Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age. Design Setting: A prospective ...Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age. Design Setting: A prospective cohort study. Setting: Two major postgraduate teaching hospitals: one in Tripoli, Libya and the other in Jeddah, Saudi Arabia. Participants: Fifty-seven patients with 79 keloids, referred from Plastic Surgery Units between April 1996 and January 2005. Main Outcome Measure: Degree of flattening of the keloidal lesion and symptomatic recovery. Results: Result of treatment has been analyzed using unified set criteria. Seventy-seven percent of this cohort had complete response. 19% of cases had partial response, 50% acknowledged the treatment outcome had been “satisfactory” and 44% had an “acceptable” outcome. There was no significant acute or delayed reaction. Conclusion: The technique appears universally adaptable, cost effective, and can safely be prescribed for children and women of child-bearing age. In spite of prolonged treatment course, compliance was excellent.展开更多
The clinical data of 18 patients with PB from April 1989 to April 2013 was analyzed retrospectively,including 11 men and 7 women,aged 45 and 76 years old(mean 53 years).There were 12 eases of PB occurrlng in right lun...The clinical data of 18 patients with PB from April 1989 to April 2013 was analyzed retrospectively,including 11 men and 7 women,aged 45 and 76 years old(mean 53 years).There were 12 eases of PB occurrlng in right lung and other cases in left lung,AraBng them,3 patients had no symptoms,and 15 patients displayed symptoms of cough,chest pain,asthenia or minor hacmoptysis.Overall,11 patients had a preoperative diagnosis of lung cancer,7 patients were preoperatively diagnosed as the other disease,which included lung benign tumor(n=5)and mediastinal mass(n=2).All patients received a radical resection.Six patients received postoperative cisplalinbascd chemothcrapy,and two paticnts received postoperative irradiation with the dose of 55 Gy.Histologically.14 eases of 18 patients had biphasie pulmonary blastema and four cases had well differentiated fetal adenocarcinoma.A total of 12 patients died in a period of 6-36 months after operation,and 1 ease was lost after 2 years of follow up.The median survival time was 19 months,PB is a rare primary lung malignant embryonal neoplasm.Despite its assumed embyonal origin,the tumor has a predileetion for adults.A preoperative correct diagnosis is very difficult in spite of modern diagnostic imaging and biopsy techniques,Surgical resection is the main method for diagnosis and treatment.Postoperative chemotherapy or irradiation can help eliminate tumor remnants.Its prognosis is very poor,especially for the biphasie type.展开更多
Background: Wilms’ tumor (WT), the most common malignant neoplasm of the urinary tract of children [1], accounts for 5.9% of childhood cancers and affects one in every 10,000 children worldwide before the age of 15 y...Background: Wilms’ tumor (WT), the most common malignant neoplasm of the urinary tract of children [1], accounts for 5.9% of childhood cancers and affects one in every 10,000 children worldwide before the age of 15 years. The care of children with Wilm’s tumor in sub-Saharan Africa is compromised due to resource deficiencies that range from inadequate healthcare budgets to paucity of appropriately trained personnel. Childhood Wilms tumor is surging as an important paediatric problem in developing and sub-Saharan Africa countries. The objective of the study is to establish an understanding on the treatment challenges and outcomes of Wilm’s tumor in South West Ethiopia. Results: Forty-three Wilm’s tumor patients who were admitted from January 2017 to December 2021 were included in the study. The most frequent presentation was painless abdominal swelling in 40 (93%) patients. Fourteen patients (32.6%) were hypertensive at the time of diagnosis and the other 13 (30.2%) were normal. In abdominal examination, 31 (72.1%) patients had abdominal mass not crossing the midline and 12 (27.9%) had mass crossing the midline. After multimodal treatment, 37.5% had improvement, 11.6% came back with relapse. Most patients (41.7%) abandoned treatment and 9.3% of the cohort died in the course of treatment. Conclusion: The outcomes in the treatment of Wilms Tumor have been found to be poor in this review. The main reason for poor outcome has been not receiving adequate chemotherapy after surgery. Doses of chemotherapy received after surgery significantly affected treatment outcomes (p = 0.026).展开更多
This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individua...This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individuals with mild-to-moderate traumatic brain injury (TBI). A total of 15 participants (7 males, 8 females, ages ranging from 20 to 78 years) diagnosed with mild-to-moderate TBI underwent 10 sessions of combined therapy. Cognitive performance was assessed using standardized neuropsychological tests before and after treatment, measuring cognitive processing speed, neural responsiveness, and executive function. The results demonstrated significant improvements across all metrics, including a 28.3 ms reduction in P300 latency, a 1.2 mV increase in P300 voltage, and reductions in completion times for the Trail-Making Tests A (14 seconds) and B (19 seconds). These findings suggest that multi-modality therapy may enhance cognitive recovery in TBI patients, with notable benefits across age and gender groups. Further research with larger sample sizes and extended follow-up is required to validate these results and explore their broader clinical applications.展开更多
