Features of structure and propagation of the 30 to SO day atmospheric oscillations are investigated using the ECMWF analysis of 1980-1983. Evidence is provided to confirm the characteristics of the oscillation in the ...Features of structure and propagation of the 30 to SO day atmospheric oscillations are investigated using the ECMWF analysis of 1980-1983. Evidence is provided to confirm the characteristics of the oscillation in the equatorial region. Those in the mid-high latitudes, however, are revealed to be very different from the tropics and pose a strong barotropic structure. Horizontal coherence shows teleconnection patterns which can be identified as EAP and PNA. The wind field of the specified time scale of the oscillation appears as long-lived vortices and vortex pairs. Mid-latitude perturbations propagate clearly westwards, especially during the winter season. In the high latitudes, they propagate westwards in the winter but eastwards in the summer. Meridional propagations are rather different from region to region.展开更多
In this part, the temporal evolution and interaction across the equator of 30-50 day oscillation in the atmosphere are investigated further. The annual variation of 30-50 day oscillation is quite obvious in the mid-hi...In this part, the temporal evolution and interaction across the equator of 30-50 day oscillation in the atmosphere are investigated further. The annual variation of 30-50 day oscillation is quite obvious in the mid-high latitudes. In the tropical atmosphere, the obvious interannual variation is an important property for temporal evolution of 30-50 day oscillation. The low-frequency wavetrain across the equator over the central Pacific and central Atlantic area, the movement of the long-lived low-frequency system across the equator and the meridional wind component across the equator will obviously show the interaction of 30-50 day oscillation in the atmosphere across the equator.展开更多
BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population.Cement augmentation is one of the effective surgical treatments for these patients.Currently,there are seve...BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population.Cement augmentation is one of the effective surgical treatments for these patients.Currently,there are several different types of cement augmentation treatments.No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures;thus,we retrospectively compared vertebroplasty,balloon kyphoplasty,and kyphoplasty with SpineJack or an intravertebral expandable pillar.AIM To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures.METHODS We retrospectively analyzed 354 patients with acute vertebral compression fractures,defined as signal changes in the T1 weighted magnetic resonance imaging,and randomly divided the patients into five groups.Their visual analog scale scores for pain,kyphotic angle,average body height,rate of cement leakage,and occurrence of adjacent vertebral compression fractures were followed for 1 year.One-way analysis of variance,the post hoc Bonferroni test,and Fisher exact probability test were used for statistical analyses.RESULTS All pain scores significantly improved 12 mo postoperatively;however,there was no significant difference between the groups(P=0.325).Kyphoplasty with SpineJack significantly reduced the kyphotic angle(P=0.028)and restored the height of the vertebral body(P=0.02).The rate of adjacent compression fractures was the highest in the vertebroplasty group,with a statistically significant difference according to the Fisher exact probability test(P=0.02).The treatment with the lowest cement leakage rate cannot be identified because of the small sample size;however,kyphoplasty with SpineJack,an IVEP,and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty.CONCLUSION Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration.Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.展开更多
Objective To investigate the relationships between erythrocyte membrane n-6：n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein （hs-CRP）. Methods The Chinese and a observational study consisted...Objective To investigate the relationships between erythrocyte membrane n-6：n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein （hs-CRP）. Methods The Chinese and a observational study consisted of a population-based cross-sectiona subsequent 1-year follow-up study of 171 subjects with the fasting cholesterol of 5.13-8.00 mmol/L. study of 456 plasma total Results In the cross-sectional analysis, plasma low-density lipoprotein cholesterol （LDL-c） had a significant and negative association with the erythrocyte membrane n-6：n-3 PUFAs ratio （P for trend=0.019） after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6：n-3 ratio in erythrocyte membrane （△=month 12-month 0）. In the top quartile whose ratios of n-6：n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6：n-3 decreased by an average of 1.13 （-1.07 mmol/L v.s. -0.32 mmol/L）. The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile （P for difference=0.052）. Conclusion Our results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.展开更多
Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factor...Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing function.Methods We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU admission.Correlations between changes in PTA threshold and patient characteristics,were evaluated.The included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were compared.Results During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility criteria.Age,sex,and the use of furosemide were not correlated with changes in PTA threshold.Univariate analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing function.Low serum platelet count and planned admission appear to be risk factors for worse hearing.展开更多
Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety...Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety and efficacy of different cement augmentation modalities for vertebral compression fractures under osteoporotic condition.Overall,this is a valuable study that can provide a reference for clinical practice.On the other hand,we also noticed some points in the article and are willing to share our views.Further studies with a higher level of evidence can add more knowledge regarding relevant concerns.展开更多
Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is impera...Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer spe-cific treatment planned and written in the patients’ medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.展开更多
BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and dea...BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and death.While an increasing number of studies suggest that the gut microbiota may play a key role in the pathophy-siology of frailty,direct evaluation of the association between gut microbiome alterations and frailty in older adults remains limited.AIM Seven electronic databases(China National Knowledge Infrastructure,VIP,SinoMed,Wanfang,PubMed,Web of Science and EMBASE)were searched for articles published before October 31,2023 to identify observational studies that compared the microbiomes of older adults with and without frailty.The diversity and composition of the gut microbiota were the main outcomes used to analyze the associations of changes in the gut microbiota with frailty in older adults.The quality of the included studies was assessed via the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality.RESULTS Eleven observational studies with 912 older adults were included in this review.Consistent results revealed a significant difference in the gut microbiota composition between frail and non-frail older adults,with a significant decrease inαdiversity and a significant increase inβdiversity in frail older adults.The pooled results revealed that at the phylum level,four microbiota(Actinobacteria,Proteo-bacteria,Verrucomicrobia and Synergistetes)were significantly enriched,and two microbiota(Firmicutes and Fusobacteria)were significantly depleted in frail older adults.At the family level,the results consistently revealed that the abundances of 6 families,most of which belong to the Actinobacteria or Proteo-bacteria phylum,were greater in frail than in non-frail older adults.At the genus or species level,consistent results from more than two studies revealed that the abundances of the genera Prevotella,Faecalibacterium,and Roseburia were significantly lower in frail older adults;individual studies revealed that the abundances of some genera or species(e.g.,Megamonas,Blautia,and Megasphaera)were significantly lower,whereas those of other genera or species(e.g.,Bifidobacterium,Oscillospira,Ruminococcus and Pyramidobacter)were significantly greater in frail older adults.CONCLUSION This systematic review suggests that changes in the gut microbiota are associated with frailty in older adults,which is commonly reflected by a reduction in beneficial species and an increase in pathogenic species.However,further studies are needed to confirm these findings.展开更多
