Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differen-tiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor ...Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differen-tiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor occurs most commonly in superficial locations. The case we describe herein is that of a 60- year-old man with two large hepatic masses. The patient＇s tumor was removed radically through an incision due to the inconclusive imaging findings. Follow-up computed tomography showed no recurrence and metastasis after 37 months, suggesting that enucleation was adequate for tumor eradication. To our knowl-edge, this is the first reported case of low-grade myofibroblastic sarcoma in the liver in the English language literature.展开更多
Background and Objectives： the effects of oral enteral nutrition （EN） in lung cancer patients receivingchemotherapy and/or radiotherapy were controversial, so we made a systematic review to analyze the clinicaleffi...Background and Objectives： the effects of oral enteral nutrition （EN） in lung cancer patients receivingchemotherapy and/or radiotherapy were controversial, so we made a systematic review to analyze the clinicalefficacy of EN in lung cancer patients after chemotherapy and/or radiotherapy. Methods and Study Design：Pertinent studies were identified by searching in PubMed, Embase, Web of Science, Cochrane Library, ChinaNational Knowledge Infrastructure （CNKI）, WanFang Database, China Biomedical Literature database （CBM） andChinese Science and Technology Periodical Database （VIP）. Energy intake, protein intake, weight and other datawere extracted. Results： Finally, 5 randomized controlled trials （RCTs） were included in this systematic review.Patients in 3 studies received chemotherapy, in 1 with radiotherapy and in 1 with chemo-radiotherapy. Thecombined results showed that EN significantly increased energy and protein intake in lung cancer duringchemotherapy, while there was no significant effect on other results after patients had received chemotherapyand/or radiotherapy. Conclusions： Limited evidence is available to judge whether EN can improve clinical effect oflung cancer with or without chemotherapy and/or radiotherapy, as clinical heterogeneity and other potentialvariation existed in this review. Further studies are needed.展开更多
Background Bronchopulmonary dysplasia(BPD)is a common chronic lung disease in extremely preterm neonates.The outcome and clinical burden vary dramatically according to severity.Although some prediction tools for BPD e...Background Bronchopulmonary dysplasia(BPD)is a common chronic lung disease in extremely preterm neonates.The outcome and clinical burden vary dramatically according to severity.Although some prediction tools for BPD exist,they seldom pay attention to disease severity and are based on populations in developed countries.This study aimed to develop machine learning prediction models for BPD severity based on selected clinical factors in a Chinese population.Methods In this retrospective,single-center study,we included patients with a gestational age<32 weeks who were diagnosed with BPD in our neonatal intensive care unit from 2016 to 2020.We collected their clinical information during the maternal,birth and early postnatal periods.Risk factors were selected through univariable and ordinal logistic regression analyses.Prediction models based on logistic regression(LR),gradient boosting decision tree,XGBoost(XGB)and random forest(RF)models were implemented and assessed by the area under the receiver operating characteristic curve(AUC).Results We ultimately included 471 patients(279 mild,147 moderate,and 45 severe cases).On ordinal logistic regression,gestational diabetes mellitus,initial fraction of inspiration O_(2) value,invasive ventilation,acidosis,hypochloremia,C-reactive protein level,patent ductus arteriosus and Gram-negative respiratory culture were independent risk factors for BPD severity.All the XGB,LR and RF models(AUC=0.85,0.86 and 0.84,respectively)all had good performance.Conclusions We found risk factors for BPD severity in our population and developed machine learning models based on them.The models have good performance and can be used to aid in predicting BPD severity in the Chinese population.展开更多
Background:Hypertension affects over 1 billion people globally and is the top risk factor of cardiovascular morbidity and mortality.Wuweijiangyasan(WWJYS),as an empirical prescription,has stable depressurization effec...Background:Hypertension affects over 1 billion people globally and is the top risk factor of cardiovascular morbidity and mortality.Wuweijiangyasan(WWJYS),as an empirical prescription,has stable depressurization effects.This study investigated the chemical composition and pharmacodynamic effects of WWJYS in regulating the blood pressure(BP),emotion,and blood lipid of spontaneous hypertensive rats,and further explored the depressurization mechanism of WWJYS.Materials and Methods:This study used network pharmacology to identify the origins and predict targets of WWJYS,and artificial intelligence-based molecular docking is used to further predict targets and mechanisms.The chemical constituents of WWJYS were analyzed and identified by ultra high-performance liquid chromatography–mass spectrometry(MS)/MS.Results:In the WWJYS group,the systolic BP level significantly was decreased,and the HR was stable.The irritability became stable after the 5-week treatment compared with the model group(P<0.05).Rats’rotation tolerance time increased after 2-weeks stabilization.Compared with the model group,angiotensin-converting enzyme 2 protein and mRNA of the WWJYS group increased significantly(P<0.05).Network pharmacology collected 64 compounds and identified 22 potential targets of WWJYS for antihypertensive activity.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that WWJYS might regulate smooth muscle cells,affect inflammatory response and improve endothelial function through multiple pathways.The molecular docking study further supported that the target proteins have good combinations with the main active components of WWJYS.Conclusions:The data indicated that WWJYS had significant depressurization,analgesic,and sedative,as well as lipid-lowering effects,and the depressurization mechanism of WWJYS may function in multiple signal pathways,especially in improving blood vessel function and intervening inflammation.展开更多
Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcome...Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcomes of ELBW infants during their Neonatal Intensive Care Unit （NICU） stay in the mainland of China. Methods： All infants admitted to 26 NICUs with a birth weight （BW） 〈1000 g were included between January 1,2011 and December 31,2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results： A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age （GA） was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants （23.3%） died and another 69 infants （26.7%） died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas （53.6% vs. 35.3%, P = 0.019）. BW 〈750 g and GA 〈28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions： Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.展开更多
Background： Hepatocellular carcinoma （HCC） is a common cancer in China, an area of high hepatitis B virus （HBV） infection. Although several staging systems are available, there is no consensus on the best classif...Background： Hepatocellular carcinoma （HCC） is a common cancer in China, an area of high hepatitis B virus （HBV） infection. Although several staging systems are available, there is no consensus on the best classification to use because multiple factors, such as etiology, clinical treatment and populations could affect the survival of HCC patients. Methods： This study analyzed 743 HBV-related Chinese HCC patients who received surgery first and evaluated the predictive values of eight different commonly used staging systems in the clinic. Results： The overall 1-, 3-, 5-year survival rates and a median survival were 91.5%, 70.3%, 55.3% and 72 months respectively. Barcelona Clinic Liver Cancer （BCLC） staging systems had the best stratification ability and showed the lowest Akaike information criterion （AIC） values （2896.577）, followed by tumor-node-metastasis Th （TNM 7^th） （AIC = 2899.980）, TNM 6th （AIC = 2902.17）, Japan integrated staging score （A1C = 2918.085）, Tokyo （AIC = 2938.822）, Cancer of the Liver Italian Program score （AIC = 2941.950）, Chinese University Prognostic Index grade （AIC = 2962.027）, and Okuda （AIC = 2979.389）. Conclusions： BCLC staging system is a better staging model for HBV infection patients with HCC in Chinese population among the eight currently used staging systems. These identifications afford a large group of Chinese HCC patients with HBV infection and could be helpful to design a new staging system for a certain population.展开更多
Background： The liver is the most common site for colorectal cancer （CRC） metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients ...Background： The liver is the most common site for colorectal cancer （CRC） metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases （CRCLM） who underwent simultaneous resections for both lesions. Methods： From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival （OS） and disease-free survival （DFS） were examined by Kaplan-Meier and log-rank methods. Results： Median follow-up time was 22.7 months： no perioperative death or serious complications were observed. Median OS was 55.5 months： postoperative OS rates were l-year： 93.8%, 3-year： 60.7%, and 5-year： 46.4%. Median DFS was 9.0 months; postoperative DFS rates were l-year： 43.1%, 3-year： 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen 〉100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age 〉60 years, no adjuvant chenlotherapy, multiple metastases, and largest diameter ≥3 cm for DFS. Conclusions： Simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRC LM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.展开更多
Neonatal care is of great significance to health capabil-ity.Since neonatal intensive care units(NICUs)started to be established in the late 1980s in China,neonatal mortal-ity has decreased each year to reach 3.4‰in ...Neonatal care is of great significance to health capabil-ity.Since neonatal intensive care units(NICUs)started to be established in the late 1980s in China,neonatal mortal-ity has decreased each year to reach 3.4‰in 2020[1,2].However,the improvement for neonatal care is still on the way.More than three-fifths of deaths included critically ill neonates occur in their first 28 days[3].Critically ill neo-nates usually have lower gestational age and body weight,leading to high mortality or requiring specific treatment and monitoring[4].It is a common practice to transfer a critically ill newborn patient to a tertiary children's hospi-tal with an excellent NICU.Therefore,it is crucial to pro-mote patients'safety by improving the neonatal transport network services[5].Owing to the complexity and rapid changes in neonatal conditions,especially for those requir-ing multi-disciplinary treatment,there is a high reliance on a specialized newborn transport team[6,7].展开更多
文摘Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differen-tiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor occurs most commonly in superficial locations. The case we describe herein is that of a 60- year-old man with two large hepatic masses. The patient＇s tumor was removed radically through an incision due to the inconclusive imaging findings. Follow-up computed tomography showed no recurrence and metastasis after 37 months, suggesting that enucleation was adequate for tumor eradication. To our knowl-edge, this is the first reported case of low-grade myofibroblastic sarcoma in the liver in the English language literature.
