BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esoph...BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esophagus.Most related papers have been case reports,and no comprehensive studies have been conducted;thus,the actual clinical situation has remained unknown for a long time.AIM To elucidate the actual clinical situation of esophageal involvement of MCL presenting with MLP,including its prognosis.METHODS From January 2001 to December 2021,among MCL patients whose gastrointestinal lesions were histopathologically confirmed by endoscopic biopsy at our center,6 patients with MLP in the esophagus were selected.We retro-spectively examined the clinical features of these patients,including their prognosis.RESULTS In all patients,multiple lesions were present in the gastrointestinal tract other than the esophagus and in the lymph nodes throughout the body,and most patients also had lesions involving the bone marrow or spleen.Most of the treatments include chemotherapy,with a 50%survival period of less than 2 years and a 5-year survival rate of approximately 30%,indicating a poor prognosis.CONCLUSION Patients with esophageal involvement of the MCL who presented with MLP had a large tumor burden and poor survival.展开更多
Objective To develop and validate a preoperative clinical-radiomics model for predicting overall survival(OS)and disease-free survival(DFS)in patients with extrahepatic cholangiocarcinoma(eCCA)undergoing radical resec...Objective To develop and validate a preoperative clinical-radiomics model for predicting overall survival(OS)and disease-free survival(DFS)in patients with extrahepatic cholangiocarcinoma(eCCA)undergoing radical resection.Methods In this retrospective study,consecutive patients with pathologically-confirmed eCCA who underwent radical resection at our institution from 2015 to 2022 were included.The patients were divided into a training cohort and a validation cohort according to the chronological order of their CT examinations.Least absolute shrinkage and selection operator(LASSO)-Cox regression was employed to select predictive radiomic features and clinical variables.The selected features and variables were incorporated into a Cox regression model.Model performance for 1-year OS and DFS prediction was assessed using calibration curves,area under receiver operating characteristic curve(AUC),and concordance index(C-index).Results This study included 123 patients(mean age 64.0±8.4 years,85 males/38 females),with 86 in the training cohort and 37 in the validation cohort.The OS-predicting model included four clinical variables and four radiomic features.It achieved a training cohort AUC of 0.858(C-index=0.800)and a validation cohort AUC of 0.649(C-index=0.605).The DFS-predicting model included four clinical variables and four other radiomic features.It achieved a training cohort AUC of 0.830(C-index=0.760)and a validation cohort AUC of 0.717(C-index=0.616).Conclusion The preoperative clinical-radiomics models show promise as a tool for predicting 1-year OS and DFS in eCCA patients after radical surgery.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedu...BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedure.AIM To evaluate the efficacy of a recently developed catheter for bile duct cannulation.METHODS We retrospectively examined 342 patients who underwent initial cholangiopan-creatography.We compared the success rate of bile duct cannulation and the incidence of complications between the groups using existing and novel catheters.RESULTS The overall success rates of bile duct cannulation were 98.3%and 99.1%in the existing and novel catheter groups,respectively(P=0.47).The bile duct cannulation rate using the standard technique was 73.0%and 82.1%in the existing and novel catheter groups,respectively(P=0.042).Furthermore,when catheterization was performed by expert physicians,the bile duct cannulation rate was significantly higher in the novel catheter group(81.3%)than in the existing catheter group(65.2%)(P=0.017).The incidence of difficult cannulation was also significantly lower in the novel catheter group(17.4%)than in the existing catheter group(33.0%)(P=0.019).CONCLUSION The novel catheter improved the bile duct cannulation rate using the standard technique and reduced the frequency of difficult cannulation cases,valuable tool in endoscopic retrograde cholangiopancreatography procedures performed by experts.展开更多
Background:Poly adenosine-diphosphate-ribose polymerase(PARP)inhibitors(PARPi)have been approved to act as first-line maintenance(FL-M)therapy and as platinum-sensitive recurrent maintenance(PSR-M)therapy for ovarian ...Background:Poly adenosine-diphosphate-ribose polymerase(PARP)inhibitors(PARPi)have been approved to act as first-line maintenance(FL-M)therapy and as platinum-sensitive recurrent maintenance(PSR-M)therapy for ovarian cancer in China for>5 years.Herein,we have analyzed the clinical-application characteristics of olaparib and niraparib in ovarian cancer-maintenance therapy in a real-world setting to strengthen our understanding and promote their rational usage.Methods:A retrospective chart review identified patients with newly diagnosed or platinum-sensitive recurrent ovarian cancer,who received olaparib or niraparib as maintenance therapy at Sichuan Cancer Hospital between August 1,2018,and December 31,2021.Patient medical records were reviewed.We grouped and analyzed patients based on the type of PARPi they used(the olaparib group and the niraparib group)and the line of PARPi maintenance therapy(the FL-M setting and the PSR-M setting).The primary endpoint was the 24-month progression-free survival(PFS)rate.Results:In total,131 patients(olaparib:n=67,51.1%;niraparib:n=64,48.9%)were enrolled.Breast cancer susceptibility genes(BRCA)mutations(BRCA m)were significantly less common in the niraparib group than in the olaparib group[9.4%(6/64)vs.62.7%(42/67),P<0.001],especially in the FL-M setting[10.4%(5/48)vs.91.4%(32/35),P<0.001].The 24-month progression-free survival(PFS)rates in the FL-M and PSR-M settings were 60.4%and 45.7%,respectively.In patients with BRCA m,the 24-month PFS rates in the FL-M and PSR-M settings were 62.2%and 72.7%,respectively.Conclusions:Olaparib and niraparib were effective in patients with ovarian cancer without any new safety signals except for skin pigmentation.In patients with BRCA m,the 24-month PFS of the PARPi used in the PSR-M setting was even higher than that used in the FL-M setting.展开更多
