BACKGROUND Chronic hepatitis B(CHB)patients rarely achieve functional cure with initial pegylated interferon alpha-2b(Peg-IFNα-2b)therapy.Validated tools to guide retreatment candidates are lacking.We hypothesized th...BACKGROUND Chronic hepatitis B(CHB)patients rarely achieve functional cure with initial pegylated interferon alpha-2b(Peg-IFNα-2b)therapy.Validated tools to guide retreatment candidates are lacking.We hypothesized that clinical indicators predict hepatitis B surface antigen(HBsAg)clearance during retreatment.AIM To develop a prediction model for HBsAg clearance in Peg-IFNα-2b retreatment.METHODS In this retrospective cohort study,we enrolled 135 CHB/compensated cirrhosis patients receiving Peg-IFNα-2b retreatment after initial non-clearance at Tianjin University Central Hospital(2017-2025).Predictors were identified through univariate Cox,least absolute shrinkage and selection operator,and multivariate Cox regression.Model performance was assessed via receiver operating characteristic analysis and Harrell’s C-index,with risk stratification by X-tile optimization.RESULTS HBsAg clearance rate was 20.74%(28/135).Independent predictors included:Combination nucleos(t)ide analogue(NA)therapy during initial treatment[hazard ratio(HR)=0.276,95%confidence interval(CI):0.092-0.833],baseline HBsAg at retreatment(HR=0.571,95%CI:0.410-0.795),HBsAg decline after initial treatment(HR=2.050,95%CI:1.108-3.793),and treatment interval(HR=1.013/week,95%CI:1.008-1.018).The retreatment HBsAg clearance prediction score(RHCP-S)demonstrated area under the curve of 0.920(95%CI:0.863-0.946),sensitivity of 92.3%,specificity of 79.3%.Clearance rates differed significantly:RHCP-S challenge group(≤74 points):3.45%,RHCP-S probable group(74-110 points):29.63%,RHCP-S dominant group(≥110 points):80.95%(P<0.001).CONCLUSION The overall HBsAg clearance rate with Peg-IFNα-2b retreatment was 20.74%(28/135).The RHCP-S model identifies optimal retreatment candidates(≥110 points)with 80.95%clearance probability,associated with the absence of combination NA therapy during initial treatment,greater initial HBsAg decline,longer intervals,and lower retreatment HBsAg.展开更多
AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole,bismuth subcitrate,furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other ...AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole,bismuth subcitrate,furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success.METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens.The therapeutic regimen consisted of 20 mg omeprazole,240 mg colloidal bismuth subcitrate,1000 mg amoxicillin,and 200 mg furazolidone,taken twice a day for 7 d.Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapid urease test and histology).Safety was determined by the presence of adverse effects.RESULTS: Fifty-one patients were enrolled.The eradication rate was 68.8% (31/45).Adverse effects were reported by 31.4% of the patients,and these were usually considered to be slight or moderate in the majority of the cases.Three patients had to withdraw from the treatment due to the presence of severe adverse effects.CONCLUSION: The association of bismuth,furazolidone,amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens.It is an effective,cheap and safe option for salvage therapy of positive patients.展开更多
Hepatitis B virus(HBV)infection is a global public health issue.Interferon-α(IFN-α)treatment has been used to treat hepatitis B for over 20 years,but fewer than 5%of Asians receiving IFN-αtreatment achieve function...Hepatitis B virus(HBV)infection is a global public health issue.Interferon-α(IFN-α)treatment has been used to treat hepatitis B for over 20 years,but fewer than 5%of Asians receiving IFN-αtreatment achieve functional cure.Thus,IFN-αretreatment has been introduced to enhance antiviral function.In recent years,immune-related studies have found that the complex interactions between immune cells and cytokines could modulate immune response networks,including both innate and adaptive immunity,triggering immune responses that control HBV replication.However,heterogeneity of the immune system to control HBV infection,particularly HBV-specific CD8^(+)T cell heterogeneity,has consequential effects on T cell-based immunotherapy for treating HBV infection.Altogether,the host’s genetic variants,negative-feedback regulators and HBV components affecting the immune system's ability to control HBV.In this study,we reviewed the literature on potential immune mechanisms affecting the immune control of HBV and the clinical effects of IFN-αtreatment and retreatment.展开更多
This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence ...This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.展开更多
AIM: To study the efficacy and factors associated with a sustained virological response (SVR) in chronic hepatitis C (CHC) relapsing patients. METHODS: Out of 1228 CHC patients treated with pegylated interferon (PEG-I...AIM: To study the efficacy and factors associated with a sustained virological response (SVR) in chronic hepatitis C (CHC) relapsing patients. METHODS: Out of 1228 CHC patients treated with pegylated interferon (PEG-IFN) and ribavirin (RBV), 165 (13%) had a relapse. Among these, 62 patients were retreated with PEG-IFN-2a or-2b and RBV. Clinical, biological, virological and histological data were collected. Initial doses and treatment modifications were recorded. The efficacy of retreatment and predictive factors for SVR were analyzed. RESULTS: An SVR was achieved in 42% of patients. SVR was higher in young (< 50 years) (61%) than old patients (27%) (P = 0.007), and in genotype 2 or 3 (57%) than in genotype 1 or 4 (28%) patients (P = 0.023). Prolonging therapy for at least 24 wk more than the previous course was associated with higher SVR rates (53% vs 28%, P = 0.04). Also, a better SVR rate was observed with RBV dose/body weight > 15.2 mg/kg per day (70% vs 35%, P = 0.04). In logistic regression, predictors of a response were age (P = 0.018), genotype (P = 0.048) and initial RBV dose/body weight (P = 0.022). None of the patients without a complete early virological response achieved an SVR (negative predictive value = 100%). CONCLUSION: Retreatment with PEG-IFN/RBV is effective in genotype 2 or 3 relapsers, especially in young patients. A high dose of RBV seems to be important for the retreatment response.展开更多
Retreatment Tuberculosis (TB) has long been a neglected area in global TB control. To determine the notification of re-treatment Tuberculosis TB cases among all enrolled TB patients, we conducted a retrospective cohor...Retreatment Tuberculosis (TB) has long been a neglected area in global TB control. To determine the notification of re-treatment Tuberculosis TB cases among all enrolled TB patients, we conducted a retrospective cohort review of routine program data from 2015-2017. A total of 8663 tuberculosis cases (all new and old forms) were registered at the study site. Of these, 1916 (22%) were pulmonary bacteriological confirmed;3498 (40.37%) were pulmonary clinical diagnosed and 3396 (39.20%) were clinically or bacteriological confirmed extra-pulmonary tuberculosis cases. Retreatment cases trend was found to be increased from 1% in 2015 to 1.6% in 2017. Majority of re-treatment cases were in the age group 18 - 43 years and only 7 patients were under the age of 15 years. This concludes that notification of re-treatment cases is very low among all enrolled TB patients and this could be possibly due to the fact that most of the re-treatment cases were registered as new cases or misdiagnosed. There is need and space to increase retreatment cases. Most of the re-treatment cases were usually converted to MDR-TB (Multi-Drug Resistant Tuberculosis) as noted in PMDT (Programmatic management of Drugs resistant tuberculosis) site. Therefore, proper history and diagnosis should be encouraged at the time of case notification.展开更多
