In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice productio...In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice production. In order to curb the recurrence momentum of rice C. suppressalis,according to the dynamic monitoring and field system survey of rice C. suppressalis in Longyou County since 2015,the causes of the annual increase of rice C. suppressalis in recent years were analyzed,and the recurrence area of C. suppressalis was introduced,and finally some prevention and control measures were put forward.展开更多
BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and...BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and recurrence after epiblepharon correction inchildren, to remove accurately redundant epiblepharon and orbicularis oculimuscle in patients via the cilia-everting suture technique combined with lidmargin splitting in some patients due to inverted lashes in the medial part of theeyelid, and to observe the therapeutic effect.METHODS From 2015 to 2019, in the Outpatient Department of Ophthalmology of BeijingTongren Hospital, 22 children (40 eyes) with epiblepharon, aged 5-12 years, weretreated due to correction failure and recurrence. Fourteen patients (28 eyes)underwent the full-thickness everting suture technique, and eight patients (16eyes) underwent incisional surgery. They were treated by reviewing the previoussurgical methods and observing epiblepharon, eyelash direction, and cornealinjury. During reoperation, a subciliary incision was made 1 mm below theinferior lash line. Incisional surgery for the lower eyelid was used to removeaccurately redundant epiblepharon and part of the pretarsal orbicularis muscle.Subcutaneous tissue and the orbicularis muscle of the upper skin-muscle flapwere anchored to the anterior fascia of the tarsal plate by rotational sutures. Lidmargin splitting was used only for patients who had seriously inverted lasheslocated in the medial part of the eyelid. All patients were followed for 6-12 moafter reoperation to observe the lower eyelid position, skin incision, eyelash direction, corneal damage, and recurrence.RESULTS After reoperation, all the patients were corrected. Photophobia, rubbing the eye,winking, and tearing disappeared. There was no lower eyelid entropion,ectropion, or retraction. There was no obvious sunken scar or lower eyelid crease.The eyelashes were far away from the cornea, and when the patients lookeddown, the eyelashes on the lower eyelid did not contact the cornea or conjunctiva.The corneal injuries were repaired. Follow-up observation for 6 mo showed norecurrence of epiblepharon.CONCLUSION The type of suture method, the failure to remove accurately redundant skin andorbicularis muscle, the lack of cilia rotational suture use, and excessive reversegrowth of eyelashes are the main causes of failure and recurrence afterepiblepharon correction in children.展开更多
Natural disasters usually involve a phenomenon with consequences that exceed the response capabilities of local communities and have a significant impact on the region’s socioeconomic development. Droughts, floods, a...Natural disasters usually involve a phenomenon with consequences that exceed the response capabilities of local communities and have a significant impact on the region’s socioeconomic development. Droughts, floods, and hurricanes are all natural disasters that jeopardize the environment and the lives of Somalis. Severe floods have devastated the south and central parts of the country multiple times, destroying infrastructure and homes and killing many vulnerable people. Droughts in the south and central parts of the country, particularly in the Middle Shebelle region, have killed a number of children and mothers. It also had a negative influence on crops and cattle. Objective of this study is to know the recurrence of Natural Disasters in Jowhar, Middle Shabelle region, Somalia: The Causes and Impacts. The Somali people are completely aware of natural disasters such as droughts and floods, and they are self-sufficient in dealing with the consequences of these disasters. Furthermore, the Somali government has not fully created environmental laws to protect and conserve the environment, and the majority of laws, rules, acts, and regulations are not used or administered effectively. We also found that the Somali government is not yet financially prepared to deal with these crises, and that there are no strategic plans in the central government or even state administrations to prevent or at least control these disasters from causing extreme harm to the community and the environment.展开更多
AIM To study the local recurrent rate and the causes of rectal cancer after surgery. METHODS The clinicopathological data of 213 rectal cancer patients and the follow up information were analyzed. The overall recu...AIM To study the local recurrent rate and the causes of rectal cancer after surgery. METHODS The clinicopathological data of 213 rectal cancer patients and the follow up information were analyzed. The overall recurrent rate and the recurrent rates from different surgical appreaches were calculated. The main causes of recurrence were investigated. RESULTS Among the 213 cases, 73 (34 27%) had local recurrence. The recurrent time ranged from 3 months to 62 months after the first operation. Most of the recurrence ( 65/73 , 89 04%) occurred within 3 years after operation. CONCLUSION Local recurrence had no significant correlation with surgical methods or pathological types, but closely related to Dukes′ stages, location of primary tumors and the length of the distal rectum resected. Early resection and a wide tumor free resection margin are key factors to prevent local recurrence.展开更多
AIM:To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.METHODS:This was a...AIM:To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.METHODS:This was a single-center,retrospective,descriptive study.The clinical data of 368 patients(387 eyes)with RRD who underwent scleral buckling(SB)surgery between August 2013 and July 2023 at our institution were collected.The aim was to analyze the causes of recurrence and the rationale for selecting reoperation methods.RESULTS:Totally 368 patients(387 eyes)were included in the analysis,comprising 222 males and 146 females.The average age was 30.26±14.18 years,and the mean follow-up duration was(48.33±20.39)mo.The success rate of SB surgery was 90.2%.Recurrent retinal detachment occurred in 38 eyes.Based on surgical records,the causes of SB failure were analyzed.The recurrence causes included abnormal compression ridge position(position,height,or width)in 14 eyes(36.8%,14/38),hole omission in 11 eyes(29.0%,11/38),proliferative vitreoretinopathy(PVR)in 10 eyes(26.3%,10/38),and new holes in 3 eyes(7.9%,3/38).Among these,8 eyes(21.1%,8/38)underwent repeat SB surgery,while the remaining 30 eyes(78.9%,30/38)underwent pars plana vitrectomy(PPV).Regarding tamponade agents,silicone oil was used in 11 eyes(36.7%,11/30),C_(3)F_(8) gas in 12 eyes(40.0%,12/30),and sterile air in 7 eyes(23.3%,7/30).CONCLUSION:SB surgery demonstrates a high success rate in the treatment of RRD.However,abnormal compression ridge position,missed holes during surgery,and PVR are the primary causes of SB failure.After addressing the reasons for failure,re-SB surgery or PPV can be effective alternatives.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
