The safety of the initial support during the construction of inclined shafts in tunnels traversing through high-hydraulic-pressure surrounding rocks is paramount.This study examines a high-hydraulic-pressure inclined ...The safety of the initial support during the construction of inclined shafts in tunnels traversing through high-hydraulic-pressure surrounding rocks is paramount.This study examines a high-hydraulic-pressure inclined shaft of a tunnel in Western Sichuan Province to analyze the damage characteristics of the initial support and propose a radial drainage and decompression treatment method.Field monitoring was conducted to assess the load and deformation of the initial support structure,and on-site investigations identified the distribution of cracked areas.In addition,numerical simulations were performed to evaluate the force and deformation characteristics of the initial support structure,which were then compared with field observations for validation.The variations in the lateral pressure coefficient and water pressure were evaluated.The results revealed that damage was primarily concentrated in the shoulder,spring line,and knee areas,with the bending moment at the knee increasing by up to 66.9%.The application of the radial drainage and decompression treatment method effectively reduced water pressure loads on the initial support.Post-treatment analysis indicated significant reductions in axial force and bending moment,enhancing structural stability.These findings provide valuable insights for improving the safety and durability of initial support systems in inclined shafts of high-hydraulicpressure railroad tunnels.展开更多
We report a case of a 12-year-old female with closed and open comedo without inflammatory lesions at the first visit. She had been treated with topical adapalene once daily, and closed and open comedo subsided without...We report a case of a 12-year-old female with closed and open comedo without inflammatory lesions at the first visit. She had been treated with topical adapalene once daily, and closed and open comedo subsided without inflammatory lesions one month after the treatment without any side effects induced by adapalen. The recurrence of comedo had not been observed afterwards. In the Japanese Dermatological Association (JDA) guidelines for the treatment of acne vulgaris, comedonal phase has not been stated. Then we propose the tentative new terminology of a comedonal phase and emphasize its importance in the early initial treatment for comedo to prevent the development of the acute inflammatory phase such as red papules and pustules and formation of acne scars.展开更多
Abstract Objectives The authors sought to describe the association between post-procedural bleeding and long-term recurrent bleeding, major adverse cardiac events （MACE）, and mortality among older patients undergoin...Abstract Objectives The authors sought to describe the association between post-procedural bleeding and long-term recurrent bleeding, major adverse cardiac events （MACE）, and mortality among older patients undergoing per-cutaneous coronary intervention （PCI）.展开更多
AIM： To evaluate the outcome predictors of percutaneous ablation therapy in patients with unresectable hepatocellular carcinoma （HCC）, especially to identify whether the initial treatment response contributes to th...AIM： To evaluate the outcome predictors of percutaneous ablation therapy in patients with unresectable hepatocellular carcinoma （HCC）, especially to identify whether the initial treatment response contributes to the survival of the patients. METHODS： The study cohort included 153 patients with single （102） and two or three （51） HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection. RESULTS： The Kaplan-Meier estimates of overall 3- and S-year survival rates were 75% and 59%, respectively. The log-rank test revealed statistically significant differences in the overall survivals according to ChildPugh class （P = 0.0275）, tumor size （P = 0.0130）, serum albumin level （P = 0.0060）, serum protein induced by vitamin K absence or antagonist Ⅱ level （P = 0.0486）, and initial treatment response （P = 0.0130）. The independent predictors of survival were serum albumin level （dsk ratio, 3.216; 950 CI, 1.407-7.353; P = 0.0056） and initial treatment response （risk ratio, 2.474; 95% CI, 1.076-5.692; P = 0.0330） based on the Cox proportional hazards regression models. The patients had a serum albumin level 3.5 g/dL and the 3- and 5-year survival rates of 86% and 82%. CONCLUSION： In HCC patients treated with percutaneous ablation therapy, serum albumin level and initial treatment response are the independent outcome predictors.展开更多
OBJECTIVE: To observe the effect of acupuncture and moxibustion on insomnia and explore its mechanism. METHODS: One hundred and twenty patients were randomly divided into an experiment group and a control group. Sixty...OBJECTIVE: To observe the effect of acupuncture and moxibustion on insomnia and explore its mechanism. METHODS: One hundred and twenty patients were randomly divided into an experiment group and a control group. Sixty patients in the experiment group were treated once a day with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) and with moxibustion at Baihui (GV 20) and Sishencong (EX-HN 1). Sixty patients in the control group were acupunctured once a day at Shenmen (HT 7), Neiguan (PC 6), and Sanyinjiao (SP 6).The Pittsburgh Sleep Quality Index (PSQI) was used to compare sleep improvement between the two groups. RESULTS: The total effective rate was 87.7% in the experiment group and 76.3% in the control group. The PSQI scores and the total score were lower after treatment than before treatment in bothgroups. However, the reduction in the experiment group was greater than that in the control group in sleeping quality, time to fall asleep, sleeping disorder, and daytime function (P<0.05). CONCLUSION: Acupuncture and moxibustion at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) significantly improved insomnia symptoms in the experiment group compared with the control group.展开更多