Silicon carbide fibers are considered ideal reinforcing materials for ceramic matrix composites due to their excellent mechanical properties and high-temperature performance.Different types of fibers necessitate indiv...Silicon carbide fibers are considered ideal reinforcing materials for ceramic matrix composites due to their excellent mechanical properties and high-temperature performance.Different types of fibers necessitate individual investigation due to variations in their composition and fabrication processes.This study presents a comprehensive investigation into evolution of the mechanical properties,surface microstructure,and composition of Shicolon-Ⅱ fibers subjected to argon heat treatment at temperatures ranging from 1300℃to 1700℃.The Shicolon-Ⅱ fibers are composed of small-sized β-SiC grains,SiC_(x)O_(y) amorphous phase,and a minor amount of graphite microcrystals.Following treatment in an argon atmosphere at 1300℃,the fibers maintain a monofilament tensile strength of 3.620 GPa,corresponding to a retention of 98.32%.This strength diminishes to 2.875 GPa,equating to a retention of 78.08%,after treatment at 1500℃.The reduction in mechanical properties of the fibers can be ascribed to the decomposition of the amorphous phase and the growth of β-SiC grains.Furthermore,creep resistance is an essential factor influencing the long-term performance of composite materials.After treatment at temperatures above 1400℃,the high-temperature creep resistance of the fibers is significantly enhanced due to growth of β-SiC grains.This study offers valuable theoretical insights into high-temperature applications of second-generation fibers,contributing to an enhanced understanding of their performance under extreme conditions.展开更多
Psoriasis is a hereditary,autoimmune,chronic illness that influences the immune system and can have both cutaneous and systemic symptoms.It can seriously impair a patient’s quality of life.Psoriasis affects 2.3 perce...Psoriasis is a hereditary,autoimmune,chronic illness that influences the immune system and can have both cutaneous and systemic symptoms.It can seriously impair a patient’s quality of life.Psoriasis affects 2.3 percent of people globally and has a significant financial cost for those who suffer from it.Genes and environmental factors are the primary etiological factors.Dendritic cells,T cells,human neutrophilic peptides,lipoprotein-2,galactosin-3,fractalkine,vaspin,and familial predispositions,among other factors,are characteristics of the pathophysiology of psoriasis.Conventional psoriasis treatments for patients include corticosteroids,biological agents,vitamin D3 analogs,acitretin,calcineurin inhibitors,cyclosporine,methotrexate,and phototherapy.Growing in popularity as a multidisciplinary field of study,nano dermatology is being used to treat psoriasis.Over the years,major advancements have been made in understanding its complex pathogenesis and developing more effective,targeted treatments.Medication delivery methods utilizing nanocarriers demonstrate promise in treating psoriasis because they improve medication penetration,reduce side effects,and provide targeted action at the afflicted areas.Because of their biological compatibility,adaptability,and capacity for carrying a variety of therapeutic substances,lipid-based and polymer-based nanocarriers have demonstrated exceptional promise among them.This article summarizes the pathogenesis,epidemiology,clinical diagnosis,and conventional psoriasis treatments.Furthermore,the review includes an overview of various nanotechnology-based psoriasis treatments.展开更多
Metal organic framework(MOF) assembled with coordination bonds has the disadvantage of poor stability that limits its application in the field of stationary phase,while covalent organic framework(COF)assembled through...Metal organic framework(MOF) assembled with coordination bonds has the disadvantage of poor stability that limits its application in the field of stationary phase,while covalent organic framework(COF)assembled through covalent bonds exhibits excellent structural stability.It has been shown that the stationary phases prepared by combining MOF and COF can make up for the poor stability of MOF@SiO_(2),and the MOF/COF composites have superior chromatographic separation performance.However,the traditional methods for preparing COF/MOF based stationary phases are generally solvent thermal synthesis.In this study,a green and low-cost synthesis method was proposed for the preparation of MOF/COF@SiO_(2) stationary phase.Firstly,COF@SiO_(2) was prepared in a choline chloride/ethylene glycol based deep eutectic solvent(DES).Secondly,another acid-base tunable DES prepared by mixing p-toluenesulfonic acid(PTSA)and 2-methylimidazole in different proportions was introduced as the reaction solvent and reactant for rapid synthesis of MOF/COF@SiO_(2).Compared with the toxic transition metal-based MOFs selected in most previous studies,a lightweight and non-toxic S-zone metal(calcium) based MOF was employed in this study.PTSA and calcium will form the calcium/oxygen-containing organic acid framework in acidic DES,which assembles with terephthalic acid dissolved in basic DES to form MOF.The strong hydrogen bonding effect of DES can facilitate rapid assembly of Ca-MOF.The obtained Ca-MOF/COF@SiO_(2) can be used for multi-mode chromatography to efficiently separate multiple isomeric/hydrophilic/hydrophobic analytes.The synthesis method of Ca-MOF/COF@SiO_(2) is green and mild,especially the use of acid-base tunable DES promotes the rapid synthesis of non-toxic Ca-MOF/COF@silica composites,which offers an innovative approach of greenly synthesizing novel MOF/COF stationary phases and extends their applications in the field of chromatography.展开更多
In multi-modal emotion recognition,excessive reliance on historical context often impedes the detection of emotional shifts,while modality heterogeneity and unimodal noise limit recognition performance.Existing method...In multi-modal emotion recognition,excessive reliance on historical context often impedes the detection of emotional shifts,while modality heterogeneity and unimodal noise limit recognition performance.Existing methods struggle to dynamically adjust cross-modal complementary strength to optimize fusion quality and lack effective mechanisms to model the dynamic evolution of emotions.To address these issues,we propose a multi-level dynamic gating and emotion transfer framework for multi-modal emotion recognition.A dynamic gating mechanism is applied across unimodal encoding,cross-modal alignment,and emotion transfer modeling,substantially improving noise robustness and feature alignment.First,we construct a unimodal encoder based on gated recurrent units and feature-selection gating to suppress intra-modal noise and enhance contextual representation.Second,we design a gated-attention crossmodal encoder that dynamically calibrates the complementary contributions of visual and audio modalities to the dominant textual features and eliminates redundant information.Finally,we introduce a gated enhanced emotion transfer module that explicitly models the temporal dependence of emotional evolution in dialogues via transfer gating and optimizes continuity modeling with a comparative learning loss.Experimental results demonstrate that the proposed method outperforms state-of-the-art models on the public MELD and IEMOCAP datasets.展开更多
