Currently,it is key to convey precise meanings to readers for translators.Observing expressing habits between different languages is the precondition to make target texts more readable.It is crucial to ensure the exac...Currently,it is key to convey precise meanings to readers for translators.Observing expressing habits between different languages is the precondition to make target texts more readable.It is crucial to ensure the exactness and seriousness of legal texts,but it does not mean that translators have to take machined way to leave out and even give up transmitting in-deep cultural implications for the intention of achieving the all-inclusive integrity of target content.It is a correct choice for translators to take overt translation and covert translation in line with traits of source language and target language and differences between civil law system and common law system.The intention of the article is to make an empirical study between overt translation and covert translation.展开更多
Participant observation is often applied in qualitative research to help researchers obtain the overall,useful data,which will lead researchers to gain the knowledge that the academia tries to.However,different levels...Participant observation is often applied in qualitative research to help researchers obtain the overall,useful data,which will lead researchers to gain the knowledge that the academia tries to.However,different levels of participant observation,mainly the covert and overt participant observation,have aroused heated discussions among scholars.Field researchers are faced with many problems when doing research,such as whether they should be a covert participant observer or an overt one;what the research will get when they are in different roles and etc.In order to solve those problems,this article tries to provide some effective methods to field researchers,especially to the new ones.This article mainly talks about two types of participant observation:covert and overt participant observation;tries to explore the issues caused by them and the strategies to help researchers deal with such issues.Finally,in qualitative research,when faced with different fieldworks,researchers should adapt themselves to choosing participant roles flexibly and appropriately.展开更多
AIM: To investigate the difference in long-term outcomes between gastric cancer patients with and without a primary symptom of overt bleeding(OB).METHODS: Consecutive patients between January 1, 2007 and March 1, 2012...AIM: To investigate the difference in long-term outcomes between gastric cancer patients with and without a primary symptom of overt bleeding(OB).METHODS: Consecutive patients between January 1, 2007 and March 1, 2012 were identified retrospectively by reviewing a gastric cancer database at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. A follow-up examination was performed on patients who underwent a radical gastrectomy. OB due to gastric cancer included hematemesis, melena or hematochezia, and gastric cancer was confirmed as the source of bleeding by endoscopy. Patients without OB were defined as cases with occult bleeding and those with other initial presentations, including epigastric pain, weakness, weight loss and obstruction. The 3-year overall survival(OS) rate, age, gender, AJCC T stage, AJCC N stage, overall AJCC stage, tumor size, histological type, macroscopic(Borrmann) type, lymphovascular invasion and R status were compared between patients with and without OB. Moreover, we carried out a subgroup analysis based on tumor location(upper, middle and lower).RESULTS: We identified 939 patients. Of these, 695(74.0%) were hospitalized for potential radical gastrectomy and another 244 received palliative resection, rerouting of the gastrointestinal tract, chemotherapy, radiotherapy or no treatment due to the presence of unresectable tumors. Notably, there was no significant difference in the percentage of OB patients between resectable cases and unresectable cases(20.3 % vs 22.1 %, P = 0.541). Fo l l o w- u p examination was performed on 653 patients(94%) who underwent radical gastrectomy. We found no significant difference in 3-year OS rate(68.2% vs 61.2%, P = 0.143) or clinicopathological characteristics(P > 0.05) between these patients with and without OB. Subgroup analysis based on tumor location showed that the 3-year OS rate of upper gastric cancer was significantly higher in patients with OB(84.6%) than in those without OB(48.1%, P < 0.01) and that AJCC stagesⅠ-Ⅱ(56.4% vs 35.1%, P = 0.017) and T1-T2 category tumors(30.8% vs 13%, P = 0.010) were more frequent in patients with OB than in those without OB. There was no significant difference in 3-year OS rate or clinicopathological characteristics between patients with and without OB(P > 0.05) for middle or lower gastric cancer.CONCLUSION: Upper gastric cancer patients with OB exhibited tumors at less advanced pathological stages and had a better prognosis than upper gastric cancer patients without OB.展开更多