Objective To compare the real-world efficacy and safety profile of tenofovir amibufenamid(TMF)and tenofovir alafenamide(TAF)tablets in the treatment of patients with chronic hepatitis B(CHB).Methods This retrospective...Objective To compare the real-world efficacy and safety profile of tenofovir amibufenamid(TMF)and tenofovir alafenamide(TAF)tablets in the treatment of patients with chronic hepatitis B(CHB).Methods This retrospective study included patientswithhchronic hepatitis B who received TMF and TAFantiviral treatment at the Infectious Disease Outpatient Department of the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023.The primary and secondary outcome was to study the patient HBV DNA conversion rate(<20 IU/ml),alanine aminotransferase(ALT)normalization rate,renal function,and lipid levels of patients at 48 weeks of treatment.TThe comparison of data between measurement data groups was differentiated using a t-test and Mann-Whitney U test.The inter-group comparison rate in count data was performed using the x?test or Fisher's exact probability.Results A total of 440 cases were enrolled,including 220 in the TMF group(63 treatment-naive and 157 treatment-experienced)and 220 cases in the TAF group(61 treatment-naive and 159 treatment-experienced).In terms of efficacy,the HBV DNA seroconversion rates in the TMF group and TAF group were 90.5%and 85.2%(P=0.372),respectively,while the ALT normalization rates were 92.1%and 88.5%(P=0.505),respectively,at 48 weeks of treatment.The HBV DNA-negative conversion rate for the newly treated patients was 99.4%and 98.7%,respectively(P=1.000),while the rates of ALT normalization were 94.9%and 92.3%,respectively(P=0.863).In terms of safety profile,the serum creatinine level was lower in the TMF group than that in the TAF group at 48 weeks of treatment[TMF group 66.5(56.3,78.3)μmol/L,TAF group 70.6(60.7,77.8)μmol/L,Z=-2.282,P=0.022].However,there was no statistically significant difference in other renal function and tubular function related indicators between the two groups of patients(P>0.05).The serum high-density lipoprotein levels were higher in the TMF group than those in the TAF group[TMF 1.4(1.1,1.6)mmol/L vs.TAF group 1.3(1.1,1.6)mmol/L,Z=-2.204,P=0.027]at 48 weeks of treatment.However,there was no statistically significant difference in other blood lipid indicators between the two groups of patients(P>0.05).Conclusion There is no statistically significant difference in efficacy and safety profiles between TMF and TAF at 48 weeks in the treatment of patients with chronic hepatitis B,and the overall safety profile is favorable.展开更多
BACKGROUND Autoimmune pancreatitis(AIP)has been linked with elevated immunoglobulin(Ig)G4 levels.The characteristics and outcomes of AIP based on serum markers have not been fully evaluated.AIM To compare clinical fea...BACKGROUND Autoimmune pancreatitis(AIP)has been linked with elevated immunoglobulin(Ig)G4 levels.The characteristics and outcomes of AIP based on serum markers have not been fully evaluated.AIM To compare clinical features,treatment efficacy,and outcome of AIP based on serum IgG4 levels and analyze predictors of relapse.METHODS A total of 213 patients with AIP were consecutively reviewed in our hospital from 2006 to 2021.According to the serum IgG4 level,all patients were divided into two groups,the abnormal group(n=148)with a high level of IgG4[>2×upper limit of normal(ULN)]and the normal group(n=65).The t-test or Mann-Whitney U test was used to compare continuous variables.Categorical parameters were compared by theχ^(2) test or Fisher’s exact test.Kaplan-Meier curves Zhou GZ et al.Clinical characteristics and outcome of AIP WJG https://www.wjgnet.com 5126 September 21,2023 Volume 29 Issue 35 and log-rank tests were established to assess the cumulative relapse rates.Univariate and multivariate analyses were used to investigate potential risk factors of AIP relapse.RESULTS Compared with the normal group,the abnormal group had a higher average male age(60.3±10.4 vs 56.5±12.9 years,P=0.047);higher level of serum total protein(72.5±7.9 g/L vs 67.2±7.5 g/L,P<0.001),IgG4(1420.5±1110.9 mg/dL vs 252.7±106.6 mg/dL,P<0.001),and IgE(635.6±958.1 IU/mL vs 231.7±352.5 IU/mL,P=0.002);and a lower level of serum complement C3(100.6±36.2 mg/dL vs 119.0±45.7 mg/dL,P=0.050).In addition,a lower number of cases with abnormal pancreatic duct and pancreatic atrophy(23.6%vs 37.9%,P=0.045;1.6%vs 8.6%,P=0.020,respectively)and a higher rate of relapse(17.6%vs 6.2%,P=0.030)were seen in the abnormal group.Multivariate analyses revealed that serum IgG4[(>2×ULN),hazard ratio(HR):3.583;95%confidence interval(CI):1.218–10.545;P=0.020]and IgA(>1×ULN;HR:5.908;95%CI:1.199–29.120;P=0.029)and age>55 years(HR:2.383;95%CI:1.056–5.378;P=0.036)were independent risk factors of relapse.CONCLUSION AIP patients with high IgG4 levels have clinical features including a more active immune system and higher relapse rate.Several factors,such as IgG4 and IgA,are associated with relapse.展开更多