The TiB+TiC dual-reinforced B_(4)C/TC4 composite was in-situ fabricated via incorporating 0.5wt%B_(4)C reinforcement during the laser melting deposition process.Different heat treatments of annealing and solid solutio...The TiB+TiC dual-reinforced B_(4)C/TC4 composite was in-situ fabricated via incorporating 0.5wt%B_(4)C reinforcement during the laser melting deposition process.Different heat treatments of annealing and solid solution were used to regulate the microstructure,mechanical properties,and corrosion properties of B_(4)C/TC4 composite.Results show that with the increase in temperature from 500℃to 800°C,partial lamellarα-Ti in the as-deposited sample is gradually transformed into equiaxedα-Ti,accompanied by the disappearance of basketweave microstructure.At 1100°C,a small portion of TiC phase suffers fusion.This composite exhibits the optimal combination of strength and plasticity after annealing at 500℃for 4 h followed by furnace cooling,which is attributed to the stress release effect and the refined basketweave microstructure.However,this composite shows a decline in corrosion resistance after various heat treatments due to grain coarsening and micro-galvanic corrosion.展开更多
Heat treatment is applied towood to improve various properties of thematerial.Thepresent study focuses on the colour changes of wood veneer samples due to heat treatment.Native wood species fromJapan and Europe,such a...Heat treatment is applied towood to improve various properties of thematerial.Thepresent study focuses on the colour changes of wood veneer samples due to heat treatment.Native wood species fromJapan and Europe,such as Japanese oak(Quercus mongolica var.crispula),field maple(Acer campestre)and Scots pine(Pinus sylvestris)were used in the experiments.A laboratory-type oven was used to apply the heat at a temperature of 190○C,in the presence of oxygen,for different periods,gradually increasing from 5 to 40 min.The CIELab system(a colour space defined by the International Commission on Illumination)and Near Infrared Spectroscopy(NIR)were employed to evaluate the colour modifications on the samples.As expected,the heat treatment affected the colour of the samples.The lightness index decreased across the three wood species during the treatment.The chroma coordinates changed for pine and maple,while little change occurred in Japanese oak.The overall total colour differences reached their maximum at the final 40-min interval for all wood types.Based on the NIR evaluation,it was found that drastic thermal denaturation of cellulose was unlikely to occur,and the changes in the intermolecular interaction of water affected the colour of the specimens.The data and information of this study could be useful for industrial applications where the veneer of such species is desired.Such heat-treated veneers can be considered as value-added products in furniture manufacturing as well as restoration of furniture units where such veneer is used as an overlay.展开更多
The global prevalence of metabolic-associated fatty liver disease(MAFLD)is on the rise,seriously threatening human health.Currently,no specific approved drugs are available for its treatment.This paper reviews the pat...The global prevalence of metabolic-associated fatty liver disease(MAFLD)is on the rise,seriously threatening human health.Currently,no specific approved drugs are available for its treatment.This paper reviews the pathogenesis of MAFLD,covering aspects like lipid accumulation and insulin resistance,oxidative stress,endoplasmic reticulum stress(ERS),lipotoxicity-induced hepatocyte damage,and fibrosis.It also elaborates on multiple treatment approaches for MAFLD,including metabolic regulation,improvement of the gut-liver axis interaction,modulation of immune and inflammatory pathways,enhancement of the adipose tissue-liver interaction,alleviation of fibrosis,prevention of hepatocyte injury,and traditional Chinese medicine(TCM)external therapies.Additionally,natural product research advancements,individual Chinese medicine components,and mixed herbal formulas for MAFLD treatment is provided.Many natural products and traditional Chinese medicines exhibit favorable effects in regulating lipid metabolism,anti-inflammation,and anti-oxidation,offering new directions and potential drug options for MAFLD treatment.This is expected to provide a reference for future clinical treatment and drug development.展开更多
Colorectal cancer(CRC)is the third most common malignancy worldwide and the second leading cause of cancer-related deaths,accounting for approximately 10%of all cancer cases.By 2050,CRC incidence is expected to rise s...Colorectal cancer(CRC)is the third most common malignancy worldwide and the second leading cause of cancer-related deaths,accounting for approximately 10%of all cancer cases.By 2050,CRC incidence is expected to rise substantially,driven by population aging and greater exposure to risk factors in developing countries.Despite advances in medicine and pharmacy,the effectiveness of available treatments remains limited,underscoring the urgent need for innovative therapeutic strategies.This review summarizes and critically evaluates currently available CRC therapies and explores new emerging directions.Particular attention is given to the role of immunotherapy,targeted therapies,nanotechnology-based approaches,metal-based compounds,PROTAC technology,and personalized medicine,with emphasis on their efficacy,safety,accessibility,and mechanisms of drug resistance.In conclusion,surgery and chemotherapy remain the backbone of CRC treatment,but novel therapeutic approaches are reshaping the treatment landscape.Emerging strategies may offer improved patient tolerability and survival outcomes by reducing the occurrence of burdensome adverse effects.Persistent challenges such as drug toxicity,the emergence of resistance mechanisms,and inequalities in access to innovative therapies underscore the need for further translational research.Integrating personalized therapeutic approaches will also be crucial to achieving more effective,safer,and accessible treatment strategies for CRC.展开更多
