Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who ...Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number table.The experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study days.The control group was fed 12 mL/(kg·d)for the first 14e48 hours.Then,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after birth.The incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were assessed.Results:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.展开更多
The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.B...The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.Based on previous literature,the article aims to introduce the publishing trend of medical books on health cultivation and prolonging life on since modern times,generally describe its significance,and initially analyze the contents related to health cultivation for the elderly.The article finds out that after the scientific concepts were imported into China in large quantities from the beginning of the 20th century,the past superstitions rose again.The sciences of nutrition,bacteriology,and physiology in such books had all verified that the road to immortality was possible.The concept of longevity at the time emphasized a concept that could be controlled by science.With the advancement of scientific research and health concepts,people believed that they could eventually achieve immortality.It was obvious that people were filled with optimism about science at that time,thus gradually subverting the definition of the elderly.展开更多
In field emission under a non-dc voltage, a displacement current is inevitable due to charging the cathode–anode condenser. Under an often-used square voltage pulse, in which the voltage rises from zero to a certain ...In field emission under a non-dc voltage, a displacement current is inevitable due to charging the cathode–anode condenser. Under an often-used square voltage pulse, in which the voltage rises from zero to a certain value abruptly, the charging current in the circuit is very large at the rising and falling edges. This large charging current makes measurement of the actual emissive current from the cathode difficult, constitutes a threat to the components in the circuit and causes attenuation of the emissive current within the pulse. To alleviate these drawbacks, trapezoid voltage pulses, whose rising edges are extended dramatically in comparison with square voltage pulses, are employed to extract the field emission. Under a trapezoid voltage pulse, the charging current is clearly lowered as expected. Furthermore, the heat generated by the charging current under the trapezoid voltage pulse is much smaller than that under the square voltage pulse. Hence the emissive current does not show any attenuation within the pulse. Finally, the average emissive currents are found to decrease with the repetition frequency of the pulses.展开更多
BACKGROUND Fracture nonunion represents a challenging complication during fracture repair,often necessitating surgical intervention.Teriparatide,a recombinant human parathyroid hormone,has demonstrated promise in enha...BACKGROUND Fracture nonunion represents a challenging complication during fracture repair,often necessitating surgical intervention.Teriparatide,a recombinant human parathyroid hormone,has demonstrated promise in enhancing fracture healing,although its efficacy in treating established nonunion remains under investigation.CASE SUMMARY We report a case of a 27-year-old male who presented with a right humerus fracture following a traffic accident.Despite undergoing open reduction and internal fixation,the fracture resulted in a delayed union and subsequent nonunion.After 4 years of conservative management,teriparatide treatment was initiated due to persistent nonunion.Teriparatide injections were administered daily for 6 months,resulting in complete fracture healing and resolution of pain.CONCLUSION Our case demonstrates the successful use of teriparatide in treating a prolonged nonunion of a humerus fracture.Teriparatide may provide a valuable therapeutic option for established bone nonunion,even in cases that have not responded to conservative treatments.展开更多
Hepatitis A virus(HAV)infection remains a significant public health concern in many developing countries.The annual incidence of HAV infection is 1.5 million,though this figure may be underestimated owing to the infec...Hepatitis A virus(HAV)infection remains a significant public health concern in many developing countries.The annual incidence of HAV infection is 1.5 million,though this figure may be underestimated owing to the infection’s asymptomatic nature and the presence of milder disease variants.The clinical spectrum of HAV infection now ranges from asymptomatic infection to fulminant hepatitis.Despite the availability of safe and highly effective vaccines,HAV infections remain a major contributor to acute viral hepatitis worldwide.展开更多
There are many short-lived animals,but those displaying a lifecycle with more than one generation per year(multivoltine lifecycle)are rare amongterrestrial vertebrates.The multivoltine lifecycle requires rapid growth ...There are many short-lived animals,but those displaying a lifecycle with more than one generation per year(multivoltine lifecycle)are rare amongterrestrial vertebrates.The multivoltine lifecycle requires rapid growth and maturation and a long active season.Thus,small lizards in humidtropical or subtropical areas are candidates for multivoltine lifecycles.To test this prediction,we conducted a capture-mark-recapture study of asubtropical grass lizard,Takydromus toyamai,endemic to Miyako Islands,Japan.Juveniles grew very quickly,averaging 0.3 mm/day in the warmseason,and attained sexual maturity at 2.5 months post-hatching.The breeding season was very long,and hatchlings emerged from May toNovember.The prolonged breeding season and rapid growth to maturity allowed some individuals to produce a second generation in their frstyear.Estimates of hatching date from growth rates indicated that many females that hatched in May-June became gravid 76-120 days afterhatching and 122-165 days after oviposition of the eggs from which they hatched.Analyses of juvenile survivorship and month of hatching suggest that nearly half of breeding adults were members of multivoltine generations,although the 2 generations were not discrete.The species isshort-lived,with only 16% of individuals surviving beyond 12 months,and few individuals reproduced in a second year.We refer to this conditionas a“semi-multivoltine lifecycle.”Individuals that hatch late in the season defer reproduction until the following year and become founders ofthe next season’s cohort.This putative advantage of late-hatching individuals may have driven the evolution of this lifecycle.展开更多
