Objective:THigh-risk non-invasive bladder cancer(NMIBC)has a high rate of recurrence and disease progression.At present,there are still insufficient effective prevention and treatment methods,especially for patients w...Objective:THigh-risk non-invasive bladder cancer(NMIBC)has a high rate of recurrence and disease progression.At present,there are still insufficient effective prevention and treatment methods,especially for patients who have failed BCG treatment.This article reviews the research progress of the molecular mechanism of BCG unresponsive NMIBC,and summarizes the current status and prospects of emerging therapeutic strategies represented by immunotherapy,providing a theoretical basis for the immunotherapy of BCG non-reactive NMIBC.Methods:We searched the PubMed and CNKI journal full-text database search system for keywords"non-muscle invasive bladder cancer,BCG unresponsive,disease recurrence,disease progression,and immunotherapy"with 126 English and 538 Chinese articles.The literature,as well as the relevant clinical research in ClinicalTrials.gov,were integrated together to obtain the results.Results:Immunotherapy was performed in various types of tumors,and the use of immunotherapeutic drugs with different oncotargets administered alone,sequentially or in combination for the treatment of BCG-unresponsive NMIBC have achieved favorable effects,and more Clinical research is still ongoing.Conclusion:Immunotherapy is currently the most promising treatment for cancer,and it is indispensable for patients with NMIBC,both biologically and clinically.We look forward to more laboratory and clinical research in immunotherapy in the future.展开更多
Diabetes mellitus is the fourth leading cause of death worldwide, following cancer, cerebrovascular disease, and heart disease. It is triggered by hyperglycemia and other metabolic disorders. Diabetes is a complex end...Diabetes mellitus is the fourth leading cause of death worldwide, following cancer, cerebrovascular disease, and heart disease. It is triggered by hyperglycemia and other metabolic disorders. Diabetes is a complex endocrine disease that causes chronic vascular complications such as diabetic nephropathy, retinopathy, and polyneuropathy.展开更多
Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into con...Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into consciousness can be drawn. A number of recent studies highlight the difficulty in making a diagnosis in patients with DOC based only on behavioral assessments. Here we aim to provide an overview of how neuroimaging techniques can help assess patients with DOC. Such techniques are expected to facilitate a more accurate understanding of brain function in states of unconsciousness and to improve the evaluation of thepatient's cognitive abilities by providing both diagnostic and prognostic indicators.展开更多
Internet routers generally see packets from a fast flow more often than a slow flow. This suggests that network fairness may be improved without per-flow information. In this paper, we propose a scheme using Most Rece...Internet routers generally see packets from a fast flow more often than a slow flow. This suggests that network fairness may be improved without per-flow information. In this paper, we propose a scheme using Most Recently Used List (MRUL)-a list storing statistics of limited active flows that sorted in most recently seen first mode-to improve the fairness of RED. Based on the list, our proposed scheme jointly considers the identification and punish of the fast and unresponsive fast flows, and the protection of slow flows. Its performance improvements are demonstrated with extensive simulations. Different from the previous proposals, the complexity of our proposed scheme is proportional to the size of the MRUL list but not coupled with the queue buffer size or the number of active flows, so it is scalable and suitable for various routers. In addition, another issue we address in this paper is queue management in RED. Specifically, we replace the linear packet dropping function in RED by a judicially designed nonlinear quadratic function, while original RED remains unchanged. We call this new scheme Nonlinear RED, or NLRED. The underlying idea is that, with the proposed nonlinear packet dropping function, packet dropping becomes gentler than RED at light traffic load but more aggressive at heavy load. As a result, at light traffic load, NLRED encourages the router to operate in a range of average queue sizes rather than a fixed one. When the load is heavy and the average queue size approaches the pre-determined maximum threshold (i.e. the queue size may soon get out of control), NLRED allows more aggressive packet dropping to back off from it. Simulations demonstrate that NLRED achieves a higher and more stable throughput than RED and REM. Since NLRED is fully compatible with RED, we can easily upgrade/replace the existing RED implementations by NLRED.展开更多