The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatme...The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.展开更多
Vibrio harveyi,a Gram-negative bacterium ubiquitous in marine environments,is recognized as an opportunistic pathogen affecting various aquatic organisms such as fish,shrimp,and shellfish.To enhance its environmental ...Vibrio harveyi,a Gram-negative bacterium ubiquitous in marine environments,is recognized as an opportunistic pathogen affecting various aquatic organisms such as fish,shrimp,and shellfish.To enhance its environmental resilience and adaptive capacity,V.harveyi employs a complex quorum sensing mechanism to modulate its virulence factors,such as bioluminescence,biofilm formation,and motility.Therefore,targeting the quorum sensing of V.harveyi could be a promising strategy to develop novel approaches to ensure the microbial safety of seafood products.This study aims to evaluate the impact of curcumin-mediated photo/sonodynamic treatment on quorum sensing in V.harveyi and its regulated functions.The results indicate a significant decrease of luminescence in V.harveyi following curcumin-mediated photo/sonodynamic treatment.Correspondingly,the biofilm formation ability and bacterial motility of V.harveyi were also greatly impaired by the treatment.Notably,the production of reactive oxygen species in bacteria induced by the photo/sonodynamic treatment could be the underlying mechanism involved in the observed disruption of quorum sensing.These findings underscore the great potential of photo/sonodynamic treatment as a promising strategy to disrupt quorum sensing and mitigate the virulence of V.harveyi,thereby contributing to the development of effective control strategies against this pervasive pathogen.展开更多
AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current resea...AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.展开更多
Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the fi...Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.展开更多
Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by...Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.展开更多
AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants rec...AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir(IVG)3 mg twice a week for 4 consecutive times(induction phase).The affected eyes were divided into stop treatment group(Group A),continue treatment group(Group B),and relapse after treatment group(Group C)according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy.RESULTS:The study included 31 participants(48 eyes)diagnosed with CMVR including 11 males and 20 females.The mean age was(28±8.2)y.There were 17 cases of binocular disease(34 eyes)and 14 cases of monocular disease(14 eyes).Visual acuity improved in 26 eyes(54.1%),remained unchanged in 9 eyes(18.8%),and decreased in 13 eyes(27.1%).The peak value of blood CMV in Group B was significantly higher than that in Group A(P=0.013).The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B(P=0.015,P=0.016).The average number of interval days was higher in Group A than in Group B.For Group A,there was a strong positive correlation between the number of eyes with CMV positive blood(r=0.712,P=0.031)and visual acuity changes.For Group B,there was a moderately strong positive correlation between the days of blood CMV after transplantation(r=0.371,P=0.043)and the times of injections.For Group C,there was a strong positive correlation between the peak value of blood CMV(r=0.719,P=0.029)and the times of injection.CONCLUSION:Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery.Patients with shorter interval days,higher peak or more days of blood CMV need more injections.Patients with positive blood CMV at initial diagnosis have worse visual prognosis.展开更多
Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predicto...Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predictors of treatment failure.Methods:This retrospective cohort study included patients who received DAA therapy at Hospital Kuala Lumpur between January 2020 and December 2023.Sustained virologic response(SVR)was assessed at least 12 weeks post-treatment by reverse transcription-polymerase chain reaction for hepatitis C virus(HCV)RNA.Demographic,clinical,and laboratory data were collected and analyzed.Multiple logistic regression analysis was performed to identify independent predictors of treatment failure.Results:A total of 335 patients in the study.The overall SVR rate was 89%.After achieving SVR,significant improvements were observed in liver enzyme levels and non-invasive liver fibrosis scores,whereas the overall Model for End-Stage Liver Disease(MELD)scores remained unchanged.Significant independent predictors of treatment failure included non-compliance with DAA therapy[adjusted odds ratio(aOR)68.3;95%confidence interval(95%CI)16.3-285.0;P<0.001],treatment with sofosbuvir/velpatasvir(aOR 6.1;95%CI 1.4-26.5;P=0.015),MELD score of 10-15(aOR 4.6;95%CI 1.1-18.2;P=0.031),HCV genotype 3 infection(aOR 4.5;95%CI 1.1-17.6;P=0.031),and elevated serum total bilirubin level(aOR 1.1;95%CI 1.0-1.1;P=0.003).Conclusions:DAA therapy yielded a high SVR rate,and treatment failure was strongly associated with non-adherence to therapy and advanced liver disease.These findings underscore the necessity of adherence support,early diagnosis,and individualized clinical management to optimize treatment outcomes in patients with chronic hepatitis C.展开更多
文摘Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age. Design Setting: A prospective cohort study. Setting: Two major postgraduate teaching hospitals: one in Tripoli, Libya and the other in Jeddah, Saudi Arabia. Participants: Fifty-seven patients with 79 keloids, referred from Plastic Surgery Units between April 1996 and January 2005. Main Outcome Measure: Degree of flattening of the keloidal lesion and symptomatic recovery. Results: Result of treatment has been analyzed using unified set criteria. Seventy-seven percent of this cohort had complete response. 19% of cases had partial response, 50% acknowledged the treatment outcome had been “satisfactory” and 44% had an “acceptable” outcome. There was no significant acute or delayed reaction. Conclusion: The technique appears universally adaptable, cost effective, and can safely be prescribed for children and women of child-bearing age. In spite of prolonged treatment course, compliance was excellent.
