Urban eco-environmental management is a key focus in the modernization of national governance systems and governance capacity.Advanced information technology should be used to identify ecological problems in urban are...Urban eco-environmental management is a key focus in the modernization of national governance systems and governance capacity.Advanced information technology should be used to identify ecological problems in urban areas accurately while enhancing the environmental management capacity to promote the sustainable development of cities.This study centers on statistical data from PM_(2.5)air monitoring stations in Shenzhen,China,and supplemental data,such as population distribution data from China Unicom’s mobile phone signaling.Data cleaning and fusion are used to construct a spatial dataset of an eco-environmental problem:PM_(2.5)concentrations.The geostatistical analysis tool ArcGIS is used to identify the most suitable interpolation method for reflecting this eco-environmental problem based on multiple parameter adjustments and repeated testing.A hotspot distribution map of PM_(2.5)concentrations is generated,and correlation analysis is conducted on the population density and distribution patterns in these hotspot areas.This enables the quantitative analysis and exploration of the spatial characteristics and coupling relationships of PM_(2.5)concentrations.The results show a positive correlation between the PM_(2.5)concentration distribution and the points of interest,road network density,number of dead-end roads,and average building height in Shenzhen.No correlation is found between population and building densities and the PM_(2.5)concentration distribution,possibly due to the city’s effective environmental management and pollution control measures.These findings help advance the development of precise,scientific,legally compliant pollution control strategies and decision-making processes.Furthermore,they provide technical support for urban eco-environmental planning,management,and sustainable development.展开更多
Based on the concept of“Lucid waters and lush mountains are invaluable assets”,Chinese government is relying on the ecological and environmental characteristics of cities,in combination with modern ecological,econom...Based on the concept of“Lucid waters and lush mountains are invaluable assets”,Chinese government is relying on the ecological and environmental characteristics of cities,in combination with modern ecological,economic,and sociological theories,to achieve sustainable urban development.However,the value realization of ecological products(EP)faces challenges in four major aspects:quantification,trading,transformation,and sustainability.At this stage,seeking breakthroughs to form a stable development path for the realization of the value of EPs is crucial.This paper examines the Guilin Sustainable Development Innovation Demonstration Zone and conducts a case study on oil tea,a characteristic EP.Based on the value realization of EPs,this paper analyzes the oil tea industry in terms of three functions:ecological protection,regional economic development,and traditional cultural support.Drawing on the theory of the gross ecosystem product,this paper examines the role of the value realization of oil tea in improving the quality of the urban living environment and ecosystem functions in Guilin.The results can help promote research on the shaping effects of endemic EPs on sustainable development with respect to the urban economy.Taking a human-centered perspective,the principles of landsenses ecology and traditional ecological knowledge can help analyze the social,historical,and cultural value of oil tea.Combined with on-site research data,a relationship map centered on oil tea culture is created to explore the importance of developing traditional cultural attributes of local EPs in promoting cultural customs,protecting the cultural diversity of ethnic minorities,and driving the development of the cultural tourism industry.By constructing a sustainable urban development model centered on developing local characteristic EPs with the core elements of ecology-economy-traditional culture,this paper aims to strengthen the ecological protection function of cities,promote high-quality economic development,and enhance the soft power of traditional culture.It provides scientific support for the sustainable development planning in Guilin.展开更多
Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and preve...Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and assessing whether the economic burden of cancer is affordable to the governments.展开更多
Objective:To describe the contemporary trends in total,inpatient,and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in China's Mainland.Methods:Home page of Inpatient ...Objective:To describe the contemporary trends in total,inpatient,and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in China's Mainland.Methods:Home page of Inpatient Medical Records(HIMRs)and Hospital Annual Reports(HARs)were used to estimate hospital care expenditure on cancer.Inpatient payments and their share of cancer were calculated with the top-down method.Kriging spatial interpolation methods were used at the county level and summed at the province level.Outpatient expenditure was estimated with inpatient expenditure and the ratios of outpatient to inpatient payments in specialized cancer hospitals,stratified by province.Total expenditure on cancer was the sum of both payments.Log-linear regression was applied to estimate annual percentage change(APC)of expenditure.Results:Total expenses for cancer of Chinese residents reached up to 304.84 billion Chinese Yuan(CNY)in2017,accounting for 5.8%of the total health expenses(THE).After adjusting for consumer price index(CPI),medical expenses for cancer have increased from 63.30 billion CNY in 2008 to 249.56 billion CNY in 2017[APC:15.2%,95%confidence interval(95%CI):13.4%-17.0%].The APC was slightly higher than THE around 2013,while was lower after 2013.During 2008-2017,the ratio of inpatient to outpatient costs for cancer decreased from4.3:1 to 3.8:1.The inpatient payments for cancer mainly happened in grade 3 general hospitals,East China,and among lung,colorectal,and stomach cancer;while the fastest increase was found in West China,and among thyroid,prostate,and colorectal cancer.Conclusions:During 2008-2017,the rapid growth trend of medical expenses for cancer has been effectively controlled with the continuous deepening of medical reform and improvements of residents’health care.More attention should be paid to potential increases of medical costs caused by technological progress and demand release.Socialized and multi-channel insurance financing modes should be explored in the future.展开更多