Hookworm infection is a relatively common cause of anemia in endemic areas.The most common hookworm species are Ancylostoma duodenale and Necator americanus.In this report we present a case of overt gastrointestinal b...Hookworm infection is a relatively common cause of anemia in endemic areas.The most common hookworm species are Ancylostoma duodenale and Necator americanus.In this report we present a case of overt gastrointestinal bleeding Wause of hookworm infection.Capsule endoscopy revealed many hookworms in the lumen of proximal jejunum where active bleeding was seen. The patient was successfully treated with Albendazole.展开更多
<strong>Background</strong><span><strong>:</strong></span><span> With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes...<strong>Background</strong><span><strong>:</strong></span><span> With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes of maternal and child mortality and morbidity worldwide and has raised health concern. It is seriously detrimental to both the women and fetuses. However, there are limited evidences of two types of gestational diabetes mellitus on clinical characteristics and outcomes.</span><span> </span><span>Therefore, this study was aimed to explore the clinical characteristics and outcomes of patients with overt diabetes mellitus</span><span> </span><span>(ODM) and gestational diabetes mellitus</span><span> </span><span><span>(GDM) at the late pregnancy. </span><b><span>Methods</span></b></span><b><span>:</span></b><span> From January 2015 to August 2016, totally 63 gestational diabetes mellitus from the Department of Clinical Nutrition in Beijing Anzhen Hospital were enrolled in the study.</span><span> </span><span>Patients were classified into two groups.</span><span> </span><span>31 patients with gestational overt diabetes mellitus were grouped into ODM group and 32 patients with gestational diabetes mellitus were grouped into GDM group.</span><span> </span><span>Clinical characteristics and outcomes were compared between ODM and GDM.</span><span> </span><span>We collected records of the age, gestational week, family history, past history, pregnancy complications, insulin use,</span><span> </span><span>blood pressure, clinical nutrition indexes, blood pressure.</span><span> </span><span>Glycosylated hemoglobin</span><span> </span><span>(HbA1c), fasting blood glucose</span><span> </span><span>(FBG), total protein</span><span> </span><span>(TP),</span><span> </span><span>albumin</span><span> </span><span>(ALB), prealbumin</span><span> </span><span>(PALB), hemoglobin</span><span> </span><span>(HGB),</span><span> </span><span>urea nitrogen</span><span> </span><span>(BUN), serum creatinine</span><span> </span><span>(CREA), and dynamic blood glucose monitoring were measured.</span><span> </span><span><span>And we recorded the changes of blood glucose and the test data. We statistically analyzed the data of two groups. </span><b><span>Results</span></b></span><b><span>:</span></b><b><span> </span></b><span>In the ODM group,</span><span> </span><span>HbA1c, FBG, average blood glucose,</span><span> </span><span>two-hour postprandial blood glucose</span><span> </span><span>(2hPBG) after breakfast, 2hPBG after dinner, the number of hyperglycemic events and high blood glucose time ratio are significantly higher than th</span><span>ose</span><span> of GDM and two groups compared with statistical significance</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05)</span><span>. </span><span>The number of patients treated with insulin</span><span> </span><span>(10/31) in ODM is significantly more than that in GDM</span><span> </span><span>(1/32) (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>45%</span><span> </span><span>(14/31) of ODM have a family history of diabetes patients.</span><span> </span><span>The ratio is significantly higher than 13%</span><span> </span><span>(4/32) of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>There was significant difference in urinary ketone positive rate between the two groups</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05), but there was no significant difference in urinary microalbumin abnormal rate between them</span><span> </span><span>(P</span><span> </span><span>></span><span> </span><span>0.05).