文摘The clinical data of 18 patients with PB from April 1989 to April 2013 was analyzed retrospectively,including 11 men and 7 women,aged 45 and 76 years old(mean 53 years).There were 12 eases of PB occurrlng in right lung and other cases in left lung,AraBng them,3 patients had no symptoms,and 15 patients displayed symptoms of cough,chest pain,asthenia or minor hacmoptysis.Overall,11 patients had a preoperative diagnosis of lung cancer,7 patients were preoperatively diagnosed as the other disease,which included lung benign tumor(n=5)and mediastinal mass(n=2).All patients received a radical resection.Six patients received postoperative cisplalinbascd chemothcrapy,and two paticnts received postoperative irradiation with the dose of 55 Gy.Histologically.14 eases of 18 patients had biphasie pulmonary blastema and four cases had well differentiated fetal adenocarcinoma.A total of 12 patients died in a period of 6-36 months after operation,and 1 ease was lost after 2 years of follow up.The median survival time was 19 months,PB is a rare primary lung malignant embryonal neoplasm.Despite its assumed embyonal origin,the tumor has a predileetion for adults.A preoperative correct diagnosis is very difficult in spite of modern diagnostic imaging and biopsy techniques,Surgical resection is the main method for diagnosis and treatment.Postoperative chemotherapy or irradiation can help eliminate tumor remnants.Its prognosis is very poor,especially for the biphasie type.
文摘Background: Wilms’ tumor (WT), the most common malignant neoplasm of the urinary tract of children [1], accounts for 5.9% of childhood cancers and affects one in every 10,000 children worldwide before the age of 15 years. The care of children with Wilm’s tumor in sub-Saharan Africa is compromised due to resource deficiencies that range from inadequate healthcare budgets to paucity of appropriately trained personnel. Childhood Wilms tumor is surging as an important paediatric problem in developing and sub-Saharan Africa countries. The objective of the study is to establish an understanding on the treatment challenges and outcomes of Wilm’s tumor in South West Ethiopia. Results: Forty-three Wilm’s tumor patients who were admitted from January 2017 to December 2021 were included in the study. The most frequent presentation was painless abdominal swelling in 40 (93%) patients. Fourteen patients (32.6%) were hypertensive at the time of diagnosis and the other 13 (30.2%) were normal. In abdominal examination, 31 (72.1%) patients had abdominal mass not crossing the midline and 12 (27.9%) had mass crossing the midline. After multimodal treatment, 37.5% had improvement, 11.6% came back with relapse. Most patients (41.7%) abandoned treatment and 9.3% of the cohort died in the course of treatment. Conclusion: The outcomes in the treatment of Wilms Tumor have been found to be poor in this review. The main reason for poor outcome has been not receiving adequate chemotherapy after surgery. Doses of chemotherapy received after surgery significantly affected treatment outcomes (p = 0.026).
文摘This study investigates the combined effects of multi-modality therapy, including mild hyperbaric therapy (mHBT), photobiomodulation (PBM), and molecular hydrogen therapy (MH), on cognitive rehabilitation in individuals with mild-to-moderate traumatic brain injury (TBI). A total of 15 participants (7 males, 8 females, ages ranging from 20 to 78 years) diagnosed with mild-to-moderate TBI underwent 10 sessions of combined therapy. Cognitive performance was assessed using standardized neuropsychological tests before and after treatment, measuring cognitive processing speed, neural responsiveness, and executive function. The results demonstrated significant improvements across all metrics, including a 28.3 ms reduction in P300 latency, a 1.2 mV increase in P300 voltage, and reductions in completion times for the Trail-Making Tests A (14 seconds) and B (19 seconds). These findings suggest that multi-modality therapy may enhance cognitive recovery in TBI patients, with notable benefits across age and gender groups. Further research with larger sample sizes and extended follow-up is required to validate these results and explore their broader clinical applications.
基金National Natural Science Foundation of China(52172108)National Key R&D Program of China(2022YFB3707700)Strategic Priority Research Program of the Chinese Academy of Sciences(XDC0144005)。
文摘Silicon carbide fibers are considered ideal reinforcing materials for ceramic matrix composites due to their excellent mechanical properties and high-temperature performance.Different types of fibers necessitate individual investigation due to variations in their composition and fabrication processes.This study presents a comprehensive investigation into evolution of the mechanical properties,surface microstructure,and composition of Shicolon-Ⅱ fibers subjected to argon heat treatment at temperatures ranging from 1300℃to 1700℃.The Shicolon-Ⅱ fibers are composed of small-sized β-SiC grains,SiC_(x)O_(y) amorphous phase,and a minor amount of graphite microcrystals.Following treatment in an argon atmosphere at 1300℃,the fibers maintain a monofilament tensile strength of 3.620 GPa,corresponding to a retention of 98.32%.This strength diminishes to 2.875 GPa,equating to a retention of 78.08%,after treatment at 1500℃.The reduction in mechanical properties of the fibers can be ascribed to the decomposition of the amorphous phase and the growth of β-SiC grains.Furthermore,creep resistance is an essential factor influencing the long-term performance of composite materials.After treatment at temperatures above 1400℃,the high-temperature creep resistance of the fibers is significantly enhanced due to growth of β-SiC grains.This study offers valuable theoretical insights into high-temperature applications of second-generation fibers,contributing to an enhanced understanding of their performance under extreme conditions.
