Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarte...Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile.展开更多
系统评价儿童肺炎死亡危险因素,检验现有肺炎患儿死亡风险量表指标合理性,为儿童肺炎死亡预测模型优化提供参考。检索Web of Science、Embase、PubMed、Cochrane、万方及中国知网数据库建库至2023年2月27日有关儿童肺炎死亡危险因素的研...系统评价儿童肺炎死亡危险因素,检验现有肺炎患儿死亡风险量表指标合理性,为儿童肺炎死亡预测模型优化提供参考。检索Web of Science、Embase、PubMed、Cochrane、万方及中国知网数据库建库至2023年2月27日有关儿童肺炎死亡危险因素的研究,采用RevMan5.4软件进行Meta分析。纳入29篇研究,共68707例患者,结果显示:在RISC评分中低氧血症、营养不良及PERCH评分中年龄<1岁、无应答、低氧血症、营养不良被证明与死亡有关;Florin模型、PCIS中指标未被验证与死亡相关;儿童版PIRO量表中伴随疾病、缺氧、多叶肺炎被证明与死亡有关。目前用于评估儿童CAP死亡风险的量表中,部分指标被验证与不良预后相关。现有风险量表仍需进一步外部验证,以得到更具适用、实用、准确性的预测模型,为临床决策提供参考。展开更多
AIM: To evaluate gut microbial dysbiosis in two visceral hypersensitive models in comparison with irritable bowel syndrome(IBS) patients and to explore the extent to which these models capture the dysbiosis of IBS pat...AIM: To evaluate gut microbial dysbiosis in two visceral hypersensitive models in comparison with irritable bowel syndrome(IBS) patients and to explore the extent to which these models capture the dysbiosis of IBS patients. METHODS: Visceral hypersensitivity was developed using the maternal separation(MS) rat model and post-inflammatory rat model. The visceral sensitivity of the model groups and control group was evaluated using the abdominal withdraw reflex score and electromyography in response to graded colorectal distention. The 16 S ribosomal RNA gene from fecal samples was pyrosequenced and analyzed. The correlation between dysbiosis in the microbiota and visceral hypersensitivity was calculated. Positive findings were compared to sequencing data from a published human IBS cohort.RESULTS: Dysbiosis triggered by neonatal maternal separation was lasting but not static. Both MS and postinflammatory rat fecal microbiota deviated from that of the control rats to an extent that was larger than the co-housing effect. Two short chain fatty acid producing genera, Fusobacterium and Clostridium XI, were shared by the human IBS cohort and by the maternal separation rats and post-inflammatory rats, respectively, to different extents. Fusobacterium was significantly increased in the MS group, and its abundance positively correlated with the degree of visceral hypersensitivity. Porphyromonadaceae was a protective biomarker for both the rat control group and healthy human controls. CONCLUSION: The dysbiosis MS rat model and the post-inflammatory rat model captured some of the dysbiosis features of IBS patients. Fusobacterium, Clostridium XI and Porphyromonadaceae were identified as targets for future mechanistic research.展开更多
This study was conducted to compare the feasibility,safety and effectiveness of the combined-laparoscopic splenectomy and esophagogastric devascularization(C-LSED)with open splenectomy and esophagogastric devasculariz...This study was conducted to compare the feasibility,safety and effectiveness of the combined-laparoscopic splenectomy and esophagogastric devascularization(C-LSED)with open splenectomy and esophagogastric devascularization surgery(OSED)in patients with portal hypertension due to liver cirrhosis.From February 2014 to June 2018,68 patients with portal hypertension were diagnosed as having serious gastroesophageal varices and/or hypersplenism in our center.Thirty patients underwent C-LSED and 38 patients received OSED.Results and outcomes were compared retrospectively.No patients of C-LSED group required an intraoperative conversion to open surgery.Significantly shorter operating time,less blood loss,lower transfusion rates,shorter postoperative hospital stay,lower rates of complications were found in C-LSED group than in C-LSED group(P<0.05).No death and rebleeding were documented in both groups during the follow-up periods of one year Postoperative endoscopy revealed that varices in the patients of both groups were alleviated significantly from severe to mild,and in a part of cases,the varices disappeared.The final results suggest that the C-LSED technique is superior to open procedure,due to slightly invasive,simplified operative procedure,significantly shorter operating time,less intraoperative bleeding and lower post-operative complication rates.And C-LSED offers comparable long-term effects to open surgery.展开更多
This study uses the WRF-Chem model combined with the empirical kinetic modeling method(EKMA curve)to study the compound pollution event in Beijing that happened in 13−23 May 2017.Sensitivity tests are conducted to ana...This study uses the WRF-Chem model combined with the empirical kinetic modeling method(EKMA curve)to study the compound pollution event in Beijing that happened in 13−23 May 2017.Sensitivity tests are conducted to analyze ozone sensitivity to its precursors,and to develop emission reduction measures.The results suggest that the model can accurately simulate the compound pollution process of photochemistry and haze.When VOCs and NOx were reduced by the same proportion,the effect of O_(3)reduction at peak time was more obvious,and the effect during daytime was more significant than at night.The degree of change in ozone was peak time>daytime average.When reducing or increasing the ratio of precursors by 25%at the same time,the effect of reducing 25%VOCs on the average ozone concentration reduction was most significant.The degree of change in ozone decreased with increasing altitude,the location of the ozone maximum change shifted westward,and its range narrowed.As the altitude increases,the VOCs-limited zone decreases,VOCs sensitivity decreases,NOx sensitivity increases.The controlled area changed from near-surface VOCs-limited to high-altitude NOx-limited.Upon examining the EKMA curve,we have found that suburban and urban are sensitive to VOCs.The sensitivity tests indicate that when VOCs in suburban are reduced about 60%,the O_(3)-1h concentration could reach the standard,and when VOCs of the urban decreased by about 50%,the O_(3)-1h concentration could reach the standard.Thus,these findings could provide references for the control of compound air pollution in Beijing.展开更多
