Objective： To evaluate the analgesic efficacy of controlled-release （CR） oxycodone and gabapentin in malignant neuropathic pain （NP）. Methods： Patients with malignant NP were enrolled and baseline pain intensi...Objective： To evaluate the analgesic efficacy of controlled-release （CR） oxycodone and gabapentin in malignant neuropathic pain （NP）. Methods： Patients with malignant NP were enrolled and baseline pain intensity （PI） was recorded. They initially took one week CR oxycodone and were allocated to two different groups at day 8 by reevaluated PI. Patients with mild pain went to CR oxycodone mono-therapy group （OO group） and took another two weeks CR oxycodone. Others went to （CR oxycodone combined gabapentin group （OG group） and received additional gabapentin. Daily doses and side effects were recorded. Results： Fifty-eight （92.06%） of the 63 enrolled patients completed the initial week＇s therapy. Twenty-two （37.93%） went to OO group and PI significantly reduced at day 15 （2.00 vs. 2.62, P=0.004）, but not improved at day 22 （1.90 vs. 2.00, P=0.54）. Thirty-six （62.07%） patients went to OG group and PI was significantly reduced at day 15 （4,47 vs. 2.94, P〈0.001）, but not improved at day 22 （2.94 vs. 2.75, P=0.136）. Mean daily dose （MDD） of CR oxycodone at day 8 was 62.64 mg. It was significantly increased at days 15 and 22 （71.43 mg vs. 62.64 rag, P=0.021; 81.90 mg vs. 71.43 mg, P=0.004） in OO group. MDD of gabapentin was significantly increased at day 22 compared to day 15 （862.50 mg vs. 993.75 mg, P〈0.001）. Constipation was occurred in 13.64% of the patients in OO group and 14.26 % in OG group. Conclusion： Malignant NP may be well controlled by oxycodone mono-therapy. Early combination with gabapentin is sensible when pain is not satisfactory relieved by oxycodone alone. The side effects of them are manageable.展开更多
Background and Objective: In computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphrag...Background and Objective: In computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphragm and bulbospongiosus musculature. In this retrospective study, we analyzed the magnetic resonance imaging (MRI) and CT scans of the patients with prostate cancer to investigate the relationship between the prostatic apex and the anatomic structure visible on CT, and to provide evidence for localizing the prostatic apex in radiotherapy planning. Methods: MRI and CT scans of 108 patients with prostate cancer were analyzed to measure the distances between the prostatic apex and the bottom of ischial tuberosities, the bottom of obturator foramen, the bottom of pubic symphysis, and the bulb of the penis. The volume of the prostate was measured to analyze its relationship with the localization of the prostatic apex. Results: The prostatic apex was located (13.1 ± 3.3) mm above the bulb of the penis, (11.0 ± 5.4) mm above the bottom of the obturator foramen, (31.3 ± 5.5) mm above the ischial tuberosities, and (7.1 ± 4.7) mm above the bottom of the symphysis pubis. There was no correlation between the size of the prostate and the localization of the prostatic apex. Conclusions: The variance of the distance between the prostatic apex and the bulb of the penis is smaller than that of the distance between the apex and bony anatomy. Delineating the target to 6 mm above the bulb of the penis can cover the prostatic apex in 95% of the patients with prostate cancer, delineating to the bottom of obturator foramen can cover the prostatic apex in 100% of the patients.展开更多
BACKGROUND Transarterial chemoembolization(TACE)is recommended for patients with intermediate hepatocellular carcinoma(HCC)according to treatment guidelines.However,a large number of patients with advanced HCC also re...BACKGROUND Transarterial chemoembolization(TACE)is recommended for patients with intermediate hepatocellular carcinoma(HCC)according to treatment guidelines.However,a large number of patients with advanced HCC also receive TACE in clinical practice,especially for those with liver-confined HCC and Eastern Cooperative Oncology Group score(ECOG)1.In view of previous studies,such patients have different prognoses from advanced HCC patients with macrovascular invasion or extrahepatic spread;therefore,patients with ECOG 1 alone might be classified into the intermediate stage and benefit from TACE treatment,but a study particularly focusing on such patients and exploring the effectiveness of TACE therapy is lacking.AIM To investigate treatment outcomes of TACE in HCC patients with ECOG 1 alone and propose a specific prognostic model.METHODS Patients from 24 Chinese tertiary hospitals were selected in this nationwide multicenter observational study from January 2010 to May 2016.Overall survival(OS)was estimated using Kaplan–Meier curves and compared by the log-rank test.Multivariate Cox regression was used to develop the potential prognostic models.The discriminatory ability of the models was compared and validated in various patient subgroups.The individual survival prediction for six-and-twelve(6&12)criteria,defined as the algebraic sum of tumor size(cm)and tumor number,was illustrated by contour plot of 3-year survival probability and nomogram.RESULTS A total of 792 eligible patients were included.During follow-up,median OS reached 18.9 mo[95%confidence interval(CI):16.9-21.0].Three independent multivariate analyses demonstrated that tumor size,tumor number,α-fetoprotein level,albumin–bilirubin grade and total bilirubin were prognostic factors of OS(P<0.05).The previously proposed 6&12 criteria was comparable or even better than currently proposed with the highest predictive ability.In addition,the 6&12 criteria was correlated with OS in various subgroups of patients.The patients were stratified into three strata with score≤6,>6 but≤12,and>12 with different median OS of 39.8 mo(95%CI:23.9-55.7),21.1 mo(95%CI:18.4-23.8)and 9.8 mo(95%CI:8.3-11.3),respectively(P<0.001).CONCLUSION TACE is effective for advanced HCC patients with ECOG 1 alone,and the 6&12 criteria may help with clinical decision-making.展开更多