The widespread popularization and application of laser technology have provided a powerful tool for a deeper understanding of the material world and given birth to several emerging research fields.This study mainly fo...The widespread popularization and application of laser technology have provided a powerful tool for a deeper understanding of the material world and given birth to several emerging research fields.This study mainly focuses on the following three key aspects.First,the classical ensemble method is adopted to conduct a comprehensive and in-depth analysis of two-dimensional(2D)matter–wave pulses in Bose–Fermi mixed gases(including linear and nonlinear pulses).Second,under the strict constraints of unitary systems,a coupled Kd V equation is successfully derived,and the prolongation structure theory is skillfully used to carry out detailed calculations and analyses on this equation.Thus,the prolongation algebra of this equation is accurately determined,and the corresponding Lax pair is rigorously derived.Finally,based on the carefully obtained Lax pair from the prolongation structure theory,the soliton solutions of this equation are further analyzed in depth,and intuitive images of each soliton solution are carefully drawn.This lays a solid foundation for subsequent detailed research on these soliton characteristics and provides great convenience.展开更多
BACKGROUND:This study aimed to develop and validate a nomogram to estimate the probability of prolonged intensive care unit(ICU)stays.METHODS:Pediatric patients who underwent cardiac surgery were included,with data co...BACKGROUND:This study aimed to develop and validate a nomogram to estimate the probability of prolonged intensive care unit(ICU)stays.METHODS:Pediatric patients who underwent cardiac surgery were included,with data collected from the pediatric intensive care database.The datasets were randomly divided into a training set(75%)and a testing set(25%).A nomogram model was developed to predict prolonged ICU stays in the training set and then validated in the testing set.RESULTS:A total of 795 patients and 266 patients were assigned to the training and testing sets,respectively,with consistent variables.The nomogram developed from the training set included eight characteristics:age,systolic blood pressure,respiratory rate,bicarbonate,direct bilirubin,high-sensitivity C-reactive protein,international normalized ratio,and operation time.The area under the curve values of the nomogram in the training and testing sets were 0.812 and 0.736,respectively.The nomogram demonstrated excellent discrimination and calibration.Decision curve analysis showed that the use of the nomogram resulted in more favorable outcomes compared with the strategies of treating all or none of the patients.CONCLUSION:This study presents a nomogram that may enable early identification of high-risk patients and facilitates tailored postoperative care and better outcomes after pediatric cardiac surgery.展开更多
Atrial fibrillation(AF)is the most common arrhythmia in clinical setting and has been increasingly prevalent due to the aging population.AF is associated with a three to fivefold increased risk of stroke.Treatment opt...Atrial fibrillation(AF)is the most common arrhythmia in clinical setting and has been increasingly prevalent due to the aging population.AF is associated with a three to fivefold increased risk of stroke.Treatment options include pharmacological and electrical cardioversion,each carrying specific risks.AF may resolve spontaneously,but often recurs,making a“watch-andwait”strategy a reasonable approach to avoid unnecessary antiarrhythmic therapy.展开更多
BACKGROUND Venlafaxine,a serotonin-norepinephrine reuptake inhibitor,is widely prescribed for the treatment of major depressive disorder.At therapeutic dose,it is generally safe,with a low incidence of adverse effects...BACKGROUND Venlafaxine,a serotonin-norepinephrine reuptake inhibitor,is widely prescribed for the treatment of major depressive disorder.At therapeutic dose,it is generally safe,with a low incidence of adverse effects.However,massive venlafaxine inge-stion can cause serious cardiotoxicity,leading to life-threatening arrhythmias.CASE SUMMARY A 31-year-old woman with a history of depression ingested 14.8 g of venlafaxine along with 6 mg of estazolam and 6 mg of flunitrazepam.On admission,2 hours post-ingestion,she presented only with mild QTc prolongation.At 4 hours post-ingestion,she developed a generalized tonic-clonic seizure.Following endo-tracheal intubation,intravenous midazolam infusion was initiated and 50 g of activated charcoal was administered via a nasogastric tube.At 15 hours post-ingestion,she developed ventricular tachycardia that rapidly progressed to refr-actory ventricular fibrillation,which was successfully treated with veno-arterial extracorporeal membrane oxygenation.Toxicological analysis revealed serum ve-nlafaxine and O-desmethylvenlafaxine concentrations 17µg/mL and 10µg/mL,respectively,at 15 hours post-ingestion.CONCLUSION In cases of massive venlafaxine ingestion,continuous intensive monitoring,particularly of QTc,is essential for at least 24 hours,even when initial clinical signs are mild.If refractory ventricular arrhythmias occur,prompt ini-tiation of veno-arterial extracorporeal membrane oxygenation should be considered.展开更多
Poyang Lake,China's largest freshwater lake,is a critical wintering ground for most of the global Siberian Grane(Grus leucogeranus)population.However,increasingly prolonged dry seasons have degraded the natural we...Poyang Lake,China's largest freshwater lake,is a critical wintering ground for most of the global Siberian Grane(Grus leucogeranus)population.However,increasingly prolonged dry seasons have degraded the natural wetlands of Poyang Lake,forcing Siberian Cranes to shift to artificial habitats.From 2015 to 2023,field surveys revealed a substantial increase in the number of Siberian Cranes in artificial habitats,with peak counts reaching 3000individuals,accounting for up to 53%of the species'global population.Satellite telemetry of 13 individuals further confirmed the spatial use of these habitats,highlighting their consistent reliance on artificial sites over multiple years.Seven high-use hotspots were identified outside of Poyang Lake,including two artificial provisioning sites that supported dense foraging flocks for extended periods.Satellite telemetry confirmed this trend,with artificial habitats making up to 64.2%of the occurrence