The history of human being is a result of various activities to live.Humanity has lived with the nature which has enabled to sustain the lives.Humanity has gained great benefits by the use of nature and its alternatio...The history of human being is a result of various activities to live.Humanity has lived with the nature which has enabled to sustain the lives.Humanity has gained great benefits by the use of nature and its alternation.The comfortable environment development made the increase of population and the alternation of nature has extended.The past few hundred years can be said the era of fossil fuels.Surprisingly,it has caused the global warming.The construction sector is the industry in which the foundation for social and economic activities is created.It has been believed that a comfortable and safety life,production and use of environments will lead to happiness for humanity.However,we could not put a break on the development.Of course it is,the construction-related sectors that consume the most large natural resources and energy,and therefore emit the largest quantity of CO_(2).Fortunately,a concept in which we can deal with this situation was developed.It is sustainability concept.In this paper,firstly the concept“sustainability”which was born at the end of 20th century is reconfirmed.As the performance-based design has played a significant role in sustainability design,secondly the concept is explained based on the author’s paper and book.Thirdly the development of sustainability in fib is comprehensively discussed including sustainability-resilience dispute and ethics.展开更多
目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列...目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列腺癌患者的临床资料进行回顾性收集和分析,根据骨扫描的检查结果辅以核磁共振,将盆腔有无骨转移的病人分为前列腺癌骨转移组80例和非骨转移组89例。所有患者在手术前都接受了MRI检查,对血清PSA、ALP、D-二聚体、FIB水平进行定量检测。对不同影像指标与前列腺癌骨转移结果之间的一致性采用Kappa一致性检验;利用单因素和多因素Logistic回归分析,评估mpMRI、ALP、D-二聚体、FIB及其他临床指标在前列腺癌骨转移诊断中的价值。利用受试者工作特征(receiver operating characteristic, ROC)曲线对前列腺癌骨转移中纳入的mpMRI、ALP、D-二聚体、FIB及其联合指标的临床应用价值进行评价。结果:T1WI、T2WI压脂、DWI及mpMRI与前列腺癌骨转移结果比较的Kappa值分别为0.536、0.470、0.629、0.691 (P Objective: To analyze the efficacy of multiparametric MRI (mpMRI) combined with serum ALP, D-dimer, and FIB in the diagnosis of bone metastasis in prostate cancer. Methods: A retrospective collection and analysis of clinical data from 169 prostate cancer patients were conducted. Based on the results of bone scans supplemented by MRI, patients with or without pelvic bone metastasis were divided into the prostate cancer bone metastasis group (80 cases) and the non-bone metastasis group (89 cases). All patients underwent MRI examination prior to surgery, and serum levels of PSA, ALP, D-dimer, and FIB were quantitatively measured. Kappa consistency tests were used to analyze the agreement between different imaging indicators and the results of prostate cancer bone metastasis. Uni- and multivariable logistic regression analyses were performed to evaluate the value of mpMRI, ALP, D-dimer, FIB, and other clinical indicators in the diagnosis of prostate cancer bone metastasis. The clinical application value of mpMRI, ALP, D-dimer, FIB, and their combined indicators in diagnosing prostate cancer bone metastasis was assessed using receiver operating characteristic (ROC) curves. Results: The Kappa values comparing T1WI, T2WI fat suppression, DWI, and mpMRI with the results of prostate cancer bone metastasis were 0.536, 0.470, 0.629, and 0.691, respectively (P < 0.001). Compared to the non-bone metastasis group, the serum levels of ALP, D-dimer, and FIB in the bone metastasis group were significantly higher (P < 0.001). Multivariable logistic regression analysis indicated that mpMRI, ALP, D-dimer, and FIB are independent risk factors for prostate cancer bone metastasis (P < 0.05). The combined indicators showed the best performance, followed by the individual indicators of D-dimer, mpMRI, ALP, and FIB, all of which demonstrated good diagnostic value (P < 0.05). Conclusion: mpMRI, ALP, D-dimer, and FIB all demonstrate certain diagnostic efficacy for prostate cancer bone metastasis. The combined use of these indicators can further enhance diagnostic value, suggesting that they should be considered for broader application in clinical practice.展开更多