Purpose:To investigate the sleep quality of patients with type 2 diabetes(T2D)and its impact on glycaemic control.Methods:Using a convenience sampling method,220 patients with T2D were recruited.The Pittsburgh Sleep Q...Purpose:To investigate the sleep quality of patients with type 2 diabetes(T2D)and its impact on glycaemic control.Methods:Using a convenience sampling method,220 patients with T2D were recruited.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep quality with threshold at PSQI8.The glycosylated haemoglobin A1c(HbA1c)test was used to measure the glycaemic control with threshold at HbA1c<7%.Results:The PSQI score was 8.30±4.12.The sleep disorder incidence rate was 47.1%.Patients with HbA1c7%had significantly lower PSQI global and factor scores(p<0.01)versus the control group.Sleep latency,sleep disturbance,and daytime dysfunction were the risk factors for poor glycaemic control.Conclusion:Patients with T2D have high sleep disorder rate negatively impacting glycaemic control.Health care providers should pay close attention to the sleep quality of T2D patients,and provide them with appropriate educational material.展开更多
BACKGROUND The treatment outcome of transarterial chemoembolization(TACE)in unresectable hepatocellular carcinoma(HCC)varies greatly due to the clinical heterogeneity of the patients.Therefore,several prognostic syste...BACKGROUND The treatment outcome of transarterial chemoembolization(TACE)in unresectable hepatocellular carcinoma(HCC)varies greatly due to the clinical heterogeneity of the patients.Therefore,several prognostic systems have been proposed for risk stratification and candidate identification for first TACE and repeated TACE(re-TACE).AIM To investigate the correlations between prognostic systems and radiological response,compare the predictive abilities,and integrate them in sequence for outcome prediction.METHODS This nationwide multicenter retrospective cohort consisted of 1107 unresectable HCC patients in 15 Chinese tertiary hospitals from January 2010 to May 2016.The Hepatoma Arterial-embolization Prognostic(HAP)score system and its modified versions(mHAP,mHAP2 and mHAP3),as well as the six-and-twelve criteria were compared in terms of their correlations with radiological response and overall survival(OS)prediction for first TACE.The same analyses were conducted in 912 patients receiving re-TACE to evaluate the ART(assessment for re-treatment with TACE)and ABCR(alpha-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh and Response)systems for post re-TACE survival(PRTS).RESULTS All the prognostic systems were correlated with radiological response achieved by first TACE,and the six-and-twelve criteria exhibited the highest correlation(Spearman R=0.39,P=0.026)and consistency(Kappa=0.14,P=0.019),with optimal performance by area under the receiver operating characteristic curve of 0.71[95%confidence interval(CI):0.68-0.74].With regard to the prediction of OS,the mHAP3 system identified patients with a favorable outcome with the highest concordance(C)-index of 0.60(95%CI:0.57-0.62)and the best area under the receiver operating characteristic curve at any time point during follow-up;whereas,PRTS was well-predicted by the ABCR system with a C-index of 0.61(95%CI:0.59-0.63),rather than ART.Finally,combining the mHAP3 and ABCR systems identified candidates suitable for TACE with an improved median PRTS of 36.6 mo,compared with non-candidates with a median PRTS of 20.0 mo(logrank test P<0.001).CONCLUSION Radiological response to TACE is closely associated with tumor burden,but superior prognostic prediction could be achieved with the combination of mHAP3 and ABCR in patients with unresectable liver-confined HCC.展开更多
In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO ...In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO report,693,224 cases of COVID-19 were confirmed globally as of March 30,2020,with more than 33,000 deaths.[2]Because COVID-19 is highly contagious and harmful,it is crucial to determine the predictors of severe infection and death for risk stratification and guiding clinical treatment and intervention.展开更多
Wound healing is a critical physiological process in living organisms that includes repair cell proliferation and migration,etc.[1,2].While effective wound-healing treatment strategies have been developed in the past,...Wound healing is a critical physiological process in living organisms that includes repair cell proliferation and migration,etc.[1,2].While effective wound-healing treatment strategies have been developed in the past,few have actively controlled the behavior of skin cells to accelerate wound healing[3,4].The importance of accelerated wound healing lies in its ability to shorten treatment time,reduce the risk of infection,and lower the cost of treatment.Electrical stimulation can modulate cell behavior during wound healing by simulating endogenous electric fields,boosting cell migration,fibroblast proliferation,and granulation tissue growth more significantly than traditional methods[5-7].However,electrical stimulation devices’size,space limitations,and unsustainability make them challenging to use in clinical surgery,hindering real-time and convenient treatment.It is therefore crucial to explore the miniaturization of electrical stimulation devices to advance the healing of skin wounds in clinical procedures.Recently,Chen et al.report a flexible micro-Zn-MnO2(mZMB)battery-based woundplast for wound management,which shows a promising path in biomedical applications(Figure 1)[8].展开更多
Nanoscale defects such as dislocations have a significant impact on the phonon thermal transport properties in non-metallic materials.To unravel these effects,an understanding of defect phonon modes is essential.Herei...Nanoscale defects such as dislocations have a significant impact on the phonon thermal transport properties in non-metallic materials.To unravel these effects,an understanding of defect phonon modes is essential.Herein,at the atomic scale,the localized phonons of individual dislocations at a Si/Ge interface are measured via monochromated electron energy loss spectroscopy in a scanning transmission electron microscope.These modes are then correlated with the local microstructure,further revealing the dislocation effects on the local thermal transport properties.The dislocation causes a phonon redshift of several milli-electron-volts within about two to four nanometers of the core,where both the strain field and Ge segregation play roles.With the presence of dislocation,the local interfacial thermal conductance can be either enhanced or reduced,depending on the complex interaction and competition between lattice disorder(dislocation)and element disorder(heterointerface mixing and Ge-segregation)at the interface.These findings provide valuable insights to improve the thermal properties of thermoelectric generators and thermal management systems through proper defect engineering.展开更多