BACKGROUND Video-capsule endoscopy(VCE)is an efficient tool that has proven to be highly useful in approaching several gastrointestinal diseases.VCE was implemented in Colombia in 2003,however current characterization...BACKGROUND Video-capsule endoscopy(VCE)is an efficient tool that has proven to be highly useful in approaching several gastrointestinal diseases.VCE was implemented in Colombia in 2003,however current characterization of patients undergoing VCE in Colombia is limited,and mainly comes from two investigations conducted before the SARS-CoV-2 pandemic period.AIM To describe the characteristics of patients undergoing VCEs and establish the main indications,findings,technical limitations,and other outstanding features.METHODS A descriptive study was carried out using data from reports of VCE(PillCam SB3 system)use in a Gastroenterology Unit in Bogotá,Colombia between September 2019 and January 2023.Demographic and clinical variables such as indication for the VCE,gastric and small bowel transit times(GTT,SBTT),endoscopic preparation quality,and limitations were described[n(%),median(IQR)].RESULTS A total of 133 VCE reports were analyzed.Most were in men with a median age of 70 years.The majority had good preparation(96.2%),and there were technical limitations in 15.8%of cases.The main indications were unexplained anemia(91%)or occult bleeding(23.3%).The median GTT and SBTT were 14 and 30 minutes,respectively.The frequencies of bleeding stigma(3.79%)and active bleeding(9.09%)were low,and the most frequent abnormal findings were red spots(28.3%),erosions(17.6%),and vascular ectasias(12.5%).CONCLUSION VCE showed high-level safety.The main indication was unexplained anemia.Active bleeding was the most frequent finding.Combined with artificial intelligence,VCE can improve diagnostic precision and targeted therapeutic interventions.展开更多
Ischemic stroke is a devastating,life altering event which can severely reduce patient quality of life.Despite years of research there have been minimal therapeutic advances.Endothelial progenitor cells(EPCs),stem cel...Ischemic stroke is a devastating,life altering event which can severely reduce patient quality of life.Despite years of research there have been minimal therapeutic advances.Endothelial progenitor cells(EPCs),stem cells involved in both vasculogenesis and angiogenesis,may be a potential therapeutic target.After a stroke,EPCs migrate to the site of ischemic injury to repair cerebrovascular damage,and their numbers and functional capacity may determine patients'outcome.This study aims to determine whether the number of circulating EPCs and their functional aspects may be used as biomarkers to identify the type(cortical or lacunar)and/or severity of ischemic stroke.The study will also investigate if there are any differences in these characteristics between healthy volunteers over and under 65 years of age.100 stroke patients(50 lacunar and 50 cortical strokes)will be recruited in this prospective,observational case-controlled study.Blood samples will be taken from stroke patients at baseline(within 48 hours of stroke)and days 7,30 and90.EPCs will be counted with flow cytometry.The plasma levels of pro-and anti-angiogenic factors and inflammatory cytokines will also be determined.Outgrowth endothelial cells will be cultured to be used in tube formation,migration and proliferation functional assays.Primary outcome is disability or dependence on day 90 after stroke,assessed by the modified Rankin Scale.Secondary outcomes are changes in circulating EPC numbers and/or functional capacity between patient and healthy volunteers,between patient subgroups and between elderly and young healthy volunteers.Recruitment started in February 2017,167 participants have been recruited.Recruitment will end in November 2019.West Midlands-Coventry&Warwickshire Research Ethics Committee approved this study(REC number:16/WM/0304)on September8,2016.Protocol version:2.0.The Bayraktutan Dunhill Medical Trust EPC Study was registered in ClinicalTrials.gov(NCT02980354)on November 15,2016.This study will determine whether the number of EPCs can be used as a prognostic or diagnostic marker for ischemic strokes and is a step towards discovering if transplantation of EPCs may aid patient recovery.展开更多
Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability...Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability in elements during onset and the established periods of the South China Sea(SCS) southwest(SW) monsoon. The averaged date of the onset SW monsoon in the SCS occurs in the middle of May climatologically. The corresponding date for the northern part is little earlier (May 12) and those for the southern parts are little later (May 20). The interannual range of the onset dates is about one month. Following the onset of the SW monsoon, the cloud amount and the precipitation increase while the convection activities enhance over the SCS. But there is a strong spatial heterogeneity within the domain. After onset of the SW monsoon the strong convective area moves northwards, while the SCS rain band moves to the center and north. Sea surface temperature(SST) increases rapidly before the onset and the leading time is about one month. The increment of SST supplies heat and vapor for the onset. From April to May the surface heat fluxes display obvious changes, e.g., latent heat exchange and evaporation enhancement. It is one of the reasons why the SW monsoon bursts firstly in the SCS.展开更多
OBJECTIVE: To present and analyze treatmentsand clinical outcomes of Chinese patients with influenza-like illness.METHODS: We conducted a multi-site observational study from December 2009 to April 2010. Patients with ...OBJECTIVE: To present and analyze treatmentsand clinical outcomes of Chinese patients with influenza-like illness.METHODS: We conducted a multi-site observational study from December 2009 to April 2010. Patients with influenza-like illness from 45 hospitals were enrolled. Patients received Chinese herbal medicine(CHM), conventional treatments, or CHM plus conventional treatments(combination treatment) according to the guidelines for influenza A/H1 N1 2009 in China. The primary outcomes were the time to alleviation of symptoms and the incidence of complications. The secondary outcomes were the time until becoming afebrile, incidence of severe illness, testing negative on an influenza A viral test, and total medical fees.RESULTS: In total, 5967 patients were enrolled. The percentages of patients prescribed CHM alone, conventional treatment, and combination treatment were 27.8%, 5.1%, and 67.7%, respectively. There were no significant differences in the time to alleviation of symptoms, incidence of complications,time to becoming afebrile, or rate of severe illness among the CHM, conventional, and combination treatment groups. The rates of testing negative on the influenza virus A rapid test and H1 N1 virus test were 90.3% and 76.3%, respectively. However,significant differences were found in the total medical fees among the three groups: CHM treatments were more economical than the other two treatments.CONCLUSION: The efficacy of CHM for influenza-like illness was not different from that of conventional treatments, but it was more economical.展开更多