Objectives:Tumor recurrence is a major determinant of poor prognosis in hepatocellular carcinoma(HCC),yet its cellular and molecular basis remains incompletely understood.This study aimed to identify recurrenceassocia...Objectives:Tumor recurrence is a major determinant of poor prognosis in hepatocellular carcinoma(HCC),yet its cellular and molecular basis remains incompletely understood.This study aimed to identify recurrenceassociated genes at single-cell resolution and to develop a prognostic model for predicting survival outcomes and immunotherapy responsiveness in HCC.Methods:Single-cell RNA sequencing data from 12 primary and 6 recurrent HCC samples were integrated and analyzed to identify genes characteristic of recurrence.After quality control,principal component analysis,and t-SNE-based clustering were used to identify highly variable genes for cell clustering and annotation.Based on macrophage characteristic genes,a recurrence-related risk score was constructed using a LASSOCox regression model,and a nomogram integrating clinical variables was developed.Prognostic performance was assessed using Kaplan-Meier analysis and time-dependent ROC curves.Immune infiltration profiling was performed to compare immune characteristics between risk groups defined by the prognostic model.Multivariate Cox regression was applied to identify independent prognostic biomarkers,which were subsequently validated by cell function experiments.Results:The risk model effectively stratified patients into high-and low-risk groups with distinct survival outcomes,demonstrating high predictive accuracy for 1-,3-,and 5-year survival.High-risk patients showed altered immune profiles and a reduced predicted response to immunotherapy.GRID2,RNF186,and SLC4A10 were identified as independent prognostic genes,with RNF186 promoting HCC cell proliferation in a SESN2-dependent manner.Conclusion:This prognostic model provides new insights into precision medicine and immunotherapy for HCC,highlighting the potential clinical significance of RNF186 as a therapeutic target.展开更多
Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurr...Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer,providing evidence-based support for optimizing clinical surgical plans.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023.Patients were divided into Group D1(n=50)and Group D2(n=50)based on the extent of lymph node dissection.Group D1 underwent limited lymph node dissection(dissection of the first station of lymph nodes around the stomach),while Group D2 underwent standard lymph node dissection(dissection of the first and second stations of lymph nodes around the stomach).Surgical-related indicators,the incidence of postoperative complications,the 2-year recurrence rate,and the 2-year survival rate were compared between the two groups of patients.Results:The operative time,intraoperative blood loss,postoperative hospital stay,and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group(all P<0.001).The overall incidence of postoperative complications was higher in the D1 group than in the D2 group,but the difference was not statistically significant(χ^(2)=0.884,P=0.766).After a 2-year follow-up,the recurrence rate was significantly higher in the D1 group than in the D2 group(χ^(2)=4.000,P=0.046).The 2-year survival rate was significantly lower in the D1 group than in the D2 group(χ^(2)=5.005,P=0.025).A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion,degree of differentiation,and lymph node metastasis status,and the recurrence rates of different subgroups were compared.The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage(χ^(2)=5.005,P=0.025),higher in poorly differentiated patients than in moderately and well-differentiated patients(χ^(2)=4.155,P=0.042),and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ^(2)=4.512,P=0.034).Conclusion:Compared with D1 limited lymph node dissection,D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications.Although the surgical trauma is slightly greater,the overall prognosis is better,making it a preferred surgical treatment option for patients with early-stage gastric cancer.展开更多
Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarte...Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile.展开更多
Understanding the levels,causes,and sources of fluoride in groundwater is critical for public health,effective water resource management,and sustainable utilization.This study employs multivariate statistical methods,...Understanding the levels,causes,and sources of fluoride in groundwater is critical for public health,effective water resource management,and sustainable utilization.This study employs multivariate statistical methods,hazard quotient assessment,and geochemical analyses,such as mineral saturation index,ionic activities,and Gibbs diagrams,to investigate the hydrochemical characteristics,causes,and noncarcinogenic risks of fluoride in Red bed groundwater and geothermal water in the Guang'an area and neighboring regions.Approximately 9%of the Red bed groundwater samples contain fluoride concentrations exceeding 1 mg·L^(-1).The predominant water types identified are Cl-Na and HCO_(3)-Na,primarily influenced by evapotranspiration.Low-fluoride groundwater and high-fluoride geothermal water exhibit distinct hydrochemical types HCO_(3)-Ca and SO_(4)-Ca,respectively,which are mainly related to the weathering of carbonate,sulfate,and fluorite-containing rocks.Correlation analysis reveals that fluoride content in Red bed groundwater is positively associated with Na^(+),Cl^(-),SO_(4)^(2-),and TDS(r^(2)=0.45-0.64,p<0.01),while in geothermal water,it correlates strongly with pH,K^(+),Ca^(2+),and Mg^(2+)(r^(2)=0.52-0.80,p<0.05).Mineral saturation indices and ionic activities indicate that ion exchange processes and the dissolution of minerals such as carbonatite and fluorite are important sources of fluoride in groundwater.The enrichment of fluorine in the Red bed groundwater is linked to evaporation,cation exchange and dissolution of fluorite,caused by the lithologic characteristics of the red bed in this area.However,it exhibits minimal correlation with the geothermal water in the adjacent area.The noncarcinogenic health risk assessment indicates that 7%(n=5)of Red bed groundwater points exceed the fluoride safety limit for adults,while 12%(n=8)exceed the limit for children.These findings underscore the importance of avoiding highly fluoridated red bed groundwater as a direct drinking source and enhancing groundwater monitoring to mitigate health risks associated with elevated fluoride levels.展开更多
BACKGROUND In diabetic patients,persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria,resulting in severe complications.Con-sequently,chronic rhinosinusitis(CRS)complicat...BACKGROUND In diabetic patients,persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria,resulting in severe complications.Con-sequently,chronic rhinosinusitis(CRS)complicated by diabetes is highly pre-valent in clinical settings.AIM To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.METHODS A retrospective analysis was conducted on the clinical data of 203 diabetic pa-tients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023.Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial suscept-ibility.Based on a one-year follow-up,patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data.Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.RESULTS Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS.A total of 134 pathogenic bacteria strains were isolated and identified,including 81 strains(60.4%)of gram-positive bacteria and 53 strains(39.6%)of gram-negative bacteria.Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin,while remaining highly sensitive to vancomycin,gentamicin,and rifampicin.Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin,but showed high sensitivity to imipenem,meropenem,cefepime,and ceftazidime.Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels,smoking history,Lund-Mackay scores,visual analog scale(VAS)scores,nasal septum deviation,allergic rhinitis,bronchial asthma,postoperative infection,long-term use of nasal decongestants,and adherence to medical prescriptions.Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.CONCLUSION In CRS patients with nasal polyps(CRSwNP),the detection rate of nasal pathogens is relatively high,and most of the isolated bacteria exhibit antimicrobial resistance.Additionally,the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.展开更多