BACKGROUND Total hip arthroplasty(THA)is an increasingly common treatment for older patients with hip osteoarthritis.Psychological stress is common before THA,although its clinical effects on selected parameters such ...BACKGROUND Total hip arthroplasty(THA)is an increasingly common treatment for older patients with hip osteoarthritis.Psychological stress is common before THA,although its clinical effects on selected parameters such as joint function,quality of life,and postoperative complications remain unclear.AIM To investigate the effects of preoperative psychological stress on selected parameters in older patients who underwent THA.METHODS Ninety older patients who underwent THA between January 2023 and August 2024 were divided into two groups by their preoperative self-rated anxiety scale and self-rated depression scale scores,including high-stress(n=42)and lowstress(n=48).The postoperative joint function,short form-36 health survey(SF36)score,incidence of postoperative complications,and other indicators were compared between the two groups.Pearson’s correlation coefficient analysis of the relationship among preoperative psychological stress,quality of life,and postoperative complications was performed.RESULTS Postoperative joint function and quality of life were lower in the high-stress group than they were in the low-stress group(P<0.05).The incidence of postoperative complications was higher in the high-stress group(29.27%)than it was in the low-stress group(9.30%)(P<0.05).Cor-relation analysis revealed that psychological stress was correlated with the Harris hip and SF-36 scores.Total scores on the scale,including physical function,physical pain,general health,mental health,social function,vitality,and emotional function,were negatively correlated(P<0.05).CONCLUSION Preoperative psychological stress results in adverse effects on quality of life and complications in older patients undergoing THA.Therefore,pre-operative psychological interventions should be strengthened to improve postoperative outcomes.展开更多
AIM: To determine the correlation between invasiveness, migration and prognosis in esophageal squamous cell carcinoma (ESCC) and expression of the B-cell-specific Moloney leukemia virus insert site 1 (Bmi-1) and plasm...AIM: To determine the correlation between invasiveness, migration and prognosis in esophageal squamous cell carcinoma (ESCC) and expression of the B-cell-specific Moloney leukemia virus insert site 1 (Bmi-1) and plasminogen activator inhibitor-1 (PAI-1).展开更多
BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First ...BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.展开更多
Objective:To achieve precision medicine,the use of imaging methods to help the clinical detection of cerebral infarction is conducive to the clinical development of a treatment plan and increase of the cure rate and i...Objective:To achieve precision medicine,the use of imaging methods to help the clinical detection of cerebral infarction is conducive to the clinical development of a treatment plan and increase of the cure rate and improvement of the prognosis of patients.Methods:In this work,T2-weighted imaging(T2WI),diffusion-weighted imaging(DWI),susceptibility-weighted imaging(SWI),and diffusion tensor imaging(DTI)examinations were performed on 34 patients with clinically diagnosed cerebral infarction to measure the difference in signal intensity between the lesion and its mirror area and make a comparative analysis by means of the Student-Newman-Keuls method.Results:The detection rate of T2WI was 79%(27/34),the detection rate of DWI was 97%(33/34),the detection rate of SWI was 88%(30/34),and the detection rate of DTI was 94%(32/34).Conclusion:The imaging performance was in the order DWI>DTI>SWI>T2WI for the diagnosis of cerebral infarction,and combined imaging is better than single imaging.展开更多
Polymer microspheres with uniform size,composition,and surface property have gained extensive researches in past decades.Conventional bottom-up approaches are using monomers or oligomers to build up desired polymer mi...Polymer microspheres with uniform size,composition,and surface property have gained extensive researches in past decades.Conventional bottom-up approaches are using monomers or oligomers to build up desired polymer microspheres.However,directly shaping high-molecular-weight polymers into well-ordered polymer microspheres remains a great challenge.Herein,we reported a facile and efficient top-down approach tofabricate microspheres with high-molecular-weight polymer microfibers.By harnessing interfacial engineering-control during the polymer microspheres formation,uniformly sized microspheres could be produced with widely ranged diameters(from 10μm to the capillary length of each polymer melt).The size limitation of this approach could be further extended by a controllable Plateau-Rayleigh instability phenomenon.Principally,the top-down approach allows fabrication of microspheres by various polymer melts with surface energy higher than 25 mN/m.Our work paves a way for green,cost-effective,and customizable production of a variety of functional polymer microspheres without any chemical reaction assistant.展开更多
