BACKGROUND It has been shown that children with Pierre Robin sequence(PRS)have a higher risk of difficult intubation before surgery.When mask ventilation or tracheobronchial intubation is expected to be challenging,fl...BACKGROUND It has been shown that children with Pierre Robin sequence(PRS)have a higher risk of difficult intubation before surgery.When mask ventilation or tracheobronchial intubation is expected to be challenging,flexible bronchoscopy(FB)is advantageous in airway safety when it is used to guide tracheobronchial intubation(TI).AIM To evaluate the complications of TI using FB in children with PRS and explore the effect of nursing services on postoperative complications.METHODS One hundred and five children with PRS underwent TI using FB before early mandibular distraction osteogenesis.One hundred and eight children with common pneumonia who did not have a difficult airway were set as the control group.Demographic data,success rates of TI,time required for TI,number of TI attempts,and the incidence of postoperative complications were assessed.Besides,the strategies used to attenuate complications were investigated.RESULTS The success rate of TI was 100%in children with PRS,while the success rate at the first attempt in the PRS group was significantly lower than that in the control group(88.6%vs 98.2%,P=0.005).The time required for TI in the PRS group was markedly longer than that in the control group(P<0.001).Children in the PRS group required repetitive operations to enter the glottis successfully(P=0.017).The incidence of complications was noticeably higher in the PRS group(50/105,47.6%)than in the control group(36/108,33.3%)(P=0.034).Seven of 105 PRS children experienced laryngeal edema (LE) (6.7%), compared with one (0.9%) in the control group(P = 0.034). Out of the seven patients who had LE, all were reintubated and managed withsteroids: six recovered with inhaled steroids alone before extubated, and one was given systemiccorticosteroids before recovery.CONCLUSIONFB contributes to a high success rate of TI in children with PRS. To prevent LE, operators shouldpay more attention to catheter material, catheter lubrication and intubation time.展开更多
Carbon emissions abatement(CEA)is an important issue that draws attention from both academicians and policymakers.Data envelopment analysis(DEA)has been a popular tool to allocate the CEA,and most previous works are b...Carbon emissions abatement(CEA)is an important issue that draws attention from both academicians and policymakers.Data envelopment analysis(DEA)has been a popular tool to allocate the CEA,and most previous works are based on radial DEA models.However,as shown in our paper,these models may give biased results due to their ignorance of slackness.To avoid such problems,we propose an allocation model based on the slack-based model and multiple-objective nonlinear programming to find the CEA allocation plan,which can minimize the GDP loss.The property of nonconvexity makes the model difficult to solve.Thus,we construct an approximation algorithm to solve this model with guaranteed error bounds and complexity.In the empirical application,we take regions of china as an illustrative example and find there is a significant region gap in China.Hence,we group the regions into eastern,central,and western,and give the main results,as well as the superiority of our allocation models compared with radial models.展开更多
Background and Aims:Protein phosphatase 2A(PP2A)is associated with many cancers.This study aimed to clarify whether PPP2CA,which encodes the alpha isoform of the catalytic subunit of PP2A,plays a role in hepatocellula...Background and Aims:Protein phosphatase 2A(PP2A)is associated with many cancers.This study aimed to clarify whether PPP2CA,which encodes the alpha isoform of the catalytic subunit of PP2A,plays a role in hepatocellular carcinoma(HCC)and to identify the potential underlying molecular pathways.Methods:Based on bioinformatics,public databases and our in-house RNA-Seq database,we analyzed the clinical value and molecular mechanism of PPP2CA in HCC.Results:Data were analyzed from 2,545 patients with HCC and 1,993 controls without HCC indexed in The Cancer Genome Atlas database,the Gene Expression Omnibus database and our in-house RNA-Seq database.PPP2CA expression was significantly higher in HCC tissue than in non-cancerous tissues(standardized mean difference:0.69,95%confidence interval[CI]:0.50–0.89).PPP2CA expression was able to differentiate HCC from non-HCC,with an area under the summary receiver operator characteristic curve of 0.79(95%CI:0.75–0.83).Immunohistochemistry of tissue sections confirmed that PPP2CA protein was up-regulated in HCC tissues.High PPP2CA expression in HCC patients was associated with shorter overall,progression-free and disease-free survival.Potential molecular pathways through which PPP2CA may be involved in HCC were determined using miRWalk 2.0 as well as analysis of Gene Ontology categories,Kyoto Encyclopedia of Genes and Genomes pathways,and protein-protein interaction networks.Conclusions:PPP2CA is up-regulated in HCC and higher expression correlates with worse prognosis.PPP2CA shows potential as a diagnostic marker for HCC.Future studies should examine whether PPP2CA contributes to HCC through the candidate microRNAs,pathways and hub genes identified in this study.展开更多