文摘Psoriasis is a hereditary,autoimmune,chronic illness that influences the immune system and can have both cutaneous and systemic symptoms.It can seriously impair a patient’s quality of life.Psoriasis affects 2.3 percent of people globally and has a significant financial cost for those who suffer from it.Genes and environmental factors are the primary etiological factors.Dendritic cells,T cells,human neutrophilic peptides,lipoprotein-2,galactosin-3,fractalkine,vaspin,and familial predispositions,among other factors,are characteristics of the pathophysiology of psoriasis.Conventional psoriasis treatments for patients include corticosteroids,biological agents,vitamin D3 analogs,acitretin,calcineurin inhibitors,cyclosporine,methotrexate,and phototherapy.Growing in popularity as a multidisciplinary field of study,nano dermatology is being used to treat psoriasis.Over the years,major advancements have been made in understanding its complex pathogenesis and developing more effective,targeted treatments.Medication delivery methods utilizing nanocarriers demonstrate promise in treating psoriasis because they improve medication penetration,reduce side effects,and provide targeted action at the afflicted areas.Because of their biological compatibility,adaptability,and capacity for carrying a variety of therapeutic substances,lipid-based and polymer-based nanocarriers have demonstrated exceptional promise among them.This article summarizes the pathogenesis,epidemiology,clinical diagnosis,and conventional psoriasis treatments.Furthermore,the review includes an overview of various nanotechnology-based psoriasis treatments.
基金supported by National Natural Science Foundation of China (Nos.21906124,32302202)Natural Science Foundation of Hubei Province (No.2017CFB220)Natural Science Foundation of Shandong Province (No.ZR2023MH278)。
文摘Metal organic framework(MOF) assembled with coordination bonds has the disadvantage of poor stability that limits its application in the field of stationary phase,while covalent organic framework(COF)assembled through covalent bonds exhibits excellent structural stability.It has been shown that the stationary phases prepared by combining MOF and COF can make up for the poor stability of MOF@SiO_(2),and the MOF/COF composites have superior chromatographic separation performance.However,the traditional methods for preparing COF/MOF based stationary phases are generally solvent thermal synthesis.In this study,a green and low-cost synthesis method was proposed for the preparation of MOF/COF@SiO_(2) stationary phase.Firstly,COF@SiO_(2) was prepared in a choline chloride/ethylene glycol based deep eutectic solvent(DES).Secondly,another acid-base tunable DES prepared by mixing p-toluenesulfonic acid(PTSA)and 2-methylimidazole in different proportions was introduced as the reaction solvent and reactant for rapid synthesis of MOF/COF@SiO_(2).Compared with the toxic transition metal-based MOFs selected in most previous studies,a lightweight and non-toxic S-zone metal(calcium) based MOF was employed in this study.PTSA and calcium will form the calcium/oxygen-containing organic acid framework in acidic DES,which assembles with terephthalic acid dissolved in basic DES to form MOF.The strong hydrogen bonding effect of DES can facilitate rapid assembly of Ca-MOF.The obtained Ca-MOF/COF@SiO_(2) can be used for multi-mode chromatography to efficiently separate multiple isomeric/hydrophilic/hydrophobic analytes.The synthesis method of Ca-MOF/COF@SiO_(2) is green and mild,especially the use of acid-base tunable DES promotes the rapid synthesis of non-toxic Ca-MOF/COF@silica composites,which offers an innovative approach of greenly synthesizing novel MOF/COF stationary phases and extends their applications in the field of chromatography.
基金funded by“the Fanying Special Program of the National Natural Science Foundation of China,grant number 62341307”“the Scientific research project of Jiangxi Provincial Department of Education,grant number GJJ200839”“theDoctoral startup fund of JiangxiUniversity of Technology,grant number 205200100402”.
文摘In multi-modal emotion recognition,excessive reliance on historical context often impedes the detection of emotional shifts,while modality heterogeneity and unimodal noise limit recognition performance.Existing methods struggle to dynamically adjust cross-modal complementary strength to optimize fusion quality and lack effective mechanisms to model the dynamic evolution of emotions.To address these issues,we propose a multi-level dynamic gating and emotion transfer framework for multi-modal emotion recognition.A dynamic gating mechanism is applied across unimodal encoding,cross-modal alignment,and emotion transfer modeling,substantially improving noise robustness and feature alignment.First,we construct a unimodal encoder based on gated recurrent units and feature-selection gating to suppress intra-modal noise and enhance contextual representation.Second,we design a gated-attention crossmodal encoder that dynamically calibrates the complementary contributions of visual and audio modalities to the dominant textual features and eliminates redundant information.Finally,we introduce a gated enhanced emotion transfer module that explicitly models the temporal dependence of emotional evolution in dialogues via transfer gating and optimizes continuity modeling with a comparative learning loss.Experimental results demonstrate that the proposed method outperforms state-of-the-art models on the public MELD and IEMOCAP datasets.
