BACKGROUND Programmed death receptor-1(PD-1)inhibitors have been approved as secondline treatment regimen in hepatocellular carcinoma(HCC),but it is still worth studying whether patients can benefit from PD-1 inhibito...BACKGROUND Programmed death receptor-1(PD-1)inhibitors have been approved as secondline treatment regimen in hepatocellular carcinoma(HCC),but it is still worth studying whether patients can benefit from PD-1 inhibitors as first-line drugs combined with targeted drugs and locoregional therapy.AIM To estimate the clinical outcome of transarterial chemoembolization(TACE)and lenvatinib plus PD-1 inhibitors for patients with unresectable HCC(uHCC).METHODS We carried out retrospective research of 65 patients with uHCC who were treated at Peking Union Medical College Hospital from September 2017 to February 2022.45 patients received the PD-1 inhibitors,lenvatinib,TACE(PD-1-Lenv-T)therapy,and 20 received the lenvatinib,TACE(Lenv-T)therapy.In terms of the dose of lenvatinib,8 mg was given orally for patients weighing less than 60 kg and 12 mg for those weighing more than 60 kg.Of the patients in the PD-1 inhibitor combination group,15 received Toripalimab,14 received Toripalimab,14 received Camrelizumab,4 received Pembrolizumab,9 received Sintilimab,and 2 received Nivolumab,1 with Tislelizumab.According to the investigators’assessment,TACE was performed every 4-6 wk when the patient had good hepatic function(Child-Pugh class A or B)until disease progression occurred.We evaluated the efficacy by the modified Response Evaluation Criteria in Solid Tumors(mRECIST criteria).We accessd the safety by the National Cancer Institute Common Terminology Criteria for Adverse Events,v 5.0.The key adverse events(AEs)after the initiation of combination therapy were observed.RESULTS Patients with uHCC who received PD-1-Lenv-T therapy(n=45)had a clearly longer overall survival than those who underwent Lenv-T therapy(n=20,26.8 vs 14.0 mo;P=0.027).The median progression-free survival time between the two treatment regimens was also measured{11.7 mo[95%confidence interval(CI):7.7-15.7]in the PD-1-Lenv-T group vs 8.5 mo(95%CI:3.0-13.9)in the Lenv-T group(P=0.028)}.The objective response rates of the PD-1-Lenv-T group and Lenv-T group were 44.4%and 20%(P=0.059)according to the mRECIST criteria,meanwhile the disease control rates were 93.3%and 64.0%(P=0.003),respectively.The type and frequency of AEs showed little distinction between patients received the two treatment regimens.CONCLUSION Our results suggest that the early combination of PD-1 inhibitors has manageable toxicity and hopeful efficacy in patients with uHCC.展开更多
BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Ma...BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Many patients have reached the advanced stage when the second primary tumor is found,resulting in no early intervention and treatment.This is due to the misunderstanding of MPMTs by clinicians,who treat such tumors as metastases.Therefore,before a patient has a second primary tumor,doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient.AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization.METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively.They were divided into metachronous MPMT and synchronous MPMT groups,and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted.Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test,respectively.A P value<0.05 was considered as statistically significant,and SPSS version 26.0(SPSS Inc.,Chicago,Illinois,United States)was used for statistical analysis.RESULTS Among the 1902 patients with MPMTs confirmed by pathology,1811(95.2%)cases were secondary primary cancers,89(4.7%)cases were tertiary primary cancers,and 2(0.1%)cases were quaternary primary cancers.Most(88.2%)of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer.The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows:Breast cancer,thyroid cancer,nonuterine cancer,lung cancer,colon cancer,kidney cancer,uterine cancer,bladder cancer,rectal cancer,and gastric cancer.The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer(11.6%),the highest incidence rate of the second primary cancer was still lung cancer(24.9%),the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer(32.7%),and the highest incidence rate of the second primary cancer was lung cancer(20.8%).Among them,breast cancer,nonuterine cancer and uterine cancer were female-specific malignant tumor types,and thyroid cancer also accounted for 79.6%of female patients.The top five metachronous cancer combinations,independent of female-specific malignant tumor types and thyroid cancer,were colon cancer and lung cancer(26 cases),kidney cancer and lung cancer(25 cases),rectal cancer and lung cancer(20 cases),gastric cancer and lung cancer(17 cases),and bladder cancer and lung cancer(17 cases).The most common synchronous cancer combination was colon cancer and rectal cancer(15 cases).CONCLUSION Screening for lung cancer should be performed six months after the detection of colon cancer while rectal cancer screening should be performed within six months.展开更多
BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and t...BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and thus,prevent liver failure.AIM To look at the safety and efficacy of heparin in preventing hepatic dysfunction after hepatectomy.METHODS The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III(MIMIC-III)v1.4 pinpointed patients who had undergone hepatectomy for liver cancer,subdividing them into two cohorts:Those who were injected with heparin and those who were not.The statistical evaluations used were unpaired ttests,Mann-Whitney U tests,chi-square tests,and Fisher’s exact tests to assess the effect of heparin administration on PHLF,duration of intensive care unit(ICU)stay,need for mechanical ventilation,use of continuous renal replacement therapy(CRRT),incidence of hypoxemia,development of acute kidney injury,and ICU mortality.Logistic regression was utilized to analyze the factors related to PHLF,with propensity score matching(PSM)aiming to balance the preoperative disparities between the two groups.RESULTS In this study,1388 patients who underwent liver cancer hepatectomy were analyzed.PSM yielded 213 matched pairs from the heparin-treated and control groups.Initial univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched samples.Further analysis in the matched cohorts confirmed a significant association,with heparin reducing the risk of PHLF(odds ratio:0.518;95%confidence interval:0.295-0.910;P=0.022).Additionally,heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations,diminished requirements for respiratory support and CRRT,and lower incidences of hypoxemia and ICU mortality.CONCLUSION Liver failure is an important hazard following hepatic surgery.During ICU care heparin administration has been proved to decrease the occurrence of hepatectomy induced liver failure.This indicates that heparin may provide a hopeful option for controlling PHLF.展开更多
The exploration and synthesis of new materials are important for materials science and condensed matter physics.Here, we report the crystal structure, magnetic properties, and electrical transport properties of the si...The exploration and synthesis of new materials are important for materials science and condensed matter physics.Here, we report the crystal structure, magnetic properties, and electrical transport properties of the single crystals of Nd_(5)ScSb_(12), which is a quasi-one-dimensional new compound. Nd_(5)ScSb_(12) exhibits antiferromagnetic transition in both directions perpendicular and parallel to the long axis. Moreover, the magnetic field-dependent magnetization reveals two metamagnetic transitions. The electrical transport properties have been measured on the same sample but with different measurement lengths between the electrodes of the voltage. The resistivity exhibits the metallic behavior. At low temperatures, the Kondo effect and negative transverse magnetoresistance(MR)(B⊥I) have been observed. Interestingly, the measurement length has a significant impact on the Kondo effect and negative MR, providing an intuitive new approach to regulate the Kondo effect. As the measurement length increases, the Kondo effect and negative MR become more pronounced. This not only indicates that the interaction between magnetic impurities and conduction electrons dominates the electrical transport of Nd_(5)ScSb_(12) at low temperatures, but also confirms that the negative MR originates from the suppression of the Kondo effect.展开更多
We report the magnetic and transport properties of EuBi_(2) single crystal. EuBi_(2) exhibits complex magnetic behavior at low temperatures. In both the in-plane and out-of-plane directions, three antiferromagnetic(AF...We report the magnetic and transport properties of EuBi_(2) single crystal. EuBi_(2) exhibits complex magnetic behavior at low temperatures. In both the in-plane and out-of-plane directions, three antiferromagnetic(AFM) transitions have been observed at T_(N1)~18.9 K, T_(N2)~7.0 K, and T_(N3)~3.1 K. Among them, the transitions at T_(N2) and T_(N3) represent the canted AFM orders with ferromagnetic components. As the magnetic field increases, the transition at T_(N3) is rapidly suppressed to disappearance. However, the transitions at T_(N1) and T_(N2) persist until high fields and their signatures can also be reflected in the resistivity and specific heat. Above the magnetic transition temperature T_(N1), the resistivity of EuBi_(2) increases linearly with temperature, exhibiting the strange-metal behavior. In the magnetically ordered region below T_(N1), EuBi_(2) exhibits the weak antilocalization(WAL) effect and large magnetoresistance(475% at 1.8 K and 14 T). It is suggested that the magnetic ordering significantly enhances the spin–orbital coupling interaction and induces the WAL effect.展开更多
BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive mod...BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.展开更多