</span><span> </span><span>The number of preeclampsia in ODM</span><span> </span><span>(8/31) is significantly higher than that of GDM (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>The level of HGB in ODM is lower than that of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05). There was no difference in the pregnancy outcomes between the two groups.</span><span> </span><b><span>Conclusion</span></b><b><span>:</span></b><span> Late pregnancy women with ODM have obvious family history, higher HbA1c, higher FBG, higher glucose levels of two-hours after breakfast and dinner,</span><span> </span><span>higher average blood glucose, longer hypoglycemia time, higher probability of hyperglycemic events and greater opportunity to use insulin in the treatment of symptomatic patients,</span><span> </span><span>higher risk of preeclampsia,</span><span> </span><span>lower HGB level than GDM,</span><span> </span><span>while GDM ha</span><span>s</span><span> higher positive rate of urine ketone than ODM.</span>展开更多
This paper examines the early acquisition of null subjects and overt subjects and how they are distributed and realized in the early speech of Arabic dialect-speaking children.①The study accounts for the phenomenon o...This paper examines the early acquisition of null subjects and overt subjects and how they are distributed and realized in the early speech of Arabic dialect-speaking children.①The study accounts for the phenomenon of subjects by examining a longitudinal corpus of two children,Wala and Ibraheem,who were around two years old,speaking Yemeni Ibbi Arabic(YIA)dialect.The production and elicited production data collection methods were used in the study to collect the corpus during five months.The results of the study showed that null-subjects appear with a high proportion compared to the overt subjects.It was found that null subjects and overt subjects in the speech of Ibraheem and Wala had a similar distribution in the imperfective and the perfective,of which 86-87%are null subjects and 12-14%are overt subjects.The paper examined the widespread linguistic phenomenon of Null Subject Parameter acquisition,(Rizzi,1982;Hyams,1986,1989)that is emergence of null subjects in line with overt subjects.The paper supports Hyam’s(1982)argument on the acquisition of Null Subject Parameter where we can find children acquire null subjects early around 2 years of age.In contrast to non-null subject languages(like English),Null Subject Languages(NSLs)like Arabic happen to have null subjects appear more frequently and this is due to the rich inflectional morphology of NSLs.展开更多
CHEN Guangbiao,President of Jiangsu Huangpu Renewable Resources,made headlines in January 2011 when he gave out red envelopes stuffed with money to those in need in Taiwan, and again in March when he handed out cash t...CHEN Guangbiao,President of Jiangsu Huangpu Renewable Resources,made headlines in January 2011 when he gave out red envelopes stuffed with money to those in need in Taiwan, and again in March when he handed out cash to survivors of earthquake-stricken Yingjiang County,Yunnan Province.The posed photos of Chen along with earthquake survivors展开更多
AIM To explore the natural history of covert hepatic encephalopathy(CHE) in absence of medication intervention.METHODS Consecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and ev...AIM To explore the natural history of covert hepatic encephalopathy(CHE) in absence of medication intervention.METHODS Consecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and evaluated for CHE diagnosis. They were followed up for a mean of 11.2 ± 1.3 mo. Time to the first cirrhosis-related complications requiring hospitalization, including overt HE(OHE), resolution of CHE and death/transplantation, were compared between CHE and no-CHE patients. Predictors for complication(s) and death/transplantation were also analyzed.RESULTS A total of 366 patients(age: 47.2 ± 8.6 years, male: 73.0%) were enrolled. CHE was identified in 131 patients(35.8%). CHE patients had higher rates of death and incidence of complications requiring hospitalization, including OHE, compared to unimpaired patients. Moreover, 17.6% of CHE patients developed OHE, 42.0% suffered persistent CHE, and 19.8% of CHE spontaneously resolved. In CHE patients, serum albumin < 30 g/L(HR = 5.22, P = 0.03) was the sole predictor for developing OHE, and blood creatinine > 133 μmol/L(HR = 4.75, P = 0.036) predicted mortality. Child-Pugh B/C(HR = 0.084, P < 0.001) and OHE history(HR = 0.15, P = 0.014) were predictors of spontaneous resolution of CHE.CONCLUSION CHE exacerbates, persists or resolves without medication intervention in clinically stable cirrhosis. Triage of patients based on these predictors will allow for more cost-effect management of CHE.展开更多
