AIM: To elucidate the potential impact of examined lymph nodes (eLNs) on long-term survival of node-negative gastric cancer patients after curative surgery.
We used a proteomic approach to identify IbpA in Cronobacter sakazokii （C. sakazaki）, which is related to heat tolerance in this strain. The abundance of IbpA in C. sakazakii strains strongly increased after heat sh...We used a proteomic approach to identify IbpA in Cronobacter sakazokii （C. sakazaki）, which is related to heat tolerance in this strain. The abundance of IbpA in C. sakazakii strains strongly increased after heat shock. C sakazakii CMCC 45402 ibpA deletion mutants were successfully constructed. The C. sakazakii CMCC 45402 AibpA and wild-type strains could not be distinguished based on colony morphology on LB agar plates or biochemical assays. The growth of the C. sakazakii CMCC 45402 AibpA mutant in heat shock conditions was indistinguishable from that of the isogenic wild-type, but showed greater heat resistance than E. coil O157：H7 strain CMCC 44828. This study suggests that the absence of a single ibpA gene has no obvious effect on the phenotype or heat resistance of the strain C. sakazakii CMCC 45402.展开更多
Based on the overall view of communication theory and spoken English language testing system,this paper has conducted a comprehensive and specific observation and research on how examiner non-verbal behavior has affec...Based on the overall view of communication theory and spoken English language testing system,this paper has conducted a comprehensive and specific observation and research on how examiner non-verbal behavior has affected candidate performance.The research has found out that not only examiner behavior including non-verbal behavior but language testing scenario itself is of communicative nature and examiner’s non-verbal behavior indeed promotes examinee’s test performance,which can help to better understand spoken testing system,examiner non-verbal behavior,and testing environment to promote the development of language speaking test and reflect examinee’s real language competence and ability.展开更多
AIM: To investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) among the health examinees in the Shanghai region, China. METHODS: A total of 11 816 subjects who underwent health examinati...AIM: To investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) among the health examinees in the Shanghai region, China. METHODS: A total of 11 816 subjects who underwent health examinations in our hospital between August 2010 and February 2011 were analyzed retrospectively. Among them, there were 7174 men and 4642 women. PLG was diagnosed by the real-time ultrasonography. Those with the body mass index (BMI) ≥ 28 were considered to be obese. Blood biochemical indices were detected with the fully automatic biochemical analyzer and hepatitis B surface antigen (HBsAg) was tested by the automated enzyme immunoassay. The correlations between the prevalence of PLG and age, sex, BMI, serum cholesterol (T-Cho), triglycerides (TG),blood sugar, HBsAg, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), gallstone and fatty liver were investigated. After univariate analysis of 11 variables, stepwise logistic regression analysis was performed to explore the risk factors of PLG. RESULTS: There was a significant difference in sex, T-Cho, HBsAg, HDL-C, LDL-C and fatty liver between the PLG-positive group and the PLG-negative group (332/163 vs 6842/4479, P = 0.003; 22/473 vs 295/11 026, P =0.013; 92/403 vs 993/10 328, P = 0.001; 47/448 vs 332/10 989, P = 0.001; 32/463 vs 381/10 940, P = 0.001; 83/412 vs 3260/8061, P = 0.001). No significant difference was found in the age, BMI, TG, blood sugar and gallstone between the two groups (47.3 ± 26 vs 45.1 ± 33, P = 0.173; 59/436 vs 1097/10 224, P = 0.102; 52/443 vs 982/10 339, P = 0.158; 17/478 vs 295/11 026, P = 0.26; 24/471 vs 395/10 926, P = 0.109). Logistic regression analysis showed that the sex, HBsAg and HDL-C were independent risk factors for the development of PLG in a descending order of HDL-C > HBsAg > sex. CONCLUSION: In healthy people, the male gender, positive HBsAg, and low HDL-C confer higher risks of PLG development.展开更多
