BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its po...BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its potential involvement in biliary diseases.However,the specific role of H.pylori in the development of cholelithiasis remains inconclusive.AIM To investigate the potential association between H.pylori infection and the development of cholelithiasis.METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle,northern and eastern China,from October 2018 to December 2021,to explore the potential association between H.pylori and cholelithiasis through univariate and multivariate analysis.Meanwhile,the influence of H.pylori on biliary-related parameters was investigated.A comprehensive analysis of previous studies concerned about H.pylori and cholelithiasis was also executed.RESULTS In our multi-center study,H.pylori was positively associated with cholelithiasis[odds ratio(OR)=1.103,95%confidence interval(CI):1.001-1.216,P=0.049].Furthermore,H.pylori patients had less total and direct bilirubin than uninfected patients,while the total cholesterol and low-density lipoprotein cholesterol were more in H.pyloripositive participants(P<0.05).In the published articles,the cohort studies indicated H.pylori was a risk factor of cholelithiasis(hazard ratio=1.3280,95%CI:1.1810-1.4933,P<0.0001).The pooled results of case-control and crosssectional studies showed positive association between H.pylori and cholelithiasis in Asia(OR=1.5993,95%CI:1.0353-2.4706,P=0.034)but not in Europe(OR=1.2770,95%CI:0.8446-1.9308,P=0.246).Besides,H.pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio(OR=3.3215,95%CI:1.1034-9.9986,P=0.033).CONCLUSION H.pylori is positively correlated with cholelithiasis,choledocholithiasis phenotype particularly,especially in Asia,which may be relevant to bilirubin/cholesterol metabolism.Cohort studies confirm an increased risk of cholelithiasis in H.pylori patients.展开更多
Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need ...Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need to infuse human albumin may be reduced or avoided in Japan if these large doses 6% HES 130/0.4 can be infused. Methods: The study was an uncontrolled, open-labeled, multi-center trial. Fifteen adult and 5 pediatric patients undergoing major elective surgery received 6% HES 130/0.4 (Voluven®) with a maximum dose of 50 mL/kg from the start of surgery until 2 hours after the end of surgery according to a treatment algorithm. The primary efficacy endpoint was the volume effect of 6% HES 130/0.4 determined by the volume of saved albumin during the investigational period and the time course of hemodynamic stability in adult and pediatric patients. Safety parameters were fluid balance, hemodynamic and laboratory parameters ECG, local and systemic tolerance and adverse events. Results: Adult patients received a mean of 32.0 mL/kg of 6% HES 130/0.4. For 12 out of 15 adult patients an average amount of 1033.8 mL (18.6 mL/kg) albumin could be saved. The other 3 adult patients did not receive more than 1000 mL of HES 130/0.4. All pediatric patients received approximately 50 mL/kg of HES 130/0.4;for these patients an average amount of 39.9 mL/kg body weight albumin could be saved. The majority of adult patients, and all pediatric patients were hemodynamically stable at all 3 time points. The observed changes of the assessed laboratory parameters including hematological and coagulation parameters or in any other safety parameter determined did not reveal any safety concern related to the administration of 6% HES 130/0.4 up to doses of 50 mL/kg body weight. Conclusion: The study results indicate that 6% HES 130/0.4 has a reliable volume effect, could contribute to significant human albumin savings and was safe and well tolerated up to a maximum dose of 50 mL/kg body weight in adult and pediatric patients undergoing major elective surgery.展开更多
BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gas...BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gastric mucosa and provide valuable guidance for improving treatment efficacy.METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included.Among them,296 patients were followed up with endoscopic and biopsy pathology.Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.RESULTS The distribution sites of LGIN among the 357 patients were as follows:Gastric antrum(54.6%),gastric cardia(24.1%),gastric angulus(8.7%),gastric body(4.8%),gastric fundus(4.8%),and multiple sites(3.1%).Additionally,of the 357 patients with LGIN,112(31.4%)developed ulceration and 59(16.5%)experienced gastric polyps.Furthermore,231 of the 357(64.71%)patients with LGIN tested positive for Helicobacter pylori(H.pylori)infection.The H.pylori infection rates of the patients with LGIN with accompanying atrophy,intestinal metaplasia,and gastric ulcer were 51.95%,59.31%,and 28.57%,respectively.Multivariate logistic regression analysis showed that age≥60 years[odds ratio(OR)=3.063,95%confidence interval(CI):1.351-6.945,P=0.007],H.pylori infection(OR=3.560,95%CI:1.158-10.949,P=0.027),multiple locations(OR=10.136,95%CI:2.045-50.237,P=0.005),lesion size≥2 cm(OR=3.921,95%CI:1.664-9.237,P=0.002),and gastric ulcer(OR=2.730,95%CI:1.197-6.223,P=0.017)were predictive factors for LGIN progression.CONCLUSION LGIN progression is closely related to age,H.pylori positivity,multiple locations,lesion size≥2 cm,and gastric ulcer.Thus,actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.展开更多