BACKGROUND In contrast to overt diabetes mellitus(DM),gestational DM(GDM)is defined as impaired glucose tolerance induced by pregnancy,which may arise from exaggerated physiologic changes in glucose metabolism.GDM pre...BACKGROUND In contrast to overt diabetes mellitus(DM),gestational DM(GDM)is defined as impaired glucose tolerance induced by pregnancy,which may arise from exaggerated physiologic changes in glucose metabolism.GDM prevalence is reported to be as high as 20%among pregnancies depending on the screening method,gestational age,and the population studied.Maternal and fetal effects of uncontrolled GDM include stillbirth,macrosomia,neonatal diabetes,birth trauma,and subsequent postpartum hemorrhage.Therefore,it is essential to find the potential target population and associated predictive and preventive measures for future intensive peripartum care.AIM To review studies that explored the cellular and molecular mechanisms of GDM as well as predictive measures and prevention strategies.METHODS The search was performed in the Medline and PubMed databases using the terms“gestational diabetes mellitus,”“overt diabetes mellitus,”and“insulin resistance.”In the literature,only full-text articles were considered for inclusion(237 articles).Furthermore,articles published before 1997 and duplicate articles were excluded.After a final review by two experts,all studies(1997-2023)included in the review met the search terms and search strategy(identification from the database,screening of the studies,selection of potential articles,and final inclusion).RESULTS Finally,a total of 79 articles were collected for review.Reported risk factors for GDM included maternal obesity or overweight,pre-existing DM,and polycystic ovary syndrome.The pathophysiology of GDM involves genetic variants responsible for insulin secretion and glycemic control,pancreaticβcell depletion or dysfunction,aggravated insulin resistance due to failure in the plasma membrane translocation of glucose transporter 4,and the effects of chronic,low-grade inflammation.Currently,many antepartum measurements including adipokines(leptin),body mass ratio(waist circumference and waist-to-hip ratio),and biomarkers(microRNA in extracellular vesicles)have been studied and confirmed to be useful markers for predicting GDM.For preventing GDM,physical activity and dietary approaches are effective interventions to control body weight,improve glycemic control,and reduce insulin resistance.CONCLUSION This review explored the possible factors that influence GDM and the underlying molecular and cellular mechanisms of GDM and provided predictive measures and prevention strategies based on results of clinical studies.展开更多
文摘Currently,it is key to convey precise meanings to readers for translators.Observing expressing habits between different languages is the precondition to make target texts more readable.It is crucial to ensure the exactness and seriousness of legal texts,but it does not mean that translators have to take machined way to leave out and even give up transmitting in-deep cultural implications for the intention of achieving the all-inclusive integrity of target content.It is a correct choice for translators to take overt translation and covert translation in line with traits of source language and target language and differences between civil law system and common law system.The intention of the article is to make an empirical study between overt translation and covert translation.
文摘Participant observation is often applied in qualitative research to help researchers obtain the overall,useful data,which will lead researchers to gain the knowledge that the academia tries to.However,different levels of participant observation,mainly the covert and overt participant observation,have aroused heated discussions among scholars.Field researchers are faced with many problems when doing research,such as whether they should be a covert participant observer or an overt one;what the research will get when they are in different roles and etc.In order to solve those problems,this article tries to provide some effective methods to field researchers,especially to the new ones.This article mainly talks about two types of participant observation:covert and overt participant observation;tries to explore the issues caused by them and the strategies to help researchers deal with such issues.Finally,in qualitative research,when faced with different fieldworks,researchers should adapt themselves to choosing participant roles flexibly and appropriately.