BACKGROUND Depression is the most common mental illness in postpartum mothers,and the etiology of postpartum depression remains poorly understood.Over the past several decades,studies have reported that postpartum dep...BACKGROUND Depression is the most common mental illness in postpartum mothers,and the etiology of postpartum depression remains poorly understood.Over the past several decades,studies have reported that postpartum depression is caused by multiple factors,such as genetic,psychological,pregnancy,and environmental factors,with the family environment being an important environmental factor.The theory of family cohesion and adaptability put forward by Olson is a classic model that describes the level of family function.However,to date,this model has not been examined regarding its applicability to patients with postpartum depression.AIM To investigate the relationship between family cohesion and adaptability and the risk of postpartum depressive symptoms.METHODS We retrospectively analyzed 1446 patients admitted to the postpartum healthcare clinic of the Affiliated Foshan Maternity and Child Healthcare Hospital from April 2021 to December 2021.Patients were grouped according to whether postpartum depression symptoms were reported(symptoms,n=454;no symptoms,n=992).All patients completed the Edinburgh Postpartum Depression Scale and the Chinese version of the Family Cohesion and Adaptability Assessment Scale II.Baseline and clinical data were compared between groups.Univariate regression analysis was used to investigate the association between different types of family cohesion and postpartum depressive symptoms and the association between different family adaptability types and postpartum depressive symptoms.RESULTS After adjusting for age,education,occupation,gravidity,parity,and mode of delivery,disengaged[adjusted odds ratio(AOR)=3.36,95%CI:1.91-5.91],and separated(AOR=1.97,95%CI:1.34-2.90)family cohesion types showed a higher risk of postpartum depression than the connection type,whereas the enmeshed type(AOR=0.38,95%CI:0.28-0.51)protected against postpartum depressive symptoms.Rigid(AOR=4.41,95%CI:3.02-6.43)and structured families(AOR=1.88,95%CI:1.34-2.63)had a higher risk of postpartum depressive symptoms than flexible families,whereas chaotic families(AOR=0.35,95%CI:0.24-0.51)protected against postpartum depressive symptoms.CONCLUSION Family cohesion and adaptability are influencing factors for postpartum depressive symptoms,with higher family cohesion and adaptability being associated with a lower risk of postpartum depressive symptoms.展开更多
BACKGROUND Metabolic syndrome(MetS)is related to poor cognitive function.However,the results of previous studies were inconsistent,and whether the ApoEε4 allele modifies the association remains unclear.AIM To elucida...BACKGROUND Metabolic syndrome(MetS)is related to poor cognitive function.However,the results of previous studies were inconsistent,and whether the ApoEε4 allele modifies the association remains unclear.AIM To elucidate the relationships among MetS,ApoEε4,and cognitive dysfunction in an elderly population in China.METHODS One hundred elderly patients with MetS and 102 age-and gender-matched controls were included in the study.Baseline clinical characteristics and biochemical index for glucose and lipid metabolism were obtained.The distribution of ApoEε4 was assessed with PCR restriction fragment length polymorphism analysis.Cognitive function was evaluated by mini-mental status examination at the 1-year follow-up examination.RESULTS Compared with controls,MetS patients had worse cognitive function and decreased ability to participate in activities of daily life(P=0.001 and 0.046,respectively).Patients with cognitive dysfunction had higher prevalence of MetS(62.1%vs 36.4%,P<0.001)and were more likely to carry the ApoEε4 allele(22.3%vs 10.1%,P=0.019).Multivariate logistic regression analyses showed that diagnosis with MetS,severe insulin resistance,status as an ApoEε4 carrier,higher systolic blood pressure,and larger waist circumference were risk factors for cognitive dysfunction(P<0.05).Repeated-measures analysis of variance,performed with data collected at the 1-year follow-up,revealed continuous influences of MetS and ApoEε4 on the deterioration of cognitive function(time×team,P<0.001 for both).CONCLUSION Diagnosis of MetS and ApoEε4 carrier status were persistently associated with cognitive dysfunction among an elderly population in China.展开更多
BACKGROUND Kidney transplantation is one of the most effective treatments for patients with end-stage renal disease.However,many regions face low deceased donor rates and limited ABO-compatible transplant availability...BACKGROUND Kidney transplantation is one of the most effective treatments for patients with end-stage renal disease.However,many regions face low deceased donor rates and limited ABO-compatible transplant availability,which increases reliance on living donors.These regional challenges necessitate the implementation of kidney paired donation(KPD)programs to overcome incompatibilities such as ABO mismatch or positive cross-matching,even when suitable and willing donors are available.AIM To evaluate the effectiveness of a single-center domino KPD model in both operational planning and clinical management processes and to assess its impact on clinical outcomes.METHODS Between April 2020 and January 2024,we retrospectively evaluated patients enrolled in our center’s domino kidney transplantation program.Donor-recipient pairs unable to proceed due to ABO incompatibility or positive cross-matching with their own living donors were included.Donors and recipients were assessed based on blood group compatibility,HLA tissue typing,and negative cross-match results.A specialized computer algorithm grouped patients into three-way,fourway,and five-way chains.All surgical procedures were performed on the same day at a single center.RESULTS A total of 169 kidney transplants were performed,forming 52 domino chains.These domino KPD transplants accounted for a notable proportion of our center’s overall transplant activity,which included both living donor kidney transplants and deceased donor transplants.Among these chains,the primary reasons for participation were ABO incompatibility(74%),positive cross-matching(10%),and the desire to improve HLA mismatch(16%).Improved HLA mismatch profiles and high graft survival(96%at 1 year,92%at 3 years)and patient survival(98%at 1 year,94%at 3 years)rates were observed,as well as low acute rejection episodes.CONCLUSION The single-center domino KPD model enhanced transplant opportunities for incompatible donor-recipient pairs while maintaining excellent clinical outcomes.By providing a framework that addresses regional challenges,improves operational efficiency,and optimizes clinical management,this model offers actionable insights to reduce waiting lists and improve patient outcomes.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural commu...This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.展开更多