<strong>Background:</strong> Fungal infections represent a significant cause of morbidity and mortality among immunocompromised individuals. Pulmonary fungal infection may be missed or misdiagnosed as tube...<strong>Background:</strong> Fungal infections represent a significant cause of morbidity and mortality among immunocompromised individuals. Pulmonary fungal infection may be missed or misdiagnosed as tuberculosis (TB) hence complicating management of these patients. The current study reports the spectrum of filamentous fungi isolated from sputum of TB relapse and retreatment cases at selected reference facilities in Kenya. <strong>Methods:</strong> A total of 340 sputum samples collected during the period of June 2018 to June 2019 were subjected to mycological investigations. The samples were mucolysed and inoculated on sabourauds dextrose agar (SDA) and incubated at 30°C for 7 days and checked daily for fungal growth. Moulds were identified by macroscopic and microscopic morphological features and the species were confirmed by sequencing. <strong>Results:</strong> The diversity of fungi out of the 340 sputum samples analyzed was as follows;16% (n = 53) were positive for moulds with Aspergillus species being the predominant constituting 68 % (n = 36). Among the Aspergilli, A. flavus and A. niger were the most frequently isolated adding up to 23%, (n = 12) and 15% (n = 8) respectively. Additionally, Paecillomyces variotii (9%, n = 5), Scedosporium aspiospermum (6%, n = 3), Mucor racemosus (8%, n = 4) and Penicillium spp. (9%, n = 5) were also recovered. <strong>Conclusion:</strong> The isolated fungi represented potential respiratory pathogens that could be responsible for persistent TB like symptoms despite treatment that could be misdiagnosed as relapse requiring treatment. Fungal investigation of all presumptive TB relapse cases should be advocated before treatment. This will reduce unnecessary retreatment, delayed antifungal intervention and unwarranted morbidity and mortality associated with misdiagnosis.展开更多
Root canal treatment failure depends on many factors. Overfillings, insufficient fillings, missing canals, failure to provide a complete apical plug, and impermeability of coronal restoration are some of them. Failed ...Root canal treatment failure depends on many factors. Overfillings, insufficient fillings, missing canals, failure to provide a complete apical plug, and impermeability of coronal restoration are some of them. Failed root canal treatment may not always manifest itself immediately after treatment. Sometimes, root canal treatments, which have not been done well, can manifest themselves with extensive lesions and severe pain in the apical after a long time. Apical resection may be considered as a solution in lesions that are too large to be treated, but retreatment without surgery should be attempted beforehand. Thus, the patient may have recovered from unnecessary surgical procedures and treated with a more conservative method. This case presents the non-surgical retreatment of a left lateral tooth with a large periapical lesion with extruded gutta percha followed by a 36-month follow-up.展开更多
The effects of TiO2 photocatalysis on the hydrolysis of protein of waste activated sludge (WAS) and its biodegradability were investigated in this study. After 12-h UV irradiation, the removal ratio of protein by TiO2...The effects of TiO2 photocatalysis on the hydrolysis of protein of waste activated sludge (WAS) and its biodegradability were investigated in this study. After 12-h UV irradiation, the removal ratio of protein by TiO2 photocatalysis reached 98.1%. The optimal condition for photocatalytic degradation of protein is TiO2 dosage of 5.0 mg·L–1 under 2.4 w·m–2 UV light irradiation. TiO2 photocatalysis in comparison with other pretreatments obviously accelerated the hydrolysis of WAS and improved the conversion of total COD (tCOD) to soluble COD (sCOD). The sCOD/tCOD ratio of WAS pretreated by TiO2 photocatalysis, UV photolysis and TiO2 adsorption and that of the control were 92.8%, 32.5%, 18.0% and 16.6%, respectively. TiO2 photocatalytic pretreatment accelerated the biohydrogen production from 10-fold diluted WAS. The bioreactors containing UV photolysis and TiO2 adsorption pretreated WASs and the control reactor require 0.5-d, 0.9-d and 0.7-d start-up period for biohydrogen production, respectively. While the bioreactor containing TiO2 photocatalysis pretreated WAS obtained a hydrogen yield of 0.5 mL-H2/g-VS merely after 0.5-d mesophilic fermentation. The cumulative biohydrogen production from TiO2 photocatalysis pretreated WAS during 4-d mesophilic fermentation reached 11.7 mL-H2/g-VS, which was 1.2 times higher than that from the control. TiO2 photocatalytic pretreatment enhanced the biohydrogen production from WAS via accelerating the hydrolysis of its macromolecular components to smaller molecule weight hydrolysates.展开更多
Background:China is the second highest pulmonary tuberculosis(PTB)burden country worldwide.However,retreatment of PTB has often developed resistance to at least one of the four first-line anti-TB drugs.The cure rate(a...Background:China is the second highest pulmonary tuberculosis(PTB)burden country worldwide.However,retreatment of PTB has often developed resistance to at least one of the four first-line anti-TB drugs.The cure rate(approximately 50.0–73.3%)and management of retreatment of PTB in China needs to be improved.Qinbudan decoction has been widely used to treat PTB in China since the 1960s.Previously clinical studies have shown that the Qinbudan tablet(QBDT)promoted sputum-culture negative conversion and lesion absorption.However,powerful evidence from a randomized controlled clinical trial is lacking.Therefore,the aim of this study was to compare the efficacy and safety of QBDT as an adjunct therapy for retreatment of PTB.Methods:We conducted a multicenter,randomized,double-blind,placebo-controlled clinical trial in China.People diagnosed with PTB were enrolled who received previous anti-TB treatment from April 2011 to March 2013.The treatment group received an anti-TB regimen and QBDT,and the control group was administered an anti-TB regimen plus placebo.Anti-TB treatment options included isoniazid,rifampicin,pyrazinamide,ethambutol,streptomycin for 2 months(2HRZES),followed by isoniazid,rifampicin,ethambutol for 6 months(6HRE),daily for 8 months.Primary outcome was sputum-culture conversion using the MGIT 960 liquid medium method.Secondary outcomes included lung lesion absorption and cavity closure.Adverse events and reactions were observed after treatment.A structured questionnaire was used to record demographic information