文摘AIM: To investigate the difference in long-term outcomes between gastric cancer patients with and without a primary symptom of overt bleeding(OB).METHODS: Consecutive patients between January 1, 2007 and March 1, 2012 were identified retrospectively by reviewing a gastric cancer database at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. A follow-up examination was performed on patients who underwent a radical gastrectomy. OB due to gastric cancer included hematemesis, melena or hematochezia, and gastric cancer was confirmed as the source of bleeding by endoscopy. Patients without OB were defined as cases with occult bleeding and those with other initial presentations, including epigastric pain, weakness, weight loss and obstruction. The 3-year overall survival(OS) rate, age, gender, AJCC T stage, AJCC N stage, overall AJCC stage, tumor size, histological type, macroscopic(Borrmann) type, lymphovascular invasion and R status were compared between patients with and without OB. Moreover, we carried out a subgroup analysis based on tumor location(upper, middle and lower).RESULTS: We identified 939 patients. Of these, 695(74.0%) were hospitalized for potential radical gastrectomy and another 244 received palliative resection, rerouting of the gastrointestinal tract, chemotherapy, radiotherapy or no treatment due to the presence of unresectable tumors. Notably, there was no significant difference in the percentage of OB patients between resectable cases and unresectable cases(20.3 % vs 22.1 %, P = 0.541). Fo l l o w- u p examination was performed on 653 patients(94%) who underwent radical gastrectomy. We found no significant difference in 3-year OS rate(68.2% vs 61.2%, P = 0.143) or clinicopathological characteristics(P > 0.05) between these patients with and without OB. Subgroup analysis based on tumor location showed that the 3-year OS rate of upper gastric cancer was significantly higher in patients with OB(84.6%) than in those without OB(48.1%, P < 0.01) and that AJCC stagesⅠ-Ⅱ(56.4% vs 35.1%, P = 0.017) and T1-T2 category tumors(30.8% vs 13%, P = 0.010) were more frequent in patients with OB than in those without OB. There was no significant difference in 3-year OS rate or clinicopathological characteristics between patients with and without OB(P > 0.05) for middle or lower gastric cancer.CONCLUSION: Upper gastric cancer patients with OB exhibited tumors at less advanced pathological stages and had a better prognosis than upper gastric cancer patients without OB.
文摘Hookworm infection is a relatively common cause of anemia in endemic areas.The most common hookworm species are Ancylostoma duodenale and Necator americanus.In this report we present a case of overt gastrointestinal bleeding Wause of hookworm infection.Capsule endoscopy revealed many hookworms in the lumen of proximal jejunum where active bleeding was seen. The patient was successfully treated with Albendazole.
文摘<strong>Background</strong><span><strong>:</strong></span><span> With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes of maternal and child mortality and morbidity worldwide and has raised health concern. It is seriously detrimental to both the women and fetuses. However, there are limited evidences of two types of gestational diabetes mellitus on clinical characteristics and outcomes.</span><span> </span><span>Therefore, this study was aimed to explore the clinical characteristics and outcomes of patients with overt diabetes mellitus</span><span> </span><span>(ODM) and gestational diabetes mellitus</span><span> </span><span><span>(GDM) at the late pregnancy. </span><b><span>Methods</span></b></span><b><span>:</span></b><span> From January 2015 to August 2016, totally 63 gestational diabetes mellitus from the Department of Clinical Nutrition in Beijing Anzhen Hospital were enrolled in the study.</span><span> </span><span>Patients were classified into two groups.</span><span> </span><span>31 patients with gestational overt diabetes mellitus were grouped into ODM group and 32 patients with gestational diabetes mellitus were grouped into GDM group.</span><span> </span><span>Clinical characteristics and outcomes were compared between ODM and GDM.</span><span> </span><span>We collected records of the age, gestational week, family history, past history, pregnancy complications, insulin use,</span><span> </span><span>blood pressure, clinical nutrition indexes, blood pressure.