Objective To introduce the design of observational trials under real-world study(RWS),and to provide guidance for clinical development of new research trials and reference for real-world researchers.Methods Relevant l...Objective To introduce the design of observational trials under real-world study(RWS),and to provide guidance for clinical development of new research trials and reference for real-world researchers.Methods Relevant literature of RWS and observational experiments at home and abroad were reviewed and analyzed,and then the design of observational studies was summarized under RWS.Results and Conclusion The data and information provided in observational studies not only help to further verify the clinical study results obtained by randomized controlled trial(RCT)in clinical practice,but also objectively reflect the real situation in the process of clinical research and application.展开更多
BACKGROUND Most of the recent research on nightmare distress and depressive symptoms has focused on adolescents and students,with less research on the nurse population.Emergency department nurses are at high risk for ...BACKGROUND Most of the recent research on nightmare distress and depressive symptoms has focused on adolescents and students,with less research on the nurse population.Emergency department nurses are at high risk for nightmare distress and depressive symptoms,but no studies have been conducted to explore the relationship between the two;thus,further investigation is needed.AIM To understand the relationship between nightmare distress and depressive symptoms among emergency department nurses in China.METHODS A convenience sampling method was used to select 280 emergency department nurses from nine provinces,including Jiangxi,Sichuan,Jiangsu,and Shanxi Provinces.The Chinese version of the Nightmare Distress Questionnaire and the Center for Epidemiological Studies Depression Scale(CES-D)were administered.RESULTS Emergency department nurses’nightmare distress scores were positively associated with depressive symptom scores(r=0.732),depressed affect(r=0.727),somatic symptoms(r=0.737),and interpersonal difficulty(r=0.647).Further multiple linear regression analyses showed that education level,work pressure,self-reported health,and CES-D scores were factors that influenced nightmare distress among Chinese emergency department nurses(P<0.05).CONCLUSION Nightmare distress is closely associated with depressive symptoms in Chinese emergency department nurses,and early intervention is recommended for professionals with this type of sleep disorder to reduce the occurrence of depressive symptoms.展开更多
BACKGROUND Pseudomyxoma peritonei is a rare tumor that can produce a biological behavior similar to that of a malignant tumor.Surgical resection combined with chemo-therapy is the traditional treatment method,but the ...BACKGROUND Pseudomyxoma peritonei is a rare tumor that can produce a biological behavior similar to that of a malignant tumor.Surgical resection combined with chemo-therapy is the traditional treatment method,but the effect is not good.Cell reduction(CRS)combined with intraperitoneal thermoperfusion chemotherapy(HIPEC)has become a new method for the treatment of peritoneal pseudomy-xoma(PMP).AIM To find out if CRS and HIPEC can be used safely and effectively to treat PMP.METHODS This is an observational study.Clinical data of PMP patients treated with CRS+HIPEC at our hospital from January 2013 to June 2023 was collated and analyzed.The main outcome measures were overall survival(OS),and the secondary outcome measures were the incidence of surgical complications and serious adverse events.Complications were graded according to common adverse event evaluation criteria.Peritoneal tumor staging was performed using the peritoneal tumor index(PCI)scoring system,and a cell reduction degree(CCR)score was performed after CRS.CCR-0 and CCR-1 were considered satisfactory CRS.RESULTS A total of 186 patients with PMP were included,with a median age of 56(48-64)years,65(34.9%)years in males,and 121(65.1%)years in females.The median PCI score was 28(20-34)points.The median operative time was 300(211-430)minutes,and no significant complications occurred.91.4%(170/186)were from the appendix,53.2%(99/186)were from the low grade,and 30.6%(57/186)were from the high grade.CCR scores showed that 55 patients(29.6%)achieved satisfactory CRS,and 113 patients(60.8%)did not achieve satisfactory CRS.The fatality rate at 30 days after surgery was 2.7%(5/186),1.6%(3/186)needed a second operation,and the fatality rate at 90 days was 4.3%(8/186).The total incidence of III-IV complications was 43.0%(80/186),among which the higher incidence was mainly anemia(27.4%,51/186),electrolyte disturbance(11.6%,21/181),and albumin decrease(7.5%,14/186).The main compli-cations associated with abdominal surgery were gastrointestinal anastomotic leakage(2.2%,4/186),abdominal hemorrhage(2.2%,4/186),and abdominal infection(4.3%,8/186).The median follow-up was 38.1(95%CI:31.2-45.1)months.The 5-year OS of PMP patients treated with CRS+HIPEC was 50.3%(95%CI:40.7%-59.9%),and the median survival time was 66.1(95%CI:43.1-89.1)months.The results of the survival analysis showed that patients with a low pathological grade,a low PCI,and a satisfactory CCR score had a higher survival rate(all P<0.05).5-year OS was 88.9%(95%CI:68.3%-100.0%)in CCR-0 patients,77.6%(95%CI:62.7%-92.5%)in CCR-1 patients,and 42.0%(95%CI:29.5%-54.5%)in CCR-2/3 patients.CONCLUSION The application of CRS+HIPEC in PMP is safe and feasible,and the survival benefit is high,especially in those who achieve satisfactory CRS,which can significantly extend the OS.展开更多
Using atmospheric observational data from 1998 to 2013,station rainfall data,TRMM（Tropical Rainfall Measuring Mission） data,as well as annual statistics for the plateau vortex and shear line,the joint activity featu...Using atmospheric observational data from 1998 to 2013,station rainfall data,TRMM（Tropical Rainfall Measuring Mission） data,as well as annual statistics for the plateau vortex and shear line,the joint activity features of sustained departure plateau vortexes（SDPVs） and southwest vortexes（SWVs） are analyzed.Some new and useful observational facts and understanding are obtained about the joint activities of the two types of vortex.The results show that：（1） The joint active period of the two vortexes is from May to August,and mostly in June and July.（2） The SDPVs of the partnership mainly originate near Zaduo,while the SWVs come from Jiulong.（3） Most of the two vortexes move in almost the same direction,moving eastward together with the low trough.The SDPVs mainly act in the area to the north of the Yangtze River,while the SWVs are situated across the Yangtze River valley.（4） The joint activity of the two vortexes often produces sustained regional heavy rainfall to the south of the Yellow River,influencing wide areas of China,and even as far as the Korean Peninsula,Japan and Vietnam.（5） Most of the two vortexes are baroclinic or cold vortexes,and they both become strengthened in terms of their joint activity.（6） When the two vortexes move over the sea,their central pressure descends and their rainfall increases,especially for SWVs.（7） The two vortexes might spin over the same area simultaneously when there are tropical cyclones in the eastern and southern seas of China,or move southward together if a tropical cyclone appears near Hainan Island.展开更多