Early recurrence(ER)following surgery for rectal cancer is a significant factor impacting patient survival rates.Tsai et al identified age,preoperative neoadjuvant therapy,length of hospital stay,tumour location,and p...Early recurrence(ER)following surgery for rectal cancer is a significant factor impacting patient survival rates.Tsai et al identified age,preoperative neoadjuvant therapy,length of hospital stay,tumour location,and pathological stage as factors influencing the risk of ER.Postoperative monitoring for ER should encompass a thorough medical history review,physical examination,tumour marker testing,and imaging studies.Additionally,noninvasive circulating tumour cell DNA testing can be utilized to predict ER.Treatment strategies may involve radical surgery,radiation therapy,chemotherapy,and immunotherapy.Through a comprehensive analysis of risk factors,the optimization of monitoring methods,and the development of personalized treatment strategies,it is anticipated that both the efficacy of treatment and the quality of life for rectal cancer patients with postoperative recurrence can be significantly improved.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is the most common primary liver malignancy.Ablation therapy is one of the first-line treatments for early HCC.Accurately predicting early recurrence(ER)is crucial for making pr...BACKGROUND Hepatocellular carcinoma(HCC)is the most common primary liver malignancy.Ablation therapy is one of the first-line treatments for early HCC.Accurately predicting early recurrence(ER)is crucial for making precise treatment plans and improving patient prognosis.AIM To establish an intratumoral and peritumoral model for predicting ER in HCC patients following curative ablation.METHODS This study included a total of 288 patients from three Centers.The patients were divided into a primary cohort(n=222)and an external cohort(n=66).Radiomics and deep learning methods were combined for feature extraction,and models were constructed following a three-step feature selection process.Model performance was evaluated using the area under the receiver operating characteristic curve(AUC),while calibration curves and decision curve analysis(DCA)were used to assess calibration and clinical utility.Finally,Kaplan-Meier(K-M)analysis was used to stratify patients according to progression-free survival(PFS)and overall survival(OS).RESULTS The combined model,which utilizes the light gradient boosting machine learning algorithm and incorporates both intratumoral and peritumoral regions(5 mm and 10 mm),demonstrated the best predictive performance for ER following HCC ablation,achieving AUCs of 0.924 in the training set,0.899 in the internal validation set,and 0.839 in the external validation set.Calibration and DCA curves confirmed strong calibration and clinical utility,whereas K-M curves provided risk stratification for PFS and OS in HCC patients.CONCLUSION The most efficient model integrated the tumor region with the peritumoral 5 mm and 10 mm regions.This model provides a noninvasive,effective,and reliable method for predicting ER after curative ablation of HCC.展开更多
Hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)presents a significant challenge,with recurrence rates ranging from 8%to 20%globally.Current biomarkers,such as alpha-fetoprotein(AFP)and des-gamm...Hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)presents a significant challenge,with recurrence rates ranging from 8%to 20%globally.Current biomarkers,such as alpha-fetoprotein(AFP)and des-gamma-carboxy prothrombin(DCP),lack specificity,limiting their utility in risk strati-fication.YKL-40,a glycoprotein involved in extracellular matrix remodeling,hepatic stellate cell activation,and immune modulation,has emerged as a promising biomarker for post-LT surveillance.Elevated serum levels of YKL-40 are associated with advanced liver disease,tumor progression,and poorer post-LT outcomes,highlighting its potential to address gaps in early detection and personalized management of HCC recurrence.This manuscript synthesizes clinical and mechanistic evidence to evaluate YKL-40’s predictive utility in post-LT care.While preliminary findings demonstrate its specificity for liver-related pathologies,challenges remain,including assay standardization,lack of pro-spective validation,and the need to distinguish between malignant and non-malignant causes of elevated levels.Integrating YKL-40 into multi-biomarker panels with AFP and DCP could enhance predictive accuracy and enable tailored therapeutic strategies.Future research should focus on multicenter studies to validate YKL-40’s clinical utility,address confounding factors like graft rejection and systemic inflammation,and explore its role in predictive models driven by emerging technologies such as artificial intelligence.YKL-40 holds transformative potential in reshaping post-LT care through precision medicine,providing a pathway for better outcomes and improved management of high-risk LT recipients.展开更多
OBJECTIVE To investigate possible associations between physical function assessment scales,such as Short Physical Performance Battery(SPPB)and Berg Balance Scale(BBS),with all-cause mortality in acute decompensated he...OBJECTIVE To investigate possible associations between physical function assessment scales,such as Short Physical Performance Battery(SPPB)and Berg Balance Scale(BBS),with all-cause mortality in acute decompensated heart failure(ADHF)patients.METHODS A total of 108 ADHF patients were analyzed from October 2020 to October 2022,and followed up to May 2023.The association between baseline clinical characteristics and all-cause mortality was analyzed by univariate Cox regression analysis,while for SPPB and BBS,univariate Cox regression analysis was followed by receiver operating characteristic curves,in which the area under the curve represented their predictive accuracy for all-cause mortality.Incremental predictive values for both physical function assessments were measured by calculating net reclassification index and integrated discrimination improvement scores.Optimal cutoff value for BBS was then identified using restricted cubic spline plots,and survival differences below and above that cut-off were compared using Kaplan-Meier survival curves and the log-rank test.The clinical utility of BBS was measured using decision curve analysis.RESULTS For baseline characteristics,age,female,blood urea nitrogen,as well as statins,angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,or angiotensin receptor-neprilysin inhibitors,were predictive for all-cause mortality for ADHF patients.With respect to SPPB and BBS,higher scores were associated with lower all-cause mortality rates for both assessments;similar area under the curves were measured for both(0.774 for SPPB and 0.776 for BBS).Furthermore,BBS≤36.5 was associated with significantly higher mortality,which was still applicable even adjusting for confounding factors;BBS was also found to have great clinical utility under decision curve analysis.CONCLUSIONS BBS or SPPB could be used as tools to assess physical function in ageing ADHF patients,as well as prognosticate on all-cause mortality.Moreover,prioritizing the improvement of balance capabilities of ADHF patients in cardiac rehabilitation regimens could aid in lowering mortality risk.展开更多
