End-stage liver disease(ESLD) is a leading cause of morbidity and mortality amongst human immunodeficiency virus(HIV)-positive individuals. Chronic hepatitis B and hepatitis C virus(HCV) infection,drug-induced hepatot...End-stage liver disease(ESLD) is a leading cause of morbidity and mortality amongst human immunodeficiency virus(HIV)-positive individuals. Chronic hepatitis B and hepatitis C virus(HCV) infection,drug-induced hepatotoxicity related to combined antiretro-viral therapy,alcohol related liver disease and non-alcohol related fatty liver disease appear to be the leading causes. It is therefore,anticipated that more HIV-positive patients with ESLD will present as potential transplant candidates. HIV infection is no longer a contraindication to liver transplantation. Key transplantation outcomes such as rejection and infection rates as well as medium term graft and patient survival match those seen in the non-HIV infected patients in the absence of co-existing HCV infection. HIV disease does not seem to be negatively impacted by transplantation. However,HIV-HCV coinfection transplant outcomes remain suboptimal due to recurrence. In this article,we review the key challenges faced by this patient cohort in the pre- and posttransplant period.展开更多
In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbumi...In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.展开更多
BACKGROUND:The nonspecifi c clinical presentation of adrenal insuffi ciency(AI)frequently leads to misdiagnosis,often as psychiatric or gastrointestinal disorders.AI is classifi ed anatomically as primary AI(PAI),seco...BACKGROUND:The nonspecifi c clinical presentation of adrenal insuffi ciency(AI)frequently leads to misdiagnosis,often as psychiatric or gastrointestinal disorders.AI is classifi ed anatomically as primary AI(PAI),secondary AI(SAI),or tertiary AI(TAI).Without timely recognition,progression to adrenal crisis(AC)can result in life-threatening outcomes.This study aimed to systematically analyze the clinical features,etiologies,and outcomes of AI in Lhasa’s emergency population to improve diagnostic accuracy and optimize clinical management.METHODS:A retrospective analysis of emergency department admissions from January 2020 to August 2024 at People’s Hospital of Xizang Autonomous Region was conducted.AI diagnoses were identifi ed via International Classifi cation of Diseases,Tenth Revision,Clinical Modifi cation(ICD-10-CM)codes from electronic health records(EHR).Patients were grouped into incipient AC(IAC)or AC cohorts based on hemodynamic status.Demographic profi les,etiologies,clinical presentations,and laboratory results were analyzed.RESULTS:Forty-three AI patients were identifi ed.The population-standardized admission rate for AI increased from 9 to 16 per million person-years,with PAI cases doubling during this period.Adrenal tuberculosis(58.1%)and adrenal hematoma(18.6%)were the leading etiologies.Compared to the IAC group,the AC group demonstrated lower systolic blood pressure(SBP)(P=0.001)and diastolic blood pressure(DBP)(P<0.001);higher neutrophil count(P=0.048),eosinophil count(P=0.044),CRP(P=0.004),blood urea nitrogen(BUN)(P=0.007);lower sodium(P<0.001)and glucose levels(P=0.001).The hospital stay was longer in the AC group(20 d vs.14 d;P<0.001).CONCLUSION:AI incidence is rising in high-altitude regions,with adrenal tuberculosis remaining the most common cause.AC is associated with increased inflammatory responses,hemodynamic instability,and metabolic disturbances.Targeted interventions are required to improve outcomes.展开更多
Molecular cloning remains a cornerstone technique in genetic engineering and synthetic biology.In this study,we conducted a systematic comparative analysis between the classical cloning method and the Golden Gate asse...Molecular cloning remains a cornerstone technique in genetic engineering and synthetic biology.In this study,we conducted a systematic comparative analysis between the classical cloning method and the Golden Gate assembly technique,utilizing Escherichia coli as the model organism.Through polymerase chain reaction(PCR)amplification,restriction enzyme digestion,ligation,transformation,and Sanger sequencing,we assessed the operational efficiency and cloning fidelity of both strategies.Our results demonstrated that Golden Gate assembly,leveraging type IIS restriction enzymes and simultaneous ligation,significantly enhanced cloning efficiency and precision,particularly for seamless multi-fragment assembly.In contrast,the classical cloning approach maintained certain advantages in simplicity and robustness for specific experimental conditions.Challenges encountered during transformation and sequencing highlighted the critical impact of technical accuracy on experimental outcomes.This study underscores the importance of selecting appropriate cloning methodologies tailored to experimental objectives and laboratory capabilities,providing a foundation for optimized molecular cloning workflows in future synthetic biology and biotechnology applications.展开更多