AIM： To assess the effectiveness and safety of ranibizumab 0.5 mg in Taiwan Residents patients with polypoidal choroidal vasculopathy（PCV） by performing a retrospective exploratory subgroup analysis of the REAL stu...AIM： To assess the effectiveness and safety of ranibizumab 0.5 mg in Taiwan Residents patients with polypoidal choroidal vasculopathy（PCV） by performing a retrospective exploratory subgroup analysis of the REAL study.METHODS： REAL was a 12-month, observational, prospective, non-interventional phase IV post-marketing surveillance study conducted at 9 centers in Taiwan. The study collected data as part of the routine patient visits from the medical records of patients with neovascular agerelated macular degeneration treated with ranibizumab 0.5 mg according to local standard medical practice and local label and/or reimbursement guidelines. The presence of PCV at baseline was determined using indocy received prior tanine green angiography. RESULTS： At baseline, PCV was diagnosed in 64 of the 303 enrolled patients（21.1%）. Of these, 41 patients（64.1%） hadreatment; 15（23.4%） patients had received ranibizumab. The intent-to-treat population included 58 patients; 47（80%） who received ranibizumab and 11（20%） who received ranibizumab plus photodynamic therapy（PDT; 9 patients received once, 2 patients received twice）. Bevacizumab was used as a concomitant medication in a similar percentage of patients who received ranibizumab（43%, n=20） or ranibizumab plus PDT（45%, n=5）. In patients who received ranibizumab, visual acuity（VA） at baseline was 50.1±12.9 Early Treatment Diabetic Retinopathy Study letters, and the gain at month 12 was 1.1±17.8 letters. In patients who received ranibizumab plus PDT, VA at baseline was 51.4±15.9 letters, and there was a marked gain in VA at month 12（14.0±9.2 letters, P=0.0009）. In the intent-totreat population, the reduction in central retinal subfield thickness from baseline at month 12 was 69.6±122.6 μm（baseline： 310.8±109.8 μm, P=0.0004）. The safety results were consistent with the well-characterized safety profile of ranibizumab.CONCLUSION： In real-world settings, ranibizumab 0.5 mg treatment for 12 mo results in maintenance of VA and reduction in central retinal subfield thickness in Taiwan Residents patients with PCV. Improvements in VA are observed in patients who received ranibizumab plus PDT. There are no new safety findings.展开更多
<strong>Background: </strong>Pre-clinical and clinical studies have shown that inflammatory pain intensity is increased under diabetes condition. Open cholecystectomy (OC) is a surgical procedure with pred...<strong>Background: </strong>Pre-clinical and clinical studies have shown that inflammatory pain intensity is increased under diabetes condition. Open cholecystectomy (OC) is a surgical procedure with predictable postoperative pain. However, the comparison of postoperative pain due to open cholecystectomy in diabetic and non-diabetic patients remains unknown. The research question to answer was whether diabetic patients undergoing OC development greater intensity of postoperative pain than non-diabetic patients. <strong>Methods: </strong>The study was conducted between June 2016 and February 2018 at the Regional Hospital of High Specialty “Dr. Juan Graham Casasús” of Villahermosa, Tabasco, Mexico. Seventy patients in two groups of 35 patients each scheduled for OC under general anesthesia were studied. Pain was assessed using the 11-point numerical rating scale (NRS). The primary endpoint was to know NRS pain scores after awaking of general anesthesia. Secondary outcomes included the time of onset of pain and comparing NRS scores between diabetic and non-diabetic patients undergoing OC. <strong>Results:</strong> Diabetic patients reported significantly greater intensity pain than non-diabetic patients. The mean overall pain score in the diabetic and non-diabetic patients was 7.2 ± 0.3 and 5.3 ± 0.3 (P = 0.0002), respectively. Furthermore, 60% of diabetic patients had severe pain (NRS ≥ 8) compared to 20% of non-diabetics (P = 0.006). The time to onset postoperative pain was about 35 minutes in both groups (P = 0.876). <strong>Conclusions:</strong> Diabetic patients undergoing OC have greater intensity postoperative pain and also more frequency of patients with severe pain scores compared with non-diabetic patients. Therefore, analgesic treatment in those patients should consider this point in order to provide a satisfactory postoperative analgesia.展开更多
AIM:To evaluate whether red meat intake is related to the risk of endometrial cancer(EC) using meta-analysis.METHODS:We searched Pub Med,EMBASE,and the Cochrane Library up to June 2013,using common keywords related to...AIM:To evaluate whether red meat intake is related to the risk of endometrial cancer(EC) using meta-analysis.METHODS:We searched Pub Med,EMBASE,and the Cochrane Library up to June 2013,using common keywords related to red meat and EC.Case-control studies and cohort studies comparing the risk of endometrial cancer among categories by the amount of intake were included.Eleven case-control studies and five cohort studies met our criteria.We performed a conventional and a dose-response meta-analysis of case-control studies using the Der Simonian-Laird method for random-effects.For cohort studies we performed a conventional meta-analysis.Publication bias was evaluated using Egger's test.RESULTS:In the meta-analysis of 11 case-control studies including 5419 cases and 12654 controls,higher red meat consumption was associated with an increased risk of EC [summary relative risk(SRR) = 1.43,95%CI:1.15-1.79;I2 = 73.3% comparing extreme intake categories).In a dose-response analysis,for red meat intake of 100 g/d,SRR was 1.84(95%CI:1.64-2.05).In contrast,in the meta-analysis of five prospective studies including a total of 2549 cases among 247746 participants,no significant association between red meat intake and EC risk(SRR = 0.97,95%CI:0.85-1.11;I2 = 4.9% comparing extreme intake categories) was observed.CONCLUSION:Our meta-analysis found a significantlinear association between red meat intake and EC risk based on case-control studies but this was not confirmed in prospective studies.展开更多
Identifying the causal impact of＇ some intervention challenging when one is faced with correlated binary end-points in observational studies is a challenging task, and it is even more The statistical literature on an...Identifying the causal impact of＇ some intervention challenging when one is faced with correlated binary end-points in observational studies is a challenging task, and it is even more The statistical literature on analyzing such data is well documented. Dependence between observations from the same study subject in correlated data renders invalid the usual chi-square tests of independence and inflates the variance ofparameter estimates. Disaggregated approaches such as hierarchical linear models which are able to adjust for individual level covariate：s are favoured in the analysis of such data, thereby gaining power over aggregated and individual-level analyses. In this article the authors, therefore, address the issue of analyzing correlated data with dichotomous end-points by using hierarchical logistic regression, a generalization of the standard logistic regression model for independent outcomes.展开更多
文摘Features of structure and propagation of the 30 to SO day atmospheric oscillations are investigated using the ECMWF analysis of 1980-1983. Evidence is provided to confirm the characteristics of the oscillation in the equatorial region. Those in the mid-high latitudes, however, are revealed to be very different from the tropics and pose a strong barotropic structure. Horizontal coherence shows teleconnection patterns which can be identified as EAP and PNA. The wind field of the specified time scale of the oscillation appears as long-lived vortices and vortex pairs. Mid-latitude perturbations propagate clearly westwards, especially during the winter season. In the high latitudes, they propagate westwards in the winter but eastwards in the summer. Meridional propagations are rather different from region to region.