To the Editor:Maturity-onset diabetes of the young(MODY)is characterized as a non-autoimmune form of diabetes with an autosomal dominant inheritance pattern.Due to the overlapping clinical phenotypes among MODY,such a...To the Editor:Maturity-onset diabetes of the young(MODY)is characterized as a non-autoimmune form of diabetes with an autosomal dominant inheritance pattern.Due to the overlapping clinical phenotypes among MODY,such as type 1 diabetes mellitus(T1DM)and type 2 diabetes mellitus(T2DM),over 80%of MODY patients are initially misdiagnosed.[1]In recent decades,the advent and development of next-generation sequencing technology have facilitated a deeper understanding of MODY.High-throughput sequencing has remarkably expanded our knowledge of the pathogenic patterns of MODY across diverse populations.展开更多
As the integration of medical big data and artificial intelligence advances,the secure sharing of medical data has become a key driving force for advancing disease research and clinical diagnosis.Federated learning,a ...As the integration of medical big data and artificial intelligence advances,the secure sharing of medical data has become a key driving force for advancing disease research and clinical diagnosis.Federated learning,a distributed approach enabling collaborative data processing without sharing raw data,offers promising solutions to challenges in multi-center medical data sharing.This review summarizes the progress of federated learning in multi-center medical data processing,analyzed from four perspectives:system architectures,data distribution strategies,clinical tasks,and algorithmic models.At the same time,this paper explores the challenges in practical applications,such as data heterogeneity,communication overhead,and privacy concerns.It proposes driving future research development by optimizing algorithms,strengthening privacy protection mechanisms,and enhancing computational efficiency.展开更多
Carotid artery plaques represent a major contributor to the morbidity and mortality associated with cerebrovascular disease,and their clinical significance is largely determined by the risk linked to plaque vulnerabil...Carotid artery plaques represent a major contributor to the morbidity and mortality associated with cerebrovascular disease,and their clinical significance is largely determined by the risk linked to plaque vulnerability.Therefore,classifying plaque risk constitutes one of themost critical tasks in the clinicalmanagement of this condition.While classification models derived from individual medical centers have been extensively investigated,these singlecenter models often fail to generalize well to multi-center data due to variations in ultrasound images caused by differences in physician expertise and equipment.To address this limitation,a Dual-Classifier Label Correction Networkmodel(DCLCN)is proposed for the classification of carotid plaque ultrasound images acrossmultiplemedical centers.TheDCLCNdesigns amulti-center domain adaptationmodule that leverages a dual-classifier strategy to extract knowledge from both source and target centers,thereby reducing feature discrepancies through a domain adaptation layer.Additionally,to mitigate the impact of image noise,a label modeling and correction module is introduced to generate pseudo-labels for the target centers and iteratively refine them using an end-to-end correction mechanism.Experiments on the carotid plaque dataset collected fromthreemedical centers demonstrate that the DCLCN achieves commendable performance and robustness.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural commu...This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.展开更多
In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audi...In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.展开更多
BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used ga...BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.展开更多