BACKGROUND Mediastinal lymph nodes(MLNs)can be enlarged due to various benign or malignant causes.Endoscopic ultrasound(EUS)is often employed for the acquisition of tissue specimens of the enlarged MLN(EMLN).AIM To de...BACKGROUND Mediastinal lymph nodes(MLNs)can be enlarged due to various benign or malignant causes.Endoscopic ultrasound(EUS)is often employed for the acquisition of tissue specimens of the enlarged MLN(EMLN).AIM To determine the causes,document the symptoms,and determine factors predicting good yield of EUS-guided EMLN biopsy.METHODS All patients having EMLN(>10 mm)on thoracic imaging and referred for EUSguided biopsy were included in this retrospective observational study.Adequacy of the tissue specimen was assessed by the endoscopist with macroscopic on-site evaluation(MOSE)and then sent to a histopathologist for final diagnosis.Analysis for factors predicting good biopsy yield was then performed.RESULTS Of the total 243 patients with EMLN,131(53.9%)were males.The mean age was 47.6(±14.7)and range 14-86 years.Commonest causes of EMLN were tuberculosis 82(33.7%),anthracosis 53(21.8%),neoplastic disease 43(17.7%)and sarcoidosis 14(5.8%).Among the 43 patients with neoplastic diseases:40 had metastatic disease(breast 9,lung 7,pancreatobiliary 6,esophagus 5,kidney 5,hepatocellular 2,neuroendocrine 2,gastrointestinal stromal 1,undetermined 3)and 3 had primary malignancies(lymphoproliferative disorder 2,Kaposi sarcoma 1).Chest related clinical symptoms were absent in more than half the patients with tuberculosis 51/82(62.2%),anthracosis 31/53(58.5%)and neoplastic disease 28/43(65.1%).Factors associated with good biopsy yield were:Subcarinal location of MLN(P=0.026),MLN size>12 mm(P<0.0001),use of fine-needle biopsy(vs fine-needle aspiration)(P=0.049)and satisfactory MOSE(P<0.0001)on univariate analysis;while MLN size>12 mm(P=0.005)and satisfactory MOSE(P<0.0001)on multivariate analysis.CONCLUSION Tuberculosis,anthracosis and metastatic disease were the commonest causes of EMLN.More than half the cases with EMLN had no chest-related symptoms.Large MLN size and satisfactory MOSE observation predicted a good biopsy yield.展开更多
Accurate fault root cause diagnosis is essential for ensuring stable industrial production. Traditional methods, which typically rely on the entire time series and overlook critical local features, can lead to biased ...Accurate fault root cause diagnosis is essential for ensuring stable industrial production. Traditional methods, which typically rely on the entire time series and overlook critical local features, can lead to biased inferences about causal relationships, thus hindering the accurate identification of root cause variables. This study proposed a shapelet-based state evolution graph for fault root cause diagnosis (SEG-RCD), which enables causal inference through the analysis of the important local features. First, the regularized autoencoder and fault contribution plot are used to identify the fault onset time and candidate root cause variables, respectively. Then, the most representative shapelets were extracted to construct a state evolution graph. Finally, the propagation path was extracted based on fault unit shapelets to pinpoint the fault root cause variable. The SEG-RCD can reduce the interference of noncausal information, enhancing the accuracy and interpretability of fault root cause diagnosis. The superiority of the proposed SEG-RCD was verified through experiments on a simulated penicillin fermentation process and an actual one.展开更多
With the rapid development of web technology,Social Networks(SNs)have become one of the most popular platforms for users to exchange views and to express their emotions.More and more people are used to commenting on a...With the rapid development of web technology,Social Networks(SNs)have become one of the most popular platforms for users to exchange views and to express their emotions.More and more people are used to commenting on a certain hot spot in SNs,resulting in a large amount of texts containing emotions.Textual Emotion Cause Extraction(TECE)aims to automatically extract causes for a certain emotion in texts,which is an important research issue in natural language processing.It is different from the previous tasks of emotion recognition and emotion classification.In addition,it is not limited to the shallow-level emotion classification of text,but to trace the emotion source.In this paper,we provide a survey for TECE.First,we introduce the development process and classification of TECE.Then,we discuss the existing methods and key factors for TECE.Finally,we enumerate the challenges and developing trend for TECE.展开更多
Fiber-to-the-Room(FTTR)has emerged as the core architecture for next-generation home and enterprise networks,offering gigabitlevel bandwidth and seamless wireless coverage.However,the complex multi-device topology of ...Fiber-to-the-Room(FTTR)has emerged as the core architecture for next-generation home and enterprise networks,offering gigabitlevel bandwidth and seamless wireless coverage.However,the complex multi-device topology of FTTR networks presents significant chal⁃lenges in identifying sources of network performance degradation and conducting accurate root cause analysis.Conventional approaches often fail to deliver efficient and precise operational improvements.To address this issue,this paper proposes a Transformer-based multi-task learn⁃ing model designed for automated root cause analysis in FTTR environments.The model integrates multidimensional time-series data col⁃lected from access points(APs),enabling the simultaneous detection of APs experiencing performance degradation and the classification of underlying root causes,such as weak signal coverage,network congestion,and signal interference.To facilitate model training and evaluation,a multi-label dataset is generated using a discrete-event simulation platform implemented in MATLAB.Experimental results demonstrate that the proposed Transformer-based multi-task learning model achieves a root cause classification accuracy of 96.75%,significantly outperform⁃ing baseline models including Long Short-Term Memory(LSTM),Gated Recurrent Unit(GRU),Random Forest,and eXtreme Gradient Boost⁃ing(XGBoost).This approach enables the rapid identification of performance degradation causes in FTTR networks,offering actionable in⁃sights for network optimization,reduced operational costs,and enhanced user experience.展开更多
文摘In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice production. In order to curb the recurrence momentum of rice C. suppressalis,according to the dynamic monitoring and field system survey of rice C. suppressalis in Longyou County since 2015,the causes of the annual increase of rice C. suppressalis in recent years were analyzed,and the recurrence area of C. suppressalis was introduced,and finally some prevention and control measures were put forward.
