1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Part...1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Partial hepatectomy is recommended for patients with early stage HCC.[2]A large proportion of patients with HCC inChina are diagnosed in the intermediate to advanced HCC stages,rendering them ineligible for hepatectomy due to aspects such as liver dysfunction,insufficient residual liver volume,or surgical technique.展开更多
Vaccination is the main prophylactic measure to reduce the mortality caused by hepatitis B virus (HBV) infection in healthy subjects since the immune response to hepatitis B recombinant vaccination occurs in over 90% ...Vaccination is the main prophylactic measure to reduce the mortality caused by hepatitis B virus (HBV) infection in healthy subjects since the immune response to hepatitis B recombinant vaccination occurs in over 90% of general population. Individuals who develop an anti-HBs titer less than 10 mIU/mL after primary vaccination cycle are defined “no responders”. Many factors could cause a non response to the HBV vaccination, such as administration of the vaccine in buttocks, impaired vaccine storage conditions, drug abuse, smoking, infections and obesity. Moreover there are some diseases, like chronic kidney disease, human immunodeficiency virus infection, chronic liver disease, celiac disease, thalassaemia, type I diabetes mellitus, down’s syndrome and other forms of mental retardation that are characterized by a poorer response to HBV vaccination than healthy subjects. To date it is still unclear how to treat this group of patients at high risk of hepatitis B infection. Recent studies seem to indicate that the administration of HBV recombinant vaccine by the intradermal route is very effective and could represent a more useful strategy than intramuscular route. This review focuses on the use of anti hepatitis B vaccine by intradermal route as alternative to conventional intramuscular vaccine in all non responder patients. A comprehensive review of the literature using PubMed database, with appropriate terms, was undertaken for articles in English published since 1983. The literature search was undertaken in September 2013.展开更多
AIM: To predict which chronic hepatitis C patients are likely to be late-responders, we herein investigated the clinical characteristics of null-responders at 36 wk with hepatitis C virus (HCV) genotype Ib and a high ...AIM: To predict which chronic hepatitis C patients are likely to be late-responders, we herein investigated the clinical characteristics of null-responders at 36 wk with hepatitis C virus (HCV) genotype Ib and a high viral load during the course of pegylated interferon (Peg-IFN)/ ribavirin ther apy. METHODS: One hundred forty-two patients with genotype Ib HCV and a high viral load were included in this study. Peg-IFNα2b (1.5 μg/kg once a week) and ribavirin (600-1000 mg per day according to body weight) were administered for 48 wk. We def ined nullresponders as the cases that never cleared serum HCV RNA as determined using RT-PCR until 36 wk. Other patients were def ined as responders. We compared the clinical characteristics (age, gender, body mass index, previous treatment) and HCV RNA titer during the therapy between null-responders and responders.RESULTS: The HCV RNA clearance rate was 17.9% (24/134), 46.3% (62/134), 60.6% (86/142), 86.6% (123/142), and 88.0% (125/142) at 4, 8, 12, 24, and 36 wk, respectively. There were 17 patients (12.0%) who were still null-responders at 36 wk. There were no differences in the clinical characteristics between the responders and null-responders except for the titer and decline rates of HCV RNA at 1 wk and 4 wk. The HCV RNA titers at 1 wk and after 4 wk of treatment were significantly higher in the null-responders in comp arison to the responders (P <0.01). The serum HCV RNA titers of the responders decreased by 1.3 log after 1 wk of treatment, and 1.6 log after 4 wk of treatm ent, respectively. On the other hand, the titers of the null responders decreased by only 0.5 log after 1 wk, and 0.7 log after 4 wk of treatment, respectively. The decrease rates of HCV RNA after 1 and 4 wk of treatm ent were signif icantly worse for null responders than for the responders (P <0.01). CONCLUSION: The HCV RNA titer at 1 wk and 4 wk after initiating treatment may be useful for predicting null-responders to Peg-IFNα2b/ribavirin therapy. However, further investigation is needed to determine the optimal time at which the decision to discontinue the Peg-IFNα2b/ribavirin therapy for null-responders can be made.展开更多
BACKGROUND After receiving entecavir or combined with FuzhengHuayu tablet(FZHY)treatment,some sufferers with hepatitis B virus(HBV)-related liver fibrosis could achieve a histological improvement while the others may ...BACKGROUND After receiving entecavir or combined with FuzhengHuayu tablet(FZHY)treatment,some sufferers with hepatitis B virus(HBV)-related liver fibrosis could achieve a histological improvement while the others may fail to improve even worsen.Serum metabolomics at baseline in these patients who were effective in treatment remain unclear.AIM To explore baseline serum metabolites characteristics in responders.METHODS A total of 132 patients with HBV-related liver fibrosis and 18 volunteers as healthy controls were recruited.First,all subjects were divided into training set and validation set.Second,the included patients were subdivided into entecavir responders(E-R),entecavir no-responders(E-N),FZHY+entecavir responders(FR),and FZHY+entecavir no-responders(F-N)following the pathological histological changes after 48 wk’treatments.Then,Serum samples of all subjects before treatment were tested by high performance liquid chromatographytandem mass spectrometry(LC-MS)high-performance LC-MS.Data processing was conducted using multivariate principal component analysis and orthogonal partial least squares discriminant analysis.Diagnostic tests of selected differential metabolites were used for Boruta analyses and logistic regression.RESULTS As for the intersection about differential metabolic pathways between the groups E-R vs E-N and F-R vs F-N,results showed that 4 pathways including linoleic acid metabolism,aminoacyl-tRNA biosynthesis,cyanoamino acid metabolism,alanine,aspartate and glutamate metabolism were screened out.As for the differential metabolites,these 7 intersected metabolites including hydroxypropionic acid,tyrosine,citric acid,taurochenodeoxycholic acid,benzoic acid,2-Furoic acid,and propionic acid were selected.CONCLUSION Our findings showed that 4 metabolic pathways and 7 differential metabolites had potential usefulness in clinical prediction of the response of entecavir or combined with FZHY on HBV fibrotic liver.展开更多
Summary： This study explored the cumulative live birth rate after three ovarian stimulation in vitro fer- tilization （IVF） cycles for poor ovarian responders according to the Bologna criteria. In this retrospec- ti...Summary： This study explored the cumulative live birth rate after three ovarian stimulation in vitro fer- tilization （IVF） cycles for poor ovarian responders according to the Bologna criteria. In this retrospec- tive cohort study, 479 poor ovarian responders according to the Bologna criteria in the first ovarian stimulation IVF cycle between July 2006 and January 2012 in our IVF centre were included. The cu- mulative live birth rate was calculated by optimistic and pessimistic methods. The cumulative live birth rate after three ovarian stimulation IVF cycles for poor ovarian responders according to the Bologna criteria was 12.7%-20.5%. The three-cycle cumulative live birth rate was 18.5%--24.5%, 13.2%-27.4% and 8.6%-14.9% for poor responders aged ≤35 years, 36-39 years and 〉40 years, re- spectively. In conclusion, poor responders according to the Bologna criteria can receive an acceptable cumulative live birth, rate after three ovarian stimulation IVF cycles, especially poor responders aged 〈40 years.展开更多
Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo tra...Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 341 IVF-ET cycles were retrospectively identified. The following inclusion criteria were applied: age ≥ 40 years and patients with tubal factors. The cycles were divided into two groups: a GnRH antagonist group (157 cycles) and a GnRH agonist group (184 cycles). Results: The duration of stimulation and the total doses of gonadotropin in the GnRH agonist group were significantly more than those in the GnRH antagonist group (P < 0.05). There were significant differences in LH and P values on the hCG measurement days between the two groups (0.91 ± 1.17 vs. 4.82 ± 4.69 U/L and 0.69 ± 0.42 vs. 1.03 ± 0.50 ng/mL, P < 0.05). The implantation rate of the GnRH antagonist group was 12.24%, which was slightly higher than that of the GnRH agonist group (10.10%, P = 0.437). The clinical pregnancy rate of the two groups showed no statistical differences (23.36% vs. 23.03%, P = 1.000). Conclusion: For expected poor ovarian responders, the GnRH antagonist protocol was, to some extent, superior to the GnRH agonist protocol in terms of the implantation and clinical pregnancy rates.展开更多
AIM: To assess the efficacy of ribavirin monotherapy in patients with biochemical relapse after combination therapy.METHODS: Twenty-four weeks of ribavirin monotherapy was given to biochemical relapsers of end treatme...AIM: To assess the efficacy of ribavirin monotherapy in patients with biochemical relapse after combination therapy.METHODS: Twenty-four weeks of ribavirin monotherapy was given to biochemical relapsers of end treatment biochemical responders within 6 mo after combination therapy, including non-responders with HCV-RNA level ≤0.2 Meq/mL and end treatment virologic responders (ETVRs) with or without reappearance of HCV-RNA.RESULTS: Sixty-two chronic HCV-infected patients completed 24 wk of interferon-α plus ribavirin combination therapy. Fifty patients (80%) achieved end treatment biochemical response including 16 non-responders and 34 of 36 ETVRs. Twenty-six patients (41.9%) were nonresponders. Ribavirin monotherapy was given to 20biochemical relapsers including 12 non-responders with HCV-RNA levels ≤0.2 Meq/mL, four of eight HCV-RNA reappearing ETVRs, and four HCV-RNA negative ETVRs.After 24 wk of ribavirin monotherapy, one of 12 nonresponders, two of four HCV-RNA reappearing ETVRs and all four RNA-negative biochemical relapsers of ETVRs showed sustained virologic response. Two of 12monotherapy treated non-responders showed persistent normalization of liver function test. In total, 50% (31/62)of patients achieved sustained virologic response.CONCLUSION: Resumption of ribavirin monotherapy in ETVRs at signs of viral rebound and recurrent biochemical abnormalities rather than continuation of monotherapy appears to be the key to success of ribavirin monotherapy after interferon-related combination therapy.展开更多
Objective To evaluate whether letrozole enhanced follicular recruitment, embryo numbers, and pregnancy rates in poor responders undergoing IVF. Methods We reviewed all IVF cycles between January 2002 and September 200...Objective To evaluate whether letrozole enhanced follicular recruitment, embryo numbers, and pregnancy rates in poor responders undergoing IVF. Methods We reviewed all IVF cycles between January 2002 and September 2003 using letrozole at Stanford University Medical Center. The entry criteria were the requirement of at least 450 IU/d of injectable gonadotropins in a prior failed cycle, which was used as a control. Results A total of 27 charts were reviewed revealing information on 54 cycles. The number of oocytes retrieved, fertilization, embryo quality and embryos transferred yielded no statistical significance, although there appeared to be a trend toward higher numbers of each in the letrozole group. The clinical pregnancy rate was 9/27 （33.3%, P〈0.001） with a viable pregnancy rate of 7/27 （25.9%, P=0. 002） in the Ietrozole cycle. Conclusion Our study is one of the first to evaluate letrozole with in vitro fertilization. Although this study showed no difference in number of oocytes or embryos, 25.9% of these ＂poor responding＂ patients achieved a pregnancy after a failed cycle at our center.展开更多
Objective To explore the predictive factors for clinical pregnancies of poor responders diagnosed according to the Bologna criteria in ovarian stimulation in vitro fertilization （IVF） .Methods The present study incl...Objective To explore the predictive factors for clinical pregnancies of poor responders diagnosed according to the Bologna criteria in ovarian stimulation in vitro fertilization （IVF） .Methods The present study included 392 poor responders diagnosed according to the Bologna criteria （392 first poor response cycles and 247 subsequent conventional stimulation cycles） in our IVF center. Binary Logistic regression analysis was used to study the association between possible predictive factors and clinical pregnancy of poor responders in ovarian stimulation IVF.Results The significant predictive factors for clinical pregnancies of poor responders in ovarian stimulation IVF were female age, number of embryos transferred and ovarian stimulation protocol. Female age had the best predictive value for clinical pregnancy of poor ovarian responders.Conclusion Poor responders should be encouraged to attempt Jurther ovarian stimulation IVF treatment as soon as possible because the pregnancy rate decreases with advancing female age. Growth hormone supplementation, intracytoplasmic sperm injection （ICSI） procedure or assisted hatching seem not be able to prominently improve the pregnancy outcomes of poor responders diagnosed according to the Bologna criteria in ovarian stimulation IVF.展开更多
Objective: To study whether the unexpected poor ovarian responders optimization of uterine receptivity with a flexible controlled ovarian hyper stimulation protocol based on the Biophysical Profile of the Uterus, has ...Objective: To study whether the unexpected poor ovarian responders optimization of uterine receptivity with a flexible controlled ovarian hyper stimulation protocol based on the Biophysical Profile of the Uterus, has an impact on their reproductive performance. Design: Observational Prospective study. Setting(s): i) General hospital-IVF and Infertility Centre;ii) University hospital. Patient(s): 44 normogonadotrophic young women (26 - 38 yrs) with previous “unexpected” poor ovarian response underwent IVF/ICSI treatment on a protocol based on the Biophysical Profile of their uterus (Group A). The same patients were used as controls in a preceded IVF cycle on the conventional stimulation protocol. Intervention(s): None. Main outcome measure(s): Pregnancy, miscarriage and home take baby rates, amount and duration of gonadotropins required, number and quality of embryos resulted, Biophysical