and clinical symptoms of all subjects.Data analysis was performed by SPSS 25.0 software in the full analysis set(FAS)population.Results:One hundred eighty-one cases of retreatment PTB were randomly divided into two groups:the placebo group(88 cases)and the QBDT group(93 cases).A total of 166 patients completed the trial and 15 patients lost to follow-up.The culture conversion rate of the QBDT group and placebo group did not show a noticeable improvement by using the covariate sites to correct the rate differences(79.6%vs 69.3%;rate difference=0.10,95%confidence interval(CI):-0.02–0.23;F=2.48,P=0.12)after treatment.A significant 16.6%increase in lesion absorption was observed in the QBDT group when compared with the placebo group(67.7%vs 51.1%;rate difference=0.17,95%CI:0.02–0.31;χ2=5.56,P=0.02).The intervention and placebo group did not differ in terms of cavity closure(25.5%vs 21.1%;rate difference=0.04,95%CI:-0.21–0.12;χ2=0.27,P=0.60).Two patients who received chemotherapy and combined QBDT reported pruritus/nausea and vomiting.Conclusions:No significant improvement in culture conversion was observed for retreatment PTB with traditional Chinese medicine plus standard anti-TB regimen.However,QBDT as an adjunct therapy significantly promoted lesion absorption,thereby reducing lung injury due to Mycobacterium tuberculosis infection.Trial registration:This trial is registered at ClinicalTrials.gov,NCT02313610.展开更多
Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have be...Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have been studied,however,few studies have investigated wavefront-optimized(WFO)technology for retreatment following primary refractive surgery.This study aimed to report the outcomes of WFO photorefractive keratectomy(PRK)retreatments of refractive error following previous laser refractive surgery with PRK,laser in situ keratomileusis(LASIK),or laser-assisted subepithelial keratectomy(LASEK).Methods:We reviewed records of patients who underwent WFO PRK retreatments using the Allegretto Wave Eye-Q 400 Hz Excimer Laser System(Alcon Surgical)between January 2008 and April 2011 at Walter Reed Army Medical Center and Madigan Army Medical Center.Outcomes were recorded in terms of uncorrected distance visual acuity(UDVA),manifest refraction spherical equivalent(MRSE),corrected distance visual acuity(CDVA),and complications at 1 month(M),3 M,and 6 M post-op.Results:Seventy-eight patients(120 eyes)underwent WFO PRK retreatment during the study period.Primary surgery was surface ablation in 87 eyes(78 PRK,9 LASEK)and LASIK in 33 eyes.The mean spherical equivalent before retreatment was−0.79±0.94 D(−3.00 to 1.88 D).UDVA was≥20/20 in 69 eyes(60.0%)at 1 M,54 eyes(71.1%)at 3 M,and 27 eyes(73.0%)at 6 M follow-up.MRSE was within±0.50 D of emmetropia in 78 eyes(67.8%)at 1 M,59 eyes(77.6%)at 3 M,and 25 eyes(67.6%)at 6 M follow-up.CDVA was maintained within±1 line of pre-op in 113 of 115 eyes(98.3%)at 1 M,74 of 76 eyes(97.4%)at 3 M,and 37 eyes(100%)at 6 M follow-up.Conclusion:Although follow-up was limited beyond 3 M,WFO PRK retreatments in patients with residual refractive error may be a safe and effective procedure.Further studies are necessary to determine the long-term safety and stability of outcomes.展开更多
At dawn in Wufu Village,in Dinghu District of Zhaoqing City,Guangdong Province,the newly restored Chaoyangli Cultural Retreat is already welcoming its first visitors.A visitor surnamed Chen,who has travelled from Guan...At dawn in Wufu Village,in Dinghu District of Zhaoqing City,Guangdong Province,the newly restored Chaoyangli Cultural Retreat is already welcoming its first visitors.A visitor surnamed Chen,who has travelled from Guangzhou with his child,stops in front of the Chaxi Academy to admire local intangible cultural heritage crafts.展开更多
The Western Himalaya,often termed the“Water Tower of Asia,”is experiencing critical hydrological changes due to global warming.This review synthesizes current scientific knowledge on climate-driven alterations in th...The Western Himalaya,often termed the“Water Tower of Asia,”is experiencing critical hydrological changes due to global warming.This review synthesizes current scientific knowledge on climate-driven alterations in the region’s water cycle,assessing impacts on ecosystems,agriculture,energy security,and local livelihoods.We conducted a systematic literature review of peer-reviewed studies(2000-2024)from Scopus,Web of Science,and regional databases,supplemented by case studies and observational/modeling data.Key themes include cryospheric loss,shifting precipitation,river flow variability,and hydrological extremes.Key findings indicate that(1)temperature increases(0.2-0.5°C/decade)have accelerated glacier retreat(up to 20-30%mass loss in some basins)and reduced snow cover(5-15%decline since 2000);(2)altered precipitation patterns have increased rainfall dominance,elevating flood risks while reducing groundwater recharge in arid zones;and(3)river discharge shows declining dry-season flows but higher peak flows,threatening water security for over 200 million downstream inhabitants.These findings underscore the urgent need for integrated,cross-scale strategies combining scientific innovation,indigenous knowledge,and adaptive policies to enhance resilience.We highlight critical gaps in high-altitude monitoring and call for transboundary cooperation to mitigate escalating climate risks.This systematic review uniquely contrasts Western Himalayan hydrology with that of the Central and Eastern regions and benchmarks policy gaps,offering a roadmap for climate-resilient water governance.展开更多
The mechanism involved in deep-seated landslide-debris flow disaster chains has been studied for many years,however,it is still not completely understood.This study aims to analyze the key factors that were involved a...The mechanism involved in deep-seated landslide-debris flow disaster chains has been studied for many years,however,it is still not completely understood.This study aims to analyze the key factors that were involved and led to the geological disaster of Shaziba 62.0 m deep landslide-debris flow.Two extensive field investigations were conducted before and after the slope failure event.The study further used drilled cores,high-density resistivity method,and aerial photographs to obtain valuable insights into the disaster chain.It was found that opencast coal mining operations broke the locked segment of the front edge and heavy rainfall softened the slip zones along the faults.Mechanical calculations demonstrated that the coupling condition of the opencast coal mining and heavy rainfall triggered the landslide.A new evolution model was put forth to describe the complex mechanism of combining progressive retreat and tractive failure of hydraulic drive landslide,which was governed by the bedding-plane rock layer.Surface runoff caused the mass of the landslide to liquefy throughout the sliding process,resulting in overlapping deposits,debris-flow-barrier-lake,and erosion.These new insights led to the indication of a different triggering mechanism of landslides-debris flows,as well as laid the foundation for the proposed physical and mechanical mechanism model based on progressive retreat soil-rock mixed landslides with an upper locked segment and lower weak interlayer under heavy rainfall.展开更多