A special cloth for keeping LiF(Mg,Cu,P)TL dosimetry elements is worn by examinees. The exposures of 128 examinees .received upper G.I.T (gastro-intestinal tram) X-ray examination are measured. The reference point of ...A special cloth for keeping LiF(Mg,Cu,P)TL dosimetry elements is worn by examinees. The exposures of 128 examinees .received upper G.I.T (gastro-intestinal tram) X-ray examination are measured. The reference point of the maximum body surface exposure given is at the middle of stomach. The average of this point is (4.97±1.94) × 10-4C.kg-1 person-1 examination-1 and (1.33±0.28)×10-4C.kg-1.min-1.展开更多
目的分析健康体检者胰岛素抵抗代谢评分(metabolic score for insulin resistance,METS-IR)轨迹变化,并探讨其与高尿酸血症(hyperuricemia,HUA)的相关性,为针对性防治HUA提供依据。方法本研究为回顾性队列研究,选取2018年1月—2021年12...目的分析健康体检者胰岛素抵抗代谢评分(metabolic score for insulin resistance,METS-IR)轨迹变化,并探讨其与高尿酸血症(hyperuricemia,HUA)的相关性,为针对性防治HUA提供依据。方法本研究为回顾性队列研究,选取2018年1月—2021年12月连续4年在山西医科大学第一医院健康管理中心进行健康体检且符合纳入、排除标准的2607例体检者作为研究对象,依据健康体检数据,采用组基轨迹模型,按照观察期间METS-IR水平进行分组,于2022、2023年健康体检时随访各组人群HUA的发病情况。用log-rank检验比较不同METS-IR轨迹组HUA发病率的差异,采用logistic回归模型分析不同METS-IR轨迹与HUA的相关性。结果识别确定3个不同的METS-IR轨迹组,分别为低水平组178例(6.8%)、中水平组2198例(84.3%)和高水平组231例(8.9%)。低水平组、中水平组和高水平组的HUA累积发病率分别为27.0%、20.1%、37.2%(χ^(2)=52.777,P<0.001);逐步校正年龄、性别、吸烟、饮酒、熬夜、失眠、运动、HUA家族史、收缩压、舒张压等多种混杂因素后,高水平组、低水平组HUA的患病风险仍为中水平组的1.617(95%CI:1.167~2.242)倍和1.441倍(95%CI:1.006~2.065)。年龄增大(OR=1.028,95%CI:1.016~1.041)、偶尔熬夜(OR=1.345,95%CI:1.064~1.701)、HUA家族史(OR=1.921,95%CI:1.397~2.642)、收缩压升高(OR=1.009,95%CI:1.002~1.015)是HUA发生的独立危险因素(均P<0.05);女性(OR=0.666,95%CI:0.475~0.934)、戒酒(OR=0.243,95%CI:0.120~0.491)是HUA发生的独立保护因素(均P<0.05)。结论HUA的发病率随METS-IR轨迹的升高而增加,METS-IR可作为HUA的预测指标。展开更多
Background:The number of lymph nodes examined(LNe)is often insufficient in patients with rectal cancer(RC)treated with neoadjuvant therapy;however,its prognostic value remains controversial.Thus,we retrospectively exp...Background:The number of lymph nodes examined(LNe)is often insufficient in patients with rectal cancer(RC)treated with neoadjuvant therapy;however,its prognostic value remains controversial.Thus,we retrospectively explored whether LNe had an influence on staging and prognosis and investigated whether there was a cut-off value for better prognosis in patients with RC treated with neoadjuvant therapy.Methods:Data were collected from seven prospective hospital databases in China from July 2002 to May 2018.Binary logistic regression models were used to predict lymph node metastasis.The cut-off value for LNe was determined using X-tile 3.6.1.Survival outcomes and risk factors were analyzed using the log-rank test and Cox regression model.Results:A total of 482 patients were included,of whom 459 had complete overall survival(OS)information.Using the percentile method,the total number of lymph nodes examined(TLNe)was 14-16(40th-60th percentile),and the proportion of patients with lymph node metastasis reached a maximum of 48.1%.Cox multivariate analysis showed that the odds ratio(OR)remained the highest when TLNe was 14-16(OR=3.379,P=0.003).The 3-year and 5-year OS were 85.4% and 77.8%,respectively.Negative lymph nodes examined(NLNe)of≤6 was an independent risk factor for 3-year and 5-year OS(3-year OS 71.1%vs.85.9%,P=0.004;5-year OS 66.3%vs.74.3%,P=0.035).Subgroup analysis for patients with ypN+showed that higher 3-year and 5-year OS were achieved when the TLNe was>10,78.8%vs.54.0%(P=0.005),and 60.8%vs.36.0%(P=0.012),respectively.Patients with ypN0M0 had a higher 5-year OS when the TLNe was>19(P=0.055).Conclusion:The TLNe and NLNe influenced the staging accuracy and demonstrated prognostic value in patients with RC treated with neoadjuvant therapy.展开更多
[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to t...[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.展开更多
Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 199...Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 1993.TM typically spares the foveal center,is asymptomatic,and is often detected incidentally during routine ophthalmic examinations.Through literature search,we did not identify racial or regional differences in TM.It predominantly affects children,with an estimated prevalence of 2 per 100000 in individuals under 16 ages[3].While previous reports have focused on pediatric and adult populations,this study presents four cases of TM in preterm infants.展开更多
AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 ...AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included.By exclusion criteria,8460 subjects were screened with 1676 myopia samples and 6784 control samples.Subsequently,baseline characteristics,association analyses,risk stratification analyses,and receive operating characteristic curve(ROC)were used to investigate the associations between covariates and myopia.Then,the causal relationship was explored in depth by MR analysis,and was estimated the reliability by sensitivity analyses and directionality tests.RESULTS:Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates(excluding gender;P<0.05).The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates[model 3:odd ratio(OR)=1.31;95%CI=1.07-1.62;P=0.0133].The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia(P<0.05,OR>1).ROC proved that the model was accurate in its prediction[area under curve(AUC)=0.7].Subsequently,the causal relationship between them was statistically significant(P<0.05)according to the inverse variance weighted(IVW)method in MR.Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders.Forest plot displayed an increasing risk of myopia on asthma(OR>1).The funnel plot demonstrated compliance with Mendel’s second law.Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.CONCLUSION:A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis,which is important implications for public health policy development and clinical practice.展开更多
With holism,dynamics,interconnectedness,and emergence as its core characteristics,the Unified Complex Systems Theory(UCST)focuses on the evolutionary laws and intrinsic mechanisms of multi-element,multi-level,and mult...With holism,dynamics,interconnectedness,and emergence as its core characteristics,the Unified Complex Systems Theory(UCST)focuses on the evolutionary laws and intrinsic mechanisms of multi-element,multi-level,and multi-dimensional systems,providing a scientific analytical framework for accurately judging the existence and development of various complex phenomena.The core philosophical views of Marx and Engels,including historical materialism,dialectics,alienation theory,and communism theory,have sparked extensive debates since their proposal-garnering numerous adherents while also facing sharp criticisms-and continue to exert a certain influence on the global intellectual and political arenas.Based on the perspective of the UCST,this paper draws on both the interpretations and developments of their views by proponents such as Lenin,Lukács,and Habermas,as well as the doubts and reflections raised by critics like Popper,Russell,and Hayek.From the dual dimensions of theoretical logic and practical verification,it comprehensively analyzes the theoretical value and inherent limitations of Marx and Engels’core philosophical views.Incorporating practical cases from multiple countries and academic research findings,this study aims to provide a neutral,objective,and pluralistic reference for the rational understanding of Marxist philosophy.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANE...AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANES)were analyzed,a nationally representative U.S.dataset.ERM was identified via retinal imaging based on the presence of cellophane changes.Key predictors included age group,eye surgery history,and refractive error,with additional demographic and health-related covariates.Weighted univariate and multiple logistic regression models were used to assess associations and interaction effects between eye surgery and refractive error.RESULTS:Totally 3925 participants were analyzed.Older age,eye surgery,and refractive errors were significantly associated with ERM.Compared to those under 65y,the odds ratio(OR)for ERM was 3.08 for ages 65–75y(P=0.0014)and 4.76 for ages 75+years(P=0.0069).Eye surgery increased ERM risk(OR=3.48,P=0.0018).Moderate to high hyperopia and myopia were also associated with ERM(OR=2.65 and 1.80,respectively).A significant interaction between refractive error and eye surgery was observed(P<0.0001).Moderate to high myopia was associated with ERM only in those without eye surgery(OR=1.92,P=0.0443).Eye surgery was most strongly associated with ERM in the emmetropic group(OR=3.60,P=0.0027),followed by the moderate to high myopia group(OR=3.01,P=0.0031).CONCLUSION:ERM is significantly associated with aging,eye surgery,and refractive errors.The interaction between eye surgery and refractive error modifies ERM risk and highlights the importance of considering combined effects in clinical risk assessments.These findings may help guide individualized ERM risk assessment that may inform personalized approaches to ERM prevention and management.展开更多
