营养不良对恶性肿瘤患者的不利影响贯穿其整个病程.肿瘤患者的营养状况如何未见大样本报道,而且已有报道差异很大,本研究旨在调查中国常见恶性肿瘤患者营养不良状况及营养治疗现状.本次观察性多中心研究采用两阶段随机抽样方法抽取全国2...营养不良对恶性肿瘤患者的不利影响贯穿其整个病程.肿瘤患者的营养状况如何未见大样本报道,而且已有报道差异很大,本研究旨在调查中国常见恶性肿瘤患者营养不良状况及营养治疗现状.本次观察性多中心研究采用两阶段随机抽样方法抽取全国22个主要省市80家三甲医院共47488例16种常见恶性肿瘤住院患者,以患者主观整体评估(Patient-Generated Subjective Global Assessment,PG-SGA)评估患者营养状况,以定量评估区分营养不良严重程度:0~1分无营养不良,2~3分、4~8分、≥9分分别定义为可疑/轻度、中度、重度营养不良.方差分析比较不同特征肿瘤患者PG-SGA评分.肿瘤患者中、重度营养不良的发病率为58.2%(中度32.1%、重度26.1%),22.2%为可疑/轻度营养不良,只有19.6%的患者无营养不良.营养不良的发病存在瘤种、年龄、性别、肿瘤分期、治疗情况及地区差异:胰腺癌患者PG-SGA评分最高(9.58±5.74),乳腺癌患者PG-SGA评分最低(3.51±3.49);<45岁年龄组患者PG-SGA评分最低(4.84±4.50),≥70岁年龄组患者PG-SGA评分最高(7.82±5.10);女性肺癌(5.87vs.5.60,P=0.006)和胃癌(8.36 vs.7.81,P<0.001)PG-SGA评分高于男性;TNM分期较高的患者其PG-SGA评分也较高,其中胰腺癌Ⅲ、Ⅳ期患者PG-SGA评分最高,乳腺癌Ⅰ~Ⅲ期患者PG-SGA评分均低于4分(3.05±2.83);接受手术治疗的患者PG-SGA评分最高(6.22±4.74),而目前还没有接受任何治疗的患者评分最低(5.61±4.68);华中区域PG-SGA评分最低(4.82±4.16),华东区域PG-SGA评分最高(7.31±5.53).此外,在某些肿瘤类型中,不同医疗保险类型、受教育水平、职业、居住地、民族的患者PG-SGA评分也有显著差异,农民、小学及以下低教育水平患者营养状况最差.68.78%的肿瘤患者没有获得任何营养治疗,重度营养不良(PG-SGA≥9)肿瘤患者的无营养治疗比例仍然高达55.03%.以上结果说明,中国常见恶性肿瘤患者营养不良发生率展开更多
以互联互动为特征的区域综合能源系统(district-level integrated energy system,DIES)对建设清洁低碳、安全高效的现代能源体系至关重要。首先,从互联和互动两个维度,分别分析多能流耦合、多系统融合、多区域联合的互联形态和多环节、...以互联互动为特征的区域综合能源系统(district-level integrated energy system,DIES)对建设清洁低碳、安全高效的现代能源体系至关重要。首先,从互联和互动两个维度,分别分析多能流耦合、多系统融合、多区域联合的互联形态和多环节、多主体、多时间尺度的互动机制对DIES的影响;然后,梳理DIES能源站和能源网络建模方法,抽象出能量转换与流动的本质特征;在此基础上,建立考虑互联互动的DIES规划基础模型,对比分析不同场景下能源站规划、能源网络规划和站网联合规划的目标函数与约束条件、不确定性因素处理方式和模型求解方法;最后,对考虑互联互动的DIES规划未来可能的发展方向进行展望。展开更多
Previous studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease(COVID-19)and the evidence of person-to-person transmission.Limited data are available for asymptomatic infectio...Previous studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease(COVID-19)and the evidence of person-to-person transmission.Limited data are available for asymptomatic infections.This study aims to present the clinical characteristics of 24 cases with asymptomatic infection screened from close contacts and to show the transmission potential of asymptomatic COVID-19 virus carriers.Epidemiological investigations were conducted among all close contacts of COVID-19 patients(or suspected patients)in Nanjing,Jiangsu Province,China,from Jan 28 to Feb 9,2020,both in clinic and in community.Asymptomatic carriers were laboratory-confirmed positive for the COVID-19 virus by testing the nucleic acid of the pharyngeal swab samples.Their clinical records,laboratory assessments,and chest CT scans were reviewed.As a result,none of the 24 asymptomatic cases presented any obvious symptoms while nucleic acid screening.Five cases(20.8%)developed symptoms(fever,cough,fatigue,etc.)during hospitalization.Twelve(50.0%)cases showed typical CT images of ground-glass chest and 5(20.8%)presented stripe shadowing in the lungs.The remaining 7(29.2%)cases showed normal CT image and had no symptoms during hospitalization.These 7 cases were younger(median age:14.0 years;P=0.012)than the rest.None of the 24 cases developed severe COVID-19 pneumonia or died.The median communicable period,defined as the interval from the first day of positive nucleic acid tests to the first day of continuous negative tests,was 9.5 days(up to 21 days among the 24 asymptomatic cases).Through epidemiological investigation,we observed a typical asymptomatic transmission to the cohabiting family members,which even caused severe COVID-19 pneumonia.Overall,the asymptomatic carriers identified from close contacts were prone to be mildly ill during hospitalization.However,the communicable period could be up to three weeks and the communicated patients could develop severe illness.These results highlighted the importance of close cont展开更多