Objective:This large-scale cross-sectional study aims to identify the characteristics of and risk factors associated with sexual repression among internal migrants in China.Methods:Between August 2013 and August 2015,...Objective:This large-scale cross-sectional study aims to identify the characteristics of and risk factors associated with sexual repression among internal migrants in China.Methods:Between August 2013 and August 2015,a total of 8,669 internal migrants from four major cities in China(Beijing,Shanghai,Chengdu,and Chongqing)voluntarily participated in our study.They were interviewed,and the data on their demographic information,occupation,and sexual activities were collected.The Chi-square test and multiple logistic regressions were conducted to identify significant associations.A stepwise method was adopted for the selection of variables.Results:There were 3,597(41.49%)males and 5,072(58.51%)females in total.A higher percentage of males reported that they felt sexual repression compared to females(14.43%vs.9.21%).After adjusting for other covariates,the consequence was showed that male migrants working for more than 5 days were more likely to report sexual repression(odds ratio[OR]=1.40,P<0.05).Living in a collective dormitory with others was also a risk factor for male migrants.The longer males spent with their partners,the less sexual repression occurred(OR=0.94,P<0.05).Similarly,agricultural household registration status and working for more than 5 days increased the risk for sexual repression among female migrants(OR=1.41 and OR=1.46,respectively,P<0.05).Frequent and constructive communication also protected females against sexual repression(P<0.05).Well-educated females experienced relatively less sexual repression when compared to their counterparts with less education(P<0.05).Conclusions:Sexual repression was significantly associated with a few demographic,occupational,and sexual risk factors.Meaningful differences have been identified between male and female migrants.More effective intervention programs such as safeguard measures and welfare policies should be designed and implemented for a majority of female migrants and for those with agricultural household registration status.展开更多
基金Supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,No.2021-I2M-1-061 and 2021-I2M-1-003Chinese Society of Clinical Oncology-Hengrui Cancer Research Fund,No.Y-HR2019-0239+1 种基金Chinese Society of Clinical Oncology-MSD Cancer Research Fund,No.Y-MSDZD2021-0213National Ten-thousand Talent Program.
文摘BACKGROUND Programmed death receptor-1(PD-1)inhibitors have been approved as secondline treatment regimen in hepatocellular carcinoma(HCC),but it is still worth studying whether patients can benefit from PD-1 inhibitors as first-line drugs combined with targeted drugs and locoregional therapy.AIM To estimate the clinical outcome of transarterial chemoembolization(TACE)and lenvatinib plus PD-1 inhibitors for patients with unresectable HCC(uHCC).METHODS We carried out retrospective research of 65 patients with uHCC who were treated at Peking Union Medical College Hospital from September 2017 to February 2022.45 patients received the PD-1 inhibitors,lenvatinib,TACE(PD-1-Lenv-T)therapy,and 20 received the lenvatinib,TACE(Lenv-T)therapy.In terms of the dose of lenvatinib,8 mg was given orally for patients weighing less than 60 kg and 12 mg for those weighing more than 60 kg.Of the patients in the PD-1 inhibitor combination group,15 received Toripalimab,14 received Toripalimab,14 received Camrelizumab,4 received Pembrolizumab,9 received Sintilimab,and 2 received Nivolumab,1 with Tislelizumab.According to the investigators’assessment,TACE was performed every 4-6 wk when the patient had good hepatic function(Child-Pugh class A or B)until disease progression occurred.We evaluated the efficacy by the modified Response Evaluation Criteria in Solid Tumors(mRECIST criteria).We accessd the safety by the National Cancer Institute Common Terminology Criteria for Adverse Events,v 5.0.The key adverse events(AEs)after the initiation of combination therapy were observed.RESULTS Patients with uHCC who received PD-1-Lenv-T therapy(n=45)had a clearly longer overall survival than those who underwent Lenv-T therapy(n=20,26.8 vs 14.0 mo;P=0.027).The median progression-free survival time between the two treatment regimens was also measured{11.7 mo[95%confidence interval(CI):7.7-15.7]in the PD-1-Lenv-T group vs 8.5 mo(95%CI:3.0-13.9)in the Lenv-T group(P=0.028)}.The objective response rates of the PD-1-Lenv-T group and Lenv-T group were 44.4%and 20%(P=0.059)according to the mRECIST criteria,meanwhile the disease control rates were 93.3%and 64.0%(P=0.003),respectively.The type and frequency of AEs showed little distinction between patients received the two treatment regimens.CONCLUSION Our results suggest that the early combination of PD-1 inhibitors has manageable toxicity and hopeful efficacy in patients with uHCC.
