We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significant...We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significantly increased;the largest was located in the right lobe(about 8.2 cm×7.4 cm×6.0cm).Abdominal multidetector computed tomographyrevealed multiple well-circumscribed,heterogeneous,hypodense masses(largest,6.4 cm×6.3 cm×5.0cm)with significant contrast enhancement during the arterial and portal phases and with contrast washout and peripheral enhancement during the delayed phases.Magnetic resonance images demonstrated multiple well-circumscribed,heterogeneous,hypointense hepatic masses with significant contrast enhancement(largest,6.4 cm×6.5 cm×5.1 cm);multiple enlarged porta lymph nodes;and multiple s l i g h t l y e n l a rg e d re t ro p e r i t o n e a l l y m p h n o d e s.Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type(grade 2 well-differentiated neuroendocrine carcinoma).After performing a systemic examination to exclude metastasis from an extrahepatic primary site,we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases.The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin(150 mg)mixed with one bottle of gelatin sponge particles(560-710μm)and lipiodol(6 m L).Primary neuroendocrine tumors of the liver are extremely rare.This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas.Previously reported cases in the literature are also reviewed.展开更多
Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The...Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The incidence of mesorectal metastasis(a special category of rectal metastases) from breast cancer has not been described before.The case reported herein concerns a 68-year-old woman who underwent mastectomy.A pelvic mass with no symptoms was subsequently identified by computed tomography in the patient.We ultimately confirmed that this mass was a metastasis from breast cancer located in the mesorectum using surgical exploration and pathology results.展开更多
Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national know...Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure,Wanfang,Chinese sci-tech journal database,PubMed,EMbase,the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer.Literature screening,data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria.Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results:A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included,among which 9 studies were conducted on patients,with a total of 299 patients,and 5 studies were conducted on lymph nodes,with 1965 patients with cervical lymph node proved pathologically.The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer.The results showed that sensitivity=0.81(95%CI:0.73-0.87),specificity=0.90(95%CI:0.83-0.94),combined likelihood ratio=7.9(95%CI:4.9-12.7),negative likelihood ratio=0.21(95%CI:0.15-0.30),diagnostic odds ratio=37(95%CI:20-67),and receiver operating characteristic curve=0.91(95%CI:0.89-0.94).Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis,and can be used as an important preoperative evaluation method for oral cancer.展开更多