MYB-type transcription factors contain the conserved MYB DNA-binding domain of approximately 50 amino acids and are involved in the regulation of many aspects of plant growth, development, metabolism and stress respon...MYB-type transcription factors contain the conserved MYB DNA-binding domain of approximately 50 amino acids and are involved in the regulation of many aspects of plant growth, development, metabolism and stress responses. From soybean plants, we identified 156 GmMYB genes using our previously obtained 206 MYB unigenes, and 48 were found to have full-length open-reading frames. Expressions of all these identified genes were examined, and we found that expressions of 43 genes were changed upon treatment with ABA, salt, drought and/or cold stress. Three GmMYB genes, GmMYB76, GmMYB92 and GmMYB177, were chosen for further analysis. Using the yeast assay system, GmMYB76 and GmMYB92 were found to have transactivation activity and can form homodimers. GmMYB177 did not appear to have transactivation activity but can form heterodimers with GmMYB76. Yeast onehybrid assay revealed that all the three GmMYBs could bind to cis-elements TAT AAC GGT TTT TT and CCG GAA AAA AGG AT, but with different affinity, and GmMYB92 could also bind to TCT CAC CTA CC. The transgenic Arabidopsis plants overexpressing GmMYB 76 or GmMYB177 showed better performance than the GmMYB92-transgenic plants in salt and freezing tolerance. However, these transgenic plants exhibited reduced sensitivity to ABA treatment at germination stage in comparison with the wild-type plants. The three GmMYB genes differentially affected a subset of stress-responsive genes in addition to their regulation of a common subset of stress-responsive genes. These resuits indicate that the three GmMYB genes may play differential roles in stress tolerance, possibly through regulation of stress-responsive genes.展开更多
AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected...AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was < 4, the rate of missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions increases with the number of biopsies.展开更多
智能软开关（soft open point,SOP）是安装于传统联络开关处的电力电子装置,能够快速、准确地控制自身功率流动,改变系统功率分布,进而改善整个配电系统的运行状态。在配电网发生故障并隔离后,SOP可以为失电区域提供有效的电压支撑,提...智能软开关（soft open point,SOP）是安装于传统联络开关处的电力电子装置,能够快速、准确地控制自身功率流动,改变系统功率分布,进而改善整个配电系统的运行状态。在配电网发生故障并隔离后,SOP可以为失电区域提供有效的电压支撑,提高配电系统的供电恢复能力。首先,对SOP的主要功能和数学模型进行阐述,给出考虑SOP的配电网故障恢复流程;其次,提出基于SOP的有源配电网供电恢复模型,这一模型本质上属于大规模非线性规划模型,采用二阶锥规划方法进行模型转化和求解;最后,在IEEE 33节点测试算例上进行分析验证,得到影响SOP供电恢复能力的因素,并在不同的分布式电源条件下进行对比分析,验证所提模型的正确性和有效性。展开更多
目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年...目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数(body mass index,BMI)标准评价儿童青少年营养状况,包括消瘦(重度消瘦和轻度消瘦)、正常BMI、超重和肥胖(重度肥胖和轻度肥胖)。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果:2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区(东部、中部和西部)逐渐降低,随BMI的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为44.2%和38.8%,分别是正常组(15.8%和10.6%)的2.8倍和3.7倍。血压偏高与消瘦(重度消瘦和轻度消瘦)呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论:我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生�展开更多