In the early December 2019,a novel coronavirus named severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan,China,followed by an outbreak that spread around the world.Numerous studies have shown t...In the early December 2019,a novel coronavirus named severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan,China,followed by an outbreak that spread around the world.Numerous studies have shown that liver injury is common in patients with coronavirus disease 2019(COVID-19),and may aggravate the severity of the disease.However,the exact cause and specific mechanism of COVID-associated liver injury needs to be elucidated further.In this review,we present an analysis of the clinical features,potential mechanisms,and treatment strategies for liver injury associated with COVID-19.We hope that this review would benefit clinicians in devising better strategies for management of such patients.展开更多
Even though immune checkpoint inhibitors(ICIs)are effective on multiple cancer types,there are still many non-responding patients.A possible factor put forward that may influence the efficacy of ICIs is the gut microb...Even though immune checkpoint inhibitors(ICIs)are effective on multiple cancer types,there are still many non-responding patients.A possible factor put forward that may influence the efficacy of ICIs is the gut microbiota.Additionally,faecal microbiota transplantation may enhance efficacy of ICIs.Nevertheless,the data available in this field are insufficient,and relevant scientific work has just commenced.As a result,the current work reviewed the latest research on the association of gut microbiota with ICI treatments based on anti-programmed cell death protein 1 antibody and anti-cytotoxic T-lymphocyte-associated protein 4 antibody and explored the therapeutic potential of faecal microbiota transplantation in combination with ICI therapy in the future.展开更多
With the high incidence of diabetes around the world,ischemic complications cause a serious influence on people’s production and living.Neovascularization plays a significant role in its development.Therefore,neovasc...With the high incidence of diabetes around the world,ischemic complications cause a serious influence on people’s production and living.Neovascularization plays a significant role in its development.Therefore,neovascularization after diabetic ischemia has aroused attention and has become a hot spot in recent years.Neovascularization is divided into angiogenesis represented by atherosclerosis and arteriogenesis characterized by coronary collateral circulation.When mononuclear macrophages successively migrate to the ischemia anoxic zone after ischemia or hypoxia,they induce the secretion of cytokines,such as vascular endothelial growth factor and hypoxia-inducible factor,activate signaling pathways such as classic Wnt and phosphatidylinositol 3 kinase(PI3K)/protein kinase B(Akt)pathways,trigger oxidative stress response,activate endothelial progenitor cells or enter the glycolysis or lactic acid process and promote the formation of new blood vessels,remodeling them into mature blood vessels and restoring blood supply.However,the hypoglycemic condition has different impacts on neovascularization.Consequently,this review aimed to introduce the mechanisms of neovascularization after diabetic ischemia,increase our understanding of diabetic ischemic complications and their therapies and provide more treatment options for clinical practice and effectively relieve patients’pain.It is believed that in the near future,neovascularization will bring more benefits and hope to patients with diabetes.展开更多
Objective： We analyzed the proportion of cancer-caused hospitalization expenses in total hospitalization expenses from national authoritative data and explored influencing factors of the proportion so as to provide e...Objective： We analyzed the proportion of cancer-caused hospitalization expenses in total hospitalization expenses from national authoritative data and explored influencing factors of the proportion so as to provide effective data information for more rational utilization of health resources.Methods： Two-level lineal regression model was used to explore influencing factors of ratios of the cancer inpatient expenditure over the total inpatient expenditure of hospitals in China in 2015. A total of 40.76 million inpatient medical records were used to generate the outcome variables, while the explanatory variables were from hospital information database and China Health and Family Planning Statistical Yearbook and literatures.Results： Inpatient expenditure pattern for cancer（IEPC） varied largely across provinces, ranging from 3.03% to19.61%. The major sources of variability were from the differences of hospital level and number of beds. There was homogeneity within a province, while heterogeneity between the provinces. Rising one level of the hospital led to the increase of 0.475 natural logarithm units of IEPC averagely. The number of beds increasing 1,000 each made the natural logarithm of IEPC increase one unit averagely.Conclusions： Our study showed that a considerable proportion of IEPC variation could be explained by the differences of hospital level and number of beds. It implied that it is possible to estimate disease-specific ratio of inpatient expense taking into account key influencing factors in China. Furthermore, this study is an input to economic and financial analyses and provides evidence for future study on the national economic burden of cancer.展开更多