Dear Editor,We present a case of acute zonal occult outer retinopathy(AZOOR)complex in a myopic patient with angioid streaks(ASs).A 19-year-old female has been experiencing visual field defects in her left eye for mor...Dear Editor,We present a case of acute zonal occult outer retinopathy(AZOOR)complex in a myopic patient with angioid streaks(ASs).A 19-year-old female has been experiencing visual field defects in her left eye for more than 3y.She was diagnosed with ASs and choroiditis at a local hospital.She has a seven-year history of bilateral high myopia.A fundus examination confirmed the presence of ASs and myopic fundus changes in both eyes.Multimodal imaging revealed an AZOOR complex in the left eye.展开更多
Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic ...Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC.Our objectives of the study were to analyze the prognostic value of the lymph node ratio(LNR)and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC.Method:We analyzed 120 patients diagnosed from January 1,1990,to December 31,2016,constituted the study cohort from the Surveillance,Epidemiology,and End Results(SEER)registry.We calculated the overall survival(OS)of these patients by using a Kaplan–Meier analysis.The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis.The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC.Receiver-operating characteristic curve(ROC)analysis to investigate the discriminatory ability of the total number of lymph nodes examined(TNLE)relative to whether lymph node metastasis was present.Results:The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14(interquartile range:6.25–20.0).According to the univariate analysis of OS,age,grade,chemotherapy,LNR,and TNLE were significantly different(P<.05).We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC,whereas radiotherapy was not associated with improved survival.The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS.TNLE≥8 showed the highest discriminatory power for evaluating lymph node metastasis(Area under curve(AUC):0.656,95%confidence interval:0.564–0.741,Youden index:0.2533,sensitivity:78.67%,specificity:46.67%,P=.003).Conclusion:Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC.Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients.An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC.展开更多
During the annual sessions of the National People’s Congress (NPC) and Chinese People’s Political Consultative Conference (CPPCC) this year, NPC deputies and CPPCC members shared their viewpoints on some hot topics ...During the annual sessions of the National People’s Congress (NPC) and Chinese People’s Political Consultative Conference (CPPCC) this year, NPC deputies and CPPCC members shared their viewpoints on some hot topics related to society and people’s livelihoods. Excerpts follow:展开更多
In China's criminal procedure system,forensic advice is one of the key types of evidence.These advices play an important part in discovering the facts of a case,convictions,and sentencing,and they cannot be ignore...In China's criminal procedure system,forensic advice is one of the key types of evidence.These advices play an important part in discovering the facts of a case,convictions,and sentencing,and they cannot be ignored in assessments of guilt and the death penalty.However,due to broad and flexible criminal laws,in actual litigation,the nonappearance of forensic examiner or mere provision of documentation of advice read in court has become the norm.This has led to the existence in name only of cross-examination rights,which directly damages the legitimate rights and interests of the parties and the objective and impartial rulings of referees.At present,there is no legal clarity in criminal proceedings that examiner should or should not be examined in court.In my opinion,the entire court system should require an appearance in court,which must be a clear mandatory appearance with specific exceptions.The system should guarantee the forensic examiner5 mandatory appearances,which would inevitably improve the rules of evidence.展开更多
基金Supported by A grant from the National Basic Research Pro-gram of China(973 Program),No.2010CB529301
文摘AIM: To elucidate the potential impact of examined lymph nodes (eLNs) on long-term survival of node-negative gastric cancer patients after curative surgery.