基金This study was supported in part by National Natural Science Foundation of China
文摘In this part, the temporal evolution and interaction across the equator of 30-50 day oscillation in the atmosphere are investigated further. The annual variation of 30-50 day oscillation is quite obvious in the mid-high latitudes. In the tropical atmosphere, the obvious interannual variation is an important property for temporal evolution of 30-50 day oscillation. The low-frequency wavetrain across the equator over the central Pacific and central Atlantic area, the movement of the long-lived low-frequency system across the equator and the meridional wind component across the equator will obviously show the interaction of 30-50 day oscillation in the atmosphere across the equator.
文摘BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population.Cement augmentation is one of the effective surgical treatments for these patients.Currently,there are several different types of cement augmentation treatments.No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures;thus,we retrospectively compared vertebroplasty,balloon kyphoplasty,and kyphoplasty with SpineJack or an intravertebral expandable pillar.AIM To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures.METHODS We retrospectively analyzed 354 patients with acute vertebral compression fractures,defined as signal changes in the T1 weighted magnetic resonance imaging,and randomly divided the patients into five groups.Their visual analog scale scores for pain,kyphotic angle,average body height,rate of cement leakage,and occurrence of adjacent vertebral compression fractures were followed for 1 year.One-way analysis of variance,the post hoc Bonferroni test,and Fisher exact probability test were used for statistical analyses.RESULTS All pain scores significantly improved 12 mo postoperatively;however,there was no significant difference between the groups(P=0.325).Kyphoplasty with SpineJack significantly reduced the kyphotic angle(P=0.028)and restored the height of the vertebral body(P=0.02).The rate of adjacent compression fractures was the highest in the vertebroplasty group,with a statistically significant difference according to the Fisher exact probability test(P=0.02).The treatment with the lowest cement leakage rate cannot be identified because of the small sample size;however,kyphoplasty with SpineJack,an IVEP,and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty.CONCLUSION Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration.Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.
基金supported by research grants from the National Natural Science Foundation of China (30872102)the Diet Nutrition Research & Communication Grant of Danone Institute China (DIC2008‐12)
文摘Objective To investigate the relationships between erythrocyte membrane n-6：n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein （hs-CRP）. Methods The Chinese and a observational study consisted of a population-based cross-sectiona subsequent 1-year follow-up study of 171 subjects with the fasting cholesterol of 5.13-8.00 mmol/L. study of 456 plasma total Results In the cross-sectional analysis, plasma low-density lipoprotein cholesterol （LDL-c） had a significant and negative association with the erythrocyte membrane n-6：n-3 PUFAs ratio （P for trend=0.019） after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6：n-3 ratio in erythrocyte membrane （△=month 12-month 0）. In the top quartile whose ratios of n-6：n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6：n-3 decreased by an average of 1.13 （-1.07 mmol/L v.s. -0.32 mmol/L）. The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile （P for difference=0.052）. Conclusion Our results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.
文摘Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing function.Methods We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU admission.Correlations between changes in PTA threshold and patient characteristics,were evaluated.The included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were compared.Results During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility criteria.Age,sex,and the use of furosemide were not correlated with changes in PTA threshold.Univariate analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing function.Low serum platelet count and planned admission appear to be risk factors for worse hearing.
文摘Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety and efficacy of different cement augmentation modalities for vertebral compression fractures under osteoporotic condition.Overall,this is a valuable study that can provide a reference for clinical practice.On the other hand,we also noticed some points in the article and are willing to share our views.Further studies with a higher level of evidence can add more knowledge regarding relevant concerns.
文摘Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer spe-cific treatment planned and written in the patients’ medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.
文摘BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and death.While an increasing number of studies suggest that the gut microbiota may play a key role in the pathophy-siology of frailty,direct evaluation of the association between gut microbiome alterations and frailty in older adults remains limited.AIM Seven electronic databases(China National Knowledge Infrastructure,VIP,SinoMed,Wanfang,PubMed,Web of Science and EMBASE)were searched for articles published before October 31,2023 to identify observational studies that compared the microbiomes of older adults with and without frailty.The diversity and composition of the gut microbiota were the main outcomes used to analyze the associations of changes in the gut microbiota with frailty in older adults.The quality of the included studies was assessed via the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality.RESULTS Eleven observational studies with 912 older adults were included in this review.Consistent results revealed a significant difference in the gut microbiota composition between frail and non-frail older adults,with a significant decrease inαdiversity and a significant increase inβdiversity in frail older adults.The pooled results revealed that at the phylum level,four microbiota(Actinobacteria,Proteo-bacteria,Verrucomicrobia and Synergistetes)were significantly enriched,and two microbiota(Firmicutes and Fusobacteria)were significantly depleted in frail older adults.At the family level,the results consistently revealed that the abundances of 6 families,most of which belong to the Actinobacteria or Proteo-bacteria phylum,were greater in frail than in non-frail older adults.At the genus or species level,consistent results from more than two studies revealed that the abundances of the genera Prevotella,Faecalibacterium,and Roseburia were significantly lower in frail older adults;individual studies revealed that the abundances of some genera or species(e.g.,Megamonas,Blautia,and Megasphaera)were significantly lower,whereas those of other genera or species(e.g.,Bifidobacterium,Oscillospira,Ruminococcus and Pyramidobacter)were significantly greater in frail older adults.CONCLUSION This systematic review suggests that changes in the gut microbiota are associated with frailty in older adults,which is commonly reflected by a reduction in beneficial species and an increase in pathogenic species.However,further studies are needed to confirm these findings.