OBJECTIVE:To assess the relationship between disease symptoms and traditional Chinese medicine (TCM) syndrome (Zheng) in rheumatoid arthritis (RA) patients.METHODS:RA Patients were recruited in Guang'anmen Hospita...OBJECTIVE:To assess the relationship between disease symptoms and traditional Chinese medicine (TCM) syndrome (Zheng) in rheumatoid arthritis (RA) patients.METHODS:RA Patients were recruited in Guang'anmen Hospital,China Academy of Chinese Medical Sciences and in the Second Affiliated Hospital of Zhejiang Chinese Medical University,and diagnosed with a particular RA Zheng from their symptoms.Demographic characteristics,self-reported symptoms,and blood samples were collected from patients.All data were input into EpiData and analyzed using SPSS software.RESULTS:The study included 302 RA patients (age range:18-86 years).All patients were Chinese,and 85.1% were women.Cold and fatigue triggers were reported by 8.6% of patients,followed by triggers such as childbirth (4.3%),cold (3.0%),dampness (2.0%),menopause (1.3%),and psychentonia (0.7%).The most prevalent Zheng was dampness and heat blockage (Shire Yuzu in Chinese,SRYZ),diagnosed in 39.4% of patients (119),followed by phlegm and stagnation blockage (Tanyu Bizu,TYBZ) in 21.5%,liver and kidney deficiency (Ganshen Buzu,GSBZ) in 18.5%,dual deficiency of Qi and blood (Qixue Liangxu,QXLX) in 9.6%,cold and dampness blockage (Hanshi Bizu,HSBZ) in 6%,and wind and dampness blockage (Fengshi Bizu,FSBZ) in 5%.Increased length of time since RA diagnosis was associated with the GSBZ group.Patients diagnosed with the SRYZ Zheng had the highest disease activity score.Patients diagnosed with the QXLX Zheng had the lowest blood platelet counts;patients diagnosed with the QXLX and HSBZ Zhengs had lower C-reactive protein levels and lower health assessment questionnaire scores.Patients diagnosed with the GSBZ and QXLX Zhengs had the highest health assessment questionnaire scores.CONCLUSION:The specific Zheng was related to RA characteristics.The findings suggest that eliminating dampness,cooling the patient,and promoting blood circulation may assist in treating severe RA.展开更多
The simple adjusted estimator of risk difference in each center is easy constructed by adding a value c on the number of successes and on the number of failures in each arm of the proportion estimator. Assessing a tre...The simple adjusted estimator of risk difference in each center is easy constructed by adding a value c on the number of successes and on the number of failures in each arm of the proportion estimator. Assessing a treatment effect in multi-center studies, we propose minimum MSE (mean square error) weights of an adjusted summary estimate of risk difference under the assumption of a constant of common risk difference over all centers. To evaluate the performance of the proposed weights, we compare not only in terms of estimation based on bias, variance, and MSE with two other conventional weights, such as the Cochran-Mantel-Haenszel weights and the inverse variance (weighted least square) weights, but also we compare the potential tests based on the type I error probability and the power of test in a variety of situations. The results illustrate that the proposed weights in terms of point estimation and hypothesis testing perform well and should be recommended to use as an alternative choice. Finally, two applications are illustrated for the practical use.展开更多
Background Restylane, a hyaluronic acid gel, has been widely used as a dermal filler in USA and European countries. This study was designed to study the safety and efficacy of Restylane as a non-permanent dermal fille...Background Restylane, a hyaluronic acid gel, has been widely used as a dermal filler in USA and European countries. This study was designed to study the safety and efficacy of Restylane as a non-permanent dermal filler for facial augmentation therapy in China for the correction of nasolabial folds during a follow-up period of 6 months. Methods The study consisted of a screening visit, a baseline visit during which injection with Restylane was given, and follow-up visits after four weeks, three months and six months. The efficacy was subjectively assessed by comparing the treatment results between pre-treatment and post-treatment. Adverse events were analyzed by severity and duration. Results At six months post-baseline, the subjects and the investigators＇ independent assessment score of Wrinkle Severity Rating Scale was decreased. Global Aesthetic Improvement Scale was considered to have improved by over 90% in some cases. Adverse events related to product and injection was reported in 21.5% of the injections. A vast majority of the post-treatment reactions were mild. Conclusions The efficacy of Restylane for nasolabial fold in a Chinese population was excellent. Restylane was well tolerated and no systemic reactions or other safety concerns were raised.展开更多