文摘BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and recurrence after epiblepharon correction inchildren, to remove accurately redundant epiblepharon and orbicularis oculimuscle in patients via the cilia-everting suture technique combined with lidmargin splitting in some patients due to inverted lashes in the medial part of theeyelid, and to observe the therapeutic effect.METHODS From 2015 to 2019, in the Outpatient Department of Ophthalmology of BeijingTongren Hospital, 22 children (40 eyes) with epiblepharon, aged 5-12 years, weretreated due to correction failure and recurrence. Fourteen patients (28 eyes)underwent the full-thickness everting suture technique, and eight patients (16eyes) underwent incisional surgery. They were treated by reviewing the previoussurgical methods and observing epiblepharon, eyelash direction, and cornealinjury. During reoperation, a subciliary incision was made 1 mm below theinferior lash line. Incisional surgery for the lower eyelid was used to removeaccurately redundant epiblepharon and part of the pretarsal orbicularis muscle.Subcutaneous tissue and the orbicularis muscle of the upper skin-muscle flapwere anchored to the anterior fascia of the tarsal plate by rotational sutures. Lidmargin splitting was used only for patients who had seriously inverted lasheslocated in the medial part of the eyelid. All patients were followed for 6-12 moafter reoperation to observe the lower eyelid position, skin incision, eyelash direction, corneal damage, and recurrence.RESULTS After reoperation, all the patients were corrected. Photophobia, rubbing the eye,winking, and tearing disappeared. There was no lower eyelid entropion,ectropion, or retraction. There was no obvious sunken scar or lower eyelid crease.The eyelashes were far away from the cornea, and when the patients lookeddown, the eyelashes on the lower eyelid did not contact the cornea or conjunctiva.The corneal injuries were repaired. Follow-up observation for 6 mo showed norecurrence of epiblepharon.CONCLUSION The type of suture method, the failure to remove accurately redundant skin andorbicularis muscle, the lack of cilia rotational suture use, and excessive reversegrowth of eyelashes are the main causes of failure and recurrence afterepiblepharon correction in children.
文摘Natural disasters usually involve a phenomenon with consequences that exceed the response capabilities of local communities and have a significant impact on the region’s socioeconomic development. Droughts, floods, and hurricanes are all natural disasters that jeopardize the environment and the lives of Somalis. Severe floods have devastated the south and central parts of the country multiple times, destroying infrastructure and homes and killing many vulnerable people. Droughts in the south and central parts of the country, particularly in the Middle Shebelle region, have killed a number of children and mothers. It also had a negative influence on crops and cattle. Objective of this study is to know the recurrence of Natural Disasters in Jowhar, Middle Shabelle region, Somalia: The Causes and Impacts. The Somali people are completely aware of natural disasters such as droughts and floods, and they are self-sufficient in dealing with the consequences of these disasters. Furthermore, the Somali government has not fully created environmental laws to protect and conserve the environment, and the majority of laws, rules, acts, and regulations are not used or administered effectively. We also found that the Somali government is not yet financially prepared to deal with these crises, and that there are no strategic plans in the central government or even state administrations to prevent or at least control these disasters from causing extreme harm to the community and the environment.
文摘AIM To study the local recurrent rate and the causes of rectal cancer after surgery. METHODS The clinicopathological data of 213 rectal cancer patients and the follow up information were analyzed. The overall recurrent rate and the recurrent rates from different surgical appreaches were calculated. The main causes of recurrence were investigated. RESULTS Among the 213 cases, 73 (34 27%) had local recurrence. The recurrent time ranged from 3 months to 62 months after the first operation. Most of the recurrence ( 65/73 , 89 04%) occurred within 3 years after operation. CONCLUSION Local recurrence had no significant correlation with surgical methods or pathological types, but closely related to Dukes′ stages, location of primary tumors and the length of the distal rectum resected. Early resection and a wide tumor free resection margin are key factors to prevent local recurrence.
文摘AIM:To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.METHODS:This was a single-center,retrospective,descriptive study.The clinical data of 368 patients(387 eyes)with RRD who underwent scleral buckling(SB)surgery between August 2013 and July 2023 at our institution were collected.The aim was to analyze the causes of recurrence and the rationale for selecting reoperation methods.RESULTS:Totally 368 patients(387 eyes)were included in the analysis,comprising 222 males and 146 females.The average age was 30.26±14.18 years,and the mean follow-up duration was(48.33±20.39)mo.The success rate of SB surgery was 90.2%.Recurrent retinal detachment occurred in 38 eyes.Based on surgical records,the causes of SB failure were analyzed.The recurrence causes included abnormal compression ridge position(position,height,or width)in 14 eyes(36.8%,14/38),hole omission in 11 eyes(29.0%,11/38),proliferative vitreoretinopathy(PVR)in 10 eyes(26.3%,10/38),and new holes in 3 eyes(7.9%,3/38).Among these,8 eyes(21.1%,8/38)underwent repeat SB surgery,while the remaining 30 eyes(78.9%,30/38)underwent pars plana vitrectomy(PPV).Regarding tamponade agents,silicone oil was used in 11 eyes(36.7%,11/30),C_(3)F_(8) gas in 12 eyes(40.0%,12/30),and sterile air in 7 eyes(23.3%,7/30).CONCLUSION:SB surgery demonstrates a high success rate in the treatment of RRD.However,abnormal compression ridge position,missed holes during surgery,and PVR are the primary causes of SB failure.After addressing the reasons for failure,re-SB surgery or PPV can be effective alternatives.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