In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audi...In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.展开更多
Existing skin adhesives may, however, cause inflammatory response to toxicity of formaldehyde generated as hydrolysate of polycyanoacrylate (the main ingredient), delay in wound closure due to the adhesive’s flowing ...Existing skin adhesives may, however, cause inflammatory response to toxicity of formaldehyde generated as hydrolysate of polycyanoacrylate (the main ingredient), delay in wound closure due to the adhesive’s flowing into the wound from the edges, or a wide scar. EpinexusTM (Mitsui Chemicals, Inc.), the skin adhesive used for this study, was developed to prevent these risks. For the method of this study, This was a single-center, open-label, single-arm, intervention study of an acrylate skin adhesive, EpinexusTM. The primary endpoint was safety. The secondary endpoints were wound closure, cosmetic outcome (Manchester Scar Scale), and usability. Failures and adverse events were also appropriately evaluated. As a result, there were no particular adverse events such as inflammatory findings, which demonstrated that there is no problem in safety. Some common adverse events were observed, but no adverse events for which a causal relationship cannot be ruled out or failures. As a conclusion, there was no problem in wound closure, cosmetic outcome, or usability. This was a pilot study of EpinexusTM of an ongoing, single-center, open-label, parallel-group, comparative study in 60 subjects comparing EpinexusTMwith an existing skin adhesive, Dermabond? Advanced.展开更多
Background: Since infections can lead to adverse outcomes in autoimmune bullous diseases (AIBD), this study aimed to analyze infection characteristics in AIBD, predict infection risk factors and provide probable sugge...Background: Since infections can lead to adverse outcomes in autoimmune bullous diseases (AIBD), this study aimed to analyze infection characteristics in AIBD, predict infection risk factors and provide probable suggestions to infection prevention, which will spot a light on early discovery and prevention of infections in AIBD patients. Methods: This is a retrospective study of the medical records of inpatients diagnosed with AIBD at the Department of Infectious Diseases and Dermatology, Huashan Hospital from January 2017 to December 2021. We collected patients’ clinical manifestations and laboratory examination results. Risk factors for infections were evaluated using multivariate logistic regression. Results: A total of 263 AIBD patients were included in the study. The overall incidence of infection was 42.2% (111/263). Pemphigus had a higher infection rate (74/142, 52.1%) than bullous pemphigoid (37/121, 30.6%). Among the patients with infections, 49.5% (55/111) had bacterial infections, 13.5% (15/111) had fungal infections, 2.7% (3/111) had virus infections, and 34.2% (38/111) had mixed infections. Staphylococcus aureus and Candida were the most common pathogens in localized infections, while Cryptococcus and Candida were predominant in systemic infections. In the multivariate logistic model, pemphigus (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.41-4.63), hypoalbuminemia (OR = 3.78, 95% CI 1.68-8.50), and systemic glucocorticoid treatment (OR = 4.67, 95% CI 2.51-8.68) were independent risk factors for infection in AIBD patients. Bullous pemphigoid (OR = 3.99, 95% CI 1.03-15.45), high-dose (average > 24 mg/day) compared to low-dose (average ≤ 6 mg/day) and medium-dose (average 6-24 mg/day) systemic glucocorticoid treatment (OR = 19.31, 95% CI 3.32-112.28, and OR = 5.71, 95% CI 1.37-23.79) were associated with increased risk factors of systemic infection in AIBD patients with systemic glucocorticoid treatment. A methylprednisolone dose averaging 14 mg/day over the past three months had a 75.0% positive predictive value for infections in AIBD patients. Conclusions: The incidence of infection in AIBD patients is high, with a broad spectrum of pathogens and infection locations. AIBD patients undergoing systemic glucocorticoid treatment, especially those receiving high doses in the previous three months, should be cautious about infection.展开更多
BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on ...BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.展开更多
BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenn...Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.展开更多
Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic g...Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
文摘BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esophagus.Most related papers have been case reports,and no comprehensive studies have been conducted;thus,the actual clinical situation has remained unknown for a long time.AIM To elucidate the actual clinical situation of esophageal involvement of MCL presenting with MLP,including its prognosis.METHODS From January 2001 to December 2021,among MCL patients whose gastrointestinal lesions were histopathologically confirmed by endoscopic biopsy at our center,6 patients with MLP in the esophagus were selected.We retro-spectively examined the clinical features of these patients,including their prognosis.RESULTS In all patients,multiple lesions were present in the gastrointestinal tract other than the esophagus and in the lymph nodes throughout the body,and most patients also had lesions involving the bone marrow or spleen.Most of the treatments include chemotherapy,with a 50%survival period of less than 2 years and a 5-year survival rate of approximately 30%,indicating a poor prognosis.CONCLUSION Patients with esophageal involvement of the MCL who presented with MLP had a large tumor burden and poor survival.