文摘营养不良对恶性肿瘤患者的不利影响贯穿其整个病程.肿瘤患者的营养状况如何未见大样本报道,而且已有报道差异很大,本研究旨在调查中国常见恶性肿瘤患者营养不良状况及营养治疗现状.本次观察性多中心研究采用两阶段随机抽样方法抽取全国22个主要省市80家三甲医院共47488例16种常见恶性肿瘤住院患者,以患者主观整体评估(Patient-Generated Subjective Global Assessment,PG-SGA)评估患者营养状况,以定量评估区分营养不良严重程度:0~1分无营养不良,2~3分、4~8分、≥9分分别定义为可疑/轻度、中度、重度营养不良.方差分析比较不同特征肿瘤患者PG-SGA评分.肿瘤患者中、重度营养不良的发病率为58.2%(中度32.1%、重度26.1%),22.2%为可疑/轻度营养不良,只有19.6%的患者无营养不良.营养不良的发病存在瘤种、年龄、性别、肿瘤分期、治疗情况及地区差异:胰腺癌患者PG-SGA评分最高(9.58±5.74),乳腺癌患者PG-SGA评分最低(3.51±3.49);<45岁年龄组患者PG-SGA评分最低(4.84±4.50),≥70岁年龄组患者PG-SGA评分最高(7.82±5.10);女性肺癌(5.87vs.5.60,P=0.006)和胃癌(8.36 vs.7.81,P<0.001)PG-SGA评分高于男性;TNM分期较高的患者其PG-SGA评分也较高,其中胰腺癌Ⅲ、Ⅳ期患者PG-SGA评分最高,乳腺癌Ⅰ~Ⅲ期患者PG-SGA评分均低于4分(3.05±2.83);接受手术治疗的患者PG-SGA评分最高(6.22±4.74),而目前还没有接受任何治疗的患者评分最低(5.61±4.68);华中区域PG-SGA评分最低(4.82±4.16),华东区域PG-SGA评分最高(7.31±5.53).此外,在某些肿瘤类型中,不同医疗保险类型、受教育水平、职业、居住地、民族的患者PG-SGA评分也有显著差异,农民、小学及以下低教育水平患者营养状况最差.68.78%的肿瘤患者没有获得任何营养治疗,重度营养不良(PG-SGA≥9)肿瘤患者的无营养治疗比例仍然高达55.03%.以上结果说明,中国常见恶性肿瘤患者营养不良发生率
文摘以互联互动为特征的区域综合能源系统(district-level integrated energy system,DIES)对建设清洁低碳、安全高效的现代能源体系至关重要。首先,从互联和互动两个维度,分别分析多能流耦合、多系统融合、多区域联合的互联形态和多环节、多主体、多时间尺度的互动机制对DIES的影响;然后,梳理DIES能源站和能源网络建模方法,抽象出能量转换与流动的本质特征;在此基础上,建立考虑互联互动的DIES规划基础模型,对比分析不同场景下能源站规划、能源网络规划和站网联合规划的目标函数与约束条件、不确定性因素处理方式和模型求解方法;最后,对考虑互联互动的DIES规划未来可能的发展方向进行展望。
基金supported by the project of Jiangsu province medical youth talent(QNRC2016059)Nanjing medical science and technique development foundation(ZKX17040 and YKK18153)+1 种基金the National Natural Science Foundation of China(81903382)Cheung Kong Scholars Program of China。
文摘Previous studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease(COVID-19)and the evidence of person-to-person transmission.Limited data are available for asymptomatic infections.This study aims to present the clinical characteristics of 24 cases with asymptomatic infection screened from close contacts and to show the transmission potential of asymptomatic COVID-19 virus carriers.Epidemiological investigations were conducted among all close contacts of COVID-19 patients(or suspected patients)in Nanjing,Jiangsu Province,China,from Jan 28 to Feb 9,2020,both in clinic and in community.Asymptomatic carriers were laboratory-confirmed positive for the COVID-19 virus by testing the nucleic acid of the pharyngeal swab samples.Their clinical records,laboratory assessments,and chest CT scans were reviewed.As a result,none of the 24 asymptomatic cases presented any obvious symptoms while nucleic acid screening.Five cases(20.8%)developed symptoms(fever,cough,fatigue,etc.)during hospitalization.Twelve(50.0%)cases showed typical CT images of ground-glass chest and 5(20.8%)presented stripe shadowing in the lungs.The remaining 7(29.2%)cases showed normal CT image and had no symptoms during hospitalization.These 7 cases were younger(median age:14.0 years;P=0.012)than the rest.None of the 24 cases developed severe COVID-19 pneumonia or died.The median communicable period,defined as the interval from the first day of positive nucleic acid tests to the first day of continuous negative tests,was 9.5 days(up to 21 days among the 24 asymptomatic cases).Through epidemiological investigation,we observed a typical asymptomatic transmission to the cohabiting family members,which even caused severe COVID-19 pneumonia.Overall,the asymptomatic carriers identified from close contacts were prone to be mildly ill during hospitalization.However,the communicable period could be up to three weeks and the communicated patients could develop severe illness.These results highlighted the importance of close cont