In the last century, there has been a significant development in the evaluation of methods to predict ground movement due to underground extraction. Some remarkable developments in three-dimensional computational meth...In the last century, there has been a significant development in the evaluation of methods to predict ground movement due to underground extraction. Some remarkable developments in three-dimensional computational methods have been supported in civil engineering, subsidence engineering and mining engineering practice. However, ground movement problem due to mining extraction sequence is effectively four dimensional （4D）. A rational prediction is getting more and more important for long-term underground mining planning. Hence, computer-based analytical methods that realistically simulate spatially distributed time-dependent ground movement process are needed for the reliable long-term underground mining planning to minimize the surface environmental damages. In this research, a new computational system is developed to simulate four-dimensional （4D） ground movement by combining a stochastic medium theory, Knothe time-delay model and geographic information system （GIS） technology. All the calculations are implemented by a computational program, in which the components of GIS are used to fulfill the spatial-temporal analysis model. In this paper a tight coupling strategy based on component object model of GIS technology is used to overcome the problems of complex three-dimensional extraction model and spatial data integration. Moreover, the implementation of computational of the interfaces of the developed tool is described. The GIS based developed tool is validated by two study cases. The developed computational tool and models are achieved within the GIS system so the effective and efficient calculation methodology can be obtained, so the simulation problems of 4D ground movement due to underground mining extraction sequence can be solved by implementation of the developed tool in GIS.展开更多
Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further contro...Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.展开更多
BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still ...BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge.AIM To evaluate the effectiveness and safety of an over-the-scope clip(OTSC)in the treatment of perforation post-endoscopic resection of duodenal SELs.METHODS From May 2015 to November 2019,18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs.Data comprising the rate of complete resection,closure of intraprocedural perforation,delayed bleeding,delayed perforation,and postoperative infection were extracted.RESULTS The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%.The median perforation size was 1 cm in diameter.Seventeen patients had minor intraoperative bleeding,while the remaining 1 patient had considerable amount of bleeding during the procedure.Seven patients had postoperative abdominal infections,of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock.All 18 patients recovered and were discharged.No delayed bleeding or perforation was reported.The mean time taken to resume normal diet after the procedure was 6.5 d.The mean postoperative hospital stay was 9.5 d.No residual or recurrent lesions were detected during the follow-up period(15-66 mo).CONCLUSION Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method.展开更多
基金supported by the National Key Research and Development Program of China under the theme“Research on urban sustainable development evaluation data fusion management technology”[Grant No.2022YFC3802903]Open Fund of Key Laboratory of Urban Land Resources Monitoring and Simulation,Ministry of Natural Resources[Grant No.KF-2022-07-013]。
文摘Urban eco-environmental management is a key focus in the modernization of national governance systems and governance capacity.Advanced information technology should be used to identify ecological problems in urban areas accurately while enhancing the environmental management capacity to promote the sustainable development of cities.This study centers on statistical data from PM_(2.5)air monitoring stations in Shenzhen,China,and supplemental data,such as population distribution data from China Unicom’s mobile phone signaling.Data cleaning and fusion are used to construct a spatial dataset of an eco-environmental problem:PM_(2.5)concentrations.The geostatistical analysis tool ArcGIS is used to identify the most suitable interpolation method for reflecting this eco-environmental problem based on multiple parameter adjustments and repeated testing.A hotspot distribution map of PM_(2.5)concentrations is generated,and correlation analysis is conducted on the population density and distribution patterns in these hotspot areas.This enables the quantitative analysis and exploration of the spatial characteristics and coupling relationships of PM_(2.5)concentrations.The results show a positive correlation between the PM_(2.5)concentration distribution and the points of interest,road network density,number of dead-end roads,and average building height in Shenzhen.No correlation is found between population and building densities and the PM_(2.5)concentration distribution,possibly due to the city’s effective environmental management and pollution control measures.These findings help advance the development of precise,scientific,legally compliant pollution control strategies and decision-making processes.Furthermore,they provide technical support for urban eco-environmental planning,management,and sustainable development.