Background Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio...Background Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents （BMS）-Multi-link （ML） Vision / ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease （CAD） after implanting the Multi-link Vision or MiniVision stent were investigated in this study. Methods An observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS- ML Vision / ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization （TLR） at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events （MACE） and serious adverse events （SAE） in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study, The average reference diameter of the lesions was （3.0±0.5） mm, and the mean length was （15.7±5.0） mm. Results The successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization （TVR） were 6.8%, 3.5% and 1.4% respectively. Conclusion The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
The application of environment-behavior studies plays an important role in studying the renewal of shantytowns.One of the most humane ways of renewal is designing and constructing the necessary urban spatial environme...The application of environment-behavior studies plays an important role in studying the renewal of shantytowns.One of the most humane ways of renewal is designing and constructing the necessary urban spatial environment from the perspective of human daily behavior.Most of the shantytown renovation projects currently carried out in China are mainly focused on demolition and reconstruction,which not only incurs high costs but also damages the original social structure and economic model.During the process of shantytown renewal,it should improve the urban landscape,living environment,and life quality of residents,and ensure the daily life of shantytown residents without increasing their economic burden,and preserve the traces of urban development.In order to achieve this goal,it should explore the renewal strategies of shantytowns from the perspective of environment-behavior studies through behavior maps,on-site research,and literature review.Updating and design from a human perspective often achieve faster and better development;the renewal of shantytowns should be a bottom-up approach and start from a grassroots perspective,completing the renovation design through the composition of the population and behavioral patterns.展开更多
Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between ...Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.展开更多
基金Supported by the National Natural Science Foundation of China,No.82270594the National Natural Science Foundation for Youths of China,No.82103151+1 种基金the Outstanding Youth Foundation of Hunan Province,No.2022JJ20092the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hospital of Central South University,No.YX202103.
文摘BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its potential involvement in biliary diseases.However,the specific role of H.pylori in the development of cholelithiasis remains inconclusive.AIM To investigate the potential association between H.pylori infection and the development of cholelithiasis.METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle,northern and eastern China,from October 2018 to December 2021,to explore the potential association between H.pylori and cholelithiasis through univariate and multivariate analysis.Meanwhile,the influence of H.pylori on biliary-related parameters was investigated.A comprehensive analysis of previous studies concerned about H.pylori and cholelithiasis was also executed.RESULTS In our multi-center study,H.pylori was positively associated with cholelithiasis[odds ratio(OR)=1.103,95%confidence interval(CI):1.001-1.216,P=0.049].Furthermore,H.pylori patients had less total and direct bilirubin than uninfected patients,while the total cholesterol and low-density lipoprotein cholesterol were more in H.pyloripositive participants(P<0.05).In the published articles,the cohort studies indicated H.pylori was a risk factor of cholelithiasis(hazard ratio=1.3280,95%CI:1.1810-1.4933,P<0.0001).The pooled results of case-control and crosssectional studies showed positive association between H.pylori and cholelithiasis in Asia(OR=1.5993,95%CI:1.0353-2.4706,P=0.034)but not in Europe(OR=1.2770,95%CI:0.8446-1.9308,P=0.246).Besides,H.pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio(OR=3.3215,95%CI:1.1034-9.9986,P=0.033).CONCLUSION H.pylori is positively correlated with cholelithiasis,choledocholithiasis phenotype particularly,especially in Asia,which may be relevant to bilirubin/cholesterol metabolism.Cohort studies confirm an increased risk of cholelithiasis in H.pylori patients.