基金funded by National Science and Technology Major Project of the Ministry of Science and Technology of China(2013ZX09304101)
文摘We used a proteomic approach to identify IbpA in Cronobacter sakazokii （C. sakazaki）, which is related to heat tolerance in this strain. The abundance of IbpA in C. sakazakii strains strongly increased after heat shock. C sakazakii CMCC 45402 ibpA deletion mutants were successfully constructed. The C. sakazakii CMCC 45402 AibpA and wild-type strains could not be distinguished based on colony morphology on LB agar plates or biochemical assays. The growth of the C. sakazakii CMCC 45402 AibpA mutant in heat shock conditions was indistinguishable from that of the isogenic wild-type, but showed greater heat resistance than E. coil O157：H7 strain CMCC 44828. This study suggests that the absence of a single ibpA gene has no obvious effect on the phenotype or heat resistance of the strain C. sakazakii CMCC 45402.
文摘Based on the overall view of communication theory and spoken English language testing system,this paper has conducted a comprehensive and specific observation and research on how examiner non-verbal behavior has affected candidate performance.The research has found out that not only examiner behavior including non-verbal behavior but language testing scenario itself is of communicative nature and examiner’s non-verbal behavior indeed promotes examinee’s test performance,which can help to better understand spoken testing system,examiner non-verbal behavior,and testing environment to promote the development of language speaking test and reflect examinee’s real language competence and ability.
文摘AIM: To investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) among the health examinees in the Shanghai region, China. METHODS: A total of 11 816 subjects who underwent health examinations in our hospital between August 2010 and February 2011 were analyzed retrospectively. Among them, there were 7174 men and 4642 women. PLG was diagnosed by the real-time ultrasonography. Those with the body mass index (BMI) ≥ 28 were considered to be obese. Blood biochemical indices were detected with the fully automatic biochemical analyzer and hepatitis B surface antigen (HBsAg) was tested by the automated enzyme immunoassay. The correlations between the prevalence of PLG and age, sex, BMI, serum cholesterol (T-Cho), triglycerides (TG),blood sugar, HBsAg, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), gallstone and fatty liver were investigated. After univariate analysis of 11 variables, stepwise logistic regression analysis was performed to explore the risk factors of PLG. RESULTS: There was a significant difference in sex, T-Cho, HBsAg, HDL-C, LDL-C and fatty liver between the PLG-positive group and the PLG-negative group (332/163 vs 6842/4479, P = 0.003; 22/473 vs 295/11 026, P =0.013; 92/403 vs 993/10 328, P = 0.001; 47/448 vs 332/10 989, P = 0.001; 32/463 vs 381/10 940, P = 0.001; 83/412 vs 3260/8061, P = 0.001). No significant difference was found in the age, BMI, TG, blood sugar and gallstone between the two groups (47.3 ± 26 vs 45.1 ± 33, P = 0.173; 59/436 vs 1097/10 224, P = 0.102; 52/443 vs 982/10 339, P = 0.158; 17/478 vs 295/11 026, P = 0.26; 24/471 vs 395/10 926, P = 0.109). Logistic regression analysis showed that the sex, HBsAg and HDL-C were independent risk factors for the development of PLG in a descending order of HDL-C > HBsAg > sex. CONCLUSION: In healthy people, the male gender, positive HBsAg, and low HDL-C confer higher risks of PLG development.