基金supported by the National Key Research and Development Program of China“Research on urban sustainable development evaluation data fusion management technology”[Grant No.2022YFC3802903]the Strategic Priority Research Program of the Chinese Academy of Sciences[Grant No.XDA23030403].
文摘Based on the concept of“Lucid waters and lush mountains are invaluable assets”,Chinese government is relying on the ecological and environmental characteristics of cities,in combination with modern ecological,economic,and sociological theories,to achieve sustainable urban development.However,the value realization of ecological products(EP)faces challenges in four major aspects:quantification,trading,transformation,and sustainability.At this stage,seeking breakthroughs to form a stable development path for the realization of the value of EPs is crucial.This paper examines the Guilin Sustainable Development Innovation Demonstration Zone and conducts a case study on oil tea,a characteristic EP.Based on the value realization of EPs,this paper analyzes the oil tea industry in terms of three functions:ecological protection,regional economic development,and traditional cultural support.Drawing on the theory of the gross ecosystem product,this paper examines the role of the value realization of oil tea in improving the quality of the urban living environment and ecosystem functions in Guilin.The results can help promote research on the shaping effects of endemic EPs on sustainable development with respect to the urban economy.Taking a human-centered perspective,the principles of landsenses ecology and traditional ecological knowledge can help analyze the social,historical,and cultural value of oil tea.Combined with on-site research data,a relationship map centered on oil tea culture is created to explore the importance of developing traditional cultural attributes of local EPs in promoting cultural customs,protecting the cultural diversity of ethnic minorities,and driving the development of the cultural tourism industry.By constructing a sustainable urban development model centered on developing local characteristic EPs with the core elements of ecology-economy-traditional culture,this paper aims to strengthen the ecological protection function of cities,promote high-quality economic development,and enhance the soft power of traditional culture.It provides scientific support for the sustainable development planning in Guilin.
基金supported by National Natural Science Foundation of China (No.71403189)
文摘Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and assessing whether the economic burden of cancer is affordable to the governments.
基金supported by the National Key Research and Development Program of China(No.2018YFC 1311704)。
文摘Objective:To describe the contemporary trends in total,inpatient,and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in China's Mainland.Methods:Home page of Inpatient Medical Records(HIMRs)and Hospital Annual Reports(HARs)were used to estimate hospital care expenditure on cancer.Inpatient payments and their share of cancer were calculated with the top-down method.Kriging spatial interpolation methods were used at the county level and summed at the province level.Outpatient expenditure was estimated with inpatient expenditure and the ratios of outpatient to inpatient payments in specialized cancer hospitals,stratified by province.Total expenditure on cancer was the sum of both payments.Log-linear regression was applied to estimate annual percentage change(APC)of expenditure.Results:Total expenses for cancer of Chinese residents reached up to 304.84 billion Chinese Yuan(CNY)in2017,accounting for 5.8%of the total health expenses(THE).After adjusting for consumer price index(CPI),medical expenses for cancer have increased from 63.30 billion CNY in 2008 to 249.56 billion CNY in 2017[APC:15.2%,95%confidence interval(95%CI):13.4%-17.0%].The APC was slightly higher than THE around 2013,while was lower after 2013.During 2008-2017,the ratio of inpatient to outpatient costs for cancer decreased from4.3:1 to 3.8:1.The inpatient payments for cancer mainly happened in grade 3 general hospitals,East China,and among lung,colorectal,and stomach cancer;while the fastest increase was found in West China,and among thyroid,prostate,and colorectal cancer.Conclusions:During 2008-2017,the rapid growth trend of medical expenses for cancer has been effectively controlled with the continuous deepening of medical reform and improvements of residents’health care.More attention should be paid to potential increases of medical costs caused by technological progress and demand release.Socialized and multi-channel insurance financing modes should be explored in the future.