文摘Objective To develop and validate a preoperative clinical-radiomics model for predicting overall survival(OS)and disease-free survival(DFS)in patients with extrahepatic cholangiocarcinoma(eCCA)undergoing radical resection.Methods In this retrospective study,consecutive patients with pathologically-confirmed eCCA who underwent radical resection at our institution from 2015 to 2022 were included.The patients were divided into a training cohort and a validation cohort according to the chronological order of their CT examinations.Least absolute shrinkage and selection operator(LASSO)-Cox regression was employed to select predictive radiomic features and clinical variables.The selected features and variables were incorporated into a Cox regression model.Model performance for 1-year OS and DFS prediction was assessed using calibration curves,area under receiver operating characteristic curve(AUC),and concordance index(C-index).Results This study included 123 patients(mean age 64.0±8.4 years,85 males/38 females),with 86 in the training cohort and 37 in the validation cohort.The OS-predicting model included four clinical variables and four radiomic features.It achieved a training cohort AUC of 0.858(C-index=0.800)and a validation cohort AUC of 0.649(C-index=0.605).The DFS-predicting model included four clinical variables and four other radiomic features.It achieved a training cohort AUC of 0.830(C-index=0.760)and a validation cohort AUC of 0.717(C-index=0.616).Conclusion The preoperative clinical-radiomics models show promise as a tool for predicting 1-year OS and DFS in eCCA patients after radical surgery.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedure.AIM To evaluate the efficacy of a recently developed catheter for bile duct cannulation.METHODS We retrospectively examined 342 patients who underwent initial cholangiopan-creatography.We compared the success rate of bile duct cannulation and the incidence of complications between the groups using existing and novel catheters.RESULTS The overall success rates of bile duct cannulation were 98.3%and 99.1%in the existing and novel catheter groups,respectively(P=0.47).The bile duct cannulation rate using the standard technique was 73.0%and 82.1%in the existing and novel catheter groups,respectively(P=0.042).Furthermore,when catheterization was performed by expert physicians,the bile duct cannulation rate was significantly higher in the novel catheter group(81.3%)than in the existing catheter group(65.2%)(P=0.017).The incidence of difficult cannulation was also significantly lower in the novel catheter group(17.4%)than in the existing catheter group(33.0%)(P=0.019).CONCLUSION The novel catheter improved the bile duct cannulation rate using the standard technique and reduced the frequency of difficult cannulation cases,valuable tool in endoscopic retrograde cholangiopancreatography procedures performed by experts.
基金This work was supported by grants from the Natural Science Foundation of Sichuan Province(No.2023NSFSC0702)the Basic Research Business Fee Project of Central Universities at the University of Electronic Science and Technology of China(No.ZYGX2022J024).
文摘Background:Poly adenosine-diphosphate-ribose polymerase(PARP)inhibitors(PARPi)have been approved to act as first-line maintenance(FL-M)therapy and as platinum-sensitive recurrent maintenance(PSR-M)therapy for ovarian cancer in China for>5 years.Herein,we have analyzed the clinical-application characteristics of olaparib and niraparib in ovarian cancer-maintenance therapy in a real-world setting to strengthen our understanding and promote their rational usage.Methods:A retrospective chart review identified patients with newly diagnosed or platinum-sensitive recurrent ovarian cancer,who received olaparib or niraparib as maintenance therapy at Sichuan Cancer Hospital between August 1,2018,and December 31,2021.Patient medical records were reviewed.We grouped and analyzed patients based on the type of PARPi they used(the olaparib group and the niraparib group)and the line of PARPi maintenance therapy(the FL-M setting and the PSR-M setting).The primary endpoint was the 24-month progression-free survival(PFS)rate.Results:In total,131 patients(olaparib:n=67,51.1%;niraparib:n=64,48.9%)were enrolled.Breast cancer susceptibility genes(BRCA)mutations(BRCA m)were significantly less common in the niraparib group than in the olaparib group[9.4%(6/64)vs.62.7%(42/67),P<0.001],especially in the FL-M setting[10.4%(5/48)vs.91.4%(32/35),P<0.001].The 24-month progression-free survival(PFS)rates in the FL-M and PSR-M settings were 60.4%and 45.7%,respectively.In patients with BRCA m,the 24-month PFS rates in the FL-M and PSR-M settings were 62.2%and 72.7%,respectively.Conclusions:Olaparib and niraparib were effective in patients with ovarian cancer without any new safety signals except for skin pigmentation.In patients with BRCA m,the 24-month PFS of the PARPi used in the PSR-M setting was even higher than that used in the FL-M setting.