Objective: To determine whether patients with unresponsive wakefulness syndrome respond to auditory stimuli based on changes in facial expressions. Participants: Six patients diagnosed with disorders of consciousness ...Objective: To determine whether patients with unresponsive wakefulness syndrome respond to auditory stimuli based on changes in facial expressions. Participants: Six patients diagnosed with disorders of consciousness due to brain injury with permission for participation from their doctor. Design: In this hypothesis-driven observational study, the facial expressions of patients with unresponsive wakefulness syndrome were video-recorded for 5 min before and during auditory stimulation in three consecutive weekly sessions. Main Measures: Facial muscle movement was quantified using FaceReader<sup>®</sup> software (Noldus, Wageningen, Netherlands). Valence/action unit values were plotted to detail facial expression changes. Heart rate values were also plotted. These parameters were compared before and after stimulation. Results: No significant differences in valence integral values or average heart rate were observed between the pre- and intra-stimulus conditions. However, valence signals increased in approximately half of the sessions, indicating that some patients with unresponsive wakefulness syndrome may exhibit emotional responses to auditory stimuli. Analysis of action unit integral values indicated that movement of the eyebrows and eyelids on the upper part of the face occurred during auditory stimulation. Furthermore, the types of auditory stimuli differed depending on the session for the 12 sessions of voice stimuli, whereas the changes in average heart rate differed in each of nine sessions of music stimuli. Because the changes in average heart rate were similar, it is possible that musical stimuli are more suitable than voice stimuli. Conclusion: Some patients with unresponsive wakefulness syndrome may have an emotional response to auditory stimuli. Our findings indicate that it may be possible to distinguish the emotional expression response of a patient based on their facial expression.展开更多
Background:It is a challenge to characterize the consciousness level of patients with severe disturbance of consciousness and predict their prognosis effectively for Chinese doctors.We aimed to investigate the psychom...Background:It is a challenge to characterize the consciousness level of patients with severe disturbance of consciousness and predict their prognosis effectively for Chinese doctors.We aimed to investigate the psychometric property and the diagnostic practicality of severe disturbance of consciousness by Chinese Nanjing persistent vegetative state scale(CNPVSS)which was first set up in 1996 and modified in 2001 and 2011.Methods:The concurrent validity,inter-rater consistency and diagnostic accuracy of CNPVSS and Chinese version of coma recovery scale-revised(CRS-R)were investigated by assessment of 380 patients with severe disorders of consciousness.Results:Total scores of the CNPVSS were correlated significantly with that of the CRS-R,indicating acceptable concurrent validity.Sub-scale analysis showed moderate to high inter-rater reliability and test-retest reliability.CNPVSS was superior to CRS-R on the diagnosis sensitivity.The CNPVSS was able to distinguish 65 patients in emergence from minimal consciousness state who were misclassified as in minimal consciousness state(MCS)by the CRS-R,and it could also distinguish two patients in MCS who were misclassified as in vegetative state by the CRS-R.Conclusion:The CNPVSS is an appropriate measurement and is sensitive to distinguish the MCS patients from the VS patients.展开更多
Background:With the development of emergency and intensive medical technologies,the survival rate of traumatic brain injury has greatly increased.More and more patients have been converted from severe coma to alleviat...Background:With the development of emergency and intensive medical technologies,the survival rate of traumatic brain injury has greatly increased.More and more patients have been converted from severe coma to alleviated state of consciousness,which can be subsequently classified within the framework of disorders of consciousness (DOC).We investigated the clinical application and characteristics of imaging indicators of diffusion tensor imaging (DTI) for the DOC patients.Methods:DTI was performed on a total of 75 cases with a clinical diagnosis of DOC from January 2014 to December 2015 in Beijing Tiantan Hospital and PLA Army General Hospital (including 66 cases of unresponsive wakefulness state (UWS) patients and 9 cases of minimally conscious state (MCS) patients).The data for the imaging indicators,such as fractional anisotropy (FA) and mean diffusivity (MD),were separately collected from three relevant regions of interest (ROIs):brainstem,thalamus,and subcortex.The indicators of two groups with different conscious states were statistically analyzed,and correlation analyses were conducted for the mean values of FA and MD in the ROIs evaluated through clinical Coma Recovery Scale-Revised (CRS-R) scores.Results:The FA value of the UWS group was evidentially lower than that of the MCS group (P ＜ 0.05),while the MD value of the UWS group was higher than that of the MCS group (P ＜ 0.05);the difference was statistically significant.The FA and MD values in the ROIs (locations:brainstem,thalamus,and subcortex) correlated with CRS-R scores,particularly in the thalamus.Conclusion:DTI has a certain clinical reference value for DOC imaging grading.The more severe the DOC,the higher the MD value and the lower the FA value.展开更多