Green development emphasizes co-development between economic and environmental dimensions,and is a peoplecentered sustainable development approach.Western China demands green development,and international experience c...Green development emphasizes co-development between economic and environmental dimensions,and is a peoplecentered sustainable development approach.Western China demands green development,and international experience could provide necessary,unique and important help and support for Western China to achieve its green development goals.This paper has made a comprehensive overall review and analysis of international experience in green development policy and its implementation,in particular,OECD countries'(mostly Australia and Canada) experience have been analyzed following the major policy foci defined by the Task Force on Strategy and Policies on Environment and Development in Western China initiated by China Council for International Cooperation on Environment and Development(CCICED).Data and information were gathered from the field surveys and investigations,expert meetings,as well as literature review.The main sessions include policy framework and road map establishment,implementation and performance assessment,co-development between economic development and environmental protection,as well as green employment and poverty alleviation.The paper has addressed five policy considerations for the future promotion of green development in Western China.展开更多
BACKGROUND Hepatic lymphangioma,a malformation of the liver lymphatic system,is a rare benign neoplasm and usually coexists with other visceral lymphangiomas.Solitary hepatic lymphangioma is much more rarely seen and ...BACKGROUND Hepatic lymphangioma,a malformation of the liver lymphatic system,is a rare benign neoplasm and usually coexists with other visceral lymphangiomas.Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy.CASE SUMMARY A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with,including Schistosome japonicum infection and jaundice,and also together with imaging results,which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase.The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation.Finally,the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation.The pathological examination indicated the mass as hepatic lymphangioma.The patient has been followed up for 30 mo without recurrence.To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future,we reviewed the published literature of solitary hepatic lymphangioma for its clinical symptoms,imaging presentation,operative techniques,histology features and prognosis.CONCLUSION Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult.Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.展开更多
Constructing the efficacious and applicable bifunctional electrocatalysts and establishing out the mechanisms of organic electro-oxidation by replacing anodic oxygen evolution reaction(OER) are critical to the develop...Constructing the efficacious and applicable bifunctional electrocatalysts and establishing out the mechanisms of organic electro-oxidation by replacing anodic oxygen evolution reaction(OER) are critical to the development of electrochemicallydriven technologies for efficient hydrogen production and avoid CO_(2) emission. Herein, the hetero-nanocrystals between monodispersed Pt(~ 2 nm) and Ni_(3)S_(2)(~ 9.6 nm) are constructed as active electrocatalysts through interfacial electronic modulation, which exhibit superior bi-functional activities for methanol selective oxidation and H_(2) generation. The experimental and theoretical studies reveal that the asymmetrical charge distribution at Pt–Ni_(3)S_(2) could be modulated by the electronic interaction at the interface of dual-monodispersed heterojunctions, which thus promote the adsorption/desorption of the chemical intermediates at the interface. As a result, the selective conversion from CH_(3)OH to formate is accomplished at very low potentials(1.45 V) to attain 100 m A cm^(-2) with high electronic utilization rate(~ 98%) and without CO_(2) emission. Meanwhile, the Pt–Ni_(3)S_(2) can simultaneously exhibit a broad potential window with outstanding stability and large current densities for hydrogen evolution reaction(HER) at the cathode. Further, the excellent bi-functional performance is also indicated in the coupled methanol oxidation reaction(MOR)//HER reactor by only requiring a cell voltage of 1.60 V to achieve a current density of 50 m A cm^(-2) with good reusability.展开更多
基金supported by grants from the National Natural Science Foundation of China(91959203,82272836 and 82373017)。
文摘Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile.