基金the CAMS Innovation Fund for Medical Sciences,No.2021-I2M-1-061 and 2021-1-I2M-003CSCOhengrui Cancer Research Fund,No.Y-HR2019-0239+1 种基金CSCO-MSD Cancer Research Fund,No.Y-MSDZD2021-0213National Ten-thousand Talent Program。
文摘BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Many patients have reached the advanced stage when the second primary tumor is found,resulting in no early intervention and treatment.This is due to the misunderstanding of MPMTs by clinicians,who treat such tumors as metastases.Therefore,before a patient has a second primary tumor,doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient.AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization.METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively.They were divided into metachronous MPMT and synchronous MPMT groups,and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted.Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test,respectively.A P value<0.05 was considered as statistically significant,and SPSS version 26.0(SPSS Inc.,Chicago,Illinois,United States)was used for statistical analysis.RESULTS Among the 1902 patients with MPMTs confirmed by pathology,1811(95.2%)cases were secondary primary cancers,89(4.7%)cases were tertiary primary cancers,and 2(0.1%)cases were quaternary primary cancers.Most(88.2%)of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer.The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows:Breast cancer,thyroid cancer,nonuterine cancer,lung cancer,colon cancer,kidney cancer,uterine cancer,bladder cancer,rectal cancer,and gastric cancer.The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer(11.6%),the highest incidence rate of the second primary cancer was still lung cancer(24.9%),the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer(32.7%),and the highest incidence rate of the second primary cancer was lung cancer(20.8%).Among them,breast cancer,nonuterine cancer and uterine cancer were female-specific malignant tumor types,and thyroid cancer also accounted for 79.6%of female patients.The top five metachronous cancer combinations,independent of female-specific malignant tumor types and thyroid cancer,were colon cancer and lung cancer(26 cases),kidney cancer and lung cancer(25 cases),rectal cancer and lung cancer(20 cases),gastric cancer and lung cancer(17 cases),and bladder cancer and lung cancer(17 cases).The most common synchronous cancer combination was colon cancer and rectal cancer(15 cases).CONCLUSION Screening for lung cancer should be performed six months after the detection of colon cancer while rectal cancer screening should be performed within six months.
基金Supported by the National Natural Science Foundation of China Youth Training Project,No.2021GZR003Medical-engineering Interdisciplinary Research Youth Training Project,No.2022YGJC001.
文摘BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver resection.Heparin,an established anticoagulant,can protect liver function through a number of mechanisms,and thus,prevent liver failure.AIM To look at the safety and efficacy of heparin in preventing hepatic dysfunction after hepatectomy.METHODS The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III(MIMIC-III)v1.4 pinpointed patients who had undergone hepatectomy for liver cancer,subdividing them into two cohorts:Those who were injected with heparin and those who were not.The statistical evaluations used were unpaired ttests,Mann-Whitney U tests,chi-square tests,and Fisher’s exact tests to assess the effect of heparin administration on PHLF,duration of intensive care unit(ICU)stay,need for mechanical ventilation,use of continuous renal replacement therapy(CRRT),incidence of hypoxemia,development of acute kidney injury,and ICU mortality.Logistic regression was utilized to analyze the factors related to PHLF,with propensity score matching(PSM)aiming to balance the preoperative disparities between the two groups.RESULTS In this study,1388 patients who underwent liver cancer hepatectomy were analyzed.PSM yielded 213 matched pairs from the heparin-treated and control groups.Initial univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched samples.Further analysis in the matched cohorts confirmed a significant association,with heparin reducing the risk of PHLF(odds ratio:0.518;95%confidence interval:0.295-0.910;P=0.022).Additionally,heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations,diminished requirements for respiratory support and CRRT,and lower incidences of hypoxemia and ICU mortality.CONCLUSION Liver failure is an important hazard following hepatic surgery.During ICU care heparin administration has been proved to decrease the occurrence of hepatectomy induced liver failure.This indicates that heparin may provide a hopeful option for controlling PHLF.