sites in some years.This reliance on artificial habitats was closely linked to the reduced tuber biomass in natural wetlands and low winter water levels in Poyang Lake,which collectively explained 83%of the variance in crane abundance in artificial habitats.Artificial habitat use peaked in December and January,indicating marked seasonal variation.Siberian Cranes also exhibited a pronounced circadian rhythm,foraging in artificial habitats during the day and returning to natural wetlands to roost at night.Despite the shift toward artificial habitats,natural wetlands remain critical for nighttime refuge.The continued dependence on artificial habitats raises concerns about disease transmission owing to dense congregations.Conservation strategies should prioritize both the careful management of artificial provisioning sites and the restoration of natural wetlands to improve food and habitat availability within natural ecosystems,ultimately enabling the return of Siberian Cranes to their traditional natural habitats.展开更多
Glioblastoma(GBM)is a highly infiltrative brain tumor.The treatment of GBM is challenging due to the existence of blood brain barrier,its highly invasive nature,and its heterogeneity.Given the limitations of conventio...Glioblastoma(GBM)is a highly infiltrative brain tumor.The treatment of GBM is challenging due to the existence of blood brain barrier,its highly invasive nature,and its heterogeneity.Given the limitations of conventional therapies,this Perspective explores the development trajectory of implantable devices,highlighting the advantages of current models.With the progression in research,these implantable devices certainly hold promising potential for GBM therapy.展开更多
Prolonged grief disorder(PGD)is characterized by intense and persistent grief that significantly impairs daily functioning.For bereaved parents,the loss of a child represents an unparalleled emotional challenge,placin...Prolonged grief disorder(PGD)is characterized by intense and persistent grief that significantly impairs daily functioning.For bereaved parents,the loss of a child represents an unparalleled emotional challenge,placing them at heightened risk of developing PGD.This review traces the evolution of PGD from early con-ceptualization to current definitions in the International Classification of Diseases,11th revision,and Diagnostic and Statistical Manual of Mental Disorders,5th Edition,Text Revision.Building on this historical foundation,the analysis examined the prevalence,risk factors,and diagnostic criteria of PGD in bereaved parents,with particular attention to sex differences,the nature of the loss,and the time elapsed since the child’s death.Furthermore,this review examines the multidimensional consequences of PGD on parents,including its emotional,physiological,and functional effects.Evidence-based treatments for PGD,such as psychotherapeutic approaches and emerging interventions,are also discussed.By synthesizing existing research,this review provides a comprehensive under-standing of PGD among bereaved parents,highlights the unique challenges they face,and offers practical insights and recommendations for clinicians working with this population.展开更多
To treat resistant Escherichia coli infection in chicks, Ampicillin was stabilized with a synthetic aluminum-magnesium silicate (AMS) to prolong its bioavailability. Its dose was also reduced to minimize adverse side ...To treat resistant Escherichia coli infection in chicks, Ampicillin was stabilized with a synthetic aluminum-magnesium silicate (AMS) to prolong its bioavailability. Its dose was also reduced to minimize adverse side effects. Vitamins A, C, E and Selenium levels in the chicks’ feeds were increased to enhance immune response of the chicks. E. coli coloning forming units, per ml of bile of the chicks, treated with Ampicillin and with Ampicillin in AMS, were: 228800.00 ± 90103.50 and 134500.00 ± 44937.97 at 10 mg/kg, 104400.00 ± 36024.44 and 34800.00 ± 8014.97 at 7.5 mg/kg, 198400.00 ± 129301.80 and 156800.00 ± 109392.70 at 5 mg/kg. Mean bacterial loads of the untreated groups, fed normal feed and those fed the fortified feed were 824400.00 ± 322424.80 and 534800.00 ± 277832.80. At 7.5 mg/kg. Ampicillin in the AMS, effectively (P E. coli infection in chicks, fed immune-stimulants, with the infection rate reduced by 95.8%.展开更多
To evaluate the efficacy and safety of gemcitabine （GEM） at 30 min standard-dose infusion （30 min-SDI） compared with prolonged low-dose infusion （P-LDI） in patients with advanced non-small-cell lung cancer （NS...To evaluate the efficacy and safety of gemcitabine （GEM） at 30 min standard-dose infusion （30 min-SDI） compared with prolonged low-dose infusion （P-LDI） in patients with advanced non-small-cell lung cancer （NSCLC）. Electronic databases including Pubmed, EMbase, Cochrane Library, CNKI, CBM, and VIP were searched using keywords ＂GEM＂, ＂P-LDI＂, and ＂NSCLC＂. Review Manager 5.3 was used to perform the recta-analysis. Primary endpoints were overall response rate （ORR） and 1-year survival rate （1-year SR）. Secondary endpoints were grade 3/4 hematotoxicity and nausea/vomiting. Six randomized controlled trials （RCTs） with a total of 637 patients were included. The results showed that P-LDI was superior in ORR （OR = 1.50, 95% CI： 1.08-2.10, P = 0.02）, but had an equal 1-year SR （OR = 1.27, 95 % CI： 0.90-1.79, P = 0.18） as compared with 30 min-SDl. For grade 3/4 adverse events, there was no significant difference in anemia （OR = 1.84, 95% CI： 0.61-5.57, P = 0.28） and nausea/vomiting （OR = 1.15, 95% CI： 0.63-2.12, P = 0.64） between the two treatments. However, patients with P-LDI experienced less leukopenia （OR = 0.64, 95% CI： 0.43-0.97, P = 0.04） and thrombocytopenia （OR = 0.37, 95% CI： 0.17-0.80, P = 0.01）. P-LDI was superior in terms of ORR, experienced less grade 3/4 thrombocytopenia and leukopenia compared with 30 min-SDI, and could be a viable treatment option for advanced NSCLC.展开更多