基金Supported by Program of Taizhou Science and Technology Grant,No.20ywb29Medical Health Science and Technology Project of Zhejiang Province,No.2021PY083,and No.2019KY239+1 种基金Key Technology Research and Development Program of Zhejiang Province,No.2019C03040Major Research Program of Taizhou Enze Medical Center Grant,No.19EZZDA2.
文摘In the early December 2019,a novel coronavirus named severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan,China,followed by an outbreak that spread around the world.Numerous studies have shown that liver injury is common in patients with coronavirus disease 2019(COVID-19),and may aggravate the severity of the disease.However,the exact cause and specific mechanism of COVID-associated liver injury needs to be elucidated further.In this review,we present an analysis of the clinical features,potential mechanisms,and treatment strategies for liver injury associated with COVID-19.We hope that this review would benefit clinicians in devising better strategies for management of such patients.
基金Science Research Start-up Fund for Doctor of Shanxi Medical University,No.XD1807Science Research Start-up Fund for Doctor of Shanxi Province,No.SD1807+1 种基金Scientific and Technological Innovation Programs of Higher Education Institutions in Shanxi,No.2019L0425Shanxi Province Science Foundation for Youths,No.201901D211314.
文摘Even though immune checkpoint inhibitors(ICIs)are effective on multiple cancer types,there are still many non-responding patients.A possible factor put forward that may influence the efficacy of ICIs is the gut microbiota.Additionally,faecal microbiota transplantation may enhance efficacy of ICIs.Nevertheless,the data available in this field are insufficient,and relevant scientific work has just commenced.As a result,the current work reviewed the latest research on the association of gut microbiota with ICI treatments based on anti-programmed cell death protein 1 antibody and anti-cytotoxic T-lymphocyte-associated protein 4 antibody and explored the therapeutic potential of faecal microbiota transplantation in combination with ICI therapy in the future.
基金Supported by the National Natural Science Foundation of China,No.82070455the Related Foundation of Jiangsu Province,No.BK20201225+1 种基金the Medical Innovation Team Project of Jiangsu Province,No.CXTDA2017010the Postgraduate Research and Practice Innovation Program of Jiangsu Province,No.KYCX20_3051.