目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠...目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠早期循环kisspeptin水平与SAB相关性的研究,检索文献的时间设置均为从建库至2020年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入3个巢式病例对照研究、2个病例对照研究和1个前瞻性队列研究,包括SAB患者157例,作为对照的正常宫内妊娠(IUP)孕妇1018例。meta分析显示,SAB组kisspeptin水平低于IUP组[SMD=-1.68,95%CI:-2.65~-0.72,P=0.0006]。结论循环metastin/kisspeptin水平降低与SAB有一定相关性,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。展开更多
In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusin...In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusing and imaging are implemented by interleaved metasurfaces.However,the disadvantages of their large size and low efficiency limit their practical applications in large-capacity and low-loss integrated systems.To solve these issues,here,we propose a non-interleaved polarization-frequency multiplexing metasurface for high-efficiency multi-channel focusing and imaging.The meta-atoms of the non-interleaved metasurface are composed of a metallic ground plate,two dielectric layers,a larger cross-shaped metal structure,and a smaller cross-shaped metal structure embedded by a circular metal aperture.By altering the size of two cross-shaped structures,the designed meta-atom can obtain the independent complete 2π phase coverage with high reflection efficiency at two different frequency ranges for two orthogonal linear polarization(LP)incidences,realizing polarization multiplexing and frequency multiplexing.Moreover,two types of metasurfaces based on the above meta-atoms are designed to realize multi-channel focusing and imaging with high efficiency.As a proof,the focusing metasurface is fabricated and measured,and the measured results are well consistent with simulated results.Therefore,the proposed scheme has the advantages of high efficiency,multi-channel,and compact size,which possesses broad application prospects in low-loss and multichannel communication integrated systems.展开更多
In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures i...In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures inject infinite vitality to shape this fantastic concept,which has fundamentally changed the way humans engineer matter–wave interactions.However,achieving full-space arbitrarily polarized beams with independent wavefronts in broadband on a single metasurface aperture still remains challenging.Herein,the authors propose a generic method for broadband transmission-reflection-integrated wavefronts shaping with multichannel arbitrary polarization regulation from 8 to 16 GHz,which is based on the chirality effect of full-space non-interleaved tetrameric meta-molecules.Through superimposing eigen-polarization responses of the two kinds of enantiomers,the possibility for high-efficiency evolution of several typical polarization states with specific wavefronts is demonstrated.As proofs-of-concept,the feasibility of our methodology is validated via implementing miscellaneous functionalities,including circularly polarized(CP)beam splitting,linearly polarized(LP)vortex beams generation,and CP and LP multifoci.Meanwhile,numerous simulated and experimental results are in excellent agreement with the theoretical predictions.Encouragingly,this proposed approach imaginatively merges broadband polarization and phase control into one single full-space and shared-aperture EM device,which can extremely enhance the functional richness and information capacity in advanced integrated systems.展开更多