The Barents Sea is a marginal sea of the Arctic Ocean and contains substantial hydrocarbon resources.In recent years,the Barents Sea has emerged as one of the Arctic regions with the most pronounced sea ice variabilit...The Barents Sea is a marginal sea of the Arctic Ocean and contains substantial hydrocarbon resources.In recent years,the Barents Sea has emerged as one of the Arctic regions with the most pronounced sea ice variability.To analyze sea ice changes in the Barents Sea,sea ice data from the National Snow and Ice Data Center were utilized.A remarkable decline in sea ice has been witnessed in the northern and eastern regions.This phenomenon has expanded the ice-free operational area for marine structures,highlighting the significance of wave factors.A site within this area was chosen to estimate the wave parameters.The wave data from ERA5 were categorized according to wave energy in each season.Four mixture joint distribution models for the wave height and period were constructed based on the mixture distribution method and copula theory,and environmental contours were developed and compared with the conditional probability method.Despite differences in the design parameter results,the mixture models demonstrate good performance in sample fitting,particularly in the distribution tails.Among these models,the Gaussian copula offers the best fit.展开更多
As a highly sensitive indicator of climate change in the arid northwest region of China,glacier dynamics in the Kaidu-Konqi River Basin directly influence regional runoff patterns,thereby playing a crucial role in sha...As a highly sensitive indicator of climate change in the arid northwest region of China,glacier dynamics in the Kaidu-Konqi River Basin directly influence regional runoff patterns,thereby playing a crucial role in shapingregional hydrology and maintaining ecological stability.This study systematically assessed glacier distribution in2020 and analyzed glacier changes from 1972 to 2020 using the Chinese Glacier Inventory of Xinjiang in 2020(CGI-XJ2020),historical satellite imagery from 1972,and data from the Second Chinese Glacier Inventory.In2020,the basin contained 713 glaciers covering 313.99 km^(2),with an estimated glacier volume of 11.81 km^(3)(0.41%glacier coverage).Glaciers were predominantly clustered in the northern and southwestern mountains.Small glaciers(<0.5 km^(2))comprised 78%of the glacier count but only 3%of the total area,whereas glaciers≥0.5 km^(2)accounted for 97%of the total area and 83.6%of the glacier volume.From 1972 to 2020,the totalglacier area decreased by 42.28%(229.99 km^(2))and glacier volume by 49.51%(11.58 km^(3)),equating to meanannual rates of−0.88%and−1.03%,respectively.Glacier retreat drives temporary increases in meltwatersupply but threatens long-term regional runoff stability and ecological water security.The retreat rate variedover different periods,with a more pronounced decline observed between 1972 and 2007.These findingshighlight an accelerating glacier loss in the basin,underscoring the need for continued monitoring and assess-ment of its hydrological and ecological impacts.展开更多
AIM： To evaluate the effectiveness of ultrasonographic screening for early detection of hepatocellular carcinoma （HCC）. METHODS： The data of 14 968 patients who had ultrasonography （US） for chronic liver disease...AIM： To evaluate the effectiveness of ultrasonographic screening for early detection of hepatocellular carcinoma （HCC）. METHODS： The data of 14 968 patients who had ultrasonography （US） for chronic liver diseases were collected into a database program from June 1995 to June 2005. The risk factors for HCC were also studied. A total of 6089 patients who had repeated US were enrolled, 264 patients were diagnosed with HCC during follow-up （mean, 39 mo）. RESULTS： The detection rate of small HCC （≤ 3 cm in diameter） was 67.7%. The tumor size detected by screening at the intervals of 6 mo was significantly smaller than that at longer intervals. Only 29.3% of HCC patients had an elevated serum alpha fetoprotein （AFP） level above 400 ng/mL. The risk of HCC development during follow-up was higher in patients with liver cirrhosis （10.9%） and hepatitis C （9.0%） than in patients with chronic hepatitis （4.2%）, hepatitis B （4.9%） and non-B, non-C hepatitis （NBNC, 3.9%）. CONCLUSION： US screening at a interval of 6 mo is beneficial to high-risk patients over 40 years old and the early detection of HCC prolongs survival.展开更多
AIM:Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology,the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA...AIM:Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology,the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (aPBC) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation.However, only 20-30% of patients respond fully to UDCA.Recently,lipoprotein-lowering agents have been found to be effective for PBC.The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory-activated receptor α,in patients with aPBC.METHODS:Fenofibrate was administered for twelve weeks in nine patients with aPBC who failed to respond to UDCA.UDCA was used along with fenofibrate during the study.The data from aPBC patients were analyzed to assess the biochemical effect of fenofibrate during the study.RESULTS: The serum levels of alkaline phosphatase (ALP)(285±114.8IU/L) and immunoglobulin M (IgM) (255.8±85.9mg/dl) significantly decreased to 186.9±76.2IU/L and 192.9±67.5mg/dL respectively, after fenofibrate treatment in patients with aPBC (P<0.05). Moreover,the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in any patients.CONCLUSION:Fenofibrate appears to be significantly effective in treating patients with aPBC who respond incompletely to UDCA alone.Although the mechanism of fenofibrate on aPBC has not yet been fully clarified,combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its antiinflammatory effect.展开更多
BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars loca...BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars located at the end of the dental arch.However,advancements in digital dental diagnosis and treatment techniques can solve these problems.Here,we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel“inlay-guided endodontics”technique based on improved computer-generated programs.CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar.The tooth,diagnosed with post-treatment endodontic disease,was initially treated by conventional methods,which were ineffective.Our“inlay-guided endodontics”technique was subsequently adopted,with the establishment of a precise integrated three-dimensional(3D)plate model of cone-beam computed tomography data and a digital impression of the dentition.An optimal root canal approach was generated for the“virtual file”in the 3D model.The plate data were imported into a 3D printer and printed.With the help of the guide plate,the file was accurately placed into the cervical third of the distal root canal.The root canal and prosthodontic treatments successfully proceeded subsequently.CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.展开更多
基金Supported by the Tianjin Health Research Project(Key Project),No.TJWJ2024ZD004Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-034A.