BACKGROUND The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder(MDD).However,the effectiveness of antidepressant treatment combined with...BACKGROUND The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder(MDD).However,the effectiveness of antidepressant treatment combined with psychodrama in these patients is unclear.AIM To evaluate the effectiveness of antidepressant treatment combined with psychodrama.METHODS Patients with childhood trauma-associated MDD treated with antidepressants were randomly assigned to either the psychodrama intervention(observation group)or the general health education intervention(control group)and received combination treatment for 6 mo.The observation group received general health education given by the investigator together with the“semi-structured group intervention model”of Yi Shu psychodrama.A total of 46 patients were recruited,including 29 cases in the observation group and 17 cases in the control group.Symptoms of depression and anxiety as well as coping style and resting-state functional magnetic resonance imaging were assessed before and after the intervention.RESULTS Symptoms of depression and anxiety,measured by the Hamilton Depression Scale,Beck Depression Inventory,and Beck Anxiety Inventory,were reduced after the intervention in both groups of patients.The coping style of the observation group improved significantly in contrast to the control group,which did not.In addition,an interaction between treatment and time in the right superior parietal gyrus node was found.Furthermore,functional connectivity between the right superior parietal gyrus and left inferior frontal gyrus in the observation group increased after the intervention,while in the control group the connectivity decreased.CONCLUSION This study supports the use of combined treatment with antidepressants and psychodrama to improve the coping style of patients with childhood trauma-associated MDD.Functional connectivity between the superior parietal gyrus and inferior frontal gyrus was increased after this combined treatment.We speculate that psychodrama enhances the internal connectivity of the cognitive control network and corrects the negative attention bias of patients with childhood trauma-associated MDD.Elucidating the neurobiological features of patients with childhood trauma-associated MDD is important for the development of methods that can assist in early diagnosis and intervention.展开更多
Background The use of ketamine in electroconvulsive therapy(ECT)has been examined in the treatment of major depressive disorder(MDD);however,there has been no systematic review and meta-analysis of related randomised ...Background The use of ketamine in electroconvulsive therapy(ECT)has been examined in the treatment of major depressive disorder(MDD);however,there has been no systematic review and meta-analysis of related randomised controlled trials(RCTs).Aim To examine the efficacy and safety of ketamine augmentation of ECT in MDD treatment.Methods Two reviewers searched Chinese(China National Knowledge Infrastructure and Wanfang)and English(PubMed,PsycINFO,Embase and Cochrane Library)databases from their inception to 23 July 2019.The included studies'bias risk was evaluated using the Cochrane risk of bias assessment tool.The primary outcome of this metaanalysis was improved d印ressive symptoms at day 1 after a single ECT treatment session.Data were pooled to calculate the standardised mean difference and risk ratio with their 95%CIs using RevMan V.5.3.We used the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach to assess the whole quality of evidence.Results Four RCTs(n=239)compared ketamine alone or ketamine plus propofol(n=149)versus propofol alone(n=90)in patients with MDD who underwent a single ECT session.Three RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of bias.Compared with propofol alone,ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1,3 and 7 after a single ECT session.Moreover,compared with propofol alone,ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy index.Compared with propofol,ketamine alone was significantly associated with increased opening-eye time.Based on the GRADE approach,the evidence level of primary and secondary outcomes ranged from very low(26.7%,4/15)to‘low'(73.3%,11/15).Conclusion Compared with propofol,there were very low or low evidence levels showing that ketamine alone and the combination of ketamine and propofol appeared to rapidly improve depressive symptoms of patients with MDD undergoing a single ECT session.There is a need for highquality RCTs.展开更多
BACKGROUND The occurrence of a diaphragmatic hernia during the third trimester of pregnancy is rare;to our knowledge,there has only been a single case report related to congenital Bochdalek hernia complicated with mil...BACKGROUND The occurrence of a diaphragmatic hernia during the third trimester of pregnancy is rare;to our knowledge,there has only been a single case report related to congenital Bochdalek hernia complicated with mild acute pancreatitis during pregnancy.Nonspecific symptoms and lack of experience due to its rarity make the diagnosis of this condition very challenging.We report a case of diaphragmatic hernia accompanied by mild acute pancreatitis in the third trimester of pregnancy,which was misdiagnosed as severe acute pancreatitis.CASE SUMMARY A 19-year-old woman presented at gestation of 31+2 weeks with continuous distension pain for 3 d in the left lumbar region of no obvious cause.Ultrasonographic findings of left ureterectasis,with nonspecific lumbago and abdominal pain,led to the misdiagnosis of renal colic.Increased serum amylase and/or lipase levels indicated acute pancreatitis.Following the treatment of pancreatitis,her condition deteriorated.The patient was finally diagnosed with a diaphragmatic hernia complicated with mild acute pancreatitis on magnetic resonance imaging at our hospital.Caesarean section was performed at gestation of 31+6 weeks,followed by hernia repair,and the pancreatitis was treated sequentially.The patient was discharged in good condition 20 d after the surgery.CONCLUSION In this case,surgical treatment was not the same as that for non-pregnant diaphragmatic hernia repair.It is important to first perform a cesarean section before commencing the therapy.展开更多
Correction to:Nuclear Science and Techniques(2024)35:145 https://doi.org/10.1007/s41365-024-01517-y In this article the author’s name Wan-Bing He was incorrectly written as Wan-Bin He.The original article has been co...Correction to:Nuclear Science and Techniques(2024)35:145 https://doi.org/10.1007/s41365-024-01517-y In this article the author’s name Wan-Bing He was incorrectly written as Wan-Bin He.The original article has been corrected.展开更多