基金Project supported by the National Key Research and Development Program of China (Grant No. 2023YFA1406500)the National Natural Science Foundation of China (Grant Nos. 12474098, 12274388, 12174361, 12404043, and 12204004)the Natural Science Foundation of Anhui Province, China (Grant No. 2408085QA024)。
文摘The exploration and synthesis of new materials are important for materials science and condensed matter physics.Here, we report the crystal structure, magnetic properties, and electrical transport properties of the single crystals of Nd_(5)ScSb_(12), which is a quasi-one-dimensional new compound. Nd_(5)ScSb_(12) exhibits antiferromagnetic transition in both directions perpendicular and parallel to the long axis. Moreover, the magnetic field-dependent magnetization reveals two metamagnetic transitions. The electrical transport properties have been measured on the same sample but with different measurement lengths between the electrodes of the voltage. The resistivity exhibits the metallic behavior. At low temperatures, the Kondo effect and negative transverse magnetoresistance(MR)(B⊥I) have been observed. Interestingly, the measurement length has a significant impact on the Kondo effect and negative MR, providing an intuitive new approach to regulate the Kondo effect. As the measurement length increases, the Kondo effect and negative MR become more pronounced. This not only indicates that the interaction between magnetic impurities and conduction electrons dominates the electrical transport of Nd_(5)ScSb_(12) at low temperatures, but also confirms that the negative MR originates from the suppression of the Kondo effect.
基金Project supported by the National Key Research and Development Program of China (Grant No. 2023YFA1406500)the National Natural Science Foundation of China (Grant Nos. 12474098, 12274388, 12174361, 12404191, 52102333, 12404043, and 12204004)the Natural Science Foundation of Anhui Province (Grant No. 2408085QA024)。
文摘We report the magnetic and transport properties of EuBi_(2) single crystal. EuBi_(2) exhibits complex magnetic behavior at low temperatures. In both the in-plane and out-of-plane directions, three antiferromagnetic(AFM) transitions have been observed at T_(N1)~18.9 K, T_(N2)~7.0 K, and T_(N3)~3.1 K. Among them, the transitions at T_(N2) and T_(N3) represent the canted AFM orders with ferromagnetic components. As the magnetic field increases, the transition at T_(N3) is rapidly suppressed to disappearance. However, the transitions at T_(N1) and T_(N2) persist until high fields and their signatures can also be reflected in the resistivity and specific heat. Above the magnetic transition temperature T_(N1), the resistivity of EuBi_(2) increases linearly with temperature, exhibiting the strange-metal behavior. In the magnetically ordered region below T_(N1), EuBi_(2) exhibits the weak antilocalization(WAL) effect and large magnetoresistance(475% at 1.8 K and 14 T). It is suggested that the magnetic ordering significantly enhances the spin–orbital coupling interaction and induces the WAL effect.
基金Supported by the National Natural Science Foundation of China Youth Training Project,No.2021GZR003and Medical-engineering Interdisciplinary Research Youth Training Project,No.2022YGJC001.
文摘BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.
基金This study was funded by the National Science and Technology R&D Programme,as a part of the 12^(th) Five_Year Plan of China(No.2012BAI32B08).
文摘Objective:This large-scale cross-sectional study aims to identify the characteristics of and risk factors associated with sexual repression among internal migrants in China.Methods:Between August 2013 and August 2015,a total of 8,669 internal migrants from four major cities in China(Beijing,Shanghai,Chengdu,and Chongqing)voluntarily participated in our study.They were interviewed,and the data on their demographic information,occupation,and sexual activities were collected.The Chi-square test and multiple logistic regressions were conducted to identify significant associations.A stepwise method was adopted for the selection of variables.Results:There were 3,597(41.49%)males and 5,072(58.51%)females in total.A higher percentage of males reported that they felt sexual repression compared to females(14.43%vs.9.21%).After adjusting for other covariates,the consequence was showed that male migrants working for more than 5 days were more likely to report sexual repression(odds ratio[OR]=1.40,P<0.05).Living in a collective dormitory with others was also a risk factor for male migrants.The longer males spent with their partners,the less sexual repression occurred(OR=0.94,P<0.05).Similarly,agricultural household registration status and working for more than 5 days increased the risk for sexual repression among female migrants(OR=1.41 and OR=1.46,respectively,P<0.05).Frequent and constructive communication also protected females against sexual repression(P<0.05).Well-educated females experienced relatively less sexual repression when compared to their counterparts with less education(P<0.05).Conclusions:Sexual repression was significantly associated with a few demographic,occupational,and sexual risk factors.Meaningful differences have been identified between male and female migrants.More effective intervention programs such as safeguard measures and welfare policies should be designed and implemented for a majority of female migrants and for those with agricultural household registration status.