基金Funding：This research was supported by NSFC （Natural Science Foundation of China） （81360351, 81660512）,the Department of Science and Technology of Guizhou Province （Grant No. Qian Ke He SY [2013] 3003）,High-level Innovative Talents Cultivation Program Of Guizhou Province, Start-Up Fund for Doctor of ZunyiMedical University and the Social Practice Program for Postgraduate of Zunyi Medical University（Grant No.zy-yjs2015004）, Applied Basic Research Programs of Science and Technology Commission Foundation of SichuanProvince （Grant No. 2012JY0058）
文摘Background and Objectives： the effects of oral enteral nutrition （EN） in lung cancer patients receivingchemotherapy and/or radiotherapy were controversial, so we made a systematic review to analyze the clinicalefficacy of EN in lung cancer patients after chemotherapy and/or radiotherapy. Methods and Study Design：Pertinent studies were identified by searching in PubMed, Embase, Web of Science, Cochrane Library, ChinaNational Knowledge Infrastructure （CNKI）, WanFang Database, China Biomedical Literature database （CBM） andChinese Science and Technology Periodical Database （VIP）. Energy intake, protein intake, weight and other datawere extracted. Results： Finally, 5 randomized controlled trials （RCTs） were included in this systematic review.Patients in 3 studies received chemotherapy, in 1 with radiotherapy and in 1 with chemo-radiotherapy. Thecombined results showed that EN significantly increased energy and protein intake in lung cancer duringchemotherapy, while there was no significant effect on other results after patients had received chemotherapyand/or radiotherapy. Conclusions： Limited evidence is available to judge whether EN can improve clinical effect oflung cancer with or without chemotherapy and/or radiotherapy, as clinical heterogeneity and other potentialvariation existed in this review. Further studies are needed.
基金funded by the Science and Technology Commission of Shanghai Municipality(No.21511104502)the National Key Research and Development Program of China(No.2021ZD0113501).
文摘Background Bronchopulmonary dysplasia(BPD)is a common chronic lung disease in extremely preterm neonates.The outcome and clinical burden vary dramatically according to severity.Although some prediction tools for BPD exist,they seldom pay attention to disease severity and are based on populations in developed countries.This study aimed to develop machine learning prediction models for BPD severity based on selected clinical factors in a Chinese population.Methods In this retrospective,single-center study,we included patients with a gestational age<32 weeks who were diagnosed with BPD in our neonatal intensive care unit from 2016 to 2020.We collected their clinical information during the maternal,birth and early postnatal periods.Risk factors were selected through univariable and ordinal logistic regression analyses.Prediction models based on logistic regression(LR),gradient boosting decision tree,XGBoost(XGB)and random forest(RF)models were implemented and assessed by the area under the receiver operating characteristic curve(AUC).Results We ultimately included 471 patients(279 mild,147 moderate,and 45 severe cases).On ordinal logistic regression,gestational diabetes mellitus,initial fraction of inspiration O_(2) value,invasive ventilation,acidosis,hypochloremia,C-reactive protein level,patent ductus arteriosus and Gram-negative respiratory culture were independent risk factors for BPD severity.All the XGB,LR and RF models(AUC=0.85,0.86 and 0.84,respectively)all had good performance.Conclusions We found risk factors for BPD severity in our population and developed machine learning models based on them.The models have good performance and can be used to aid in predicting BPD severity in the Chinese population.