There are numerous published theories that cover the different biological processes relating to ageing. No one seems to have integrated such complex and seemingly unrelated information into a holistic framework that e...There are numerous published theories that cover the different biological processes relating to ageing. No one seems to have integrated such complex and seemingly unrelated information into a holistic framework that explains in simple terms the key aspects of ageing and provides a set of daily practices for staying young and healthy. An atiempt is made here to select a 6-dimensional framework symbolized by heart, mind, passion, focus, body and health, and correlate it to the mental, emotional, physical and health aspects of ageing. Based on grounded theory, this paper empirically correlates 30 practical methods that can be used to develop all six dimensions, with 18 key factors that were found to infl uence ageing: Neurogenesis;Epigenetic reprogramming;Removing dying cells;Mitochondria resuscitation;Calorie restriction;Plant-based diet;Regular physical activity;Chi Kung (Qigong);Overcoming anxiety, depression and stress;Positive mind-set;Some worrying;Vitamins and minerals;L-Theanine;Omega-3 and healthy fats;Coenzyme Q-10;Pyrroloquinoline quinone;Nitric oxide;Choline. In this study, 26 references were used to establish that all 18 of these seemingly unrelated key anti-ageing factors can be developed using 30 daily practices derived from the 6-dimensional framework. These simple daily prac-tices can help people of all ages to stay young and healthy, and help older people who are living alone to self-improve their quality of life without needing anyone to look atier them. Since many anti-ageing drugs seem to be ineffective, this study provides a holistic new research direction for using modern science and ancient human energy practices combined with wholesome nutrition to slow ageing and age-related illnesses.展开更多
This study examined regional prolonged low temperature （PLT） events in China from the observational station data for the period 1960–2008 using the new criteria. The new definition of a site PLT event is that the d...This study examined regional prolonged low temperature （PLT） events in China from the observational station data for the period 1960–2008 using the new criteria. The new definition of a site PLT event is that the daily minimum temperature does not exceed the 10th percentile threshold of the local daily minimum temperature climatology for at least 5 days at a station. The regional PLT event is defined as at least five adjacent stations exhibiting site PLT simultaneously for 5 d. Under the new definition, 552 regional PLT events were identified, and three indices： duration, extent, and intensity, as well as a comprehensive index （CI） were used to quantify the event severity. In addition, geographical patterns and temporal variations of regional PLT events were investigated using three event categories： strong, moderate, and weak. Spatially, strong events were mainly located in the north of Xinjiang and along the Yangtze River to the south of the Yangtze River; moderate events occurred in Xinjiang and south of the Yangtze River; and weak events occurred south of the Yellow River. The variation for the annual frequency of regional PLT events in China in the last 49 years showed a significant decreasing trend with a rate of-1.99 times per decade, and the significant transition decade was the 1980s.展开更多
Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnan...Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.展开更多
BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent gastrectomy.Evidence on the predictors of PPOI after gastrectomy is limited and few prediction ...BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent gastrectomy.Evidence on the predictors of PPOI after gastrectomy is limited and few prediction models of nomogram are used to estimate the risk of PPOI.We hypothesized that a predictive nomogram can be used for clinical risk estimation of PPOI in gastric cancer patients.AIM To investigate the risk factors for PPOI and establish a nomogram for clinical risk estimation.METHODS Between June 2016 and March 2017,the data of 162 patients with gastrectomy were obtained from a prospective and observational registry database.Clinical data of patients who fulfilled the criteria were obtained.Univariate and multivariable logistic regression models were performed to detect the relationship between variables and PPOI.A nomogram for PPOI was developed and verified by bootstrap resampling.The calibration curve was employed to detect the concentricity between the model probability curve and ideal curve.The clinical usefulness of our model was evaluated using the net benefit curve.RESULTS This study analyzed 14 potential variables of PPOI in 162 gastric cancer patients who underwent gastrectomy.The incidence of PPOI was 19.75%in patients with gastrectomy.Age older than 60 years,open surgery,advanced stage(III–IV),and postoperative use of opioid analgesic were independent risk factors for PPOI.We developed a simple and easy-to-use prediction nomogram of PPOI after gastrectomy.This nomogram had an excellent diagnostic performance[area under the curve(AUC)=0.836,sensitivity=84.4%,and specificity=75.4%].This nomogram was further validated by bootstrapping for 500 repetitions.The AUC of the bootstrap model was 0.832(95%CI:0.741–0.924).This model showed a good fitting and calibration and positive net benefits in decision curve analysis.CONCLUSION We have developed a prediction nomogram of PPOI for gastric cancer.This novel nomogram might serve as an essential early warning sign of PPOI in gastric cancer patients.展开更多
We examined the possible multiple defects induced by acute and prolonged exposure to high levels of manganese（Mn） solution by monitoring the endpoints of lifespan,development,reproduction,and stress response.Our dat...We examined the possible multiple defects induced by acute and prolonged exposure to high levels of manganese（Mn） solution by monitoring the endpoints of lifespan,development,reproduction,and stress response.Our data suggest that acute exposure（6 h） to Mn did not cause severe defects of life span,development,and reproduction,similarly,no significant defect could be found in animals exposed to a low concentration of Mn（2.5 μmol/L） for 48 h.In contrast,prolonged exposure（48 h） to high Mn concentrations（75 and 200 μmol/L） resulted in significant defects of life span,development,and reproduction,as well as the increase of the percentage of population with hsp-16.2：：gfp expression indicating the obvious induction of stress responses in exposed animals.Moreover,prolonged exposure（48 h） to high concentrations（75 and 200 μmol/L） of Mn decreased the expression levels of antioxidant genes of sod-1,sod-2,sod-3,and sod-4 compared to control.Therefore,prolonged exposure to high concentrations of Mn will induce the severe defects of life span,development,and reproduction in nematodes possibly by affecting the stress response and expression of antioxidant genes in Caenorhabditis elegans.展开更多
基金The study was funded by the Zhejiang Provincial Traditional Chinese Medicine Administration of China(approval number 2011ZB083)the Quality of Nursing Practice Project of the Chinese Medical Association.