文摘Objective To compare the real-world efficacy and safety profile of tenofovir amibufenamid(TMF)and tenofovir alafenamide(TAF)tablets in the treatment of patients with chronic hepatitis B(CHB).Methods This retrospective study included patientswithhchronic hepatitis B who received TMF and TAFantiviral treatment at the Infectious Disease Outpatient Department of the First Affiliated Hospital of Zhengzhou University from January 2021 to December 2023.The primary and secondary outcome was to study the patient HBV DNA conversion rate(<20 IU/ml),alanine aminotransferase(ALT)normalization rate,renal function,and lipid levels of patients at 48 weeks of treatment.TThe comparison of data between measurement data groups was differentiated using a t-test and Mann-Whitney U test.The inter-group comparison rate in count data was performed using the x?test or Fisher's exact probability.Results A total of 440 cases were enrolled,including 220 in the TMF group(63 treatment-naive and 157 treatment-experienced)and 220 cases in the TAF group(61 treatment-naive and 159 treatment-experienced).In terms of efficacy,the HBV DNA seroconversion rates in the TMF group and TAF group were 90.5%and 85.2%(P=0.372),respectively,while the ALT normalization rates were 92.1%and 88.5%(P=0.505),respectively,at 48 weeks of treatment.The HBV DNA-negative conversion rate for the newly treated patients was 99.4%and 98.7%,respectively(P=1.000),while the rates of ALT normalization were 94.9%and 92.3%,respectively(P=0.863).In terms of safety profile,the serum creatinine level was lower in the TMF group than that in the TAF group at 48 weeks of treatment[TMF group 66.5(56.3,78.3)μmol/L,TAF group 70.6(60.7,77.8)μmol/L,Z=-2.282,P=0.022].However,there was no statistically significant difference in other renal function and tubular function related indicators between the two groups of patients(P>0.05).The serum high-density lipoprotein levels were higher in the TMF group than those in the TAF group[TMF 1.4(1.1,1.6)mmol/L vs.TAF group 1.3(1.1,1.6)mmol/L,Z=-2.204,P=0.027]at 48 weeks of treatment.However,there was no statistically significant difference in other blood lipid indicators between the two groups of patients(P>0.05).Conclusion There is no statistically significant difference in efficacy and safety profiles between TMF and TAF at 48 weeks in the treatment of patients with chronic hepatitis B,and the overall safety profile is favorable.
基金Young Scholar Independent Innovation Science Fund of Chinese PLA General Hospital,No.22QNCZ020National Key Research and Development Program,No.2022YFC2504003.
文摘BACKGROUND Autoimmune pancreatitis(AIP)has been linked with elevated immunoglobulin(Ig)G4 levels.The characteristics and outcomes of AIP based on serum markers have not been fully evaluated.AIM To compare clinical features,treatment efficacy,and outcome of AIP based on serum IgG4 levels and analyze predictors of relapse.METHODS A total of 213 patients with AIP were consecutively reviewed in our hospital from 2006 to 2021.According to the serum IgG4 level,all patients were divided into two groups,the abnormal group(n=148)with a high level of IgG4[>2×upper limit of normal(ULN)]and the normal group(n=65).The t-test or Mann-Whitney U test was used to compare continuous variables.Categorical parameters were compared by theχ^(2) test or Fisher’s exact test.Kaplan-Meier curves Zhou GZ et al.Clinical characteristics and outcome of AIP WJG https://www.wjgnet.com 5126 September 21,2023 Volume 29 Issue 35 and log-rank tests were established to assess the cumulative relapse rates.Univariate and multivariate analyses were used to investigate potential risk factors of AIP relapse.RESULTS Compared with the normal group,the abnormal group had a higher average male age(60.3±10.4 vs 56.5±12.9 years,P=0.047);higher level of serum total protein(72.5±7.9 g/L vs 67.2±7.5 g/L,P<0.001),IgG4(1420.5±1110.9 mg/dL vs 252.7±106.6 mg/dL,P<0.001),and IgE(635.6±958.1 IU/mL vs 231.7±352.5 IU/mL,P=0.002);and a lower level of serum complement C3(100.6±36.2 mg/dL vs 119.0±45.7 mg/dL,P=0.050).In addition,a lower number of cases with abnormal pancreatic duct and pancreatic atrophy(23.6%vs 37.9%,P=0.045;1.6%vs 8.6%,P=0.020,respectively)and a higher rate of relapse(17.6%vs 6.2%,P=0.030)were seen in the abnormal group.Multivariate analyses revealed that serum IgG4[(>2×ULN),hazard ratio(HR):3.583;95%confidence interval(CI):1.218–10.545;P=0.020]and IgA(>1×ULN;HR:5.908;95%CI:1.199–29.120;P=0.029)and age>55 years(HR:2.383;95%CI:1.056–5.378;P=0.036)were independent risk factors of relapse.CONCLUSION AIP patients with high IgG4 levels have clinical features including a more active immune system and higher relapse rate.Several factors,such as IgG4 and IgA,are associated with relapse.