文摘Objectives:Tumor recurrence is a major determinant of poor prognosis in hepatocellular carcinoma(HCC),yet its cellular and molecular basis remains incompletely understood.This study aimed to identify recurrenceassociated genes at single-cell resolution and to develop a prognostic model for predicting survival outcomes and immunotherapy responsiveness in HCC.Methods:Single-cell RNA sequencing data from 12 primary and 6 recurrent HCC samples were integrated and analyzed to identify genes characteristic of recurrence.After quality control,principal component analysis,and t-SNE-based clustering were used to identify highly variable genes for cell clustering and annotation.Based on macrophage characteristic genes,a recurrence-related risk score was constructed using a LASSOCox regression model,and a nomogram integrating clinical variables was developed.Prognostic performance was assessed using Kaplan-Meier analysis and time-dependent ROC curves.Immune infiltration profiling was performed to compare immune characteristics between risk groups defined by the prognostic model.Multivariate Cox regression was applied to identify independent prognostic biomarkers,which were subsequently validated by cell function experiments.Results:The risk model effectively stratified patients into high-and low-risk groups with distinct survival outcomes,demonstrating high predictive accuracy for 1-,3-,and 5-year survival.High-risk patients showed altered immune profiles and a reduced predicted response to immunotherapy.GRID2,RNF186,and SLC4A10 were identified as independent prognostic genes,with RNF186 promoting HCC cell proliferation in a SESN2-dependent manner.Conclusion:This prognostic model provides new insights into precision medicine and immunotherapy for HCC,highlighting the potential clinical significance of RNF186 as a therapeutic target.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund,“Research on the Role and Mechanism of PIGU in Regulating MUC-1 in Gastric Cancer Immune Escape”(Project No.:2023YJY-29)Shaanxi Provincial Natural Science Basic Research Program,“Research on the Mechanism and Clinical Significance of miR-140-5p Related to Gastric Cancer Recurrence and Metastasis”(Project No.:2023-JC-YB-639)。
文摘Early-stage gastric cancer;Extent of lymph node dissection;D1 dissection;D2 dissection;Recurrence rate;Survival rateObjective:To investigate the impact of different lymph node dissection scopes on postoperative recurrence and survival rates in patients with early gastric cancer,providing evidence-based support for optimizing clinical surgical plans.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with early gastric cancer who underwent surgical treatment at our hospital from October 2021 to October 2023.Patients were divided into Group D1(n=50)and Group D2(n=50)based on the extent of lymph node dissection.Group D1 underwent limited lymph node dissection(dissection of the first station of lymph nodes around the stomach),while Group D2 underwent standard lymph node dissection(dissection of the first and second stations of lymph nodes around the stomach).Surgical-related indicators,the incidence of postoperative complications,the 2-year recurrence rate,and the 2-year survival rate were compared between the two groups of patients.Results:The operative time,intraoperative blood loss,postoperative hospital stay,and the number of lymph nodes dissected were significantly higher in the D2 group than in the D1 group(all P<0.001).The overall incidence of postoperative complications was higher in the D1 group than in the D2 group,but the difference was not statistically significant(χ^(2)=0.884,P=0.766).After a 2-year follow-up,the recurrence rate was significantly higher in the D1 group than in the D2 group(χ^(2)=4.000,P=0.046).The 2-year survival rate was significantly lower in the D1 group than in the D2 group(χ^(2)=5.005,P=0.025).A total of 100 patients with early-stage gastric cancer were grouped according to the depth of invasion,degree of differentiation,and lymph node metastasis status,and the recurrence rates of different subgroups were compared.The results showed that the recurrence rate was higher in patients with T1b stage than in those with T1a stage(χ^(2)=5.005,P=0.025),higher in poorly differentiated patients than in moderately and well-differentiated patients(χ^(2)=4.155,P=0.042),and higher in patients with lymph node metastasis than in those without lymph node metastasis(χ^(2)=4.512,P=0.034).Conclusion:Compared with D1 limited lymph node dissection,D2 standard lymph node dissection can significantly reduce the postoperative recurrence rate and improve the 2-year survival rate in patients with early-stage gastric cancer without significantly increasing the risk of postoperative complications.Although the surgical trauma is slightly greater,the overall prognosis is better,making it a preferred surgical treatment option for patients with early-stage gastric cancer.
基金supported by grants from the National Natural Science Foundation of China(91959203,82272836 and 82373017)。
文摘Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile.
基金supported by the China Geological Survey Project(Nos.DD20220864 and DD20243077).
文摘Understanding the levels,causes,and sources of fluoride in groundwater is critical for public health,effective water resource management,and sustainable utilization.This study employs multivariate statistical methods,hazard quotient assessment,and geochemical analyses,such as mineral saturation index,ionic activities,and Gibbs diagrams,to investigate the hydrochemical characteristics,causes,and noncarcinogenic risks of fluoride in Red bed groundwater and geothermal water in the Guang'an area and neighboring regions.Approximately 9%of the Red bed groundwater samples contain fluoride concentrations exceeding 1 mg·L^(-1).The predominant water types identified are Cl-Na and HCO_(3)-Na,primarily influenced by evapotranspiration.Low-fluoride groundwater and high-fluoride geothermal water exhibit distinct hydrochemical types HCO_(3)-Ca and SO_(4)-Ca,respectively,which are mainly related to the weathering of carbonate,sulfate,and fluorite-containing rocks.Correlation analysis reveals that fluoride content in Red bed groundwater is positively associated with Na^(+),Cl^(-),SO_(4)^(2-),and TDS(r^(2)=0.45-0.64,p<0.01),while in geothermal water,it correlates strongly with pH,K^(+),Ca^(2+),and Mg^(2+)(r^(2)=0.52-0.80,p<0.05).Mineral saturation indices and ionic activities indicate that ion exchange processes and the dissolution of minerals such as carbonatite and fluorite are important sources of fluoride in groundwater.The enrichment of fluorine in the Red bed groundwater is linked to evaporation,cation exchange and dissolution of fluorite,caused by the lithologic characteristics of the red bed in this area.However,it exhibits minimal correlation with the geothermal water in the adjacent area.The noncarcinogenic health risk assessment indicates that 7%(n=5)of Red bed groundwater points exceed the fluoride safety limit for adults,while 12%(n=8)exceed the limit for children.These findings underscore the importance of avoiding highly fluoridated red bed groundwater as a direct drinking source and enhancing groundwater monitoring to mitigate health risks associated with elevated fluoride levels.