Profile of the Uterus score. Result(s). Treatment in Group A in comparison to Group B resulted in significantly larger number of eggs retrieved per patient, and improved fertilization rates and higher number of embryos/ET (p = 0.011, 0.010 and 0.034 respectively). Group A also demonstrated a trend for higher rates of clinical pregnancy (29.5% v.s. 15.9%), viable stage pregnancies ≥ 24 weeks (33.3% v.s. 20%) and home take babies (26.6% v.s. 16%). The amount of gonadotropins used per patient (IU) was similar in the two groups (p = 0.264). Cancellation, implantation and miscarriage rates as well as embryos quality, although superior in the treatment Group A, showed no significant difference. The number of pregnancies achieved in Group A, were directly related with the score in the Biophysical Profile of the Uterus 12 point scale. Conclusion(s): Unexpected Poor Ovarian Responders on the flexible IVF/ICSI protocol (Group A), adjusting the management according to the Biophysical Profile of their uterus (duration of stimulation, day of HCG and day of embryo transfer), had a significantly better performance in comparison to the Group B managed on the conventional protocol in this difficult to manage and so far, rather understudied population.展开更多
Objective: Dehydroepiandrosterone (DHEA) has been previously reported to improve ovarian response in IVF for poor responders. Its effect remains uncertain. The purpose of this study was to evaluate the effect of DHEA ...Objective: Dehydroepiandrosterone (DHEA) has been previously reported to improve ovarian response in IVF for poor responders. Its effect remains uncertain. The purpose of this study was to evaluate the effect of DHEA given during two years in our unit, in order to build hypothesis for a future randomized controlled trial. Design: Cohort of exposed and non-exposed DHEA study. Patient(s): 224 patients with AMH under 1.6 ng/ml undergoing IVF with a short antagonist protocol adding FSH and LH rec were enrolled for 327 IVF cycles. 176 patients had been treated with DHEA before IVF, and 151 had not. Intervention(s): None. Main Outcome Measure(s): Cancellation cycle rate, amount of gonadotrophins used, estradiol level on day six of stimulation, number of oocytes retrieved, metaphase II oocytes, blastocysts and frozen embryos, clinical pregnancy rate and miscarriage rate. Results: The cancellation rate was significantly higher in the group without DHEA (29.8% versus 13.1%, p = 0.002). The amount of gonadotrophins used for stimulation, the estradiol level on day six of stimulation, the number of oocytes retrieved, metaphase II oocytes, blastocysts, frozen embryos and miscarriage rate were not different in both groups. The clinical pregnancy rate per included patient in the DHEA group was 17.1% versus 8.6% in the non-treated group (p = 0.02). Conclusion: DHEA appears to improve clinical pregnancy rate by decreasing the cancellation rate.展开更多
Objective To evaluate the therapeutic efficacy of Longchai Jiangxue Formula(LCJX)in polycythemia vera(PV)patients and identify optimal responder subpopulations.Methods Eighty PV patients were allocated into control(33...Objective To evaluate the therapeutic efficacy of Longchai Jiangxue Formula(LCJX)in polycythemia vera(PV)patients and identify optimal responder subpopulations.Methods Eighty PV patients were allocated into control(33 cases)and experimental(47 cases)groups based on their preference.展开更多
Background:Chronic low back pain(cLBP)is a major cause of disability,with varied patient responses to treatments.Auricular point acupressure(APA)has shown potential as a non-pharmacological intervention,but individual...Background:Chronic low back pain(cLBP)is a major cause of disability,with varied patient responses to treatments.Auricular point acupressure(APA)has shown potential as a non-pharmacological intervention,but individual responses may differ significantly.Objective:This study aimed to determine the predictability of baseline characteristics,including functional disability,symptom severity,and treatment expectancy,on clinically significant responses to APA in reducing pain and improving function.Methods:A secondary analysis was performed using data from a randomized controlled trial with 263 cLBP patients.Participants were randomly assigned to targeted APA(T-APA),non-targeted APA(NT-APA),or to a control group.APA responders were defined as those with at least a 1.5-point reduction in pain intensity or a 2.5point improvement in the Roland-Morris Disability Questionnaire(RMDQ).Predictors of response were assessed using logistic regression and machine learning models,including the Random Forest and Support Vector Machine(SVM).Results:Baseline pain,physical function,sleep disturbance,and treatment expectancy were key predictors.The Random Forest model had the highest accuracy for T-APA;however,logistic regression performed best in NTAPA.SVM was most accurate in the control group,with predictive accuracy varying by group(AUC 60.9%—80%).The Least Absolute Shrinkage and Selection Operator(LAssO)method was found to be overly aggressive,often eliminating important variables.Conclusion:This study highlights the variability in APA treatment responses for cLBP.While predictive models provide useful insights,further research with larger datasets is needed to improve prediction accuracy and generalizability,enhancing personalized treatment approaches for cLBP.展开更多
Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensu...Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to find the optimal transfer strategy for different subgroups of patients. Methods From April 2010 to December 2010, patients who meet the following criteria were included in this study; primary infertility, female age 〈35 years, FSH level on female cycle day 2-3 〈12 mlU/ml, at least six good quality embryos available on day three.The clinical outcomes using different transfer strategies between normal responders and high responders were reviewed and compared. Results For the normal responders, the clinical pregnancy rate of day three double-embryo transfer （DET） was comparable to that of day five elective single blastocyst transfer （eSBT）, 64.04% vs. 60.33% （P〉0.05）. For the high responders, the clinical pregnancy rate of day five eSBT was significantly lower than that of day three DET, 43.35% vs. 57.21% （P〈0.05）. For the high responders, the rates of clinical pregnancy and implantation in frozen-thawed embryo transfer （FET） cycles were notably higher than in eSBT cycles （64.56% vs. 43.35% and 62.11% vs. 43.35% respectively） （P〈0.05）. Conclusions For normal responders, eSBT might be an applicabte strategy to reduce multiple pregnancy rates while maintaining acceptable overall pregnancy rates. And in order to reduce multiple pregnancies and increase the chance of pregnancy of high responders, FET may be a preferable strategy.展开更多