基金Supported by Foundation of Bureau of Science and Technology of Foshan City,No.2020001005566。
文摘BACKGROUND Depression is the most common mental illness in postpartum mothers,and the etiology of postpartum depression remains poorly understood.Over the past several decades,studies have reported that postpartum depression is caused by multiple factors,such as genetic,psychological,pregnancy,and environmental factors,with the family environment being an important environmental factor.The theory of family cohesion and adaptability put forward by Olson is a classic model that describes the level of family function.However,to date,this model has not been examined regarding its applicability to patients with postpartum depression.AIM To investigate the relationship between family cohesion and adaptability and the risk of postpartum depressive symptoms.METHODS We retrospectively analyzed 1446 patients admitted to the postpartum healthcare clinic of the Affiliated Foshan Maternity and Child Healthcare Hospital from April 2021 to December 2021.Patients were grouped according to whether postpartum depression symptoms were reported(symptoms,n=454;no symptoms,n=992).All patients completed the Edinburgh Postpartum Depression Scale and the Chinese version of the Family Cohesion and Adaptability Assessment Scale II.Baseline and clinical data were compared between groups.Univariate regression analysis was used to investigate the association between different types of family cohesion and postpartum depressive symptoms and the association between different family adaptability types and postpartum depressive symptoms.RESULTS After adjusting for age,education,occupation,gravidity,parity,and mode of delivery,disengaged[adjusted odds ratio(AOR)=3.36,95%CI:1.91-5.91],and separated(AOR=1.97,95%CI:1.34-2.90)family cohesion types showed a higher risk of postpartum depression than the connection type,whereas the enmeshed type(AOR=0.38,95%CI:0.28-0.51)protected against postpartum depressive symptoms.Rigid(AOR=4.41,95%CI:3.02-6.43)and structured families(AOR=1.88,95%CI:1.34-2.63)had a higher risk of postpartum depressive symptoms than flexible families,whereas chaotic families(AOR=0.35,95%CI:0.24-0.51)protected against postpartum depressive symptoms.CONCLUSION Family cohesion and adaptability are influencing factors for postpartum depressive symptoms,with higher family cohesion and adaptability being associated with a lower risk of postpartum depressive symptoms.
基金Supported by Basic and Clinical Cooperation Project of Capital Medical University,No.16JL82.
文摘BACKGROUND Metabolic syndrome(MetS)is related to poor cognitive function.However,the results of previous studies were inconsistent,and whether the ApoEε4 allele modifies the association remains unclear.AIM To elucidate the relationships among MetS,ApoEε4,and cognitive dysfunction in an elderly population in China.METHODS One hundred elderly patients with MetS and 102 age-and gender-matched controls were included in the study.Baseline clinical characteristics and biochemical index for glucose and lipid metabolism were obtained.The distribution of ApoEε4 was assessed with PCR restriction fragment length polymorphism analysis.Cognitive function was evaluated by mini-mental status examination at the 1-year follow-up examination.RESULTS Compared with controls,MetS patients had worse cognitive function and decreased ability to participate in activities of daily life(P=0.001 and 0.046,respectively).Patients with cognitive dysfunction had higher prevalence of MetS(62.1%vs 36.4%,P<0.001)and were more likely to carry the ApoEε4 allele(22.3%vs 10.1%,P=0.019).Multivariate logistic regression analyses showed that diagnosis with MetS,severe insulin resistance,status as an ApoEε4 carrier,higher systolic blood pressure,and larger waist circumference were risk factors for cognitive dysfunction(P<0.05).Repeated-measures analysis of variance,performed with data collected at the 1-year follow-up,revealed continuous influences of MetS and ApoEε4 on the deterioration of cognitive function(time×team,P<0.001 for both).CONCLUSION Diagnosis of MetS and ApoEε4 carrier status were persistently associated with cognitive dysfunction among an elderly population in China.
文摘BACKGROUND Kidney transplantation is one of the most effective treatments for patients with end-stage renal disease.However,many regions face low deceased donor rates and limited ABO-compatible transplant availability,which increases reliance on living donors.These regional challenges necessitate the implementation of kidney paired donation(KPD)programs to overcome incompatibilities such as ABO mismatch or positive cross-matching,even when suitable and willing donors are available.AIM To evaluate the effectiveness of a single-center domino KPD model in both operational planning and clinical management processes and to assess its impact on clinical outcomes.METHODS Between April 2020 and January 2024,we retrospectively evaluated patients enrolled in our center’s domino kidney transplantation program.Donor-recipient pairs unable to proceed due to ABO incompatibility or positive cross-matching with their own living donors were included.Donors and recipients were assessed based on blood group compatibility,HLA tissue typing,and negative cross-match results.A specialized computer algorithm grouped patients into three-way,fourway,and five-way chains.All surgical procedures were performed on the same day at a single center.RESULTS A total of 169 kidney transplants were performed,forming 52 domino chains.These domino KPD transplants accounted for a notable proportion of our center’s overall transplant activity,which included both living donor kidney transplants and deceased donor transplants.Among these chains,the primary reasons for participation were ABO incompatibility(74%),positive cross-matching(10%),and the desire to improve HLA mismatch(16%).Improved HLA mismatch profiles and high graft survival(96%at 1 year,92%at 3 years)and patient survival(98%at 1 year,94%at 3 years)rates were observed,as well as low acute rejection episodes.CONCLUSION The single-center domino KPD model enhanced transplant opportunities for incompatible donor-recipient pairs while maintaining excellent clinical outcomes.By providing a framework that addresses regional challenges,improves operational efficiency,and optimizes clinical management,this model offers actionable insights to reduce waiting lists and improve patient outcomes.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金supported by“Dalian Maritime University Teaching Reform Research Fund 2022 Annual Project”(Fund No.XJG2022-96).
