bursts in space and time was established. We have presented the intensity weakening theory for rock bursts and a strong-soft-strong (3S) structural model for controlling the impact on rock surrounding roadways, with the objective of laying a theoretical foundation and establishing references for parameters for the weakening control of rock bursts. For the purpose of prevention, key technical parameters of directional hydraulic fracturing are revealed. Based on these results, as well as those from deep-hole controlled blasting in coal seams and rock, integrated control techniques were established and anti-impact hydraulic props, suitable for roadways subject to hazards from rockbursts have also been developed. These technologies have been widely used in most coal mines in China, subject to these hazards and have achieved remarkable economic and social benefits.
基金Supported by National Natural Science Foundation of China(No.81273673)Integrated Chinese and Western Medicine,Tianjin Health Bureau,China(No.11027)
文摘Objective： To observe wet cupping therapy（WCT） on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis（NT-CS）. Methods： Fifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture（JA） group according a random number table. WCT group（30 cases） was treated with WCT for 10 min, and JA group（27 cases） was treated with acupuncture for 10 min. The treatment efficacies were evaluated with a Visual Analogue Scale（VAS）. Blood perfusion at Dazhui（GV 14） and Jianjing（GB 21） acupoints（affected side） was observed with a laser speckle flowmetry, and its variations before and after treatment in both groups were compared as well. Results： In both groups, the VAS scores significantly decreased after the intervention（P〈0.01）, while the blood perfusion at the two acupoints significantly increased after intervention（P〈0.05）; however, the increasement magnitude caused by WCT was obvious compared with JA（P〈0.05）. Conclusion： WCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.
基金Supported by National Basic Research Program of China (Grant Nos. 2006CB403606, 2007CB411800)National Natural Science Foundation of China (Grant Nos. 40830955, 40675030, 40505013)+1 种基金Institute of Atmospheric Physics, Chinese Academy of Sciences (Grant No. IAP07202)LASG State Key Labora-tory Special Fund
文摘Conditional nonlinear optimal perturbation (CNOP) is a nonlinear generalization of linear singular vector (LSV) and features the largest nonlinear evolution at prediction time for the initial perturbations in a given constraint. It was proposed initially for predicting the limitation of predictability of weather or climate. Then CNOP has been applied to the studies of the problems related to predictability for weather and climate. In this paper, we focus on reviewing the recent advances of CNOP's applications, which involves the ones of CNOP in problems of ENSO amplitude asymmetry, block onset, and the sensitivity analysis of ecosystem and ocean's circulations, etc. Especially, CNOP has been primarily used to construct the initial perturbation fields of ensemble forecasting, and to determine the sensitive area of target observation for precipitations. These works extend CNOP's applications to investigating the nonlinear dynamical behaviors of atmospheric or oceanic systems, even a coupled system, and studying the problem of the transition between the equilibrium states. These contributions not only attack the particular physical problems, but also show the superiority of CNOP to LSV in revealing the effect of nonlinear physical processes. Consequently, CNOP represents the optimal precursors for a weather or climate event; in predictability studies, CNOP stands for the initial error that has the largest negative effect on prediction; and in sensitivity analysis, CNOP is the most unstable (sensitive) mode. In multi-equilibrium state regime, CNOP is the initial perturbation that induces the transition between equilibriums most probably. Furthermore, CNOP has been used to construct ensemble perturbation fields in ensemble forecast studies and to identify sensitive area of target observation. CNOP theory has become more and more substantial. It is expected that CNOP also serves to improve the predictability of the realistic predictions for weather and climate events plays an increasingly important role in exploring th
文摘AIM:To compare the effects and postoperative complications between tissue selecting therapy stapler(TST)and Milligan-Morgan hemorrhoidectomy(M-M).METHODS:Four hundred and eighty patients with severe prolapsing hemorrhoids,who were admitted to the Shenyang Coloproctology Hospital between 2009and 2012,were randomly divided into observation(n=240)and control(n=240)groups.Hemorrhoidectomies were performed with TST in the observation group and with the M-M technique in the control group.The therapeutic effects,operation security,and postoperative complications in the two groups were compared.The immediate and long-term complications were assessed according to corresponding criteria.Pain was assessed on a visual analogue scale.The efficacy was assessed by specialized criteria.The follow-up was conducted one year after the operation.RESULTS:The total effective rates of the observation and control groups were 99.5%(217/218)and 98.6%(218/221)respectively;the difference was not statistically significant(P=0.322).Their were significant differences between observation and control groups in intraoperative blood loss(5.07±1.14 vs 2.45±0.57,P=0.000),pain(12 h after the surgery:5.08±1.62 vs 7.19±2.01,P=0.000;at first dressing change:2.64±0.87 vs 4.34±1.15,P=0.000;first defecation:3.91±1.47 vs 5.63±1.98,P=0.001),urine retention(n=22 vs n=47,P=0.001),anal pendant expansion after the surgery(2.35±0.56 vs 5.16±1.42,P=0.000),operation time(18.3±5.6 min vs 29.5±8.2 min,P=0.000),and the length of hospital stay(5.3±0.6 d vs 11.4±1.8 d,P=0.000).Moreover TST showed significant reductions compared to M-M in the rates of long-term complications such as fecal incontinence(n=3 vs n=16,P=0.003),difficult bowel movement(n=1 vs n=9,P=0.011),intractable pain(n=2 vs n=12,P=0.007),and anal discharge(n=3 vs n=23,P=0.000).CONCLUSION:TST for severe prolapsing hemorrhoids is a satisfactory technique for more rapid recovery,lower complication rates,and higher operation security.