Objective:To examine referral pattern,the timing of diagnostic/staging processes,and treatment initiation for new head and neck cancer patients in a community setting.Methods:Patients with a newly diagnosed previously...Objective:To examine referral pattern,the timing of diagnostic/staging processes,and treatment initiation for new head and neck cancer patients in a community setting.Methods:Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020.Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation.Results:One hundred and five patients were included in the study.The primary referral sources were external general otolaryngology(56.3%).Oral surgery and dermatology obtained tissue biopsy approximately 80%of the time before referral.The average time from the ordering of initial staging positron emission tomography/computed tomography to finalized results was 14 days(range:10-25 days).Patients referred from dermatology and oral surgery were more likely to require single modality care,namely definitive surgical management.Time to treatment initiation average was 37 days(range:29-41 days).Patients with longer treatment times noted significantly higher times to both radiation and medical oncology consults(48.42 vs.18.13 days;P<0.001).Conclusions:No notable differences in treatment initiation times were identified based on referral source or extent of workup performed before head/neck surgery consult.It appears the largest opportunities for improvement in terms of reducing overall treatment length exist in the optimization of radiation initiation time.展开更多
Cord blood(CB)plays an important role as a medical resource containing hematopoietic stem cells(HSCs)and mature immune cells.Cord blood transplantation(CBT)for hematopoietic disorders offers several advantages,includi...Cord blood(CB)plays an important role as a medical resource containing hematopoietic stem cells(HSCs)and mature immune cells.Cord blood transplantation(CBT)for hematopoietic disorders offers several advantages,including the ability to initiate treatment early,lower rates of severe chronic graft-versus-host disease even in human leukocyte antigen(HLA)-mismatched recipients,resulting in better post-transplant quality of life,and stronger anti-tumor immune responses compared to other transplantation methods,thereby reducing the risk of post-transplant relapse. In addition,techniques such as the introduction of chimeric antigen receptor genes have been used to enable immune cells in CB,such as T cells and natural killer(NK)cells,to be used as sources for cell therapies.展开更多
Chimeric antigen receptor(CAR)-T cell therapy has revolutionized the treatment landscape for relapsed and refractory haematological malignancies[1].Despite its remarkable clinical success,the ex vivo manufacturing of ...Chimeric antigen receptor(CAR)-T cell therapy has revolutionized the treatment landscape for relapsed and refractory haematological malignancies[1].Despite its remarkable clinical success,the ex vivo manufacturing of autologous CAR-T cells remains costly,time-consuming,and logistically burdensome.To address these limitations,in vivo engineering of CAR-T cells—whereby functional CAR-T cells are generated directly within the patient's body—has emerged as a promising and potentially transformative alternative.Unlike conventional CAR-T approaches that rely on complex ex vivo manipulation of autologous or allogeneic T cells,in vivo strategies offer the potential to streamline manufacturing,lower production costs,and enable more rapid treatment initiation[2].展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.42277165,41920104007)the Hubei Natural Science Foundation(Grant No.2023AFD217).
文摘The safety of the initial support during the construction of inclined shafts in tunnels traversing through high-hydraulic-pressure surrounding rocks is paramount.This study examines a high-hydraulic-pressure inclined shaft of a tunnel in Western Sichuan Province to analyze the damage characteristics of the initial support and propose a radial drainage and decompression treatment method.Field monitoring was conducted to assess the load and deformation of the initial support structure,and on-site investigations identified the distribution of cracked areas.In addition,numerical simulations were performed to evaluate the force and deformation characteristics of the initial support structure,which were then compared with field observations for validation.The variations in the lateral pressure coefficient and water pressure were evaluated.The results revealed that damage was primarily concentrated in the shoulder,spring line,and knee areas,with the bending moment at the knee increasing by up to 66.9%.The application of the radial drainage and decompression treatment method effectively reduced water pressure loads on the initial support.Post-treatment analysis indicated significant reductions in axial force and bending moment,enhancing structural stability.These findings provide valuable insights for improving the safety and durability of initial support systems in inclined shafts of high-hydraulicpressure railroad tunnels.
文摘We report a case of a 12-year-old female with closed and open comedo without inflammatory lesions at the first visit. She had been treated with topical adapalene once daily, and closed and open comedo subsided without inflammatory lesions one month after the treatment without any side effects induced by adapalen. The recurrence of comedo had not been observed afterwards. In the Japanese Dermatological Association (JDA) guidelines for the treatment of acne vulgaris, comedonal phase has not been stated. Then we propose the tentative new terminology of a comedonal phase and emphasize its importance in the early initial treatment for comedo to prevent the development of the acute inflammatory phase such as red papules and pustules and formation of acne scars.
文摘Abstract Objectives The authors sought to describe the association between post-procedural bleeding and long-term recurrent bleeding, major adverse cardiac events （MACE）, and mortality among older patients undergoing per-cutaneous coronary intervention （PCI）.