Objective： The purpose of this study was to explore the relationships between perceived social support and retention in Chinese mainland patients receiving methadone maintenance treatment （MMT）. Methods： This was ...Objective： The purpose of this study was to explore the relationships between perceived social support and retention in Chinese mainland patients receiving methadone maintenance treatment （MMT）. Methods： This was a cross-sectional two-year follow-up study. The data collected included patients＇ baseline characteristics, perceived social support and retention in MMT. Results： A total of 1212 patients completed the cross-sectional survey; 809 （66.7%） had good perceived social support and 458 （3Z8~） had experienced readmissions. With and without controlling for baseline characteristics, past retention had no significant influence on perceived social support. By the end of the follow-up, 527 （43.5%） patients had terminated MMT. The patients without good perceived social support were more likely to terminate treatment than those with good perceived social support [hazard ratio： 1.31, 95% confidence interval： 1.10, 1.57; 1.25 （1.04,1.51 ）] regardless of their baseline characteristics and past retention. Conclusions： Retention, thus, had no significant influence on perceived social support in MMT, whereas good oerceived social suooort was a stron~ orotective oredictor of retention.展开更多
文摘Objective： To evaluate the analgesic efficacy of controlled-release （CR） oxycodone and gabapentin in malignant neuropathic pain （NP）. Methods： Patients with malignant NP were enrolled and baseline pain intensity （PI） was recorded. They initially took one week CR oxycodone and were allocated to two different groups at day 8 by reevaluated PI. Patients with mild pain went to CR oxycodone mono-therapy group （OO group） and took another two weeks CR oxycodone. Others went to （CR oxycodone combined gabapentin group （OG group） and received additional gabapentin. Daily doses and side effects were recorded. Results： Fifty-eight （92.06%） of the 63 enrolled patients completed the initial week＇s therapy. Twenty-two （37.93%） went to OO group and PI significantly reduced at day 15 （2.00 vs. 2.62, P=0.004）, but not improved at day 22 （1.90 vs. 2.00, P=0.54）. Thirty-six （62.07%） patients went to OG group and PI was significantly reduced at day 15 （4,47 vs. 2.94, P〈0.001）, but not improved at day 22 （2.94 vs. 2.75, P=0.136）. Mean daily dose （MDD） of CR oxycodone at day 8 was 62.64 mg. It was significantly increased at days 15 and 22 （71.43 mg vs. 62.64 rag, P=0.021; 81.90 mg vs. 71.43 mg, P=0.004） in OO group. MDD of gabapentin was significantly increased at day 22 compared to day 15 （862.50 mg vs. 993.75 mg, P〈0.001）. Constipation was occurred in 13.64% of the patients in OO group and 14.26 % in OG group. Conclusion： Malignant NP may be well controlled by oxycodone mono-therapy. Early combination with gabapentin is sensible when pain is not satisfactory relieved by oxycodone alone. The side effects of them are manageable.
文摘Background and Objective: In computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphragm and bulbospongiosus musculature. In this retrospective study, we analyzed the magnetic resonance imaging (MRI) and CT scans of the patients with prostate cancer to investigate the relationship between the prostatic apex and the anatomic structure visible on CT, and to provide evidence for localizing the prostatic apex in radiotherapy planning. Methods: MRI and CT scans of 108 patients with prostate cancer were analyzed to measure the distances between the prostatic apex and the bottom of ischial tuberosities, the bottom of obturator foramen, the bottom of pubic symphysis, and the bulb of the penis. The volume of the prostate was measured to analyze its relationship with the localization of the prostatic apex. Results: The prostatic apex was located (13.1 ± 3.3) mm above the bulb of the penis, (11.0 ± 5.4) mm above the bottom of the obturator foramen, (31.3 ± 5.5) mm above the ischial tuberosities, and (7.1 ± 4.7) mm above the bottom of the symphysis pubis. There was no correlation between the size of the prostate and the localization of the prostatic apex. Conclusions: The variance of the distance between the prostatic apex and the bulb of the penis is smaller than that of the distance between the apex and bony anatomy. Delineating the target to 6 mm above the bulb of the penis can cover the prostatic apex in 95% of the patients with prostate cancer, delineating to the bottom of obturator foramen can cover the prostatic apex in 100% of the patients.
文摘BACKGROUND Transarterial chemoembolization(TACE)is recommended for patients with intermediate hepatocellular carcinoma(HCC)according to treatment guidelines.However,a large number of patients with advanced HCC also receive TACE in clinical practice,especially for those with liver-confined HCC and Eastern Cooperative Oncology Group score(ECOG)1.In view of previous studies,such patients have different prognoses from advanced HCC patients with macrovascular invasion or extrahepatic spread;therefore,patients with ECOG 1 alone might be classified into the intermediate stage and benefit from TACE treatment,but a study particularly focusing on such patients and exploring the effectiveness of TACE therapy is lacking.AIM To investigate treatment outcomes of TACE in HCC patients with ECOG 1 alone and propose a specific prognostic model.METHODS Patients from 24 Chinese tertiary hospitals were selected in this nationwide multicenter observational study from January 2010 to May 2016.Overall survival(OS)was estimated using Kaplan–Meier curves and compared by the log-rank test.Multivariate Cox regression was used to develop the potential prognostic models.The discriminatory ability of the models was compared and validated in various patient subgroups.The individual survival prediction for six-and-twelve(6&12)criteria,defined as the algebraic sum of tumor size(cm)and tumor number,was illustrated by contour plot of 3-year survival probability and nomogram.RESULTS A total of 792 eligible patients were included.During follow-up,median OS reached 18.9 mo[95%confidence interval(CI):16.9-21.0].Three independent multivariate analyses demonstrated that tumor size,tumor number,α-fetoprotein level,albumin–bilirubin grade and total bilirubin were prognostic factors of OS(P<0.05).The previously proposed 6&12 criteria was comparable or even better than currently proposed with the highest predictive ability.In addition,the 6&12 criteria was correlated with OS in various subgroups of patients.The patients were stratified into three strata with score≤6,>6 but≤12,and>12 with different median OS of 39.8 mo(95%CI:23.9-55.7),21.1 mo(95%CI:18.4-23.8)and 9.8 mo(95%CI:8.3-11.3),respectively(P<0.001).CONCLUSION TACE is effective for advanced HCC patients with ECOG 1 alone,and the 6&12 criteria may help with clinical decision-making.