To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation thera...To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.展开更多
目的系统分析开颅术后发生手术部位感染(SSI)的危险因素,为SSI防控提供循证依据。方法检索建库至2025年6月的中英文数据库,包括CNKI、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science,收集开颅术后SSI相关文献。经...目的系统分析开颅术后发生手术部位感染(SSI)的危险因素,为SSI防控提供循证依据。方法检索建库至2025年6月的中英文数据库,包括CNKI、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science,收集开颅术后SSI相关文献。经文献筛选后,采用纽卡斯尔-渥太华量表(NOS)评价文献质量,使用RevMan 5.3软件进行数据分析。结果最终纳入15篇文献,共36042例研究对象。Meta分析结果显示,与开颅术后SSI显著相关的危险因素为五项,包括性别(男性)(OR=1.23,95%CI:1.09~1.38,P<0.001)、急诊手术(OR=2.04,95%CI:1.10~3.79,P=0.020)、二次手术(OR=3.44,95%CI:1.82~6.50,P<0.001)、脑脊液漏(OR=13.11,95%CI:5.09~33.77,P<0.001)、术后留置引流管(OR=3.42,95%CI:1.62~7.18,P=0.001)。结论开颅术后发生手术部位感染对患者危害大,多种因素可导致发生发展。临床需重点针对高风险因素实施重点防控,如强化脑脊液漏预防与引流管规范化管理、优化急诊/二次手术操作流程、加强男性患者围术期监测,以有效降低神经外科开颅术后SSI发生率。展开更多
目的分析伏诺拉生(VPZ)治疗消化性溃疡(PU)和内镜黏膜下剥离术(ESD)术后溃疡的安全性与有效性,为临床实践、医疗决策提供循证药学证据。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、...目的分析伏诺拉生(VPZ)治疗消化性溃疡(PU)和内镜黏膜下剥离术(ESD)术后溃疡的安全性与有效性,为临床实践、医疗决策提供循证药学证据。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、the Cochrane Library等数据库,获取VPZ治疗PU和ESD术后溃疡相关的Meta分析/系统评价。由2名研究者独立进行文献筛选、数据提取、文献质量评估、文献重叠程度评估,采用伞形评价分析方法;当纳入的文献高度重叠时,对所有相关原始研究数据重新进行Meta分析。结果共纳入17项Meta分析,质量从高质量到极低质量不等;所有涉及的结局指标,在纳入的相关Meta分析中均存在非常高的重叠水平(校正覆盖面积为22.22%~100%)。治疗ESD术后溃疡时,与质子泵抑制剂(PPI)比较,VPZ可显著提高ESD术后4周的溃疡愈合率[RR=1.27,95%CI(1.03,1.56),Z=2.21,P=0.027]和溃疡收缩率[MD=0.08,95%CI(0.00,0.16),Z=2.09,P=0.037],显著降低具有PU病史患者的溃疡复发率[RR=0.49,95%CI(0.32,0.73),Z=3.49,P=0.001];VPZ组延迟出血率较兰索拉唑亚组显著降低[RR=0.47,95%CI(0.25,0.90),Z=2.28,P=0.02]。治疗PU时,十二指肠溃疡亚组中,VPZ的不良事件发生率明显高于PPI[RR=1.13,95%CI(1.02,1.26),Z=2.38,P=0.017]。结论对于ESD术后溃疡,VPZ的治疗效果优于PPI,且可以降低具有PU病史患者的溃疡复发率,但在治疗十二指肠溃疡的安全性方面并不具有优势。展开更多
目的:系统评价、整合糖尿病病人共享门诊体验的质性研究,为临床开展及改善共享门诊提供参考依据。方法:计算机检索PubMed、Web of Science、EMbase、Cochrane Library、CINAHL、MedLine、PsycINFO、中国知网、万方数据库、维普数据库和...目的:系统评价、整合糖尿病病人共享门诊体验的质性研究,为临床开展及改善共享门诊提供参考依据。方法:计算机检索PubMed、Web of Science、EMbase、Cochrane Library、CINAHL、MedLine、PsycINFO、中国知网、万方数据库、维普数据库和中国生物医学文献数据库中关于糖尿病病人共享门诊体验的质性研究,检索时限为建库至2024年12月4日。采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心质性研究质量评价标准(2016)进行文献质量评价,采用汇集性整合方法对研究结果进行归纳整合。结果:共纳入12篇文献,提炼出45个研究结果,归纳为10个类别,概括为4个整合结果:共享门诊体验评价,感知共享门诊益处,感知共享门诊障碍,对共享门诊的需求和期望。结论:糖尿病病人参与共享门诊在提升疾病知识、自我管理能力和心理状态等方面成效显著,但其设置和内容仍需进一步优化,以提升病人体验。同时,应加强人才培养、推动跨学科合作,并依托政策支持与技术创新,推动共享门诊在国内高质量发展。展开更多
目的系统评价环泊酚用于全身麻醉/深度镇静的效果与安全性。方法通过计算机系统,全面检索万方数据知识服务平台、维普网、中国知网、中国生物医学文献数据库、PubMed、Cochrane、Embase、Web of Science等数据库,检索时间从建库至2024年...目的系统评价环泊酚用于全身麻醉/深度镇静的效果与安全性。方法通过计算机系统,全面检索万方数据知识服务平台、维普网、中国知网、中国生物医学文献数据库、PubMed、Cochrane、Embase、Web of Science等数据库,检索时间从建库至2024年1月。严格筛选以环泊酚为干预组、丙泊酚为对照组用于全身麻醉/深度镇静的随机对照试验文献。根据明确的纳入标准、排除标准及文献质量评价,对筛选出的文献进行细致分析。采用Revman 5.4软件进行综合的Meta分析。结果共纳入文献31篇,涉及患者4580例。