文摘Objective:THigh-risk non-invasive bladder cancer(NMIBC)has a high rate of recurrence and disease progression.At present,there are still insufficient effective prevention and treatment methods,especially for patients who have failed BCG treatment.This article reviews the research progress of the molecular mechanism of BCG unresponsive NMIBC,and summarizes the current status and prospects of emerging therapeutic strategies represented by immunotherapy,providing a theoretical basis for the immunotherapy of BCG non-reactive NMIBC.Methods:We searched the PubMed and CNKI journal full-text database search system for keywords"non-muscle invasive bladder cancer,BCG unresponsive,disease recurrence,disease progression,and immunotherapy"with 126 English and 538 Chinese articles.The literature,as well as the relevant clinical research in ClinicalTrials.gov,were integrated together to obtain the results.Results:Immunotherapy was performed in various types of tumors,and the use of immunotherapeutic drugs with different oncotargets administered alone,sequentially or in combination for the treatment of BCG-unresponsive NMIBC have achieved favorable effects,and more Clinical research is still ongoing.Conclusion:Immunotherapy is currently the most promising treatment for cancer,and it is indispensable for patients with NMIBC,both biologically and clinically.We look forward to more laboratory and clinical research in immunotherapy in the future.
文摘Diabetes mellitus is the fourth leading cause of death worldwide, following cancer, cerebrovascular disease, and heart disease. It is triggered by hyperglycemia and other metabolic disorders. Diabetes is a complex endocrine disease that causes chronic vascular complications such as diabetic nephropathy, retinopathy, and polyneuropathy.
基金Supported by The European Commissionthe James McDon-nell Foundation+5 种基金the European Space AgencyMind Science Foundationthe French Speaking Community Concerted Research Actionthe Belgian interuniversity attraction polethe Public Utility Foundation"Université Européenne du Travail""Fondazione Europea di Ricerca Biomedica"and the University and University Hospital of Liège
文摘Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into consciousness can be drawn. A number of recent studies highlight the difficulty in making a diagnosis in patients with DOC based only on behavioral assessments. Here we aim to provide an overview of how neuroimaging techniques can help assess patients with DOC. Such techniques are expected to facilitate a more accurate understanding of brain function in states of unconsciousness and to improve the evaluation of thepatient's cognitive abilities by providing both diagnostic and prognostic indicators.
文摘Internet routers generally see packets from a fast flow more often than a slow flow. This suggests that network fairness may be improved without per-flow information. In this paper, we propose a scheme using Most Recently Used List (MRUL)-a list storing statistics of limited active flows that sorted in most recently seen first mode-to improve the fairness of RED. Based on the list, our proposed scheme jointly considers the identification and punish of the fast and unresponsive fast flows, and the protection of slow flows. Its performance improvements are demonstrated with extensive simulations. Different from the previous proposals, the complexity of our proposed scheme is proportional to the size of the MRUL list but not coupled with the queue buffer size or the number of active flows, so it is scalable and suitable for various routers. In addition, another issue we address in this paper is queue management in RED. Specifically, we replace the linear packet dropping function in RED by a judicially designed nonlinear quadratic function, while original RED remains unchanged. We call this new scheme Nonlinear RED, or NLRED. The underlying idea is that, with the proposed nonlinear packet dropping function, packet dropping becomes gentler than RED at light traffic load but more aggressive at heavy load. As a result, at light traffic load, NLRED encourages the router to operate in a range of average queue sizes rather than a fixed one. When the load is heavy and the average queue size approaches the pre-determined maximum threshold (i.e. the queue size may soon get out of control), NLRED allows more aggressive packet dropping to back off from it. Simulations demonstrate that NLRED achieves a higher and more stable throughput than RED and REM. Since NLRED is fully compatible with RED, we can easily upgrade/replace the existing RED implementations by NLRED.