基金the National Natural Science Foundation of China,No.81701881the Nanjing Medical Science and Technology Development Foundation,No.YKK15098 and No.YKK17102
文摘BACKGROUND The imbalance of Th17/Treg cells and the IL-23/IL-17 axis have been confirmed to be associated with sepsis and various inflammatory diseases. Early enteral nutrition (EEN) can modulate the inflammatory response, improve immune dysfunction, and prevent enterogenic infection in critically ill patients;however, the precise mechanisms remain unclear. Considering the important roles of Th17 and Treg lymphocytes in the development of inflammatory and infectious diseases, we hypothesized that EEN could improve the immune dysfunction in sepsis by maintaining a balanced Th17/Treg cell ratio and by regulating the IL- 23/IL-17 axis. AIM To investigate the effects of EEN on the Th17/Treg cell ratios and the IL-23/IL-17 axis in septic patients. METHODS In this prospective clinical trial, patients were randomly divided into an EEN or delayed enteral nutrition (DEN) group. Enteral feeding was started within 48 h in the EEN group, whereas enteral feeding was started on the 4th day in the DEN group. The Th17 and Treg cell percentages and the interleukin levels were tested on days 1, 3, and 7 after admission. The clinical severity and outcome variables were also recorded. RESULTS Fifty-three patients were enrolled in this trial from October 2017 to June 2018. The Th17 cell percentages, Th17/Treg cell ratios, IL-17, IL-23, and IL-6 levels of the EEN group were lower than those of the DEN group on the 7th day after admission (P < 0.05). The duration of mechanical ventilation and of the intensive care unit stay of the EEN group were shorter than those of the DEN group (P <0.05). However, no difference in the 28-d mortality was found between the two groups (P = 0.728). CONCLUSION EEN could regulate the imbalance of Th17/Treg cell ratios and suppress the IL- 23/IL-17 axis during sepsis. Moreover, EEN could reduce the clinical severity of sepsis but did not reduce the 28-d mortality of septic patients.
文摘Objective:To investigate current status of diagnosis and treatment of bladder cancer in China.Methods:A database was generated by Chinese Bladder Cancer Consortium(CBCC).From January 2007 to December 2012,14,260 cases from 44 CBCC centers were included.Data of diagnosis,treatment and pathology were collected.Results:The average age was 63.5 year-old and most patients were male(84.3%).The most common histologic types were urothelial carcinoma(91.4%),adenocarcinoma(1.8%),and squamous carcinoma(1.9%).According to 1973 and 2004 WHO grading system,42.0%,41.0%,and 17.0% of patients were grade 1,2,and 3,and 16.0%,48.7%,and 35.3% of patients were papillary urothelial neoplasms of low malignant potential,low,and high grade,respectively.Non-muscle invasive bladder cancer(NMIBC)and muscle invasive bladder cancer(MIBC)were 25.2% and 74.1%,respectively(0.8% not clear).Carcinoma in situ was only 2.4%.Most patients were diagnosed by white-light cystoscopy with biopsy(74.3%).Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%,respectively.Diagnostic transurethral resection(TUR)provided detection rate of 16.9%.Most NMIBCs were treated with TUR(89.2%).After initial TUR,2.6%accepted second TUR,and 45.7%,69.9%,and 58.7% accepted immediate,induced,and maintenance chemotherapy instillation,respectively.Most MIBCs were treated with radical cystectomy(RC,59.7%).Laparoscopic RCs were 35.1%,while open RC 63.4%.Extended and standard pelvic lymph node dissection were 7% and 66%,respectively.Three most common urinary diversions were orthotopic neobladder(44%),ileal conduit(31%),and ureterocutaneostomy(23%).Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18%of T3 and T4 patients accepted adjuvant chemotherapy.Conclusion:Disease characteristics are similar to international reports,while differences of diagnosis and treatment exist.This study can provide evidences for revisions of the guideline on bladder cancer in China.
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.