Meta分析结果显示,干预组与对照组麻醉诱导成功时间比较差异无统计学意义[MD=2.62,95%CI(-4.35,9.60),P=0.46],干预组麻醉苏醒时间较对照组长[MD=0.44,95%CI(0.08,0.81),P=0.02];干预组患者及麻醉科医师满意度评分较对照组高[MD=1.10,95%CI(0.15,2.05),P=0.02;MD=0.78,95%CI(0.13,1.43),P=0.02],干预组与对照组内镜医师满意度比较差异无统计学意义[MD=0.40,95%CI(-0.28,1.07),P=0.25];干预组麻醉诱导前后血氧饱和度、平均动脉压差值较对照组小[MD=0.75,95%CI(0.03,1.47),P=0.04;MD=3.90,95%CI(2.33,5.47),P<0.00001],干预组与对照组麻醉诱导前后脑电双频指数与心率差值比较差异无统计学意义(P>0.05);干预组不良反应总发生率及低血压、注射痛、低氧血症发生率较对照组低[OR=0.37,95%CI(0.22,0.64),P=0.0003;OR=0.54,95%CI(0.41,0.71),P<0.0001;OR=0.07,95%CI(0.04,0.11),P<0.00001;OR=0.48,95%CI(0.36,0.65),P<0.00001],干预组与对照组心动过缓、高血压、恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论全身麻醉/深度镇静中环泊酚的麻醉效果与丙泊酚相当,且安全性优于丙泊酚。展开更多
目的:通过meta分析全面评估认知行为疗法(CBT)在治疗创伤后应激障碍(PTSD)的效果。方法:系统检索PubMed、Web of Science、PsycINFO、中国知网(CNKI)、万方数据库、维普数据库,筛选相关随机对照试验(RCTs),以标准化评定量表评估PTSD症...目的:通过meta分析全面评估认知行为疗法(CBT)在治疗创伤后应激障碍(PTSD)的效果。方法:系统检索PubMed、Web of Science、PsycINFO、中国知网(CNKI)、万方数据库、维普数据库,筛选相关随机对照试验(RCTs),以标准化评定量表评估PTSD症状的减轻程度为主要结局指标。对纳入的研究进行了数据提取、质量评估和meta分析,检索时限为2005年1月-2024年10月。Meta分析采用Review Manager Software 5.4完成。结果:共纳入21项研究(总样本量1 683例)。Meta分析结果显示,CBT在减轻PTSD症状方面显著优于对照组,(SMD=-0.25,95%CI:-0.43~-0.06,P<0.05)。亚组分析探讨了研究区域、样本量和创伤来源等因素对结果的影响,为CBT在不同情境下的应用提供了参考。结论:CBT在缓解成年人PTSD症状方面具有良好疗效。展开更多
目的运用meta分析方法系统评价补肾方剂治疗男性不育症患者精子DNA损伤(SDF)的有效性和安全性。方法从中国知网、维普、万方、PubMed、Cochrane Library、Embase、Web of Science数据库中检索补肾方剂改善SDF的随机对照试验(RCT)研究,...目的运用meta分析方法系统评价补肾方剂治疗男性不育症患者精子DNA损伤(SDF)的有效性和安全性。方法从中国知网、维普、万方、PubMed、Cochrane Library、Embase、Web of Science数据库中检索补肾方剂改善SDF的随机对照试验(RCT)研究,对文献进行方法学质量评价,运用RevMan5.3.5软件进行meta分析,并对结局指标进行GRADE质量分级。结果共纳入17项RCT研究,涉及2164例男性患者。与西医常规治疗相比,补肾方剂能够显著改善男性不育症患者DNA碎片指数(DFI)(MD=-6.50,95%CI:-7.88~-5.11,P<0.01),提高配偶妊娠率(RR=2.11,95%CI:1.12~4.00,P=0.87)、精子总活率(MD=5.56,95%CI:4.39~6.74,P<0.01)、前向运动精子百分率(MD=6.82,95%CI:5.62~8.03,P<0.01)、精子浓度(MD=6.51,95%CI:3.81~9.21,P<0.01)和正常形态精子百分率(MD=1.26,95%CI:0.45~2.06,P<0.01),且补肾方剂不会增加不良反应的发生。结论低到中等质量证据表明,与西医常规治疗相比,补肾方剂在改善男性不育症患者DFI、精液参数、配偶妊娠率等方面具有一定优势,且安全性较好。展开更多
文摘We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significantly increased;the largest was located in the right lobe(about 8.2 cm×7.4 cm×6.0cm).Abdominal multidetector computed tomographyrevealed multiple well-circumscribed,heterogeneous,hypodense masses(largest,6.4 cm×6.3 cm×5.0cm)with significant contrast enhancement during the arterial and portal phases and with contrast washout and peripheral enhancement during the delayed phases.Magnetic resonance images demonstrated multiple well-circumscribed,heterogeneous,hypointense hepatic masses with significant contrast enhancement(largest,6.4 cm×6.5 cm×5.1 cm);multiple enlarged porta lymph nodes;and multiple s l i g h t l y e n l a rg e d re t ro p e r i t o n e a l l y m p h n o d e s.Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type(grade 2 well-differentiated neuroendocrine carcinoma).After performing a systemic examination to exclude metastasis from an extrahepatic primary site,we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases.The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin(150 mg)mixed with one bottle of gelatin sponge particles(560-710μm)and lipiodol(6 m L).Primary neuroendocrine tumors of the liver are extremely rare.This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas.Previously reported cases in the literature are also reviewed.