文摘Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm infants.Methods:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number table.The experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study days.The control group was fed 12 mL/(kg·d)for the first 14e48 hours.Then,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after birth.The incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were assessed.Results:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.
基金funded by Research Institute of Chinese Medicine,MOHW,and the project number is MOHW106-NRICM-C-124-000005。
文摘The present research of Chinese medical history lack detailed discussions on Chinese medicine philology of the elderly and the various sorting of related literature of physiology and diseases both at home and abroad.Based on previous literature,the article aims to introduce the publishing trend of medical books on health cultivation and prolonging life on since modern times,generally describe its significance,and initially analyze the contents related to health cultivation for the elderly.The article finds out that after the scientific concepts were imported into China in large quantities from the beginning of the 20th century,the past superstitions rose again.The sciences of nutrition,bacteriology,and physiology in such books had all verified that the road to immortality was possible.The concept of longevity at the time emphasized a concept that could be controlled by science.With the advancement of scientific research and health concepts,people believed that they could eventually achieve immortality.It was obvious that people were filled with optimism about science at that time,thus gradually subverting the definition of the elderly.
基金Supported by the Natural Science Foundation of Jiangsu Province of China under Grant Nos BK20161243 and BK20161242the National Natural Science Foundation of China under Grant No 61774007
文摘In field emission under a non-dc voltage, a displacement current is inevitable due to charging the cathode–anode condenser. Under an often-used square voltage pulse, in which the voltage rises from zero to a certain value abruptly, the charging current in the circuit is very large at the rising and falling edges. This large charging current makes measurement of the actual emissive current from the cathode difficult, constitutes a threat to the components in the circuit and causes attenuation of the emissive current within the pulse. To alleviate these drawbacks, trapezoid voltage pulses, whose rising edges are extended dramatically in comparison with square voltage pulses, are employed to extract the field emission. Under a trapezoid voltage pulse, the charging current is clearly lowered as expected. Furthermore, the heat generated by the charging current under the trapezoid voltage pulse is much smaller than that under the square voltage pulse. Hence the emissive current does not show any attenuation within the pulse. Finally, the average emissive currents are found to decrease with the repetition frequency of the pulses.
基金Supported by National Natural Science Foundation of China,No.82172441Suzhou City Major Disease Multicenter Clinical Research Project,No.DZXYJ202312+2 种基金Special Funding for Jiangsu Province Science and Technology Plan(Key Research and Development Program for Social Development),No.BE2023737Gusu Health Talent Plan Scientific Research Project,No.GSWS2022109Postgraduate Research and Practice Innovation Program of Jiangsu Province,No.SJCX24_2446.
文摘BACKGROUND Fracture nonunion represents a challenging complication during fracture repair,often necessitating surgical intervention.Teriparatide,a recombinant human parathyroid hormone,has demonstrated promise in enhancing fracture healing,although its efficacy in treating established nonunion remains under investigation.CASE SUMMARY We report a case of a 27-year-old male who presented with a right humerus fracture following a traffic accident.Despite undergoing open reduction and internal fixation,the fracture resulted in a delayed union and subsequent nonunion.After 4 years of conservative management,teriparatide treatment was initiated due to persistent nonunion.Teriparatide injections were administered daily for 6 months,resulting in complete fracture healing and resolution of pain.CONCLUSION Our case demonstrates the successful use of teriparatide in treating a prolonged nonunion of a humerus fracture.Teriparatide may provide a valuable therapeutic option for established bone nonunion,even in cases that have not responded to conservative treatments.
文摘Hepatitis A virus(HAV)infection remains a significant public health concern in many developing countries.The annual incidence of HAV infection is 1.5 million,though this figure may be underestimated owing to the infection’s asymptomatic nature and the presence of milder disease variants.The clinical spectrum of HAV infection now ranges from asymptomatic infection to fulminant hepatitis.Despite the availability of safe and highly effective vaccines,HAV infections remain a major contributor to acute viral hepatitis worldwide.
基金supported fnancially by the Nanseishoto Project of WWFJ,Pro Natura Foundation Japan’s 31st Pro Natura Fundthe Project for Biodiversity Conservation Promotion of the Japan Ministry of the Environment.
文摘There are many short-lived animals,but those displaying a lifecycle with more than one generation per year(multivoltine lifecycle)are rare amongterrestrial vertebrates.The multivoltine lifecycle requires rapid growth and maturation and a long active season.Thus,small lizards in humidtropical or subtropical areas are candidates for multivoltine lifecycles.To test this prediction,we conducted a capture-mark-recapture study of asubtropical grass lizard,Takydromus toyamai,endemic to Miyako Islands,Japan.Juveniles grew very quickly,averaging 0.3 mm/day in the warmseason,and attained sexual maturity at 2.5 months post-hatching.The breeding season was very long,and hatchlings emerged from May toNovember.The prolonged breeding season and rapid growth to maturity allowed some individuals to produce a second generation in their frstyear.Estimates of hatching date from growth rates indicated that many females that hatched in May-June became gravid 76-120 days afterhatching and 122-165 days after oviposition of the eggs from which they hatched.Analyses of juvenile survivorship and month of hatching suggest that nearly half of breeding adults were members of multivoltine generations,although the 2 generations were not discrete.The species isshort-lived,with only 16% of individuals surviving beyond 12 months,and few individuals reproduced in a second year.We refer to this conditionas a“semi-multivoltine lifecycle.”Individuals that hatch late in the season defer reproduction until the following year and become founders ofthe next season’s cohort.This putative advantage of late-hatching individuals may have driven the evolution of this lifecycle.