目的 探讨基于4个因素的纤维化指数(fibrosis index based on four factors,FIB-4)在长期接受抗病毒治疗的慢性乙型肝炎(chronic hepatitis B,CHB)患者前瞻队列人群中对发生肝细胞癌(hepatocellular carcinoma,HCC)的预测能力。方法 收...目的 探讨基于4个因素的纤维化指数(fibrosis index based on four factors,FIB-4)在长期接受抗病毒治疗的慢性乙型肝炎(chronic hepatitis B,CHB)患者前瞻队列人群中对发生肝细胞癌(hepatocellular carcinoma,HCC)的预测能力。方法 收集2008年10月至2021年7月首都医科大学附属北京地坛医院829例接受口服抗病毒治疗或在研究开始前接受治疗的成年CHB患者的基线数据,每3~6个月进行1次随访,HCC经腹超声、腹部计算机断层扫描(computed tomography,CT)或磁共振成像(magnetic resonance imaging,MRI)或肝血管造影检查或HCC的细胞学/组织学诊断。结果 共纳入764例CHB患者,中位随访时间为8.8(6.7~10.6)年。多因素Cox回归分析显示,年龄、HCC家族史、饮酒、肝硬化和FIB-4均为CHB患者HCC发病独立风险预测因子,差异均有统计学意义(P<0.001)。通过限制性立条图RCS分析,随着FIB-4指数的增加HCC发生风险呈非线性升高。相对于FIB-4指数<1.4组,FIB-4指数≥1.4组HCC的HR为8.89(95%CI:3.16~25.07),校正多因素影响后HR为4.84(95%CI:1.64~14.34)。肝硬化患者发生HCC的HR为3.46(95%CI:1.69~7.07)。中介效应模型分析,FIB-4指数与肝硬化有中介效应,其中有40.25%通过肝硬化间接影响HCC的发生。结论 FIB-4指数在预测接受抗病毒治疗的CHB患者的HCC风险方面具有优势。可用于临床实践,以帮助决策长期HCC监测策略,尤其是对中度和高危患者。展开更多
AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ...AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCV-RNA, HIV-RNA, duration of highly active anti-retroviraltherapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ 2M H = 4, P < 0.04). In fact, LS ≥ 9.5 was significantly higher in co-infected than in HIV and HCV mono-infected pa-tients (χ 2 = 5, P < 0.03). Also APRI and the FIB-4 index showed more LF in co-infected than in HIV mono-infect-ed patients (P < 0.0001), but not in HCV mono-infected patients. In HIV?HCV co-infected patients, the extent of LS was significantly associated with alcohol intake (P < 0.04) and lower CD4+ cell count (P < 0.02). In HCV pa-tients, LS was correlated with alcohol intake (P < 0.001) and cholesterol levels (P < 0.03). Body mass index, dia-betes, HCV-and HIV-viremia were not significantly cor-related with LS. In addition, 20% of co-infected patients had virologically unsuccessful HAART; in 50% compliance was low, CD4+ levels were < 400 cells/mm 3 and LS was > 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protective immunological effects of HAART on LF progression outweigh its hepatotoxic effects.展开更多
文摘The history of human being is a result of various activities to live.Humanity has lived with the nature which has enabled to sustain the lives.Humanity has gained great benefits by the use of nature and its alternation.The comfortable environment development made the increase of population and the alternation of nature has extended.The past few hundred years can be said the era of fossil fuels.Surprisingly,it has caused the global warming.The construction sector is the industry in which the foundation for social and economic activities is created.It has been believed that a comfortable and safety life,production and use of environments will lead to happiness for humanity.However,we could not put a break on the development.Of course it is,the construction-related sectors that consume the most large natural resources and energy,and therefore emit the largest quantity of CO_(2).Fortunately,a concept in which we can deal with this situation was developed.It is sustainability concept.In this paper,firstly the concept“sustainability”which was born at the end of 20th century is reconfirmed.As the performance-based design has played a significant role in sustainability design,secondly the concept is explained based on the author’s paper and book.Thirdly the development of sustainability in fib is comprehensively discussed including sustainability-resilience dispute and ethics.