基金Supported by Affiliated Zhongshan Hospital of Dalian University,Dalian,Liaoning,China
文摘Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The incidence of mesorectal metastasis(a special category of rectal metastases) from breast cancer has not been described before.The case reported herein concerns a 68-year-old woman who underwent mastectomy.A pelvic mass with no symptoms was subsequently identified by computed tomography in the patient.We ultimately confirmed that this mass was a metastasis from breast cancer located in the mesorectum using surgical exploration and pathology results.
文摘Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure,Wanfang,Chinese sci-tech journal database,PubMed,EMbase,the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer.Literature screening,data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria.Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results:A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included,among which 9 studies were conducted on patients,with a total of 299 patients,and 5 studies were conducted on lymph nodes,with 1965 patients with cervical lymph node proved pathologically.The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer.The results showed that sensitivity=0.81(95%CI:0.73-0.87),specificity=0.90(95%CI:0.83-0.94),combined likelihood ratio=7.9(95%CI:4.9-12.7),negative likelihood ratio=0.21(95%CI:0.15-0.30),diagnostic odds ratio=37(95%CI:20-67),and receiver operating characteristic curve=0.91(95%CI:0.89-0.94).Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis,and can be used as an important preoperative evaluation method for oral cancer.
文摘目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠早期循环kisspeptin水平与SAB相关性的研究,检索文献的时间设置均为从建库至2020年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入3个巢式病例对照研究、2个病例对照研究和1个前瞻性队列研究,包括SAB患者157例,作为对照的正常宫内妊娠(IUP)孕妇1018例。meta分析显示,SAB组kisspeptin水平低于IUP组[SMD=-1.68,95%CI:-2.65~-0.72,P=0.0006]。结论循环metastin/kisspeptin水平降低与SAB有一定相关性,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
基金National Natural Science Foundation of China(62075052,6227419)National Key Research and Development Program of China(2024YFE0108300)+2 种基金Science and Technology Major Project of Guangxi,China(Gui Ke AA21077015,Gui Ke AA24263032)Science Foundation of the National Key Laboratory of Science and Technology on Advanced Composites in Special Environments(JCKYS2020603C009,6142905212711)Project of Innovative and Entrepreneurship Training Program for College Students in Heilongjiang Province(201810214105)。
文摘In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusing and imaging are implemented by interleaved metasurfaces.However,the disadvantages of their large size and low efficiency limit their practical applications in large-capacity and low-loss integrated systems.To solve these issues,here,we propose a non-interleaved polarization-frequency multiplexing metasurface for high-efficiency multi-channel focusing and imaging.The meta-atoms of the non-interleaved metasurface are composed of a metallic ground plate,two dielectric layers,a larger cross-shaped metal structure,and a smaller cross-shaped metal structure embedded by a circular metal aperture.By altering the size of two cross-shaped structures,the designed meta-atom can obtain the independent complete 2π phase coverage with high reflection efficiency at two different frequency ranges for two orthogonal linear polarization(LP)incidences,realizing polarization multiplexing and frequency multiplexing.Moreover,two types of metasurfaces based on the above meta-atoms are designed to realize multi-channel focusing and imaging with high efficiency.As a proof,the focusing metasurface is fabricated and measured,and the measured results are well consistent with simulated results.Therefore,the proposed scheme has the advantages of high efficiency,multi-channel,and compact size,which possesses broad application prospects in low-loss and multichannel communication integrated systems.
基金National Key Research and Development Program of China(SQ2022YFB3806200)National Natural Science Foundation of China(62301596,62101588)+1 种基金Young Talent Fund of Association for Science and Technology in Shaanxi(20240129)Postdoctoral Fellowship Program of CPSF(GZC20242285)。
文摘In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures inject infinite vitality to shape this fantastic concept,which has fundamentally changed the way humans engineer matter–wave interactions.However,achieving full-space arbitrarily polarized beams with independent wavefronts in broadband on a single metasurface aperture still remains challenging.Herein,the authors propose a generic method for broadband transmission-reflection-integrated wavefronts shaping with multichannel arbitrary polarization regulation from 8 to 16 GHz,which is based on the chirality effect of full-space non-interleaved tetrameric meta-molecules.Through superimposing eigen-polarization responses of the two kinds of enantiomers,the possibility for high-efficiency evolution of several typical polarization states with specific wavefronts is demonstrated.As proofs-of-concept,the feasibility of our methodology is validated via implementing miscellaneous functionalities,including circularly polarized(CP)beam splitting,linearly polarized(LP)vortex beams generation,and CP and LP multifoci.Meanwhile,numerous simulated and experimental results are in excellent agreement with the theoretical predictions.Encouragingly,this proposed approach imaginatively merges broadband polarization and phase control into one single full-space and shared-aperture EM device,which can extremely enhance the functional richness and information capacity in advanced integrated systems.