</span><span> </span><span>Glycosylated hemoglobin</span><span> </span><span>(HbA1c), fasting blood glucose</span><span> </span><span>(FBG), total protein</span><span> </span><span>(TP),</span><span> </span><span>albumin</span><span> </span><span>(ALB), prealbumin</span><span> </span><span>(PALB), hemoglobin</span><span> </span><span>(HGB),</span><span> </span><span>urea nitrogen</span><span> </span><span>(BUN), serum creatinine</span><span> </span><span>(CREA), and dynamic blood glucose monitoring were measured.</span><span> </span><span><span>And we recorded the changes of blood glucose and the test data. We statistically analyzed the data of two groups. </span><b><span>Results</span></b></span><b><span>:</span></b><b><span> </span></b><span>In the ODM group,</span><span> </span><span>HbA1c, FBG, average blood glucose,</span><span> </span><span>two-hour postprandial blood glucose</span><span> </span><span>(2hPBG) after breakfast, 2hPBG after dinner, the number of hyperglycemic events and high blood glucose time ratio are significantly higher than th</span><span>ose</span><span> of GDM and two groups compared with statistical significance</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05)</span><span>. </span><span>The number of patients treated with insulin</span><span> </span><span>(10/31) in ODM is significantly more than that in GDM</span><span> </span><span>(1/32) (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>45%</span><span> </span><span>(14/31) of ODM have a family history of diabetes patients.</span><span> </span><span>The ratio is significantly higher than 13%</span><span> </span><span>(4/32) of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>There was significant difference in urinary ketone positive rate between the two groups</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05), but there was no significant difference in urinary microalbumin abnormal rate between them</span><span> </span><span>(P</span><span> </span><span>></span><span> </span><span>0.05).</span><span> </span><span>The number of preeclampsia in ODM</span><span> </span><span>(8/31) is significantly higher than that of GDM (P</span><span> </span><span><</span><span> </span><span>0.05).</span><span> </span><span>The level of HGB in ODM is lower than that of GDM</span><span> </span><span>(P</span><span> </span><span><</span><span> </span><span>0.05). There was no difference in the pregnancy outcomes between the two groups.</span><span> </span><b><span>Conclusion</span></b><b><span>:</span></b><span> Late pregnancy women with ODM have obvious family history, higher HbA1c, higher FBG, higher glucose levels of two-hours after breakfast and dinner,</span><span> </span><span>higher average blood glucose, longer hypoglycemia time, higher probability of hyperglycemic events and greater opportunity to use insulin in the treatment of symptomatic patients,</span><span> </span><span>higher risk of preeclampsia,</span><span> </span><span>lower HGB level than GDM,</span><span> </span><span>while GDM ha</span><span>s</span><span> higher positive rate of urine ketone than ODM.</span>
文摘This paper examines the early acquisition of null subjects and overt subjects and how they are distributed and realized in the early speech of Arabic dialect-speaking children.①The study accounts for the phenomenon of subjects by examining a longitudinal corpus of two children,Wala and Ibraheem,who were around two years old,speaking Yemeni Ibbi Arabic(YIA)dialect.The production and elicited production data collection methods were used in the study to collect the corpus during five months.The results of the study showed that null-subjects appear with a high proportion compared to the overt subjects.It was found that null subjects and overt subjects in the speech of Ibraheem and Wala had a similar distribution in the imperfective and the perfective,of which 86-87%are null subjects and 12-14%are overt subjects.The paper examined the widespread linguistic phenomenon of Null Subject Parameter acquisition,(Rizzi,1982;Hyams,1986,1989)that is emergence of null subjects in line with overt subjects.The paper supports Hyam’s(1982)argument on the acquisition of Null Subject Parameter where we can find children acquire null subjects early around 2 years of age.In contrast to non-null subject languages(like English),Null Subject Languages(NSLs)like Arabic happen to have null subjects appear more frequently and this is due to the rich inflectional morphology of NSLs.