文摘系统评价儿童肺炎死亡危险因素,检验现有肺炎患儿死亡风险量表指标合理性,为儿童肺炎死亡预测模型优化提供参考。检索Web of Science、Embase、PubMed、Cochrane、万方及中国知网数据库建库至2023年2月27日有关儿童肺炎死亡危险因素的研究,采用RevMan5.4软件进行Meta分析。纳入29篇研究,共68707例患者,结果显示:在RISC评分中低氧血症、营养不良及PERCH评分中年龄<1岁、无应答、低氧血症、营养不良被证明与死亡有关;Florin模型、PCIS中指标未被验证与死亡相关;儿童版PIRO量表中伴随疾病、缺氧、多叶肺炎被证明与死亡有关。目前用于评估儿童CAP死亡风险的量表中,部分指标被验证与不良预后相关。现有风险量表仍需进一步外部验证,以得到更具适用、实用、准确性的预测模型,为临床决策提供参考。
基金Supported by National Natural Science Foundation of China,No.81330012 and No.81170352
文摘AIM: To evaluate gut microbial dysbiosis in two visceral hypersensitive models in comparison with irritable bowel syndrome(IBS) patients and to explore the extent to which these models capture the dysbiosis of IBS patients. METHODS: Visceral hypersensitivity was developed using the maternal separation(MS) rat model and post-inflammatory rat model. The visceral sensitivity of the model groups and control group was evaluated using the abdominal withdraw reflex score and electromyography in response to graded colorectal distention. The 16 S ribosomal RNA gene from fecal samples was pyrosequenced and analyzed. The correlation between dysbiosis in the microbiota and visceral hypersensitivity was calculated. Positive findings were compared to sequencing data from a published human IBS cohort.RESULTS: Dysbiosis triggered by neonatal maternal separation was lasting but not static. Both MS and postinflammatory rat fecal microbiota deviated from that of the control rats to an extent that was larger than the co-housing effect. Two short chain fatty acid producing genera, Fusobacterium and Clostridium XI, were shared by the human IBS cohort and by the maternal separation rats and post-inflammatory rats, respectively, to different extents. Fusobacterium was significantly increased in the MS group, and its abundance positively correlated with the degree of visceral hypersensitivity. Porphyromonadaceae was a protective biomarker for both the rat control group and healthy human controls. CONCLUSION: The dysbiosis MS rat model and the post-inflammatory rat model captured some of the dysbiosis features of IBS patients. Fusobacterium, Clostridium XI and Porphyromonadaceae were identified as targets for future mechanistic research.
基金grants from Liver Surgery Medical Research Center Project in Hubei Province and China National Key Projects for Infectious Diseases(No.2008ZX10002-025).
文摘This study was conducted to compare the feasibility,safety and effectiveness of the combined-laparoscopic splenectomy and esophagogastric devascularization(C-LSED)with open splenectomy and esophagogastric devascularization surgery(OSED)in patients with portal hypertension due to liver cirrhosis.From February 2014 to June 2018,68 patients with portal hypertension were diagnosed as having serious gastroesophageal varices and/or hypersplenism in our center.Thirty patients underwent C-LSED and 38 patients received OSED.Results and outcomes were compared retrospectively.No patients of C-LSED group required an intraoperative conversion to open surgery.Significantly shorter operating time,less blood loss,lower transfusion rates,shorter postoperative hospital stay,lower rates of complications were found in C-LSED group than in C-LSED group(P<0.05).No death and rebleeding were documented in both groups during the follow-up periods of one year Postoperative endoscopy revealed that varices in the patients of both groups were alleviated significantly from severe to mild,and in a part of cases,the varices disappeared.The final results suggest that the C-LSED technique is superior to open procedure,due to slightly invasive,simplified operative procedure,significantly shorter operating time,less intraoperative bleeding and lower post-operative complication rates.And C-LSED offers comparable long-term effects to open surgery.