文摘BACKGROUND In diabetic patients,persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria,resulting in severe complications.Con-sequently,chronic rhinosinusitis(CRS)complicated by diabetes is highly pre-valent in clinical settings.AIM To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.METHODS A retrospective analysis was conducted on the clinical data of 203 diabetic pa-tients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023.Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial suscept-ibility.Based on a one-year follow-up,patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data.Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.RESULTS Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS.A total of 134 pathogenic bacteria strains were isolated and identified,including 81 strains(60.4%)of gram-positive bacteria and 53 strains(39.6%)of gram-negative bacteria.Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin,while remaining highly sensitive to vancomycin,gentamicin,and rifampicin.Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin,but showed high sensitivity to imipenem,meropenem,cefepime,and ceftazidime.Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels,smoking history,Lund-Mackay scores,visual analog scale(VAS)scores,nasal septum deviation,allergic rhinitis,bronchial asthma,postoperative infection,long-term use of nasal decongestants,and adherence to medical prescriptions.Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.CONCLUSION In CRS patients with nasal polyps(CRSwNP),the detection rate of nasal pathogens is relatively high,and most of the isolated bacteria exhibit antimicrobial resistance.Additionally,the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.
基金Supported by the Key Clinical Specialty Discipline Construction Program of Fujian,Fujian Health Medicine and Politics,No.[2022]884.
文摘Early recurrence(ER)following surgery for rectal cancer is a significant factor impacting patient survival rates.Tsai et al identified age,preoperative neoadjuvant therapy,length of hospital stay,tumour location,and pathological stage as factors influencing the risk of ER.Postoperative monitoring for ER should encompass a thorough medical history review,physical examination,tumour marker testing,and imaging studies.Additionally,noninvasive circulating tumour cell DNA testing can be utilized to predict ER.Treatment strategies may involve radical surgery,radiation therapy,chemotherapy,and immunotherapy.Through a comprehensive analysis of risk factors,the optimization of monitoring methods,and the development of personalized treatment strategies,it is anticipated that both the efficacy of treatment and the quality of life for rectal cancer patients with postoperative recurrence can be significantly improved.
基金Supported by Anhui Provincial Key Research and Development Plan,No.202104j07020048.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is the most common primary liver malignancy.Ablation therapy is one of the first-line treatments for early HCC.Accurately predicting early recurrence(ER)is crucial for making precise treatment plans and improving patient prognosis.AIM To establish an intratumoral and peritumoral model for predicting ER in HCC patients following curative ablation.METHODS This study included a total of 288 patients from three Centers.The patients were divided into a primary cohort(n=222)and an external cohort(n=66).Radiomics and deep learning methods were combined for feature extraction,and models were constructed following a three-step feature selection process.Model performance was evaluated using the area under the receiver operating characteristic curve(AUC),while calibration curves and decision curve analysis(DCA)were used to assess calibration and clinical utility.Finally,Kaplan-Meier(K-M)analysis was used to stratify patients according to progression-free survival(PFS)and overall survival(OS).RESULTS The combined model,which utilizes the light gradient boosting machine learning algorithm and incorporates both intratumoral and peritumoral regions(5 mm and 10 mm),demonstrated the best predictive performance for ER following HCC ablation,achieving AUCs of 0.924 in the training set,0.899 in the internal validation set,and 0.839 in the external validation set.Calibration and DCA curves confirmed strong calibration and clinical utility,whereas K-M curves provided risk stratification for PFS and OS in HCC patients.CONCLUSION The most efficient model integrated the tumor region with the peritumoral 5 mm and 10 mm regions.This model provides a noninvasive,effective,and reliable method for predicting ER after curative ablation of HCC.
文摘Hepatocellular carcinoma(HCC)recurrence after liver transplantation(LT)presents a significant challenge,with recurrence rates ranging from 8%to 20%globally.Current biomarkers,such as alpha-fetoprotein(AFP)and des-gamma-carboxy prothrombin(DCP),lack specificity,limiting their utility in risk strati-fication.YKL-40,a glycoprotein involved in extracellular matrix remodeling,hepatic stellate cell activation,and immune modulation,has emerged as a promising biomarker for post-LT surveillance.Elevated serum levels of YKL-40 are associated with advanced liver disease,tumor progression,and poorer post-LT outcomes,highlighting its potential to address gaps in early detection and personalized management of HCC recurrence.This manuscript synthesizes clinical and mechanistic evidence to evaluate YKL-40’s predictive utility in post-LT care.While preliminary findings demonstrate its specificity for liver-related pathologies,challenges remain,including assay standardization,lack of pro-spective validation,and the need to distinguish between malignant and non-malignant causes of elevated levels.Integrating YKL-40 into multi-biomarker panels with AFP and DCP could enhance predictive accuracy and enable tailored therapeutic strategies.Future research should focus on multicenter studies to validate YKL-40’s clinical utility,address confounding factors like graft rejection and systemic inflammation,and explore its role in predictive models driven by emerging technologies such as artificial intelligence.YKL-40 holds transformative potential in reshaping post-LT care through precision medicine,providing a pathway for better outcomes and improved management of high-risk LT recipients.
基金supported by the Key Research and Development Special Project of the Autonomous Region(No.2022B03023-3)the Key Supported Discipline of Health System in Shanghai(No.2023ZDFC0302)。
文摘OBJECTIVE To investigate possible associations between physical function assessment scales,such as Short Physical Performance Battery(SPPB)and Berg Balance Scale(BBS),with all-cause mortality in acute decompensated heart failure(ADHF)patients.METHODS A total of 108 ADHF patients were analyzed from October 2020 to October 2022,and followed up to May 2023.The association between baseline clinical characteristics and all-cause mortality was analyzed by univariate Cox regression analysis,while for SPPB and BBS,univariate Cox regression analysis was followed by receiver operating characteristic curves,in which the area under the curve represented their predictive accuracy for all-cause mortality.Incremental predictive values for both physical function assessments were measured by calculating net reclassification index and integrated discrimination improvement scores.Optimal cutoff value for BBS was then identified using restricted cubic spline plots,and survival differences below and above that cut-off were compared using Kaplan-Meier survival curves and the log-rank test.The clinical utility of BBS was measured using decision curve analysis.RESULTS For baseline characteristics,age,female,blood urea nitrogen,as well as statins,angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,or angiotensin receptor-neprilysin inhibitors,were predictive for all-cause mortality for ADHF patients.With respect to SPPB and BBS,higher scores were associated with lower all-cause mortality rates for both assessments;similar area under the curves were measured for both(0.774 for SPPB and 0.776 for BBS).Furthermore,BBS≤36.5 was associated with significantly higher mortality,which was still applicable even adjusting for confounding factors;BBS was also found to have great clinical utility under decision curve analysis.CONCLUSIONS BBS or SPPB could be used as tools to assess physical function in ageing ADHF patients,as well as prognosticate on all-cause mortality.Moreover,prioritizing the improvement of balance capabilities of ADHF patients in cardiac rehabilitation regimens could aid in lowering mortality risk.