基金Tianjin Municipal Natural Science Foundation(23JCYBJC00040)National Natural Science Foundation of China(52175369)。
文摘The TiB+TiC dual-reinforced B_(4)C/TC4 composite was in-situ fabricated via incorporating 0.5wt%B_(4)C reinforcement during the laser melting deposition process.Different heat treatments of annealing and solid solution were used to regulate the microstructure,mechanical properties,and corrosion properties of B_(4)C/TC4 composite.Results show that with the increase in temperature from 500℃to 800°C,partial lamellarα-Ti in the as-deposited sample is gradually transformed into equiaxedα-Ti,accompanied by the disappearance of basketweave microstructure.At 1100°C,a small portion of TiC phase suffers fusion.This composite exhibits the optimal combination of strength and plasticity after annealing at 500℃for 4 h followed by furnace cooling,which is attributed to the stress release effect and the refined basketweave microstructure.However,this composite shows a decline in corrosion resistance after various heat treatments due to grain coarsening and micro-galvanic corrosion.
文摘Heat treatment is applied towood to improve various properties of thematerial.Thepresent study focuses on the colour changes of wood veneer samples due to heat treatment.Native wood species fromJapan and Europe,such as Japanese oak(Quercus mongolica var.crispula),field maple(Acer campestre)and Scots pine(Pinus sylvestris)were used in the experiments.A laboratory-type oven was used to apply the heat at a temperature of 190○C,in the presence of oxygen,for different periods,gradually increasing from 5 to 40 min.The CIELab system(a colour space defined by the International Commission on Illumination)and Near Infrared Spectroscopy(NIR)were employed to evaluate the colour modifications on the samples.As expected,the heat treatment affected the colour of the samples.The lightness index decreased across the three wood species during the treatment.The chroma coordinates changed for pine and maple,while little change occurred in Japanese oak.The overall total colour differences reached their maximum at the final 40-min interval for all wood types.Based on the NIR evaluation,it was found that drastic thermal denaturation of cellulose was unlikely to occur,and the changes in the intermolecular interaction of water affected the colour of the specimens.The data and information of this study could be useful for industrial applications where the veneer of such species is desired.Such heat-treated veneers can be considered as value-added products in furniture manufacturing as well as restoration of furniture units where such veneer is used as an overlay.
基金supported by the National Natural Science Foundation of China(82574477)the Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan(QN202426)+5 种基金Jiangsu Province“333 High-level Talents Training Project”((2024)3-0189)Youth Talent Support Project of the Jiangsu Association for Science and Technology(TJ-2023-053)Shanxi Provincial Department-Municipal Key Laboratory Cultivation Base for Quality Enhancement and Utilization of Shangdang Chinese Medicinal Materials(KF202401)Fundamental Research Program of Shanxi Province(202403021221211)the research project supported by the Shanxi Scholarship Council of China(No.2023-158)Open Project of Key Laboratory of Tibetan Medicine Basic Research,Ministry of Education.
文摘The global prevalence of metabolic-associated fatty liver disease(MAFLD)is on the rise,seriously threatening human health.Currently,no specific approved drugs are available for its treatment.This paper reviews the pathogenesis of MAFLD,covering aspects like lipid accumulation and insulin resistance,oxidative stress,endoplasmic reticulum stress(ERS),lipotoxicity-induced hepatocyte damage,and fibrosis.It also elaborates on multiple treatment approaches for MAFLD,including metabolic regulation,improvement of the gut-liver axis interaction,modulation of immune and inflammatory pathways,enhancement of the adipose tissue-liver interaction,alleviation of fibrosis,prevention of hepatocyte injury,and traditional Chinese medicine(TCM)external therapies.Additionally,natural product research advancements,individual Chinese medicine components,and mixed herbal formulas for MAFLD treatment is provided.Many natural products and traditional Chinese medicines exhibit favorable effects in regulating lipid metabolism,anti-inflammation,and anti-oxidation,offering new directions and potential drug options for MAFLD treatment.This is expected to provide a reference for future clinical treatment and drug development.
文摘Colorectal cancer(CRC)is the third most common malignancy worldwide and the second leading cause of cancer-related deaths,accounting for approximately 10%of all cancer cases.By 2050,CRC incidence is expected to rise substantially,driven by population aging and greater exposure to risk factors in developing countries.Despite advances in medicine and pharmacy,the effectiveness of available treatments remains limited,underscoring the urgent need for innovative therapeutic strategies.This review summarizes and critically evaluates currently available CRC therapies and explores new emerging directions.Particular attention is given to the role of immunotherapy,targeted therapies,nanotechnology-based approaches,metal-based compounds,PROTAC technology,and personalized medicine,with emphasis on their efficacy,safety,accessibility,and mechanisms of drug resistance.In conclusion,surgery and chemotherapy remain the backbone of CRC treatment,but novel therapeutic approaches are reshaping the treatment landscape.Emerging strategies may offer improved patient tolerability and survival outcomes by reducing the occurrence of burdensome adverse effects.Persistent challenges such as drug toxicity,the emergence of resistance mechanisms,and inequalities in access to innovative therapies underscore the need for further translational research.Integrating personalized therapeutic approaches will also be crucial to achieving more effective,safer,and accessible treatment strategies for CRC.
文摘The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.