文摘A special cloth for keeping LiF(Mg,Cu,P)TL dosimetry elements is worn by examinees. The exposures of 128 examinees .received upper G.I.T (gastro-intestinal tram) X-ray examination are measured. The reference point of the maximum body surface exposure given is at the middle of stomach. The average of this point is (4.97±1.94) × 10-4C.kg-1 person-1 examination-1 and (1.33±0.28)×10-4C.kg-1.min-1.
文摘目的分析健康体检者胰岛素抵抗代谢评分(metabolic score for insulin resistance,METS-IR)轨迹变化,并探讨其与高尿酸血症(hyperuricemia,HUA)的相关性,为针对性防治HUA提供依据。方法本研究为回顾性队列研究,选取2018年1月—2021年12月连续4年在山西医科大学第一医院健康管理中心进行健康体检且符合纳入、排除标准的2607例体检者作为研究对象,依据健康体检数据,采用组基轨迹模型,按照观察期间METS-IR水平进行分组,于2022、2023年健康体检时随访各组人群HUA的发病情况。用log-rank检验比较不同METS-IR轨迹组HUA发病率的差异,采用logistic回归模型分析不同METS-IR轨迹与HUA的相关性。结果识别确定3个不同的METS-IR轨迹组,分别为低水平组178例(6.8%)、中水平组2198例(84.3%)和高水平组231例(8.9%)。低水平组、中水平组和高水平组的HUA累积发病率分别为27.0%、20.1%、37.2%(χ^(2)=52.777,P<0.001);逐步校正年龄、性别、吸烟、饮酒、熬夜、失眠、运动、HUA家族史、收缩压、舒张压等多种混杂因素后,高水平组、低水平组HUA的患病风险仍为中水平组的1.617(95%CI:1.167~2.242)倍和1.441倍(95%CI:1.006~2.065)。年龄增大(OR=1.028,95%CI:1.016~1.041)、偶尔熬夜(OR=1.345,95%CI:1.064~1.701)、HUA家族史(OR=1.921,95%CI:1.397~2.642)、收缩压升高(OR=1.009,95%CI:1.002~1.015)是HUA发生的独立危险因素(均P<0.05);女性(OR=0.666,95%CI:0.475~0.934)、戒酒(OR=0.243,95%CI:0.120~0.491)是HUA发生的独立保护因素(均P<0.05)。结论HUA的发病率随METS-IR轨迹的升高而增加,METS-IR可作为HUA的预测指标。
文摘Background:The number of lymph nodes examined(LNe)is often insufficient in patients with rectal cancer(RC)treated with neoadjuvant therapy;however,its prognostic value remains controversial.Thus,we retrospectively explored whether LNe had an influence on staging and prognosis and investigated whether there was a cut-off value for better prognosis in patients with RC treated with neoadjuvant therapy.Methods:Data were collected from seven prospective hospital databases in China from July 2002 to May 2018.Binary logistic regression models were used to predict lymph node metastasis.The cut-off value for LNe was determined using X-tile 3.6.1.Survival outcomes and risk factors were analyzed using the log-rank test and Cox regression model.Results:A total of 482 patients were included,of whom 459 had complete overall survival(OS)information.Using the percentile method,the total number of lymph nodes examined(TLNe)was 14-16(40th-60th percentile),and the proportion of patients with lymph node metastasis reached a maximum of 48.1%.Cox multivariate analysis showed that the odds ratio(OR)remained the highest when TLNe was 14-16(OR=3.379,P=0.003).The 3-year and 5-year OS were 85.4% and 77.8%,respectively.Negative lymph nodes examined(NLNe)of≤6 was an independent risk factor for 3-year and 5-year OS(3-year OS 71.1%vs.85.9%,P=0.004;5-year OS 66.3%vs.74.3%,P=0.035).Subgroup analysis for patients with ypN+showed that higher 3-year and 5-year OS were achieved when the TLNe was>10,78.8%vs.54.0%(P=0.005),and 60.8%vs.36.0%(P=0.012),respectively.Patients with ypN0M0 had a higher 5-year OS when the TLNe was>19(P=0.055).Conclusion:The TLNe and NLNe influenced the staging accuracy and demonstrated prognostic value in patients with RC treated with neoadjuvant therapy.