文摘Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need to infuse human albumin may be reduced or avoided in Japan if these large doses 6% HES 130/0.4 can be infused. Methods: The study was an uncontrolled, open-labeled, multi-center trial. Fifteen adult and 5 pediatric patients undergoing major elective surgery received 6% HES 130/0.4 (Voluven®) with a maximum dose of 50 mL/kg from the start of surgery until 2 hours after the end of surgery according to a treatment algorithm. The primary efficacy endpoint was the volume effect of 6% HES 130/0.4 determined by the volume of saved albumin during the investigational period and the time course of hemodynamic stability in adult and pediatric patients. Safety parameters were fluid balance, hemodynamic and laboratory parameters ECG, local and systemic tolerance and adverse events. Results: Adult patients received a mean of 32.0 mL/kg of 6% HES 130/0.4. For 12 out of 15 adult patients an average amount of 1033.8 mL (18.6 mL/kg) albumin could be saved. The other 3 adult patients did not receive more than 1000 mL of HES 130/0.4. All pediatric patients received approximately 50 mL/kg of HES 130/0.4;for these patients an average amount of 39.9 mL/kg body weight albumin could be saved. The majority of adult patients, and all pediatric patients were hemodynamically stable at all 3 time points. The observed changes of the assessed laboratory parameters including hematological and coagulation parameters or in any other safety parameter determined did not reveal any safety concern related to the administration of 6% HES 130/0.4 up to doses of 50 mL/kg body weight. Conclusion: The study results indicate that 6% HES 130/0.4 has a reliable volume effect, could contribute to significant human albumin savings and was safe and well tolerated up to a maximum dose of 50 mL/kg body weight in adult and pediatric patients undergoing major elective surgery.
基金the Research Project of the Chinese Digestive Early Cancer Physicians’Joint Growth Program,No.GTCZ-2021-AH-34-0012.
文摘BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gastric mucosa and provide valuable guidance for improving treatment efficacy.METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included.Among them,296 patients were followed up with endoscopic and biopsy pathology.Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.RESULTS The distribution sites of LGIN among the 357 patients were as follows:Gastric antrum(54.6%),gastric cardia(24.1%),gastric angulus(8.7%),gastric body(4.8%),gastric fundus(4.8%),and multiple sites(3.1%).Additionally,of the 357 patients with LGIN,112(31.4%)developed ulceration and 59(16.5%)experienced gastric polyps.Furthermore,231 of the 357(64.71%)patients with LGIN tested positive for Helicobacter pylori(H.pylori)infection.The H.pylori infection rates of the patients with LGIN with accompanying atrophy,intestinal metaplasia,and gastric ulcer were 51.95%,59.31%,and 28.57%,respectively.Multivariate logistic regression analysis showed that age≥60 years[odds ratio(OR)=3.063,95%confidence interval(CI):1.351-6.945,P=0.007],H.pylori infection(OR=3.560,95%CI:1.158-10.949,P=0.027),multiple locations(OR=10.136,95%CI:2.045-50.237,P=0.005),lesion size≥2 cm(OR=3.921,95%CI:1.664-9.237,P=0.002),and gastric ulcer(OR=2.730,95%CI:1.197-6.223,P=0.017)were predictive factors for LGIN progression.CONCLUSION LGIN progression is closely related to age,H.pylori positivity,multiple locations,lesion size≥2 cm,and gastric ulcer.Thus,actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.
基金supported by grants from the National Natural Science Foundation of China for Distinguished Young Scholars(No.82325010)Medical-Engineering Cross Foundation of Shanghai Jiao Tong University(No.YG2021ZD20)+6 种基金Shuguang Project(No.21SG11)Innovative Research Team of High-level Local Universities in Shanghai(No.SHSMU-ZDCX20212700)Shanghai Sixth People’s Hospital Grant(No.ynhg202204)National Natural Science Foundation of China for Young Scientists(No.82300891)Shanghai Research Center for Endocrine and Metabolic Diseases(No.2022ZZ01002)National Key Clinical Specialty(No.Z155080000004)Shanghai Municipal Key Clinical Specialty.