文摘目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列腺癌患者的临床资料进行回顾性收集和分析,根据骨扫描的检查结果辅以核磁共振,将盆腔有无骨转移的病人分为前列腺癌骨转移组80例和非骨转移组89例。所有患者在手术前都接受了MRI检查,对血清PSA、ALP、D-二聚体、FIB水平进行定量检测。对不同影像指标与前列腺癌骨转移结果之间的一致性采用Kappa一致性检验;利用单因素和多因素Logistic回归分析,评估mpMRI、ALP、D-二聚体、FIB及其他临床指标在前列腺癌骨转移诊断中的价值。利用受试者工作特征(receiver operating characteristic, ROC)曲线对前列腺癌骨转移中纳入的mpMRI、ALP、D-二聚体、FIB及其联合指标的临床应用价值进行评价。结果:T1WI、T2WI压脂、DWI及mpMRI与前列腺癌骨转移结果比较的Kappa值分别为0.536、0.470、0.629、0.691 (P Objective: To analyze the efficacy of multiparametric MRI (mpMRI) combined with serum ALP, D-dimer, and FIB in the diagnosis of bone metastasis in prostate cancer. Methods: A retrospective collection and analysis of clinical data from 169 prostate cancer patients were conducted. Based on the results of bone scans supplemented by MRI, patients with or without pelvic bone metastasis were divided into the prostate cancer bone metastasis group (80 cases) and the non-bone metastasis group (89 cases). All patients underwent MRI examination prior to surgery, and serum levels of PSA, ALP, D-dimer, and FIB were quantitatively measured. Kappa consistency tests were used to analyze the agreement between different imaging indicators and the results of prostate cancer bone metastasis. Uni- and multivariable logistic regression analyses were performed to evaluate the value of mpMRI, ALP, D-dimer, FIB, and other clinical indicators in the diagnosis of prostate cancer bone metastasis. The clinical application value of mpMRI, ALP, D-dimer, FIB, and their combined indicators in diagnosing prostate cancer bone metastasis was assessed using receiver operating characteristic (ROC) curves. Results: The Kappa values comparing T1WI, T2WI fat suppression, DWI, and mpMRI with the results of prostate cancer bone metastasis were 0.536, 0.470, 0.629, and 0.691, respectively (P < 0.001). Compared to the non-bone metastasis group, the serum levels of ALP, D-dimer, and FIB in the bone metastasis group were significantly higher (P < 0.001). Multivariable logistic regression analysis indicated that mpMRI, ALP, D-dimer, and FIB are independent risk factors for prostate cancer bone metastasis (P < 0.05). The combined indicators showed the best performance, followed by the individual indicators of D-dimer, mpMRI, ALP, and FIB, all of which demonstrated good diagnostic value (P < 0.05). Conclusion: mpMRI, ALP, D-dimer, and FIB all demonstrate certain diagnostic efficacy for prostate cancer bone metastasis. The combined use of these indicators can further enhance diagnostic value, suggesting that they should be considered for broader application in clinical practice.
文摘目的 探讨基于4个因素的纤维化指数(fibrosis index based on four factors,FIB-4)在长期接受抗病毒治疗的慢性乙型肝炎(chronic hepatitis B,CHB)患者前瞻队列人群中对发生肝细胞癌(hepatocellular carcinoma,HCC)的预测能力。方法 收集2008年10月至2021年7月首都医科大学附属北京地坛医院829例接受口服抗病毒治疗或在研究开始前接受治疗的成年CHB患者的基线数据,每3~6个月进行1次随访,HCC经腹超声、腹部计算机断层扫描(computed tomography,CT)或磁共振成像(magnetic resonance imaging,MRI)或肝血管造影检查或HCC的细胞学/组织学诊断。结果 共纳入764例CHB患者,中位随访时间为8.8(6.7~10.6)年。多因素Cox回归分析显示,年龄、HCC家族史、饮酒、肝硬化和FIB-4均为CHB患者HCC发病独立风险预测因子,差异均有统计学意义(P<0.001)。通过限制性立条图RCS分析,随着FIB-4指数的增加HCC发生风险呈非线性升高。相对于FIB-4指数<1.4组,FIB-4指数≥1.4组HCC的HR为8.89(95%CI:3.16~25.07),校正多因素影响后HR为4.84(95%CI:1.64~14.34)。肝硬化患者发生HCC的HR为3.46(95%CI:1.69~7.07)。中介效应模型分析,FIB-4指数与肝硬化有中介效应,其中有40.25%通过肝硬化间接影响HCC的发生。结论 FIB-4指数在预测接受抗病毒治疗的CHB患者的HCC风险方面具有优势。可用于临床实践,以帮助决策长期HCC监测策略,尤其是对中度和高危患者。
文摘AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCV-RNA, HIV-RNA, duration of highly active anti-retroviraltherapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ 2M H = 4, P < 0.04). In fact, LS ≥ 9.5 was significantly higher in co-infected than in HIV and HCV mono-infected pa-tients (χ 2 = 5, P < 0.03). Also APRI and the FIB-4 index showed more LF in co-infected than in HIV mono-infect-ed patients (P < 0.0001), but not in HCV mono-infected patients. In HIV?HCV co-infected patients, the extent of LS was significantly associated with alcohol intake (P < 0.04) and lower CD4+ cell count (P < 0.02). In HCV pa-tients, LS was correlated with alcohol intake (P < 0.001) and cholesterol levels (P < 0.03). Body mass index, dia-betes, HCV-and HIV-viremia were not significantly cor-related with LS. In addition, 20% of co-infected patients had virologically unsuccessful HAART; in 50% compliance was low, CD4+ levels were < 400 cells/mm 3 and LS was > 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protective immunological effects of HAART on LF progression outweigh its hepatotoxic effects.