文摘This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.
文摘In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.
文摘Existing skin adhesives may, however, cause inflammatory response to toxicity of formaldehyde generated as hydrolysate of polycyanoacrylate (the main ingredient), delay in wound closure due to the adhesive’s flowing into the wound from the edges, or a wide scar. EpinexusTM (Mitsui Chemicals, Inc.), the skin adhesive used for this study, was developed to prevent these risks. For the method of this study, This was a single-center, open-label, single-arm, intervention study of an acrylate skin adhesive, EpinexusTM. The primary endpoint was safety. The secondary endpoints were wound closure, cosmetic outcome (Manchester Scar Scale), and usability. Failures and adverse events were also appropriately evaluated. As a result, there were no particular adverse events such as inflammatory findings, which demonstrated that there is no problem in safety. Some common adverse events were observed, but no adverse events for which a causal relationship cannot be ruled out or failures. As a conclusion, there was no problem in wound closure, cosmetic outcome, or usability. This was a pilot study of EpinexusTM of an ongoing, single-center, open-label, parallel-group, comparative study in 60 subjects comparing EpinexusTMwith an existing skin adhesive, Dermabond? Advanced.
基金supported by National Natural Science Foundation of China(82271794 and 82302533)Shanghai Science and Technology Commission sailing project(22YF1404900).
文摘Background: Since infections can lead to adverse outcomes in autoimmune bullous diseases (AIBD), this study aimed to analyze infection characteristics in AIBD, predict infection risk factors and provide probable suggestions to infection prevention, which will spot a light on early discovery and prevention of infections in AIBD patients. Methods: This is a retrospective study of the medical records of inpatients diagnosed with AIBD at the Department of Infectious Diseases and Dermatology, Huashan Hospital from January 2017 to December 2021. We collected patients’ clinical manifestations and laboratory examination results. Risk factors for infections were evaluated using multivariate logistic regression. Results: A total of 263 AIBD patients were included in the study. The overall incidence of infection was 42.2% (111/263). Pemphigus had a higher infection rate (74/142, 52.1%) than bullous pemphigoid (37/121, 30.6%). Among the patients with infections, 49.5% (55/111) had bacterial infections, 13.5% (15/111) had fungal infections, 2.7% (3/111) had virus infections, and 34.2% (38/111) had mixed infections. Staphylococcus aureus and Candida were the most common pathogens in localized infections, while Cryptococcus and Candida were predominant in systemic infections. In the multivariate logistic model, pemphigus (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.41-4.63), hypoalbuminemia (OR = 3.78, 95% CI 1.68-8.50), and systemic glucocorticoid treatment (OR = 4.67, 95% CI 2.51-8.68) were independent risk factors for infection in AIBD patients. Bullous pemphigoid (OR = 3.99, 95% CI 1.03-15.45), high-dose (average > 24 mg/day) compared to low-dose (average ≤ 6 mg/day) and medium-dose (average 6-24 mg/day) systemic glucocorticoid treatment (OR = 19.31, 95% CI 3.32-112.28, and OR = 5.71, 95% CI 1.37-23.79) were associated with increased risk factors of systemic infection in AIBD patients with systemic glucocorticoid treatment. A methylprednisolone dose averaging 14 mg/day over the past three months had a 75.0% positive predictive value for infections in AIBD patients. Conclusions: The incidence of infection in AIBD patients is high, with a broad spectrum of pathogens and infection locations. AIBD patients undergoing systemic glucocorticoid treatment, especially those receiving high doses in the previous three months, should be cautious about infection.
基金Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties,No.SZGSP013Shenzhen Key Medical Discipline Construction Fund,No.SZXK042+2 种基金Sanming Project of Medicine in Shenzhen,No.SZSM202311025Natural Science Fund of Fujian Province,No.2023J011622Natural Science Fund of Xiamen City,No.3502Z20224ZD1259.
文摘BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金supported by the High-level Talents Introduction Plan from Central South University(No.502045003)the National Natural Science Foundation of China(No.42277438)Hunan Provincial Natural Science Foundation for Distinguished Young Scholars(No.2024JJ2082)to Fang Xiao,and the Postgraduate Independent Exploration and Innovation Project of Central South University,China(Nos.2024ZZTS0557 and 2023ZZTS0993)。
文摘Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.
文摘Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