文摘AIM： To evaluate the outcome predictors of percutaneous ablation therapy in patients with unresectable hepatocellular carcinoma （HCC）, especially to identify whether the initial treatment response contributes to the survival of the patients. METHODS： The study cohort included 153 patients with single （102） and two or three （51） HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection. RESULTS： The Kaplan-Meier estimates of overall 3- and S-year survival rates were 75% and 59%, respectively. The log-rank test revealed statistically significant differences in the overall survivals according to ChildPugh class （P = 0.0275）, tumor size （P = 0.0130）, serum albumin level （P = 0.0060）, serum protein induced by vitamin K absence or antagonist Ⅱ level （P = 0.0486）, and initial treatment response （P = 0.0130）. The independent predictors of survival were serum albumin level （dsk ratio, 3.216; 950 CI, 1.407-7.353; P = 0.0056） and initial treatment response （risk ratio, 2.474; 95% CI, 1.076-5.692; P = 0.0330） based on the Cox proportional hazards regression models. The patients had a serum albumin level 3.5 g/dL and the 3- and 5-year survival rates of 86% and 82%. CONCLUSION： In HCC patients treated with percutaneous ablation therapy, serum albumin level and initial treatment response are the independent outcome predictors.
基金Supported by Chinese National Natural Science Foundation 81173335, Research into Effect of Acupuncture on Expression of Protein Difference in Brain Tissue of Rat Model with Insomnia
文摘OBJECTIVE: To observe the effect of acupuncture and moxibustion on insomnia and explore its mechanism. METHODS: One hundred and twenty patients were randomly divided into an experiment group and a control group. Sixty patients in the experiment group were treated once a day with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) and with moxibustion at Baihui (GV 20) and Sishencong (EX-HN 1). Sixty patients in the control group were acupunctured once a day at Shenmen (HT 7), Neiguan (PC 6), and Sanyinjiao (SP 6).The Pittsburgh Sleep Quality Index (PSQI) was used to compare sleep improvement between the two groups. RESULTS: The total effective rate was 87.7% in the experiment group and 76.3% in the control group. The PSQI scores and the total score were lower after treatment than before treatment in bothgroups. However, the reduction in the experiment group was greater than that in the control group in sleeping quality, time to fall asleep, sleeping disorder, and daytime function (P<0.05). CONCLUSION: Acupuncture and moxibustion at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) significantly improved insomnia symptoms in the experiment group compared with the control group.
文摘Objective:To examine referral pattern,the timing of diagnostic/staging processes,and treatment initiation for new head and neck cancer patients in a community setting.Methods:Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020.Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation.Results:One hundred and five patients were included in the study.The primary referral sources were external general otolaryngology(56.3%).Oral surgery and dermatology obtained tissue biopsy approximately 80%of the time before referral.The average time from the ordering of initial staging positron emission tomography/computed tomography to finalized results was 14 days(range:10-25 days).Patients referred from dermatology and oral surgery were more likely to require single modality care,namely definitive surgical management.Time to treatment initiation average was 37 days(range:29-41 days).Patients with longer treatment times noted significantly higher times to both radiation and medical oncology consults(48.42 vs.18.13 days;P<0.001).Conclusions:No notable differences in treatment initiation times were identified based on referral source or extent of workup performed before head/neck surgery consult.It appears the largest opportunities for improvement in terms of reducing overall treatment length exist in the optimization of radiation initiation time.
文摘Cord blood(CB)plays an important role as a medical resource containing hematopoietic stem cells(HSCs)and mature immune cells.Cord blood transplantation(CBT)for hematopoietic disorders offers several advantages,including the ability to initiate treatment early,lower rates of severe chronic graft-versus-host disease even in human leukocyte antigen(HLA)-mismatched recipients,resulting in better post-transplant quality of life,and stronger anti-tumor immune responses compared to other transplantation methods,thereby reducing the risk of post-transplant relapse. In addition,techniques such as the introduction of chimeric antigen receptor genes have been used to enable immune cells in CB,such as T cells and natural killer(NK)cells,to be used as sources for cell therapies.
基金supported by the National Natural Science Foundation of China(Grant Nos.32430059,52422305,32471434,and 32271442)Guangdong Basic and Applied Basic Research Foundation(Grant No.2022B1515020025)the TCL Young Scholar(2024–2027)。
文摘Chimeric antigen receptor(CAR)-T cell therapy has revolutionized the treatment landscape for relapsed and refractory haematological malignancies[1].Despite its remarkable clinical success,the ex vivo manufacturing of autologous CAR-T cells remains costly,time-consuming,and logistically burdensome.To address these limitations,in vivo engineering of CAR-T cells—whereby functional CAR-T cells are generated directly within the patient's body—has emerged as a promising and potentially transformative alternative.Unlike conventional CAR-T approaches that rely on complex ex vivo manipulation of autologous or allogeneic T cells,in vivo strategies offer the potential to streamline manufacturing,lower production costs,and enable more rapid treatment initiation[2].