Disaster response work is associated with various psychological outcomes. In post-disaster conditions,social support is generally observed to impact mental health, particularly for survivors. This review was conducted...Disaster response work is associated with various psychological outcomes. In post-disaster conditions,social support is generally observed to impact mental health, particularly for survivors. This review was conducted to survey the extent of social support effectiveness on disaster responder groups. Published quantitative social support studies on police, emergency medical responders,rescue and recovery workers, firefighters, and military responders were searched in various academic databases using keyword searches, a reference list search, and a citation search that resulted in 24 studies with 90 effect sizes being included in the final data base. Articles were coded and effect sizes were averaged using the Hedges–Vevea Random Effects model. Nineteen categories of psychological outcomes(for example, anxiety, depression,posttraumatic stress symptoms, and psychological distress)and eight classifications of support were coded. Social support was found to be associated with anxiety, burnout,depression, job control, job satisfaction, psychological distress, turnover intentions, and work engagement, with mean effect sizes from-0.36 to 0.57. Most studies measured perceived social support and negative outcomes.Social support correlated with outcomes in police responders and rescue and recovery workers. This review discusses the breadth of effect of social support, as well as other elements, such as temporal factors, that may affect the effectiveness of social support in disaster responders.展开更多
Objective:This study aimed to compare the efficacy of clomiphene citrate(CC)with human menopausal gonadotropin(hMG)and that of medroxyprogesterone acetate(MPA)with hMG in poor responders defined according to the Bolog...Objective:This study aimed to compare the efficacy of clomiphene citrate(CC)with human menopausal gonadotropin(hMG)and that of medroxyprogesterone acetate(MPA)with hMG in poor responders defined according to the Bologna criteria.Methods:The data of patients with poor ovarian response(POR)according to the Bologna criteria from September 2016 to November 2017 were retrospectively reviewed.All participants received either CC+hMG or the progesterone-primed ovarian stimulation protocol(PPOS)protocol.Results:A total of 340 patients and 563 in vitro fertilization cycles were analyzed in this study.The incidence of spontaneous luteinizing hormone(LH)surge and the mean LH level on trigger day were significantly lower in the PPOS group than in the CC+HMG group(0.04%vs.3.49%and 4.26±3.59 vs.9.38±6.92 mIU/mL,respectively,P<0.05);however,the incidence of premature ovulation was similar between the two groups.The number of viable embryos harvested was not statistically different between the two groups(1.7±1.1 vs.1.5±0.8,P=0.06).The mean dose and duration of hMG were significantly higher in the PPOS group than in the CC+hMG group(908.7±556.6 vs.177.9±214.5 IU and 6.0±3.4 vs.1.2±1.5 days,respectively,P<0.05).However,the number of oocytes retrieved,number of metaphase II oocytes,and fertilization rate were comparable between the two groups.Conclusions:The CC with low-dose gonadotropin strategy was superior to the MPA with hMG protocol for POR.展开更多
The brain is one of the most common metastatic sites for carcinoma,especially for breast cancer,the second leading cause of brain metastases(BrM)after lung cancer[1].During organ‐tropic metastases,cancer cells have t...The brain is one of the most common metastatic sites for carcinoma,especially for breast cancer,the second leading cause of brain metastases(BrM)after lung cancer[1].During organ‐tropic metastases,cancer cells have to survive and expand in target organs through a process involving a complex interplay between invading cells and the microenvironment.展开更多
Objectives:At the time of the bombing of the federal building in Oklahoma City,Oklahoma(OKC),it was the deadliest terrorist attack in the United States of America.Available research on this incident,and in general,has...Objectives:At the time of the bombing of the federal building in Oklahoma City,Oklahoma(OKC),it was the deadliest terrorist attack in the United States of America.Available research on this incident,and in general,has been quantitative,using deductive methods.The purpose of the current study was to systematically examine professional disaster response workers’emotions elicited spontaneously and in detail as they were experienced over time after a major disaster.This qualitative study will add to existing knowledge of psychopathology and the psychosocial effects of disasters on professional responders,which have not been explored by prior quantitative studies.Methods:A volunteer sample of 181 rescue and recovery workers for the 1995 bombing of the OKC Murrah Federal Building was interviewed approximately 3 years after the bombing.These responders were asked open-ended questions to elicit undirected responses in their own words.In these interviews,they were prompted to describe their feelings at 3 distinct time points:upon their arrival at the bombing scene(“immediately”),in the first 1 week following the bombing,and currently at the time of the interview(“now”).Results:Data items were coded into the 5 themes:Anticipation,Shock and awe,Negative reactions,Positive reactions,and Emotionally unengaged/unaffected.The emotional themes of the responders mapped into 2 conceptual domains.The first domain is related to common human responses to horrible events such as the bombing.The second domain is related to the professional identities of the disaster responders.Conclusions:Specific aspects of the professional responder roles asserted themselves,shaping their emotional responses distinctly from those of the bomb blast survivors.This study identified both negative and positive emotions,which may help identify risk for or resistance to posttraumatic stress disorder(PTSD).展开更多
Emergency medical services (EMS) are a vital element of the public healthcare system in China,^([1])providing an opportunity to respond to critical medical conditions and save people’s lives.^([2])The accessibility o...Emergency medical services (EMS) are a vital element of the public healthcare system in China,^([1])providing an opportunity to respond to critical medical conditions and save people’s lives.^([2])The accessibility of EMS has received considerable attention in health and transport geography studies.^([3])One of the optimal gauges for evaluating the accessibility of EMS is the response time,which is defined as the time from receiving an emergency call to the arrival of an ambulance.^([4])Beijing has already reduced the response time to approximately12 min,and the next goal is to ensure that the response time across Beijing does not exceed 12 min (the information comes from the Beijing Emergency Medical Center).展开更多
Editorial message Every advancement in the field of laboratory animal science and technology,from exploring basic mechanisms to validating the development of new drugs,and from establishing disease models to respondin...Editorial message Every advancement in the field of laboratory animal science and technology,from exploring basic mechanisms to validating the development of new drugs,and from establishing disease models to responding to public health emergencies,strengthens the foundation for human health and well-being,serving as an important cornerstone for promoting global scientific innovation.For this reason.展开更多
文摘1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Partial hepatectomy is recommended for patients with early stage HCC.[2]A large proportion of patients with HCC inChina are diagnosed in the intermediate to advanced HCC stages,rendering them ineligible for hepatectomy due to aspects such as liver dysfunction,insufficient residual liver volume,or surgical technique.