文摘Objective: To determine whether patients with unresponsive wakefulness syndrome respond to auditory stimuli based on changes in facial expressions. Participants: Six patients diagnosed with disorders of consciousness due to brain injury with permission for participation from their doctor. Design: In this hypothesis-driven observational study, the facial expressions of patients with unresponsive wakefulness syndrome were video-recorded for 5 min before and during auditory stimulation in three consecutive weekly sessions. Main Measures: Facial muscle movement was quantified using FaceReader<sup>®</sup> software (Noldus, Wageningen, Netherlands). Valence/action unit values were plotted to detail facial expression changes. Heart rate values were also plotted. These parameters were compared before and after stimulation. Results: No significant differences in valence integral values or average heart rate were observed between the pre- and intra-stimulus conditions. However, valence signals increased in approximately half of the sessions, indicating that some patients with unresponsive wakefulness syndrome may exhibit emotional responses to auditory stimuli. Analysis of action unit integral values indicated that movement of the eyebrows and eyelids on the upper part of the face occurred during auditory stimulation. Furthermore, the types of auditory stimuli differed depending on the session for the 12 sessions of voice stimuli, whereas the changes in average heart rate differed in each of nine sessions of music stimuli. Because the changes in average heart rate were similar, it is possible that musical stimuli are more suitable than voice stimuli. Conclusion: Some patients with unresponsive wakefulness syndrome may have an emotional response to auditory stimuli. Our findings indicate that it may be possible to distinguish the emotional expression response of a patient based on their facial expression.
文摘Background:It is a challenge to characterize the consciousness level of patients with severe disturbance of consciousness and predict their prognosis effectively for Chinese doctors.We aimed to investigate the psychometric property and the diagnostic practicality of severe disturbance of consciousness by Chinese Nanjing persistent vegetative state scale(CNPVSS)which was first set up in 1996 and modified in 2001 and 2011.Methods:The concurrent validity,inter-rater consistency and diagnostic accuracy of CNPVSS and Chinese version of coma recovery scale-revised(CRS-R)were investigated by assessment of 380 patients with severe disorders of consciousness.Results:Total scores of the CNPVSS were correlated significantly with that of the CRS-R,indicating acceptable concurrent validity.Sub-scale analysis showed moderate to high inter-rater reliability and test-retest reliability.CNPVSS was superior to CRS-R on the diagnosis sensitivity.The CNPVSS was able to distinguish 65 patients in emergence from minimal consciousness state who were misclassified as in minimal consciousness state(MCS)by the CRS-R,and it could also distinguish two patients in MCS who were misclassified as in vegetative state by the CRS-R.Conclusion:The CNPVSS is an appropriate measurement and is sensitive to distinguish the MCS patients from the VS patients.
基金Ministry of Science and Technology of China grant (2012CB825505) Natural Science Foundation of China
文摘Background:With the development of emergency and intensive medical technologies,the survival rate of traumatic brain injury has greatly increased.More and more patients have been converted from severe coma to alleviated state of consciousness,which can be subsequently classified within the framework of disorders of consciousness (DOC).We investigated the clinical application and characteristics of imaging indicators of diffusion tensor imaging (DTI) for the DOC patients.Methods:DTI was performed on a total of 75 cases with a clinical diagnosis of DOC from January 2014 to December 2015 in Beijing Tiantan Hospital and PLA Army General Hospital (including 66 cases of unresponsive wakefulness state (UWS) patients and 9 cases of minimally conscious state (MCS) patients).The data for the imaging indicators,such as fractional anisotropy (FA) and mean diffusivity (MD),were separately collected from three relevant regions of interest (ROIs):brainstem,thalamus,and subcortex.The indicators of two groups with different conscious states were statistically analyzed,and correlation analyses were conducted for the mean values of FA and MD in the ROIs evaluated through clinical Coma Recovery Scale-Revised (CRS-R) scores.Results:The FA value of the UWS group was evidentially lower than that of the MCS group (P ＜ 0.05),while the MD value of the UWS group was higher than that of the MCS group (P ＜ 0.05);the difference was statistically significant.The FA and MD values in the ROIs (locations:brainstem,thalamus,and subcortex) correlated with CRS-R scores,particularly in the thalamus.Conclusion:DTI has a certain clinical reference value for DOC imaging grading.The more severe the DOC,the higher the MD value and the lower the FA value.