基金We thank Meng Li from the 1st Affiliated Hospital of Xi'an Jiaotong University and Xiao-Hong Li from the 2nd Affiliated Hospital of Xi'an Jiaotong University for helping with the data collection,and their continuous support throughout this study.
文摘Purpose:To investigate the sleep quality of patients with type 2 diabetes(T2D)and its impact on glycaemic control.Methods:Using a convenience sampling method,220 patients with T2D were recruited.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep quality with threshold at PSQI8.The glycosylated haemoglobin A1c(HbA1c)test was used to measure the glycaemic control with threshold at HbA1c<7%.Results:The PSQI score was 8.30±4.12.The sleep disorder incidence rate was 47.1%.Patients with HbA1c7%had significantly lower PSQI global and factor scores(p<0.01)versus the control group.Sleep latency,sleep disturbance,and daytime dysfunction were the risk factors for poor glycaemic control.Conclusion:Patients with T2D have high sleep disorder rate negatively impacting glycaemic control.Health care providers should pay close attention to the sleep quality of T2D patients,and provide them with appropriate educational material.
文摘BACKGROUND The treatment outcome of transarterial chemoembolization(TACE)in unresectable hepatocellular carcinoma(HCC)varies greatly due to the clinical heterogeneity of the patients.Therefore,several prognostic systems have been proposed for risk stratification and candidate identification for first TACE and repeated TACE(re-TACE).AIM To investigate the correlations between prognostic systems and radiological response,compare the predictive abilities,and integrate them in sequence for outcome prediction.METHODS This nationwide multicenter retrospective cohort consisted of 1107 unresectable HCC patients in 15 Chinese tertiary hospitals from January 2010 to May 2016.The Hepatoma Arterial-embolization Prognostic(HAP)score system and its modified versions(mHAP,mHAP2 and mHAP3),as well as the six-and-twelve criteria were compared in terms of their correlations with radiological response and overall survival(OS)prediction for first TACE.The same analyses were conducted in 912 patients receiving re-TACE to evaluate the ART(assessment for re-treatment with TACE)and ABCR(alpha-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh and Response)systems for post re-TACE survival(PRTS).RESULTS All the prognostic systems were correlated with radiological response achieved by first TACE,and the six-and-twelve criteria exhibited the highest correlation(Spearman R=0.39,P=0.026)and consistency(Kappa=0.14,P=0.019),with optimal performance by area under the receiver operating characteristic curve of 0.71[95%confidence interval(CI):0.68-0.74].With regard to the prediction of OS,the mHAP3 system identified patients with a favorable outcome with the highest concordance(C)-index of 0.60(95%CI:0.57-0.62)and the best area under the receiver operating characteristic curve at any time point during follow-up;whereas,PRTS was well-predicted by the ABCR system with a C-index of 0.61(95%CI:0.59-0.63),rather than ART.Finally,combining the mHAP3 and ABCR systems identified candidates suitable for TACE with an improved median PRTS of 36.6 mo,compared with non-candidates with a median PRTS of 20.0 mo(logrank test P<0.001).CONCLUSION Radiological response to TACE is closely associated with tumor burden,but superior prognostic prediction could be achieved with the combination of mHAP3 and ABCR in patients with unresectable liver-confined HCC.
文摘In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO report,693,224 cases of COVID-19 were confirmed globally as of March 30,2020,with more than 33,000 deaths.[2]Because COVID-19 is highly contagious and harmful,it is crucial to determine the predictors of severe infection and death for risk stratification and guiding clinical treatment and intervention.
基金supported by the Natural Science Foundation of Jiangsu Province(BK20230117)the Natural Science Research Project of Nanjing Polytechnic Institute(NJPI-2023-04)+1 种基金the Startup Fund for Advanced Talents of Putian University(Grant No.2021070)the Qinglan Project of Jiangsu Province.
文摘Wound healing is a critical physiological process in living organisms that includes repair cell proliferation and migration,etc.[1,2].While effective wound-healing treatment strategies have been developed in the past,few have actively controlled the behavior of skin cells to accelerate wound healing[3,4].The importance of accelerated wound healing lies in its ability to shorten treatment time,reduce the risk of infection,and lower the cost of treatment.Electrical stimulation can modulate cell behavior during wound healing by simulating endogenous electric fields,boosting cell migration,fibroblast proliferation,and granulation tissue growth more significantly than traditional methods[5-7].However,electrical stimulation devices’size,space limitations,and unsustainability make them challenging to use in clinical surgery,hindering real-time and convenient treatment.It is therefore crucial to explore the miniaturization of electrical stimulation devices to advance the healing of skin wounds in clinical procedures.Recently,Chen et al.report a flexible micro-Zn-MnO2(mZMB)battery-based woundplast for wound management,which shows a promising path in biomedical applications(Figure 1)[8].