基金Acknowledgments This work was supported by the National Natural Science Foundation of China （30490254, 30671316）, the National Basic Research Program of China （2006CB100102）, and the Hi-Tech Research and Development Program of China （2006AA10Z113, 2006AA10A111）.
文摘MYB-type transcription factors contain the conserved MYB DNA-binding domain of approximately 50 amino acids and are involved in the regulation of many aspects of plant growth, development, metabolism and stress responses. From soybean plants, we identified 156 GmMYB genes using our previously obtained 206 MYB unigenes, and 48 were found to have full-length open-reading frames. Expressions of all these identified genes were examined, and we found that expressions of 43 genes were changed upon treatment with ABA, salt, drought and/or cold stress. Three GmMYB genes, GmMYB76, GmMYB92 and GmMYB177, were chosen for further analysis. Using the yeast assay system, GmMYB76 and GmMYB92 were found to have transactivation activity and can form homodimers. GmMYB177 did not appear to have transactivation activity but can form heterodimers with GmMYB76. Yeast onehybrid assay revealed that all the three GmMYBs could bind to cis-elements TAT AAC GGT TTT TT and CCG GAA AAA AGG AT, but with different affinity, and GmMYB92 could also bind to TCT CAC CTA CC. The transgenic Arabidopsis plants overexpressing GmMYB 76 or GmMYB177 showed better performance than the GmMYB92-transgenic plants in salt and freezing tolerance. However, these transgenic plants exhibited reduced sensitivity to ABA treatment at germination stage in comparison with the wild-type plants. The three GmMYB genes differentially affected a subset of stress-responsive genes in addition to their regulation of a common subset of stress-responsive genes. These resuits indicate that the three GmMYB genes may play differential roles in stress tolerance, possibly through regulation of stress-responsive genes.
文摘AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was < 4, the rate of missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions increases with the number of biopsies.
文摘智能软开关（soft open point,SOP）是安装于传统联络开关处的电力电子装置,能够快速、准确地控制自身功率流动,改变系统功率分布,进而改善整个配电系统的运行状态。在配电网发生故障并隔离后,SOP可以为失电区域提供有效的电压支撑,提高配电系统的供电恢复能力。首先,对SOP的主要功能和数学模型进行阐述,给出考虑SOP的配电网故障恢复流程;其次,提出基于SOP的有源配电网供电恢复模型,这一模型本质上属于大规模非线性规划模型,采用二阶锥规划方法进行模型转化和求解;最后,在IEEE 33节点测试算例上进行分析验证,得到影响SOP供电恢复能力的因素,并在不同的分布式电源条件下进行对比分析,验证所提模型的正确性和有效性。
文摘目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数(body mass index,BMI)标准评价儿童青少年营养状况,包括消瘦(重度消瘦和轻度消瘦)、正常BMI、超重和肥胖(重度肥胖和轻度肥胖)。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果:2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区(东部、中部和西部)逐渐降低,随BMI的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为44.2%和38.8%,分别是正常组(15.8%和10.6%)的2.8倍和3.7倍。血压偏高与消瘦(重度消瘦和轻度消瘦)呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论:我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生�
