In connection with the current prospect of decarbonization of coal energy through the use of small nuclear power plants (SNPPs) at existing TPPs as heat sources for heat supply to municipal heating networks, there is ...In connection with the current prospect of decarbonization of coal energy through the use of small nuclear power plants (SNPPs) at existing TPPs as heat sources for heat supply to municipal heating networks, there is a technological need to improve heat supply schemes to increase their environmental friendliness and efficiency. The paper proves the feasibility of using the heat-feeding mode of ASHPs for urban heat supply by heating the network water with steam taken from the turbine. The ratio of electric and thermal power of a “nuclear” combined heat and power plant is given. The advantage of using a heat pump, which provides twice as much electrical power with the same heat output, is established. Taking into account that heat in these modes is supplied with different potential, the energy efficiency was used to compare these options. To increase the heat supply capacity, a scheme with the use of a high-pressure heater in the backpressure mode and with the heating of network water with hot steam was proposed. Heat supply from ASHPs is efficient and environmentally friendly even in the case of significant remoteness of heat consumers.展开更多
Today, the most urgent problem of the existing and future nuclear power industry is to ensure the nuclear and environmental safety of the operation of nuclear power reactor units (NPPs) and nuclear power plants (NPPs)...Today, the most urgent problem of the existing and future nuclear power industry is to ensure the nuclear and environmental safety of the operation of nuclear power reactor units (NPPs) and nuclear power plants (NPPs). It is solved thanks to the application of deeply echeloned protection and an anti-accident complex of methods and means for effective control of the operation of active reactor zones (AZR). However, the danger of existing NPPs in the world from time to time manifests itself in the form of severe post-project accidents and catastrophes with the release into the environment of a significant amount of radioactive materials dangerous for all living things. The results of the analysis show that the unconditional fulfillment of the main requirements of nuclear environmental safety and biocompatibility is possible only in the so-called wave nuclear reactor of the G-V generation, which, unlike reactors of the previous generations III, II+ and IV, does not require supercritical loading of the core with nuclear fuel. In the active zone of this reactor, nuclear-physical processes governed by physical law are implemented, which exclude the operator’s participation in regulating the reactivity of the reactor’s active zone, which makes it the reactor with the highest level of nuclear and environmental safety today, which is based on the principles of so-called internal safety, free from the human factor. The possibility of burning nuclear fuel based on U238 and Th232 in it expands the reserves of energetic nuclear fuel almost to inexhaustibility. The technology of nuclear reactors of the G5 generation through the secondary use of spent irradiated nuclear fuel (SNF) for the production of energy and energy raw materials with simultaneous burning of it to an environmentally safe state is able to quickly reduce the available stocks and further production of dangerous SNF, guarantee the nuclear and environmental safety of NPPs with reactors G5 and to technologically make nuclear post-project accidents and disasters impossible at the level of physical law with the complete elimination of the human factor.展开更多
The process of ultrafiltration(UF)of natural seawater often encounters the problems of variation in water quality and coastal blooms.To validate the feasibility of UF in shellfish farms,this study compared the hydraul...The process of ultrafiltration(UF)of natural seawater often encounters the problems of variation in water quality and coastal blooms.To validate the feasibility of UF in shellfish farms,this study compared the hydraulic performance and pollutant removal efficiency of the UF process with those of the commonly used treatments that combine several filtration steps with ultraviolet(UV)disinfection.The comparison was conducted in the cases of natural seawater and a coastal bloom.Given that the UF process encountered the specific type of pollution,this study evaluated the filtration performance of the UF process and the retention of total suspended solids(TSS),bacteria,phytoplankton,and zooplankton.A real coastal bloom was considered in the case study of an experimental shellfish hatchery/nursery in France.The results show that both treatments were able to eliminate approximately 50%of TSS.However,in contrast with UV treatment combined with filtration,the UF process retained total amounts of phytoplankton,zooplankton,and bacteria in the bloom.Although the hydraulic performance of the UF process was impacted by the coastal bloom,the fouling was eliminated through chemical cleaning conducted at a frequency less than once per 12 h.Despite the severe pollution,this study confirmed the pollution resistance and treatment performance of the UF process,indicating that UF has the potential to enhance the biosecurity level.展开更多
Northwest China includes Xinjiang Ugyur Autonomous Region, Qinghai Province, Gansu Province, Ningxia Hui Autonomous Region and Shaanxi Province, covering 308×104 km2. It is located in the warm-temperate zone and ...Northwest China includes Xinjiang Ugyur Autonomous Region, Qinghai Province, Gansu Province, Ningxia Hui Autonomous Region and Shaanxi Province, covering 308×104 km2. It is located in the warm-temperate zone and the climate is arid or semi-arid. Precipitation is very scarce but evaporation is extremely high. The climate is dry, the water resources are deficient, the eco-environment is fragile, and the distribution of water resources is uneven. In this region, precipitation is the only input, and evaporation is the only output in the inland rivers, and precipitation, surface water and groundwater change with each other for many times, which benefits the storage and utilization of water resources. The average precipitation in this region is 232 mm, the total precipitation amount is 7003×108 m3/a, the surface water resources are 1891×108 m3/a, the total natural groundwater resources are 1150×108 m3/a, the total available water resources are 438×108 m3/a, and the total water resources are 1996×108 m3/a and per capita water resources are 2278 m3/a. The water resources of the whole area are 5.94×104 m3/(a.km2), being only one-fifth of the mean value in China. Now, the available water resources are 876×108 m3/a, among which groundwater is proximate 130×108 m3/a.展开更多
With increasing population and changing demographics,food consumption has experienced a significant transition in quantity and quality.However,a dearth of knowledge remains regarding its environmental impacts and how ...With increasing population and changing demographics,food consumption has experienced a significant transition in quantity and quality.However,a dearth of knowledge remains regarding its environmental impacts and how it responds to demographic dynamics,particularly in emerging economies like China.Using the two-stage Quadratic Almost Demand System(QUAIDS)model,this study empirically examines the impact of demographic dynamics on food consumption and its environmental outcomes based on the provincial data from 2000 to 2020 in China.Under various scenarios,according to changes in demographics,we extend our analysis to project the long-term trend of food consumption and its environmental impacts,including greenhouse gas(GHG)emissions,water footprint(WF),and land appropriation(LA).The results reveal that an increase in the proportion of senior people significantly decreases the consumption of grain and livestock meat and increases the consumption of poultry,egg,and aquatic products,particularly for urban residents.Moreover,an increase in the proportion of males in the population leads to higher consumption of poultry and aquatic products.Correspondingly,in the current scenario of an increased aging population and sex ratio,it is anticipated that GHG emissions,WF,and LA are likely to decrease by 1.37,2.52,and 3.56%,respectively.More importantly,in the scenario adhering to the standards of nutritional intake according to the Dietary Guidelines for Chinese Residents in 2022,GHG emissions,WF,and LA in urban areas would increase by 12.78,20.94,and 18.32%,respectively.Our findings suggest that changing demographics should be considered when designing policies to mitigate the diet-environment-health trilemma and achieve sustainable food consumption.展开更多
An Environmental Impact Assessment(EIA)was conducted for 2×150 MW Floating Photovoltaic(FPV)plants,based on the World Bank’s new Environmental and Social Framework(ESF).The project was the first of its kind fina...An Environmental Impact Assessment(EIA)was conducted for 2×150 MW Floating Photovoltaic(FPV)plants,based on the World Bank’s new Environmental and Social Framework(ESF).The project was the first of its kind financed by the World Bank in Pakistan and was geared towards renewable energy development in the country.Key components of the project included the installation of high-density polyethylene floats,Photovoltaic(PV)panels,underwater transmission cables to floating or shoreline inverters and transformers,and overhead transmission lines to existing or new substations.The EIA was commissioned to identify all environmental,health,and safety challenges associated with the construction and operation of the FPV plants.A risk screening criterion based on the World Bank ESF was employed to identify these challenges,while a mitigation hierarchy and hierarchy of control were used in providing measures to address these challenges.The environmental challenges identified were pollution of surface water and degradation of aquatic habitat from bird droppings on the floating panels;changes to the thermal structure and evaporation rate of the water body as a result of decreased sunlight access;direct impacts of shading on fish and aquatic algae;impacts on migratory birds and their habitats;and impacts on fish movements due to the anchoring and cabling of the floats.Likewise,the project-specific occupational health and safety challenges identified were the risk of falling and drowning in the water during the installation and maintenance of the panels over the water.Mitigation measures were provided for the identified challenges.In conclusion,the construction and operation of FPV plants have environmental,health,and safety issues.It is therefore recommended that the mitigation measures provided should be incorporated into the earlier stages of the design and operation of future similar FPV plants around the world.展开更多
Ganoderma lucidum,one of the most well-known edible fungi,is believed to be very beneficial for longevity and vitality.A long usage history suggests that G.lucidum has various clinical therapeutic effects.And experime...Ganoderma lucidum,one of the most well-known edible fungi,is believed to be very beneficial for longevity and vitality.A long usage history suggests that G.lucidum has various clinical therapeutic effects.And experimental studies have confirmed that G.lucidum has multiple pharmacological effects,including antitumor,anti-microbial,anti-HIV protease,and antidiabetic activity and so on.With the deepening of research,more than 300 compounds have been isolated from G.lucidum.There is an increasing population of G.lucidum-based products,and its international development is expanding.Currently,G.lucidum has drawn much attention to its chemical composition,therapeutic effect,clinical value,and safety.This paper provides a comprehensive review of these aspects to enhance the global promotion of G.lucidum.展开更多
Human normal flora is a source of probiotics.The safety characteristics of a specific isolate determine its application in foods or drugs.The food-borne-pathogen antagonist strain Lactobacillus gasseri HMV18 is one of...Human normal flora is a source of probiotics.The safety characteristics of a specific isolate determine its application in foods or drugs.The food-borne-pathogen antagonist strain Lactobacillus gasseri HMV18 is one of the isolates from normal human flora.In this work,we assessed the in vitro pH tolerance,bile tolerance,biogenic amine production,mucin utilization,and safety of in vivo administration to mice to evaluate general health,organ-body weight index,organ histopathological change,whether L.gasseri HMV18 can colonize in the gut or modulate the gut microbiota after oral administration.The results suggest that L.gasseri HMV18 can tolerate pH 3 for 2 h,3%bile for 3 h,biogenic amine negative,mucin usage negative,does not encode verified toxins,and cause no visible change in mice's organs.L.gasseri HMV18 might not colonize in mice's gut,but can significantly affect the structure of gut microbiota.A bibliographical survey suggested that there were as few as 8 opportunistic infection cases from 1984 to 2022 and that the possibility for L.gasseri to cause infection is relatively low.Therefore,this work provides a basis for the foods or drugs application of L.gasseri HMV18 and gives a map of experiments for the safety assessment of probiotics.展开更多
Synthetic micromotor has gained substantial attention in biomedicine and environmental remediation.Metal-based degradable micromotor composed of magnesium(Mg),zinc(Zn),and iron(Fe)have promise due to their nontoxic fu...Synthetic micromotor has gained substantial attention in biomedicine and environmental remediation.Metal-based degradable micromotor composed of magnesium(Mg),zinc(Zn),and iron(Fe)have promise due to their nontoxic fuel-free propulsion,favorable biocompatibility,and safe excretion of degradation products Recent advances in degradable metallic micromotor have shown their fast movement in complex biological media,efficient cargo delivery and favorable biocompatibility.A noteworthy number of degradable metal-based micromotors employ bubble propulsion,utilizing water as fuel to generate hydrogen bubbles.This novel feature has projected degradable metallic micromotors for active in vivo drug delivery applications.In addition,understanding the degradation mechanism of these micromotors is also a key parameter for their design and performance.Its propulsion efficiency and life span govern the overall performance of a degradable metallic micromotor.Here we review the design and recent advancements of metallic degradable micromotors.Furthermore,we describe the controlled degradation,efficient in vivo drug delivery,and built-in acid neutralization capabilities of degradable micromotors with versatile biomedical applications.Moreover,we discuss micromotors’efficacy in detecting and destroying environmental pollutants.Finally,we address the limitations and future research directions of degradable metallic micromotors.展开更多
With the development of the integration of aviation safety and artificial intelligence,research on the combination of risk assessment and artificial intelligence is particularly important in the field of risk manageme...With the development of the integration of aviation safety and artificial intelligence,research on the combination of risk assessment and artificial intelligence is particularly important in the field of risk management,but searching for an efficient and accurate risk assessment algorithm has become a challenge for the civil aviation industry.Therefore,an improved risk assessment algorithm(PS-AE-LSTM)based on long short-term memory network(LSTM)with autoencoder(AE)is proposed for the various supervised deep learning algorithms in flight safety that cannot adequately address the problem of the quality on risk level labels.Firstly,based on the normal distribution characteristics of flight data,a probability severity(PS)model is established to enhance the quality of risk assessment labels.Secondly,autoencoder is introduced to reconstruct the flight parameter data to improve the data quality.Finally,utilizing the time-series nature of flight data,a long and short-termmemory network is used to classify the risk level and improve the accuracy of risk assessment.Thus,a risk assessment experimentwas conducted to analyze a fleet landing phase dataset using the PS-AE-LSTMalgorithm to assess the risk level associated with aircraft hard landing events.The results show that the proposed algorithm achieves an accuracy of 86.45%compared with seven baseline models and has excellent risk assessment capability.展开更多
Thermal runaway(TR)is a critical issue hindering the large-scale application of lithium-ion batteries(LIBs).Understanding the thermal safety behavior of LIBs at the cell and module level under different state of charg...Thermal runaway(TR)is a critical issue hindering the large-scale application of lithium-ion batteries(LIBs).Understanding the thermal safety behavior of LIBs at the cell and module level under different state of charges(SOCs)has significant implications for reinforcing the thermal safety design of the lithium-ion battery module.This study first investigates the thermal safety boundary(TSB)correspondence at the cells and modules level under the guidance of a newly proposed concept,safe electric quantity boundary(SEQB).A reasonable thermal runaway propagation(TRP)judgment indicator,peak heat transfer power(PHTP),is proposed to predict whether TRP occurs.Moreover,a validated 3D model is used to quantitatively clarify the TSB at different SOCs from the perspective of PHTP,TR trigger temperature,SOC,and the full cycle life.Besides,three different TRP transfer modes are discovered.The interconversion relationship of three different TRP modes is investigated from the perspective of PHTP.This paper explores the TSB of LIBs under different SOCs at both cell and module levels for the first time,which has great significance in guiding the thermal safety design of battery systems.展开更多
Overtaking is a crucial maneuver in road transportation that requires a clear view of the road ahead.However,limited visibility of ahead vehicles can often make it challenging for drivers to assess the safety of overt...Overtaking is a crucial maneuver in road transportation that requires a clear view of the road ahead.However,limited visibility of ahead vehicles can often make it challenging for drivers to assess the safety of overtaking maneuvers,leading to accidents and fatalities.In this paper,we consider atrous convolution,a powerful tool for explicitly adjusting the field-of-view of a filter as well as controlling the resolution of feature responses generated by Deep Convolutional Neural Networks in the context of semantic image segmentation.This article explores the potential of seeing-through vehicles as a solution to enhance overtaking safety.See-through vehicles leverage advanced technologies such as cameras,sensors,and displays to provide drivers with a real-time view of the vehicle ahead,including the areas hidden from their direct line of sight.To address the problems of safe passing and occlusion by huge vehicles,we designed a see-through vehicle system in this study,we employed a windshield display in the back car together with cameras in both cars.The server within the back car was used to segment the car,and the segmented portion of the car displayed the video from the front car.Our see-through system improves the driver’s field of vision and helps him change lanes,cross a large car that is blocking their view,and safely overtake other vehicles.Our network was trained and tested on the Cityscape dataset using semantic segmentation.This transparent technique will instruct the driver on the concealed traffic situation that the front vehicle has obscured.For our findings,we have achieved 97.1% F1-score.The article also discusses the challenges and opportunities of implementing see-through vehicles in real-world scenarios,including technical,regulatory,and user acceptance factors.展开更多
The application of microorganisms as probiotics is limited due to lack of safety evaluation.Here,a novel multi-stress-tolerant yeast Meyerozyma guilliermondii GXDK6 with aroma-producing properties was identified from ...The application of microorganisms as probiotics is limited due to lack of safety evaluation.Here,a novel multi-stress-tolerant yeast Meyerozyma guilliermondii GXDK6 with aroma-producing properties was identified from marine mangrove microorganisms.Its safety and probiotic properties were assessed in accordance with phenotype and whole-genome sequencing analysis.Results showed that the genes and phenotypic expression of related virulence,antibiotic resistance and retroelement were rarely found.Hyphal morphogenesis genes(SIT4,HOG1,SPA2,ERK1,ICL1,CST20,HSP104,TPS1,and RHO1)and phospholipase secretion gene(VPS4)were annotated.True hyphae and phospholipase were absent.Only one retroelement(Tad1-65_BG)was found.Major biogenic amines(BAs)encoding genes were absent,except for spermidine synthase(JA9_002594),spermine synthase(JA9_004690),and tyrosine decarboxylase(inx).The production of single BAs and total BAs was far below the food-defined thresholds.GXDK6 had no resistance to common antifungal drugs.Virulence enzymes,such as gelatinase,DNase,hemolytic,lecithinase,and thrombin were absent.Acute toxicity test with mice demonstrated that GXDK6 is safe.GXDK6 has a good reproduction ability in the simulation gastrointestinal tract.GXDK6 also has a strong antioxidant ability,β-glucosidase,and inulinase activity.To sum up,GXDK6 is considered as a safe probiotic for human consumption and food fermentation.展开更多
BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has ...BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.展开更多
The poor thermal stability and high sensitivity severely hinder the practical application of hexanitrohexaazaisowurtzitane(CL-20).Herein,a kind of novel core@double-shell CL-20 based energetic composites were fabricat...The poor thermal stability and high sensitivity severely hinder the practical application of hexanitrohexaazaisowurtzitane(CL-20).Herein,a kind of novel core@double-shell CL-20 based energetic composites were fabricated to address the above issues.The coordination complexes which consist of natural polyphenol tannic acid(TA) and Fe~Ⅲ were chosen to construct the inner shell,while the graphene sheets were used to build the outer shell.The resulting CL-20/TA-Fe~Ⅲ/graphene composites exhibited simultaneously improved thermal stability and safety performance with only 1 wt% double-shell content,which should be ascribed to the intense physical encapsulation effect from inner shell combined with the desensitization effect of carbon nano-materials from outer shell.The phase transition(ε to γ) temperature increased from 173.70 ℃ of pure CL-20 to 191.87℃ of CL-20/TA-Fe~Ⅲ/graphene composites.Meanwhile,the characteristic drop height(H_(50)) dramatically increased from 14.7 cm of pure CL-20 to112.8 cm of CL-20/TA-Fe~Ⅲ/graphene composites,indicating much superior safety performance after the construction of the double-shell structure.In general,this work has provided an effective and versatile strategy to conquer the thermal stability and safety issues of CL-20 and contributes to the future application of high energy density energetic materials.展开更多
Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are ...Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.展开更多
BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditi...BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing.展开更多
BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is cons...BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is considered a potential first-line treatment for advanced pancreatic cancer.However,their comparative benefits and potential risks remain unclear.AIM To assess the clinical efficacy and safety of erlotinib combined with other chemotherapy regimens for the treatment of advanced pancreatic cancer.METHODS Literature on the clinical efficacy and safety of erlotinib combined with chemotherapy for advanced pancreatic cancer was retrieved through an online search.The retrieved literature was subjected to a methodological qualitative assessment and was analyzed using the RevMan 5.3 software.Ten randomized controlled trials involving 2444 patients with advanced pancreatic cancer were included in the meta-analysis.RESULTS Compared with chemotherapeutic treatment,erlotinib combined with chemotherapy significantly prolonged the progression-free survival time of pancreatic cancer patients[hazard ratio(HR)=0.78,95%CI:0.66-0.92,P=0.003].Meanwhile,the overall survival(HR=0.99,95%CI:0.72-1.37,and P=0.95)and disease control rate(OR=0.93,95%CI:0.45-0.91,P=0.84)were not significantly favorable.In terms of safety,the erlotinib and chemotherapy combination was associated with a significantly higher risk of diarrhea(OR=3.59,95%CI:1.63-7.90,P<0.05)and rash(OR=3.63,95%CI:1.64-8.01,P<0.05)compared with single-agent chemotherapy.Moreover,the risk of vomiting(OR=1.27,95%CI:0.62-2.59,P=0.51),regurgitation/anorexia(OR=1.61,95%CI:0.25-10.31,P=0.62),and infection(OR=0.72,95%CI:0.28-1.87,P=0.50)were not significant in either group.CONCLUSION Compared with a single chemotherapeutic modality,erlotinib combined with gemcitabine can prolong progression-free survival in pancreatic cancer,but does not improve survival benefit or disease control rate,and can increase the risk of diarrhea and rash.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most commonly diagnosed malignancy worldwide,with over 1 million new cases per year,and the third leading cause of cancer-related death.AIM To determine the optimal perioperat...BACKGROUND Gastric cancer(GC)is the fifth most commonly diagnosed malignancy worldwide,with over 1 million new cases per year,and the third leading cause of cancer-related death.AIM To determine the optimal perioperative treatment regimen for patients with locally resectable GC.METHODS A comprehensive literature search was conducted,focusing on phase II/III randomized controlled trials(RCTs)assessing perioperative chemotherapy and chemoradiotherapy in treating locally resectable GC.The R0 resection rate,overall survival(OS),disease-free survival(DFS),and incidence of grade 3 or higher nonsurgical severe adverse events(SAEs)associated with various perioperative regimens were analyzed.A Bayesian network meta-analysis was performed to compare treatment regimens and rank their efficacy.RESULTS Thirty RCTs involving 8346 patients were included in this study.Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared with surgery alone,and the former had the highest probability of being the most effective option in this context.Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for improving OS.Owing to limited data,no definitive ranking could be determined for DFS.Considering nonsurgical SAEs,FLO has emerged as the safest treatment regimen.CONCLUSION This study provides valuable insights for clinicians when selecting perioperative treatment regimens for patients with locally resectable GC.Further studies are required to validate these findings.展开更多
文摘In connection with the current prospect of decarbonization of coal energy through the use of small nuclear power plants (SNPPs) at existing TPPs as heat sources for heat supply to municipal heating networks, there is a technological need to improve heat supply schemes to increase their environmental friendliness and efficiency. The paper proves the feasibility of using the heat-feeding mode of ASHPs for urban heat supply by heating the network water with steam taken from the turbine. The ratio of electric and thermal power of a “nuclear” combined heat and power plant is given. The advantage of using a heat pump, which provides twice as much electrical power with the same heat output, is established. Taking into account that heat in these modes is supplied with different potential, the energy efficiency was used to compare these options. To increase the heat supply capacity, a scheme with the use of a high-pressure heater in the backpressure mode and with the heating of network water with hot steam was proposed. Heat supply from ASHPs is efficient and environmentally friendly even in the case of significant remoteness of heat consumers.