文摘With the high incidence of diabetes around the world,ischemic complications cause a serious influence on people’s production and living.Neovascularization plays a significant role in its development.Therefore,neovascularization after diabetic ischemia has aroused attention and has become a hot spot in recent years.Neovascularization is divided into angiogenesis represented by atherosclerosis and arteriogenesis characterized by coronary collateral circulation.When mononuclear macrophages successively migrate to the ischemia anoxic zone after ischemia or hypoxia,they induce the secretion of cytokines,such as vascular endothelial growth factor and hypoxia-inducible factor,activate signaling pathways such as classic Wnt and phosphatidylinositol 3 kinase(PI3K)/protein kinase B(Akt)pathways,trigger oxidative stress response,activate endothelial progenitor cells or enter the glycolysis or lactic acid process and promote the formation of new blood vessels,remodeling them into mature blood vessels and restoring blood supply.However,the hypoglycemic condition has different impacts on neovascularization.Consequently,this review aimed to introduce the mechanisms of neovascularization after diabetic ischemia,increase our understanding of diabetic ischemic complications and their therapies and provide more treatment options for clinical practice and effectively relieve patients’pain.It is believed that in the near future,neovascularization will bring more benefits and hope to patients with diabetes.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective： We analyzed the proportion of cancer-caused hospitalization expenses in total hospitalization expenses from national authoritative data and explored influencing factors of the proportion so as to provide effective data information for more rational utilization of health resources.Methods： Two-level lineal regression model was used to explore influencing factors of ratios of the cancer inpatient expenditure over the total inpatient expenditure of hospitals in China in 2015. A total of 40.76 million inpatient medical records were used to generate the outcome variables, while the explanatory variables were from hospital information database and China Health and Family Planning Statistical Yearbook and literatures.Results： Inpatient expenditure pattern for cancer（IEPC） varied largely across provinces, ranging from 3.03% to19.61%. The major sources of variability were from the differences of hospital level and number of beds. There was homogeneity within a province, while heterogeneity between the provinces. Rising one level of the hospital led to the increase of 0.475 natural logarithm units of IEPC averagely. The number of beds increasing 1,000 each made the natural logarithm of IEPC increase one unit averagely.Conclusions： Our study showed that a considerable proportion of IEPC variation could be explained by the differences of hospital level and number of beds. It implied that it is possible to estimate disease-specific ratio of inpatient expense taking into account key influencing factors in China. Furthermore, this study is an input to economic and financial analyses and provides evidence for future study on the national economic burden of cancer.
文摘In the last century, there has been a significant development in the evaluation of methods to predict ground movement due to underground extraction. Some remarkable developments in three-dimensional computational methods have been supported in civil engineering, subsidence engineering and mining engineering practice. However, ground movement problem due to mining extraction sequence is effectively four dimensional （4D）. A rational prediction is getting more and more important for long-term underground mining planning. Hence, computer-based analytical methods that realistically simulate spatially distributed time-dependent ground movement process are needed for the reliable long-term underground mining planning to minimize the surface environmental damages. In this research, a new computational system is developed to simulate four-dimensional （4D） ground movement by combining a stochastic medium theory, Knothe time-delay model and geographic information system （GIS） technology. All the calculations are implemented by a computational program, in which the components of GIS are used to fulfill the spatial-temporal analysis model. In this paper a tight coupling strategy based on component object model of GIS technology is used to overcome the problems of complex three-dimensional extraction model and spatial data integration. Moreover, the implementation of computational of the interfaces of the developed tool is described. The GIS based developed tool is validated by two study cases. The developed computational tool and models are achieved within the GIS system so the effective and efficient calculation methodology can be obtained, so the simulation problems of 4D ground movement due to underground mining extraction sequence can be solved by implementation of the developed tool in GIS.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.
基金Supported by Program of Taizhou Science and Technology Grant,No.20ywb29Medical Health Science and Technology Project of Zhejiang Province,No.2021PY083 and No.2019KY239+2 种基金Key Technology Research and Development Program of Zhejiang Province,No.2019C03040Major Research Program of Taizhou Enze Medical Center Grant,No.19EZZDA2Open Fund of Key Laboratory of Key Laboratory of Minimally Invasive Techniques&Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province,No.21SZDSYS01 and No.21SZDSYS09。
文摘BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge.AIM To evaluate the effectiveness and safety of an over-the-scope clip(OTSC)in the treatment of perforation post-endoscopic resection of duodenal SELs.METHODS From May 2015 to November 2019,18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs.Data comprising the rate of complete resection,closure of intraprocedural perforation,delayed bleeding,delayed perforation,and postoperative infection were extracted.RESULTS The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%.The median perforation size was 1 cm in diameter.Seventeen patients had minor intraoperative bleeding,while the remaining 1 patient had considerable amount of bleeding during the procedure.Seven patients had postoperative abdominal infections,of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock.All 18 patients recovered and were discharged.No delayed bleeding or perforation was reported.The mean time taken to resume normal diet after the procedure was 6.5 d.The mean postoperative hospital stay was 9.5 d.No residual or recurrent lesions were detected during the follow-up period(15-66 mo).CONCLUSION Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method.