文摘BACKGROUND Chronic hepatitis B(CHB)patients rarely achieve functional cure with initial pegylated interferon alpha-2b(Peg-IFNα-2b)therapy.Validated tools to guide retreatment candidates are lacking.We hypothesized that clinical indicators predict hepatitis B surface antigen(HBsAg)clearance during retreatment.AIM To develop a prediction model for HBsAg clearance in Peg-IFNα-2b retreatment.METHODS In this retrospective cohort study,we enrolled 135 CHB/compensated cirrhosis patients receiving Peg-IFNα-2b retreatment after initial non-clearance at Tianjin University Central Hospital(2017-2025).Predictors were identified through univariate Cox,least absolute shrinkage and selection operator,and multivariate Cox regression.Model performance was assessed via receiver operating characteristic analysis and Harrell’s C-index,with risk stratification by X-tile optimization.RESULTS HBsAg clearance rate was 20.74%(28/135).Independent predictors included:Combination nucleos(t)ide analogue(NA)therapy during initial treatment[hazard ratio(HR)=0.276,95%confidence interval(CI):0.092-0.833],baseline HBsAg at retreatment(HR=0.571,95%CI:0.410-0.795),HBsAg decline after initial treatment(HR=2.050,95%CI:1.108-3.793),and treatment interval(HR=1.013/week,95%CI:1.008-1.018).The retreatment HBsAg clearance prediction score(RHCP-S)demonstrated area under the curve of 0.920(95%CI:0.863-0.946),sensitivity of 92.3%,specificity of 79.3%.Clearance rates differed significantly:RHCP-S challenge group(≤74 points):3.45%,RHCP-S probable group(74-110 points):29.63%,RHCP-S dominant group(≥110 points):80.95%(P<0.001).CONCLUSION The overall HBsAg clearance rate with Peg-IFNα-2b retreatment was 20.74%(28/135).The RHCP-S model identifies optimal retreatment candidates(≥110 points)with 80.95%clearance probability,associated with the absence of combination NA therapy during initial treatment,greater initial HBsAg decline,longer intervals,and lower retreatment HBsAg.
文摘AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole,bismuth subcitrate,furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success.METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens.The therapeutic regimen consisted of 20 mg omeprazole,240 mg colloidal bismuth subcitrate,1000 mg amoxicillin,and 200 mg furazolidone,taken twice a day for 7 d.Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapid urease test and histology).Safety was determined by the presence of adverse effects.RESULTS: Fifty-one patients were enrolled.The eradication rate was 68.8% (31/45).Adverse effects were reported by 31.4% of the patients,and these were usually considered to be slight or moderate in the majority of the cases.Three patients had to withdraw from the treatment due to the presence of severe adverse effects.CONCLUSION: The association of bismuth,furazolidone,amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens.It is an effective,cheap and safe option for salvage therapy of positive patients.
文摘Hepatitis B virus(HBV)infection is a global public health issue.Interferon-α(IFN-α)treatment has been used to treat hepatitis B for over 20 years,but fewer than 5%of Asians receiving IFN-αtreatment achieve functional cure.Thus,IFN-αretreatment has been introduced to enhance antiviral function.In recent years,immune-related studies have found that the complex interactions between immune cells and cytokines could modulate immune response networks,including both innate and adaptive immunity,triggering immune responses that control HBV replication.However,heterogeneity of the immune system to control HBV infection,particularly HBV-specific CD8^(+)T cell heterogeneity,has consequential effects on T cell-based immunotherapy for treating HBV infection.Altogether,the host’s genetic variants,negative-feedback regulators and HBV components affecting the immune system's ability to control HBV.In this study,we reviewed the literature on potential immune mechanisms affecting the immune control of HBV and the clinical effects of IFN-αtreatment and retreatment.
基金supported by ‘Follow-up Study of Retreatment TB Patients with Sputum Smear Positive Two Years after Declared Cured’(TB10-002)
文摘This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.
基金Supported by Assistance publique-H pitaux de Paris, IN-SERM U773-CRB3 and University Paris-DiderotFees from Roche, Schering Plough, Novartis, Gilead Sciences, BMS,MSD, Vertex, Tibotec, Biolex, to Marcellin PZymmogenetics and grants from Gilead Sciences, Roche and Schering Plough
文摘AIM: To study the efficacy and factors associated with a sustained virological response (SVR) in chronic hepatitis C (CHC) relapsing patients. METHODS: Out of 1228 CHC patients treated with pegylated interferon (PEG-IFN) and ribavirin (RBV), 165 (13%) had a relapse. Among these, 62 patients were retreated with PEG-IFN-2a or-2b and RBV. Clinical, biological, virological and histological data were collected. Initial doses and treatment modifications were recorded. The efficacy of retreatment and predictive factors for SVR were analyzed. RESULTS: An SVR was achieved in 42% of patients. SVR was higher in young (< 50 years) (61%) than old patients (27%) (P = 0.007), and in genotype 2 or 3 (57%) than in genotype 1 or 4 (28%) patients (P = 0.023). Prolonging therapy for at least 24 wk more than the previous course was associated with higher SVR rates (53% vs 28%, P = 0.04). Also, a better SVR rate was observed with RBV dose/body weight > 15.2 mg/kg per day (70% vs 35%, P = 0.04). In logistic regression, predictors of a response were age (P = 0.018), genotype (P = 0.048) and initial RBV dose/body weight (P = 0.022). None of the patients without a complete early virological response achieved an SVR (negative predictive value = 100%). CONCLUSION: Retreatment with PEG-IFN/RBV is effective in genotype 2 or 3 relapsers, especially in young patients. A high dose of RBV seems to be important for the retreatment response.