文摘Today, the most urgent problem of the existing and future nuclear power industry is to ensure the nuclear and environmental safety of the operation of nuclear power reactor units (NPPs) and nuclear power plants (NPPs). It is solved thanks to the application of deeply echeloned protection and an anti-accident complex of methods and means for effective control of the operation of active reactor zones (AZR). However, the danger of existing NPPs in the world from time to time manifests itself in the form of severe post-project accidents and catastrophes with the release into the environment of a significant amount of radioactive materials dangerous for all living things. The results of the analysis show that the unconditional fulfillment of the main requirements of nuclear environmental safety and biocompatibility is possible only in the so-called wave nuclear reactor of the G-V generation, which, unlike reactors of the previous generations III, II+ and IV, does not require supercritical loading of the core with nuclear fuel. In the active zone of this reactor, nuclear-physical processes governed by physical law are implemented, which exclude the operator’s participation in regulating the reactivity of the reactor’s active zone, which makes it the reactor with the highest level of nuclear and environmental safety today, which is based on the principles of so-called internal safety, free from the human factor. The possibility of burning nuclear fuel based on U238 and Th232 in it expands the reserves of energetic nuclear fuel almost to inexhaustibility. The technology of nuclear reactors of the G5 generation through the secondary use of spent irradiated nuclear fuel (SNF) for the production of energy and energy raw materials with simultaneous burning of it to an environmentally safe state is able to quickly reduce the available stocks and further production of dangerous SNF, guarantee the nuclear and environmental safety of NPPs with reactors G5 and to technologically make nuclear post-project accidents and disasters impossible at the level of physical law with the complete elimination of the human factor.
基金This work was supported by Fonds Europeen Pour les Affaires Maritimes et la P^eche(FEAMP)(Grant No.R FEA 4700 16FA 1000001).
文摘The process of ultrafiltration(UF)of natural seawater often encounters the problems of variation in water quality and coastal blooms.To validate the feasibility of UF in shellfish farms,this study compared the hydraulic performance and pollutant removal efficiency of the UF process with those of the commonly used treatments that combine several filtration steps with ultraviolet(UV)disinfection.The comparison was conducted in the cases of natural seawater and a coastal bloom.Given that the UF process encountered the specific type of pollution,this study evaluated the filtration performance of the UF process and the retention of total suspended solids(TSS),bacteria,phytoplankton,and zooplankton.A real coastal bloom was considered in the case study of an experimental shellfish hatchery/nursery in France.The results show that both treatments were able to eliminate approximately 50%of TSS.However,in contrast with UV treatment combined with filtration,the UF process retained total amounts of phytoplankton,zooplankton,and bacteria in the bloom.Although the hydraulic performance of the UF process was impacted by the coastal bloom,the fouling was eliminated through chemical cleaning conducted at a frequency less than once per 12 h.Despite the severe pollution,this study confirmed the pollution resistance and treatment performance of the UF process,indicating that UF has the potential to enhance the biosecurity level.
基金National Natural Science Foundation of China, No.40235053 No.40401012+1 种基金 AIACC, No.AS25 Lanzhou Jiaotong University Foundation
文摘Northwest China includes Xinjiang Ugyur Autonomous Region, Qinghai Province, Gansu Province, Ningxia Hui Autonomous Region and Shaanxi Province, covering 308×104 km2. It is located in the warm-temperate zone and the climate is arid or semi-arid. Precipitation is very scarce but evaporation is extremely high. The climate is dry, the water resources are deficient, the eco-environment is fragile, and the distribution of water resources is uneven. In this region, precipitation is the only input, and evaporation is the only output in the inland rivers, and precipitation, surface water and groundwater change with each other for many times, which benefits the storage and utilization of water resources. The average precipitation in this region is 232 mm, the total precipitation amount is 7003×108 m3/a, the surface water resources are 1891×108 m3/a, the total natural groundwater resources are 1150×108 m3/a, the total available water resources are 438×108 m3/a, and the total water resources are 1996×108 m3/a and per capita water resources are 2278 m3/a. The water resources of the whole area are 5.94×104 m3/(a.km2), being only one-fifth of the mean value in China. Now, the available water resources are 876×108 m3/a, among which groundwater is proximate 130×108 m3/a.
基金This work was supported by the Qinchuangyuan Project of Shaanxi Province,China(QCYRCXM-2022-145)the Major Project of the Key Research Base of Humanities and Social Sciences of the Ministry of Education,China(22JJD790052)+1 种基金the Chinese Universities Scientific Fund(Z1010422003)the National Natural Science Foundation of China(72373117).
文摘With increasing population and changing demographics,food consumption has experienced a significant transition in quantity and quality.However,a dearth of knowledge remains regarding its environmental impacts and how it responds to demographic dynamics,particularly in emerging economies like China.Using the two-stage Quadratic Almost Demand System(QUAIDS)model,this study empirically examines the impact of demographic dynamics on food consumption and its environmental outcomes based on the provincial data from 2000 to 2020 in China.Under various scenarios,according to changes in demographics,we extend our analysis to project the long-term trend of food consumption and its environmental impacts,including greenhouse gas(GHG)emissions,water footprint(WF),and land appropriation(LA).The results reveal that an increase in the proportion of senior people significantly decreases the consumption of grain and livestock meat and increases the consumption of poultry,egg,and aquatic products,particularly for urban residents.Moreover,an increase in the proportion of males in the population leads to higher consumption of poultry and aquatic products.Correspondingly,in the current scenario of an increased aging population and sex ratio,it is anticipated that GHG emissions,WF,and LA are likely to decrease by 1.37,2.52,and 3.56%,respectively.More importantly,in the scenario adhering to the standards of nutritional intake according to the Dietary Guidelines for Chinese Residents in 2022,GHG emissions,WF,and LA in urban areas would increase by 12.78,20.94,and 18.32%,respectively.Our findings suggest that changing demographics should be considered when designing policies to mitigate the diet-environment-health trilemma and achieve sustainable food consumption.