文摘[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.
基金Supported by the National Natural Science Foundation of China(No.82070991).
文摘Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 1993.TM typically spares the foveal center,is asymptomatic,and is often detected incidentally during routine ophthalmic examinations.Through literature search,we did not identify racial or regional differences in TM.It predominantly affects children,with an estimated prevalence of 2 per 100000 in individuals under 16 ages[3].While previous reports have focused on pediatric and adult populations,this study presents four cases of TM in preterm infants.
基金Supported by the Hainan Provincial Natural Science Foundation of China(No.825RC898)Hainan Province Clinical Medical Center。
文摘AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included.By exclusion criteria,8460 subjects were screened with 1676 myopia samples and 6784 control samples.Subsequently,baseline characteristics,association analyses,risk stratification analyses,and receive operating characteristic curve(ROC)were used to investigate the associations between covariates and myopia.Then,the causal relationship was explored in depth by MR analysis,and was estimated the reliability by sensitivity analyses and directionality tests.RESULTS:Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates(excluding gender;P<0.05).The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates[model 3:odd ratio(OR)=1.31;95%CI=1.07-1.62;P=0.0133].The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia(P<0.05,OR>1).ROC proved that the model was accurate in its prediction[area under curve(AUC)=0.7].Subsequently,the causal relationship between them was statistically significant(P<0.05)according to the inverse variance weighted(IVW)method in MR.Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders.Forest plot displayed an increasing risk of myopia on asthma(OR>1).The funnel plot demonstrated compliance with Mendel’s second law.Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.CONCLUSION:A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis,which is important implications for public health policy development and clinical practice.
基金supported by the start-up funding from Westlake University under Grant Number 041030150118the scientific research project of Westlake University“Theoretical Research and Demonstration Application of Complex Systems and Deep-Sea Technology(Phase I)”under Grant Number WU2025A006.
文摘With holism,dynamics,interconnectedness,and emergence as its core characteristics,the Unified Complex Systems Theory(UCST)focuses on the evolutionary laws and intrinsic mechanisms of multi-element,multi-level,and multi-dimensional systems,providing a scientific analytical framework for accurately judging the existence and development of various complex phenomena.The core philosophical views of Marx and Engels,including historical materialism,dialectics,alienation theory,and communism theory,have sparked extensive debates since their proposal-garnering numerous adherents while also facing sharp criticisms-and continue to exert a certain influence on the global intellectual and political arenas.Based on the perspective of the UCST,this paper draws on both the interpretations and developments of their views by proponents such as Lenin,Lukács,and Habermas,as well as the doubts and reflections raised by critics like Popper,Russell,and Hayek.From the dual dimensions of theoretical logic and practical verification,it comprehensively analyzes the theoretical value and inherent limitations of Marx and Engels’core philosophical views.Incorporating practical cases from multiple countries and academic research findings,this study aims to provide a neutral,objective,and pluralistic reference for the rational understanding of Marxist philosophy.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
基金Supported by Chengdu Municipal Science and Technology Bureau Key R&D Support Program(No.2023-YF09-00041-SN)。