基金Project supported by the National Natural Science Foundation of China(Grant No.12261072)。
文摘The widespread popularization and application of laser technology have provided a powerful tool for a deeper understanding of the material world and given birth to several emerging research fields.This study mainly focuses on the following three key aspects.First,the classical ensemble method is adopted to conduct a comprehensive and in-depth analysis of two-dimensional(2D)matter–wave pulses in Bose–Fermi mixed gases(including linear and nonlinear pulses).Second,under the strict constraints of unitary systems,a coupled Kd V equation is successfully derived,and the prolongation structure theory is skillfully used to carry out detailed calculations and analyses on this equation.Thus,the prolongation algebra of this equation is accurately determined,and the corresponding Lax pair is rigorously derived.Finally,based on the carefully obtained Lax pair from the prolongation structure theory,the soliton solutions of this equation are further analyzed in depth,and intuitive images of each soliton solution are carefully drawn.This lays a solid foundation for subsequent detailed research on these soliton characteristics and provides great convenience.
基金supported by the National Natural Science Foundation of China(82230074,81971809 and 82372159)the Liangshan Prefecture Science and Technology Plan Project(23ZDYF0180 and 24YYYJ0043).
文摘BACKGROUND:This study aimed to develop and validate a nomogram to estimate the probability of prolonged intensive care unit(ICU)stays.METHODS:Pediatric patients who underwent cardiac surgery were included,with data collected from the pediatric intensive care database.The datasets were randomly divided into a training set(75%)and a testing set(25%).A nomogram model was developed to predict prolonged ICU stays in the training set and then validated in the testing set.RESULTS:A total of 795 patients and 266 patients were assigned to the training and testing sets,respectively,with consistent variables.The nomogram developed from the training set included eight characteristics:age,systolic blood pressure,respiratory rate,bicarbonate,direct bilirubin,high-sensitivity C-reactive protein,international normalized ratio,and operation time.The area under the curve values of the nomogram in the training and testing sets were 0.812 and 0.736,respectively.The nomogram demonstrated excellent discrimination and calibration.Decision curve analysis showed that the use of the nomogram resulted in more favorable outcomes compared with the strategies of treating all or none of the patients.CONCLUSION:This study presents a nomogram that may enable early identification of high-risk patients and facilitates tailored postoperative care and better outcomes after pediatric cardiac surgery.
文摘Atrial fibrillation(AF)is the most common arrhythmia in clinical setting and has been increasingly prevalent due to the aging population.AF is associated with a three to fivefold increased risk of stroke.Treatment options include pharmacological and electrical cardioversion,each carrying specific risks.AF may resolve spontaneously,but often recurs,making a“watch-andwait”strategy a reasonable approach to avoid unnecessary antiarrhythmic therapy.
文摘BACKGROUND Venlafaxine,a serotonin-norepinephrine reuptake inhibitor,is widely prescribed for the treatment of major depressive disorder.At therapeutic dose,it is generally safe,with a low incidence of adverse effects.However,massive venlafaxine inge-stion can cause serious cardiotoxicity,leading to life-threatening arrhythmias.CASE SUMMARY A 31-year-old woman with a history of depression ingested 14.8 g of venlafaxine along with 6 mg of estazolam and 6 mg of flunitrazepam.On admission,2 hours post-ingestion,she presented only with mild QTc prolongation.At 4 hours post-ingestion,she developed a generalized tonic-clonic seizure.Following endo-tracheal intubation,intravenous midazolam infusion was initiated and 50 g of activated charcoal was administered via a nasogastric tube.At 15 hours post-ingestion,she developed ventricular tachycardia that rapidly progressed to refr-actory ventricular fibrillation,which was successfully treated with veno-arterial extracorporeal membrane oxygenation.Toxicological analysis revealed serum ve-nlafaxine and O-desmethylvenlafaxine concentrations 17µg/mL and 10µg/mL,respectively,at 15 hours post-ingestion.CONCLUSION In cases of massive venlafaxine ingestion,continuous intensive monitoring,particularly of QTc,is essential for at least 24 hours,even when initial clinical signs are mild.If refractory ventricular arrhythmias occur,prompt ini-tiation of veno-arterial extracorporeal membrane oxygenation should be considered.