基金This study is funded by Air Pollution Special Project of the Ministry of Science and Technology(Grant No.2017YFCOZ10006)the National Natural Science Foundation of China(Grant No.41975173)。
文摘This study uses the WRF-Chem model combined with the empirical kinetic modeling method(EKMA curve)to study the compound pollution event in Beijing that happened in 13−23 May 2017.Sensitivity tests are conducted to analyze ozone sensitivity to its precursors,and to develop emission reduction measures.The results suggest that the model can accurately simulate the compound pollution process of photochemistry and haze.When VOCs and NOx were reduced by the same proportion,the effect of O_(3)reduction at peak time was more obvious,and the effect during daytime was more significant than at night.The degree of change in ozone was peak time>daytime average.When reducing or increasing the ratio of precursors by 25%at the same time,the effect of reducing 25%VOCs on the average ozone concentration reduction was most significant.The degree of change in ozone decreased with increasing altitude,the location of the ozone maximum change shifted westward,and its range narrowed.As the altitude increases,the VOCs-limited zone decreases,VOCs sensitivity decreases,NOx sensitivity increases.The controlled area changed from near-surface VOCs-limited to high-altitude NOx-limited.Upon examining the EKMA curve,we have found that suburban and urban are sensitive to VOCs.The sensitivity tests indicate that when VOCs in suburban are reduced about 60%,the O_(3)-1h concentration could reach the standard,and when VOCs of the urban decreased by about 50%,the O_(3)-1h concentration could reach the standard.Thus,these findings could provide references for the control of compound air pollution in Beijing.
基金finally supported by the "Strategy and Policies on Environment and Development in Western China" project of "China Council for International Cooperation on Environment and Development(CCICED)"
文摘Green development emphasizes co-development between economic and environmental dimensions,and is a peoplecentered sustainable development approach.Western China demands green development,and international experience could provide necessary,unique and important help and support for Western China to achieve its green development goals.This paper has made a comprehensive overall review and analysis of international experience in green development policy and its implementation,in particular,OECD countries'(mostly Australia and Canada) experience have been analyzed following the major policy foci defined by the Task Force on Strategy and Policies on Environment and Development in Western China initiated by China Council for International Cooperation on Environment and Development(CCICED).Data and information were gathered from the field surveys and investigations,expert meetings,as well as literature review.The main sessions include policy framework and road map establishment,implementation and performance assessment,co-development between economic development and environmental protection,as well as green employment and poverty alleviation.The paper has addressed five policy considerations for the future promotion of green development in Western China.
文摘BACKGROUND Hepatic lymphangioma,a malformation of the liver lymphatic system,is a rare benign neoplasm and usually coexists with other visceral lymphangiomas.Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy.CASE SUMMARY A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with,including Schistosome japonicum infection and jaundice,and also together with imaging results,which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase.The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation.Finally,the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation.The pathological examination indicated the mass as hepatic lymphangioma.The patient has been followed up for 30 mo without recurrence.To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future,we reviewed the published literature of solitary hepatic lymphangioma for its clinical symptoms,imaging presentation,operative techniques,histology features and prognosis.CONCLUSION Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult.Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.
基金the financial support of Guangdong Basic and Applied Basic Research Foundation (No. 2023A1515010940)Shenzhen Natural Science Fund (the Stable Support Plan Program No. 20220809160022001)the Shenzhen Science and Technology Programs (No. ZDSYS20220527171401003, KQTD20190929173914967)。
文摘Constructing the efficacious and applicable bifunctional electrocatalysts and establishing out the mechanisms of organic electro-oxidation by replacing anodic oxygen evolution reaction(OER) are critical to the development of electrochemicallydriven technologies for efficient hydrogen production and avoid CO_(2) emission. Herein, the hetero-nanocrystals between monodispersed Pt(~ 2 nm) and Ni_(3)S_(2)(~ 9.6 nm) are constructed as active electrocatalysts through interfacial electronic modulation, which exhibit superior bi-functional activities for methanol selective oxidation and H_(2) generation. The experimental and theoretical studies reveal that the asymmetrical charge distribution at Pt–Ni_(3)S_(2) could be modulated by the electronic interaction at the interface of dual-monodispersed heterojunctions, which thus promote the adsorption/desorption of the chemical intermediates at the interface. As a result, the selective conversion from CH_(3)OH to formate is accomplished at very low potentials(1.45 V) to attain 100 m A cm^(-2) with high electronic utilization rate(~ 98%) and without CO_(2) emission. Meanwhile, the Pt–Ni_(3)S_(2) can simultaneously exhibit a broad potential window with outstanding stability and large current densities for hydrogen evolution reaction(HER) at the cathode. Further, the excellent bi-functional performance is also indicated in the coupled methanol oxidation reaction(MOR)//HER reactor by only requiring a cell voltage of 1.60 V to achieve a current density of 50 m A cm^(-2) with good reusability.