文摘AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANES)were analyzed,a nationally representative U.S.dataset.ERM was identified via retinal imaging based on the presence of cellophane changes.Key predictors included age group,eye surgery history,and refractive error,with additional demographic and health-related covariates.Weighted univariate and multiple logistic regression models were used to assess associations and interaction effects between eye surgery and refractive error.RESULTS:Totally 3925 participants were analyzed.Older age,eye surgery,and refractive errors were significantly associated with ERM.Compared to those under 65y,the odds ratio(OR)for ERM was 3.08 for ages 65–75y(P=0.0014)and 4.76 for ages 75+years(P=0.0069).Eye surgery increased ERM risk(OR=3.48,P=0.0018).Moderate to high hyperopia and myopia were also associated with ERM(OR=2.65 and 1.80,respectively).A significant interaction between refractive error and eye surgery was observed(P<0.0001).Moderate to high myopia was associated with ERM only in those without eye surgery(OR=1.92,P=0.0443).Eye surgery was most strongly associated with ERM in the emmetropic group(OR=3.60,P=0.0027),followed by the moderate to high myopia group(OR=3.01,P=0.0031).CONCLUSION:ERM is significantly associated with aging,eye surgery,and refractive errors.The interaction between eye surgery and refractive error modifies ERM risk and highlights the importance of considering combined effects in clinical risk assessments.These findings may help guide individualized ERM risk assessment that may inform personalized approaches to ERM prevention and management.
基金Supported by the National Natural Science Foundation of China(No.82171073).
文摘Dear Editor,We present a case of acute zonal occult outer retinopathy(AZOOR)complex in a myopic patient with angioid streaks(ASs).A 19-year-old female has been experiencing visual field defects in her left eye for more than 3y.She was diagnosed with ASs and choroiditis at a local hospital.She has a seven-year history of bilateral high myopia.A fundus examination confirmed the presence of ASs and myopic fundus changes in both eyes.Multimodal imaging revealed an AZOOR complex in the left eye.
文摘Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC.Our objectives of the study were to analyze the prognostic value of the lymph node ratio(LNR)and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC.Method:We analyzed 120 patients diagnosed from January 1,1990,to December 31,2016,constituted the study cohort from the Surveillance,Epidemiology,and End Results(SEER)registry.We calculated the overall survival(OS)of these patients by using a Kaplan–Meier analysis.The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis.The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC.Receiver-operating characteristic curve(ROC)analysis to investigate the discriminatory ability of the total number of lymph nodes examined(TNLE)relative to whether lymph node metastasis was present.Results:The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14(interquartile range:6.25–20.0).According to the univariate analysis of OS,age,grade,chemotherapy,LNR,and TNLE were significantly different(P<.05).We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC,whereas radiotherapy was not associated with improved survival.The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS.TNLE≥8 showed the highest discriminatory power for evaluating lymph node metastasis(Area under curve(AUC):0.656,95%confidence interval:0.564–0.741,Youden index:0.2533,sensitivity:78.67%,specificity:46.67%,P=.003).Conclusion:Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC.Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients.An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC.
文摘During the annual sessions of the National People’s Congress (NPC) and Chinese People’s Political Consultative Conference (CPPCC) this year, NPC deputies and CPPCC members shared their viewpoints on some hot topics related to society and people’s livelihoods. Excerpts follow:
文摘In China's criminal procedure system,forensic advice is one of the key types of evidence.These advices play an important part in discovering the facts of a case,convictions,and sentencing,and they cannot be ignored in assessments of guilt and the death penalty.However,due to broad and flexible criminal laws,in actual litigation,the nonappearance of forensic examiner or mere provision of documentation of advice read in court has become the norm.This has led to the existence in name only of cross-examination rights,which directly damages the legitimate rights and interests of the parties and the objective and impartial rulings of referees.At present,there is no legal clarity in criminal proceedings that examiner should or should not be examined in court.In my opinion,the entire court system should require an appearance in court,which must be a clear mandatory appearance with specific exceptions.The system should guarantee the forensic examiner5 mandatory appearances,which would inevitably improve the rules of evidence.