文摘To the Editor:Maturity-onset diabetes of the young(MODY)is characterized as a non-autoimmune form of diabetes with an autosomal dominant inheritance pattern.Due to the overlapping clinical phenotypes among MODY,such as type 1 diabetes mellitus(T1DM)and type 2 diabetes mellitus(T2DM),over 80%of MODY patients are initially misdiagnosed.[1]In recent decades,the advent and development of next-generation sequencing technology have facilitated a deeper understanding of MODY.High-throughput sequencing has remarkably expanded our knowledge of the pathogenic patterns of MODY across diverse populations.
基金supported and funded by the National Natural Science Foundation of China(82101079)the Key R&D Program of Jiangsu Province(BE2023836)the National Key Research and Development Program of China(SQ2023YFC2400025).
文摘As the integration of medical big data and artificial intelligence advances,the secure sharing of medical data has become a key driving force for advancing disease research and clinical diagnosis.Federated learning,a distributed approach enabling collaborative data processing without sharing raw data,offers promising solutions to challenges in multi-center medical data sharing.This review summarizes the progress of federated learning in multi-center medical data processing,analyzed from four perspectives:system architectures,data distribution strategies,clinical tasks,and algorithmic models.At the same time,this paper explores the challenges in practical applications,such as data heterogeneity,communication overhead,and privacy concerns.It proposes driving future research development by optimizing algorithms,strengthening privacy protection mechanisms,and enhancing computational efficiency.
基金supported by Shanghai Technical Service Computing Center of Science and Engineering,Shanghai University.
文摘Carotid artery plaques represent a major contributor to the morbidity and mortality associated with cerebrovascular disease,and their clinical significance is largely determined by the risk linked to plaque vulnerability.Therefore,classifying plaque risk constitutes one of themost critical tasks in the clinicalmanagement of this condition.While classification models derived from individual medical centers have been extensively investigated,these singlecenter models often fail to generalize well to multi-center data due to variations in ultrasound images caused by differences in physician expertise and equipment.To address this limitation,a Dual-Classifier Label Correction Networkmodel(DCLCN)is proposed for the classification of carotid plaque ultrasound images acrossmultiplemedical centers.TheDCLCNdesigns amulti-center domain adaptationmodule that leverages a dual-classifier strategy to extract knowledge from both source and target centers,thereby reducing feature discrepancies through a domain adaptation layer.Additionally,to mitigate the impact of image noise,a label modeling and correction module is introduced to generate pseudo-labels for the target centers and iteratively refine them using an end-to-end correction mechanism.Experiments on the carotid plaque dataset collected fromthreemedical centers demonstrate that the DCLCN achieves commendable performance and robustness.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金supported by“Dalian Maritime University Teaching Reform Research Fund 2022 Annual Project”(Fund No.XJG2022-96).
文摘This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.
文摘In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.
文摘BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.
基金Supported by the National Key Basic Research Program of China(973 Program,No.2014CB543001)the Twelfth Five-Year National Science and Technology Support Program(No.2013BAI02B06)
文摘OBJECTIVE:To assess the relationship between disease symptoms and traditional Chinese medicine (TCM) syndrome (Zheng) in rheumatoid arthritis (RA) patients.METHODS:RA Patients were recruited in Guang'anmen Hospital,China Academy of Chinese Medical Sciences and in the Second Affiliated Hospital of Zhejiang Chinese Medical University,and diagnosed with a particular RA Zheng from their symptoms.Demographic characteristics,self-reported symptoms,and blood samples were collected from patients.All data were input into EpiData and analyzed using SPSS software.RESULTS:The study included 302 RA patients (age range:18-86 years).All patients were Chinese,and 85.1% were women.Cold and fatigue triggers were reported by 8.6% of patients,followed by triggers such as childbirth (4.3%),cold (3.0%),dampness (2.0%),menopause (1.3%),and psychentonia (0.7%).The most prevalent Zheng was dampness and heat blockage (Shire Yuzu in Chinese,SRYZ),diagnosed in 39.4% of patients (119),followed by phlegm and stagnation blockage (Tanyu Bizu,TYBZ) in 21.5%,liver and kidney deficiency (Ganshen Buzu,GSBZ) in 18.5%,dual deficiency of Qi and blood (Qixue Liangxu,QXLX) in 9.6%,cold and dampness blockage (Hanshi Bizu,HSBZ) in 6%,and wind and dampness blockage (Fengshi Bizu,FSBZ) in 5%.Increased length of time since RA diagnosis was associated with the GSBZ group.Patients diagnosed with the SRYZ Zheng had the highest disease activity score.Patients diagnosed with the QXLX Zheng had the lowest blood platelet counts;patients diagnosed with the QXLX and HSBZ Zhengs had lower C-reactive protein levels and lower health assessment questionnaire scores.Patients diagnosed with the GSBZ and QXLX Zhengs had the highest health assessment questionnaire scores.CONCLUSION:The specific Zheng was related to RA characteristics.The findings suggest that eliminating dampness,cooling the patient,and promoting blood circulation may assist in treating severe RA.