基金funded by grants from the Shanghai Science Committee Foundation(No.19411967700)the National Natural Science Foundation of China(No.31570993)the Wu Jieping Medical Foundation(No.320.6750.2020-14-7).
文摘To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.
文摘目的系统分析开颅术后发生手术部位感染(SSI)的危险因素,为SSI防控提供循证依据。方法检索建库至2025年6月的中英文数据库,包括CNKI、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science,收集开颅术后SSI相关文献。经文献筛选后,采用纽卡斯尔-渥太华量表(NOS)评价文献质量,使用RevMan 5.3软件进行数据分析。结果最终纳入15篇文献,共36042例研究对象。Meta分析结果显示,与开颅术后SSI显著相关的危险因素为五项,包括性别(男性)(OR=1.23,95%CI:1.09~1.38,P<0.001)、急诊手术(OR=2.04,95%CI:1.10~3.79,P=0.020)、二次手术(OR=3.44,95%CI:1.82~6.50,P<0.001)、脑脊液漏(OR=13.11,95%CI:5.09~33.77,P<0.001)、术后留置引流管(OR=3.42,95%CI:1.62~7.18,P=0.001)。结论开颅术后发生手术部位感染对患者危害大,多种因素可导致发生发展。临床需重点针对高风险因素实施重点防控,如强化脑脊液漏预防与引流管规范化管理、优化急诊/二次手术操作流程、加强男性患者围术期监测,以有效降低神经外科开颅术后SSI发生率。
文摘目的分析伏诺拉生(VPZ)治疗消化性溃疡(PU)和内镜黏膜下剥离术(ESD)术后溃疡的安全性与有效性,为临床实践、医疗决策提供循证药学证据。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、the Cochrane Library等数据库,获取VPZ治疗PU和ESD术后溃疡相关的Meta分析/系统评价。由2名研究者独立进行文献筛选、数据提取、文献质量评估、文献重叠程度评估,采用伞形评价分析方法;当纳入的文献高度重叠时,对所有相关原始研究数据重新进行Meta分析。结果共纳入17项Meta分析,质量从高质量到极低质量不等;所有涉及的结局指标,在纳入的相关Meta分析中均存在非常高的重叠水平(校正覆盖面积为22.22%~100%)。治疗ESD术后溃疡时,与质子泵抑制剂(PPI)比较,VPZ可显著提高ESD术后4周的溃疡愈合率[RR=1.27,95%CI(1.03,1.56),Z=2.21,P=0.027]和溃疡收缩率[MD=0.08,95%CI(0.00,0.16),Z=2.09,P=0.037],显著降低具有PU病史患者的溃疡复发率[RR=0.49,95%CI(0.32,0.73),Z=3.49,P=0.001];VPZ组延迟出血率较兰索拉唑亚组显著降低[RR=0.47,95%CI(0.25,0.90),Z=2.28,P=0.02]。治疗PU时,十二指肠溃疡亚组中,VPZ的不良事件发生率明显高于PPI[RR=1.13,95%CI(1.02,1.26),Z=2.38,P=0.017]。结论对于ESD术后溃疡,VPZ的治疗效果优于PPI,且可以降低具有PU病史患者的溃疡复发率,但在治疗十二指肠溃疡的安全性方面并不具有优势。