文摘BACKGROUND It has been shown that children with Pierre Robin sequence(PRS)have a higher risk of difficult intubation before surgery.When mask ventilation or tracheobronchial intubation is expected to be challenging,flexible bronchoscopy(FB)is advantageous in airway safety when it is used to guide tracheobronchial intubation(TI).AIM To evaluate the complications of TI using FB in children with PRS and explore the effect of nursing services on postoperative complications.METHODS One hundred and five children with PRS underwent TI using FB before early mandibular distraction osteogenesis.One hundred and eight children with common pneumonia who did not have a difficult airway were set as the control group.Demographic data,success rates of TI,time required for TI,number of TI attempts,and the incidence of postoperative complications were assessed.Besides,the strategies used to attenuate complications were investigated.RESULTS The success rate of TI was 100%in children with PRS,while the success rate at the first attempt in the PRS group was significantly lower than that in the control group(88.6%vs 98.2%,P=0.005).The time required for TI in the PRS group was markedly longer than that in the control group(P<0.001).Children in the PRS group required repetitive operations to enter the glottis successfully(P=0.017).The incidence of complications was noticeably higher in the PRS group(50/105,47.6%)than in the control group(36/108,33.3%)(P=0.034).Seven of 105 PRS children experienced laryngeal edema (LE) (6.7%), compared with one (0.9%) in the control group(P = 0.034). Out of the seven patients who had LE, all were reintubated and managed withsteroids: six recovered with inhaled steroids alone before extubated, and one was given systemiccorticosteroids before recovery.CONCLUSIONFB contributes to a high success rate of TI in children with PRS. To prevent LE, operators shouldpay more attention to catheter material, catheter lubrication and intubation time.
基金Key Laboratory of Management,Decision and Information Systems,Chinese Academy of Sciences.
文摘Carbon emissions abatement(CEA)is an important issue that draws attention from both academicians and policymakers.Data envelopment analysis(DEA)has been a popular tool to allocate the CEA,and most previous works are based on radial DEA models.However,as shown in our paper,these models may give biased results due to their ignorance of slackness.To avoid such problems,we propose an allocation model based on the slack-based model and multiple-objective nonlinear programming to find the CEA allocation plan,which can minimize the GDP loss.The property of nonconvexity makes the model difficult to solve.Thus,we construct an approximation algorithm to solve this model with guaranteed error bounds and complexity.In the empirical application,we take regions of china as an illustrative example and find there is a significant region gap in China.Hence,we group the regions into eastern,central,and western,and give the main results,as well as the superiority of our allocation models compared with radial models.
基金This research was supported by the Innovation and Entrepreneurship Training Program for College Students of Guangxi Medical University(202010598047)the China Postdoctoral Science Foundation(2019M663876XB)+2 种基金the National Natural Science Foundation of China(81960450,82060510)the‘Guangxi BaGui Scholars’Special Fund(2019AQ20)the National Major Special Science and Technology Project(2017ZX10203207).
文摘Background and Aims:Protein phosphatase 2A(PP2A)is associated with many cancers.This study aimed to clarify whether PPP2CA,which encodes the alpha isoform of the catalytic subunit of PP2A,plays a role in hepatocellular carcinoma(HCC)and to identify the potential underlying molecular pathways.Methods:Based on bioinformatics,public databases and our in-house RNA-Seq database,we analyzed the clinical value and molecular mechanism of PPP2CA in HCC.Results:Data were analyzed from 2,545 patients with HCC and 1,993 controls without HCC indexed in The Cancer Genome Atlas database,the Gene Expression Omnibus database and our in-house RNA-Seq database.PPP2CA expression was significantly higher in HCC tissue than in non-cancerous tissues(standardized mean difference:0.69,95%confidence interval[CI]:0.50–0.89).PPP2CA expression was able to differentiate HCC from non-HCC,with an area under the summary receiver operator characteristic curve of 0.79(95%CI:0.75–0.83).Immunohistochemistry of tissue sections confirmed that PPP2CA protein was up-regulated in HCC tissues.High PPP2CA expression in HCC patients was associated with shorter overall,progression-free and disease-free survival.Potential molecular pathways through which PPP2CA may be involved in HCC were determined using miRWalk 2.0 as well as analysis of Gene Ontology categories,Kyoto Encyclopedia of Genes and Genomes pathways,and protein-protein interaction networks.Conclusions:PPP2CA is up-regulated in HCC and higher expression correlates with worse prognosis.PPP2CA shows potential as a diagnostic marker for HCC.Future studies should examine whether PPP2CA contributes to HCC through the candidate microRNAs,pathways and hub genes identified in this study.