文摘The simple adjusted estimator of risk difference in each center is easy constructed by adding a value c on the number of successes and on the number of failures in each arm of the proportion estimator. Assessing a treatment effect in multi-center studies, we propose minimum MSE (mean square error) weights of an adjusted summary estimate of risk difference under the assumption of a constant of common risk difference over all centers. To evaluate the performance of the proposed weights, we compare not only in terms of estimation based on bias, variance, and MSE with two other conventional weights, such as the Cochran-Mantel-Haenszel weights and the inverse variance (weighted least square) weights, but also we compare the potential tests based on the type I error probability and the power of test in a variety of situations. The results illustrate that the proposed weights in terms of point estimation and hypothesis testing perform well and should be recommended to use as an alternative choice. Finally, two applications are illustrated for the practical use.
文摘Background Restylane, a hyaluronic acid gel, has been widely used as a dermal filler in USA and European countries. This study was designed to study the safety and efficacy of Restylane as a non-permanent dermal filler for facial augmentation therapy in China for the correction of nasolabial folds during a follow-up period of 6 months. Methods The study consisted of a screening visit, a baseline visit during which injection with Restylane was given, and follow-up visits after four weeks, three months and six months. The efficacy was subjectively assessed by comparing the treatment results between pre-treatment and post-treatment. Adverse events were analyzed by severity and duration. Results At six months post-baseline, the subjects and the investigators＇ independent assessment score of Wrinkle Severity Rating Scale was decreased. Global Aesthetic Improvement Scale was considered to have improved by over 90% in some cases. Adverse events related to product and injection was reported in 21.5% of the injections. A vast majority of the post-treatment reactions were mild. Conclusions The efficacy of Restylane for nasolabial fold in a Chinese population was excellent. Restylane was well tolerated and no systemic reactions or other safety concerns were raised.
文摘Background Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents （BMS）-Multi-link （ML） Vision / ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease （CAD） after implanting the Multi-link Vision or MiniVision stent were investigated in this study. Methods An observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS- ML Vision / ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization （TLR） at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events （MACE） and serious adverse events （SAE） in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study, The average reference diameter of the lesions was （3.0±0.5） mm, and the mean length was （15.7±5.0） mm. Results The successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization （TVR） were 6.8%, 3.5% and 1.4% respectively. Conclusion The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
文摘The application of environment-behavior studies plays an important role in studying the renewal of shantytowns.One of the most humane ways of renewal is designing and constructing the necessary urban spatial environment from the perspective of human daily behavior.Most of the shantytown renovation projects currently carried out in China are mainly focused on demolition and reconstruction,which not only incurs high costs but also damages the original social structure and economic model.During the process of shantytown renewal,it should improve the urban landscape,living environment,and life quality of residents,and ensure the daily life of shantytown residents without increasing their economic burden,and preserve the traces of urban development.In order to achieve this goal,it should explore the renewal strategies of shantytowns from the perspective of environment-behavior studies through behavior maps,on-site research,and literature review.Updating and design from a human perspective often achieve faster and better development;the renewal of shantytowns should be a bottom-up approach and start from a grassroots perspective,completing the renovation design through the composition of the population and behavioral patterns.
文摘Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.