文摘An Environmental Impact Assessment(EIA)was conducted for 2×150 MW Floating Photovoltaic(FPV)plants,based on the World Bank’s new Environmental and Social Framework(ESF).The project was the first of its kind financed by the World Bank in Pakistan and was geared towards renewable energy development in the country.Key components of the project included the installation of high-density polyethylene floats,Photovoltaic(PV)panels,underwater transmission cables to floating or shoreline inverters and transformers,and overhead transmission lines to existing or new substations.The EIA was commissioned to identify all environmental,health,and safety challenges associated with the construction and operation of the FPV plants.A risk screening criterion based on the World Bank ESF was employed to identify these challenges,while a mitigation hierarchy and hierarchy of control were used in providing measures to address these challenges.The environmental challenges identified were pollution of surface water and degradation of aquatic habitat from bird droppings on the floating panels;changes to the thermal structure and evaporation rate of the water body as a result of decreased sunlight access;direct impacts of shading on fish and aquatic algae;impacts on migratory birds and their habitats;and impacts on fish movements due to the anchoring and cabling of the floats.Likewise,the project-specific occupational health and safety challenges identified were the risk of falling and drowning in the water during the installation and maintenance of the panels over the water.Mitigation measures were provided for the identified challenges.In conclusion,the construction and operation of FPV plants have environmental,health,and safety issues.It is therefore recommended that the mitigation measures provided should be incorporated into the earlier stages of the design and operation of future similar FPV plants around the world.
基金supported by Macao Science and Technology Development Fund(001/2023/ALC and 0006/2020/AKP)the Research Fund of University of Macao(CPG2023-00028-ICMS)+1 种基金the Guangxi Science and Technology Major Project(GUIKEAA22096029)Macao Young Scholars Program(AM2022022)。
文摘Ganoderma lucidum,one of the most well-known edible fungi,is believed to be very beneficial for longevity and vitality.A long usage history suggests that G.lucidum has various clinical therapeutic effects.And experimental studies have confirmed that G.lucidum has multiple pharmacological effects,including antitumor,anti-microbial,anti-HIV protease,and antidiabetic activity and so on.With the deepening of research,more than 300 compounds have been isolated from G.lucidum.There is an increasing population of G.lucidum-based products,and its international development is expanding.Currently,G.lucidum has drawn much attention to its chemical composition,therapeutic effect,clinical value,and safety.This paper provides a comprehensive review of these aspects to enhance the global promotion of G.lucidum.
基金financially supported by postdoctoral funding of Hebei Medical UniversityHebei Province Postdoctoral Research Project Funding(B2022003035)+5 种基金Natural Science Foundation of Hebei Province(H2020206579)CAMS Innovation Found for Medical Sciences(2019-I2M-5-055)2023 Scientific Research Projects of Colleges and Universities in Hebei Province(QN2023131)S&T Program of Hebei(18277743D)Undergraduate Innovation Experiment Project from Hebei Medical University(USIP2019008)Spring rain project of Hebei Medical University(CYCZ201906)。
文摘Human normal flora is a source of probiotics.The safety characteristics of a specific isolate determine its application in foods or drugs.The food-borne-pathogen antagonist strain Lactobacillus gasseri HMV18 is one of the isolates from normal human flora.In this work,we assessed the in vitro pH tolerance,bile tolerance,biogenic amine production,mucin utilization,and safety of in vivo administration to mice to evaluate general health,organ-body weight index,organ histopathological change,whether L.gasseri HMV18 can colonize in the gut or modulate the gut microbiota after oral administration.The results suggest that L.gasseri HMV18 can tolerate pH 3 for 2 h,3%bile for 3 h,biogenic amine negative,mucin usage negative,does not encode verified toxins,and cause no visible change in mice's organs.L.gasseri HMV18 might not colonize in mice's gut,but can significantly affect the structure of gut microbiota.A bibliographical survey suggested that there were as few as 8 opportunistic infection cases from 1984 to 2022 and that the possibility for L.gasseri to cause infection is relatively low.Therefore,this work provides a basis for the foods or drugs application of L.gasseri HMV18 and gives a map of experiments for the safety assessment of probiotics.
基金the National Convergence Research of Scientific Challenges through the National Research Foundation of Korea(NRF)the DGIST R&D Program(No.2021M3F7A1082275 and 23-CoE-BT-02)funded by the Ministry of Science and ICT.
文摘Synthetic micromotor has gained substantial attention in biomedicine and environmental remediation.Metal-based degradable micromotor composed of magnesium(Mg),zinc(Zn),and iron(Fe)have promise due to their nontoxic fuel-free propulsion,favorable biocompatibility,and safe excretion of degradation products Recent advances in degradable metallic micromotor have shown their fast movement in complex biological media,efficient cargo delivery and favorable biocompatibility.A noteworthy number of degradable metal-based micromotors employ bubble propulsion,utilizing water as fuel to generate hydrogen bubbles.This novel feature has projected degradable metallic micromotors for active in vivo drug delivery applications.In addition,understanding the degradation mechanism of these micromotors is also a key parameter for their design and performance.Its propulsion efficiency and life span govern the overall performance of a degradable metallic micromotor.Here we review the design and recent advancements of metallic degradable micromotors.Furthermore,we describe the controlled degradation,efficient in vivo drug delivery,and built-in acid neutralization capabilities of degradable micromotors with versatile biomedical applications.Moreover,we discuss micromotors’efficacy in detecting and destroying environmental pollutants.Finally,we address the limitations and future research directions of degradable metallic micromotors.