文摘Vaccination is the main prophylactic measure to reduce the mortality caused by hepatitis B virus (HBV) infection in healthy subjects since the immune response to hepatitis B recombinant vaccination occurs in over 90% of general population. Individuals who develop an anti-HBs titer less than 10 mIU/mL after primary vaccination cycle are defined “no responders”. Many factors could cause a non response to the HBV vaccination, such as administration of the vaccine in buttocks, impaired vaccine storage conditions, drug abuse, smoking, infections and obesity. Moreover there are some diseases, like chronic kidney disease, human immunodeficiency virus infection, chronic liver disease, celiac disease, thalassaemia, type I diabetes mellitus, down’s syndrome and other forms of mental retardation that are characterized by a poorer response to HBV vaccination than healthy subjects. To date it is still unclear how to treat this group of patients at high risk of hepatitis B infection. Recent studies seem to indicate that the administration of HBV recombinant vaccine by the intradermal route is very effective and could represent a more useful strategy than intramuscular route. This review focuses on the use of anti hepatitis B vaccine by intradermal route as alternative to conventional intramuscular vaccine in all non responder patients. A comprehensive review of the literature using PubMed database, with appropriate terms, was undertaken for articles in English published since 1983. The literature search was undertaken in September 2013.
文摘AIM: To predict which chronic hepatitis C patients are likely to be late-responders, we herein investigated the clinical characteristics of null-responders at 36 wk with hepatitis C virus (HCV) genotype Ib and a high viral load during the course of pegylated interferon (Peg-IFN)/ ribavirin ther apy. METHODS: One hundred forty-two patients with genotype Ib HCV and a high viral load were included in this study. Peg-IFNα2b (1.5 μg/kg once a week) and ribavirin (600-1000 mg per day according to body weight) were administered for 48 wk. We def ined nullresponders as the cases that never cleared serum HCV RNA as determined using RT-PCR until 36 wk. Other patients were def ined as responders. We compared the clinical characteristics (age, gender, body mass index, previous treatment) and HCV RNA titer during the therapy between null-responders and responders.RESULTS: The HCV RNA clearance rate was 17.9% (24/134), 46.3% (62/134), 60.6% (86/142), 86.6% (123/142), and 88.0% (125/142) at 4, 8, 12, 24, and 36 wk, respectively. There were 17 patients (12.0%) who were still null-responders at 36 wk. There were no differences in the clinical characteristics between the responders and null-responders except for the titer and decline rates of HCV RNA at 1 wk and 4 wk. The HCV RNA titers at 1 wk and after 4 wk of treatment were significantly higher in the null-responders in comp arison to the responders (P <0.01). The serum HCV RNA titers of the responders decreased by 1.3 log after 1 wk of treatment, and 1.6 log after 4 wk of treatm ent, respectively. On the other hand, the titers of the null responders decreased by only 0.5 log after 1 wk, and 0.7 log after 4 wk of treatment, respectively. The decrease rates of HCV RNA after 1 and 4 wk of treatm ent were signif icantly worse for null responders than for the responders (P <0.01). CONCLUSION: The HCV RNA titer at 1 wk and 4 wk after initiating treatment may be useful for predicting null-responders to Peg-IFNα2b/ribavirin therapy. However, further investigation is needed to determine the optimal time at which the decision to discontinue the Peg-IFNα2b/ribavirin therapy for null-responders can be made.
基金Supported by National Science and Technology Major Project,No.2014ZX10005001 and No.2018ZX10302204National Natural Science Foundation of China,No.81730109 and No.82274305+2 种基金Shanghai Key Specialty of Traditional Chinese Clinical Medicine,No.shslczdzk01201China Postdoctoral Science Foundation,No.2022M722162Siming Youth Fund of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,No.SGKJ-202104.
文摘BACKGROUND After receiving entecavir or combined with FuzhengHuayu tablet(FZHY)treatment,some sufferers with hepatitis B virus(HBV)-related liver fibrosis could achieve a histological improvement while the others may fail to improve even worsen.Serum metabolomics at baseline in these patients who were effective in treatment remain unclear.AIM To explore baseline serum metabolites characteristics in responders.METHODS A total of 132 patients with HBV-related liver fibrosis and 18 volunteers as healthy controls were recruited.First,all subjects were divided into training set and validation set.Second,the included patients were subdivided into entecavir responders(E-R),entecavir no-responders(E-N),FZHY+entecavir responders(FR),and FZHY+entecavir no-responders(F-N)following the pathological histological changes after 48 wk’treatments.Then,Serum samples of all subjects before treatment were tested by high performance liquid chromatographytandem mass spectrometry(LC-MS)high-performance LC-MS.Data processing was conducted using multivariate principal component analysis and orthogonal partial least squares discriminant analysis.Diagnostic tests of selected differential metabolites were used for Boruta analyses and logistic regression.RESULTS As for the intersection about differential metabolic pathways between the groups E-R vs E-N and F-R vs F-N,results showed that 4 pathways including linoleic acid metabolism,aminoacyl-tRNA biosynthesis,cyanoamino acid metabolism,alanine,aspartate and glutamate metabolism were screened out.As for the differential metabolites,these 7 intersected metabolites including hydroxypropionic acid,tyrosine,citric acid,taurochenodeoxycholic acid,benzoic acid,2-Furoic acid,and propionic acid were selected.CONCLUSION Our findings showed that 4 metabolic pathways and 7 differential metabolites had potential usefulness in clinical prediction of the response of entecavir or combined with FZHY on HBV fibrotic liver.