文摘目的:系统评价、整合糖尿病病人共享门诊体验的质性研究,为临床开展及改善共享门诊提供参考依据。方法:计算机检索PubMed、Web of Science、EMbase、Cochrane Library、CINAHL、MedLine、PsycINFO、中国知网、万方数据库、维普数据库和中国生物医学文献数据库中关于糖尿病病人共享门诊体验的质性研究,检索时限为建库至2024年12月4日。采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心质性研究质量评价标准(2016)进行文献质量评价,采用汇集性整合方法对研究结果进行归纳整合。结果:共纳入12篇文献,提炼出45个研究结果,归纳为10个类别,概括为4个整合结果:共享门诊体验评价,感知共享门诊益处,感知共享门诊障碍,对共享门诊的需求和期望。结论:糖尿病病人参与共享门诊在提升疾病知识、自我管理能力和心理状态等方面成效显著,但其设置和内容仍需进一步优化,以提升病人体验。同时,应加强人才培养、推动跨学科合作,并依托政策支持与技术创新,推动共享门诊在国内高质量发展。
文摘目的系统评价环泊酚用于全身麻醉/深度镇静的效果与安全性。方法通过计算机系统,全面检索万方数据知识服务平台、维普网、中国知网、中国生物医学文献数据库、PubMed、Cochrane、Embase、Web of Science等数据库,检索时间从建库至2024年1月。严格筛选以环泊酚为干预组、丙泊酚为对照组用于全身麻醉/深度镇静的随机对照试验文献。根据明确的纳入标准、排除标准及文献质量评价,对筛选出的文献进行细致分析。采用Revman 5.4软件进行综合的Meta分析。结果共纳入文献31篇,涉及患者4580例。Meta分析结果显示,干预组与对照组麻醉诱导成功时间比较差异无统计学意义[MD=2.62,95%CI(-4.35,9.60),P=0.46],干预组麻醉苏醒时间较对照组长[MD=0.44,95%CI(0.08,0.81),P=0.02];干预组患者及麻醉科医师满意度评分较对照组高[MD=1.10,95%CI(0.15,2.05),P=0.02;MD=0.78,95%CI(0.13,1.43),P=0.02],干预组与对照组内镜医师满意度比较差异无统计学意义[MD=0.40,95%CI(-0.28,1.07),P=0.25];干预组麻醉诱导前后血氧饱和度、平均动脉压差值较对照组小[MD=0.75,95%CI(0.03,1.47),P=0.04;MD=3.90,95%CI(2.33,5.47),P<0.00001],干预组与对照组麻醉诱导前后脑电双频指数与心率差值比较差异无统计学意义(P>0.05);干预组不良反应总发生率及低血压、注射痛、低氧血症发生率较对照组低[OR=0.37,95%CI(0.22,0.64),P=0.0003;OR=0.54,95%CI(0.41,0.71),P<0.0001;OR=0.07,95%CI(0.04,0.11),P<0.00001;OR=0.48,95%CI(0.36,0.65),P<0.00001],干预组与对照组心动过缓、高血压、恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论全身麻醉/深度镇静中环泊酚的麻醉效果与丙泊酚相当,且安全性优于丙泊酚。
文摘目的运用meta分析方法系统评价补肾方剂治疗男性不育症患者精子DNA损伤(SDF)的有效性和安全性。方法从中国知网、维普、万方、PubMed、Cochrane Library、Embase、Web of Science数据库中检索补肾方剂改善SDF的随机对照试验(RCT)研究,对文献进行方法学质量评价,运用RevMan5.3.5软件进行meta分析,并对结局指标进行GRADE质量分级。结果共纳入17项RCT研究,涉及2164例男性患者。与西医常规治疗相比,补肾方剂能够显著改善男性不育症患者DNA碎片指数(DFI)(MD=-6.50,95%CI:-7.88~-5.11,P<0.01),提高配偶妊娠率(RR=2.11,95%CI:1.12~4.00,P=0.87)、精子总活率(MD=5.56,95%CI:4.39~6.74,P<0.01)、前向运动精子百分率(MD=6.82,95%CI:5.62~8.03,P<0.01)、精子浓度(MD=6.51,95%CI:3.81~9.21,P<0.01)和正常形态精子百分率(MD=1.26,95%CI:0.45~2.06,P<0.01),且补肾方剂不会增加不良反应的发生。结论低到中等质量证据表明,与西医常规治疗相比,补肾方剂在改善男性不育症患者DFI、精液参数、配偶妊娠率等方面具有一定优势,且安全性较好。