文摘CHEN Guangbiao,President of Jiangsu Huangpu Renewable Resources,made headlines in January 2011 when he gave out red envelopes stuffed with money to those in need in Taiwan, and again in March when he handed out cash to survivors of earthquake-stricken Yingjiang County,Yunnan Province.The posed photos of Chen along with earthquake survivors
基金Supported by Science and Technology Planning Project of Health and Family Planning Commission of Jiangxi Province,No.20171022National Natural Science Fund of China,No.81460122+2 种基金Project in the Science and Technology Pillar Program of Jiangxi Provincial Department of Science and Technology,No.20161BBG70166Jiangxi Provincial Outstanding Young Talent Program,No.20171BCB23085Natural Science Fund of Jiangxi Province For Young Scholars,No.20171BAB215008
文摘AIM To explore the natural history of covert hepatic encephalopathy(CHE) in absence of medication intervention.METHODS Consecutive outpatient cirrhotic patients in a Chinese tertiary care hospital were enrolled and evaluated for CHE diagnosis. They were followed up for a mean of 11.2 ± 1.3 mo. Time to the first cirrhosis-related complications requiring hospitalization, including overt HE(OHE), resolution of CHE and death/transplantation, were compared between CHE and no-CHE patients. Predictors for complication(s) and death/transplantation were also analyzed.RESULTS A total of 366 patients(age: 47.2 ± 8.6 years, male: 73.0%) were enrolled. CHE was identified in 131 patients(35.8%). CHE patients had higher rates of death and incidence of complications requiring hospitalization, including OHE, compared to unimpaired patients. Moreover, 17.6% of CHE patients developed OHE, 42.0% suffered persistent CHE, and 19.8% of CHE spontaneously resolved. In CHE patients, serum albumin < 30 g/L(HR = 5.22, P = 0.03) was the sole predictor for developing OHE, and blood creatinine > 133 μmol/L(HR = 4.75, P = 0.036) predicted mortality. Child-Pugh B/C(HR = 0.084, P < 0.001) and OHE history(HR = 0.15, P = 0.014) were predictors of spontaneous resolution of CHE.CONCLUSION CHE exacerbates, persists or resolves without medication intervention in clinically stable cirrhosis. Triage of patients based on these predictors will allow for more cost-effect management of CHE.
文摘BACKGROUND In contrast to overt diabetes mellitus(DM),gestational DM(GDM)is defined as impaired glucose tolerance induced by pregnancy,which may arise from exaggerated physiologic changes in glucose metabolism.GDM prevalence is reported to be as high as 20%among pregnancies depending on the screening method,gestational age,and the population studied.Maternal and fetal effects of uncontrolled GDM include stillbirth,macrosomia,neonatal diabetes,birth trauma,and subsequent postpartum hemorrhage.Therefore,it is essential to find the potential target population and associated predictive and preventive measures for future intensive peripartum care.AIM To review studies that explored the cellular and molecular mechanisms of GDM as well as predictive measures and prevention strategies.METHODS The search was performed in the Medline and PubMed databases using the terms“gestational diabetes mellitus,”“overt diabetes mellitus,”and“insulin resistance.”In the literature,only full-text articles were considered for inclusion(237 articles).Furthermore,articles published before 1997 and duplicate articles were excluded.After a final review by two experts,all studies(1997-2023)included in the review met the search terms and search strategy(identification from the database,screening of the studies,selection of potential articles,and final inclusion).RESULTS Finally,a total of 79 articles were collected for review.Reported risk factors for GDM included maternal obesity or overweight,pre-existing DM,and polycystic ovary syndrome.The pathophysiology of GDM involves genetic variants responsible for insulin secretion and glycemic control,pancreaticβcell depletion or dysfunction,aggravated insulin resistance due to failure in the plasma membrane translocation of glucose transporter 4,and the effects of chronic,low-grade inflammation.Currently,many antepartum measurements including adipokines(leptin),body mass ratio(waist circumference and waist-to-hip ratio),and biomarkers(microRNA in extracellular vesicles)have been studied and confirmed to be useful markers for predicting GDM.For preventing GDM,physical activity and dietary approaches are effective interventions to control body weight,improve glycemic control,and reduce insulin resistance.CONCLUSION This review explored the possible factors that influence GDM and the underlying molecular and cellular mechanisms of GDM and provided predictive measures and prevention strategies based on results of clinical studies.