BACKGROUND:Neuroendocrine dysfunction after traumatic brain injury(TBI)has received increased attention due to its impact on the recovery of neural function.The purpose of this study is to investigate the incidence an...BACKGROUND:Neuroendocrine dysfunction after traumatic brain injury(TBI)has received increased attention due to its impact on the recovery of neural function.The purpose of this study is to investigate the incidence and risk factors of adrenocortical insuffi ciency(AI)after TBI to reveal independent predictors and build a prediction model of AI after TBI.METHODS:Enrolled patients were grouped into the AI and non-AI groups.Fourteen preset impact factors were recorded.Patients were regrouped according to each impact factor as a categorical variable.Univariate and multiple logistic regression analyses were performed to screen the related independent risk factors of AI after TBI and develop the predictive model.RESULTS:A total of 108 patients were recruited,of whom 34(31.5%)patients had AI.Nine factors(age,Glasgow Coma Scale[GCS]score on admission,mean arterial pressure[MAP],urinary volume,serum sodium level,cerebral hernia,frontal lobe contusion,diff use axonal injury[DAI],and skull base fracture)were probably related to AI after TBI.Three factors(urinary volume[X4],serum sodium level[X5],and DAI[X8])were independent variables,based on which a prediction model was developed(logit P=-3.552+2.583X4+2.235X5+2.269X8).CONCLUSIONS:The incidence of AI after TBI is high.Factors such as age,GCS score,MAP,urinary volume,serum sodium level,cerebral hernia,frontal lobe contusion,DAI,and skull base fracture are probably related to AI after TBI.Urinary volume,serum sodium level,and DAI are the independent predictors of AI after TBI.展开更多
BACKGROUND: The present study aimed to determine the short-term and long-term outcomes of critically ill patients with acute respiratory insuffi ciency who had received sedation or no sedation.METHODS: The data of 91 ...BACKGROUND: The present study aimed to determine the short-term and long-term outcomes of critically ill patients with acute respiratory insuffi ciency who had received sedation or no sedation.METHODS: The data of 91 patients who had received mechanical ventilation in the first 24 hours between November 2008 and October 2009 were retrospectively analyzed. These patients were divided into two groups: a sedation group(n=28) and a non-sedation group(n=63). The patients were also grouped in two groups: deep sedation group and daily interruption and /or light sedation group.RESULTS: Overall, the 91 patients who had received ventilation ≥48 hours were analyzed. Multivariate analysis demonstrated two independent risk factors for in-hospital death: sequential organ failure assessment score(P=0.019, RR 1.355, 95%CI 1.051–1.747, B=0.304, SE=0.130, Wald=50483) and sedation(P=0.041, RR 5.015, 95%CI 1.072–23.459, B=1.612, SE=0.787, Wald=4.195). Compared with the patients who had received no sedation, those who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and hospital, and an increased in-hospital mortality rate. The Kaplan-Meier method showed that patients who had received sedation had a lower 60-month survival rate than those who had received no sedation(76.7% vs. 88.9%, Log-rank test=3.630, P=0.057). Compared with the patients who had received deep sedation, those who had received daily interruption or light sedation showed a decreased in-hospital mortality rate(57.1% vs. 9.5%, P=0.008). The 60-month survival of the patients who had received deep sedation was signifi cantly lower than that of those who had daily interruption or light sedation(38.1% vs. 90.5%, Log-rank test=6.783, P=0.009).CONCLUSIONS: Sedation was associated with in-hospital death. The patients who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and in hospital, and an increased in-hospital mortality rate compared with the patients who did not receive sedation. Compared with daily interruption or light sedation, deep sedation increased the in-hospital mortality and decreased the 60-month survival for patients who had received sedation.展开更多