基金supported by grants from Comprehensive Strategic Sciences Cooperation Projects of Guangdong Province and Chinese Academy (No. 2010B090301026)Guangzhou Science and Technology Program Key Projects (No. 11C22120737)+1 种基金National Natural Science Foundation of China (No. 81170574)Scientific Research Plan of Southern Medical University
文摘Summary： This study explored the cumulative live birth rate after three ovarian stimulation in vitro fer- tilization （IVF） cycles for poor ovarian responders according to the Bologna criteria. In this retrospec- tive cohort study, 479 poor ovarian responders according to the Bologna criteria in the first ovarian stimulation IVF cycle between July 2006 and January 2012 in our IVF centre were included. The cu- mulative live birth rate was calculated by optimistic and pessimistic methods. The cumulative live birth rate after three ovarian stimulation IVF cycles for poor ovarian responders according to the Bologna criteria was 12.7%-20.5%. The three-cycle cumulative live birth rate was 18.5%--24.5%, 13.2%-27.4% and 8.6%-14.9% for poor responders aged ≤35 years, 36-39 years and 〉40 years, re- spectively. In conclusion, poor responders according to the Bologna criteria can receive an acceptable cumulative live birth, rate after three ovarian stimulation IVF cycles, especially poor responders aged 〈40 years.
文摘Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 341 IVF-ET cycles were retrospectively identified. The following inclusion criteria were applied: age ≥ 40 years and patients with tubal factors. The cycles were divided into two groups: a GnRH antagonist group (157 cycles) and a GnRH agonist group (184 cycles). Results: The duration of stimulation and the total doses of gonadotropin in the GnRH agonist group were significantly more than those in the GnRH antagonist group (P < 0.05). There were significant differences in LH and P values on the hCG measurement days between the two groups (0.91 ± 1.17 vs. 4.82 ± 4.69 U/L and 0.69 ± 0.42 vs. 1.03 ± 0.50 ng/mL, P < 0.05). The implantation rate of the GnRH antagonist group was 12.24%, which was slightly higher than that of the GnRH agonist group (10.10%, P = 0.437). The clinical pregnancy rate of the two groups showed no statistical differences (23.36% vs. 23.03%, P = 1.000). Conclusion: For expected poor ovarian responders, the GnRH antagonist protocol was, to some extent, superior to the GnRH agonist protocol in terms of the implantation and clinical pregnancy rates.
基金Supported by the Chang Gung Memorial Hospital Medical Research Program CMRPG-2044 and CMRP-800-VI
文摘AIM: To assess the efficacy of ribavirin monotherapy in patients with biochemical relapse after combination therapy.METHODS: Twenty-four weeks of ribavirin monotherapy was given to biochemical relapsers of end treatment biochemical responders within 6 mo after combination therapy, including non-responders with HCV-RNA level ≤0.2 Meq/mL and end treatment virologic responders (ETVRs) with or without reappearance of HCV-RNA.RESULTS: Sixty-two chronic HCV-infected patients completed 24 wk of interferon-α plus ribavirin combination therapy. Fifty patients (80%) achieved end treatment biochemical response including 16 non-responders and 34 of 36 ETVRs. Twenty-six patients (41.9%) were nonresponders. Ribavirin monotherapy was given to 20biochemical relapsers including 12 non-responders with HCV-RNA levels ≤0.2 Meq/mL, four of eight HCV-RNA reappearing ETVRs, and four HCV-RNA negative ETVRs.After 24 wk of ribavirin monotherapy, one of 12 nonresponders, two of four HCV-RNA reappearing ETVRs and all four RNA-negative biochemical relapsers of ETVRs showed sustained virologic response. Two of 12monotherapy treated non-responders showed persistent normalization of liver function test. In total, 50% (31/62)of patients achieved sustained virologic response.CONCLUSION: Resumption of ribavirin monotherapy in ETVRs at signs of viral rebound and recurrent biochemical abnormalities rather than continuation of monotherapy appears to be the key to success of ribavirin monotherapy after interferon-related combination therapy.
文摘Objective To evaluate whether letrozole enhanced follicular recruitment, embryo numbers, and pregnancy rates in poor responders undergoing IVF. Methods We reviewed all IVF cycles between January 2002 and September 2003 using letrozole at Stanford University Medical Center. The entry criteria were the requirement of at least 450 IU/d of injectable gonadotropins in a prior failed cycle, which was used as a control. Results A total of 27 charts were reviewed revealing information on 54 cycles. The number of oocytes retrieved, fertilization, embryo quality and embryos transferred yielded no statistical significance, although there appeared to be a trend toward higher numbers of each in the letrozole group. The clinical pregnancy rate was 9/27 （33.3%, P〈0.001） with a viable pregnancy rate of 7/27 （25.9%, P=0. 002） in the Ietrozole cycle. Conclusion Our study is one of the first to evaluate letrozole with in vitro fertilization. Although this study showed no difference in number of oocytes or embryos, 25.9% of these ＂poor responding＂ patients achieved a pregnancy after a failed cycle at our center.