文摘BACKGROUND Video-capsule endoscopy(VCE)is an efficient tool that has proven to be highly useful in approaching several gastrointestinal diseases.VCE was implemented in Colombia in 2003,however current characterization of patients undergoing VCE in Colombia is limited,and mainly comes from two investigations conducted before the SARS-CoV-2 pandemic period.AIM To describe the characteristics of patients undergoing VCEs and establish the main indications,findings,technical limitations,and other outstanding features.METHODS A descriptive study was carried out using data from reports of VCE(PillCam SB3 system)use in a Gastroenterology Unit in Bogotá,Colombia between September 2019 and January 2023.Demographic and clinical variables such as indication for the VCE,gastric and small bowel transit times(GTT,SBTT),endoscopic preparation quality,and limitations were described[n(%),median(IQR)].RESULTS A total of 133 VCE reports were analyzed.Most were in men with a median age of 70 years.The majority had good preparation(96.2%),and there were technical limitations in 15.8%of cases.The main indications were unexplained anemia(91%)or occult bleeding(23.3%).The median GTT and SBTT were 14 and 30 minutes,respectively.The frequencies of bleeding stigma(3.79%)and active bleeding(9.09%)were low,and the most frequent abnormal findings were red spots(28.3%),erosions(17.6%),and vascular ectasias(12.5%).CONCLUSION VCE showed high-level safety.The main indication was unexplained anemia.Active bleeding was the most frequent finding.Combined with artificial intelligence,VCE can improve diagnostic precision and targeted therapeutic interventions.
基金supported by a grant to Dr Ulvi Bayraktutan from The Dunhill Medical Trust(R459/0216)
文摘Ischemic stroke is a devastating,life altering event which can severely reduce patient quality of life.Despite years of research there have been minimal therapeutic advances.Endothelial progenitor cells(EPCs),stem cells involved in both vasculogenesis and angiogenesis,may be a potential therapeutic target.After a stroke,EPCs migrate to the site of ischemic injury to repair cerebrovascular damage,and their numbers and functional capacity may determine patients'outcome.This study aims to determine whether the number of circulating EPCs and their functional aspects may be used as biomarkers to identify the type(cortical or lacunar)and/or severity of ischemic stroke.The study will also investigate if there are any differences in these characteristics between healthy volunteers over and under 65 years of age.100 stroke patients(50 lacunar and 50 cortical strokes)will be recruited in this prospective,observational case-controlled study.Blood samples will be taken from stroke patients at baseline(within 48 hours of stroke)and days 7,30 and90.EPCs will be counted with flow cytometry.The plasma levels of pro-and anti-angiogenic factors and inflammatory cytokines will also be determined.Outgrowth endothelial cells will be cultured to be used in tube formation,migration and proliferation functional assays.Primary outcome is disability or dependence on day 90 after stroke,assessed by the modified Rankin Scale.Secondary outcomes are changes in circulating EPC numbers and/or functional capacity between patient and healthy volunteers,between patient subgroups and between elderly and young healthy volunteers.Recruitment started in February 2017,167 participants have been recruited.Recruitment will end in November 2019.West Midlands-Coventry&Warwickshire Research Ethics Committee approved this study(REC number:16/WM/0304)on September8,2016.Protocol version:2.0.The Bayraktutan Dunhill Medical Trust EPC Study was registered in ClinicalTrials.gov(NCT02980354)on November 15,2016.This study will determine whether the number of EPCs can be used as a prognostic or diagnostic marker for ischemic strokes and is a step towards discovering if transplantation of EPCs may aid patient recovery.
文摘Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability in elements during onset and the established periods of the South China Sea(SCS) southwest(SW) monsoon. The averaged date of the onset SW monsoon in the SCS occurs in the middle of May climatologically. The corresponding date for the northern part is little earlier (May 12) and those for the southern parts are little later (May 20). The interannual range of the onset dates is about one month. Following the onset of the SW monsoon, the cloud amount and the precipitation increase while the convection activities enhance over the SCS. But there is a strong spatial heterogeneity within the domain. After onset of the SW monsoon the strong convective area moves northwards, while the SCS rain band moves to the center and north. Sea surface temperature(SST) increases rapidly before the onset and the leading time is about one month. The increment of SST supplies heat and vapor for the onset. From April to May the surface heat fluxes display obvious changes, e.g., latent heat exchange and evaporation enhancement. It is one of the reasons why the SW monsoon bursts firstly in the SCS.
基金Supported by the National Special Program of TCM of China:Clinical Research on H1N1 Pandemic Influenza Treated with Traditional Chinese Medicine(No.200907001-2B)Science and Technology Planning Project of Guangdong Province(No.2017B030314166)
文摘OBJECTIVE: To present and analyze treatmentsand clinical outcomes of Chinese patients with influenza-like illness.METHODS: We conducted a multi-site observational study from December 2009 to April 2010. Patients with influenza-like illness from 45 hospitals were enrolled. Patients received Chinese herbal medicine(CHM), conventional treatments, or CHM plus conventional treatments(combination treatment) according to the guidelines for influenza A/H1 N1 2009 in China. The primary outcomes were the time to alleviation of symptoms and the incidence of complications. The secondary outcomes were the time until becoming afebrile, incidence of severe illness, testing negative on an influenza A viral test, and total medical fees.RESULTS: In total, 5967 patients were enrolled. The percentages of patients prescribed CHM alone, conventional treatment, and combination treatment were 27.8%, 5.1%, and 67.7%, respectively. There were no significant differences in the time to alleviation of symptoms, incidence of complications,time to becoming afebrile, or rate of severe illness among the CHM, conventional, and combination treatment groups. The rates of testing negative on the influenza virus A rapid test and H1 N1 virus test were 90.3% and 76.3%, respectively. However,significant differences were found in the total medical fees among the three groups: CHM treatments were more economical than the other two treatments.CONCLUSION: The efficacy of CHM for influenza-like illness was not different from that of conventional treatments, but it was more economical.