This study seeks to evaluate the comparative productivity of 32 listed tourism companies which are the main suppliers of China tourism, using the popular methodology known as the data envelopment analysis(DEA). This s...This study seeks to evaluate the comparative productivity of 32 listed tourism companies which are the main suppliers of China tourism, using the popular methodology known as the data envelopment analysis(DEA). This study analyzes the productivity of listed tourism companies from business and region aspects based on the calculation of Malmquist index. The results show that(1) the overall productivity is non-effi cient(0.954);(2) the productivity of accommodation and catering is biggest, which shows the tourism develops quickly with supports from technology;(3) the productivity in western China is highest, where the economy and tourism attraction are better than other regions; and(4) the effi ciency differences among the listed tourism companies are not signifi cant, and they attribute to the scale effi-ciency, that is the input of the fi nance, resource, talents and policy.展开更多
Prediction of the nutrient deficiency range and control of it through application of an appropriate amount of fertiliser at all growth stages is critical to achieving a qualitative and quantitative yield.Distributing f...Prediction of the nutrient deficiency range and control of it through application of an appropriate amount of fertiliser at all growth stages is critical to achieving a qualitative and quantitative yield.Distributing fertiliser in optimum amounts will protect the environment’s condition and human health risks.Early identification also prevents the disease’s occurrence in groundnut crops.A convo-lutional neural network is a computer vision algorithm that can be replaced in the place of human experts and laboratory methods to predict groundnut crop nitro-gen nutrient deficiency through image features.Since chlorophyll and nitrogen are proportionate to one another,the Smart Nutrient Deficiency Prediction System(SNDP)is proposed to detect and categorise the chlorophyll concentration range via which nitrogen concentration can be known.The model’sfirst part is to per-form preprocessing using Groundnut Leaf Image Preprocessing(GLIP).Then,in the second part,feature extraction using a convolution process with Non-negative ReLU(CNNR)is done,and then,in the third part,the extracted features areflat-tened and given to the dense layer(DL)layer.Next,the Maximum Margin clas-sifier(MMC)is deployed and takes the input from DL for the classification process tofind CCR.The dataset used in this work has no visible symptoms of a deficiency with three categories:low level(LL),beginning stage of low level(BSLL),and appropriate level(AL).This model could help to predict nitrogen deficiency before perceivable symptoms.The performance of the implemented model is analysed and compared with ImageNet pre-trained models.The result shows that the CNNR-MMC model obtained the highest training and validation accuracy of 99%and 95%,respectively,compared to existing pre-trained models.展开更多
文摘End-stage liver disease(ESLD) is a leading cause of morbidity and mortality amongst human immunodeficiency virus(HIV)-positive individuals. Chronic hepatitis B and hepatitis C virus(HCV) infection,drug-induced hepatotoxicity related to combined antiretro-viral therapy,alcohol related liver disease and non-alcohol related fatty liver disease appear to be the leading causes. It is therefore,anticipated that more HIV-positive patients with ESLD will present as potential transplant candidates. HIV infection is no longer a contraindication to liver transplantation. Key transplantation outcomes such as rejection and infection rates as well as medium term graft and patient survival match those seen in the non-HIV infected patients in the absence of co-existing HCV infection. HIV disease does not seem to be negatively impacted by transplantation. However,HIV-HCV coinfection transplant outcomes remain suboptimal due to recurrence. In this article,we review the key challenges faced by this patient cohort in the pre- and posttransplant period.
文摘In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.
基金supported by grants from the National Natural Science Foundation of China(82241052)Natural Science Foundation of Xizang Autonomous Region(XZZR202402133[W])Peking University People’s Hospital Scientifi c Research Development Funds(RDJP2023-29).