文摘Retreatment Tuberculosis (TB) has long been a neglected area in global TB control. To determine the notification of re-treatment Tuberculosis TB cases among all enrolled TB patients, we conducted a retrospective cohort review of routine program data from 2015-2017. A total of 8663 tuberculosis cases (all new and old forms) were registered at the study site. Of these, 1916 (22%) were pulmonary bacteriological confirmed;3498 (40.37%) were pulmonary clinical diagnosed and 3396 (39.20%) were clinically or bacteriological confirmed extra-pulmonary tuberculosis cases. Retreatment cases trend was found to be increased from 1% in 2015 to 1.6% in 2017. Majority of re-treatment cases were in the age group 18 - 43 years and only 7 patients were under the age of 15 years. This concludes that notification of re-treatment cases is very low among all enrolled TB patients and this could be possibly due to the fact that most of the re-treatment cases were registered as new cases or misdiagnosed. There is need and space to increase retreatment cases. Most of the re-treatment cases were usually converted to MDR-TB (Multi-Drug Resistant Tuberculosis) as noted in PMDT (Programmatic management of Drugs resistant tuberculosis) site. Therefore, proper history and diagnosis should be encouraged at the time of case notification.
文摘<strong>Background:</strong> Fungal infections represent a significant cause of morbidity and mortality among immunocompromised individuals. Pulmonary fungal infection may be missed or misdiagnosed as tuberculosis (TB) hence complicating management of these patients. The current study reports the spectrum of filamentous fungi isolated from sputum of TB relapse and retreatment cases at selected reference facilities in Kenya. <strong>Methods:</strong> A total of 340 sputum samples collected during the period of June 2018 to June 2019 were subjected to mycological investigations. The samples were mucolysed and inoculated on sabourauds dextrose agar (SDA) and incubated at 30°C for 7 days and checked daily for fungal growth. Moulds were identified by macroscopic and microscopic morphological features and the species were confirmed by sequencing. <strong>Results:</strong> The diversity of fungi out of the 340 sputum samples analyzed was as follows;16% (n = 53) were positive for moulds with Aspergillus species being the predominant constituting 68 % (n = 36). Among the Aspergilli, A. flavus and A. niger were the most frequently isolated adding up to 23%, (n = 12) and 15% (n = 8) respectively. Additionally, Paecillomyces variotii (9%, n = 5), Scedosporium aspiospermum (6%, n = 3), Mucor racemosus (8%, n = 4) and Penicillium spp. (9%, n = 5) were also recovered. <strong>Conclusion:</strong> The isolated fungi represented potential respiratory pathogens that could be responsible for persistent TB like symptoms despite treatment that could be misdiagnosed as relapse requiring treatment. Fungal investigation of all presumptive TB relapse cases should be advocated before treatment. This will reduce unnecessary retreatment, delayed antifungal intervention and unwarranted morbidity and mortality associated with misdiagnosis.
文摘Root canal treatment failure depends on many factors. Overfillings, insufficient fillings, missing canals, failure to provide a complete apical plug, and impermeability of coronal restoration are some of them. Failed root canal treatment may not always manifest itself immediately after treatment. Sometimes, root canal treatments, which have not been done well, can manifest themselves with extensive lesions and severe pain in the apical after a long time. Apical resection may be considered as a solution in lesions that are too large to be treated, but retreatment without surgery should be attempted beforehand. Thus, the patient may have recovered from unnecessary surgical procedures and treated with a more conservative method. This case presents the non-surgical retreatment of a left lateral tooth with a large periapical lesion with extruded gutta percha followed by a 36-month follow-up.
文摘The effects of TiO2 photocatalysis on the hydrolysis of protein of waste activated sludge (WAS) and its biodegradability were investigated in this study. After 12-h UV irradiation, the removal ratio of protein by TiO2 photocatalysis reached 98.1%. The optimal condition for photocatalytic degradation of protein is TiO2 dosage of 5.0 mg·L–1 under 2.4 w·m–2 UV light irradiation. TiO2 photocatalysis in comparison with other pretreatments obviously accelerated the hydrolysis of WAS and improved the conversion of total COD (tCOD) to soluble COD (sCOD). The sCOD/tCOD ratio of WAS pretreated by TiO2 photocatalysis, UV photolysis and TiO2 adsorption and that of the control were 92.8%, 32.5%, 18.0% and 16.6%, respectively. TiO2 photocatalytic pretreatment accelerated the biohydrogen production from 10-fold diluted WAS. The bioreactors containing UV photolysis and TiO2 adsorption pretreated WASs and the control reactor require 0.5-d, 0.9-d and 0.7-d start-up period for biohydrogen production, respectively. While the bioreactor containing TiO2 photocatalysis pretreated WAS obtained a hydrogen yield of 0.5 mL-H2/g-VS merely after 0.5-d mesophilic fermentation. The cumulative biohydrogen production from TiO2 photocatalysis pretreated WAS during 4-d mesophilic fermentation reached 11.7 mL-H2/g-VS, which was 1.2 times higher than that from the control. TiO2 photocatalytic pretreatment enhanced the biohydrogen production from WAS via accelerating the hydrolysis of its macromolecular components to smaller molecule weight hydrolysates.