文摘Objective To introduce the design of observational trials under real-world study(RWS),and to provide guidance for clinical development of new research trials and reference for real-world researchers.Methods Relevant literature of RWS and observational experiments at home and abroad were reviewed and analyzed,and then the design of observational studies was summarized under RWS.Results and Conclusion The data and information provided in observational studies not only help to further verify the clinical study results obtained by randomized controlled trial(RCT)in clinical practice,but also objectively reflect the real situation in the process of clinical research and application.
基金The study was approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University(Ethics number:IIT2023196).
文摘BACKGROUND Most of the recent research on nightmare distress and depressive symptoms has focused on adolescents and students,with less research on the nurse population.Emergency department nurses are at high risk for nightmare distress and depressive symptoms,but no studies have been conducted to explore the relationship between the two;thus,further investigation is needed.AIM To understand the relationship between nightmare distress and depressive symptoms among emergency department nurses in China.METHODS A convenience sampling method was used to select 280 emergency department nurses from nine provinces,including Jiangxi,Sichuan,Jiangsu,and Shanxi Provinces.The Chinese version of the Nightmare Distress Questionnaire and the Center for Epidemiological Studies Depression Scale(CES-D)were administered.RESULTS Emergency department nurses’nightmare distress scores were positively associated with depressive symptom scores(r=0.732),depressed affect(r=0.727),somatic symptoms(r=0.737),and interpersonal difficulty(r=0.647).Further multiple linear regression analyses showed that education level,work pressure,self-reported health,and CES-D scores were factors that influenced nightmare distress among Chinese emergency department nurses(P<0.05).CONCLUSION Nightmare distress is closely associated with depressive symptoms in Chinese emergency department nurses,and early intervention is recommended for professionals with this type of sleep disorder to reduce the occurrence of depressive symptoms.
文摘BACKGROUND Pseudomyxoma peritonei is a rare tumor that can produce a biological behavior similar to that of a malignant tumor.Surgical resection combined with chemo-therapy is the traditional treatment method,but the effect is not good.Cell reduction(CRS)combined with intraperitoneal thermoperfusion chemotherapy(HIPEC)has become a new method for the treatment of peritoneal pseudomy-xoma(PMP).AIM To find out if CRS and HIPEC can be used safely and effectively to treat PMP.METHODS This is an observational study.Clinical data of PMP patients treated with CRS+HIPEC at our hospital from January 2013 to June 2023 was collated and analyzed.The main outcome measures were overall survival(OS),and the secondary outcome measures were the incidence of surgical complications and serious adverse events.Complications were graded according to common adverse event evaluation criteria.Peritoneal tumor staging was performed using the peritoneal tumor index(PCI)scoring system,and a cell reduction degree(CCR)score was performed after CRS.CCR-0 and CCR-1 were considered satisfactory CRS.RESULTS A total of 186 patients with PMP were included,with a median age of 56(48-64)years,65(34.9%)years in males,and 121(65.1%)years in females.The median PCI score was 28(20-34)points.The median operative time was 300(211-430)minutes,and no significant complications occurred.91.4%(170/186)were from the appendix,53.2%(99/186)were from the low grade,and 30.6%(57/186)were from the high grade.CCR scores showed that 55 patients(29.6%)achieved satisfactory CRS,and 113 patients(60.8%)did not achieve satisfactory CRS.The fatality rate at 30 days after surgery was 2.7%(5/186),1.6%(3/186)needed a second operation,and the fatality rate at 90 days was 4.3%(8/186).The total incidence of III-IV complications was 43.0%(80/186),among which the higher incidence was mainly anemia(27.4%,51/186),electrolyte disturbance(11.6%,21/181),and albumin decrease(7.5%,14/186).The main compli-cations associated with abdominal surgery were gastrointestinal anastomotic leakage(2.2%,4/186),abdominal hemorrhage(2.2%,4/186),and abdominal infection(4.3%,8/186).The median follow-up was 38.1(95%CI:31.2-45.1)months.The 5-year OS of PMP patients treated with CRS+HIPEC was 50.3%(95%CI:40.7%-59.9%),and the median survival time was 66.1(95%CI:43.1-89.1)months.The results of the survival analysis showed that patients with a low pathological grade,a low PCI,and a satisfactory CCR score had a higher survival rate(all P<0.05).5-year OS was 88.9%(95%CI:68.3%-100.0%)in CCR-0 patients,77.6%(95%CI:62.7%-92.5%)in CCR-1 patients,and 42.0%(95%CI:29.5%-54.5%)in CCR-2/3 patients.CONCLUSION The application of CRS+HIPEC in PMP is safe and feasible,and the survival benefit is high,especially in those who achieve satisfactory CRS,which can significantly extend the OS.
基金supported by project funds from the National Natural Science Foundation of China(Grant Nos.91332715 and 41275052)the National Key Foundation Development Study Developing(973)Programme(Grant No.2012CB417202)
文摘Using atmospheric observational data from 1998 to 2013,station rainfall data,TRMM（Tropical Rainfall Measuring Mission） data,as well as annual statistics for the plateau vortex and shear line,the joint activity features of sustained departure plateau vortexes（SDPVs） and southwest vortexes（SWVs） are analyzed.Some new and useful observational facts and understanding are obtained about the joint activities of the two types of vortex.The results show that：（1） The joint active period of the two vortexes is from May to August,and mostly in June and July.（2） The SDPVs of the partnership mainly originate near Zaduo,while the SWVs come from Jiulong.（3） Most of the two vortexes move in almost the same direction,moving eastward together with the low trough.The SDPVs mainly act in the area to the north of the Yangtze River,while the SWVs are situated across the Yangtze River valley.（4） The joint activity of the two vortexes often produces sustained regional heavy rainfall to the south of the Yellow River,influencing wide areas of China,and even as far as the Korean Peninsula,Japan and Vietnam.（5） Most of the two vortexes are baroclinic or cold vortexes,and they both become strengthened in terms of their joint activity.（6） When the two vortexes move over the sea,their central pressure descends and their rainfall increases,especially for SWVs.（7） The two vortexes might spin over the same area simultaneously when there are tropical cyclones in the eastern and southern seas of China,or move southward together if a tropical cyclone appears near Hainan Island.