文摘BACKGROUND:The nonspecifi c clinical presentation of adrenal insuffi ciency(AI)frequently leads to misdiagnosis,often as psychiatric or gastrointestinal disorders.AI is classifi ed anatomically as primary AI(PAI),secondary AI(SAI),or tertiary AI(TAI).Without timely recognition,progression to adrenal crisis(AC)can result in life-threatening outcomes.This study aimed to systematically analyze the clinical features,etiologies,and outcomes of AI in Lhasa’s emergency population to improve diagnostic accuracy and optimize clinical management.METHODS:A retrospective analysis of emergency department admissions from January 2020 to August 2024 at People’s Hospital of Xizang Autonomous Region was conducted.AI diagnoses were identifi ed via International Classifi cation of Diseases,Tenth Revision,Clinical Modifi cation(ICD-10-CM)codes from electronic health records(EHR).Patients were grouped into incipient AC(IAC)or AC cohorts based on hemodynamic status.Demographic profi les,etiologies,clinical presentations,and laboratory results were analyzed.RESULTS:Forty-three AI patients were identifi ed.The population-standardized admission rate for AI increased from 9 to 16 per million person-years,with PAI cases doubling during this period.Adrenal tuberculosis(58.1%)and adrenal hematoma(18.6%)were the leading etiologies.Compared to the IAC group,the AC group demonstrated lower systolic blood pressure(SBP)(P=0.001)and diastolic blood pressure(DBP)(P<0.001);higher neutrophil count(P=0.048),eosinophil count(P=0.044),CRP(P=0.004),blood urea nitrogen(BUN)(P=0.007);lower sodium(P<0.001)and glucose levels(P=0.001).The hospital stay was longer in the AC group(20 d vs.14 d;P<0.001).CONCLUSION:AI incidence is rising in high-altitude regions,with adrenal tuberculosis remaining the most common cause.AC is associated with increased inflammatory responses,hemodynamic instability,and metabolic disturbances.Targeted interventions are required to improve outcomes.
文摘Molecular cloning remains a cornerstone technique in genetic engineering and synthetic biology.In this study,we conducted a systematic comparative analysis between the classical cloning method and the Golden Gate assembly technique,utilizing Escherichia coli as the model organism.Through polymerase chain reaction(PCR)amplification,restriction enzyme digestion,ligation,transformation,and Sanger sequencing,we assessed the operational efficiency and cloning fidelity of both strategies.Our results demonstrated that Golden Gate assembly,leveraging type IIS restriction enzymes and simultaneous ligation,significantly enhanced cloning efficiency and precision,particularly for seamless multi-fragment assembly.In contrast,the classical cloning approach maintained certain advantages in simplicity and robustness for specific experimental conditions.Challenges encountered during transformation and sequencing highlighted the critical impact of technical accuracy on experimental outcomes.This study underscores the importance of selecting appropriate cloning methodologies tailored to experimental objectives and laboratory capabilities,providing a foundation for optimized molecular cloning workflows in future synthetic biology and biotechnology applications.
基金a grant from the National Clinical Specialty Construction Project of China(2013-544).
文摘BACKGROUND:Neuroendocrine dysfunction after traumatic brain injury(TBI)has received increased attention due to its impact on the recovery of neural function.The purpose of this study is to investigate the incidence and risk factors of adrenocortical insuffi ciency(AI)after TBI to reveal independent predictors and build a prediction model of AI after TBI.METHODS:Enrolled patients were grouped into the AI and non-AI groups.Fourteen preset impact factors were recorded.Patients were regrouped according to each impact factor as a categorical variable.Univariate and multiple logistic regression analyses were performed to screen the related independent risk factors of AI after TBI and develop the predictive model.RESULTS:A total of 108 patients were recruited,of whom 34(31.5%)patients had AI.Nine factors(age,Glasgow Coma Scale[GCS]score on admission,mean arterial pressure[MAP],urinary volume,serum sodium level,cerebral hernia,frontal lobe contusion,diff use axonal injury[DAI],and skull base fracture)were probably related to AI after TBI.Three factors(urinary volume[X4],serum sodium level[X5],and DAI[X8])were independent variables,based on which a prediction model was developed(logit P=-3.552+2.583X4+2.235X5+2.269X8).CONCLUSIONS:The incidence of AI after TBI is high.Factors such as age,GCS score,MAP,urinary volume,serum sodium level,cerebral hernia,frontal lobe contusion,DAI,and skull base fracture are probably related to AI after TBI.Urinary volume,serum sodium level,and DAI are the independent predictors of AI after TBI.