基金financially supported by National Natural Science Foundation of China(32272450)Science Fund for Distinguished Young Scholars of Fujian Province(2023J06020)Special Funds for Science and Technology Innovation of Fujian Agriculture and Forestry University(KFB23132A)。
文摘Vibrio harveyi,a Gram-negative bacterium ubiquitous in marine environments,is recognized as an opportunistic pathogen affecting various aquatic organisms such as fish,shrimp,and shellfish.To enhance its environmental resilience and adaptive capacity,V.harveyi employs a complex quorum sensing mechanism to modulate its virulence factors,such as bioluminescence,biofilm formation,and motility.Therefore,targeting the quorum sensing of V.harveyi could be a promising strategy to develop novel approaches to ensure the microbial safety of seafood products.This study aims to evaluate the impact of curcumin-mediated photo/sonodynamic treatment on quorum sensing in V.harveyi and its regulated functions.The results indicate a significant decrease of luminescence in V.harveyi following curcumin-mediated photo/sonodynamic treatment.Correspondingly,the biofilm formation ability and bacterial motility of V.harveyi were also greatly impaired by the treatment.Notably,the production of reactive oxygen species in bacteria induced by the photo/sonodynamic treatment could be the underlying mechanism involved in the observed disruption of quorum sensing.These findings underscore the great potential of photo/sonodynamic treatment as a promising strategy to disrupt quorum sensing and mitigate the virulence of V.harveyi,thereby contributing to the development of effective control strategies against this pervasive pathogen.
基金Suppotred by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-3-004A-2).
文摘AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.
文摘Due to the special anatomical location,complex functions,and significant impact on patients’appearance and psychology,the treatment of oral and maxillofacial tumors has always been a key and difficult issue in the field of head and neck surgery.With the rapid development of surgical technology,microsurgical reconstruction technology,perioperative management,and multidisciplinary treatment models,surgical treatment has occupied a core position in the comprehensive treatment system of oral and maxillofacial tumors.Based on this,this paper conducts research on the clinical outcomes of surgical treatment for patients with oral and maxillofacial tumors,expounds the optimization strategies of surgical treatment,and analyzes the clinical effects of the optimized surgical treatment,aiming to provide a reference for the clinical treatment of oral and maxillofacial tumors.
基金the 2026 Health Commission Fund of Guizhou Province,China.the freestatistics suite for its technical support.
文摘Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.
文摘AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir(IVG)3 mg twice a week for 4 consecutive times(induction phase).The affected eyes were divided into stop treatment group(Group A),continue treatment group(Group B),and relapse after treatment group(Group C)according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy.RESULTS:The study included 31 participants(48 eyes)diagnosed with CMVR including 11 males and 20 females.The mean age was(28±8.2)y.There were 17 cases of binocular disease(34 eyes)and 14 cases of monocular disease(14 eyes).Visual acuity improved in 26 eyes(54.1%),remained unchanged in 9 eyes(18.8%),and decreased in 13 eyes(27.1%).The peak value of blood CMV in Group B was significantly higher than that in Group A(P=0.013).The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B(P=0.015,P=0.016).The average number of interval days was higher in Group A than in Group B.For Group A,there was a strong positive correlation between the number of eyes with CMV positive blood(r=0.712,P=0.031)and visual acuity changes.For Group B,there was a moderately strong positive correlation between the days of blood CMV after transplantation(r=0.371,P=0.043)and the times of injections.For Group C,there was a strong positive correlation between the peak value of blood CMV(r=0.719,P=0.029)and the times of injection.CONCLUSION:Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery.Patients with shorter interval days,higher peak or more days of blood CMV need more injections.Patients with positive blood CMV at initial diagnosis have worse visual prognosis.
文摘Objective:To evaluate the effectiveness of direct-acting antivirals(DAAs)in patients with chronic hepatitis C,assess changes in liver function and hepatic fibrosis following treatment,and identify independent predictors of treatment failure.Methods:This retrospective cohort study included patients who received DAA therapy at Hospital Kuala Lumpur between January 2020 and December 2023.Sustained virologic response(SVR)was assessed at least 12 weeks post-treatment by reverse transcription-polymerase chain reaction for hepatitis C virus(HCV)RNA.Demographic,clinical,and laboratory data were collected and analyzed.Multiple logistic regression analysis was performed to identify independent predictors of treatment failure.Results:A total of 335 patients in the study.The overall SVR rate was 89%.After achieving SVR,significant improvements were observed in liver enzyme levels and non-invasive liver fibrosis scores,whereas the overall Model for End-Stage Liver Disease(MELD)scores remained unchanged.Significant independent predictors of treatment failure included non-compliance with DAA therapy[adjusted odds ratio(aOR)68.3;95%confidence interval(95%CI)16.3-285.0;P<0.001],treatment with sofosbuvir/velpatasvir(aOR 6.1;95%CI 1.4-26.5;P=0.015),MELD score of 10-15(aOR 4.6;95%CI 1.1-18.2;P=0.031),HCV genotype 3 infection(aOR 4.5;95%CI 1.1-17.6;P=0.031),and elevated serum total bilirubin level(aOR 1.1;95%CI 1.0-1.1;P=0.003).Conclusions:DAA therapy yielded a high SVR rate,and treatment failure was strongly associated with non-adherence to therapy and advanced liver disease.These findings underscore the necessity of adherence support,early diagnosis,and individualized clinical management to optimize treatment outcomes in patients with chronic hepatitis C.