基金supported by the National Natural Science Foundation of China(No.32260275)Fundamental Research Funds of CAF(CAFYBB2024ZA033)。
文摘Poyang Lake,China's largest freshwater lake,is a critical wintering ground for most of the global Siberian Grane(Grus leucogeranus)population.However,increasingly prolonged dry seasons have degraded the natural wetlands of Poyang Lake,forcing Siberian Cranes to shift to artificial habitats.From 2015 to 2023,field surveys revealed a substantial increase in the number of Siberian Cranes in artificial habitats,with peak counts reaching 3000individuals,accounting for up to 53%of the species'global population.Satellite telemetry of 13 individuals further confirmed the spatial use of these habitats,highlighting their consistent reliance on artificial sites over multiple years.Seven high-use hotspots were identified outside of Poyang Lake,including two artificial provisioning sites that supported dense foraging flocks for extended periods.Satellite telemetry confirmed this trend,with artificial habitats making up to 64.2%of the occurrence sites in some years.This reliance on artificial habitats was closely linked to the reduced tuber biomass in natural wetlands and low winter water levels in Poyang Lake,which collectively explained 83%of the variance in crane abundance in artificial habitats.Artificial habitat use peaked in December and January,indicating marked seasonal variation.Siberian Cranes also exhibited a pronounced circadian rhythm,foraging in artificial habitats during the day and returning to natural wetlands to roost at night.Despite the shift toward artificial habitats,natural wetlands remain critical for nighttime refuge.The continued dependence on artificial habitats raises concerns about disease transmission owing to dense congregations.Conservation strategies should prioritize both the careful management of artificial provisioning sites and the restoration of natural wetlands to improve food and habitat availability within natural ecosystems,ultimately enabling the return of Siberian Cranes to their traditional natural habitats.
基金financially supported by the National Natural Science Foundation of China(U23A20591 and 52273158).
文摘Glioblastoma(GBM)is a highly infiltrative brain tumor.The treatment of GBM is challenging due to the existence of blood brain barrier,its highly invasive nature,and its heterogeneity.Given the limitations of conventional therapies,this Perspective explores the development trajectory of implantable devices,highlighting the advantages of current models.With the progression in research,these implantable devices certainly hold promising potential for GBM therapy.
文摘Prolonged grief disorder(PGD)is characterized by intense and persistent grief that significantly impairs daily functioning.For bereaved parents,the loss of a child represents an unparalleled emotional challenge,placing them at heightened risk of developing PGD.This review traces the evolution of PGD from early con-ceptualization to current definitions in the International Classification of Diseases,11th revision,and Diagnostic and Statistical Manual of Mental Disorders,5th Edition,Text Revision.Building on this historical foundation,the analysis examined the prevalence,risk factors,and diagnostic criteria of PGD in bereaved parents,with particular attention to sex differences,the nature of the loss,and the time elapsed since the child’s death.Furthermore,this review examines the multidimensional consequences of PGD on parents,including its emotional,physiological,and functional effects.Evidence-based treatments for PGD,such as psychotherapeutic approaches and emerging interventions,are also discussed.By synthesizing existing research,this review provides a comprehensive under-standing of PGD among bereaved parents,highlights the unique challenges they face,and offers practical insights and recommendations for clinicians working with this population.
文摘To treat resistant Escherichia coli infection in chicks, Ampicillin was stabilized with a synthetic aluminum-magnesium silicate (AMS) to prolong its bioavailability. Its dose was also reduced to minimize adverse side effects. Vitamins A, C, E and Selenium levels in the chicks’ feeds were increased to enhance immune response of the chicks. E. coli coloning forming units, per ml of bile of the chicks, treated with Ampicillin and with Ampicillin in AMS, were: 228800.00 ± 90103.50 and 134500.00 ± 44937.97 at 10 mg/kg, 104400.00 ± 36024.44 and 34800.00 ± 8014.97 at 7.5 mg/kg, 198400.00 ± 129301.80 and 156800.00 ± 109392.70 at 5 mg/kg. Mean bacterial loads of the untreated groups, fed normal feed and those fed the fortified feed were 824400.00 ± 322424.80 and 534800.00 ± 277832.80. At 7.5 mg/kg. Ampicillin in the AMS, effectively (P E. coli infection in chicks, fed immune-stimulants, with the infection rate reduced by 95.8%.
文摘To evaluate the efficacy and safety of gemcitabine （GEM） at 30 min standard-dose infusion （30 min-SDI） compared with prolonged low-dose infusion （P-LDI） in patients with advanced non-small-cell lung cancer （NSCLC）. Electronic databases including Pubmed, EMbase, Cochrane Library, CNKI, CBM, and VIP were searched using keywords ＂GEM＂, ＂P-LDI＂, and ＂NSCLC＂. Review Manager 5.3 was used to perform the recta-analysis. Primary endpoints were overall response rate （ORR） and 1-year survival rate （1-year SR）. Secondary endpoints were grade 3/4 hematotoxicity and nausea/vomiting. Six randomized controlled trials （RCTs） with a total of 637 patients were included. The results showed that P-LDI was superior in ORR （OR = 1.50, 95% CI： 1.08-2.10, P = 0.02）, but had an equal 1-year SR （OR = 1.27, 95 % CI： 0.90-1.79, P = 0.18） as compared with 30 min-SDl. For grade 3/4 adverse events, there was no significant difference in anemia （OR = 1.84, 95% CI： 0.61-5.57, P = 0.28） and nausea/vomiting （OR = 1.15, 95% CI： 0.63-2.12, P = 0.64） between the two treatments. However, patients with P-LDI experienced less leukopenia （OR = 0.64, 95% CI： 0.43-0.97, P = 0.04） and thrombocytopenia （OR = 0.37, 95% CI： 0.17-0.80, P = 0.01）. P-LDI was superior in terms of ORR, experienced less grade 3/4 thrombocytopenia and leukopenia compared with 30 min-SDI, and could be a viable treatment option for advanced NSCLC.