基金supported by the National Natural Science Foundation of China(Grant No.52125307)the National Key R&D Program of China(Grant No.2021YFB3501500)the support from the New Cornerstone Science Foundation through the XPLORER PRIZE。
文摘Nanoscale defects such as dislocations have a significant impact on the phonon thermal transport properties in non-metallic materials.To unravel these effects,an understanding of defect phonon modes is essential.Herein,at the atomic scale,the localized phonons of individual dislocations at a Si/Ge interface are measured via monochromated electron energy loss spectroscopy in a scanning transmission electron microscope.These modes are then correlated with the local microstructure,further revealing the dislocation effects on the local thermal transport properties.The dislocation causes a phonon redshift of several milli-electron-volts within about two to four nanometers of the core,where both the strain field and Ge segregation play roles.With the presence of dislocation,the local interfacial thermal conductance can be either enhanced or reduced,depending on the complex interaction and competition between lattice disorder(dislocation)and element disorder(heterointerface mixing and Ge-segregation)at the interface.These findings provide valuable insights to improve the thermal properties of thermoelectric generators and thermal management systems through proper defect engineering.
文摘BACKGROUND Total hip arthroplasty(THA)is an increasingly common treatment for older patients with hip osteoarthritis.Psychological stress is common before THA,although its clinical effects on selected parameters such as joint function,quality of life,and postoperative complications remain unclear.AIM To investigate the effects of preoperative psychological stress on selected parameters in older patients who underwent THA.METHODS Ninety older patients who underwent THA between January 2023 and August 2024 were divided into two groups by their preoperative self-rated anxiety scale and self-rated depression scale scores,including high-stress(n=42)and lowstress(n=48).The postoperative joint function,short form-36 health survey(SF36)score,incidence of postoperative complications,and other indicators were compared between the two groups.Pearson’s correlation coefficient analysis of the relationship among preoperative psychological stress,quality of life,and postoperative complications was performed.RESULTS Postoperative joint function and quality of life were lower in the high-stress group than they were in the low-stress group(P<0.05).The incidence of postoperative complications was higher in the high-stress group(29.27%)than it was in the low-stress group(9.30%)(P<0.05).Cor-relation analysis revealed that psychological stress was correlated with the Harris hip and SF-36 scores.Total scores on the scale,including physical function,physical pain,general health,mental health,social function,vitality,and emotional function,were negatively correlated(P<0.05).CONCLUSION Preoperative psychological stress results in adverse effects on quality of life and complications in older patients undergoing THA.Therefore,pre-operative psychological interventions should be strengthened to improve postoperative outcomes.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2012211A035Graduate Research and Innovation Project of Xnjiang Uygur Autonomous Region,No.XJGRI2013076Research and Innovation Project of Xinjiang Medical University,No.XJC201314
文摘AIM: To determine the correlation between invasiveness, migration and prognosis in esophageal squamous cell carcinoma (ESCC) and expression of the B-cell-specific Moloney leukemia virus insert site 1 (Bmi-1) and plasminogen activator inhibitor-1 (PAI-1).
文摘BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.
文摘Objective:To achieve precision medicine,the use of imaging methods to help the clinical detection of cerebral infarction is conducive to the clinical development of a treatment plan and increase of the cure rate and improvement of the prognosis of patients.Methods:In this work,T2-weighted imaging(T2WI),diffusion-weighted imaging(DWI),susceptibility-weighted imaging(SWI),and diffusion tensor imaging(DTI)examinations were performed on 34 patients with clinically diagnosed cerebral infarction to measure the difference in signal intensity between the lesion and its mirror area and make a comparative analysis by means of the Student-Newman-Keuls method.Results:The detection rate of T2WI was 79%(27/34),the detection rate of DWI was 97%(33/34),the detection rate of SWI was 88%(30/34),and the detection rate of DTI was 94%(32/34).Conclusion:The imaging performance was in the order DWI>DTI>SWI>T2WI for the diagnosis of cerebral infarction,and combined imaging is better than single imaging.
基金supported by the National Natural Science Foundation of China(No.21603026)Sichuan Science and Technology Program(No.2018RZ0115).
文摘Polymer microspheres with uniform size,composition,and surface property have gained extensive researches in past decades.Conventional bottom-up approaches are using monomers or oligomers to build up desired polymer microspheres.However,directly shaping high-molecular-weight polymers into well-ordered polymer microspheres remains a great challenge.Herein,we reported a facile and efficient top-down approach tofabricate microspheres with high-molecular-weight polymer microfibers.By harnessing interfacial engineering-control during the polymer microspheres formation,uniformly sized microspheres could be produced with widely ranged diameters(from 10μm to the capillary length of each polymer melt).The size limitation of this approach could be further extended by a controllable Plateau-Rayleigh instability phenomenon.Principally,the top-down approach allows fabrication of microspheres by various polymer melts with surface energy higher than 25 mN/m.Our work paves a way for green,cost-effective,and customizable production of a variety of functional polymer microspheres without any chemical reaction assistant.