文摘BACKGROUND: The present study aimed to determine the short-term and long-term outcomes of critically ill patients with acute respiratory insuffi ciency who had received sedation or no sedation.METHODS: The data of 91 patients who had received mechanical ventilation in the first 24 hours between November 2008 and October 2009 were retrospectively analyzed. These patients were divided into two groups: a sedation group(n=28) and a non-sedation group(n=63). The patients were also grouped in two groups: deep sedation group and daily interruption and /or light sedation group.RESULTS: Overall, the 91 patients who had received ventilation ≥48 hours were analyzed. Multivariate analysis demonstrated two independent risk factors for in-hospital death: sequential organ failure assessment score(P=0.019, RR 1.355, 95%CI 1.051–1.747, B=0.304, SE=0.130, Wald=50483) and sedation(P=0.041, RR 5.015, 95%CI 1.072–23.459, B=1.612, SE=0.787, Wald=4.195). Compared with the patients who had received no sedation, those who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and hospital, and an increased in-hospital mortality rate. The Kaplan-Meier method showed that patients who had received sedation had a lower 60-month survival rate than those who had received no sedation(76.7% vs. 88.9%, Log-rank test=3.630, P=0.057). Compared with the patients who had received deep sedation, those who had received daily interruption or light sedation showed a decreased in-hospital mortality rate(57.1% vs. 9.5%, P=0.008). The 60-month survival of the patients who had received deep sedation was signifi cantly lower than that of those who had daily interruption or light sedation(38.1% vs. 90.5%, Log-rank test=6.783, P=0.009).CONCLUSIONS: Sedation was associated with in-hospital death. The patients who had received sedation had a longer duration of ventilation, a longer stay in intensive care unit and in hospital, and an increased in-hospital mortality rate compared with the patients who did not receive sedation. Compared with daily interruption or light sedation, deep sedation increased the in-hospital mortality and decreased the 60-month survival for patients who had received sedation.
基金supported by the project of Shaanxi Normal University(Grant No.999521)Xianyang Normal University(Grant Nos.11XSYK316,201002001)
文摘This study seeks to evaluate the comparative productivity of 32 listed tourism companies which are the main suppliers of China tourism, using the popular methodology known as the data envelopment analysis(DEA). This study analyzes the productivity of listed tourism companies from business and region aspects based on the calculation of Malmquist index. The results show that(1) the overall productivity is non-effi cient(0.954);(2) the productivity of accommodation and catering is biggest, which shows the tourism develops quickly with supports from technology;(3) the productivity in western China is highest, where the economy and tourism attraction are better than other regions; and(4) the effi ciency differences among the listed tourism companies are not signifi cant, and they attribute to the scale effi-ciency, that is the input of the fi nance, resource, talents and policy.
文摘Prediction of the nutrient deficiency range and control of it through application of an appropriate amount of fertiliser at all growth stages is critical to achieving a qualitative and quantitative yield.Distributing fertiliser in optimum amounts will protect the environment’s condition and human health risks.Early identification also prevents the disease’s occurrence in groundnut crops.A convo-lutional neural network is a computer vision algorithm that can be replaced in the place of human experts and laboratory methods to predict groundnut crop nitro-gen nutrient deficiency through image features.Since chlorophyll and nitrogen are proportionate to one another,the Smart Nutrient Deficiency Prediction System(SNDP)is proposed to detect and categorise the chlorophyll concentration range via which nitrogen concentration can be known.The model’sfirst part is to per-form preprocessing using Groundnut Leaf Image Preprocessing(GLIP).Then,in the second part,feature extraction using a convolution process with Non-negative ReLU(CNNR)is done,and then,in the third part,the extracted features areflat-tened and given to the dense layer(DL)layer.Next,the Maximum Margin clas-sifier(MMC)is deployed and takes the input from DL for the classification process tofind CCR.The dataset used in this work has no visible symptoms of a deficiency with three categories:low level(LL),beginning stage of low level(BSLL),and appropriate level(AL).This model could help to predict nitrogen deficiency before perceivable symptoms.The performance of the implemented model is analysed and compared with ImageNet pre-trained models.The result shows that the CNNR-MMC model obtained the highest training and validation accuracy of 99%and 95%,respectively,compared to existing pre-trained models.