基金This study was supported by the Eleventh Five-Year Support Project of the Ministry of Science and Technology from Ministry of Public Health of China(2010ZX09101-107)。
文摘Background:China is the second highest pulmonary tuberculosis(PTB)burden country worldwide.However,retreatment of PTB has often developed resistance to at least one of the four first-line anti-TB drugs.The cure rate(approximately 50.0–73.3%)and management of retreatment of PTB in China needs to be improved.Qinbudan decoction has been widely used to treat PTB in China since the 1960s.Previously clinical studies have shown that the Qinbudan tablet(QBDT)promoted sputum-culture negative conversion and lesion absorption.However,powerful evidence from a randomized controlled clinical trial is lacking.Therefore,the aim of this study was to compare the efficacy and safety of QBDT as an adjunct therapy for retreatment of PTB.Methods:We conducted a multicenter,randomized,double-blind,placebo-controlled clinical trial in China.People diagnosed with PTB were enrolled who received previous anti-TB treatment from April 2011 to March 2013.The treatment group received an anti-TB regimen and QBDT,and the control group was administered an anti-TB regimen plus placebo.Anti-TB treatment options included isoniazid,rifampicin,pyrazinamide,ethambutol,streptomycin for 2 months(2HRZES),followed by isoniazid,rifampicin,ethambutol for 6 months(6HRE),daily for 8 months.Primary outcome was sputum-culture conversion using the MGIT 960 liquid medium method.Secondary outcomes included lung lesion absorption and cavity closure.Adverse events and reactions were observed after treatment.A structured questionnaire was used to record demographic information and clinical symptoms of all subjects.Data analysis was performed by SPSS 25.0 software in the full analysis set(FAS)population.Results:One hundred eighty-one cases of retreatment PTB were randomly divided into two groups:the placebo group(88 cases)and the QBDT group(93 cases).A total of 166 patients completed the trial and 15 patients lost to follow-up.The culture conversion rate of the QBDT group and placebo group did not show a noticeable improvement by using the covariate sites to correct the rate differences(79.6%vs 69.3%;rate difference=0.10,95%confidence interval(CI):-0.02–0.23;F=2.48,P=0.12)after treatment.A significant 16.6%increase in lesion absorption was observed in the QBDT group when compared with the placebo group(67.7%vs 51.1%;rate difference=0.17,95%CI:0.02–0.31;χ2=5.56,P=0.02).The intervention and placebo group did not differ in terms of cavity closure(25.5%vs 21.1%;rate difference=0.04,95%CI:-0.21–0.12;χ2=0.27,P=0.60).Two patients who received chemotherapy and combined QBDT reported pruritus/nausea and vomiting.Conclusions:No significant improvement in culture conversion was observed for retreatment PTB with traditional Chinese medicine plus standard anti-TB regimen.However,QBDT as an adjunct therapy significantly promoted lesion absorption,thereby reducing lung injury due to Mycobacterium tuberculosis infection.Trial registration:This trial is registered at ClinicalTrials.gov,NCT02313610.
文摘Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have been studied,however,few studies have investigated wavefront-optimized(WFO)technology for retreatment following primary refractive surgery.This study aimed to report the outcomes of WFO photorefractive keratectomy(PRK)retreatments of refractive error following previous laser refractive surgery with PRK,laser in situ keratomileusis(LASIK),or laser-assisted subepithelial keratectomy(LASEK).Methods:We reviewed records of patients who underwent WFO PRK retreatments using the Allegretto Wave Eye-Q 400 Hz Excimer Laser System(Alcon Surgical)between January 2008 and April 2011 at Walter Reed Army Medical Center and Madigan Army Medical Center.Outcomes were recorded in terms of uncorrected distance visual acuity(UDVA),manifest refraction spherical equivalent(MRSE),corrected distance visual acuity(CDVA),and complications at 1 month(M),3 M,and 6 M post-op.Results:Seventy-eight patients(120 eyes)underwent WFO PRK retreatment during the study period.Primary surgery was surface ablation in 87 eyes(78 PRK,9 LASEK)and LASIK in 33 eyes.The mean spherical equivalent before retreatment was−0.79±0.94 D(−3.00 to 1.88 D).UDVA was≥20/20 in 69 eyes(60.0%)at 1 M,54 eyes(71.1%)at 3 M,and 27 eyes(73.0%)at 6 M follow-up.MRSE was within±0.50 D of emmetropia in 78 eyes(67.8%)at 1 M,59 eyes(77.6%)at 3 M,and 25 eyes(67.6%)at 6 M follow-up.CDVA was maintained within±1 line of pre-op in 113 of 115 eyes(98.3%)at 1 M,74 of 76 eyes(97.4%)at 3 M,and 37 eyes(100%)at 6 M follow-up.Conclusion:Although follow-up was limited beyond 3 M,WFO PRK retreatments in patients with residual refractive error may be a safe and effective procedure.Further studies are necessary to determine the long-term safety and stability of outcomes.
文摘At dawn in Wufu Village,in Dinghu District of Zhaoqing City,Guangdong Province,the newly restored Chaoyangli Cultural Retreat is already welcoming its first visitors.A visitor surnamed Chen,who has travelled from Guangzhou with his child,stops in front of the Chaxi Academy to admire local intangible cultural heritage crafts.
文摘The Western Himalaya,often termed the“Water Tower of Asia,”is experiencing critical hydrological changes due to global warming.This review synthesizes current scientific knowledge on climate-driven alterations in the region’s water cycle,assessing impacts on ecosystems,agriculture,energy security,and local livelihoods.We conducted a systematic literature review of peer-reviewed studies(2000-2024)from Scopus,Web of Science,and regional databases,supplemented by case studies and observational/modeling data.Key themes include cryospheric loss,shifting precipitation,river flow variability,and hydrological extremes.Key findings indicate that(1)temperature increases(0.2-0.5°C/decade)have accelerated glacier retreat(up to 20-30%mass loss in some basins)and reduced snow cover(5-15%decline since 2000);(2)altered precipitation patterns have increased rainfall dominance,elevating flood risks while reducing groundwater recharge in arid zones;and(3)river discharge shows declining dry-season flows but higher peak flows,threatening water security for over 200 million downstream inhabitants.These findings underscore the urgent need for integrated,cross-scale strategies combining scientific innovation,indigenous knowledge,and adaptive policies to enhance resilience.We highlight critical gaps in high-altitude monitoring and call for transboundary cooperation to mitigate escalating climate risks.This systematic review uniquely contrasts Western Himalayan hydrology with that of the Central and Eastern regions and benchmarks policy gaps,offering a roadmap for climate-resilient water governance.
基金the Key Research and Development Project of Hubei Province(No.2021BCA219)。
文摘The mechanism involved in deep-seated landslide-debris flow disaster chains has been studied for many years,however,it is still not completely understood.This study aims to analyze the key factors that were involved and led to the geological disaster of Shaziba 62.0 m deep landslide-debris flow.Two extensive field investigations were conducted before and after the slope failure event.The study further used drilled cores,high-density resistivity method,and aerial photographs to obtain valuable insights into the disaster chain.It was found that opencast coal mining operations broke the locked segment of the front edge and heavy rainfall softened the slip zones along the faults.Mechanical calculations demonstrated that the coupling condition of the opencast coal mining and heavy rainfall triggered the landslide.A new evolution model was put forth to describe the complex mechanism of combining progressive retreat and tractive failure of hydraulic drive landslide,which was governed by the bedding-plane rock layer.Surface runoff caused the mass of the landslide to liquefy throughout the sliding process,resulting in overlapping deposits,debris-flow-barrier-lake,and erosion.These new insights led to the indication of a different triggering mechanism of landslides-debris flows,as well as laid the foundation for the proposed physical and mechanical mechanism model based on progressive retreat soil-rock mixed landslides with an upper locked segment and lower weak interlayer under heavy rainfall.