基金supported by the National Natural Science Foundation of China(No.81473521,81973697)。
文摘Background:Hypertension affects over 1 billion people globally and is the top risk factor of cardiovascular morbidity and mortality.Wuweijiangyasan(WWJYS),as an empirical prescription,has stable depressurization effects.This study investigated the chemical composition and pharmacodynamic effects of WWJYS in regulating the blood pressure(BP),emotion,and blood lipid of spontaneous hypertensive rats,and further explored the depressurization mechanism of WWJYS.Materials and Methods:This study used network pharmacology to identify the origins and predict targets of WWJYS,and artificial intelligence-based molecular docking is used to further predict targets and mechanisms.The chemical constituents of WWJYS were analyzed and identified by ultra high-performance liquid chromatography–mass spectrometry(MS)/MS.Results:In the WWJYS group,the systolic BP level significantly was decreased,and the HR was stable.The irritability became stable after the 5-week treatment compared with the model group(P<0.05).Rats’rotation tolerance time increased after 2-weeks stabilization.Compared with the model group,angiotensin-converting enzyme 2 protein and mRNA of the WWJYS group increased significantly(P<0.05).Network pharmacology collected 64 compounds and identified 22 potential targets of WWJYS for antihypertensive activity.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that WWJYS might regulate smooth muscle cells,affect inflammatory response and improve endothelial function through multiple pathways.The molecular docking study further supported that the target proteins have good combinations with the main active components of WWJYS.Conclusions:The data indicated that WWJYS had significant depressurization,analgesic,and sedative,as well as lipid-lowering effects,and the depressurization mechanism of WWJYS may function in multiple signal pathways,especially in improving blood vessel function and intervening inflammation.
文摘Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcomes of ELBW infants during their Neonatal Intensive Care Unit （NICU） stay in the mainland of China. Methods： All infants admitted to 26 NICUs with a birth weight （BW） 〈1000 g were included between January 1,2011 and December 31,2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results： A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age （GA） was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants （23.3%） died and another 69 infants （26.7%） died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas （53.6% vs. 35.3%, P = 0.019）. BW 〈750 g and GA 〈28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions： Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.
文摘Background： Hepatocellular carcinoma （HCC） is a common cancer in China, an area of high hepatitis B virus （HBV） infection. Although several staging systems are available, there is no consensus on the best classification to use because multiple factors, such as etiology, clinical treatment and populations could affect the survival of HCC patients. Methods： This study analyzed 743 HBV-related Chinese HCC patients who received surgery first and evaluated the predictive values of eight different commonly used staging systems in the clinic. Results： The overall 1-, 3-, 5-year survival rates and a median survival were 91.5%, 70.3%, 55.3% and 72 months respectively. Barcelona Clinic Liver Cancer （BCLC） staging systems had the best stratification ability and showed the lowest Akaike information criterion （AIC） values （2896.577）, followed by tumor-node-metastasis Th （TNM 7^th） （AIC = 2899.980）, TNM 6th （AIC = 2902.17）, Japan integrated staging score （A1C = 2918.085）, Tokyo （AIC = 2938.822）, Cancer of the Liver Italian Program score （AIC = 2941.950）, Chinese University Prognostic Index grade （AIC = 2962.027）, and Okuda （AIC = 2979.389）. Conclusions： BCLC staging system is a better staging model for HBV infection patients with HCC in Chinese population among the eight currently used staging systems. These identifications afford a large group of Chinese HCC patients with HBV infection and could be helpful to design a new staging system for a certain population.
文摘Background： The liver is the most common site for colorectal cancer （CRC） metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases （CRCLM） who underwent simultaneous resections for both lesions. Methods： From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival （OS） and disease-free survival （DFS） were examined by Kaplan-Meier and log-rank methods. Results： Median follow-up time was 22.7 months： no perioperative death or serious complications were observed. Median OS was 55.5 months： postoperative OS rates were l-year： 93.8%, 3-year： 60.7%, and 5-year： 46.4%. Median DFS was 9.0 months; postoperative DFS rates were l-year： 43.1%, 3-year： 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen 〉100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age 〉60 years, no adjuvant chenlotherapy, multiple metastases, and largest diameter ≥3 cm for DFS. Conclusions： Simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRC LM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.
基金funded by the National Key Research and Development Program of China(No.202IZD0113501)the Science and Technology Commission of Shanghai Municipality(No.21511104502)。
文摘Neonatal care is of great significance to health capabil-ity.Since neonatal intensive care units(NICUs)started to be established in the late 1980s in China,neonatal mortal-ity has decreased each year to reach 3.4‰in 2020[1,2].However,the improvement for neonatal care is still on the way.More than three-fifths of deaths included critically ill neonates occur in their first 28 days[3].Critically ill neo-nates usually have lower gestational age and body weight,leading to high mortality or requiring specific treatment and monitoring[4].It is a common practice to transfer a critically ill newborn patient to a tertiary children's hospi-tal with an excellent NICU.Therefore,it is crucial to pro-mote patients'safety by improving the neonatal transport network services[5].Owing to the complexity and rapid changes in neonatal conditions,especially for those requir-ing multi-disciplinary treatment,there is a high reliance on a specialized newborn transport team[6,7].