文摘Objective To explore the predictive factors for clinical pregnancies of poor responders diagnosed according to the Bologna criteria in ovarian stimulation in vitro fertilization （IVF） .Methods The present study included 392 poor responders diagnosed according to the Bologna criteria （392 first poor response cycles and 247 subsequent conventional stimulation cycles） in our IVF center. Binary Logistic regression analysis was used to study the association between possible predictive factors and clinical pregnancy of poor responders in ovarian stimulation IVF.Results The significant predictive factors for clinical pregnancies of poor responders in ovarian stimulation IVF were female age, number of embryos transferred and ovarian stimulation protocol. Female age had the best predictive value for clinical pregnancy of poor ovarian responders.Conclusion Poor responders should be encouraged to attempt Jurther ovarian stimulation IVF treatment as soon as possible because the pregnancy rate decreases with advancing female age. Growth hormone supplementation, intracytoplasmic sperm injection （ICSI） procedure or assisted hatching seem not be able to prominently improve the pregnancy outcomes of poor responders diagnosed according to the Bologna criteria in ovarian stimulation IVF.
文摘Objective: To study whether the unexpected poor ovarian responders optimization of uterine receptivity with a flexible controlled ovarian hyper stimulation protocol based on the Biophysical Profile of the Uterus, has an impact on their reproductive performance. Design: Observational Prospective study. Setting(s): i) General hospital-IVF and Infertility Centre;ii) University hospital. Patient(s): 44 normogonadotrophic young women (26 - 38 yrs) with previous “unexpected” poor ovarian response underwent IVF/ICSI treatment on a protocol based on the Biophysical Profile of their uterus (Group A). The same patients were used as controls in a preceded IVF cycle on the conventional stimulation protocol. Intervention(s): None. Main outcome measure(s): Pregnancy, miscarriage and home take baby rates, amount and duration of gonadotropins required, number and quality of embryos resulted, Biophysical Profile of the Uterus score. Result(s). Treatment in Group A in comparison to Group B resulted in significantly larger number of eggs retrieved per patient, and improved fertilization rates and higher number of embryos/ET (p = 0.011, 0.010 and 0.034 respectively). Group A also demonstrated a trend for higher rates of clinical pregnancy (29.5% v.s. 15.9%), viable stage pregnancies ≥ 24 weeks (33.3% v.s. 20%) and home take babies (26.6% v.s. 16%). The amount of gonadotropins used per patient (IU) was similar in the two groups (p = 0.264). Cancellation, implantation and miscarriage rates as well as embryos quality, although superior in the treatment Group A, showed no significant difference. The number of pregnancies achieved in Group A, were directly related with the score in the Biophysical Profile of the Uterus 12 point scale. Conclusion(s): Unexpected Poor Ovarian Responders on the flexible IVF/ICSI protocol (Group A), adjusting the management according to the Biophysical Profile of their uterus (duration of stimulation, day of HCG and day of embryo transfer), had a significantly better performance in comparison to the Group B managed on the conventional protocol in this difficult to manage and so far, rather understudied population.
文摘Objective: Dehydroepiandrosterone (DHEA) has been previously reported to improve ovarian response in IVF for poor responders. Its effect remains uncertain. The purpose of this study was to evaluate the effect of DHEA given during two years in our unit, in order to build hypothesis for a future randomized controlled trial. Design: Cohort of exposed and non-exposed DHEA study. Patient(s): 224 patients with AMH under 1.6 ng/ml undergoing IVF with a short antagonist protocol adding FSH and LH rec were enrolled for 327 IVF cycles. 176 patients had been treated with DHEA before IVF, and 151 had not. Intervention(s): None. Main Outcome Measure(s): Cancellation cycle rate, amount of gonadotrophins used, estradiol level on day six of stimulation, number of oocytes retrieved, metaphase II oocytes, blastocysts and frozen embryos, clinical pregnancy rate and miscarriage rate. Results: The cancellation rate was significantly higher in the group without DHEA (29.8% versus 13.1%, p = 0.002). The amount of gonadotrophins used for stimulation, the estradiol level on day six of stimulation, the number of oocytes retrieved, metaphase II oocytes, blastocysts, frozen embryos and miscarriage rate were not different in both groups. The clinical pregnancy rate per included patient in the DHEA group was 17.1% versus 8.6% in the non-treated group (p = 0.02). Conclusion: DHEA appears to improve clinical pregnancy rate by decreasing the cancellation rate.
文摘Objective To evaluate the therapeutic efficacy of Longchai Jiangxue Formula(LCJX)in polycythemia vera(PV)patients and identify optimal responder subpopulations.Methods Eighty PV patients were allocated into control(33 cases)and experimental(47 cases)groups based on their preference.
基金supported by the National Institute on Aging under grant number R01AG056587。
文摘Background:Chronic low back pain(cLBP)is a major cause of disability,with varied patient responses to treatments.Auricular point acupressure(APA)has shown potential as a non-pharmacological intervention,but individual responses may differ significantly.Objective:This study aimed to determine the predictability of baseline characteristics,including functional disability,symptom severity,and treatment expectancy,on clinically significant responses to APA in reducing pain and improving function.Methods:A secondary analysis was performed using data from a randomized controlled trial with 263 cLBP patients.Participants were randomly assigned to targeted APA(T-APA),non-targeted APA(NT-APA),or to a control group.APA responders were defined as those with at least a 1.5-point reduction in pain intensity or a 2.5point improvement in the Roland-Morris Disability Questionnaire(RMDQ).Predictors of response were assessed using logistic regression and machine learning models,including the Random Forest and Support Vector Machine(SVM).Results:Baseline pain,physical function,sleep disturbance,and treatment expectancy were key predictors.The Random Forest model had the highest accuracy for T-APA;however,logistic regression performed best in NTAPA.SVM was most accurate in the control group,with predictive accuracy varying by group(AUC 60.9%—80%).The Least Absolute Shrinkage and Selection Operator(LAssO)method was found to be overly aggressive,often eliminating important variables.Conclusion:This study highlights the variability in APA treatment responses for cLBP.While predictive models provide useful insights,further research with larger datasets is needed to improve prediction accuracy and generalizability,enhancing personalized treatment approaches for cLBP.