文摘AIM： To assess the effectiveness and safety of ranibizumab 0.5 mg in Taiwan Residents patients with polypoidal choroidal vasculopathy（PCV） by performing a retrospective exploratory subgroup analysis of the REAL study.METHODS： REAL was a 12-month, observational, prospective, non-interventional phase IV post-marketing surveillance study conducted at 9 centers in Taiwan. The study collected data as part of the routine patient visits from the medical records of patients with neovascular agerelated macular degeneration treated with ranibizumab 0.5 mg according to local standard medical practice and local label and/or reimbursement guidelines. The presence of PCV at baseline was determined using indocy received prior tanine green angiography. RESULTS： At baseline, PCV was diagnosed in 64 of the 303 enrolled patients（21.1%）. Of these, 41 patients（64.1%） hadreatment; 15（23.4%） patients had received ranibizumab. The intent-to-treat population included 58 patients; 47（80%） who received ranibizumab and 11（20%） who received ranibizumab plus photodynamic therapy（PDT; 9 patients received once, 2 patients received twice）. Bevacizumab was used as a concomitant medication in a similar percentage of patients who received ranibizumab（43%, n=20） or ranibizumab plus PDT（45%, n=5）. In patients who received ranibizumab, visual acuity（VA） at baseline was 50.1±12.9 Early Treatment Diabetic Retinopathy Study letters, and the gain at month 12 was 1.1±17.8 letters. In patients who received ranibizumab plus PDT, VA at baseline was 51.4±15.9 letters, and there was a marked gain in VA at month 12（14.0±9.2 letters, P=0.0009）. In the intent-totreat population, the reduction in central retinal subfield thickness from baseline at month 12 was 69.6±122.6 μm（baseline： 310.8±109.8 μm, P=0.0004）. The safety results were consistent with the well-characterized safety profile of ranibizumab.CONCLUSION： In real-world settings, ranibizumab 0.5 mg treatment for 12 mo results in maintenance of VA and reduction in central retinal subfield thickness in Taiwan Residents patients with PCV. Improvements in VA are observed in patients who received ranibizumab plus PDT. There are no new safety findings.
文摘<strong>Background: </strong>Pre-clinical and clinical studies have shown that inflammatory pain intensity is increased under diabetes condition. Open cholecystectomy (OC) is a surgical procedure with predictable postoperative pain. However, the comparison of postoperative pain due to open cholecystectomy in diabetic and non-diabetic patients remains unknown. The research question to answer was whether diabetic patients undergoing OC development greater intensity of postoperative pain than non-diabetic patients. <strong>Methods: </strong>The study was conducted between June 2016 and February 2018 at the Regional Hospital of High Specialty “Dr. Juan Graham Casasús” of Villahermosa, Tabasco, Mexico. Seventy patients in two groups of 35 patients each scheduled for OC under general anesthesia were studied. Pain was assessed using the 11-point numerical rating scale (NRS). The primary endpoint was to know NRS pain scores after awaking of general anesthesia. Secondary outcomes included the time of onset of pain and comparing NRS scores between diabetic and non-diabetic patients undergoing OC. <strong>Results:</strong> Diabetic patients reported significantly greater intensity pain than non-diabetic patients. The mean overall pain score in the diabetic and non-diabetic patients was 7.2 ± 0.3 and 5.3 ± 0.3 (P = 0.0002), respectively. Furthermore, 60% of diabetic patients had severe pain (NRS ≥ 8) compared to 20% of non-diabetics (P = 0.006). The time to onset postoperative pain was about 35 minutes in both groups (P = 0.876). <strong>Conclusions:</strong> Diabetic patients undergoing OC have greater intensity postoperative pain and also more frequency of patients with severe pain scores compared with non-diabetic patients. Therefore, analgesic treatment in those patients should consider this point in order to provide a satisfactory postoperative analgesia.
基金Supported by A grant of the Korean Health Technology R and D Project,Ministry of Health and Welfare,Republic of Korea,No.HI12C0050
文摘AIM:To evaluate whether red meat intake is related to the risk of endometrial cancer(EC) using meta-analysis.METHODS:We searched Pub Med,EMBASE,and the Cochrane Library up to June 2013,using common keywords related to red meat and EC.Case-control studies and cohort studies comparing the risk of endometrial cancer among categories by the amount of intake were included.Eleven case-control studies and five cohort studies met our criteria.We performed a conventional and a dose-response meta-analysis of case-control studies using the Der Simonian-Laird method for random-effects.For cohort studies we performed a conventional meta-analysis.Publication bias was evaluated using Egger's test.RESULTS:In the meta-analysis of 11 case-control studies including 5419 cases and 12654 controls,higher red meat consumption was associated with an increased risk of EC [summary relative risk(SRR) = 1.43,95%CI:1.15-1.79;I2 = 73.3% comparing extreme intake categories).In a dose-response analysis,for red meat intake of 100 g/d,SRR was 1.84(95%CI:1.64-2.05).In contrast,in the meta-analysis of five prospective studies including a total of 2549 cases among 247746 participants,no significant association between red meat intake and EC risk(SRR = 0.97,95%CI:0.85-1.11;I2 = 4.9% comparing extreme intake categories) was observed.CONCLUSION:Our meta-analysis found a significantlinear association between red meat intake and EC risk based on case-control studies but this was not confirmed in prospective studies.
文摘Identifying the causal impact of＇ some intervention challenging when one is faced with correlated binary end-points in observational studies is a challenging task, and it is even more The statistical literature on analyzing such data is well documented. Dependence between observations from the same study subject in correlated data renders invalid the usual chi-square tests of independence and inflates the variance ofparameter estimates. Disaggregated approaches such as hierarchical linear models which are able to adjust for individual level covariate：s are favoured in the analysis of such data, thereby gaining power over aggregated and individual-level analyses. In this article the authors, therefore, address the issue of analyzing correlated data with dichotomous end-points by using hierarchical logistic regression, a generalization of the standard logistic regression model for independent outcomes.