基金the National Natural Science Foundation of China(U2033213)the Fundamental Research Funds for the Central Universities(FZ2021ZZ01,FZ2022ZX50).
文摘With the development of the integration of aviation safety and artificial intelligence,research on the combination of risk assessment and artificial intelligence is particularly important in the field of risk management,but searching for an efficient and accurate risk assessment algorithm has become a challenge for the civil aviation industry.Therefore,an improved risk assessment algorithm(PS-AE-LSTM)based on long short-term memory network(LSTM)with autoencoder(AE)is proposed for the various supervised deep learning algorithms in flight safety that cannot adequately address the problem of the quality on risk level labels.Firstly,based on the normal distribution characteristics of flight data,a probability severity(PS)model is established to enhance the quality of risk assessment labels.Secondly,autoencoder is introduced to reconstruct the flight parameter data to improve the data quality.Finally,utilizing the time-series nature of flight data,a long and short-termmemory network is used to classify the risk level and improve the accuracy of risk assessment.Thus,a risk assessment experimentwas conducted to analyze a fleet landing phase dataset using the PS-AE-LSTMalgorithm to assess the risk level associated with aircraft hard landing events.The results show that the proposed algorithm achieves an accuracy of 86.45%compared with seven baseline models and has excellent risk assessment capability.
基金supported by the National Natural Science Foundation of China(No.U20A20310 and No.52176199)sponsored by the Program of Shanghai Academic/Technology Research Leader(No.22XD1423800)。
文摘Thermal runaway(TR)is a critical issue hindering the large-scale application of lithium-ion batteries(LIBs).Understanding the thermal safety behavior of LIBs at the cell and module level under different state of charges(SOCs)has significant implications for reinforcing the thermal safety design of the lithium-ion battery module.This study first investigates the thermal safety boundary(TSB)correspondence at the cells and modules level under the guidance of a newly proposed concept,safe electric quantity boundary(SEQB).A reasonable thermal runaway propagation(TRP)judgment indicator,peak heat transfer power(PHTP),is proposed to predict whether TRP occurs.Moreover,a validated 3D model is used to quantitatively clarify the TSB at different SOCs from the perspective of PHTP,TR trigger temperature,SOC,and the full cycle life.Besides,three different TRP transfer modes are discovered.The interconversion relationship of three different TRP modes is investigated from the perspective of PHTP.This paper explores the TSB of LIBs under different SOCs at both cell and module levels for the first time,which has great significance in guiding the thermal safety design of battery systems.
基金financially supported by the Ministry of Trade,Industry and Energy(MOTIE)and Korea Institute for Advancement of Technology(KIAT)through the International Cooperative R&D Program(Project No.P0016038)supported by the MSIT(Ministry of Sci-ence and ICT),Korea,under the ITRC(Information Technology Research Center)support program(IITP-2022-RS-2022-00156354)supervised by the IITP(Institute for Information&Communications Technology Planning&Evaluation).
文摘Overtaking is a crucial maneuver in road transportation that requires a clear view of the road ahead.However,limited visibility of ahead vehicles can often make it challenging for drivers to assess the safety of overtaking maneuvers,leading to accidents and fatalities.In this paper,we consider atrous convolution,a powerful tool for explicitly adjusting the field-of-view of a filter as well as controlling the resolution of feature responses generated by Deep Convolutional Neural Networks in the context of semantic image segmentation.This article explores the potential of seeing-through vehicles as a solution to enhance overtaking safety.See-through vehicles leverage advanced technologies such as cameras,sensors,and displays to provide drivers with a real-time view of the vehicle ahead,including the areas hidden from their direct line of sight.To address the problems of safe passing and occlusion by huge vehicles,we designed a see-through vehicle system in this study,we employed a windshield display in the back car together with cameras in both cars.The server within the back car was used to segment the car,and the segmented portion of the car displayed the video from the front car.Our see-through system improves the driver’s field of vision and helps him change lanes,cross a large car that is blocking their view,and safely overtake other vehicles.Our network was trained and tested on the Cityscape dataset using semantic segmentation.This transparent technique will instruct the driver on the concealed traffic situation that the front vehicle has obscured.For our findings,we have achieved 97.1% F1-score.The article also discusses the challenges and opportunities of implementing see-through vehicles in real-world scenarios,including technical,regulatory,and user acceptance factors.
基金This research was supported by the Funding Project of Chinese Central Government Guiding to the Guangxi Local Science and Technology Development(GUIKEZY21195021)the Natural Science Fund for Distinguished Young Scholars of Guangxi Zhuang Autonomous Region of China(2019GXNSFFA245011)+3 种基金the Funding Project of Chinese Central Government Guiding to the Nanning Local Science and Technology Development(20231012)the Funding Projects of Guangxi Key Research and Development Plan(GUIKE AB23075173)the Funding Project of Technological Development from Angel Yeast(Chongzuo)Co.,Ltd.(JS1006020230722019)the Innovation Project of Guangxi Graduate Education(YCBZ2021012).
文摘The application of microorganisms as probiotics is limited due to lack of safety evaluation.Here,a novel multi-stress-tolerant yeast Meyerozyma guilliermondii GXDK6 with aroma-producing properties was identified from marine mangrove microorganisms.Its safety and probiotic properties were assessed in accordance with phenotype and whole-genome sequencing analysis.Results showed that the genes and phenotypic expression of related virulence,antibiotic resistance and retroelement were rarely found.Hyphal morphogenesis genes(SIT4,HOG1,SPA2,ERK1,ICL1,CST20,HSP104,TPS1,and RHO1)and phospholipase secretion gene(VPS4)were annotated.True hyphae and phospholipase were absent.Only one retroelement(Tad1-65_BG)was found.Major biogenic amines(BAs)encoding genes were absent,except for spermidine synthase(JA9_002594),spermine synthase(JA9_004690),and tyrosine decarboxylase(inx).The production of single BAs and total BAs was far below the food-defined thresholds.GXDK6 had no resistance to common antifungal drugs.Virulence enzymes,such as gelatinase,DNase,hemolytic,lecithinase,and thrombin were absent.Acute toxicity test with mice demonstrated that GXDK6 is safe.GXDK6 has a good reproduction ability in the simulation gastrointestinal tract.GXDK6 also has a strong antioxidant ability,β-glucosidase,and inulinase activity.To sum up,GXDK6 is considered as a safe probiotic for human consumption and food fermentation.