文摘BACKGROUND Mediastinal lymph nodes(MLNs)can be enlarged due to various benign or malignant causes.Endoscopic ultrasound(EUS)is often employed for the acquisition of tissue specimens of the enlarged MLN(EMLN).AIM To determine the causes,document the symptoms,and determine factors predicting good yield of EUS-guided EMLN biopsy.METHODS All patients having EMLN(>10 mm)on thoracic imaging and referred for EUSguided biopsy were included in this retrospective observational study.Adequacy of the tissue specimen was assessed by the endoscopist with macroscopic on-site evaluation(MOSE)and then sent to a histopathologist for final diagnosis.Analysis for factors predicting good biopsy yield was then performed.RESULTS Of the total 243 patients with EMLN,131(53.9%)were males.The mean age was 47.6(±14.7)and range 14-86 years.Commonest causes of EMLN were tuberculosis 82(33.7%),anthracosis 53(21.8%),neoplastic disease 43(17.7%)and sarcoidosis 14(5.8%).Among the 43 patients with neoplastic diseases:40 had metastatic disease(breast 9,lung 7,pancreatobiliary 6,esophagus 5,kidney 5,hepatocellular 2,neuroendocrine 2,gastrointestinal stromal 1,undetermined 3)and 3 had primary malignancies(lymphoproliferative disorder 2,Kaposi sarcoma 1).Chest related clinical symptoms were absent in more than half the patients with tuberculosis 51/82(62.2%),anthracosis 31/53(58.5%)and neoplastic disease 28/43(65.1%).Factors associated with good biopsy yield were:Subcarinal location of MLN(P=0.026),MLN size>12 mm(P<0.0001),use of fine-needle biopsy(vs fine-needle aspiration)(P=0.049)and satisfactory MOSE(P<0.0001)on univariate analysis;while MLN size>12 mm(P=0.005)and satisfactory MOSE(P<0.0001)on multivariate analysis.CONCLUSION Tuberculosis,anthracosis and metastatic disease were the commonest causes of EMLN.More than half the cases with EMLN had no chest-related symptoms.Large MLN size and satisfactory MOSE observation predicted a good biopsy yield.
基金support from the following foundations:the National Natural Science Foundation of China(62322309,62433004)Shanghai Science and Technology Innovation Action Plan(23S41900500)Shanghai Pilot Program for Basic Research(22TQ1400100-16).
文摘Accurate fault root cause diagnosis is essential for ensuring stable industrial production. Traditional methods, which typically rely on the entire time series and overlook critical local features, can lead to biased inferences about causal relationships, thus hindering the accurate identification of root cause variables. This study proposed a shapelet-based state evolution graph for fault root cause diagnosis (SEG-RCD), which enables causal inference through the analysis of the important local features. First, the regularized autoencoder and fault contribution plot are used to identify the fault onset time and candidate root cause variables, respectively. Then, the most representative shapelets were extracted to construct a state evolution graph. Finally, the propagation path was extracted based on fault unit shapelets to pinpoint the fault root cause variable. The SEG-RCD can reduce the interference of noncausal information, enhancing the accuracy and interpretability of fault root cause diagnosis. The superiority of the proposed SEG-RCD was verified through experiments on a simulated penicillin fermentation process and an actual one.
基金partially supported by the National Natural Science Foundation of China under Grant No.62372121the Ministry of education of Humanities and Social Science project under Grant No.20YJAZH118+1 种基金the National Key Research and Development Program of China under Grant No.2020YFB1005804the MOE Project at Center for Linguistics and Applied Linguistics,Guangdong University of Foreign Studies。
文摘With the rapid development of web technology,Social Networks(SNs)have become one of the most popular platforms for users to exchange views and to express their emotions.More and more people are used to commenting on a certain hot spot in SNs,resulting in a large amount of texts containing emotions.Textual Emotion Cause Extraction(TECE)aims to automatically extract causes for a certain emotion in texts,which is an important research issue in natural language processing.It is different from the previous tasks of emotion recognition and emotion classification.In addition,it is not limited to the shallow-level emotion classification of text,but to trace the emotion source.In this paper,we provide a survey for TECE.First,we introduce the development process and classification of TECE.Then,we discuss the existing methods and key factors for TECE.Finally,we enumerate the challenges and developing trend for TECE.
基金supported in part by the National Key R&D Program of China under Grant No.2024YFE0200504NSFC key international joint project under Grant No.62120106007Interdisciplinary Research Program of HUST under Grant No.2024JCYJ022.
文摘Fiber-to-the-Room(FTTR)has emerged as the core architecture for next-generation home and enterprise networks,offering gigabitlevel bandwidth and seamless wireless coverage.However,the complex multi-device topology of FTTR networks presents significant chal⁃lenges in identifying sources of network performance degradation and conducting accurate root cause analysis.Conventional approaches often fail to deliver efficient and precise operational improvements.To address this issue,this paper proposes a Transformer-based multi-task learn⁃ing model designed for automated root cause analysis in FTTR environments.The model integrates multidimensional time-series data col⁃lected from access points(APs),enabling the simultaneous detection of APs experiencing performance degradation and the classification of underlying root causes,such as weak signal coverage,network congestion,and signal interference.To facilitate model training and evaluation,a multi-label dataset is generated using a discrete-event simulation platform implemented in MATLAB.Experimental results demonstrate that the proposed Transformer-based multi-task learning model achieves a root cause classification accuracy of 96.75%,significantly outperform⁃ing baseline models including Long Short-Term Memory(LSTM),Gated Recurrent Unit(GRU),Random Forest,and eXtreme Gradient Boost⁃ing(XGBoost).This approach enables the rapid identification of performance degradation causes in FTTR networks,offering actionable in⁃sights for network optimization,reduced operational costs,and enhanced user experience.