基金the National Natural Science Foundation of China(No.52171284)the Natural Science Foundation of Shandong Province(No.ZR2023QE016).
文摘The Barents Sea is a marginal sea of the Arctic Ocean and contains substantial hydrocarbon resources.In recent years,the Barents Sea has emerged as one of the Arctic regions with the most pronounced sea ice variability.To analyze sea ice changes in the Barents Sea,sea ice data from the National Snow and Ice Data Center were utilized.A remarkable decline in sea ice has been witnessed in the northern and eastern regions.This phenomenon has expanded the ice-free operational area for marine structures,highlighting the significance of wave factors.A site within this area was chosen to estimate the wave parameters.The wave data from ERA5 were categorized according to wave energy in each season.Four mixture joint distribution models for the wave height and period were constructed based on the mixture distribution method and copula theory,and environmental contours were developed and compared with the conditional probability method.Despite differences in the design parameter results,the mixture models demonstrate good performance in sample fitting,particularly in the distribution tails.Among these models,the Gaussian copula offers the best fit.
基金supported by the Third Xinjiang Scientific Expedition Program(Grant Nos.2022xjkk0101,2022xjkk0802)the Second Qinghai-Tibet Scientific Expedition Program(Grant No.2019QZKK0201)+2 种基金the National Natural Science Foundation of China(Grant No.42301166)the China-Tajikistan intergovernmental Joint R&D Project(Grant No.2025YFE0102800)the Science and Technology Program of Gansu Province(Grant Nos.23ZDFA017,22ZD6FA005)
文摘As a highly sensitive indicator of climate change in the arid northwest region of China,glacier dynamics in the Kaidu-Konqi River Basin directly influence regional runoff patterns,thereby playing a crucial role in shapingregional hydrology and maintaining ecological stability.This study systematically assessed glacier distribution in2020 and analyzed glacier changes from 1972 to 2020 using the Chinese Glacier Inventory of Xinjiang in 2020(CGI-XJ2020),historical satellite imagery from 1972,and data from the Second Chinese Glacier Inventory.In2020,the basin contained 713 glaciers covering 313.99 km^(2),with an estimated glacier volume of 11.81 km^(3)(0.41%glacier coverage).Glaciers were predominantly clustered in the northern and southwestern mountains.Small glaciers(<0.5 km^(2))comprised 78%of the glacier count but only 3%of the total area,whereas glaciers≥0.5 km^(2)accounted for 97%of the total area and 83.6%of the glacier volume.From 1972 to 2020,the totalglacier area decreased by 42.28%(229.99 km^(2))and glacier volume by 49.51%(11.58 km^(3)),equating to meanannual rates of−0.88%and−1.03%,respectively.Glacier retreat drives temporary increases in meltwatersupply but threatens long-term regional runoff stability and ecological water security.The retreat rate variedover different periods,with a more pronounced decline observed between 1972 and 2007.These findingshighlight an accelerating glacier loss in the basin,underscoring the need for continued monitoring and assess-ment of its hydrological and ecological impacts.
文摘AIM： To evaluate the effectiveness of ultrasonographic screening for early detection of hepatocellular carcinoma （HCC）. METHODS： The data of 14 968 patients who had ultrasonography （US） for chronic liver diseases were collected into a database program from June 1995 to June 2005. The risk factors for HCC were also studied. A total of 6089 patients who had repeated US were enrolled, 264 patients were diagnosed with HCC during follow-up （mean, 39 mo）. RESULTS： The detection rate of small HCC （≤ 3 cm in diameter） was 67.7%. The tumor size detected by screening at the intervals of 6 mo was significantly smaller than that at longer intervals. Only 29.3% of HCC patients had an elevated serum alpha fetoprotein （AFP） level above 400 ng/mL. The risk of HCC development during follow-up was higher in patients with liver cirrhosis （10.9%） and hepatitis C （9.0%） than in patients with chronic hepatitis （4.2%）, hepatitis B （4.9%） and non-B, non-C hepatitis （NBNC, 3.9%）. CONCLUSION： US screening at a interval of 6 mo is beneficial to high-risk patients over 40 years old and the early detection of HCC prolongs survival.
文摘AIM:Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology,the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (aPBC) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation.However, only 20-30% of patients respond fully to UDCA.Recently,lipoprotein-lowering agents have been found to be effective for PBC.The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory-activated receptor α,in patients with aPBC.METHODS:Fenofibrate was administered for twelve weeks in nine patients with aPBC who failed to respond to UDCA.UDCA was used along with fenofibrate during the study.The data from aPBC patients were analyzed to assess the biochemical effect of fenofibrate during the study.RESULTS: The serum levels of alkaline phosphatase (ALP)(285±114.8IU/L) and immunoglobulin M (IgM) (255.8±85.9mg/dl) significantly decreased to 186.9±76.2IU/L and 192.9±67.5mg/dL respectively, after fenofibrate treatment in patients with aPBC (P<0.05). Moreover,the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in any patients.CONCLUSION:Fenofibrate appears to be significantly effective in treating patients with aPBC who respond incompletely to UDCA alone.Although the mechanism of fenofibrate on aPBC has not yet been fully clarified,combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its antiinflammatory effect.
基金the Youth Development Project of Army Military Medical University,No.2018XQN014the Clinical Innovation Project of Army Military Medical University,No.2019XLC2014the Science and Technology Foundation of Chongqing,China,No.cstc2014jcyjA10092.
文摘BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars located at the end of the dental arch.However,advancements in digital dental diagnosis and treatment techniques can solve these problems.Here,we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel“inlay-guided endodontics”technique based on improved computer-generated programs.CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar.The tooth,diagnosed with post-treatment endodontic disease,was initially treated by conventional methods,which were ineffective.Our“inlay-guided endodontics”technique was subsequently adopted,with the establishment of a precise integrated three-dimensional(3D)plate model of cone-beam computed tomography data and a digital impression of the dentition.An optimal root canal approach was generated for the“virtual file”in the 3D model.The plate data were imported into a 3D printer and printed.With the help of the guide plate,the file was accurately placed into the cervical third of the distal root canal.The root canal and prosthodontic treatments successfully proceeded subsequently.CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.