文摘BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.
基金financially supported by the National Natural Science Foundation of China (Grant No. 22275173)the Open Project of State Key Laboratory of Environment-friendly Energy Materials (Grant No. 22kfhg10)。
文摘The poor thermal stability and high sensitivity severely hinder the practical application of hexanitrohexaazaisowurtzitane(CL-20).Herein,a kind of novel core@double-shell CL-20 based energetic composites were fabricated to address the above issues.The coordination complexes which consist of natural polyphenol tannic acid(TA) and Fe~Ⅲ were chosen to construct the inner shell,while the graphene sheets were used to build the outer shell.The resulting CL-20/TA-Fe~Ⅲ/graphene composites exhibited simultaneously improved thermal stability and safety performance with only 1 wt% double-shell content,which should be ascribed to the intense physical encapsulation effect from inner shell combined with the desensitization effect of carbon nano-materials from outer shell.The phase transition(ε to γ) temperature increased from 173.70 ℃ of pure CL-20 to 191.87℃ of CL-20/TA-Fe~Ⅲ/graphene composites.Meanwhile,the characteristic drop height(H_(50)) dramatically increased from 14.7 cm of pure CL-20 to112.8 cm of CL-20/TA-Fe~Ⅲ/graphene composites,indicating much superior safety performance after the construction of the double-shell structure.In general,this work has provided an effective and versatile strategy to conquer the thermal stability and safety issues of CL-20 and contributes to the future application of high energy density energetic materials.
文摘Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.
文摘BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing.
基金Supported by National Natural Science Foundation of China,No.31870993Fundamental Research Funds for the Central Universities,No.WK9110000005+3 种基金Anhui Provincial Health Research Project,No.AHWJ2022c020Anhui Medical University Campus Level Research Fund,No.2020xkj229Lu'an City Science and Technology Plan Project,No.2022Lakj009New Technology and Project of Lu'an People's Hospital,No.2021xjs10.
文摘BACKGROUND Advanced pancreatic cancer is resistant to chemotherapeutic drugs,resulting in limited treatment efficacy and poor prognosis.Combined administration of the chemotherapeutic gemcitabine and erlotinib is considered a potential first-line treatment for advanced pancreatic cancer.However,their comparative benefits and potential risks remain unclear.AIM To assess the clinical efficacy and safety of erlotinib combined with other chemotherapy regimens for the treatment of advanced pancreatic cancer.METHODS Literature on the clinical efficacy and safety of erlotinib combined with chemotherapy for advanced pancreatic cancer was retrieved through an online search.The retrieved literature was subjected to a methodological qualitative assessment and was analyzed using the RevMan 5.3 software.Ten randomized controlled trials involving 2444 patients with advanced pancreatic cancer were included in the meta-analysis.RESULTS Compared with chemotherapeutic treatment,erlotinib combined with chemotherapy significantly prolonged the progression-free survival time of pancreatic cancer patients[hazard ratio(HR)=0.78,95%CI:0.66-0.92,P=0.003].Meanwhile,the overall survival(HR=0.99,95%CI:0.72-1.37,and P=0.95)and disease control rate(OR=0.93,95%CI:0.45-0.91,P=0.84)were not significantly favorable.In terms of safety,the erlotinib and chemotherapy combination was associated with a significantly higher risk of diarrhea(OR=3.59,95%CI:1.63-7.90,P<0.05)and rash(OR=3.63,95%CI:1.64-8.01,P<0.05)compared with single-agent chemotherapy.Moreover,the risk of vomiting(OR=1.27,95%CI:0.62-2.59,P=0.51),regurgitation/anorexia(OR=1.61,95%CI:0.25-10.31,P=0.62),and infection(OR=0.72,95%CI:0.28-1.87,P=0.50)were not significant in either group.CONCLUSION Compared with a single chemotherapeutic modality,erlotinib combined with gemcitabine can prolong progression-free survival in pancreatic cancer,but does not improve survival benefit or disease control rate,and can increase the risk of diarrhea and rash.
基金National Natural Science Foundation of China,No.82305347.
文摘BACKGROUND Gastric cancer(GC)is the fifth most commonly diagnosed malignancy worldwide,with over 1 million new cases per year,and the third leading cause of cancer-related death.AIM To determine the optimal perioperative treatment regimen for patients with locally resectable GC.METHODS A comprehensive literature search was conducted,focusing on phase II/III randomized controlled trials(RCTs)assessing perioperative chemotherapy and chemoradiotherapy in treating locally resectable GC.The R0 resection rate,overall survival(OS),disease-free survival(DFS),and incidence of grade 3 or higher nonsurgical severe adverse events(SAEs)associated with various perioperative regimens were analyzed.A Bayesian network meta-analysis was performed to compare treatment regimens and rank their efficacy.RESULTS Thirty RCTs involving 8346 patients were included in this study.Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared with surgery alone,and the former had the highest probability of being the most effective option in this context.Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for improving OS.Owing to limited data,no definitive ranking could be determined for DFS.Considering nonsurgical SAEs,FLO has emerged as the safest treatment regimen.CONCLUSION This study provides valuable insights for clinicians when selecting perioperative treatment regimens for patients with locally resectable GC.Further studies are required to validate these findings.