文摘BACKGROUND The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder(MDD).However,the effectiveness of antidepressant treatment combined with psychodrama in these patients is unclear.AIM To evaluate the effectiveness of antidepressant treatment combined with psychodrama.METHODS Patients with childhood trauma-associated MDD treated with antidepressants were randomly assigned to either the psychodrama intervention(observation group)or the general health education intervention(control group)and received combination treatment for 6 mo.The observation group received general health education given by the investigator together with the“semi-structured group intervention model”of Yi Shu psychodrama.A total of 46 patients were recruited,including 29 cases in the observation group and 17 cases in the control group.Symptoms of depression and anxiety as well as coping style and resting-state functional magnetic resonance imaging were assessed before and after the intervention.RESULTS Symptoms of depression and anxiety,measured by the Hamilton Depression Scale,Beck Depression Inventory,and Beck Anxiety Inventory,were reduced after the intervention in both groups of patients.The coping style of the observation group improved significantly in contrast to the control group,which did not.In addition,an interaction between treatment and time in the right superior parietal gyrus node was found.Furthermore,functional connectivity between the right superior parietal gyrus and left inferior frontal gyrus in the observation group increased after the intervention,while in the control group the connectivity decreased.CONCLUSION This study supports the use of combined treatment with antidepressants and psychodrama to improve the coping style of patients with childhood trauma-associated MDD.Functional connectivity between the superior parietal gyrus and inferior frontal gyrus was increased after this combined treatment.We speculate that psychodrama enhances the internal connectivity of the cognitive control network and corrects the negative attention bias of patients with childhood trauma-associated MDD.Elucidating the neurobiological features of patients with childhood trauma-associated MDD is important for the development of methods that can assist in early diagnosis and intervention.
文摘Background The use of ketamine in electroconvulsive therapy(ECT)has been examined in the treatment of major depressive disorder(MDD);however,there has been no systematic review and meta-analysis of related randomised controlled trials(RCTs).Aim To examine the efficacy and safety of ketamine augmentation of ECT in MDD treatment.Methods Two reviewers searched Chinese(China National Knowledge Infrastructure and Wanfang)and English(PubMed,PsycINFO,Embase and Cochrane Library)databases from their inception to 23 July 2019.The included studies'bias risk was evaluated using the Cochrane risk of bias assessment tool.The primary outcome of this metaanalysis was improved d印ressive symptoms at day 1 after a single ECT treatment session.Data were pooled to calculate the standardised mean difference and risk ratio with their 95%CIs using RevMan V.5.3.We used the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach to assess the whole quality of evidence.Results Four RCTs(n=239)compared ketamine alone or ketamine plus propofol(n=149)versus propofol alone(n=90)in patients with MDD who underwent a single ECT session.Three RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of bias.Compared with propofol alone,ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1,3 and 7 after a single ECT session.Moreover,compared with propofol alone,ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy index.Compared with propofol,ketamine alone was significantly associated with increased opening-eye time.Based on the GRADE approach,the evidence level of primary and secondary outcomes ranged from very low(26.7%,4/15)to‘low'(73.3%,11/15).Conclusion Compared with propofol,there were very low or low evidence levels showing that ketamine alone and the combination of ketamine and propofol appeared to rapidly improve depressive symptoms of patients with MDD undergoing a single ECT session.There is a need for highquality RCTs.
基金the National Natural Science Foundation of China,No.81860099.
文摘BACKGROUND The occurrence of a diaphragmatic hernia during the third trimester of pregnancy is rare;to our knowledge,there has only been a single case report related to congenital Bochdalek hernia complicated with mild acute pancreatitis during pregnancy.Nonspecific symptoms and lack of experience due to its rarity make the diagnosis of this condition very challenging.We report a case of diaphragmatic hernia accompanied by mild acute pancreatitis in the third trimester of pregnancy,which was misdiagnosed as severe acute pancreatitis.CASE SUMMARY A 19-year-old woman presented at gestation of 31+2 weeks with continuous distension pain for 3 d in the left lumbar region of no obvious cause.Ultrasonographic findings of left ureterectasis,with nonspecific lumbago and abdominal pain,led to the misdiagnosis of renal colic.Increased serum amylase and/or lipase levels indicated acute pancreatitis.Following the treatment of pancreatitis,her condition deteriorated.The patient was finally diagnosed with a diaphragmatic hernia complicated with mild acute pancreatitis on magnetic resonance imaging at our hospital.Caesarean section was performed at gestation of 31+6 weeks,followed by hernia repair,and the pancreatitis was treated sequentially.The patient was discharged in good condition 20 d after the surgery.CONCLUSION In this case,surgical treatment was not the same as that for non-pregnant diaphragmatic hernia repair.It is important to first perform a cesarean section before commencing the therapy.
文摘Correction to:Nuclear Science and Techniques(2024)35:145 https://doi.org/10.1007/s41365-024-01517-y In this article the author’s name Wan-Bing He was incorrectly written as Wan-Bin He.The original article has been corrected.
基金funding from the National T&S Major Project of China(NO.2012ZX10002001)
文摘Objective： The purpose of this study was to explore the relationships between perceived social support and retention in Chinese mainland patients receiving methadone maintenance treatment （MMT）. Methods： This was a cross-sectional two-year follow-up study. The data collected included patients＇ baseline characteristics, perceived social support and retention in MMT. Results： A total of 1212 patients completed the cross-sectional survey; 809 （66.7%） had good perceived social support and 458 （3Z8~） had experienced readmissions. With and without controlling for baseline characteristics, past retention had no significant influence on perceived social support. By the end of the follow-up, 527 （43.5%） patients had terminated MMT. The patients without good perceived social support were more likely to terminate treatment than those with good perceived social support [hazard ratio： 1.31, 95% confidence interval： 1.10, 1.57; 1.25 （1.04,1.51 ）] regardless of their baseline characteristics and past retention. Conclusions： Retention, thus, had no significant influence on perceived social support in MMT, whereas good oerceived social suooort was a stron~ orotective oredictor of retention.