文摘There are numerous published theories that cover the different biological processes relating to ageing. No one seems to have integrated such complex and seemingly unrelated information into a holistic framework that explains in simple terms the key aspects of ageing and provides a set of daily practices for staying young and healthy. An atiempt is made here to select a 6-dimensional framework symbolized by heart, mind, passion, focus, body and health, and correlate it to the mental, emotional, physical and health aspects of ageing. Based on grounded theory, this paper empirically correlates 30 practical methods that can be used to develop all six dimensions, with 18 key factors that were found to infl uence ageing: Neurogenesis;Epigenetic reprogramming;Removing dying cells;Mitochondria resuscitation;Calorie restriction;Plant-based diet;Regular physical activity;Chi Kung (Qigong);Overcoming anxiety, depression and stress;Positive mind-set;Some worrying;Vitamins and minerals;L-Theanine;Omega-3 and healthy fats;Coenzyme Q-10;Pyrroloquinoline quinone;Nitric oxide;Choline. In this study, 26 references were used to establish that all 18 of these seemingly unrelated key anti-ageing factors can be developed using 30 daily practices derived from the 6-dimensional framework. These simple daily prac-tices can help people of all ages to stay young and healthy, and help older people who are living alone to self-improve their quality of life without needing anyone to look atier them. Since many anti-ageing drugs seem to be ineffective, this study provides a holistic new research direction for using modern science and ancient human energy practices combined with wholesome nutrition to slow ageing and age-related illnesses.
基金supported jointly by the National Natural Science Foundation of China (GrantNo. 40975039)the Key Technologies R&D Program(Grant No. 2009BAC51B00)
文摘This study examined regional prolonged low temperature （PLT） events in China from the observational station data for the period 1960–2008 using the new criteria. The new definition of a site PLT event is that the daily minimum temperature does not exceed the 10th percentile threshold of the local daily minimum temperature climatology for at least 5 days at a station. The regional PLT event is defined as at least five adjacent stations exhibiting site PLT simultaneously for 5 d. Under the new definition, 552 regional PLT events were identified, and three indices： duration, extent, and intensity, as well as a comprehensive index （CI） were used to quantify the event severity. In addition, geographical patterns and temporal variations of regional PLT events were investigated using three event categories： strong, moderate, and weak. Spatially, strong events were mainly located in the north of Xinjiang and along the Yangtze River to the south of the Yangtze River; moderate events occurred in Xinjiang and south of the Yangtze River; and weak events occurred south of the Yellow River. The variation for the annual frequency of regional PLT events in China in the last 49 years showed a significant decreasing trend with a rate of-1.99 times per decade, and the significant transition decade was the 1980s.
文摘Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.
基金Supported by the National Nature Science Foundation of China,No.81672319,No.81602507,and No.81773135the National Key Research and Development Plan,No.2017YFC0908300Beijing Nova Program,No.Z181100006218011
文摘BACKGROUND Prolonged postoperative ileus(PPOI)is one of the common complications in gastric cancer patients who underwent gastrectomy.Evidence on the predictors of PPOI after gastrectomy is limited and few prediction models of nomogram are used to estimate the risk of PPOI.We hypothesized that a predictive nomogram can be used for clinical risk estimation of PPOI in gastric cancer patients.AIM To investigate the risk factors for PPOI and establish a nomogram for clinical risk estimation.METHODS Between June 2016 and March 2017,the data of 162 patients with gastrectomy were obtained from a prospective and observational registry database.Clinical data of patients who fulfilled the criteria were obtained.Univariate and multivariable logistic regression models were performed to detect the relationship between variables and PPOI.A nomogram for PPOI was developed and verified by bootstrap resampling.The calibration curve was employed to detect the concentricity between the model probability curve and ideal curve.The clinical usefulness of our model was evaluated using the net benefit curve.RESULTS This study analyzed 14 potential variables of PPOI in 162 gastric cancer patients who underwent gastrectomy.The incidence of PPOI was 19.75%in patients with gastrectomy.Age older than 60 years,open surgery,advanced stage(III–IV),and postoperative use of opioid analgesic were independent risk factors for PPOI.We developed a simple and easy-to-use prediction nomogram of PPOI after gastrectomy.This nomogram had an excellent diagnostic performance[area under the curve(AUC)=0.836,sensitivity=84.4%,and specificity=75.4%].This nomogram was further validated by bootstrapping for 500 repetitions.The AUC of the bootstrap model was 0.832(95%CI:0.741–0.924).This model showed a good fitting and calibration and positive net benefits in decision curve analysis.CONCLUSION We have developed a prediction nomogram of PPOI for gastric cancer.This novel nomogram might serve as an essential early warning sign of PPOI in gastric cancer patients.
基金supported by the National Natural Science Foundation of China (No. 30771113, 30870810)the Program for New Century Excellent Talents in University
文摘We examined the possible multiple defects induced by acute and prolonged exposure to high levels of manganese（Mn） solution by monitoring the endpoints of lifespan,development,reproduction,and stress response.Our data suggest that acute exposure（6 h） to Mn did not cause severe defects of life span,development,and reproduction,similarly,no significant defect could be found in animals exposed to a low concentration of Mn（2.5 μmol/L） for 48 h.In contrast,prolonged exposure（48 h） to high Mn concentrations（75 and 200 μmol/L） resulted in significant defects of life span,development,and reproduction,as well as the increase of the percentage of population with hsp-16.2：：gfp expression indicating the obvious induction of stress responses in exposed animals.Moreover,prolonged exposure（48 h） to high concentrations（75 and 200 μmol/L） of Mn decreased the expression levels of antioxidant genes of sod-1,sod-2,sod-3,and sod-4 compared to control.Therefore,prolonged exposure to high concentrations of Mn will induce the severe defects of life span,development,and reproduction in nematodes possibly by affecting the stress response and expression of antioxidant genes in Caenorhabditis elegans.