文摘Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to find the optimal transfer strategy for different subgroups of patients. Methods From April 2010 to December 2010, patients who meet the following criteria were included in this study; primary infertility, female age 〈35 years, FSH level on female cycle day 2-3 〈12 mlU/ml, at least six good quality embryos available on day three.The clinical outcomes using different transfer strategies between normal responders and high responders were reviewed and compared. Results For the normal responders, the clinical pregnancy rate of day three double-embryo transfer （DET） was comparable to that of day five elective single blastocyst transfer （eSBT）, 64.04% vs. 60.33% （P〉0.05）. For the high responders, the clinical pregnancy rate of day five eSBT was significantly lower than that of day three DET, 43.35% vs. 57.21% （P〈0.05）. For the high responders, the rates of clinical pregnancy and implantation in frozen-thawed embryo transfer （FET） cycles were notably higher than in eSBT cycles （64.56% vs. 43.35% and 62.11% vs. 43.35% respectively） （P〈0.05）. Conclusions For normal responders, eSBT might be an applicabte strategy to reduce multiple pregnancy rates while maintaining acceptable overall pregnancy rates. And in order to reduce multiple pregnancies and increase the chance of pregnancy of high responders, FET may be a preferable strategy.
文摘Disaster response work is associated with various psychological outcomes. In post-disaster conditions,social support is generally observed to impact mental health, particularly for survivors. This review was conducted to survey the extent of social support effectiveness on disaster responder groups. Published quantitative social support studies on police, emergency medical responders,rescue and recovery workers, firefighters, and military responders were searched in various academic databases using keyword searches, a reference list search, and a citation search that resulted in 24 studies with 90 effect sizes being included in the final data base. Articles were coded and effect sizes were averaged using the Hedges–Vevea Random Effects model. Nineteen categories of psychological outcomes(for example, anxiety, depression,posttraumatic stress symptoms, and psychological distress)and eight classifications of support were coded. Social support was found to be associated with anxiety, burnout,depression, job control, job satisfaction, psychological distress, turnover intentions, and work engagement, with mean effect sizes from-0.36 to 0.57. Most studies measured perceived social support and negative outcomes.Social support correlated with outcomes in police responders and rescue and recovery workers. This review discusses the breadth of effect of social support, as well as other elements, such as temporal factors, that may affect the effectiveness of social support in disaster responders.
文摘Objective:This study aimed to compare the efficacy of clomiphene citrate(CC)with human menopausal gonadotropin(hMG)and that of medroxyprogesterone acetate(MPA)with hMG in poor responders defined according to the Bologna criteria.Methods:The data of patients with poor ovarian response(POR)according to the Bologna criteria from September 2016 to November 2017 were retrospectively reviewed.All participants received either CC+hMG or the progesterone-primed ovarian stimulation protocol(PPOS)protocol.Results:A total of 340 patients and 563 in vitro fertilization cycles were analyzed in this study.The incidence of spontaneous luteinizing hormone(LH)surge and the mean LH level on trigger day were significantly lower in the PPOS group than in the CC+HMG group(0.04%vs.3.49%and 4.26±3.59 vs.9.38±6.92 mIU/mL,respectively,P<0.05);however,the incidence of premature ovulation was similar between the two groups.The number of viable embryos harvested was not statistically different between the two groups(1.7±1.1 vs.1.5±0.8,P=0.06).The mean dose and duration of hMG were significantly higher in the PPOS group than in the CC+hMG group(908.7±556.6 vs.177.9±214.5 IU and 6.0±3.4 vs.1.2±1.5 days,respectively,P<0.05).However,the number of oocytes retrieved,number of metaphase II oocytes,and fertilization rate were comparable between the two groups.Conclusions:The CC with low-dose gonadotropin strategy was superior to the MPA with hMG protocol for POR.
文摘The brain is one of the most common metastatic sites for carcinoma,especially for breast cancer,the second leading cause of brain metastases(BrM)after lung cancer[1].During organ‐tropic metastases,cancer cells have to survive and expand in target organs through a process involving a complex interplay between invading cells and the microenvironment.
文摘Objectives:At the time of the bombing of the federal building in Oklahoma City,Oklahoma(OKC),it was the deadliest terrorist attack in the United States of America.Available research on this incident,and in general,has been quantitative,using deductive methods.The purpose of the current study was to systematically examine professional disaster response workers’emotions elicited spontaneously and in detail as they were experienced over time after a major disaster.This qualitative study will add to existing knowledge of psychopathology and the psychosocial effects of disasters on professional responders,which have not been explored by prior quantitative studies.Methods:A volunteer sample of 181 rescue and recovery workers for the 1995 bombing of the OKC Murrah Federal Building was interviewed approximately 3 years after the bombing.These responders were asked open-ended questions to elicit undirected responses in their own words.In these interviews,they were prompted to describe their feelings at 3 distinct time points:upon their arrival at the bombing scene(“immediately”),in the first 1 week following the bombing,and currently at the time of the interview(“now”).Results:Data items were coded into the 5 themes:Anticipation,Shock and awe,Negative reactions,Positive reactions,and Emotionally unengaged/unaffected.The emotional themes of the responders mapped into 2 conceptual domains.The first domain is related to common human responses to horrible events such as the bombing.The second domain is related to the professional identities of the disaster responders.Conclusions:Specific aspects of the professional responder roles asserted themselves,shaping their emotional responses distinctly from those of the bomb blast survivors.This study identified both negative and positive emotions,which may help identify risk for or resistance to posttraumatic stress disorder(PTSD).
基金supported by National Key Research & Development Program of China (2022YFC3006201)。
文摘Emergency medical services (EMS) are a vital element of the public healthcare system in China,^([1])providing an opportunity to respond to critical medical conditions and save people’s lives.^([2])The accessibility of EMS has received considerable attention in health and transport geography studies.^([3])One of the optimal gauges for evaluating the accessibility of EMS is the response time,which is defined as the time from receiving an emergency call to the arrival of an ambulance.^([4])Beijing has already reduced the response time to approximately12 min,and the next goal is to ensure that the response time across Beijing does not exceed 12 min (the information comes from the Beijing Emergency Medical Center).
文摘Editorial message Every advancement in the field of laboratory animal science and technology,from exploring basic mechanisms to validating the development of new drugs,and from establishing disease models to responding to public health emergencies,strengthens the foundation for human health and well-being,serving as an important cornerstone for promoting global scientific innovation.For this reason.
